THE A TO Z OF ADOLESCENT DRUG USE & ADDICTION

I’ve heard the questions dozens of times: How can I tell if my child is in trouble with drugs?  How do I separate what is “normal” adolescent behavior from what might be drug-related behavior?

When kids use drugs regularly, certain telltale symptoms begin to appear. Over time, as the brain gradually becomes dependent on drugs (literally, physically needing the drugs to function normally), the adolescent’s thoughts, emotions, and actions will be affected in characteristic ways.

I compiled this list of symptoms to help parents determine if their child might have a drug problem.  Because it’s a long, detailed list, the second half will appear in my next column. 

ANXIETY:  Anxiety is universal in kids who use drugs regularly.  Many drugs cause physical changes (increased pulse rate, body temperature changes) that contribute to anxiety, and all addictive drugs can create feelings of apprehension, dread, fear, panic, and paranoia, especially during the withdrawal phase.  Symptoms of anxiety include irritability, emotional instability, mood swings, mental confusion, and panic attacks.

BLOODSHOT EYES:  Alcohol, marijuana, and inhalants cause tiny blood vessels in the eyes to swell and burst, leading to red, bloodshot eyes.  Stimulant drugs (cocaine, methamphetamines, Ritalin) can interrupt normal sleep patterns, another cause of bloodshot eyes.  Lots of Visine containers around the house or in cars or backpacks should raise suspicion.

CRAVING:  Kids call it “feening” or “fiending” and like all these symptoms, craving gets worse as drug use continues.  When young people first start using alcohol or other drugs, they may crave the pleasure, euphoria, relaxation, and/or stimulation associated with using drugs.  As drug use increases, craving for drugs represents a true physiological need for the drug caused by changes in brain chemistry and function.

DEFENSIVE:  Adolescents with a drug problem will fiercely protect their right to use drugs, resist attempts to discuss their use, react with suspicion or hostility when confronted, and generally shield their behaviors from prying eyes.

EMOTIONAL HIGHS AND LOWS:  Emotions change rapidly and often take uncharacteristic forms.  Normally shy and sensitive adolescents may become loud-mouthed and belligerent.  Friendly, outgoing kids may become hostile and paranoid. Intense emotional ups-and-downs often occur during the withdrawal period (hours, days, weeks or even months after using) and may include irritability, anxiety, depression, fear, and paranoia.

FEAR:  As drug use continues, mild apprehension or nervousness often intensifies to chronic anxiety, suspiciousness, and an overall sense of dread.

GASTROINTESTINAL (GI) COMPLAINTS:  The gastrointestinal system — basically all the organs involved in processing and eliminating wastes — is hit hard by drug use.  Symptoms of GI distress include nausea, abdominal cramping, loss of appetite, vomiting, diarrhea, constipation, and indigestion.

HARDHEADED:  Adolescent drug users are notoriously hardheaded — stubborn, willful, headstrong, and obstinate.  Every conversation, it seems, ends in an argument. Defiance and bullheadedness are often typical of adolescent behavior but with drug-using kids, even a simple question or statement of loving concern can lead to full-scale battles.

INSOMNIA:  Drugs interfere with sleeping patterns, and adolescent drug users often complain of insomnia, restlessness, interrupted sleep, and vivid nightmares.  Hoping to fix the problem, they may use calming or sedating drugs such as sedatives, tranquilizers, or sleeping pills.

JOYLESSNESS:  As the adolescent’s drug use continues and escalates, feelings of gloom and doom begin to cloud almost every aspect of life.  Guilt, shame, depression, and despair intensify as drug use continues and escalates.

KEEPING TO ONESELF:  Adolescent drug users often spend a great deal of time alone, hiding away from prying eyes, locking themselves in their rooms, refusing to show up for meals or family events.  Over time, the adolescent becomes increasingly tight-lipped and secretive.

LEGAL PROBLEMS: Problems with the police and the juvenile justice system are common and include (but are definitely not limited to) truancy, possession, stealing, vandalism, drunk and disorderly conduct, assault, and DUIs (driving under the influence).

MONEY PROBLEMS:  Both legal drugs (alcohol, tobacco, vaping products and, in certain states, marijuana) and illegal drugs are expensive.  When adolescents use regularly, they go through cash fast. They may sell or pawn their (or your) possessions or steal from friends, relatives, or strangers to buy drugs.  As drug use progresses into addiction, tolerance increases and they will need to use more of the drug to feel the same effects and/or to delay the pain and misery of withdrawal.

NERVOUSNESS:  When adolescents use regularly, they are often apprehensive tense, restless, and jittery.  Stimulant drugs such as cocaine, amphetamines and methamphetamines are most likely to cause physical agitation when the user is high, but all addictive drugs will cause jittery nerves during withdrawal which, again, can continue for months after drug use ends.

OBLIVION:  Adolescents in trouble with drugs are typically preoccupied, forgetful, and absorbed in their own thoughts.  The only thing that really matters is drugs — getting them, using them, getting more of them. As one former user explains, “everything else fades into oblivion.”  

Another “O”?  OBSESSION: As a wise treatment professional put it (speaking not just about adolescents): “One half of an addicted person’s mind is in the business of manufacturing BS.  The other half is in the business of buying it.” 

PROMISES BROKEN: “I promise I’ll cut back,” “I promise I’ll stay out of trouble,” “I promise I’ll study harder.” Adolescents may make sincere and heartfelt promises that they are then unable to keep because the addiction subverts their best intentions. That clash between wanting to do the right thing – what they know, deep inside, is the healthy thing for themselves and their families -- and then being unable to follow through creates intense and sometimes overwhelming feelings of guilt, shame, and despair.

QUIRKY BEHAVIOR: Strange or bizarre body movements or gestures including jittery hands and feet, constant lip licking, and scratching or picking at the skin are common, depending upon the drug(s) used. Sudden and dramatic changes in clothing, hairstyles, body art -- tattoos, multiple piercings -- may be a sign of trouble but, again, may be merely a symptom of adolescent identity-seeking behavior.

RESENTMENTS: Drug use breeds resentment. Old friendships are abandoned in fury or exasperation. The slightest criticism is met with defensiveness and hostility. Grudges are held for weeks or months. Feelings of annoyance, bitterness, and frustration seem ever-present. And blame is big — if it’s not the teacher, coach, parents, police, or probation officers who are causing the problem, it’s the “system,” the community, or the world itself.

SHAME: Adolescents in trouble with drugs often feel inadequate, abnormal, worthless, powerless, and out of control. They may believe they are no good and conclude that they are truly bad kids or “lost causes” (as they are all too often told). When they get high, they can mask these feelings for a short time, but inevitably shame and feelings of self-loathing return. Overcome with shame and despair, many adolescent drug users consider or attempt suicide. Uncovering and dealing with shame in counseling and treatment is absolutely essential to health, well-being, and long-term recovery.

TEMPER TANTRUMS: Temper tantrums are common in adolescence, but when drugs are involved, sudden violent outbursts are often unprovoked and occur regularly. The adolescent seems irritated, annoyed, and angry all the time and is often difficult to reason with, restrain, or pacify.

UNDERACHIEVEMENT: This is one of the classic symptoms of drug addiction — adolescents who once had great energy and potential could suddenly care less about school, grades, sports, church, old friends, family relationships, or the future. Adolescent drug users often stop studying and their grades drop precipitously. They seem unconcerned with the future and are quick to renounce long-time goals such as going to college or finding a steady summer job. They may sit passively and watch TV, listen to music, or play video games and stubbornly refuse to become involved in hobbies, sports, or outside activities.

VIOLENT EPISODES: Certain drugs — alcohol, cocaine, amphetamines, and PCP, for example — are more likely to make users aggressive and potentially violent. Combining drugs can also lead to paranoid, hostile, aggressive, and violent behaviors. Physical and emotional instability increase during the withdrawal period and can lead to violent behaviors, including self-harm.

WEIGHT CHANGES: Rapid weight loss or sudden weight gain may be a sign of regular drug use. Adolescents who regularly use stimulant drugs such as cocaine and amphetamines tend to lose weight fast. Kids who regularly use marijuana tend to gain weight.

XENOPHOBIA: Xenophobia is a fear or hatred of anything foreign or strange. Regular drug use often exacerbates suspicion and paranoia toward authority figures and even former friends or mentors (teachers, coaches, pastors).

YEARNING: An intense but often unexpressed longing for peace, serenity and an end to the constant drama associated with drug use (arguments with friends and family, shattered relationships, legal and financial problems) are common in adolescents who use drugs regularly. This yearning can be filled in the short term by drugs and/or material possessions, but inevitably feelings of emptiness and despair return.

ZONED: All addictive drugs alter brain chemistry to one extent or another, pulling users into a different reality. Adolescents high on drugs or in withdrawal often appear distracted, spacey, and zoned out. “All I had to do was look in my daughter’s bloodshot, unseeing eyes,” one mother explains, “and I knew the truth.”