Signs Of Substance Misuse In Teenagers


As a parent, teacher or guardian, it can be difficult to tell if a teenager in your care is struggling with something, hiding things or simply growing up.

Adolescence can be a very challenging time with so much physical and psychological development occurring within a short period of time, and this can be confusing for both the teenagers themselves and their loved ones. However, adolescence is also a time when one’s social circle often expands, teens can get influenced by their friends, life gets more and more stressful and this often leads teens to exploring things like drugs and alcohol.

Recognising the signs of substance misuse in teenagers can help you care for your loved one and provide support for them to get help before their substance use becomes a longstanding addiction.

1. Changes In Personality And Behaviour

Drugs and alcohol are psychoactive substances, meaning that they affect a person’s mental processes. These mental processes can include cognition and memory, emotion and perception of the world around them, all of which can impact how someone behaves.

Therefore, if your teenager has been misusing substances, then you might find that their personality and/or behaviour has changed and there is a marked difference in the way they are now and how they have been previously.

The change in behaviour may be temporary e.g. only when they are taking the substance or long-term e.g. have evolved through long-term use.

The specific changes can vary depending on the substance, but some of the most common behavioural changes which might be due to substances include:

  • Irritability
  • Mood swings
  • Forgetfulness
  • Absent-mindedness
  • Anger
  • Appetite changes
  • Increased energy and confidence
  • Lethargy and sadness
  • Paranoia

There are many potential behavioural signs of substance misuse, but in teenagers it can be particularly difficult to pin down the cause of behavioural changes.

The adolescent brain is always developing, so they might experience mood swings or irritability due to their life stage or due to other stressors such as school and friendships.

Therefore it is key to observe their behaviour over a period of time, and keep an eye on any other factors which might affect their personality or behaviour.

Drastic behaviour changes with no obvious cause may be due to substance misuse. Having an open and honest dialogue with your teenager is also essential, and will mean that they are more likely to come to you if experiencing difficulties.

If your teenager is experiencing an addiction, they might also resort to theft from yourself or others and you might notice that they are asking for money more or are quickly spending any money that they have but you are not sure what they are buying.

Their addiction could also affect aspects of their life such as school work, grades and social interactions. If you notice behavioural changes, or are concerned about the behaviour of your teen, then it might be time to seek help.

2. Changes In Physical Appearance

Changes in physical appearance can occur with substance misuse, and some changes might be more visible than others.

If your teenager is actively engaging in substances (alcohol or drugs) and you suspect that they are currently under the influence, then some indications include:

  • Very dilated or constricted pupils
  • Bloodshot eyes
  • Slurred speech
  • Tremors or shakes
  • Poor coordination, falling or stumbling

The physical changes can also have different causes, and it is important to rule out disorders or illnesses which may cause the above symptoms.

However, if it is a short-term physical change which accompanies a behavioural change (e.g. being giggly, having poor coordination and having bloodshot eyes) then it is likely that they are currently drunk or high.

Long term changes in physical appearance can vary also depending on the substance, but some of the most common changes include:

  • Significant weight loss or weight gain
  • Scarring or scabs forming on the skin
  • Reduced personal hygiene, grooming and care
  • Pale skin

Again for many physical changes such as weight changes and changes in personal care, it might be due to other factors (e.g. mental health) or a consequence of their growing and changing body.

However, these signs can be indicators that there is something wrong and opening up a non-judgemental dialogue with your teenager and/or seeking help for substance misuse might be necessary.

3. Secrecy And Evading Questions

You might find that your teenager is hiding things and evading questions, even if those questions are non-invasive.

It is important to be mindful that teenagers value their independence and need their privacy just like everyone else, and as they grow out of childhood they are more likely to want to keep some things to themselves.

If your teenager is wanting more privacy in their own space e.g. their bedroom, and does not want to discuss their day or where they have been in great detail, this could simply be a normal part of development as they are learning to be more independent.

Warning signs however, might come in the specific things that your teenager is private about, the extent to which they are private or evasive of questions, the anxiety they might show if you question them on certain topics and outright lying about things.

They might also feel shame or guilt for their substance abuse and for their behaviour (e.g. lying, theft etc.) and therefore might not want to make eye contact with you or might avoid you.

For example if they hide specific things such as bags which could indicate they contain drug paraphernalia, if they get overly hostile or anxious when asked questions such as where they have been or who they were with or if they are consistently lying about these things.

4. Self-isolating And Avoiding Others

Substance misuse can often be a result of peer pressure and many teenagers are introduced to substances by their friends.

However, particularly as people can further into a substance addiction, it is common for them to avoid others more and spend more time alone rather than with others.

This is often for a combination of reasons, including their need to take the substance often, the shame that they feel for their addiction, their desire to use the substance to ‘escape’ the real world and the mental health struggles which are often perpetuated by, and/or the partial cause of, an addiction.

If your teen is spending more time in their room, avoiding their friends and family and/or not engaging in activities they previously enjoyed, then this could be a sign of either a mental health disorder such as depression or/and a substance use disorder.

What To Do If You Suspect Teenage Substance Misuse 

If you are concerned that your child might be misusing substances, it is important to take positive steps towards getting them help.

Keeping an eye out for the signs of substance misuse is an important first step, and researching what substances they might be taking can help you prepare for the type of support they might need.

If you suspect that they are on substances, then before confronting them or reaching out for help from an addiction treatment centre, try starting an open and honest conversation about what is going on in their life.

Begin with a casual conversation about how they have been feeling and what they’ve been up to in general.

They might open up about something they are struggling with, however if they are misusing substances or going through difficult mental health struggles then they may bottle these up and appear closed off.

If this is the case then a more serious conversation can be had, where you sit your teenager down and have an open conversation where you address your concerns.

If you fear that your teen is far down the road of addiction and will not be responsive, you can reach out to an interventionist who practises the CRAFT model of intervention to give you advice on approaching and supporting your teenager.

If your teenager is currently experimenting with drugs or alcohol and has not developed an active addiction, then discussing the negative physical and psychological consequences of substance misuse could deter them from continuing to experiment.

Talking to them about mental health and how to support them if they are struggling with anything else is also essential, as mental health issues are closely related to drug and alcohol misuse.

If your teen opens up about their struggles and feels that they need help to stop misusing substances, then you can seek help in the form of addiction treatments at a drug and alcohol rehab clinic. There are several places to reach out for help, which are outlined below.

For those who are less responsive, the CRAFT intervention method above has been shown effective in helping teenagers get into treatment, and you can also get in touch with the below services for advice on next steps.

Where To Get Help For Teenage Drug And Alcohol Abuse

Getting in contact with someone who can help your teenager with their substance abuse is key to ensuring their safety and supporting their mental and physical wellness.

There are many services which provide drug and alcohol treatment, and your local GP is a good initial point of contact as they can recommend different treatment options as well as refer your teenager for treatment if needed.

Reputable private alcohol and drug rehab centres, such as Rehab Recovery and Turning Point, can help you access help for your teenager quickly, and you can reach them directly or discuss options with your GP.

You can also contact NHS and charity alcohol and drug addiction support services, which are available all over the UK as well as online.

Charities such as Young Minds and Frank are also full of helpful advice and services specifically for children and adolescents as well as advice for parents and carers.

What Drug And Alcohol Rehab For Teenagers Involves

There are a variety of treatment options available for people of all ages who are struggling with substance misuse, including more intensive inpatient services and less intensive outpatient programmes.

When you reach out for treatment, there will be an initial assessment conducted where you can share your concerns, your teenager can discuss what they are going through and a treatment plan can be created.

This plan will usually involve a detox period, one or more treatments which are effective in treating the substance misuse, a timescale of when the treatment will be conducted and any aftercare services for ongoing support that they might need. There will also be a discussion about co-occurring disorders, if relevant, to ensure that any other mental or physical health issues are addressed and treated.

Your teen might need to remain inside the rehab clinic on an inpatient basis for treatment, however if it is early on in the addiction and they have a good support network at home, they are more likely to receive outpatient treatments and stay at home whilst attending regular treatments at the clinic.

Treatment Options For Teenage Drug And Alcohol Misuse

There are a range of treatments available at drug and alcohol rehab clinics, including those for teenagers far into their addiction and those for teens who might fall into an addiction due to mental health issues and/or persistent substance misuse.

Some of the most commonly used treatments for teenage substance misuse include:

  • Cognitive Behavioural Therapy
  • Dialectical Behavioural Therapy
  • Family Therapy
  • Addiction Counselling
  • Holistic Therapies (e.g. Art or Music Therapy)
  • Medically Assisted Therapy

Treatment options for drug and alcohol addiction can also often be effective for other mental health disorders too which commonly occur alongside substance abuse (co-occurring disorders) such as anxiety, depression, ADHD and PTSD. However, both the addiction and the mental health disorder will be diagnosed and treated separately and together to ensure that both are properly addressed.

If you suspect that your child is misusing substances, then taking the right steps towards getting them help is essential to support their physical and mental health. Providing an open, honest and supportive environment can help your child to open up to you about what they are going through, and offering a non-judgemental space for them to talk can help get them the professional treatment they need.

Advice and support is available for you both, and reaching out for addiction treatment can help your teenager to process and overcome what they are going through.

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