How to tell if your child is on drugs

SAMHSA’s National Helpline | SAMHSA

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SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

Suggested Resources
What Is Substance Abuse Treatment? A Booklet for Families
Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.
It's Not Your Fault (NACoA) (PDF | 12 KB)
Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.
After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.
Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.
For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).

Alcohol

Data:

Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers. The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH)
Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44.4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31. 4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily

Programs/Initiatives:

STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
Interagency Coordinating Committee on the Prevention of Underage Drinking
Talk. They Hear You.
Underage Drinking: Myths vs. Facts
Talking with your College-Bound Young Adult About Alcohol

Relevant links:

National Association of State Alcohol and Drug Abuse Directors
Department of Transportation Office of Drug & Alcohol Policy & Compliance
Alcohol Policy Information Systems Database (APIS)
National Institute on Alcohol Abuse and Alcoholism

Tobacco

Data:

In 2020, 20. 7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month. The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people).
Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3.4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals

Resources:

Tips for Teens: Tobacco
Tips for Teens: E-cigarettes
Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
Synar Amendment Program

Links:

Truth Initiative
FDA Center for Tobacco Products
CDC Office on Smoking and Health
National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
National Institute on Drug Abuse: E-Cigarettes

Opioids

Data:

Among people aged 12 or older in 2021, 3. 3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH)
Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose

Resources:

Medication-Assisted Treatment
Opioid Overdose Prevention Toolkit
TIP 63: Medications for Opioid Use Disorder
Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
Opioid Use Disorder and Pregnancy
Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
The Facts about Buprenorphine for Treatment of Opioid Addiction
Pregnancy Planning for Women Being Treated for Opioid Use Disorder
Tips for Teens: Opioids
Rural Opioid Technical Assistance Grants
Tribal Opioid Response Grants
Provider’s Clinical Support System - Medication Assisted Treatment Grant Program

Links:

National Institute on Drug Abuse: Opioids
National Institute on Drug Abuse: Heroin
HHS Prevent Opioid Abuse
Community Anti-Drug Coalitions of America
Addiction Technology Transfer Center (ATTC) Network
Prevention Technology Transfer Center (PTTC) Network

Marijuana

Data:

In 2021, marijuana was the most commonly used illicit drug, with 18. 7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people).
The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
Marijuana can have significant health effects on youth and pregnant women.

Resources:

Know the Risks of Marijuana
Marijuana and Pregnancy
Tips for Teens: Marijuana

Relevant links:

National Institute on Drug Abuse: Marijuana
Addiction Technology Transfer Centers on Marijuana
CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.

Resources:

Tips for Teens: Methamphetamine
Tips for Teens: Cocaine
National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 01/05/2023

How to find out if a child uses alcohol and drugs

Adolescents who use alcohol, drugs

Increasing secrecy characteristic,
Deterioration in school performance: lack of interest and incentive to study, absenteeism,
Deterioration of the appearance of a teenager: hair, clothes, shoes, personal items look untidy, dirty,
Changing relationships with peers. The appearance of new, suspicious friends, which can greatly affect whether a child will take alcohol, drugs or not.
Change in behavior towards loved ones, such as aggressiveness or unwillingness to communicate.

If you think your child has used alcohol or other drugs more than once:

Ask about it. Find out what substances he used and what he experienced while doing it, whether he liked it. Listen carefully to the teenager's story, namely, whether he liked using it and why. The closeness of your relationship will affect the frankness of the child. Ask about peers who gave him drugs and those who used them with him.
Talk about your concerns, not just about drug abuse, but about other important issues such as school performance
Remind them of the norms of behavior in the family, whether it is accepted in the family to use these substances and the consequences if the teenager does not adhere to family values. If you do not want your child to use any kind of drugs, including smoking and alcohol, tell him directly about it.
Ask your child to stop using alcohol or drugs, especially if there is a history of addiction in the family. If the child stops now, he may avoid negative consequences.
Maintain an outreach policy. It is very important to give your teenager information about the influences and consequences of alcohol, toxic substances, smoking and drugs.

Do not lose control of the situation!

The child may have problems at school or at home, difficulties in communicating with others and with the law as a result of taking drugs. If you suspect your teen is continuing to use alcohol or substance abuse, take action. This is much more serious than you think and requires immediate attention. Frequent or constant use of narcotic substances leads to physical and psychological dependence or already to the presence of such.

To help a teenager:

Make inquiries. See if there is evidence that the child is taking toxic substances. Review the information on how to find out if a teenager is taking drugs again. If you are inclined to believe that the child uses a certain type of drug, collect all the necessary information about him.
Choose the right moment, namely, when the child has not yet had time to take the next dose. It makes no sense to talk with someone who is in a state of alcoholic or drug intoxication.
Ask directly. Find out what drugs your child takes, how often and where they take it. As a rule, teenagers are silent about this.
Assess the situation. Take your child to a drug specialist. Ask the doctor to examine your child. Early intervention will facilitate the eventual withdrawal of drug use.
Call for help. Attend a support group for relatives of alcoholics and drug addicts. There are special courses for parents where the consequences of alcohol and drug addiction are discussed. The use of toxic substances is a family problem, since all family members feel the negative effects. Relatives of such teenagers should change their attitude towards them.

Narcological assistance in Grodno:

ME GOCC "Psychiatry - Narcology":

narcology registry - 8 (0152) 75-67-54;
adolescent narcologist - 8 (0152) 75-69-44.

Helpline Grodno - 170

Republican "Helpline" for narcological patients - 8 801 100-21-21

Drugs: how can parents understand that a child is in danger? - Ulyanovsk today

Information about the dangers of drug use surrounds us everywhere: it pours on teenagers from TV screens and computer monitors, and is discussed at lessons and extracurricular activities at school. There are severe penalties for those who manufacture, distribute, transport, possess or use prohibited substances. However, even in the 21st century, this problem has not been solved, and adolescents are the first to be hit.

Parents often do not even suspect that their child has been exposed to drugs. What are the warning signs of these substances, why are they so attractive to teenagers, and how can parents help their child? These and other questions were answered by the medical psychologist of the Ulyanovsk Regional Clinical Narcological Hospital Elena Makarova.

— What is the reason a teenager decides to try drugs? Under the pressure of distributors, criminal elements?

— Conventionally, the reasons for a teenager's addiction to drugs can be divided into three groups: intra-family, social (teenager environment), personal. Let's analyze them in more detail.

Problems in the family, both material and emotional, high rates of alienation of children and parents. The degree of risk increases with an increase in the number of conflicts between parents and practically reaches a maximum when they divorce.
The presence of close relatives suffering from alcohol or drug addiction.
Rejection of the personality of a teenager by the reference group of peers (a social group that serves as a kind of standard for the individual, a frame of reference). He must change his "I" and live according to the laws of this group.
Low external assessment in case of immaturity of the "I" automatically generates low self-esteem.
The predominance of imitative behavior (the desire to "be like everyone else").
Low vitality and resistance to stress, inability to achieve one's goal, the desire to get everything from life "here and now."
Vulnerability, touchiness, emotional instability. Inability to adequately express one's feelings and control over them, fitting one's own feelings and emotions to the emotional range of the external environment.
Desire for pleasure and change of emotional state are higher than self-control skills.
Unwillingness to take responsibility for one's own life and own actions. The desire to use adult opportunities, delegating responsibility to either the family, or the school, or the "leaders of the pack."
The immaturity of the mechanisms of logical thinking, which do not allow analyzing the situation in its entirety.
Lack of permanent and sustainable personal interests and hobbies. The feeling of boredom as a manifestation of the infantilism of a person who is unable to find a job to his liking.
Presence of other forms of addictive behavior (gambling, computer and Internet addiction).
Childhood traumatic brain injury, including birth trauma.
Inability to say: "No."

The most common case of addiction to drugs is in the company of peers. In adolescence, approval and acceptance from others acquires special significance. A teenager is driven at this moment by the motivation to be “one’s own” among people significant to him, to gain new experience, to get impressions. The first test can take place in a club, at a party, at a party or on the street. A teenager is afraid that by saying "no", he will gain a reputation as "too correct", "mother's son" and will be excluded from the company. The fear is so strong that it forces him to risk his health and life.

— What signs should cause parental anxiety?

- Determining whether your child is using drugs or not is difficult, especially if the child has done it for the first time or uses the drug periodically. It is important to draw the right conclusions and take into account that some signs may appear for a completely different reason. And yet, you should be wary if they appear.

Physiological signs:

- paleness or redness of the skin,
Dilated or constricted pupils, reddened or cloudy eyes
Incoherent, slow or rapid speech
Loss of appetite, weight loss or excessive eating
Chronic cough
Poor coordination (staggering or stumbling)
- sharp jumps in blood pressure,
- a disorder of the gastrointestinal tract.

Behavioral signs:

- causeless excitement, lethargy,
- increasing indifference to everything, deterioration of memory and attention,
- leaving home, absenteeism from school for unknown reasons,
- difficulty concentrating on something in particular,
- insomnia or drowsiness,
- painful reaction to criticism, frequent and abrupt mood changes,
- avoiding communication with people, with whom you used to be close,
- decrease in school performance,
- constant requests for money,
- missing valuables from home,
- frequent phone calls, use of jargon, "secret" conversations,
- self-isolation, withdrawal from participation in affairs that used to be interesting,
- frequent lies, resourcefulness, deceit,
- avoiding answers to direct questions, a tendency to compose fables,
- untidiness of appearance.

Obvious signs:

- injection marks (especially on the veins), cuts, bruises,
- papers and banknotes rolled into tubes,
- sooty spoons, foil,
- capsules, vials, cans,
- packs of sleeping pills or sedatives,
- cigarettes in cigarette packs.

— In order to teach a child to say no, do you need to talk to him about the dangers of drugs?

— I advise you to conduct such a conversation when your son or daughter is 10-12 years old, since it is at this age that children try their first “drugs”: the first cigarette, the first glass from the festive table, etc.

While every parent has a different approach to talking to their children, there are general, proven guidelines.

Be careful about the choice of place and time. Find the right moment when the child is open, attentive and not busy with other things. Find a place where he will feel comfortable. Tell him that the world is both black and white, and joy, and pain, and birth, and death. Talk about how sometimes people themselves attract death by making mistakes, and drug addiction is a step towards death. Ask the child if he knows what drugs are, if he knows the names of drugs. Don't be surprised if your son or daughter says yes - just take it for granted.

Tell your child that drug addiction is a disease, an incurable and fatal disease, and the only sure way to avoid it is to prevent the first time. Most often, children agree to try the drug because they are afraid of being thrown out of a certain social circle or because of a desire to imitate, keep in touch with the guys, be “respected” and not be “cowards”. For whatever! Many agree even when they don't really feel like or tempted to try the drug. That is why you need to teach your child to firmly refuse drugs.

Saying “no” is a whole science, which, by the way, is not always comprehended even by adults, accomplished people. It is important to find words for refusal together with the child, so that at the right moment he is not at a loss and behaves confidently. Explain to the child and work out with examples the typology of refusals: refusal-agreement, refusal-promise, refusal-alternative, refusal-denial, refusal-conflict.

— Now the summer holidays have come, in connection with this, what do you want to warn parents of teenagers about?

- Today, many sites are full of lucrative job offers for "high income" courier jobs. Often these vacancies turn out to be a drug distribution offer. Such employees are called "miners" or "mortgagers". And for such activities, teenagers receive real terms of imprisonment. I want to remind you that criminal liability related to drug trafficking can follow from the age of 14, and these are very serious terms of imprisonment - from 4 years to life imprisonment.

Every parent should know and understand that their child may be involved in these situations. And to prevent this from happening, you must be aware of who your child communicates with, what social networks he is on, what communities he is in, whether he hides his communication.