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Signs of Substance Use - Topic Overview

The following are some obvious signs that a person may be smoking cigarettes, drinking alcohol, or using other substances. This is not a complete list of signs to look for. If you suspect a particular drug or drugs, get more information on signs of use for those substances. For more information, see Teen Alcohol and Drug Abuse.


  • A distinctive smell on the breath and clothing
  • Cigarettes and lighter in his or her possession
  • Cigarette butts outside a bedroom window or in other odd places around the home



  • Sweet smell on clothing or bloodshot eyes, if recently used, and frequent use of eyedrops to reduce the redness
  • Drug paraphernalia (pipes) in his or her possession
  • Carelessness in grooming, increased fatigue, and changes in eating and sleeping patterns, if using regularly


  • Chemical breath, red eyes, or stains on clothing or face, if recently used
  • Soaked rags or empty aerosol containers in the trash

Club drugs

  • Skin rash similar to acne
  • Small bottles with liquid or powder in his or her possession


  • Persistent runny nose and nosebleeds, injection marks on arms or other parts of the body, or long periods of time without sleep
  • Possession of drug paraphernalia, such as syringes, spoons with smoke stains, small pieces of glass, and razor blades

LSD or other hallucinogens

  • Trance-like appearance with dilated pupils, if recently used
  • Small squares of blotter paper (sometimes stamped with cartoon characters) or other forms of the drug in his or her possession


  • Very small pupils and a drowsy or relaxed look, if recently used
  • Possession of injecting supplies, called an outfit or rig, that may consist of a spoon or bottle cap, syringe, tourniquet, cotton, and matches

Anabolic steroids

  • An unpleasant breath odor
  • Mood changes, including increased aggression
  • Changes in physical appearance that can't be attributed to expected patterns of growth and development
  • Possession of medicines or syringes

Other general signs

  • Changes in sleeping patterns
  • Changes in appetite or weight loss
  • Changes in dress
  • Loss of interest and motivation
  • Hoarseness, wheezing, or persistent cough

    WebMD Medical Reference from Healthwise

    Last Updated: 2/, 014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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