By Edmund Murphy

Last updated: 30 January 2024 & medically reviewed by Hailey Shafir

As a parent, it can be hard to identify whether your child is using substances and even if they are, it’s even harder to accept they may be struggling with an addiction. Behavior changes, risk-taking, moodiness, and an increased desire for peer acceptance are normal parts of adolescent development, but they also can place teens at higher risk for developing substance use disorders. Increased supervision and monitoring are some of the best ways that parents can detect early signs of substance use disorders in teens, helping them get early treatment.

Key takeaways:

  • In 2020, 20.5% of 8th graders, 40.7% of 10th graders, and 53.3% of 12th graders reported underage drinking in the past year

  • Of teens who reported abusing prescription medication, 60% reported getting the medication from either a friend or relative, and many steal them from their parent’s medicine cabinet

  • Waiting or ignoring the early warning signs can put your teenager at risk of becoming addicted, overdosing, or making other decisions that could have lasting impacts on their health, life, and future

Statistics on teen substance use

Experimentation with drugs and alcohol in adolescence is common, and some types of substances are more common than others in teens. Below are some statistics from the 2020 Monitoring the Future Survey, one of the largest and most comprehensive surveys on drug use trends among kids and teens in the US: [1][2]

  • Two out of three teens will drink alcohol before they graduate from high school

  • In 2020, 20.5% of 8th graders, 40.7% of 10th graders, and 53.3% of 12th graders reported underage drinking in the past year

  • Vaping nicotine is increasingly common with 16.6% of 8th graders, 30.7% of 10th graders, and 34.5% of 12th graders reporting vaping in the past year

  • Regular use of marijuana is also rising in teens, with 11.4% of 8th graders, 28% of 10th graders, and 35.2% of high school seniors reporting smoking marijuana in 2020

  • The number of teens who report vaping marijuana in 2020 is also rising, with 8.1% of 8th graders, 19.1% of 10th graders, and 22.1% of 12th graders reporting past-year use

  • In 2020, 15.6 of 8th graders, 30.4% of 10th graders, and 36.8% of 12th graders reported using an illicit substance

  • Nearly 5% of 12th graders report misusing a prescription medication

  • Of teens who reported abusing prescription medication, 60% reported getting the medication from either a friend or relative, and many steal them from their parent’s medicine cabinet

  • Teens and adolescents are reported to have the highest rates of inhalant abuse, with between 13.1 and 16.1% of 8th graders reporting use. Inhalant abuse can include glue-sniffing, aerosol abuse, and huffing whippet canisters.

These statistics help to demonstrate that teen drug abuse is surprisingly common, making it more important than ever for parents to be able to identify the early signs of substance use, abuse, and addiction in their children.

Signs and indicators of drug and alcohol use in teens

Some of the indicators and signs of drug and alcohol use in teens are listed below. While not all of these signs will be present, parents should be vigilant, watching their teen for any changes in mood, behavior, peer group, or activities.

Physical signs of substance use

Some of the physical signs of substance use may include: [3]

  • Bloodshot eyes

  • Enlarged or very small pupils

  • Frequent nosebleeds 

  • Changes in appetite or sleep patterns

  • Sudden weight loss or weight gain

  • Seizures without a history of epilepsy

  • Deterioration in personal grooming or physical appearance

  • Marks or bruises, including needle marks on arms, legs, or feet

  • Unusual smells on breath, body, or clothing

  • Shakes, tremors, slurred speech

  • Possession of drug paraphernalia

Behavioral signs of alcohol or drug abuse

Here are some of the behavioral warning signs of substance use: [3]

  • Academic or behavioral problems at school

  • Changes in peer group

  • Disinterest in hobbies or activities previously enjoyed

  • Being overly secretive or evasive

  • Changes in routine or sleep schedule

  • Neglected hygiene or physical appearance

  • Stealing money or valuables

  • Spending money without being able to account for it

  • Isolation and social withdrawal

  • Finding paraphernalia, such as pipes, baggies, rolled-up notes, etc.

  • Demanding more privacy, locking doors, and avoiding eye contact

  • Mood swings

  • Sudden change in relationships, friends, etc

  • Frequently getting into trouble (arguments, fights, accidents, illegal activities)

  • Using incense, perfume, air freshener to hide drug smells (marijuana smoke, etc)

  • Using eye drops to mask bloodshot eyes and dilated pupils

Related: How alcohol abuse affects appearance

Psychological warning signs of alcohol or drug abuse

Some of the psychological and mental health signs that can indicate substance use include: [3]

  • Unexplained, confusing change in personality and attitude

  • Sudden mood changes, irritability, anxiety

  • Periods of unusual hyperactivity or agitation

  • Inability to focus, appearing spaced out or lethargic

  • Appears fearful, withdrawn, anxious, or paranoid, with no apparent reason

  • Becoming very angry or defensive when asked about substance or alcohol use

  • Deteriorating relationships with friends and family

  • Trouble focusing and concentrating

Related blog: Substance use among adolescents remains low in 2022

What to do if you notice signs of substance abuse

If you are a parent concerned that your child may be abusing drugs or alcohol, such as binge drinking or taking an illicit drug, it’s important to take action immediately. Waiting or ignoring the early warning signs can put your teenager at risk of becoming addicted, overdosing, or making other decisions that could have lasting impacts on their health, life, and future. 

Some of the important steps parents can take to reduce their child’s risk of substance use include:

  • Verify whether a young person is abusing substances by administering a home drug test or asking their pediatrician to administer a drug test

  • Look in your child’s phone, room, and personal belongings for substances or paraphernalia 

  • Initiate open conversations about drug and alcohol use, including working to educate them about the short and long-term risks

  • Help to keep your child safe by not allowing them to drive if you suspect they are intoxicated

  • Take your child to the ER if you suspect they have overdosed on alcohol or other drugs like opioids or sedatives

  • Know where your child is, who they are with, and what they are doing at all times

  • Use parental controls to limit their access to explicit content online, including drug and alcohol-related content

  • Monitor your teens spending by getting access to their bank account, overseeing their use of cash and debit cards

  • Get your teen treatment if you suspect they are struggling with substance use or mental health condition

Final thoughts

Knowing the signs of drug use in teens can help you to intervene before they develop a substance use disorder. Also, parental supervision and monitoring are some of the best and most proven ways to help keep your child safe and prevent their risk of developing an addiction.