If you or your teen is in immediate danger or having thoughts of suicide, call or text 988 to reach the Suicide & Crisis Lifeline, or call 911. The National Rehab Hotline at 866-210-1303 is for non-emergency information, support and referrals.
If you’re worried that your teenager might be using drugs or alcohol, that’s a hard place to be standing. Maybe you’ve noticed something off and you can’t quite name it. Maybe you’ve found something. Maybe a teacher or another parent has said something that’s been hard to shake. Whatever brought you here, you’re trying to figure out what to do, and that itself is the right instinct.
According to the 2024 Monitoring the Future survey funded by the National Institute on Drug Abuse, teen substance use has actually declined since the start of the pandemic and remains below pre-pandemic levels, but it’s still common. In 2024, 41.7% of 12th graders reported drinking alcohol in the past year, and adolescents most commonly reported using alcohol, nicotine vaping and cannabis. Lower numbers don’t mean low risk, especially given how unpredictable the current illicit drug supply has become.
This page is written primarily for parents, guardians and other adults concerned about a teenager. If you’re a teen reading this yourself: You’re not in trouble for being here, and you can call the National Rehab Hotline at 866-210-1303 — it’s free, confidential and available any time, day or night. Reaching out to a trusted adult in your life — a parent, a school counselor or another adult who knows you — also makes a real difference.
Warning Signs of Teen Drug Use
Teen substance use rarely looks like a single dramatic moment. It usually shows up as a cluster of changes that build over time. Any one of these can have other explanations — adolescence is itself a period of rapid change — but several appearing together warrants a closer look.
Behavior Changes
These shifts often track with mood swings driven by intoxication and withdrawal cycles:
- Sudden shifts in personality or mood: increased aggression, secrecy, defensiveness or irritability
- Withdrawal from family members
- Lying about whereabouts or who they’re with
- New hostility toward conversations they used to engage with
Academic Decline
Look for:
- Falling grades
- Missed assignments
- Skipped classes
- Loss of interest in school activities and extracurriculars they previously cared about
Substance use makes concentration, memory and motivation genuinely harder, and the academic effects often appear before the substance use itself becomes visible.
Risky Behavior and New Peer Group
Teens often use with new peer groups before parents see signs at home. Watch for:
- New friends you haven’t met, distance from longtime friends or a quiet shift in social circle
- Risk-taking that’s out of character — driving recklessly, breaking curfew without explanation, getting into trouble at school or with the law
Physical Symptoms
These are frequently the easiest to spot. Changes in appearance and physical health may include:
- Bloodshot eyes
- Dilated or pinpoint pupils
- Frequent runny nose
- Unexplained weight loss or gain
- Neglected hygiene
- Sleep changes
- Sores on the skin
Hidden paraphernalia — pipes, papers, small bags, prescription bottles that aren’t theirs — is an even stronger signal. Our guide to common hiding places for drugs can help if you suspect something is being concealed at home.
Withdrawal Symptoms Between Uses
Withdrawal patterns are one of the strongest indicators that use has progressed beyond experimentation:
- Anxiety
- Irritability
- Tremors
- Sweating
- Nausea
- Sleep problems when they haven’t used for a stretch of time — followed by relief when they do
Why Teen Substance Use Looks Different
Adolescent substance use isn’t just adult substance use in a younger body. The teen brain is still developing — particularly the prefrontal cortex, which governs impulse control, risk assessment and long-term planning — and substance use during this window can have lasting effects on how that development unfolds.
That developmental difference is why early intervention matters so much. As NIDA Director Dr. Nora Volkow has noted, delaying the start of substance use among young people, even by one year, can decrease substance use for the rest of their lives. Time itself is a meaningful protective factor.
Teen substance use also tends to co-occur with mental health conditions — anxiety, depression, ADHD and trauma exposure are all elevated risk factors. Trauma in particular is a strong predictor of adolescent substance use, and addressing the underlying mental health picture is often essential to addressing the substance use itself.
Today’s drug supply also raises stakes that didn’t exist for prior generations. Counterfeit pills sold to teens through social media frequently contain fentanyl, often at lethal doses. A pill that looks like Xanax, Adderall or oxycodone may not be what it appears to be. This isn’t a hypothetical risk — it’s a leading driver of adolescent overdose deaths in recent years, even as overall teen drug use has declined.
How to Talk to Your Teen About Drug Use
If you suspect your teen is using, the conversation matters — and how you have it matters as much as having it at all. A few principles that tend to help:
- Choose a calm moment. Not in the heat of an incident, not during a fight. A car ride, a walk, a quiet evening — settings where your teen doesn’t feel cornered.
- Lead with concern, not accusation. “I’ve been worried about you” lands differently than “I know what you’ve been doing.” Defensiveness is the enemy of useful conversation.
- Listen more than you talk. Most teens have something they want to say if they trust they’ll be heard without immediate punishment. The first conversation usually shouldn’t be the deciding one.
- Don’t moralize. Lectures about willpower or character close the door fast. Substance use is a medical issue with real causes — usually some combination of mental health, peer dynamics, family stress or curiosity that escalated.
- Be specific about what you’ve noticed. Concrete observations (“Your grades dropped, you’ve stopped seeing Marcus, you came home Friday and went straight to your room”) are harder to dismiss than vague concern.
- Keep the door open. Even if the first conversation doesn’t go well, your teen needs to know they can come back to you. Permanently shutting them out drives the behavior further underground.
If your teen denies use but the warning signs continue, you don’t have to wait for them to admit it. Calling a hotline, talking to their pediatrician, consulting a school counselor or scheduling an evaluation with an addiction-trained clinician are all reasonable next steps.
When to Call the Teen Drug Addiction Hotline
There’s no severity threshold you need to cross before reaching out. Calling doesn’t commit you or your teen to anything — it’s a way to get information, talk through what you’re seeing and figure out what to do next.
When you call the National Rehab Hotline at 866-210-1303, you’ll be connected with information, guidance and answers about teen substance use, the treatment options that exist and programs in your area. The call is free, confidential and anonymous — you don’t need to give your name or your teen’s name. We can also help you understand insurance coverage and identify free or low-cost programs if cost is a concern. Resources for family members are available, and if you’re considering more structured intervention, our intervention guide can help you understand what that process looks like.
Important: The National Rehab Hotline provides information and referrals, not clinical advice or therapy. For diagnosis, treatment planning or therapy, we’ll connect you to qualified providers.
For deeper data on teen substance use trends, see our companion article on teen drug use statistics.
Crisis Resources for Teens and Families
Beyond NRH, several specialized hotlines serve teens and the people supporting them:
- 988 Suicide & Crisis Lifeline — call or text 988. 24/7 crisis support for anyone, including teens. The right resource for any acute mental health emergency.
- SAMHSA National Helpline — 800-662-HELP (4357). Free, confidential, 24/7 referral service for substance use and mental health treatment. samhsa.gov/find-help.
- Crisis Text Line — text HOME to 741741. 24/7 text-based crisis support, particularly useful for teens who find phone calls harder than texting. crisistextline.org.
- National Runaway Safeline — 800-RUNAWAY (800-786-2929). Support and resources for youth who have run away or are considering it and for families trying to reach them. 1800runaway.org.
Frequently Asked Questions
- How Can I Tell If My Teen Is Using Drugs or Just Being a Teenager?
Mood swings, irritability, secrecy and shifting friend groups are common in adolescence and don’t automatically signal substance use. The signal is usually a cluster of changes appearing together — academic decline plus new peer group plus physical symptoms plus secrecy, for example — rather than any single behavior. Trust your read of your teen’s baseline. If something has shifted in ways that don’t add up, that intuition is worth following up on. - Should I Drug Test My Teen?
Drug testing can be useful in some situations, especially as part of a structured treatment plan agreed to by your teen. Drug testing without their knowledge or as a primary tool in early conversations often backfires — it damages trust and can drive use further underground. If you’re considering it, talking to your teen’s pediatrician or an addiction specialist first is usually a stronger move than buying a home test. - What If My Teen Denies They’re Using Anything?
Denial is common and doesn’t mean you should stop being concerned. If the warning signs persist, you don’t need a confession to take action — you can talk to their pediatrician, request a school counselor evaluation or schedule an assessment with an addiction-trained clinician. Calling a hotline to talk through what you’re seeing can also help you decide on next steps without confronting your teen directly. - Are Calls to the Hotline Really Confidential?
Yes. You don’t need to share your name, your teen’s name or any identifying information, and the call is confidential. The one exception is if someone is in imminent danger — in that situation, we have an obligation to act to help keep them safe. An ordinary call about a teen’s drug use is simply a private conversation about how to get help. - What If I Can’t Afford Treatment?
State-funded treatment programs, Medicaid-covered programs, sliding-scale clinics and nonprofit treatment options exist in most states for adolescents. A call can help identify what’s available in your area and walk you through how to access programs that fit your situation. Cost is one of the most addressable barriers to teen treatment — often it just takes someone helping you navigate the options. - What Happens When I Call the National Rehab Hotline?
When you call, you’ll be connected with information, guidance and referrals to treatment resources for your teen — including residential, outpatient and medication-assisted options when appropriate. The call is free, confidential and available 24/7. Call 866-210-1303.
Take the Next Step
Worrying about your teen is exhausting, and the urge to handle it on your own is understandable. But the families who get through this best are usually the ones who reach out early — for information, for guidance, for help thinking through options before things escalate.
Call the National Rehab Hotline at 866-210-1303, available 24 hours a day, 7 days a week. The call is free and confidential. You don’t have to know what kind of help you’re looking for — that’s what we’ll figure out together. If a loved one is in mental health crisis, we can also help you navigate that.