• changes in mood or behavior — depression, anxiety, being irritable, withdrawing from family, school or social activities, spending increased time alone, impulsiveness; 
• changes in friends — no longer associates with friends and is reluctant to bring friends home, or to have you meet them; 
• changes in school behavior — cuts classes, gets lower grades, loses interest in school or extracurricular activities; and 
• injuries — falls, bruises, accidents. Any unexplained injury (unlike a sports related injury) is a serious warning.
• Drug Paraphernalia Products designed for use with controlled substances, “paraphernalia,” are legally sold in various types of stores that youth may frequent.  A few examples are: rolling papers, roach clips, stash cans, bongs, frisbees with attached pot pipes and cocaine spoons. Every day items may also be associated with drug use. The following items are used with the corresponding drugs and may be found in closets, under beds, in the hem of curtains and in various hiding places: 
• marijuana: rolling papers, plastic baggies, stash cans, pipes, bongs, roach clips; 
• PCP: tin foil; 
• inhalants: cleaning rags, empty spray cans, tubes of glue, soft  drink cans, ping pong balls; 
• Codeine: Cough syrup bott les, needles, syringes; 
• heroin and morphine: needles, syringes, cotton balls, teaspoons, medicine droppers; 
• cocaine: glassy surfaces, mirrors, single-edged razor blades, rolled-up paper tubes, straws, nasal sprays; and • crack: pipes, small glass vials, colored stoppers, pyrex tubes, small screens. 

For parents who suspect a child is using drugs, finding any of these items may be cause for alarm. If found, it is time to frankly discuss drug use with the youth and also to seek professional help.