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:  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:  Adolescents experience less health risks when their parents know about what is going on with them and their lives (CDC-April 2023)
  • Fact:  DEA National RX Take Back Day reported 599,897 lbs (300 tons) of Prescription drugs collected in Michigan on October 2023 with 4675 Collections sites now In Michigan.
  • Fact:  Michigan has distributed more than 730,000 naloxone kits and recorded over 6,600 overdose reversals since the 2020 launch of Michigan’s Naloxone Direct Portal, which provides the opioid overdose reversal medication at no charge to community groups
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