What to Do If You Are Concerned Your Child May Have a Substance Use Problem

Substance use in young people is a medical issue.  Like other health conditions, it can be treated, and early action leads to better outcomes. If you are worried about your child, you are already taking an important first step.  As described in a previous blog post, substance use disorder (SUD) in pediatrics refers to symptoms in which a child or adolescent continues using a substance despite significant substance-related problems, as defined by the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5)

Key Steps If You Are Worried About a Substance Use Problem in a Child

Step 1: Know the Warning Signs

No single sign means your child is using substances, but a pattern of changes may be cause for concern. Watch for:

– Sudden changes in mood, energy level, or sleep patterns

– Declining grades or loss of interest in school, sports, or hobbies

– New friend groups, especially if your child avoids introducing them

– Withdrawal from family activities or increased secrecy

– Unexplained money issues — missing cash, or having more money than expected

– Physical signs: bloodshot eyes, frequent nosebleeds, unusual smells on breath or clothing, sudden weight changes

– Finding unfamiliar items: vape pens, cartridges, pipes, rolling papers, small baggies, eye drops, or breath mints used excessively

– Increased irritability, hostility, or defensiveness when asked about activities

 

Step 2: Start a Conversation

– Choose a calm, private moment — not during an argument or when you suspect your child is under the influence.

– Use a caring, nonjudgmental tone. Try: “I’ve noticed some changes and I’m worried about you. I want to help.”

– Listen more than you talk. Avoid lecturing, threatening, or using labels like “addict” or “druggie.”

– Be honest about your concerns and specific about what you have observed.

– Let your child know that your goal is their health and safety, not punishment.

– It is normal for teens to deny or minimize use. Stay calm and keep the door open for future conversations.

 

Step 3: Contact Your Child’s Doctor

This is one of the most important steps you can take. Your child’s pediatrician or primary care physician can:

– Screen your child using quick, confidential tools designed for teens

– Assess whether substance use has reached a level that needs treatment

– Check for related issues such as depression, anxiety, or attention problems, which often go hand-in-hand with substance use

– Help connect your family with the right type of care

What to tell the doctor: Share what you have observed at home — changes in behavior, mood, school performance, or anything you have found. Even if your child denies use, your observations are valuable information.

 

Step 4: Understand the Types of Help Available

-Treatment is not one-size-fits-all. Your child’s doctor or a behavioral health specialist can help match your child to the right level of care:

-Brief counseling: Short sessions (1–2 visits) using motivational techniques, often effective for early or mild use

-Outpatient therapy: Regular sessions with a therapist trained in adolescent substance use, including cognitive behavioral therapy (CBT) or motivational interviewing

-Family therapy: Works on communication, supervision, and family dynamics — this is one of the most effective approaches for teens

-Intensive outpatient programs (IOP): Several hours of treatment multiple days per week, while your child continues living at home

-Residential or inpatient treatment: For severe situations where safety is a concern or outpatient treatment has not been effective

 

Step 5: Secure Your Home

-Lock up or safely dispose of prescription medications, including opioid painkillers, stimulants (such as ADHD medications), and sedatives.

– Lock up alcohol and monitor supplies.

– Learn about naloxone (Narcan), a medication that can reverse an opioid overdose. Ask your child’s doctor or pharmacist how to get it and how to use it. It can save a life.

 

Step 6: Take Care of Yourself and Your Family

– Substance use affects the whole family. Consider joining a support group for parents, such as those offered by your local community or online.

– Set clear, consistent boundaries at home while maintaining a loving, supportive relationship.

– Avoid blaming yourself. Substance use disorder has many causes, including genetics, brain development, peer influence, and stress.

– Ask your child’s treatment team how you can be involved — family participation improves outcomes.

When to Seek Immediate Help

Call 911 or go to the nearest emergency room if your child:

– Is unconscious, unresponsive, or having trouble breathing

– Has taken an unknown substance or a large amount of any substance

– Is talking about or threatening suicide or self-harm

– Is experiencing seizures, chest pain, or extreme confusion

 

Helpful Resources

– SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7 referrals and information)

– SAMHSA Treatment Locator: findtreatment.samhsa.gov

– Crisis Text Line: Text HOME to 741741

– 988 Suicide Crisis Lifeline: Call or text 988

 

MEDICAL DISCLAIMER

Medical Emergency Notice: Do NOT use this document for medical emergencies. If you have a medical emergency, call a physician or qualified healthcare provider, or CALL 911 immediately. Under no circumstances should you attempt self-treatment based on anything you have seen or read in this document.

General Information is Not Medical Advice: The general information provided in this document is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute. Always seek the advice of your physician or other qualified health provider concerning any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read in this document.