Signs of Addiction in Teens

It is never easy to find out your teen is using drugs. Communication is a powerful tool for reducing and preventing teen drug abuse. Talking to your teens about drug use can help them make the decision not to use in the first place or to stop using if they already are. It is important that as a parent, you remain aware of the warning signs of drug use so you can give your children the help they need in a timely manner.

Substance use often begins in adolescence, and the scientific evidence is clear — addictive substances cannot be safely used by teenagers or young adults. Addiction in these years can have major impacts for two reasons:

  1. The areas of the brain that are needed for decision-making, judgment, impulse control, emotion and memory are not fully developed until the mid-twenties. This makes young people more likely to take risks compared to adults. Risk-taking can include experimenting with tobacco, alcohol and other drugs.
  2. When the brain is still developing, addictive substances physically alter its structure and function faster and more intensely than occurs in adults. These effects interfere with brain development, which can affect the user’s judgment and increase addiction’s risks.

If you have reason to suspect use, don’t be afraid to err on the side of caution. Prepare to take action and have a conversation during which you can ask direct questions like “Have you been drinking, vaping or using drugs?” No parent wants to hear “yes,” but being prepared for how you would respond can be the starting point for a more positive outcome.

Chances are your teen’s mood swings can be attributed to the racing and changing hormones that come with adolescence. In other words, teen mood swings are normal. You’ll want to pay attention, though, if your teenage son or daughter is experiencing mood swings along with changes in behavior or appearance, such as:

  • Losing interest in activities they once enjoyed
  • Dropping old friends for a new group
  • Acting despondent, aggressive or angry
  • Sleeping more than usual
  • Breaking rules
  • Exhibiting physical changes like sudden weight loss, frequent nosebleeds, bloody or watery eyes, or shakes and tremors

These are behavioral and physical signs that your child could be misusing medications or using drugs or drinking alcohol. Knowing the signs and symptoms of teen drug use can help you better understand if or when you should involve a professional. 

What are some early signs of teen drug abuse and addiction?

One of the most challenging aspects of addiction is that it is a progressive disease.  Early warning signs can be hard to spot, and unhealthy patterns can develop into a full-blown substance use disorder (often referred to as substance abuse) if not addressed.

When you know your teenage son or daughter’s passions, interests and habits, the early warning signs of trouble will be more apparent because you will sense when something seems off or amiss. Casual drug use can quickly spiral out of control if you ignore problems, rationalize underage drinking or smoking marijuana as “experimentation” or “just a phase,” or avoid having open and honest discussions with your child. It’s much easier to turn problematic behavior around when warning signs first surface, rather than when the situation escalates or an emergency occurs. Especially for kids who are at higher risk of alcohol or other drug addiction, paying attention to early signs of trouble can reduce the likelihood of a future problem. As a parent or concerned adult, you can never intervene too soon.

Friends in a teen’s social circle may be aware of drug use before adults are, either by directly observing the risky behavior or hearing stories from others in their friend group. Don’t expect adolescent friends to convince their peers to stop drinking or using drugs, though. Adolescents will typically avoid having such a potentially awkward conversation or otherwise intervening. Unfortunately, this has the effect of passively enabling the unhealthy behaviors. If your child is surrounded by friends who avoid saying anything negative about smoking marijuana,  drinking alcohol, using prescription drugs such as opioids, or other stimulants in a non-medical way, or doing cocaine or heroin, the unspoken message is that those dangerous behaviors are acceptable. At this age, a friend’s opinion has power, so it’s more important than ever to keep the lines of communication open with your son or daughter, rather than relying on their friends to intervene.

What kinds of behaviors or symptoms could indicate teen drug abuse or substance abuse?

Behavioral signs of drug use or substance abuse include:

  • Avoiding eye contact
  • Ignoring or breaking curfew
  • Acting irresponsibly
  • Frequently asking for money
  • Stealing
  • Locking bedroom doors
  • Making secretive calls
  • Isolating from others/damaging relationships with family or friends
  • Making excuses (or outright lying)
  • Withdrawing from classroom participation/slipping in grades
  • Resisting discipline or feedback
  • Missing school or work
  • Losing interest in hobbies or activities
  • Abandoning long-time friends

Physical and emotional indicators of possible substance use, or abuse include:

  • Poor hygiene/change in appearance
  • Paranoia, irritability, anxiety, fidgeting
  • Difficulty staying on task/staying focused
  • Small track marks on arms or legs (wears long sleeves even in warm weather)
  • Pupils larger or smaller than usual
  • Cold, sweaty palms or shaking hands
  • Sores on mouth
  • Headaches
  • Puffy, swollen face
  • Extremely tired or extremely hyperactive
  • Rapid weight gain or loss
  • Fatigue with a noticeable change in sleep patterns
  • Loss of appetite and/or periods of binge eating
  • Changes in dress or appearance
  • Threats or attempts to commit suicide
  • Changes in physical appearance – You’ve noticed a lack of hygiene or unusual changes in your teen’s style
  • Sudden shifts in relationships or social circles – Your teen changes friend groups and does not introduce new friends to the family. Relationships with family members and old friends have also changed.
  • Unexplainable mood swings and changes in behavior – Your teen is emotionally unstable and shifts from happy to hostile in minutes. He or she may be defensive, negative, paranoid, aggressive, or anxious.
  • Sensitive and defensive – Your teen overreacts to criticism or your attempts at a serious conversation. In return, he or she acts rebellious.
  • Distant and isolated – Your teen has stopped talking to you regularly about his or her personal life; he or she may no longer come to you for help with challenges at work or school
  • Depression – Your teen seems unhappy and unmotivated
  • Secretive or deceitful – You may feel your teen is hiding things from you by the way he or she is acting. Your child takes a long time to answer your questions, gives you indirect answers, makes endless excuses, locks his or her bedroom door, and avoids discussions when possible
  • Lethargic or overly tired – You’ve noticed your teen is unusually tired and has developed seemingly off sleeping habits (e.g. periods of sleeplessness followed by long hours of “catch-up” sleep)
  • Drastic weight loss or weight gain
  • Your teen disappears for long periods of time or stays over friends’ houses for nights on end

Social indicators

  • Changes in friends, including secret calls and visits
  • Avoiding contact with family members and others who express concern
  • Losing interest in hobbies and activities
  • Attempting to keep actions and activities secret
  • Defensiveness regarding actions and activities
  • Reluctance to introduce new friends to the family

Family and home issues

  • Refusing to respect curfews and other house rules
  • Withdrawal from family activities
  • Isolation from family members and increased absence from home
  • Collecting alcohol and drug paraphernalia
  • Lying or providing unrealistic explanations to parents
  • Using air fresheners or breath mints to cover scents
  • Running away from home
  • Loss of interest in family activities – Your child no longer wants to hang out at home, sit down for family dinners, or attend your annual family parties
  • Consistently borrows or asks for money – Your teen is always asking for money, but you don’t know where it’s all going. Or, you’ve noticed your teen carrying excessive amounts of cash around.
  • Disrespects the family rules – Your teen disobeys curfew, disregards punishments, and seems to live by his or her own rules
  • Lying or avoidance – Your teen does not tell you where he or she is going or lies about activities
  • Money or valuables are missing from your bags or home – You’ve noticed some cash is missing from your wallet, or from your secret cash stash in the house.
  • Prescription pills or bottles of alcohol have disappeared – You cannot find your old pain meds or that bottle of liquor you stashed away months back.
  • You’ve discovered unusual containers, wrappers, baggies, or seeds left on surfaces in your home
  • You’ve discovered pipes, medicine bottles, rolling papers, eye drops, lighters, roach clips, or makeshift smoking devices in your home

School problems

  • Missing excessive time from school
  • Failure to turn in assignments
  • Sleeping in class
  • Persistent behavioral problems
  • Poor grades
  • Increased tardiness
  • Reduced interest in extracurricular activities
  • Grades have declined – You notice your teen’s grades have suddenly slipped or dropped dramatically
  • Truancy – Your teen has missed classes, accrued random absences, or has been consistently late for school
  • Loss of interest in schoolwork – Your teen no longer completes homework or has a poor attitude towards afterschool activities (sports, clubs, etc.)
  • Defiance of authority – Your teen disregards teachers’ rules, consistently gets detentions, and you’ve heard complaints from teacher’s multiple times.
  • Sleeping in class
  • Reduced attention span or inability to focus
  • Your teen does not inform you of teacher meetings, conferences, or open houses at school

Financial concerns

  • Stealing money or objects from family and friends
  • Unexplained shortages of money
  • Lost or missing possessions
  • Alcohol that goes missing in the home
  • Lack of tangible evidence of how money is spent (such as clothes, music or other specific items)
  • Unexplained amounts or sources of money (possible indicator that teen is dealing drugs)


Legal problems

  • Increased involvement with police, such as having authorities appear at parties/social functions
  • Arrests for alcohol or other drug-related charges


What are the risk factors for teen drug abuse?

If you discover that your child has a drug or alcohol problem, it’s normal to wonder what you could have done differently, if you should have seen it coming and what signals you may have missed. In other words, how could you have prevented this problem? And, perhaps more urgently, when does drug use or abuse progress to addiction?

These are complicated questions with complicated answers. The good news is that science has defined tangible early warning signs and symptoms that, if recognized and addressed, can help adults steer kids away from risks that could make them more vulnerable to addiction.

There are five main factors that contribute to a heightened risk for addiction, spelling out the acronym FACTS.

Family history
Age of first use

  • Family
    When someone in a child’s biological family—parents, siblings, or extended family members—has a history of substance use (alcohol, tobacco/nicotine, marijuana, prescription drugs or other drugs), that child may have a predisposition to addiction and will be at a greater risk of developing the disorder than a young person without a family history. Research from the Yale University School of Medicine indicates that first-degree relatives (children, siblings and parents) of alcoholics have eight times the risk of developing alcoholism than individuals without a family link.
  • Age
    Age is another important risk factor for substance use disorder. The younger a person is when they start using alcohol or other drugs, the more likely they are to develop an addiction. Current research by the National Institute of Mental Health suggests that a person’s brain isn’t fully developed until they’re in their twenties—alcohol and drugs can damage the “wiring” in a teenager’s brain, leading to issues in the future.
  • Cravings and Tolerance
    Because younger brains are still developing, they are more sensitive to alcohol and other drugs than fully developed adult brains. As a result, when a teen uses alcohol or other drugs early on, they can develop physical cravings and tolerance to the substances being used—a progressive cycle that may very rapidly lead to active addiction.
  • Surroundings
    Surroundings may be the most noticeable warning sign of substance use. Exposure to the use of alcohol and other drugs, whether within a family or a peer group, “normalizes” use so that it’s perceived as what everyone is doing. In this regard, parents have a critical opportunity to act as positive role models. Such environment also increases access to substances, making a person more vulnerable to first-time use and opportunities to keep using.

There are many circles of influence in a teenager’s life. Beginning with families, teens gain an understanding of both healthy and unhealthy behaviors. When parents and other caregivers clearly discuss the risks of drug abuse with their children, the likelihood that they will misuse substances is reduced by 50 percent. Set a good example. The positive behavior that you and other family members model can have a dramatic impact on how your teenager perceives alcohol and other drugs.

A teen’s circle of friends can also shape their beliefs and behavior regarding substance use. Teens are constantly trying to figure out how they fit into their world. As they work to find their place, they can be strongly influenced by peer pressure. If young people spend time with other teens who are engaged in risky, unhealthy behaviors, they are more likely to engage in those behaviors themselves.

As a caring adult, be aware of any shifts in friendships, associations and activities. Ask simple questions of the teens in your life (e.g., “How’s so-and-so doing these days?”) as a way to uncover any red flags in peer relationships. If a teen is vague about who they hang out with—or how they’re spending their time away from home—take that opportunity to dig a little deeper. In these conversations, relate, don’t interrogate. Don’t lecture. Listen and show that you’re genuinely interested. Try to establish a strong bond of trust.

What’s portrayed in movies, on TV, online and in music can also help shape perceptions about alcohol and drug addiction. Whether it’s Ewan McGregor shooting heroin in Trainspotting, Tony Montana snorting cocaine in Scarface, or glamorizing underage drinking and smoking marijuana in Superbad, the media can portray drug use as cool, fun and entertaining—while neglecting to broadcast the negative consequences of addiction and drug abuse, serious health consequences, relationship troubles, financial issues, incarceration, overdose and even death. Incomplete media messages can lead to dangerous misperceptions. If your teenager likes a movie or a song referencing alcohol or other drug use, this might not be a warning sign in and of itself; however, these interests can lead to misperceptions about substance use. Perceptions shape behavior. 

Being aware of your teenager’s views regarding alcohol and other drug use can be a valuable tool in identifying risk and taking a preventative stance in their lives. Talking with your teenager about the realities of substance use can powerfully impact their perceptions; don’t be afraid to finish a conversation that society has started.

How & where to look for signs of drug use

Use your nose.

Have a real, face-to-face conversation when child comes home after hanging out with friends. If there has been drinking or smoking, the smell will be on their breath, on clothing and in their hair.

Look them in the eyes.

Pay attention to their eyes, which will be red and heavy-lidded, with constricted pupils if they’ve used marijuana. Pupils will be dilated, and they may have difficulty focusing if they’ve been drinking. In addition, red, flushed color of the face and cheeks can also be a sign of drinking.

Watch their behavior.

How do they act after a night out with friends? Are they particularly loud and obnoxious, or laughing hysterically at nothing? Unusually clumsy to the point of stumbling into furniture and walls, tripping over their own feet and knocking things over? Sullen, withdrawn, and unusually tired and slack-eyed for the hour of night? Do they look queasy and stumble into the bathroom? These are all signs that they could have been drinking or using marijuana or other substances.

Search their spaces.

The limits you set with your child don’t stop at the front door or their bedroom door. If you have cause for concern, it’s important to find out what’s going on. Be prepared to explain your reasons for a search though, whether or not you tell them about it beforehand. You can let them know it’s out of concern for their health and safety. Common places to conceal vapes, alcohol, drugs or paraphernalia include:

  • Inside drawers, beneath or between other items
  • In small boxes or cases — think jewelry, makeup or pencil cases, or cases for earbuds
  • Under a bed or other pieces of furniture
  • In a plant, buried in the dirt
  • In between or inside books
  • Under a loose floor board
  • Inside over-the-counter medicine containers (Tylenol, Advil, etc.)
  • Inside empty candy bags such as M&Ms or Skittles
  • In fake soda cans or other fake containers designed to conceal

Don’t overlook your teen’s cell phone or other digital devices. Do you recognize their frequent contacts? Do recent messages or social media posts hint at drug use or contradict what they’ve told you?

If your search turns up evidence of drug use, prepare for the conversation ahead and do not be deterred by the argument of invaded privacy. Stand by your decision to search and the limits you’ve set.

If you discover that your child is not likely to have been drinking or using other substances, this could be a good time to find out if there’s another explanation for any changes in their appearance or behavior that needs to be addressed.

Does my child need help?

The disease of addiction can be hard to recognize, especially in a growing child or teenager. Depending on the number of signs and symptoms you observe, it may be hard to know if this is just a phase or period of experimentation — or if your child is on a path to addiction. Making it even more difficult, your child may insist that there is no problem at all.

You want to trust your child, and it’s easy to second-guess yourself. All parents go through this. However, if there is any question in your mind, it’s always best to have a professional evaluation. Trained counselors will give you the answers you need and you, your child and your family will be able to move toward a healthy life.

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