95 Kids and the Law What are signs of substance use? Warning signs of drug and alcohol problems in teens include: • Sudden change in appetite. This may be an increase in appetite and weight gain over time or decreased appetite and weight loss. • Change in appearance of the eyes, such as redness or change in pupil size. Teens may hide their eyes with sunglasses or avoid making eye contact. • Mood changes and irritability. The child shows increased sensitivity and decreased frustration tolerance—more than is typical of adolescence. The child may cry easily or fly off the handle with little provocation. • Change in sleep patterns, such as sleeping too much or too little, or sleep- ing during the day and being awake at night. • Loss of interest in school. This may include a drop in grades and perfor- mance, or a loss of interest in sports, activities, and hobbies previously en- joyed. • Changes in friends. Old friends are dropped and new friends seem secre- tive and less involved in positive activities. • Odd behaviors. These might include periods of absence from the home that cannot be easily explained, selling their property, secretive late night phone calls or slurred or disorganized speech. • Stealing. This may include taking money, jewelry, or other valuable items from family members or others. • Getting in trouble. This may include stealing, trespassing, damaging prop- erty, getting into fights or other increased risk-taking behavior. These are just some of the many warning signs of drug and alcohol problems in teens. These signs can indicate other physical or emotional problems as well. Usually drug and alcohol problems are part of a complicated larger picture and are often combined with mental health problems. For this reason, men- tal health issues and substance use disorders are sometimes called “co-occur- ring” disorders. It is very important for parents or guardians to follow-up on the signs they see. If people ignore these signs, small problems can become bigger and more difficult to treat. Mental Health and Substance Use Issues 8