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Substance Use Disorder: Recognize the Signs



  • Substance abuse and dependence are patterns of using alcohol or drugs that lead to serious personal, family and health problems.
  • Signs of abuse may include physical symptoms such as headaches or a constant runny nose, emotional signs such as moodiness or sudden anger, or behaviors such as losing interest in school, sports, or hobbies. Some of these warning signs of drug or alcohol abuse can also be signs of other problems.
  • If you are concerned that your child is abusing alcohol or drugs, talk to your child, or to a healthcare provider.


What is a substance use disorder?

A substance use disorder is a pattern of using alcohol or drugs that leads to serious personal, family, and health problems. The more of these statements that apply to your child, the more severe your child’s substance use disorder is.

  1. Your child uses more or uses the substance for longer than planned.
  2. Your child wants to cut down or quit but is not able to do so.
  3. Your child spends a lot of time and energy getting drugs, using drugs, and getting over the effects.
  4. Your child craves alcohol or drugs so much that your child has trouble thinking about anything else.
  5. Your child has problems at work or school.
  6. Your child has relationship problems because your child doesn’t keep promises, or your child argues or gets violent with other people.
  7. Your child stops doing things that used to matter to him or her, such as sports, hobbies, or spending time with family members and friends, because of the substance use.
  8. Your child uses alcohol or drugs even when it is dangerous such as while driving or operating machinery.
  9. Your child keeps using substances even though your child knows that it is hurting his or her physical or mental health.
  10. Your child needs to use more of the drug or alcohol or use it more often to get the same effects. This is called tolerance.
  11. Your child has withdrawal symptoms when your child stops using.

Substance use disorder may also be called drug or substance dependence or addiction.

There are many kinds of drugs, both legal and illegal, that can be abused:

  • Alcohol
  • Marijuana
  • Heroin and cocaine
  • Inhalants, which are fumes from glue, paint thinner, or lighter fluid
  • Synthetic drugs such as methamphetamine, bath salts, K2, Ecstasy, PCP, or LSD
  • Nicotine
  • Nonprescription cough, cold, sleep, and diet medicines
  • Prescription medicines such as steroids, stimulants, sleep medicines, narcotic pain medicines, or medicines to treat anxiety

What are signs of a substance use disorder?

If your child is abusing alcohol or drugs, he or she may:

  • Be clumsy and have a lot of accidents
  • Be unable to pay attention
  • Become moody, angry, depressed, or worried all the time
  • Have headaches, stomach pain, shaking, coughing, slurred speech, staggering, or a constant runny nose
  • Have changes in appearance such as red or puffy eyes, or rapid weight changes
  • Have changes in appetite or sleep
  • Lose interest in activities that used to bring pleasure such as hobbies or sports
  • Neglecting personal appearance such as not bathing or combing hair
  • Stop showing interest in school, have a drop in grades, or stop going to school
  • Stop spending time with friends or start hanging out with kids who use drugs
  • Asking for money often or taking money or items from the home to sell

Some of these warning signs of drug or alcohol abuse can also be signs of other problems. Your child's healthcare provider will examine your child and ask about symptoms to find out if there is a physical cause for the symptoms. You child may be treated for physical problems or referred to a substance abuse or mental health specialist.

Some of these symptoms are normal in teenagers. If you are concerned that your child is using drugs, talk to your teenager.

How can I help my child?

  • Talk to your child about the risks of smoking, using e-cigarettes, drinking alcohol, and using drugs. Teach in a way that fits your child's age and ability to understand.
    • If you are watching TV with your 6-year-old and cocaine is mentioned on a program, you can ask if your child knows what cocaine is, and tell your child that it is a bad drug that can hurt you. If your child has more questions, answer them. If not, let it go. Short, simple comments repeated often will get the message across.
    • For your 12-year-old, you might explain what cocaine and crack look like, the different names for cocaine, and how using cocaine will change his or her brain and body. Repeat the message. Talk to your child about not using drugs whenever you can.
  • Ask what your child thinks about drugs and alcohol. Keep the conversation positive and calm. Talking “with” your child, rather than “to” your child helps your child learn to make healthy decisions on his or her own. Listen to your child's feelings and concerns, so that your child feels comfortable talking with you. Listen without getting angry or giving lectures.
  • Be prepared for your child to ask you about your own drug use. If you have never used drugs, let your child know this and explain why. If you have used drugs, be honest, but explain what you learned and why you stopped. Make your family position on drugs clear. For example, explain that in our family, we don't use drugs and children are not allowed to drink alcohol. Set a good example. Your child is much more likely to use smoke, drink, or use drugs if you smoke, drink, or use drugs, even if you tell them not to.
  • Talk about what makes a good friend. Peer pressure is a big part of why kids get involved with drugs and alcohol. Help your child understand that friends who pressure them to smoke, use e-cigarettes (vape), drink or use drugs aren't friends at all. Role-play ways for your child to say no to drugs such as:
    • Say “no, thanks” and walk away.
    • Suggest something else to do such as playing a video game.
    • Use humor such as, "No thanks. I don’t want to fry my brain."
  • Build self-esteem and good coping skills. Children who feel good about themselves are much less likely to turn to drugs. Offer lots of praise for a job well done. If you need to criticize or discipline your child, talk about the action, not the child. For example, instead of saying "you should know better" try saying, "what you're doing is not safe." Set aside time every day to talk, play a game, or take a walk with each of your children.

People and resources in your community that can help you include your healthcare providers, therapists, support groups, mental health centers, and alcohol or substance abuse treatment programs.

For more information, contact:

Developed by Change Healthcare.
Pediatric Advisor 2022.1 published by Change Healthcare.
Last modified: 2022-01-03
Last reviewed: 2020-12-30
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2022 Change Healthcare LLC and/or one of its subsidiaries
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