How can you spot teenage substance use? Read about the warning signs, risk factors, how to talk to your teenager and when to seek AMATEM or medical help.
A packet you have never seen before in your teenager's room, unexplained spending, new friends you do not know, a young person who cannot wake in the mornings and has bloodshot eyes... Faced with signs like these, many parents swing between panic, anger and helplessness. Teenage substance use, across a wide range from cigarettes and alcohol to cannabis, stimulants and synthetic substances, is a serious issue that can affect a young person's health, development and future. But when it is noticed early and approached in the right way, there are important opportunities for the young person to come through it. In this article we look step by step at the warning signs of substance use in teenagers, the risk and protective factors, how to talk to your teenager and where to turn in which situations.
Why Is Teenage Substance Use So Important?
Adolescence is a period in which the brain develops and is restructured rapidly. The brain regions involved in decision-making, impulse control and risk assessment continue developing until the mid-twenties. Substances used in this period can affect the developing brain more than they would an adult's and can increase the risk of addiction.
Teenage substance use usually progresses as a process: curiosity and experimentation, occasional use, regular use and addiction. Not every experiment turns into addiction; but the earlier use begins, the greater the likelihood of problems in later years. For this reason, noticing and intervening early is of great importance.
In Turkey in recent years too, it has often been stressed that synthetic substances can spread among young people and that, because their contents are uncertain, they can lead to unpredictable and severe consequences. E-cigarettes and flavoured products are also among the products that young people try easily because they are perceived as "harmless".
What Are the Warning Signs of Substance Use in Teenagers?
Many of the signs below can also be confused with the ordinary changes of adolescence. A single sign does not mean substance use; but several signs appearing together, with marked and sudden changes in behaviour, is a situation that needs attention.
Physical Signs
- Bloodshot eyes, dilated or constricted pupils
- Sudden change in sleep pattern: sleeping excessively or insomnia
- Marked increase or decrease in appetite, changes in weight
- Slurred speech, problems with balance and coordination
- Unusual smells on the body, clothes or breath
- Frequent runny nose, nosebleeds
- Marked neglect of personal care
Behavioural Signs
- A sudden drop in school performance, frequent absences
- Moving away from old friends, a new circle of friends they do not want to introduce
- Excessive secrecy, locking their room, constantly hiding their phone
- Unexplained need for money, money or belongings going missing from home
- Coming home late, inconsistent explanations about where they were
- Losing interest in activities they used to enjoy
Emotional Signs
- Sudden mood swings, unexplained outbursts of anger
- Restlessness, anxiety or paranoid thoughts
- Apathy, loss of motivation, not caring
- Depressive feelings, withdrawal
Clues That May Be Noticed at Home
- Materials such as rolling papers, lighters, small bags or burnt foil
- Frequent use of eye drops or deodorisers
- Medicines or alcohol at home going down
When you notice these signs, it is important to stay calm and try to understand the situation rather than jumping to a conclusion at once.
Why Do Young People Use Substances?
Curiosity and the Wish to Experiment
In adolescence, openness to new experiences and the wish to push limits increase. The thought "Once won't hurt" is common among young people.
Peer Influence and the Need to Belong
Being accepted by a group is very important for teenagers. If there is substance use in the friendship group, the young person may feel pressure to try it in order not to be excluded.
Trying to Cope with Emotional Difficulties
Some young people who experience anxiety, depressive feelings, loneliness, traumatic experiences or intense exam stress may use a substance as a way of coping with these feelings. This is also described as "self-medication" and requires the underlying problem to be addressed.
Family and Environmental Factors
- Substance or alcohol use in the family
- Conflict, violence or neglect at home
- Little parental supervision and interest
- Easy access to substances
- Content on social media that glamorises substances and presents them as "fun" and "harmless"
Suppose a seventeen-year-old, in a year when YKS preparation (the national university entrance exam in Turkey) is intense, tries a substance said to be "relaxing" in their friendship group. At first they feel their exam anxiety ease; over time they begin to use the substance more often and to need it before studying. In this example, although the substance appears to be a temporary solution to the anxiety the young person cannot cope with, it actually creates a cycle that makes the anxiety and problems worse.
Individual Vulnerabilities
Attention deficit hyperactivity disorder, impulsivity, low self-esteem and academic difficulties are counted among the risk factors for substance use.
Protective Factors: How Important Is the Family?
As well as risk factors there are protective factors, and a significant part of them are in the family's hands:
- A warm, trust-based and open relationship with the parent
- An engaged parenting style in which the parent knows where the young person is and who they are with
- Clear, consistent rules with explained reasons
- Areas in which the young person feels valued and capable: sport, art, volunteering
- A home environment in which they can express their feelings and share their problems
- Commitment to school and positive relationships with teachers
These protective factors keep their importance after substance use has begun, too. Young people who keep their bond with their family, who have an area in which they feel valued and who have an adult they can tell their problems to can join the treatment process more easily and sustain change for longer. For this reason, even in a difficult period it is necessary not to break the relationship with the young person and to remember that every short, calm contact you make is valuable.
One of the strongest protections against substance use is that you are the first person who comes to the young person's mind in a difficult moment.
How Should You Talk to Your Teenager? Step-by-Step Advice
1. Calm Yourself First
When you notice a sign, your first reaction may be anger or fear. This is very understandable. But a conversation held in anger usually ends in denial and shutting down. Give yourself time before talking, and if necessary talk to your partner or a specialist and plan how you will approach it.
2. Choose the Right Time and Place
Do not try to talk when the young person is under the influence of a substance or very tired. Choose a time that is calm, private and not rushed.
3. Share Your Observations Instead of Accusing
Instead of "You're taking drugs!", use sentences based on observation and feeling, such as "I've seen you looking very tired lately, your grades have dropped and I found this in your room. This worries me, and I want to understand what's going on."
4. Listen
Listen to what the young person says without interrupting. Try to understand their curiosity, the situations in which they felt pressure and why they tried the substance. Listening does not mean you approve; it means you are trying to understand.
5. Set Clear but Loving Boundaries
State clearly that you do not accept substance use; but while doing so, let them feel that your love is not conditional: "I don't accept your using substances, because your health and your future matter so much to me. I love you and I'm with you through this."
6. Avoid Threats and Humiliation
Sentences like "I'll throw you out of the house" or "You're a disgrace to this family" can lead the young person to move even further from the family and towards a circle that uses substances.
7. Take a United Stance as Parents
When one parent is strict and the other lenient, the young person can exploit this contradiction. Talk to your partner beforehand and agree a common stance.
8. Do Not Put Off Getting Support
Even if the conversation goes well, when substance use is involved it is important to get support from a specialist. To understand how addiction affects the family and how the family can protect itself in this process, you can look at the article on addiction and the family.
9. Look After Yourself Too
Being the parent of a young person who uses substances can create intense anxiety, guilt and burnout. Finding a support space where you can share your own feelings lets you accompany your young person in a healthier way.
10. Start Talking Before a Problem Arises
You do not have to wait for a sign to talk about substance use. Something encountered in the news, a series or social media can be a natural opportunity for a chat: "Did you see this story? Are things like this talked about at your school too?" Chats like these let the young person gain information and think in advance about how they can say "no" when they meet an offer. It also provides a protective assurance to tell the young person that if they find themselves in a difficult situation, for example in a setting where substances are being used, they can call you and that their safety will come first.
When Should You Seek Professional Support? AMATEM and Psychiatric Referral
Whenever you suspect substance use or learn that it is happening, it is recommended that you consult a specialist. Get support without waiting especially in the following situations:
- If use is regular or increasing in frequency
- If synthetic substances, stimulants or more than one substance are being used
- If school, family or legal problems related to substance use have arisen
- If withdrawal symptoms such as restlessness, insomnia or tremor are seen when use is stopped
- If depression, intense anxiety or thoughts of self-harm accompany it
A medical assessment is essential in substance use. In this process, an assessment by a psychiatrist is necessary. In Turkey, treatment for substance addiction is carried out in the psychiatry departments of state and university hospitals and in AMATEM (Alcohol and Substance Addiction Treatment Centre) units, the state addiction treatment centres. For young people under 18, child and adolescent psychiatry departments and ÇEMATEM (Child and Adolescent Substance Addiction Treatment Centre) units provide services. For information and referral you can also call ALO 191, the Narcotics Control Advice Line. If you wonder about the difference between the roles of a psychologist and a psychiatrist, you can read the article on the difference between a psychologist and a psychiatrist.
If the young person has an emergency such as clouded consciousness, difficulty breathing, a seizure, extreme agitation or a risk of self-harm, call 112 (emergency services) without delay.
How Is Teenage Substance Use Addressed in Therapy?
Treatment of substance use is often a multifaceted process. Psychiatric assessment and medical follow-up are fundamental, but psychotherapy is also an important part of the process and is carried out in cooperation with the treatment team.
In the adolescent counselling process, a safe relationship is first built in which the young person can express themselves without being judged. In the Cognitive Behavioural Therapy (CBT) approach, the young person learns to notice the situations, thoughts and feelings that trigger the urge to use. Work focuses on the ability to say "no" to peer pressure, coping with stress in healthy ways, problem solving and emotion regulation. Prevention plans are prepared for situations in which the risk of returning to use is high.
Problems underlying substance use, such as anxiety, depression, traumatic experiences or low self-esteem, are also brought into the focus of therapy. Family sessions help parents strengthen their communication skills, build consistent boundaries at home and support the young person's recovery process.
Frequently Asked Questions
Should I secretly check my teenager's room or phone?
Where there is a serious concern about safety, it is understandable for parents to supervise more closely. However, secret checks can damage trust. Where possible, it is healthier to voice your concerns openly and, if a check is needed, to explain the reason for it to the young person.
They only tried it once. Will they become addicted?
Not every experiment turns into addiction; but this experiment is a sign that should be taken seriously. Having a calm conversation with your teenager, understanding the reasons for the experiment and, if necessary, getting an assessment from a specialist can help prevent the process from progressing.
Does an e-cigarette count as substance use?
E-cigarettes generally contain nicotine, and nicotine is an addictive substance. Although young people often perceive these products as harmless, nicotine addiction can have negative effects on the teenage brain and can open the door to trying other substances.
My teenager refuses treatment. What can I do?
This is very common. As a first step, you as a parent can talk to a specialist and plan together how to approach your teenager. You can also get referral from AMATEM, ÇEMATEM or psychiatry units and from the ALO 191 line; it is important to know that you are not alone in this difficult process and that getting support is always possible.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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