Recognising Substance Abuse in Children

Addiction in children is a very difficult reality. As a society, we like to think that youth acts as a protective factor for a range of tough situations – including mental health concerns, exposure to conflict and violence, and engagement with substance abuse. But the harsh truth is that substance abuse isn’t an adult-only affair. As guardians of young people, it is important to be aware of ways that substance abuse can manifest. This can look very different from person to person, varying from unexplained behaviour changes to a decline in performance at school.

So, how do we even define substance abuse, and how common is it in children? How do we know that the children in our care are dabbling in substance use, and what steps should we take to help them?

What is substance abuse?

The NHS describes substance use as

‘A patterned use of a drug in which the user consumes the substance in amounts or with methods that are harmful to themselves or others.’

Substance abuse and substance misuse are often interchangeable terms. However, addiction is slightly different. An addiction is when substance use increases and deepens, therefore turning into a dependency. It is important to be aware that not all individuals who abuse substances experience addiction. This can depend on a range of factors, such as the substance that is being used and how frequently this is occurring. But whether abuse turns into addiction or not, it still carries potent risks – especially for young people.

When we think of drug-use, we often jump straight to illegal substances like heroin, cocaine, and cannabis. But substance abuse also refers to the misuse of:

• Prescription medications
• Alcohol
• Solvents, gases, and other inhalant substances

This means that lots of different substances can be abused, including common household objects such as cleaning supplies.

Addiction in children

A lot of the time, we focus on how the presence of addiction in the household negatively impacts children. There are many charities that work to explain the dangers children affected by substance abuse experience. Unfortunately, however, addiction is not only experienced by adults. It is not rare for young people to begin experimenting with substances themselves. This can occur for a range of different reasons.

How common is it?

Between April 2022 and March 2023, a total of 12,418 young people in England were ‘in contact with alcohol and drug services.’ This is a 10% increase from the previous year. As this number only highlights those in active treatment, we can estimate that the true number of children struggling with substances is much higher. Lots of people (both adults, teens, and younger children) battle with substance issues for some time before treatment begins.

This highlights, more than anything, the number of young people who may fall underneath the radar for a period.

What substances do children get addicted to?

Of course, like adults, young people can become addicted to any compound that has a physical and psychological addictive potential. But, there are some drugs and substances that have a higher prevalence in younger demographics.

In England, between 2022 and 2023:

• cannabis was associated with 87% of young people in treatment,
• alcohol was associated with 44%,
• cocaine was associated with 9%,
• ecstasy with 7%,
• solvent misuse with, 5.1%,
• ketamine with 4.5%,
• benzodiazepines with 2%,
• and codeine with 0.8%.

This data suggests particular increases in use of ketamine and solvent use among under 18s in the past year.

Out of all of these young people, 79% started using substances before they were 15, and 56% reported using more than one drug.

Signs of substance abuse

One of the best ways to recognise youth drug use is to be aware of the varying signs and symptoms of substance abuse in children. Some of these symptoms may be quite similar to those displayed by adults who use drugs, but others can be more specific to younger people. We also find that the specific manifestations of youth drug use can alter with age.

For example, someone aged between 8 and 10 may have a set of experiences that differ from someone in their late teens.

Warning signs

• ‘moodiness’
• unpredictability
• appearing low, sad, down or empty
• anxiety
• sudden and extreme boosts in mood
• being defensive
• lying about whereabouts and activities
• changes to social life
• isolation
• truancy
• changes in performance at school
• lack of interest in hobbies
• being combative or argumentative
• breaking rules (whether household or school rules, or the law)
• lack of hygiene
• sore, red eyes
• changes to pupil size
• sickness
• unexplained ill health
• tiredness
• withdrawal

Researchers have also linked substance use in young people with other maladaptive harmful behaviours. You may find that your child begins to engage with secondary behaviours, such as:

• self-harming
• violence towards others
• stealing
• increases use of the internet and social media
• antisocial behaviours

Signs of specific drug use

• bruises or needle marks
• sore or bleeding nose
• smelling of cannabis
• smelling of paint
• paint or miscellaneous substances on clothes, hands, or face
• sharps or other drug paraphernalia amongst personal items
• losing, spending or asking for more money than usual
• cryptic texts or online messages

Not all children will display the same signs. We are all very individual, which means that substance misuse can play out in different ways. Whilst the above signs can also signal other forms of distress, there can be more specific behaviours or evidence of potential youth substance abuse. These include:

As a parent, guardian, carer or teacher, you are often best placed to notice sudden changes in a young person’s demeanour. With that in mind, it is important to trust your gut and pursue options for support if you feel that they are necessary.

The Risks

Substance use in children and young people carries a range of significant risk. According to the CDC,

‘Youth with substance use disorders also experience higher rates of physical and mental illnesses, diminished overall health and well-being, and potential progression to addiction.’

Whilst young people can (and do) move beyond substance use, it can cause significant difficulties in both the short and longer term. Potentially the biggest risks associated with youth substance use are:

• overdose
• life-long substance difficulties
• depression
• complex mental health problems
• threats to personal safety
• engagement with criminality
• academic and professional difficulties
• financial struggles (including a heightened risk of housing insecurity)

How to Safeguard

As explained by Drug charity Talk to Frank, as a parent, ‘you probably can’t stop your child coming into some contact with drugs and alcohol,’ but that doesn’t mean that you cannot take steps to safeguard them. Safeguarding can take several forms. This includes being able to identify physical, behavioural and mental health traits connected to illicit use in children. You can support your child through substance use by:

• Helping them to access appropriate support
• Making your home a safe, open space
• Avoiding judgment
• Creating fair boundaries
• Keeping informed
• Accessing support yourself

If you are concerned about a child in your care, then there are ways to initiate support on their behalf. You can contact:

• A GP
• Their school
• A social worker
• A children’s charity
• A mental health charity
• An addiction specialist 
• Mental health professionals
• Support groups