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 2,729 overdose deaths in 2017. 1,941 were opioid-related and 699 were a result of Heroin use.
  • Fact:  2017 MAPS Data indicates 19,943,203 Controlled Substance Prescriptions were dispensed in MI.
  • Fact:  October 2018, National drug Take Back Day, Michiganians collected approximately 40,000 opioids at 60 statewide collection sites.
  • 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.
  • Fact:  In 2017, the number of opioid prescriptions dispensed decreased by 10.7 percent since 2015.
  • Fact:  In 2017, there were more deaths from drug overdoses than car crashes in Michigan.
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