It is important
to stress
that these
are possible
but not
conclusive
signs of drug use.

There are many signs and symptoms that go along with substance use and abuse.  The following list describes some of the changes you may see take place.  In and of themselves, the symptoms may not mean a thing. However, if you see several of them, consider it a warning flag and seek further help.

PHYSICAL SYMPTOMS

• Acting intoxicated.
• Bloodshot or red eyes, droopy eyelids.
• Imprecise eye movement.
• Wearing sunglasses at inappropriate times.
• Abnormally pale complexion.
• Change in speech patterns and vocabulary patterns.
• Repressed physical development.
• Sudden appetite, especially for sweets.
• Unexplained weight loss or loss of appetite.
• Neglect of personal appearance, grooming.

BEHAVIORAL
   PROBLEMS

• Unexplained periods of moodiness, depression, anxiety or irritability.
• Strongly inappropriate overreaction to mild criticism or simple requests.
• Decreased interaction and communication with others.
• Preoccupation with self, less concern for the feelings of others.
• Loss of interest in previously important things, such as hobbies and sports.
• Loss of motivation and enthusiasm.
• Lethargy, lack of energy and vitality.
• Loss of ability to assume responsibility.
• Need for instant gratification.
• Changes in values, ideas, beliefs.
• Change in friends, unwillingness to introduce friends to family.
• Curfew violations.
• Unexplained large sums of money.

CHANGES IN SCHOOL

• Decline in academic performance, drop in grades.
• Reduced short-term memory, concentration and attention span.
• Loss of motivation, interest, participation in school activities, energy.

• Frequent tardiness and absenteeism.
• Less interest in participation in classes and meetings.
• Sleeping in class or meetings.
• Untidy appearance, dress, personal hygiene.
• Slow to respond, forgetful, apathetic.
• Increased discipline, behavioral problems.
• Change in peer group.
• Disappearance of money or items of value.

PHYSICAL EVIDENCE

• Odor of marijuana (like burnt rope) in room or on clothing.
• Incense or room deodorizers.
• Eye drops, mouthwash.
• Marijuana cigarettes.  (hand rolled and twisted at each end)
• Powders, seeds, leaves, plants, mushrooms.
• Capsules or tablets.
• Cigarette rolling papers.
• Pipes, pipe filters, screens, strainers.
• "Roach" clips.  (metal clips to hold the butt of the marijuana joint)
• "Bongs," water pipes.  (usually glass or plastic)
• Small spoons, straws, razor blades, mirrors.  (for use with cocaine)
• Stash cans.  (soft drink, beer, deodorant and other cans that unscrew)
• Unfamiliar small containers or locked boxes.
• Plastic baggies or small glass vials.
• Drug-related books, magazines, comics.

Heroin. After an initial rush, users experience alternately wakeful and drowsy states, often feeling drowsy for several hours. Due to the depression of the central nervous system, mental functioning becomes clouded, and breathing may become slowed to the point of respiratory failure. Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, and liver disease. In addition, pulmonary complications, including various types of pneumonia, may also result. Heroin overdose may cause slow and shallow breathing, convulsions, coma, and possibly death. Injection remains the most prevalent method of ingestion, particularly for low purity heroin.

Cocaine. Cocaine use inflicts tremendous damage to American society, enslaving over 3 million hard-core addicts and sending more than 160,000 Americans to hospital emergency departments annually. People who use cocaine can experience increased heart rate, muscle spasms, and convulsions. They often don't eat or sleep regularly. Cocaine can cause heart attacks, seizures, strokes, and respiratory failure. If snorted, it can permanently damage nasal tissue. It also can make people feel paranoid, angry, hostile, and anxious, even when they're not high. Cocaine interferes with the way the brain processes chemicals that create feelings of pleasure, so users continue to need more of the drug to feel normal. People who become addicted start to lose interest in other areas of their life, such as school and friends. People who share needles can also contract hepatitis, HIV/AIDS, or other diseases. Cocaine may be snorted as a powder, converted to a liquid form for injection with a needle, or processed into a crystal form to be smoked.

Methamphetamine. Methamphetamine is highly addictive, and its effects include psychotic behavior and brain damage. Chronic methamphetamine use can cause violent behavior, anxiety, confusion, and insomnia. Users also can exhibit psychotic behavior including auditory hallucinations, mood disturbances, delusions, and paranoia, possibly resulting in homicidal or suicidal thoughts. The drug can cause damage to the brain detectable months after use, similar to damage caused by Alzheimer's disease, stroke, or epilepsy. Withdrawal symptoms include depression, anxiety, fatigue, paranoia, aggression, and intense cravings for the drug.

Marijuana. Marijuana contains toxins and cancer-causing chemicals, which are stored in fat cells for as long as several months. Users experience the same health problems as tobacco smokers, such as bronchitis, emphysema and bronchial asthma. Some effects of marijuana use include increased heart rate, dryness of the mouth, reddening of the eyes, impaired motor skills and concentration, frequently hunger, and increased desire for sweets. Extended use increases risk to the lungs and reproductive system, as well as suppression of the immune system. Occasionally, hallucinations, fantasies, and paranoia are reported.

Inhalants. Inhalants affect the brain with great speed and force and can cause irreversible, physical and mental damage. Users can lose their sense of smell; experience nausea and nosebleeds; and develop liver, lung, and kidney problems. Inhalants can starve the body of oxygen, forcing the heart to beat irregularly and more rapidly. Chronic use can lead to muscle wasting and reduced muscle tone and strength. Inhalants can be deadly, even with the first-time use, causing death by suffocation, choking on vomit, or heart attack. Inhalants include numerous household and commercial products (glue, paint thinner) that can be abused by sniffing or "huffing" (inhaling through one's mouth) for an intoxicating effect.

Club Drugs. Club drugs, such as Ecstasy (MDMA, methylenedioxy- methamphetamine), Rohypnol (flunitrazepam), GHB (gamma-hydroxybutyrate), and ketamine (ketamine hydrochloride) can damage neurons in the brain and impair senses, memory, judgment, and coordination. The physical effects of Ecstasy include muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, and chills or sweating. Health risks include severe dehydration and death from heat stroke or heart failure. The drug suppresses the need to eat, drink, or sleep and subsequently allows people to stay up all night, dancing at raves. Heavy users can have significant impairments in visual and verbal memory. Users may experience increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease. Ecstasy also induces a state characterized as "excessive talking." Side effects including anorexia, psychomotor agitation, and profound feelings of empathy, result from the flooding of the serotonin system. Often used in conjunction with other drugs, a growing numbers of users are combining Ecstasy with heroin, a practice known as "rolling."

Steroids. The repercussions of steroid use are enormous. Among teen-agers, steroid use can lead to an untimely halting of growth due to premature skeletal maturation and accelerated puberty changes. Steroid users risk liver tumors, high blood pressure, severe acne, and trembling.

Alcohol. Symptoms include, and many doctors miss these: Recurrent abdominal pains, job-related anxiety and stress, intermittent elevated blood pressure, gastritis visible on gastroscopy, trouble sleeping and irritability, normal libido, no psychiatric history.