Q: I am pretty sure my teenager has used drugs, but am not sure (how can I tell??) and feel a little in the dark and like I missed the boat on preventing this from happening. What do I do now?
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A: This is a question we hear often. Early intervention in teen substance use is part of deterring the problem. People too quickly think that they have missed the opportunity for “prevention” once a teen uses. Yet, there is still the opportunity to prevent continued use, to make this something that happened a few times versus something that turns into an on-going substance use and abuse problem.

Parents must educate themselves about red flags that may indicate substance use, so that they can respond quickly when a red flag occurs. The American Council for Drug Education website provides the following indicators that have been linked to possible drug use. These indicators should motivate you to explore more and clarify if it is substances causing the symptoms:

1. Sudden decline in school achievement.
2. Cigarette smoking.
3. Marked shift in the child’s friends, especially association with known or suspected drug users.
4. Serious erosion of parental trust in the child.
5. Support by the child for the idea of legalizing marijuana.
6. Marked personality changes. (Such as social withdrawal, a new guardedness in communication with family members, depression, changes in sleep patterns, etc.)
7. Withdrawal from extracurricular activities that were previously important to the child.
8. Cutting classes, tardiness or truancy from school.
9. Deterioration in appearance and personal hygiene, or dramatic image changes.
10. Increased secretiveness, unexplained phone calls, heightened hostility to inquiry, sudden onset of hypersensitivity.
11. Going out every night. (Especially “hanging around” as opposed to scheduled youth activities.)
12. Unexplained disappearance of family funds or family and personal possessions (to buy drugs) and/or appearance of unexplained money or items such as new clothes and CDs (from selling drugs).
13. Aggressive behavior such as recurrent fighting, violent hostility, or other evidence of social alienation from the mainstream.
14. Heavy use of over-the-counter preparations to reduce eye reddening, nasal irritation, or bad breath.

While a red flag does not provide enough indication on its own that your teen is using, each of these red flags should result in some action by the parent to explore what has caused it. Substance use can be ruled out, and early intervention can occur to help fix the problem, whether the problem is substance use or something else.