What is teen substance use?

Sometimes it's hard to tell if a teen is using alcohol or drugs. Parents may worry that their teens are involved with drugs or alcohol if they become withdrawn or negative. But these behaviors are common for teens going through challenging times. These behaviors may also be signs of a mental health condition, such as depression.

It's important not to accuse your teen unfairly. Try to find out why their behavior has changed. Tell your teen that you're concerned.

Signs of teen substance use

Experts recommend that parents look for a pattern or a number of changes in appearance, behavior, and attitude, and not just one or two of the changes listed here.

Signs that a teen may be using substances include a:

• Change in appearance. Examples include:
  • Red and glassy eyes, and frequent use of eyedrops and breath mints.
  • "Track marks" where drugs have been injected into veins.
  • Less attention paid to dressing and grooming.
  • Loss of appetite or unexplained weight loss.
• Change in behavior. Examples include:
  • Decreased attendance and performance at school.
  • Loss of interest in school, sports, or other activities.
  • Repeated health complaints, such as being overly tired.
  • Newly developed secrecy, or deceptive or sneaky behavior.
  • Withdrawing from family and friends.
  • Having new friends and being reluctant to introduce them.
  • Lying or stealing.
• Change in attitude. Examples include:
  • Disrespectful behavior.
  • A mood or attitude that is getting worse.
  • Lack of concern about the future.

Teens may try a number of substances, including alcohol, drugs, and tobacco. Teens use alcohol more than any other substance. Marijuana is also commonly used.

Other substances teens use include:

• Inhalants (household products such as glues, aerosol sprays, gasoline, paints, and paint thinners). These are often misused by teens because they don't cost much and are easy to get.
• Drugs like ecstasy (MDMA), Rohypnol, and meth (also called crank or speed).
• Hallucinogens, including ketamine, LSD, and PCP.
• Opioids. These include:
  • Prescription medicines such as codeine, hydrocodone (Norco), and oxycodone (OxyContin).
  • Illegal drugs such as heroin.
• Prescription medicines such as diazepam (for example, Valium) and methylphenidate (Ritalin).
• Over-the-counter medicines such as cough syrups and cold pills.
• Anabolic steroids. Teens may use them to build muscle tissue and decrease body fat.

Your teen will need a complete evaluation to determine the level of substance use and the presence of other mental health or medical conditions.

If you need to place your teen in a treatment program, look for one that uses evidence-based practices to treat substance use. Cost may also be an important factor to consider. Be sure to ask how long treatment may last and how much it will cost. High price is not always a sign of the best care. Also find out what insurance plans are accepted, what they cover, and what kinds of payment plans the program offers.

A good program should include:

• Counseling and support.

  The program should include group and individual counseling along with support and self-help groups. These groups need to be separate from adult groups. Counseling may include cognitive behavioral therapy (CBT). It can help your teen learn coping skills to prevent future substance use.

• Education.

  Treatment needs to include a way for your teen to continue their education. Doing even a small amount of schoolwork during treatment may help boost your teen's self-confidence.

• Parental involvement.

  Most likely, family therapy will be part of the treatment. You need to provide support and encouragement for your teen both during and after the program.

• Support for their interests.

  Treatment programs should provide time for your teen to pursue a hobby or interest. Having interests they can continue after treatment will help your teen have something healthy to do rather than use substances.

• Special services.

  Special services such as mental health services, vocational (job) training, and counseling are important parts of treatment that need to be part of the program. If your teen has other conditions, such as depression, attention deficit hyperactivity disorder (ADHD), or anxiety disorder, these conditions should be treated during substance use treatment.

• Urine drug screens.

  A treatment program should require that your teen not use substances during treatment. Random urine drug screens can be used to monitor teens during treatment and even in an aftercare program.

• Relapse prevention.

  Relapse (returning to substance use) is common after treatment for substance use. The program should help your teen make a plan to deal with cravings, high-risk situations, and relapse.

• Aftercare.

  An aftercare program should keep your teen involved and around people who are staying sober while in recovery. This helps lower the chance that your teen will relapse.

• Be a role model. Your attitude toward alcohol is one of the greatest influences on whether your teen will drink. If you drink alcohol, do it in moderation.
• Learn about alcohol. Find out what the signs of drinking are. Learn how alcohol can harm your teen's growth and development.
• Share your beliefs. Teens need to know what you think about important issues, including alcohol use. Talk with your teen about what drinking can do physically and emotionally. If you have a family history of alcohol use disorder, talk with your teen about their increased risk.
• Stay connected. Set times when the family is expected to be together, such as at mealtimes. Plan family outings or other family-fun activities. Let your teen know that you value them and that they contribute to the family. Get to know your teen's friends, and know where your teen is at all times. Be awake and talk to your teen when your teen comes home at night.
• Be fair and consistent. Find a mix between supervising your teen and giving them privacy and independence. Set rules, and let your teen know what will happen if the rules are broken. Always follow through and discipline your teen if your teen breaks the rules. But don't make the consequence too severe for the rule.
• Encourage activities. Find things your teen likes to do, and keep your teen busy with those things. Sports and playing in the school band are two examples.

Many teens try substances like alcohol or drugs. Some try them only a few times and stop. Teens who keep using substances may form a strong need for them. This can lead to substance use disorder. Substances teens may try include tobacco, alcohol, marijuana or other drugs, household products (inhalants), and prescription or over-the-counter medicines.

Teens may use alcohol or other substances for many reasons. For example, they may do it because they:

• Want to fit in with friends or certain groups.
• Like the way it makes them feel.
• Believe it makes them more grown up.
• Want to escape problems.

Teens tend to try new things and take risks, so they may take drugs or drink alcohol because it seems exciting.

Substance use can become a serious issue and lead to long-term problems, injury, and even death. For example:

• Alcohol and drug use is a leading cause of teen death or injury related to car crashes, suicides, violence, and drowning.
• Even occasional alcohol use by a teen increases the risk for future alcohol and drug use.
• Substance use can affect growth and development. Teens who use alcohol and drugs may have trouble finding their identity, building relationships, and preparing for their future.
• Substance use can affect memory and learning.
• Substance use can lead to unprotected sex. This increases the risk of unwanted pregnancy and sexually transmitted infections (STIs).
• Tobacco use can cause cancer and heart and lung problems.
• Even casual use of certain drugs can cause severe health problems, such as an overdose or brain damage. Many illegal drugs are made in home labs, so they may contain unsafe substances.

Substances can include more than illegal drugs like heroin or meth. You also can have problems with alcohol, marijuana, prescription medicines, or medicines you can buy without a prescription.

You may have substance use disorder and need help if you have any of these signs:

• You use larger amounts of a substance than you ever meant to. Or you've been using it for a longer time than you ever meant to.
• You can't cut down or control your use. Or you constantly wish you could cut down.
• You spend a lot of time getting or using the substance or recovering from the effects.
• You have strong cravings for the substance.
• You can no longer do your main jobs at school, at work, or at home.
• You keep using, even though your substance use hurts your relationships.
• You have stopped doing important activities because of your substance use.
• You use substances in situations where doing so is dangerous.
• You keep using the substance even though you know it's causing health problems.
• You need more and more of the substance to get the same effect, or you get less effect from the same amount over time. This is called tolerance.
• You have uncomfortable symptoms when you stop using the substance or use less. This is called withdrawal.

If you think you need help:

• Talk to your parents. That may sound odd, but they love you and were also teens once. They can help you.
• Talk to your family doctor, a school counselor, an adult relative, a faith leader, or a friend's parents.
• Contact the national Substance Abuse and Mental Health Services Administration (SAMHSA) help line at 1-800-662-HELP (4357) or online at www.samhsa.gov to learn about treatment programs in your area. Talking to someone about your feelings about substance use can help.

If your teen is using alcohol, tobacco, or other substances, take it seriously. One of the most important things you can do is to talk openly with your teen about the problem. Urge your teen to be open too.

Try not to use harsh, judging words. In most cases, an angry face-to-face meeting will push a teen away. Be as supportive as you can during this time.

If you don't know what to do or if you don't feel comfortable, ask for help. Talk to your teen's doctor, a pediatrician, a psychologist, or a psychiatrist.