Substance abuse of any kind is dangerous. Persons of all ages can quickly, or over a period of time, become victims of their own negative behavior. Substance abuse becomes substance dependence. A person's choice of abused substance is often determined by age, economics, social or ethnic group, peer pressure and other personal and societal factors.

Remember: Some of the signs of abuse listed below may signify normal behavior variability or health problems. Signs are not proof. Conclusions should be based on facts, not on assumptions.

We hope this information will help you to recognize persons abusing substances so that they can be helped. In situations where signs and symptoms seem obvious, it is advisable to bring your observations to the attention of an appropriate person such as school nurse or counselor, family member, employee assistance or personnel liaison or the primary care physician.

A word for parents: Be very frank but not accusatory in discussing and questioning adolescents about suspected substance abuse. If you are unsure as to how to do this, consult with a local treatment professional licensed by the state in which you live. If you live on Long Island, call (516) 364-2220 and we will be pleased to help you.

Alcohol Abuse Warning Signs:

• odor on the breath
• intoxication
• difficulty focusing: glazed appearance of the eyes
• uncharacteristically passive behavior; or combative and argumentative behavior
• gradual (or sudden in adolescents) deterioration in personal appearance and hygiene
• gradual development of dysfunction, especially in job performance or school work
• absenteeism (particularly on Monday)
• unexplained bruises and accidents
• irritability
• flushed skin
• loss of memory (blackouts)
• availability and consumption of alcohol becomes the focus of social or professional activities
• changes in peer-group associations and friendships
• impaired interpersonal relationships (troubled marriage, unexplainable termination of deep relationships, alienation from close family members)

Depressant Abuse Warning Signs:

There are few readily apparent symptoms of depressant abuse, which may be indicated by activities such as frequent visits to different physicians for prescriptions to treat "nervousness," "anxiety," "stress," and so on.

• symptoms of alcohol intoxication with no alcohol odor on breath (remember that depressants are frequently used with alcohol)
• lack of facial expression or animation
• flat affect
• flaccid appearance
• slurred speech

Hallucinogen Abuse Warning Signs:

• extremely dilated pupils
• warm skin, excessive perspiration and body odor
• distorted sense of sight, hearing, touch; distorted image of self and time perception
• mood and behavior changes, the extent depending on emotional state of the user and environmental conditions
• unpredictable flashback episodes, even long after withdrawal (although these are rare)

Inhalant Abuse Warning Signs:

• substance odor on breath and clothes
• runny nose
• watering eyes
• drowsiness or unconsciousness
• poor muscle control
• prefers group activity to being alone
• presence of bags or rags containing dry plastic cement or other solvent at home, in locker at school, or at work
• discarded whipped cream, spray paint, or similar chargers (users of nitrous oxide)
• small bottles labeled "incense" (users of butyl nitrite)

Marijuana Abuse Warning Signs:

Marijuana users are difficult to recognize unless they are under the influence of the drug at the time of observation. Casual users may show none of the general symptoms.

• rapid, loud talking and bursts of laughter in early stages of intoxication
• sleepy or stuporous in the later stages
• forgetfulness in conversation
• inflammation in whites of eyes; pupils unlikely to be dilated
• odor similar to burnt rope on clothing or breath
• tendency to drive slowly - below speed limit
• distorted sense of time passage - tendency to overestimate time intervals
• use or possession of paraphernalia including roach clip, packs of rolling papers, pipes or bongs

Narcotic Abuse Warning Signs:

• lethargy and drowsiness
• constricted pupils fail to respond to light
• redness and raw nostrils from inhaling heroin in powder form, possibly traces of white powder on nostril
• scars (tracks) on inner arms or other parts of body from needle injections
• use or possession of paraphernalia, including syringes, bent spoons, bottle caps, eye droppers, rubber tubing, cotton, and needles; such items may be left in lockers or drawers at work or school, or hidden at home

PCP (Angel Dust) Abuse Warning Signs:

• unpredictable behavior; mood may swing from passiveness to violence for no apparent reason
• symptoms of intoxication
• disorientation; agitation and violence if exposed to excessive sensory stimulation
• fear, terror
• rigid muscles
• strange gait
• deadened sensory perception (may experience severe injuries while appearing not to notice)
• pupils may appear dilated
• mask-like facial appearance
• floating pupils, appear to follow a moving object
• comatose (unresponsive) if large amount consumed; eyes may be open or closed

Stimulant Abuse Warning Signs:

• dry mouth and nose, bad breath, frequent lip-licking
• excessive activity, difficulty sitting still, lack of interest in food or sleep
• irritability, argumentative nature, nervousness
• talkative, but conversation often lacks continuity; changes subjects rapidly
• runny nose, cold or chronic sinus/nasal problems, nosebleeds
• use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws