Signs of Substance Use-Topic Overview The following are some obvious signs that a person may be smoking cigarettes, drinking alcohol, or using other substances. This is not a complete list of signs to look for. If you suspect a particular drug or drugs, get more information on signs of use for those substances. For more information, see Teen Alcohol and Drug Abuse.

Cigarettes

• A distinctive smell on the breath and clothing
• Cigarettes and lighter in his or her possession
• Cigarette butts outside a bedroom window or in other odd places around the home

Alcohol

• Alcoholic beverages missing from the home storage cabinet
• Alcohol or mouthwash (used to cover up alcohol) breath or hangover symptoms (nausea, vomiting, or headache), if recently used

Marijuana

• Sweet smell on clothing or bloodshot eyes, if recently used, and frequent use of eyedrops to reduce the redness
• Drug paraphernalia (pipes) in his or her possession
• Carelessness in grooming, increased fatigue, and changes in eating and sleeping patterns, if using regularly

Inhalants

• Chemical breath, red eyes, or stains on clothing or face, if recently used
• Soaked rags or empty aerosol containers in the trash

Club drugs

• Skin rash similar to acne
• Small bottles with liquid or powder in his or her possession

Stimulants

• Persistent runny nose and nosebleeds, injection marks on arms or other parts of the body, or long periods of time without sleep
• Possession of drug paraphernalia, such as syringes, spoons with smoke stains, small pieces of glass, and razor blades

LSD or other hallucinogens

• Trance-like appearance with dilated pupils, if recently used
• Small squares of blotter paper (sometimes stamped with cartoon characters) or other forms of the drug in his or her possession

Heroin

• Very small pupils and a drowsy or relaxed look, if recently used
• Possession of injecting supplies, called an outfit or rig, that may consist of a spoon or bottle cap, syringe, tourniquet, cotton, and matches

Anabolic steroids

• An unpleasant breath odor
• Mood changes, including increased aggression
• Changes in physical appearance that can't be attributed to expected patterns of growth and development
• Possession of medicines or syringes

Other general signs

• Changes in sleeping patterns
• Changes in appetite or weight loss
• Changes in dress
• Loss of interest and motivation
• Hoarseness, wheezing, or persistent cough

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