Recognizing Substance Use

For more detailed information on individual substances, visit the "Drugs" page at

Early Signs 

  • A change in peer group
  • Decline in academic performance
  • Missing classes or skipping school
  • Loss of interest in favorite activities
  • Carelessness with grooming
  • Changes in eating or sleeping habits
  • Deteriorating relationships with family members and friends


  • Red bloodshot eyes
  • Very giddy 
  • Paranoid or anxious
  • Increased appetite (the "munchies")
  • Slowed speech/reactions
  • Increased mood swings
  • Odors remain on clothing


  • Glassy and unfocused eyes
  • Poor balance and reaction time
  • Slurred speech
  • Odor remains on breath
  • Increased energy at night - sleepy in the morning
  • Possible headache or vomitting after heavy consumption/binge drinking

Opiods (Prescription medications, heroin)

  • Pinpoint pupils
  • Fatigue
  • Impaired condition
  • Slowed breathing, heart rate, reflexes,
  • Sleepiness or sedation
  • Heroin smells like vinegar on breath
  • High energy - then falls asleep

Cocaine, LSD, Ecstasy, Methamphetamines

  • Pupils dilate - grow larger
  • Needle tracks
  • Runny nose, nose bleeds
  • Paranoia or anxiousness
  • Chronic bad breath - chemical, sulfur smell
  • Smoked crack - smells of burning rubber
  • Snorting - excessive nosebleeds or sniffles
  • Manic episodes = lack of sleep
  • Cocaine - breath smells of gasoline or ether
  • Fast heart rate
  • Agitation or erratic attention span
  • Mood swings or depression
  • Twitching, shaking, itching
  • Hallucinations
  • Fact:  Michigan had 2,335 overdose deaths in 2016. 1,689 were opioid-related, up from 1,275 opioid-related deaths in 2015.
  • Fact:  MAPS Data indicates 690,782 Controlled Substance Prescriptions were dispensed in MI equaling 47,943,624 units prescribed in 2016.
  • Fact:  On 4/29/17, National drug Take Back Day, Michiganians gave back 20,370 pounds of unused prescription pills, according to the U.S. DEA.
  • Fact:  There are over 23.5 million people in long-term recovery in the U.S. from a substance use disorder. People do recover and get well.
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