If you or someone you know is in crisis right now: call or text 988 (Suicide & Crisis Lifeline). For a possible overdose or any medical emergency, call 911. For help finding treatment, the SAMHSA National Helpline is free and open 24/7 at 1-800-662-4357.
The short answer
Stay calm, keep communication open, find out how serious the use is and get a professional assessment. Not every teen who experiments has a disorder, but substance use during adolescence carries real risks, and early help works well. Start with your pediatrician, and keep naloxone at home. In an emergency, call 911.
First: if it is an emergency
Call 911 if your teen:
- Is unresponsive, very drowsy or not breathing normally
- Has seizures, chest pain or severe confusion
- May have overdosed. Give naloxone if opioids might be involved. (See [How to Get Naloxone (Narcan): Where to Find It Free and When to Use It].)
- Is talking about suicide. Call or text 988.
Counterfeit pills can contain fentanyl, so any pill not from a pharmacy can be deadly.
Signs a teen may be using
Teens change as they grow, so these are clues, not proof:
- Changes in friends, mood, sleep or appetite
- Declining grades or missing school
- Secrecy, lying, new need for money
- Loss of interest in activities
- Red eyes, smells, unusual items such as vapes or pipes
- Missing medications or alcohol at home
Step by step
1. Pause and plan
Do not react in anger. Take time to calm down and decide how to talk.
2. Talk privately and calmly
- Choose a time when everyone is calm and your teen is sober.
- Start with care: “I’m worried about you, and I want to understand.”
- Use “I” statements and specific observations.
- Listen. Ask open questions about what is happening and why.
- Avoid labels, lectures and threats.
(See [How to Talk to a Loved One About Addiction Without Pushing Them Away].)
3. Find out what and how much
Experimenting once is different from regular use. Ask about what, how often and with whom, and whether anything has gone wrong.
4. Get an assessment
- Call your pediatrician or family doctor. They can screen with adolescent tools, such as the CRAFFT questionnaire, and recommend next steps.
- Ask about a substance use evaluation with an adolescent specialist.
- Check for co-occurring conditions such as depression, anxiety, ADHD or trauma. (See [Dual Diagnosis Treatment: When Addiction and Mental Health Overlap].)
5. Set clear expectations and consequences
Be consistent and fair. Link rules to safety and health, not punishment alone. Include your teen in setting some limits when possible.
6. Stay connected
Keep family routines, praise positive choices and stay involved in school and activities.
7. Secure your home
Lock up alcohol and medications, and dispose of old prescriptions.
8. Keep naloxone at home
Even if you think your teen is not using opioids. (See [How to Get Naloxone (Narcan): Where to Find It Free and When to Use It].)
Levels of care for teens
| Level | When it may fit |
|---|---|
| Brief intervention and counseling | Early or low-risk use |
| Outpatient therapy | Ongoing use with stable home |
| Intensive outpatient or partial hospitalization | Need more structure |
| Residential treatment | Serious use, unsafe situations or past treatment failures |
Look for programs designed for adolescents, with licensed staff, family involvement, school support and mental health care. (See [Teen and Adolescent Rehab: Levels of Care and Parental Rights] and [Inpatient vs Outpatient Rehab: Which Level of Care Is Right for You?].)
Therapies that help teens
- Family-based therapies, which involve parents and strengthen communication
- Motivational interviewing
- CBT
- Contingency management, in some programs
(See [Evidence-Based Therapies in Addiction Treatment: CBT, DBT and Contingency Management].)
Privacy and your teen’s trust
Ask providers how they handle confidentiality with teens and what they share with parents. Balanced, honest conversations help keep your teen engaged.
Common mistakes
- Reacting with rage or punishment alone
- Ignoring signs or hoping it goes away
- Assuming it is just a phase without checking
- Giving up after one conversation
- Blaming yourself or your teen
- Trying drug tests at home without a plan for what you will do with the results. Ask your doctor first.
Take care of yourself
Support groups for parents can help. (See [Support Groups for Families: Al-Anon, Nar-Anon and SMART Recovery Family & Friends] and [Enabling vs Supporting: Setting Healthy Boundaries].)
Cost and insurance
Many plans cover adolescent treatment. (See [Does Insurance Cover Rehab? How to Check Your Benefits Step by Step] and [Free and Low-Cost Rehab Options Without Insurance].) Ask schools and local health departments about resources.
Frequently asked questions
What should I do if I find out my teen is using drugs?
Stay calm, talk privately, listen, find out how serious it is and call your pediatrician for an assessment.
Should I punish my teen?
Consequences can be part of the plan, but punishment alone rarely helps. Combine clear rules with support and treatment where needed.
How do I know if it is a phase or a problem?
Frequency, loss of control, changes in functioning and risky situations matter. A professional can assess.
Can I drug test my teen?
Talk to your doctor first about whether and how to use testing.
Where can I get help for my teen?
Your pediatrician, a school counselor, FindTreatment.gov and the SAMHSA helpline (1-800-662-4357).
Sources
- National Institute on Drug Abuse. Principles of Adolescent Substance Use Disorder Treatment. nida.nih.gov
- American Academy of Pediatrics. Substance Use resources. aap.org
- SAMHSA. FindTreatment.gov and National Helpline. samhsa.gov
This article is for general information only and is not medical advice. In an emergency, call 911. For thoughts of suicide, call or text 988.