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Substance Abuse

Warning Signs

Adolescents and young adults are at a phase in life where they undergo rapid exploration, growth, and change as they try to figure out who they are and what their place is in the world. Some of their seemingly unsual or impulsive behaviors during this process -like going “goth” overnight- are very normal, which can make it harder to see when there is a problem. Studies show that most will try alcohol before leaving high school, many will drink regularly. Many young people will try marijuana, some will smoke regularly. Some individuals and social circles experiment with more taboo substances like cocaine, ecstasy, psychedelics, and opioids. Within a lifetime, most people will not develop a substance addiction, but some people will - and to different degrees with different outcomes. There are some general warning signs that are cause for concern and call for self reflection on the young person’s part, and active but judgement free inquiry by parents or loved ones.

General Warning Signs

  • Performance in school becomes erratic or declines

  • New behavioral problems in school or at work that lead to consequences such as suspension or threat of job loss

  • Withdrawing from normal interests and activities

  • Withdrawing from friends, spending time with a new social circle

  • Personality changes

  • New social circle contains known drug users

  • Withdrawal from and avoidance of family

  • Changes in daily routine, unexplained or abnormal periods of disappearance

  • Increased need to “run errands”

  • New people briefly stopping by home or work, minimal interaction before departure

  • Secretive about friends, whereabouts, bedroom

  • Unexplained financial troubles

  • Decreased appetite

  • Disappearing personal valuables

  • Frequent Symptoms of illness such as pallor, sweating, runny nose, bloodshot eyes, vomiting, gastrointestinal upset, headaches, aches,

  • Signs of unnatural injury such as punctures, bruising, burns, or sudden emergence of bloody noses

  • Inability to stay alert or hyperalert

  • Neglecting personal hygiene and grooming

Signs of Opioid Abuse:

  • Constricted Pupils (even in darker spaces)

  • Glassy eyes, heavy eyelids

  • Shallow or slow respiration

  • Sedation

  • itching

  • Flushed skin

  • Decreased appetite

  • Nausea or vomiting

  • Weight Loss

  • Slurred or forced speech

  • Difficulty staying awake/alert (may vary throughout day)

  • Dozing off at inappropriate times, head bobbing

  • Confusion or poor judgement

  • Extreme calmness

  • Long sleeves and/or pants even in warm weather, concealing of skin

  • Unnatural punctures, bruising of limbs

  • Blood stains on sleeves

  • Volatile behavior

  • Sudden flu like symptoms and spontaneous recovery

  • Extreme restlessness and spontaneous calming

Opioid Paraphernalia:

  • Straws cut into pieces lined with powder

  • Disassembled pens or plastic tampon applicators, rolled up paper/cash

  • Powder on smooth surfaces

  • Spoons with char marks and residue

  • Tinfoil with char marks or residue

  • Glass pipes

  • Cotton balls

  • Distilled water

  • Syringe caps

  • Cigarette Filters

  • Empty pill bottles

  • Small plastic bags

  • Rubbing Alcohol

  • Oddly placed shoelaces, belts, or strings

  • Laxatives or enemas (for constipation side effects)

What is Substance Abuse?

A substance use disorder is characterized by hazardous or deeply involved maladaptive patterns of substance use behavior that lead to distressing impairment in one’s ability to function and can be marked by an increase in quantity and frequency of substance consumption. Another definition is overwhelming involvement with a substance to the point that you are harming yourself and/or the people around you. Prolonged or consistent consumption of a substance can lead to physical and/or psychological withdrawal symptoms that can include cravings when drug use is stopped or the dose is lowered. 

Why Marijuana Abuse? 

Although marijuana is not known to have the potential to kill and may have medicinal value, excessive and compulsive use can be a sign of self-medication for deeper problems or a sign of polydrug abuse

Signs of Marijuana Abuse:

  • Glassy, bloodshot eyes

  • Heavy Eyelids

  • Dry mouth, licking lips, swishing mouth with water

  • Abnormally Increased appetite, especially for junk food (munchies)

  • Impaired memory and focus

  • Cognitive impairment

  • Disorganized or outlandish speech/ideas

  • Inability to follow conversation

  • Paranoia/skittishness

  • Drowsiness

  • Sedation

  • Euphoria

  • Excessive Giggling/laughter at socially awkward or inappropriate times

  • Increased coughing/phlegm

  • Clothes and hair smell skunk-like

  • Excessive use of breath mints, gum, mouthwash

  • Excessive cologne/perfume

Marijuana Paraphernalia:

  • Thin white rectangle papers (rolling papers)

  • Empty cigar wrappers (blunts)

  • Glass or ceramic pipes’

  • Loose tobacco (mixed with marijuana to roll “spliffs”)

  • Paper towel or toilet paper rolls and dryer sheets

  • Electronic cigarettes (for hash oil)

  • Clear plastic bags

  • Pill bottles

  • Jars

  • Film canisters

  • Visine

A Note on "Dual Diagnosis"

It is not uncommon to see mental illnesses and substance abuse occurring at the same time. Substance abuse can be a symptom of mental illnesses, and many of the behavioral changes seen with mental illnesses can also be symptoms of substance abuse. Many therapists and recovery programs we have listed treat people with "dual diagnosis" cases.  

Basic Opioid Harm Reduction

  • Who is it for?: People who are struggling to stop using heroin, fentanyl, oxycodone, hydrocodone, etc. and IV drug users

  • What is the intention: Reduce the risk of disease and death that come with active drug use, keeping the door open to treatment and recovery by reducing risk of death

  • What services are out there?: clean needle distribution/exchange, clean injection kits, HIV and Hepatitis C testing, Narcan training and distribution, counselors to advise on safer use

  • Benefits: gets dirty needles off the street, reduces the risk of blood borne diseases such as HIV and hepatitis C from sharing needles or stepping on them, 

  • Where to get clean needles: Pharmacies are required to sell clean syringes without a prescription

  • Where to get Narcan: Greater Lawrence Family Health Center at 40 Haverhill street in Lawrence, MA has a voucher program with the Andover Police Department to give Narcan to residents with Andover addresses who request it at no cost and without prescription

What is Harm Reduction?

Harm reduction is a set of practical treatment strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

Did You Know?

Labeling your teenager or young adult child an addict or alcoholic early on may make them resistant to seeking help and further understanding underlying reasons for their behavior. During times of turbulence like a parental divorce or grief after the death of a loved one, teens and young adults may act out or self medicate with substances, substance abuse being a problematic symptom rather than THE root problem. Labeling too soon may miss root problems for which tangible coping mechanisms may be developed and may cause the young person to adopt a self-perpetuating addict identity. Problematic substance use can and should still be addressed, which is why finding a treatment provider who tailors treatment plans to individual needs is so important. Our ever expanding list of treatment providers will help you find that right fit.

Signs of Alcohol Abuse:

  • Memory lapses

  • Poor concentration

  • Slurring speech

  • Loud obnoxious behavior

  • Poor coordination

  • Unexplained accidents, injuries and bruises

  • Emotional volatility

  • Decreased inhibitions

  • Nausea and Vomiting

  • Sores in mouth

  • Significant weight gain or weight loss

  • Reckless driving

  • Dents in car

  • Smell of alcohol on breath

  • Attempt to conceal breath

  • Lethargy

  • Tremors

  • Dizziness

  • Headaches

  • Sweatiness

  • “passing out” in unusual places

  • Secrecy

Alcohol Paraphernalia

  • Flasks

  • *hidden* alcohol stashes

  • Empty nips

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