Drug use is surprisingly common among teenagers. According to the 2023 Monitoring the Future survey, 31.2% of high school seniors reported illicit drug use in the past year. Recognizing the signs of teenage drug addiction and other drug use can help parents protect teens and guide them toward proper treatment.
Signs of Teenage Substance Use
Signs of substance use present differently for each teen, but you can typically observe changes and warning signs when use becomes regular or is approaching addiction.
Keep in mind that the presence of risk factors or common use indicators doesn’t necessarily mean a teen is using drugs. Behavioral, emotional, and physical changes can come from other stressors or problems in a teen’s life. These signs typically mark some kind of change in a teen’s life that can benefit from open conversation and support, whether drug use is involved or not.
Behavioral Changes
Parents may notice behavioral changes first in teens who engage in substance use behaviors. The more quickly that changes happen, the more concerned you may feel. However, even changes over longer periods can reveal a teen’s distress and need for support.
To distinguish between normal developmental changes and potential addiction or substance use-associated behaviors, watch out for:
- Withdrawal from family and friends or previously enjoyed activities
- Sudden change in social circles for no apparent reason
- Decline in school performance or truancy
- Secretive or suspicious behavior, including lying about their whereabouts
Emotional Changes
Strong feelings and mood swings are natural parts of teenage development. However, when particularly intense or coinciding with other changes, emotional changes may indicate a deeper issue.
When using substances, teens are likely to experience:
- Increased irritability or aggression
- Sudden mood swings
- Depression and apathy
- Increased paranoia, anxiety, or agitation
Some substances can trigger hallucinations or delusions, especially with long-term use. If your teen experiences these symptoms, seek immediate medical help.
Physical Changes
Different substances cause distinct physical changes, though most are only noticeable over time. However, changes in eye appearance are often more immediately noticeable. You can learn more about specific drugs in our guide below.
In general, teens are likely to experience:
- Differences in pupillary responses, bloodshot eyes, or a glassy look
- Increased or unexplained periods of fatigue
- Unexplained weight loss or gain
- Changes in personal hygiene habits or body odors
Signs of Teenage Addiction
While any substance use can be detrimental and may require intervention, it doesn’t always amount to addiction. Addiction is a clinical diagnosis marked by compulsive and repetitive behaviors. When addiction is present, teens may need more involved interventions, treatment, and support. Addiction is the most severe substance use disorder or SUD.
Teens who experience addiction are likely to experience more intense versions of the behavioral, emotional, and physical changes that indicate substance use. Irritability, deteriorating productivity, and declining physical health are hallmark signals of addiction. Additionally, addiction involves:
- Inability to stop substance use despite the consequences
- Physical reliance on substances, including withdrawal symptoms if use stops
- Hyperfocus on the substance, with overwhelming thoughts and cravings
- Increased tolerance for the substance, leading to higher dosages of consumption
- Anger, blame, or paranoia focused on barriers to accessing substances
Teens who experience addiction may also feel shame about substance use or lash out with increasing justification for substance use upon discovery. Learn more about the nuances of substance use versus addiction.
Addiction Risk Factors
Some teens are more at risk for drug use escalating into addiction. If you recognize these risk factors, you can educate your teens about their risk and support them in sobriety. Teens are more at risk for addiction if they have:
- Family history of substance use or dependence
- Psychiatric disorders, including depression and anxiety
- History of trauma, including experiences of abuse
Teens are also more at risk for substance use and dependence if they do not have strong social support. Building meaningful family ties and peer relationships can be a protective factor against substance use disorders. Learn more about signs and risk factors for addiction.
Signs of Specific Drug Use and Addiction
The presentation of drug use may look different depending on the substance your teen uses. Recognizing these specific signs of drug use may help parents identify usage sooner and direct teens to appropriate treatment.
Signs of Cocaine Use
Cocaine is a nervous system stimulant that can produce euphoric feelings or mental alertness. While “snorting” the drug is common in media portrayals, cocaine can also be rubbed into the gums, injected into the bloodstream, or smoked. Signs of cocaine use in teens include:
- Periods of intense hyperactivity followed by fatigue
- Nosebleeds, frequent sniffling, or new nasal problems
- Other risk-taking behavior, propelled by euphoric or violent feelings
Cocaine interacts with the reward system in the brain, which can lead to increasingly erratic behavior over time. Long-term use can also cause increased levels of anxiety, convulsions, and heart problems. Those addicted to cocaine are more likely to experience intense or long-term effects of the drug.
Signs of Opioid Use
Opioids are a class of drugs that includes substances like fentanyl, morphine, oxycodone, and hydrocodone. The illicit drug heroin is also classified as an opioid. The legal versions of these drugs are used to treat pain when prescribed in a medical setting. Signs of a morphine addiction or other opioid use include:
- Drowsiness or increased lethargy, particularly when coupled with constricted pupils
- Gastrointestinal issues, including constipation and nausea
- Slowed breathing
As illicit drugs, heroin and fentanyl can be particularly dangerous. Signs of fentanyl addiction can include behaviors associated with obtaining illegal drugs, like visiting new locations at odd hours, spending excessive money, and keeping secrets. Learn more about the dangers of illicit fentanyl use.
Heroin comes with specific physical effects, like itchy skin and dry mouth. In addition, heroin is usually injected, so needle marks or bruises can be a significant sign of heroin addiction. Learn more about the warning signs of heroin use.
Methadone is classified as an opioid and is often used to treat opioid addiction. It can be lifesaving as a treatment option for heroin addicts. The drug blocks the euphoric effects of other opioids, but high doses can produce euphoric feelings and lead to dependence or drug-seeking behavior. Methadone addiction is complex because of its treatment applications; one sign of methadone addiction is undergoing repeated methadone treatments.
Signs of Adderall Use
Adderall is a brand name for a prescription drug made from a combination of amphetamine and dextroamphetamine. It is most commonly used to treat people with ADHD or narcolepsy.
Adderall is a stimulant and commonly misused by teens seeking a high or focus aid. Chronic misuse can lead to reliance and addiction, as it interferes with dopamine release in the brain. Signs of non-prescribed or improper Adderall use in teens include:
- Intense periods of unusual focus or energy followed by exhaustion
- Loss of appetite, limited food intake, and weight loss
- New or increased nighttime restlessness and insomnia
- Increased irritability or anger
In teens, misuse of this drug often stems from a desire to stay alert or accomplish more. This distinction from other substance use can make it challenging to identify Adderall addiction, as it often presents in high-achieving teens who meet desirable social expectations.
Signs of Meth Use
Methamphetamine—also known as meth—is a stimulant. An illicit version called crystal meth has become a popular party drug. Teens using meth may exhibit these symptoms:
- Hyperactivity, including twitching or other repetitive physical movements
- Unexplained scratches or unhealed skin sores
- Decreased appetite and extreme weight loss
Long-term use of meth, often fueled by addiction, may lead to significant changes in mood. Teens may experience elevated anxiety, violence, paranoia, delusions, and even hallucinations.
Distinctive tooth decay, sometimes called meth mouth, is another common side effect of long-term use. Because of this unique presentation, dentists are sometimes the first medical providers to recognize the signs of meth use; some even do drug screening as part of their patient care. They can be an excellent resource for parents concerned that their teen may be using meth.
Signs of Marijuana Use
Marijuana is made from cannabis plants, though not all cannabis products have the psychoactive chemical THC that makes the drug addictive. When smoked, marijuana has a distinctive odor that you may notice lingering on teens or their belongings. Teens may also display behavioral or physical signs such as:
- Red or bloodshot eyes
- Poor coordination or reaction time and balance issues
- Apathy and lack of motivation
- Increased appetite or unexplained weight gain
Marijuana is legal in some jurisdictions, both for medical use and recreational use, which may influence how teens regard the drug or have access to it. Classifying marijuana use as addiction has also been complicated by the wide availability and applications of it. However, reliance on the substance—particularly in teens, who cannot legally use it recreationally—is a strong indicator of addiction. Learn more about marijuana addiction and marijuana use treatment for teens.
Signs of Benzodiazepine Use
Benzodiazepines, also called benzos, belong to a class of drugs that depress the central nervous system. Prescription drugs such as Xanax, Klonopin, Ativan, and Valium fall into this category. Signs of benzo addiction include:
- Increased drowsiness or confusion
- Memory problems and difficulty concentrating
- Slurred speech or other movement problems
Over time, users of benzodiazepines are likely to develop tolerances to the substances. This often leads to increased anxiety, insomnia, and weakness—which often spurs increased use in an attempt to once again subdue these symptoms. A cycle of use like this is often a sign of benzodiazepine addiction.
Valium can be particularly dangerous because it has longer-lasting effects than other drugs in this category. Because of this, signs of Valium addiction may develop more quickly or be more pronounced.
Misuse of Prescription Drugs
Teens may be able to gain access to prescription drugs through people they know, such as classmates, friends, or family. Teenagers may even have their own prescription for legitimate medical needs, which can complicate the diagnosis and treatment for addiction or substance use. Learn more about prescription drug use from these resources:
Symptoms of Specific Drug Use and Addiction
| Drug Type | General Symptoms | Long-Term Use/Addiction Symptoms |
| Cocaine | Euphoria Increased energy NauseaHeadacheIncreased heart rate | Enlarged pupilsViolent behavior ParanoiaInsomniaLoss of smell Nosebleeds or nasal damage |
| Adderall | Increased wakefulnessDecreased appetiteIncreased heart rate | Increased focus Insomnia |
| Meth | Increased wakefulnessDecreased appetiteIncreased breathing Increased heart rate | Irregular heartbeatItching and skin soresTooth decay Paranoia or delusions |
| Marijuana | Euphoria Drowsiness Increased appetiteIncreased heart rate | Slowed reaction timeProblems with coordination Memory problems Chronic cough or respiratory problems |
| Fentanyl | Euphoria DrowsinessNauseaConstipation | |
| Morphine | Euphoria DrowsinessNauseaConstipation Slowed breathing | |
| Methadone | DrowsinessNauseaConstipation Slowed breathing | Lack of euphoric response to other opioids |
| Oxycodone | Euphoria DrowsinessNauseaConstipation Slowed breathing | |
| Heroin | Euphoria NauseaSlowed breathing | Dry Mouth Itching Injection marks BruisingPneumonia Liver or kidney disease |
| Xanax | DrowsinessConfusion DizzinessSlowed breathing | Lowered blood pressureSlurred speech Poor concentration |
| Valium | DrowsinessConfusion DizzinessSlowed breathing | Lowered blood pressureSlurred speech Poor concentration |
Sources:
National Institute on Drug Use
What to Do If You Notice These Signs
If you notice signs of drug use, have an open and honest conversation with your teen. This can help you gauge the extent of their substance use and may prompt the teen to reflect on their actions. Because of their still-developing brains and problem-solving skills, teens do not always have the insight to understand or stop risky behaviors on their own.
When confronted with the consequences of drug use and access to support, teens are more likely to accept help. A structured intervention may also give your family the tools you need to communicate with a teen who engages in substance use behaviors, particularly if the teen has developed an addiction or becomes defensive or combative.
Professional evaluation may be necessary to fully understand a teen’s drug use and any underlying causes, such as addiction or substance use disorders. A primary care physician, psychiatrist, or intervention specialist can evaluate your teen or give you referrals for further evaluation and treatment.
Addiction and Substance Use Treatment with Muir Wood
Seek help for your teen from Muir Wood. We treat substance use when it coexists with behavioral or mental health problems (dual-diagnosis). Our integrated approach aims for holistic and long-term healing. Learn more about our treatment programs.
If your teen is struggling with addiction or substance use, call us at 866-705-0828 or fill out an assessment form today.