Substance Use

If children take the substances often enough, their body or mind may become dependent on them (in other words, they need the substances to function). The child will have negative physical and emotional reactions to not having the alcohol or drugs. Children can also develop a tolerance for the substance. The alcohol or drug will no longer make them feel drunk or high the way it did at first, and they need more of it to feel that way.

Signs and Symptoms

Typical signs and symptoms of substance use and dependence include:

• Fatigue or red and glazed eyes
• A lasting cough
• Sudden mood changes or irritability
• Irresponsible behavior
• Withdrawal from the family
• Decreased interest in school or a negative attitude toward school
• A drop in grades
• Discipline problems at school or problems with the law

Evaluation and Diagnosis

Substance use can affect every aspect of a child’s life and can lead to problems in school, with relationships, and even with law enforcement. Continued substance use can lead to medical problems, as well. For these reasons, it is important that it is diagnosed as early as possible. Unfortunately, substance use is also an issue that can be easily hidden. Substance use and dependence is typically diagnosed in adolescence, but it can occur in younger children.

If you think your child has a substance use and dependence problem, your child may need a comprehensive psychiatric evaluation or psychotherapy evaluation.

In addition to an evaluation, a provider will usually do a toxicology screening to determine what types of substances are in your child’s system. Sometimes a child may not know exactly what he or she has ingested, so it is important to establish exactly what types of chemicals are present.

Typical Co-Existing Diagnoses

Substance use is often a sign of other mental illnesses. A child may use alcohol or other drugs as a way to feel better and reduce the symptoms of a mental illness. For example, a child who is depressed may use drugs as a way to feel happier, or a child with anxiety may use alcohol to help him or her relax. If your child is using substances, it is important to both seek treatment for the substance use and have him or her evaluated and possibly treated for other mental illnesses.

Treatment

Substance use and dependence can be treated by a licensed mental health counselor, a psychotherapist, a child and adolescent psychiatrist, or an advanced practice registered nurse.

Learn more about mental health support

There are many successful treatments for substance use and dependence. Treatment includes drug or alcohol rehabilitation, which allows the child’s body to get over any physical dependence to the substance. In addition, individual and family psychotherapy are suggested forms of treatment. Medication may be used to reduce emotional or psychological dependence on a substance. Treatment of any existing mental illnesses can also help in treating substance use.

Learn more about mental health treatment

Many treatment facilities exist specifically to treat substance use and dependence and provide comprehensive programs for children with substance use problems. Treatment programs can include twelve step programs and peer support from friends who do not use substances. In particular, treatment programs usually address how the child is spending their time and figure out a way to keep the child busy through recreational or vocational services. As children with substance use problems may have trouble in other areas, comprehensive programs also usually include legal, family, and medical services. 

If substance use and dependence is affecting the child’s ability to learn, adjustments may need to be made in their education program.

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