Example of Substance Abuse Emma is a 14 year-old 9th grader. In the past 6 months, she has been skipping classes and frequently coming into school several hours late. On her most recent report card, Emma received all Cs and Ds, perhaps unsurprising given that she has difficulty completing assignments and would prefer to hang out with her new friends rather than study. She has also decreased the amount of time she spends with her family in favor of smoking marijuana in the evenings after school with her friends. In addition, once a week they meet up before school and smoke a joint before heading to class at 10:00 am. Emma's parents frequently express their growing concern for her safety and their disapproval with her behavior, which often spirals into an intense argument. Emma admits that her drug use has been getting in the way of her schoolwork and feels bad that her family has been so upset. To make matters worse, Emma was approached by police on two different occasions, and almost faced an arrest for possession. She said her encounters with the police were quite frightening and made her think about cutting down on her marijuana use, but she finds it very difficult to stop.

Substance abuse and dependence are each forms of problematic substance use. Signs that an individual's substance use has reached the level of abuse are that his or her substance use interferes with school or a job and/or disrupts family relationships and friendships. Someone struggling with substance abuse may show sudden drops in academic performance and be unable to stop despite frequent conflict with family or friends.

Substance dependence is more severe. Some signs that an individual's substance use has reached the level of dependence are that he or she repeatedly uses drugs in a physically dangerous situation (i.e., driving under the influence), focuses on substance use to the neglect of other interests, often uses more than intended or for longer periods of time, and cannot cut down or quit if desired. Someone struggling with substance dependence may show academic failure, spend most of his or her time using alcohol or drugs, hang out exclusively with substance-using friends, and have experienced injury, illness, or legal repercussions related to substance use.

Source: Waldron, H. B. & Turner, C. W. (2008). Evidence-based psychosocial treatments for adolescent substance abuse. Journal of Clinical Child & Adolescent Psychology, 37, 238-261.