Signs of Teen Drug and Alcohol Use

October 31, 2025
Reading Time: 7m

More often than not, teen drug and alcohol use-related behavior may be disguised as everyday mood swings, social changes, or stress-related behavior.

If you’re a parent or caregiver, you’ve probably wondered if it’s just typical teen behavior or perhaps something more concerning. That uncertainty can be unnerving. Recognizing the early signs of teen drug and alcohol use—and knowing when and how to respond—can make a meaningful difference in your child’s life and future.

Key Takeaways 

  • Teen drug and alcohol use often begins with subtle behavioral and emotional changes.  
  • Emotional withdrawal is the most common sign of substance abuse in adolescents.  
  • Preventing substance abuse in youth relies on emotional connection and honest dialogue.  
  • Early intervention dramatically improves long-term outcomes.  
  • Paradigm Treatment offers specialized, evidence-based support for teens and their families.

Quick Read

Substance use in teens often begins with changes in mood, energy, or motivation that don’t fade with time. Emotional distance, secrecy, or a drop in school or social engagement can be early signs. Early support and open communication make a major difference. 

What Do the Statistics Say About Teen Substance Use?

According to the 2020 National Survey on Drug Use and Health (NSDUH), about 2.8% of adolescents aged 12 to 17 (roughly 712,000 teens) met the criteria for an alcohol use disorder that year. Around 8.2% (or 2.1 million teens) reported using alcohol within the past month. Among young adults aged 18 to 25, 15.6% (or 5.2 million people) had an alcohol use disorder in 2020.

The most commonly used substances among teens are alcohol, marijuana, and prescription medications, such as opioid painkillers and ADHD stimulants.

Signs of Substance Use

What Are the Early Signs of Substance Use in Teens?

The earliest signs of substance use tend to be emotional or behavioral, rather than physical. These changes are often subtle at first but become more pronounced over time.

  • Withdrawal from family or longtime friends  
  • Loss of interest in hobbies or extracurriculars  
  • Declining academic performance or skipping school  
  • Unexplained mood swings or irritability
  • Oversleeping or persistent fatigue

For instance, a teen who used to love weekend sports might suddenly quit the team, spend more time alone, and become vague about their activities. 

What Are the Physical, Emotional, and Behavioral Signs of Substance Use?

Substance use often affects multiple areas of a teen’s life. Being aware of patterns across physical, emotional, and behavioral domains can help you identify when something’s not right.

Physical Signs

  • Bloodshot eyes or dilated pupils  
  • Sudden weight changes  
  • Neglected hygiene or disheveled appearance  
  • Frequent nosebleeds or unexplained bruises

Behavioral Signs

  • Increased secrecy, especially around phone or internet use  
  • Locking bedroom doors more often  
  • Spending time with a new, secretive group of friends  
  • Lying or offering vague answers about daily activities

Emotional Signs

  • Emotional numbness or flat affect  
  • Sudden mood swings or angry outbursts  
  • Avoiding eye contact or meaningful conversations

How Do These Warning Signs Work Together?

Signs of substance use rarely appear in isolation. They tend to form patterns that reflect broader emotional or behavioral shifts.

For example:  

  • Chronic fatigue could stem from substance use, late-night screen time, or depression  
  • Irritability or emotional outbursts might indicate withdrawal symptoms or unmanaged anxiety  
  • New, secretive friendships could signal a shift in values or increasing exposure to risky behaviors

Even if only a few signs are present, the frequency, duration, and impact on daily life matter most. If troubling changes persist and disrupt your teen’s routine, it’s time to take them seriously.

Preventing Substance Abuse in Youth

Preventing substance abuse in youth begins with connection, not control. Teens who feel emotionally safe, heard, and supported at home are far less likely to seek comfort in substances. Education also plays a vital role. Talk with your teen about substance use in a calm, factual way. Avoid scare tactics, as they often backfire. Instead, help them understand the real risks and how to navigate peer pressure with confidence.

Why Is Early Intervention So Important?

The earlier substance use or emotional distress is addressed, the better the long-term outcome. 

The goal isn’t just to eliminate the behavior, though that’s important. It’s to uncover and address the emotional pain driving it. Early support can prevent a temporary coping mechanism from becoming a long-term struggle.

When Should You Seek Professional Help?

If your teen’s behavior has shifted in ways that feel lasting or unfamiliar (as in, they’ve become distant, unpredictable, or untruthful), it’s worth reaching out for professional support. You don’t need proof of substance use to ask for help. What matters is the pattern. When emotional volatility, secrecy, or signs of intoxication start showing up alongside disconnection from family or friends, that’s your cue to get guidance from someone who works with teens every day.

Preventing Substance Abuse in Youth

Other Frequently Asked Questions

How can I tell the difference between typical teen behavior and substance use?

It’s normal for teens to want more privacy or seem moody. What matters is duration and intensity. Typical changes come and go and don’t usually affect school, friendships, or daily life. Substance use tends to create lasting shifts. You might notice a loss of motivation, avoidance, secretive behavior, or emotional flatness that doesn’t pass with time. When those changes start interfering with your teen’s relationships or responsibilities, it’s worth taking a closer look.

What’s the most common sign of substance abuse in adolescents? 

The most common sign is a noticeable change in behavior or mood. A teen might seem more withdrawn, irritable, secretive, or disconnected than usual. These shifts can look different for everyone, but when they persist and start to affect daily life, it’s a cause for concern. 

Is experimenting with alcohol or marijuana always a sign of a deeper issue?

Not always, but it can be a warning sign. Some teens experiment out of curiosity or peer pressure without developing a pattern. The concern grows when use becomes something they rely on to manage stress, loneliness, or emotional pain. Repeated use, secrecy, or defensiveness about it usually points to something deeper that needs attention.

What kind of professional help should I look for?

If you’re unsure where to start, begin with a licensed mental health professional who specializes in adolescents. Outpatient therapy can help if the situation is still manageable at home. If substance use or emotional distress is more serious, residential programs like Paradigm Treatment provide 24/7 support and integrated care for teens ages 12-17 that addresses both mental health and substance use. 

How can I support my teen after treatment?

The best thing you can do is keep communication open, stay consistent with expectations, and model the stability they’re trying to rebuild. Encourage regular therapy follow-ups, attendance at support groups, and healthy outlets such as exercise or creative expression. 

For Parents and Caregivers

You don’t need clear evidence to be concerned. If your teen feels distant, unpredictable, or harder to reach than usual, pay attention to that. Most substance use starts quietly, through small shifts in behavior that don’t go away on their own.

At Paradigm Treatment, we help families understand what’s driving their teen’s behavior and find support that addresses the real issues, not just the surface ones. Our admissions team can answer questions, explain our programs, and help you decide what kind of care makes sense for your situation.

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