The possibility that your teen may be struggling with addiction or a substance use disorder (SUD) can feel confusing and devastating. You may be overwhelmed with questions, such as: How can I be sure what’s going on before talking to my child? How common is drug use in teens? Where did I or they go wrong? What am I supposed to do now? How can I help?
The NIH Monitoring the Future 2021 Survey found that 10.2% of 8th graders, 18.7% of 10th graders, and 32.0% of 12th graders, reported illicit drug use in the past year.1 To avoid joining the 29.5 million people worldwide who struggle with substance misuse, early intervention is important.2
Substance use disorders are the result of many influences, including brain development, genetics, peer influence, home life, and individual risk factors. For example, the part of the brain that helps with planning ahead, weighing consequences, and self-control over impulses (the prefrontal cortex) is the last part to develop in humans.3
So, in combination with any genetic predisposition to mental health disorders or SUD, the adolescent vulnerability to peer influence, instability at home, or any individual risk factors sometimes teens are at a very high risk for developing a SUD.4, 5, 6, 7, 8
There is no universal solution, but you are not alone. An important part of a successful recovery is finding the right rehab center and realizing that recovery is possible. This guide for parents of addicted teens provides information to help you better understand your child and the journey ahead.
Signs and Symptoms Your Teen May be Misusing Drugs
There are several warning signs that can indicate when someone might be misusing drugs. Unfortunately, many behavioral and personality changes are also common in adolescents who are not using drugs. It is important to look for extreme changes and to know your child well. Some of these changes include the following:6, 9
- Bloodshot eyes
- Pinpoint or very large pupils
- Chest pain
- High heart rate
- Increased appetite
- Slowed breathing
- Slurred speech
- Unexplained weight loss or gain
- Exceptional changes in sleep (extreme tiredness or insomnia)
- Smell of substance on personal items or breath
- Feeling nauseous, vomiting, or uncontrolled shaking of head or extremities
- Blank stares
- Marks in their inner elbow (from needle injection)
- Raw, dripping nostrils (from snorting cocaine)
- Scratching or picking at skin and hair
- Unusual drowsiness/fatigue
- Switching friend groups suddenly or frequently
- Stealing money or valuables
- Significantly changing the way they dress, possibly to cover evidence of drug use
- Self-isolation from family routines and activities
- Challenging established rules, such as a curfew
- Exhibiting uncharacteristic behaviors, such as violence, aggression, or lying
- Threatening to quit school, destroy property, or run away
- Unexpected drop in grades, increased truancy, or decreased attention to work
- Extreme and/or quickly changing emotions (moody, irritable, anxious, giddy)
- Lack of motivation/apathy
- Disinterest in previously enjoyed activities
- Depression and mood instability
- Sleeping more in the day and/or staying up all night
- Possession of drug paraphernalia
How Should Parents Respond?
Parents should take a deep breath, seek help from professionals, and remember the primary goal: to help your child. Ultimately, getting your teenager to the right rehab center is an important part of treatment and recovery. To heal, your teen may need to leave the environment and relationships that started and perpetuated their substance use. But to get there as willingly as possible, you must first prepare to have a discussion with them.
Important dos and don’ts of helping someone with drug or alcohol addiction include the following:10
- Learn everything you can about substance misuse and addiction and ask questions.
- Speak with clarity and offer your willingness to support them and get help.
- Communicate love and concern.
- Suggest family therapy and find a therapist.
- Support/encourage recovery as a lifelong process.
- Take care of yourself, regardless of the outcome.
- Reduce accessibility to drugs and alcohol at home.
- Establish and hold consistent boundaries and consequences for behaviors.
- Assume you know what they are experiencing.
- Preach, lecture, threaten, or moralize their behavior.
- Make up excuses for their behavior, lie, or cover it up.
- Feel personal guilt for their behavior.
- Remove consequences by taking over their personal responsibilities.
- Try to discuss or argue when they are under the influence.
- Join them in using drugs to “understand.”
- Expect them to stop without help.
In starting a conversation with your teenager, come prepared. You’ll want to observe any physical evidence that might suggest they are currently under the influence. Be ready for their response, which might be anger and denial. Let them know that you have a plan for treatment, a timeline, and how you will help them in their recovery journey.
It is important to communicate your concern without condescension, judgment, labeling, or blame. Once addiction becomes established, the person’s brain circuits have been physically changed, and they cannot change them back on their own.11
Illicit Drug Use and Today’s Teens
You can start that conversation by reiterating that illicit drug use is dangerous. It has long-term consequences on a growing teenager’s brain and body development, puts them at higher risk for dangerous behaviors, and compromises their futures. Many teenagers are not thinking about the possibility that their social use of drugs could become a lifelong reliance on substances.
Approximately 60% of teens who fit into a category of “severe” substance use disorder and 54% of teens with “mild” substance use disorder still exhibited symptoms of a substance use disorder in adulthood.12
Despite the COVID-19 pandemic, 2021 was the first year that the rates of illicit substance abuse in the United States decreased in 8th, 10th, and 12th graders, according to the Monitoring the Future Survey 2021.1 Though this is positive news, there are still thousands of teens who use, abuse, and become addicted every year. The most commonly used illicit drugs are:
- Alcohol – 7% of 8th graders and 26% of 12th graders reported use in the past 30 days.13
- Marijuana – In 2019, 37% of high schoolers reported lifetime use and 22% reported use in the past 30 days.14
- Nicotine (vaping and cigarettes) – In 2020, 20% of high schoolers used e-cigarettes and 24% used tobacco products.15
Prescription Drug Abuse Among Teens
According to data from the 2021 Monitoring the Future Survey, prescription drug use among 12th graders decreased (from 17.1% to 4.4%) during 2005–2021.16 Most high schoolers abuse prescription drugs (particularly stimulants) for fun or out of curiosity rather than for performance enhancement.17
Some of the most commonly misused substances among 12th graders include:17
- Hydrocodone-acetaminophen (Vicodin)
- Amphetamine/dextroamphetamine (Adderall)
- Oxycodone hydrochloride (OxyContin)
- Methylphenidate (Ritalin)
Most teens choose to try prescription drugs due to easy access and perceived safety.17 Approximately 62% of teens selected a certain prescription drug to use based on how easy it was to find in their home medicine cabinets.17 Around 35% reported they believed (incorrectly) that prescription medications were “safer than illegal drugs.”17
Fortunately, the problems of easy access and misinformation are things that can change, at least in your own home. You can protect your teen at home by storing prescriptions in a locked cabinet and talking to your teen about any medications you may have at home. Education about what they are for, and the potential results of misuse, can help your teen make more informed decisions.
Addiction Treatment for Teens
Substance use and misuse can have long-term negative consequences. As a teenager, substance use can change the way normal joys are experienced (like good food, healthy relationships, and recreational activities), and may cause particular damage since the brain is still developing.11, 18
The dangers of substance use go beyond the biological effect of the substance itself. Risk-taking behaviors that are unfortunately common in adolescence (like driving under the influence, violence, and unsafe sexual practices) increase with frequent and heavy illicit drug use.19
If substance use progresses to SUD as a teen, there is a high possibility that a lifetime SUD could develop. One research group analyzed individuals aged 18 to 50 years old. Most of the teens that had SUD at 18 still had at least 2 symptoms of SUD when middle aged.20 The exact reasons why SUD carries over are not well-defined and is under review for continued research.20
So, what can you do to help? First, you can have your teen screened (by your pediatrician), diagnosed, and referred to one of the 5 treatment levels determined by the American Society of Addiction Medicine (ASAM).21 If a person is not diagnosed and assessed for risk factors before starting treatment, successful treatment may take much longer. Based on your teen’s unique circumstances, they may need:22
- Prevention/Early Intervention – Largely educational or brief interventions.
- Level 1: Outpatient Treatment – 6 hours/week or less of treatment until your teen makes enough progress.
- Level 2: Intensive Outpatient/Partial Hospitalization – Patients receive treatment during the day (up to 20 hours/week) but live at home.
- Level 3: Residential/Inpatient – Staff in a residential setting provide treatment to your teen.
- Level 4: Intensive Inpatient – For teens whose condition is so severe they may require around-the-clock primary medical care alongside mental health treatment.
- Once your doctor determines a diagnosis and treatment plan, your teen could transition to a lower treatment level as they make progress in recovery.
Professionals use a variety of therapeutic techniques and medications to lead to a teen’s recovery. The most common therapeutic techniques are cognitive-behavioral therapy (CBT), brief intervention/motivational interviewing (BI/MI), and the contingency management reinforcement approach. These apply in many of the following settings:22
- Individual therapy: One-on-one sessions with a therapist allow your teen to spend time reflecting on their personal choices and receive counseling specific to their own thought process.
- Group therapy: Through attending sessions with a therapist and a small group of other peers, your teen may become aware of others who are similarly struggling. Each member provides encouragement to the group as they experience breakthroughs in recovery.
- Family-based therapy: The teenager and at least 1 parent or guardian meet with a therapist during family-based therapy to discover and address any factors in their home life that may be increasing their risk of current and future substance abuse.
- 12-Step programs: Often a final step that continues past rehab, 12-Step programs require a large personal commitment. They encourage a person to help themself toward recovery while in a supportive community context.
Because teenagers (and their use and misuse of substances) are heavily influenced by their peer groups, family stability, health, and success or failure in school, treatment of their SUD requires solutions different from their adult counterparts. The Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes the following 6 approaches that focus on childhood and adolescence that promote long-term healing:3
- Behavior modification and behavior management
- Classroom management
- Full-service schools
- Home visiting services
- Parenting skills education
- Social and emotional skills education
Discovering, responding to, and treating your teenager for a SUD can seem like a long, difficult journey. But you and your teen are not alone. Through the efforts of thousands of parents and teenagers who have struggled ahead of you, there are many options for successful treatment going forward. You just have to take the first step. Verify your benefits now or call us at and our admissions navigators can help you find the right program for your teen.