Ask An Expert / Drugs and Alcohol

Is my teenager a substance abuser?

When to worry about kids and drugs and alcohol

Alan Ravitz, MD, MS

How can I tell if my teenager is using alcohol and recreational drugs or abusing prescription meds?

While we would all feel more comfortable if teenagers abstained from the use of alcohol, pot, and other recreational drugs—all of which are illegal for minors—realistic parents know that most kids will be exposed to them, and many will partake. So how do we know when kids are slipping into territory that’s dangerous, and very difficult to return from?

Some drugs should be immediate cause for concern—heroin, opiate pain killers, cocaine, and methamphetamine. In the case of alcohol and pot, which in some high schools are ubiquitous, signs that a child might be developing a serious problem include the following:

  • Your child is frequently intoxicated, uses substances before or during school, or conceals alcohol or drugs in his room.
  • He has been skipping school frequently or his performance in school has declined.
  • He has changed friends, or dropped activities and former interests.
  • He’s been exhibiting dangerous behavior like getting in fights or driving while impaired.
  • He’s developed a tolerance for his substance of choice, so he has to take greater quantities to obtain the desired effect.
  • He exhibits withdrawal symptoms if he’s not drinking or using.
  • He’s tried and failed to cut down or control his drug or alcohol consumption.
  • He has a psychiatric disorder that might be exacerbated by substance use—stimulants can induce manic episodes, and marijuana, alcohol, and opiates can lead to depression in kids who are already vulnerable.
  • He’s taking medication for another psychiatric disorder; drug or alcohol use will interfere with its effectiveness, since the medicine and dosage have been calculated for a normal brain, not one altered by other substances.