According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 1:
- 27 million people in the U.S. over age 12 abused illicit drugs during the last month.
- Nearly 140 million people over age 12 reported using alcohol in the last month.
If you have concerns that your child is abusing substances, you may already be looking for signs of substance abuse like 2:
- Changes in attendance or performance at work or school.
- Spending time with new people that use drugs or alcohol.
- Stealing or selling items to acquire more money.
- Odd behaviors such as wearing sunglasses inside or long sleeves on a hot day.
- A decline in physical appearance and hygiene.
These general signs are only the beginning, however. Each substance of abuse has a number of characteristic
These general signs are only the beginning, however. Each substance of abuse has a number of characteristic effects, appearances, smells, and associated paraphernalia that will help you accurately distinguish one drug from another.
Alcohol is the most widely used substance of abuse.
What alcohol is: Any beverage that contains the active ingredient ethyl alcohol (also known as ethanol) is commonly referred to as alcohol 4.
Alcohol is the most widely used substance of abuse. Millions of adults have had a drink in the last month, and according to the National Institute on Drug Abuse (NIDA), 58% of high school seniors have abused alcohol in the last year 3.
Adolescents are most likely to begin using alcohol with malt beverages (e.g., coolers, hard lemonades and iced teas, canned ‘rita’ drinks, ‘ice’ drinks) due to their sweeter, more appealing tastes 5.
What alcohol does: Alcohol is a central nervous system (CNS) depressant. Use can produce effects like 5:
- Feelings of calm and relaxation.
- Rapidly changing moods.
- Decreased inhibition.
Someone currently intoxicated from alcohol will show some telltale signs of alcohol abuse including 5:
- Impaired motor coordination.
- Slurred speech.
Physical items to note: Paraphernalia to look out for include 5:
- Empty bottles.
- Shot glasses.
- Funnel attached to a long tube (beer bong).
- Clothing or merchandise advertising alcohol.
What alcohol smells like: Typically, you can smell the alcohol itself on the drinker’s breath; however, as much as 5% of alcohol consumed is excreted from the body in the saliva, urine, or sweat 4. Since alcohol is unchanged in these excretions, someone’s urine or breath might smell of alcohol. Their body odor might also smell of alcohol.
Some alcohol products have no taste, no smell, and no color. Alcohol that doesn’t smell —generally called grain alcohol—can be relatively challenging to identify and more dangerous to consume due to its strength (in many locations, it can be purchased as strong as a 95% alcohol by volume, or 190 proof product) 6.
What marijuana is: Marijuana is a psychoactive drug that comes from the leaves, stems, seeds, and flowers of the hemp plant and contains the active chemical THC (tetrahydrocannabinol). Marijuana – sometimes referred to as weed, pot, or grass – is the most widely used illicit substance and second only to alcohol in popularity 1,5. NIDA reports that nearly 35% of 12th graders have used marijuana in the last year 3.
What weed looks like: The marijuana leaf is green and has a distinctive, symmetrical, 5-point shape. The drug is commonly found as a green, brown, or gray mixture of shredded plants. Marijuana resembles other plants that look like weed, including tobacco 5, 8. It is commonly smoked after having been rolled into a cigarette (joint), but it is also sometimes mixed into foods or brewed into a tea 8.
What marijuana does: When consumed, the effects of marijuana will include 5,7,8:
- Increased hunger.
- Increased relaxation.
- Decreased motivation.
Someone currently intoxicated on the substance will display signs such as:
- Red and bloodshot eyes.
- Lack of coordination.
- Acting silly or laughing often.
Physical items to note: Many items are associated with marijuana use, including 5:
- Rolling papers.
- Hollow cigar wrappers.
- Tweezers or clips (roach clips) to hold a joint.
- Eye drops to reduce redness.
- Clothing or jewelry displaying marijuana leaves.
What marijuana smells like: Marijuana smoke will leave a strong odor on someone’s clothes or in the location in which they consumed the weed. The slang term, “skunk,” reflects its strong, unpleasant scent. Marijuana odor can also smell like burning rope or alfalfa 2. Some users will attempt to mask the smell of weed with incense or air fresheners 5.
What heroin is: Heroin is an illicit opioid drug synthesized from the opiate morphine. Heroin is a potent narcotic and is capable of rapidly producing a strong, addictive high. SAMHSA survey data indicated that in 2015, 400,000 people reported using heroin in the last month 1.
What heroin does: Heroin acts quickly on the brain to produce a sedating and powerfully euphoric high. The effects of heroin use include 5,8:
- A surge of euphoria called a “rush.”
- A state of being partially awake and partially asleep—what is sometimes colloquially referred to as “the nods.”
- Feeling of heaviness in the arms and legs.
Someone abusing heroin may present with a number of signs that include 5,7:
- Small pupils.
- Needle marks on arms.
- Nausea and vomiting.
What heroin looks like: There are a number of forms of heroin available on the street. Frequently, heroin looks like powder that appears in a variety of colors like white, yellow, and brown 5. These powder variations are common on the East Coast 8. Powder heroin can be compacted into pill form or packaged into a balloon 5.
Black tar heroin is another variation commonly found in the western U.S. It is a black, sticky substance that appears like dark pieces of wax 8.
Physical items to note: Heroin use involves a large amount of paraphernalia that differs by method of use. Someone injecting heroin will sometimes have kits that include 2,5:
- Medicine droppers.
- String, belt, or elastic cord to tie off the arm.
Other heroin paraphernalia includes 5:
- Aluminum foil.
What heroin smells like: In its most common forms (white or light brown), heroin has no smell 2. Often, darker brown powder and black tar heroin, however, will smell like vinegar 11. If the substance is smoked, you may notice the black tar heroin smoke smell maintains the vinegar scent.
If your child is using drugs, call 1-888-744-0069 and find a program now.
What cocaine is: Cocaine is a powerful and addictive substance made from the coca plant. Cocaine is abused by snorting, smoking, or injecting it. This stimulant substance is frequently consumed in binges 8.
What cocaine does: When ingested, cocaine will produce effects that are influenced by the methods of use. Smoking or injecting will result in very rapid, intense effects. Snorting will be slightly slower and less intense but longer-lasting. The effects of cocaine include 8:
- Higher self-esteem.
- Euphoric rush.
Someone abusing or currently intoxicated on the drug will show signs like 7:
- Larger pupils.
- Increased alertness.
- Erratic or aggressive behavior.
What cocaine looks like: Cocaine is typically found as a white powder. Pure cocaine might be mixed with other substances that change the color from a bright white to a duller variation 8.
What cocaine smells like: There is no noticeable odor to pure or unadulterated cocaine 2.
What crack cocaine is: Cocaine base (or “crack”) is smoked, which creates effects that are very intense but short in duration 8.
What crack cocaine does: Crack cocaine’s effects will be felt just seconds after the substance is smoked. These effects will be similar to those produced by powder cocaine but will be even more intense and come on more quickly 8.
Similarly, many of the signs of crack cocaine abuse will overlap with those of powdered cocaine but differ in intensity. A notable exception will be the “crash” into depression and exhaustion that follows a long binge on crack 8.
What crack looks like: Crack cocaine looks like chunks of a white substance. The pieces will be irregularly shaped and come in many different sizes. Pieces of crack are sometimes called “rocks” due to their size and shape 8.
What crack cocaine smells like: The smell associated with crack will be of smoke or a general burning smell, since the drug is smoked with a small pipe 5.
Physical items to note: Items associated with drugs like crack include 5:
- Small spoon-shaped tools to sniff.
- Rolled up dollar bills.
- Razor blades to make lines to snort.
- Small pipe for smoking.
- Bags, bottles, or vials to hold or transport the drug.
What methamphetamine is: Methamphetamine is available as a prescription medication called Desoxyn, but it has very limited medical use 8. Illicit meth is extremely potent and is frequently made with pseudoephedrine, an ingredient in cold medicines, and numerous toxins 14. SAMHSA reports that there are about 570,000 people that are currently abusing methamphetamine 1.
What meth does: As a central nervous system (CNS) stimulant, meth is a highly addictive drug that speeds up the body and mind and produces feelings of wakefulness and long periods of energy 8. Meth users will typically go on “runs” because the high caused by the drug is so powerful and rewarding it reduces the desire to eat or sleep 5,8. Other effects of meth will include 5:
- A rush of euphoria.
- Mood changes.
- Heightened libido.
As use continues, the signs of meth abuse will be more prevalent. Methamphetamine can be swallowed, snorted, smoked, or injected. Someone smoking meth may display 5:
- Restlessness and anxiety.
- Jerky or spastic movements.
- Changes in physical appearance like sores on the face and arms or dental decay.
What meth looks like: Meth is seen in many forms including pills, powder, and crystals. The prescription form of methamphetamine, Desoxyn, is a pill, while illicit meth is frequently encountered as a white or off-white powder 8.
What crystal meth is: A variation of methamphetamine is called crystal meth. Crystal meth is named for the larger crystals that are produced when crystal meth is made. Crystal meth is frequently made in homemade “meth labs” using cold medicines for the main ingredient. This form is typically smoked 8.
The effects of crystal meth use will be consistent with powder methamphetamine effects as long as the substances are consumed in the same manner, just as the signs of crystal meth abuse will be similar to other stimulants and include 8:
- Extreme weight loss.
- Memory loss.
What crystal meth looks like: Crystal meth looks like crystals of different colors including clear, white, yellow, blue, and pink 5,8. The crystals will vary in size, shape, and clarity.
What a meth lab looks like: Meth labs are usually very dangerous, as toxic chemicals are use in the production of meth. Meth labs will be identifiable by the various items required to make crystal meth, including14:
- Baking dishes.
- Plastic soda bottles.
- Coffee filters.
- Gas tanks.
Windows may be covered with sheets to conceal the activity inside 14.
What a meth lab smells like: One of the best indicators of a meth lab is the smell from the chemical fumes. You can expect a meth lab to produce an overwhelming smell of chemicals. You might smell 14:
- Paint thinner.
- Ammonia/cat urine.
Strong chemical smells may be retained on the skin or clothing of those who have been in the lab.
Physical items to note: While many items are used to make meth, the paraphernalia needed to consume it will depend largely on the route of administration and included 5:
- Glass pipes.
- Metal spoons.
- Foil shaped into bowls.
- Razor blades.
Prescription Painkillers (Opioids)
Painkillers are abused by more than 4 million people in the U.S.
What prescription painkillers are: Painkillers, or narcotics, are a group of prescription medications designed to relieve pain. These medications are all opioids, which means that, like heroin, they are related to or derived from the opium poppy 8. Opioid painkillers include 7:
- Hydrocodone – Vicodin.
- Oxycodone – OxyContin, Percocet.
These medications are found as pills, tablets, capsules, patches, lozenges, and liquids 7.
What painkillers do: Aside from their ability to relieve pain, prescription opioids can produce a profound sense of well-being. The effects of painkiller use include 8:
- Reduced perceptions of pain.
- A euphoric high.
Painkillers are abused by more than 4 million people in the U.S. 1. Abuse of these medications may lead to opioid addiction and painkiller overdose 7.
You can identify someone under the influence of these medications from signs like 8:
- Pinpoint pupils.
- Depressed breathing.
- Slowed movements.
What prescription opioids look like: The appearance of prescription pain medication will vary greatly depending on the particular substance, brand, dose, and route of administration.
Two of the most widely abused pain medications among high school students are OxyContin and Vicodin 3:
- OxyContin tablets are round and are manufactured in a variety of colors with “OP” or “OC” stamped on one side and numbers (e.g., 10, 20, 40) stamped on the other side, which corresponds to the dose in milligrams 9.
- Vicodin tablets are white ovals scored down the middle with “Vicodin” stamped on them 10.
Physical items to note: In addition to being taken orally, many of these medications are abused through nasal insufflation (snorting), or injection 8. Less commonly, they are abused via smoking. Those who abuse these drugs via these alternate routes may possess paraphernalia that corresponds with their preferred method(s) of use.
What benzodiazepines are: Benzodiazepines (benzos) are a group of substances typically prescribed for the treatment of anxiety and panic disorders. They fit into a large group of drugs referred to as sedatives, tranquilizers, or depressants 7.
What benzodiazepines do: Many parents know a lot about the usual drugs of abuse like painkillers, weed, and heroin, but may be left wondering ‘what do benzos like Xanax do?’ As CNS depressants, Xanax and other benzodiazepines work to slow down brain activity to produce a calming effect. Benzo users may experience 8:
- Feelings of euphoria.
- Slowed breathing.
If someone you love is abusing benzos, you may notice 7:
- Poor concentration and attention.
- Slurred speech.
These signs may be challenging to differentiate from alcohol abuse.
What benzodiazepines look like: There are many variations of benzos based on their brand name and chemical composition. They are found in pill, capsule, and liquid form 7.
Popular benzos include Xanax (alprazolam), Ativan (lorazepam), and Valium (diazepam):
- Xanax pills are ovals (football shaped) with “Xanax” and the dose on one side. The other side is scored down the middle. Colors of Xanax will change according to dose. For example, blue football Xanax are the 1 mg version. 12.
- Ativan looks like small white pentagons.
- Valium looks like round tablets with “V”s cut out 12.
It is important to note, though, that generic versions of benzos will come in a variety of shapes, colors, and sizes.
Physical items to note: When abused, benzodiazepines are consumed orally or snorted 8. Paraphernalia might include devices to crush and snort the pills like straws or mirrors.
Don’t wait to get help. Call 1-888-744-0069 now.
What sleeping pills are: “Sleeping pill” is a general term that relates to non-benzodiazepine medications that help someone fall or stay asleep. Sleep aids slow down brain activity to foster relaxation and alleviate insomnia. They include 7:
What sleeping pills do: Sometimes called “z-drugs” for their chemical names and ability to induce sleep, drugs like Ambien will induce effects like 7,13:
- Reduced anxiety.
- Increased drowsiness.
- Slowed movement.
Signs of prescription sleeping pill abuse are similar across all of the drugs in the class, which include effects similar to those of alcohol intoxication and 7:
- Slurred speech.
- Poor concentration.
Someone on sleep aids may perform complex behaviors like eating, having sex, or driving while sleeping 13. This can be extremely dangerous for both the user and those around them.
What sleeping pills look like: Since they all have similar effects, accurately identifying the medication by appearance will allow you to differentiate between sleeping pills, benzodiazepines, and alcohol use.
- Ambien looks like a long oval tablet. One side will have “AMB” followed by the dose stamped into the tablet. The reverse will have a 4-digit number in large font stamped into it. Ambien is found in colors like white and dark pink 12.
- Lunesta is a round tablet that is either blue or white in color. Lunesta will be blank on one side with a stamp on the back beginning with “S19”
- Sonata is a two-tone capsule that is either green/dark green or dark green/white, depending on the dose. The name of the drug and the specific dose will be printed in black 18.
Physical items to note: Sleeping pills like Ambien are meant to be consumed orally; however, abusers may also snort the pills. Check for pill bottles and tools used to crush and snort drugs.
What prescription stimulants are: Prescription stimulants are medications widely used to treat symptoms of attention-deficit/ hyperactivity disorder (ADHD) and narcolepsy.
There are two main types of prescription stimulants 15:
- Amphetamines like Adderall, Dexedrine, and Vyvanse.
- Methylphenidate — brand names: Ritalin and Concerta.
What prescription stimulants do: Despite the differences in name, all prescription stimulants will speed up the processes in the body and brain. Some effects of stimulant drugs include 15:
- Increased sense of alertness and energy.
- Hypertension (raised blood pressure).
- Tachycardia (raised heart rate).
These drugs carry a strong risk of addiction when the medications are misused. Signs of stimulant abuse include 15:
- Suppressed appetite/weight loss.
- More frequent and intense anger.
- Paranoid thoughts or behaviors.
What prescription stimulants look like: Prescription stimulants will all vary in their appearance based on the specific drug and dose.
Dexedrine looks like a two-part capsule that is brown on one side and clear on the other with orange spheres inside. “SB” and the corresponding dose will be printed on the capsule.
Adderall XR will be easier to identify than the standard Adderall. Despite a variety of colors based on the dose, all Adderall XR will appear as a capsule with the name and dose printed on it. Adderall will be a round tablet with “AD” stamped on one side and the dose on the other 19.
Ritalin looks like a white, round tablet with “CIBA” stamped on one side 3,16. The other side is partially scored with a number stamped in the middle 16.
Physical items to note: Since these products are only available with a prescription, any possession without a prescription is a signal of abuse. Also check for tools used to crush and snort the medication.
What MDMA/ecstasy is: Commonly used in dance clubs and parties, ecstasy is a methylated amphetamine substance with both stimulant and hallucinogenic properties 8. Although sometimes used interchangeably, the chemical MDMA is the primary psychoactive substance in ecstasy. Ecstasy may contain other stimulant or hallucinogenic substances as well.
What MDMA/ecstasy does: The effects of ecstasy use include 5:
- Changed perceptions of colors, touch, and sounds.
- A feeling of euphoria.
- A strong need to be physically close to others.
If you child is abusing MDMA, they may demonstrate signs and symptoms like 5:
- Dilated pupils.
- Excessive thirst and sweatiness.
- Being overly alert.
What MDMA/ecstasy looks like: Although the drug can be smoked and injected, ecstasy is most often snorted or swallowed. In some cases, ecstasy tablets may look like brightly colored candies with logos or designs stamped into the sides, possibly with shapes like 4-leaf clovers or words like “SEX” on them8.
Physical items to note: People abusing ecstasy/MDMA may have accessories like 5:
- Lollipops and pacifiers to counteract the drug’s teeth-grinding effect.
- Glow sticks.
- Candies or mints to hide the ecstasy pills amongst.
Inhalants are noteworthy because they are more frequently abused by younger teens, particularly because they are commonly accessible around the house.
What inhalants are: Inhalants encompass a wide variety of products that give off chemical fumes can be inhaled for the purpose of getting high 8. As a class of drugs, inhalants are noteworthy because they are more frequently abused by younger teens (particularly because they are commonly accessible around the house).
What inhalants do: When breathed in, the effects of inhalants will include 5:
If you child is currently intoxicated, you can look for signs like 5:
- Watery eyes.
- Runny nose.
- Appearing sleepy or disoriented.
What inhalants look like: Many items can be used as inhalants, including 5:
- Aerosol cans.
What inhalants smell like: Smell will be a major indicator of inhalant use. The products themselves will have a range of strong, chemical scents, but so will your child. Their skin and clothing will retain the pungent smell long after the substance has been inhaled 5.
Physical items to note: In order to sniff inhalants, your child may use paraphernalia like 5:
- Old rags.
- Paper or plastic bags.
Their use of inhalants may also be seen from stains on their face, hands, or clothing 5.
As a parent, your goal is to do all you can to prevent or detect substance abuse in your child and other loved ones. If you suspect that anyone you care about has an issue with alcohol or other drugs, call or encourage them to call 1-888-744-0069 today to begin the process of addiction treatment. Treatment can help to end use and avoid future risks associated with substance use.
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- North Carolina Department of Justice. (n.d.). Signs of a Meth Lab.
- National Institute on Drug Abuse for Teens. (2016). Prescription Stimulant Medications (Amphetamines).
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- Drugs.com: Pill Identifier. (n.d.). Lunesta.
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