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Clinical Reference Systems: Pediatric Advisor 10.0

Warning Signs of Teenage Alcohol and Drug Abuse

Most teenagers will have some experience with alcohol and other drugs. Most will experiment and stop. Some will continue to use alcohol or drugs casually without significant problems. Others will use regularly, with varying degrees of physical, emotional, and social problems. Some will die, and some will cause others to die.

Since there is no certain way to predict which teenagers will develop serious problems, all use of alcohol and drugs should be considered dangerous.

Some teenagers are more at risk than others of developing problems related to alcohol and other drugs. Highest on the list are teenagers with a family history of substance abuse.

Legally available products include alcohol (for those over 21); tobacco (for those over a certain age, depending on where they live); prescribed medications; inhalants; and over-the-counter cough, cold, sleep, and diet medications. Illegal drugs include marijuana, cocaine/crack, LSD, PCP, opioids, heroin, and the so-called "designer drugs."

Although the use of some drugs has leveled off recently, the use of others has not. In particular, the use of alcohol, cigarettes, and crack remain major areas of concern.

Teenagers who begin to smoke or drink during their early teens are at particularly high risk. These substances are the typical gateway drugs, which lead first to marijuana and then to other illegal drugs.

Warning signs of teenage drug abuse may include:

  • Physical: persistent fatigue, repeated health complaints, red and dull eyes, and a steady cough.
  • Emotional: personality change, sudden mood changes, irresponsible behavior, low self-esteem, depression, and a general lack of interest.
  • Family: starting arguments, breaking rules, or withdrawing from the family.
  • School: drop in grades, many absences, discipline problems.
  • Social problems: new friends who are less interested in standard home and school activities, scrapes with the law, and changes to less conventional styles in dress and music.

The warning signs listed above can also be signs of other problems. Parents may recognize signs of trouble but should not be expected to make the diagnosis. Consulting a physician to rule out physical causes of the warning signs is a good first step. This may be followed by a comprehensive evaluation by a mental health professional.


Developed by the American Academy of Child & Adolescent Psychiatry.
Copyright 1999 Clinical Reference Systems