Identifying Drug Abuse Among Students: A Guide for Teachers

Identifying Drug Abuse Among Students:A Guide for Teachers

It is safe to say that teachers have their hands full in today’s education system. On top of their regular responsibilities, they also have to tackle issues regarding funding, staff politics, class sizes, parental involvement, bullying, and classroom technological changes. While that does not include any personal or situation-specific elements, it is still a lot to deal with individually. Any help or guidance is greatly appreciated when it is available.

A new problem has developed in the last few decades, and many teachers are not entirely sure of how to approach it: students with drug abuse or addiction issues. Information regarding drugs often changes as new kinds and methods of use become popular. The demographics of people who abuse drugs—either in general or specific drugs—are also changing and the person using is not always an individual one might expect. Add in everything else a teacher must watch for among their students, and it can get challenging to keep up.

This guide is intended to help teachers in every branch of education catch up to what is currently known about drug and alcohol abuse and provide them with options of how to handle instances among their students. Keep in mind that this is only current information and portions of this guide may be rendered obsolete by future laws, drugs, or policies relevant to substance abuse. It is a comprehensive guide that educators can apply to multiple scenarios, even those that may occur outside of the classroom.

Educator
Responsibilities

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Student drug abuse often falls under responsibilities related to student safety and associated prevention measures. When a child is in school, the teachers, administrators, and other staff members on campus are responsible for student’s safety and well-being while the student is on campus. From a legal standpoint, federal and state laws have been put in place to create drug-free schools where any type of illicit or addictive substances are banned.[1] Prescription medications that are necessary for the treatment of a medical condition are usually excluded, but only if they meet certain requirements laid out in policies placed by the school, district, or local or state government. It is often the responsibility of any staff or student on a school campus to report violations to school administrators, who often address such situations and contact authorities when necessary.

Prevention programs, like Project ALERT[2] or the D.A.R.E program[3], are often staples in schools, and teachers are expected to encourage student participation in such programs. National or state operated-prevention programs, or even those specifically created by a school or school district, are often valuable resources for teachers in their efforts to prevent and recognize drug abuse issues in their classrooms. Some schools may also have programs designed to detect and combat instances in the event that prevention fails, with educators holding some responsibility in the execution and enforcement of such programs.[4]

Teachers may also have some responsibility to address student drug abuse under mandatory reporting laws. These laws are applicable to cases of child neglect and abuse where certain individuals, like educators, are expected to report instances to the proper authorities.[5] However, the circumstances of a student’s drug use may constitute an application of mandated reporting.

If the parent(s) are exposing or otherwise supplying their child with drugs, may be deemed as abuse under the law as they are jeopardizing their child’s safety, which makes it a mandatory reporting situation for the teacher. A report would also be necessary when the parent(s) abuse drugs, as there can be suspected abuse and neglect.[6] Indirect or unintentional drug exposure can be included, as a home-based production of methamphetamine can expose everyone in the home to the drug’s toxins.[7]

Statistics

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Without being directly impacted by it, many people are unaware of how widespread drug abuse actually is.
According to data collected by the Centers for Disease Control (CDC) in a 2016 report, 10.1% of children twelve years and older reported using illicit drugs within the last month.[8]
That may not seem like a lot, but keep in mind that that is only what was reported and only covered instances within a certain time frame. It also excludes alcohol (51.7%), prescription drug abuse (2.4%), marijuana (8.3%), and legal tobacco items (23.9%) whose usage was also reported in the same data group.
In terms of those who are of school age (12-17 years), 8.8% reported illicit drug usage, 7.0% for marijuana, 2.0% for prescription drugs, 9.6% for alcohol, and 6.0% for tobacco items in the same report.[MB18]
The Substances Abuse and Mental Health Services Administration (SAMHSA) compiled their own report in their 2015 National Survey on Drug Use and Health.[9] SAMHSA’s survey found similar data to the CDC’s, with 10.1% of those aged twelve and older reporting illicit drug use within the last month. They also expanded on usage within the past year to 17.8%, and throughout the person’s lifetime at 48.8%.[10] (See graph for more details, [11], [12]) SAMHSA’s survey did not include data on alcohol or tobacco usage. The data collection was from those who willingly reported their usage and came from a select sample size.

Symptoms by Drug Type

Universal Symptoms

While some drugs have noticeable physical signs of usage in a person that is unique to a certain type of drug (e.g., vivid and active hallucinations with hallucinogenic drugs like LSD or PCP), other symptoms generally apply to the use of virtually any illicit substance. Some of the most telling signs are behavioral. Many who abuse drugs try to hide it, either out of shame or denial.[42] These signs may include [43]:

  • Being protective of their space and things. For example, they may become extremely angry or upset if someone touches or attempts to look into his or her backpack or locker. This behavior is likely if there is evidence of their drug abuse (e.g., paraphernalia, actual drugs) in those areas.
  • Changes in interpersonal relationships, e.g., whom they are hanging out with, which can include sudden changes in friend groups or isolating from others.
  • Mood swings, especially when sudden or inappropriate to the situation. For example, being happy and angered suddenly or becoming angry in a happy situation.
  • Disinterest in extracurricular activities, especially things they were passionate about previously. Behavior changes, like being late or failing to show up for meetings or practices, poor performance, or antagonistic behavior towards peers and teammates.
  • Schoolwork issues, including poor performance and late or missing assignments. They may also have attendance issues like frequent absences or tardiness to classes or school.
  • Memory problems that can be related to school work like an inability to remember details or entire events.

In addition to behavior changes, there may also be physical signs of drug abuse in the student’s overall appearance:

  • Sudden changes in weight, including both loss and gain due to a byproduct of drug induced appetite changes.
  • Specific signs of drug use like nosebleeds or nasal irritation from snorting, coughing, or an increased thirst due to dry mouth/throat. An irritation of the mouth or throat from smoking, unexplained bruising or marks on skin, or wearing inappropriate clothing like long sleeves in warm weather to cover injection marks.[44]
  • Bloodshot eyes or noticeable changes in pupil size (e.g., small like a pinpoint or overly large).
  • Uncharacteristic poor hygiene, such as wearing dirty clothes, a strong body odor from not bathing, noticeable poor oral hygiene or health, and a general unkempt appearance.[45]
  • Flushed skin or heavy breathing, which may be a result of increased heart rate and blood pressure. The student may exhibit body shaking, trembling, tic-like movements not previously noticed, or noticeable evidence of picking at the skin on the face or arms.
  • Complaints of a headache, runny nose, profuse sweating, nausea, vomiting, or excessive fatigue and sleeplessness may be the result of substance use or withdrawal.[46]

Keep in mind that many cases of drug abuse will often time result in multiple symptoms with some degree of frequency rather than a one-time instance. There may also be a legitimate, non-drug related explanation for some of these signs, such as medical and psychiatric conditions (e.g., eating disorders, depression, or intentional self-injury). It could be due to the effects of prescribed medication or issues at home. However, educators should make efforts to take note of any of these symptoms and address them seriously.

Alcohol

Not all instances of substance abuse involve what most would consider as drugs. Alcohol is one such example. Due to its ease of accessibility and sweeping use among adolescents, alcohol use will be covered extensively in this guide. There is a social element when it comes to drinking, and students may choose or be pressured by their peers to drink in a variety of settings.[13] Students may also use drinking to cope with things in their life stress, other health conditions, situations at home, and more.

Alcohol use does not always entail constant, regular drinking; instances of binge drinking often occur, especially with young, inexperienced drinking teens. With young teens, fewer than 4 or 5 drinks in a sitting can constitute binge drinking and can entail the same consequences.  Their physical size alone (particularly young, lightweight middle schoolers) gives a single shot of alcohol more punch than it would a football-playing high schooler, for example.

It can be especially dangerous as the individual consumes more alcohol than their body can process at one time.  This may lead to alcohol poisoning, seizures, choking from vomiting while unconscious, organ or brain damage, and death.[14] The amount of drinking that commonly occurs at parties is often binge drinking, which is common among high school students.  Teenagers and young adult’s drinking at a party accounts for about 90% of their alcohol consumption.[15]

Most instances of alcohol abuse will not happen on campus, but teachers will likely be able to identify the effects it has on the student after the fact. Some signs to look for include:[16]

  • Problems with physical coordination. For example, the student may be stumbling, weaving on their feet, or experiencing balance issues.
  • Changes in speech like slurring, inability to form a coherent sentence, using an uncharacteristically loud tone, or making impulsive and inappropriate comments.
  • Lack of energy or drowsiness. A person may fall asleep or pass out if they have consumed a large quantity of alcohol.
  • Difficulty concentrating or remembering things while intoxicated.
  • Marked changes in physical appearances, such as poor physical and dental hygiene, inappropriate dress, dark circles under the eyes, or a redness of the face and neck.
  • The smell of alcohol on their breath, clothes, hair, and so forth. Keep in mind that some kinds of alcohol have a weak scent that may be undetectable.
  • Frequent hangover-like symptoms, such as headaches, sensitivity to light or sound, nausea, vomiting, extreme fatigue, or a general malaise.
  • Behavioral changes like neglecting responsibilities or producing poor quality work.

Narcotics/Opioids

Narcotics or opioids are drugs that impact a person’s senses. Many of these drugs are used legally for medical purposes, such as pain relievers, but they have strict restrictions in place that can easily cause their usage to be deemed illegal like their illicit counterparts. Opiates can be abused due to their ability to produce a sensation of euphoria in the absence of pain.  The return of that pain when the opioid leaves the person’s system can be intense, causing them to seek relief again.[17]

The longer the individual’s exposure to the drug, the higher their tolerance will become, and they will then need to take an increasingly higher dosage in order to experience its effects. Tolerance leads to dependence and addiction, and it can occur with nearly every drug in this guide.

Some opioids are prescribed, while others may be purchased on the street. They may be natural, semi-synthetic, or synthetic in the chemical makeup. Some of the most common include:

  • Fentanyl, a pharmaceutical analgesic commonly used to treat pain caused by conditions like cancer. It is similar to morphine, but is much more powerful—about 50-100 times stronger.[18] The drug can appear as a lozenge, tablet, spray, patch, or injectable.  Abused it may be injected, smoked, swallowed, smoked, or snorted depending on the form.[19]
  • Heroin, one of the more commonly known abused illicit drugs. It is derived from morphine and is a fast-acting version. Heroin appears as a powder (white or brown), or as a black substance called “black tar heroin”.[20] It can be smoked, snorted, or injected. Much of the opiates used throughout the country are in the form of heroin, and it is often mixed with fentanyl or other opioids for a stronger high.[21]
  • Methadone is an opioid often used to treat opioid addiction, and it can also be abused. Methadone can come in the form of a liquid or 5-10mg tablets, and when abused, it is often injected or swallowed.[22] Typically it can only be obtained and used under medical supervision, but some treatment programs allow for take-home use, which is the opportunity for it to make its way to the street for sale.[23]

Most opioids and narcotics produce a euphoric feeling for the user, which might not be easily identifiable to those around them. For educators, it may be best to look for the following signs[24]:

  • Noticeable changes in pupil size or response – constricted, pinpoint and a slowed response.
  • Slowed response and movements. The individual may even seem very relaxed, drowsy, and may appear to “nod off” as they may be struggling to hold their head up. An uncharacteristically sense of euphoria.
  • Other physical signs can be flushed skin, especially on the face and neck, nausea or vomiting, and a slowed breath rate and pulse.
  • Common symptoms of overdose can include shallow or labored breathing, clammy and pale skin, or convulsions.
Naloxone, a treatment for an opioid overdose, quickly reverses the effect of an overdose. According to SAMHSA, Naloxone is becoming more readily available for public use due to the high frequency of overdoses, especially in young people.

Depressants

Depressants are medications that have a calming effect on the user, and many are used to address anxiety and sleep problems. They are also commonly used to treat muscular conditions and seizures. As a result, many depressants have a legitimate usage outside of drug abuse. Most depressants come in the form of pills, and some are available as a liquid or syrup for oral or injectable use.

The effects of depressant use are largely the same regardless of the drug taken, and often with symptoms developing at different intensities. Some of the most common signs teachers may notice from students using depressants include [25]:

  • Sleepiness or lethargy that may be mistaken as laziness or tiredness.
  • Slurred or nonsensical speech.
  • Slowed or labored breathing and a slowed pulse rate.
  • Lack of coordination or muscle control, which can lead to a difficulty walking or moving normally and muscle weakness.
  • Dizziness, lightheadedness, confusion, dulled senses, and a reduced reaction time.

There are four different types of depressants, with only one having no legal usage and not an approved medication on the market in the United States.

  • Barbiturates are commonly used as sedatives and anesthetics. Most are predominantly used for medical purposes and come in either pill or tablet form. In low doses, they often cause sleepiness, mild euphoria, and a lack of inhibitions, but may also cause irritability, paranoia, and memory impairments in larger dosages.[26]
  • Benzodiazepines are prescription only depressants that were created to replace barbiturates, and thus are similar in appearance and effects. They can, however, cause hostility and disturbing dreams for some users. Some teens may be prescribed a benzodiazepine for anxiety or sleep and often are taken as needed, which can include during their school day.[27]
  • GHB or Gamma-Hydroxybutyric Acid has few legal uses and is predominantly used illegally. It is found in powdered or liquid forms, which are usually added to other liquids and swallowed. GHB has a slightly salty taste, and is otherwise unidentifiable in its liquid state. Some believe that GHB helps build muscle and contributes to weight loss.  The bulk of its illicit use is on victims of crimes, such as sexual assault because of GHB’s ability to impair memory.[28]
  • Rohypnol is neither made or sold in the U.S. through legitimate means and is entirely illegal. It appears as a tablet that can be dissolved into drinks; like GHB, it has few identifiable traits when consumed because it is completely tasteless.[29] It is predominantly used in sexual assault, but some use it recreationally by snorting it to produce a euphoric high.

Stimulants

Just as there are depressants that calm or slow the body down, there are stimulants which speed things up. They also are frequently available through legitimate means for medical usage, but can be abused to produce a rush as they increase dopamine production in the brain. The sense of exhilaration, increase energy and activity, and wakefulness stimulants produce makes them popular for those seeking a boost in focus and performance. Some stimulants are legal to purchase without a prescription and fairly common, like caffeine. Prescription amphetamines are used to treat conditions like ADD/ADHD and have a high potential for abuse. The majority, however, are illegal and not available through legitimate channels.

  • Cocaine is a stimulant derived from the natural coca plant, and is one of the most common and powerfully addictive drugs in the world. It frequently appears as a fine white powder and can be found on its own (pure) or mixed with other substances, illegal or otherwise. A “speedball,” for example, is a combination of cocaine and heroin that is injected.[30] One processed version appears as a crystal-like rock, called “crack.” Cocaine can be snorted, smoked, injected, or rubbed into the gums, and users quickly gain a tolerance and need to take increasingly higher doses to maintain their high.
  • Amphetamines are a stimulant that is often legally obtainable through a prescription, but there are some illegal versions. Ritalin and Adderall, used in the treatment of ADHD, are the most commonly prescribed, and also the most commonly available on the street. Most come in a pill form, although powdered formats are available, and are frequently swallowed or ground up for injection.[31] Prolonged legitimate usage can have the same effects as misuse, as amphetamine tolerance can build quickly.
  • Methamphetamine shares a similar chemical makeup as amphetamines, which are often used in meth production.  Methamphetamines have a more intense effect. They can appear as a white powder or a pill, or glass fragments and whitish rocks if it is in the form of crystal meth. Meth is an extremely dangerous drug, as users can develop violent behaviors, mood swings, delusions, and severe psychological effects.[32] Physically, it can increase a person’s body temperature to potentially lethal levels, cause convulsions, heart attack, and severe medical and dental problems with prolonged usage.[33]

Due to the potentially intense effects that stimulants can have on a person, there are several signs and symptoms of use that teachers can identify.

  • Notable high energy that may present through the student’s performance, such as a lot of work completed in a short amount of time, hyperactive behaviors, and repetitive movements.
  • Lack of appetite, which may cause marked weight loss and may appear to be anorexia (a restriction of food).
  • High heart rate and blood pressure are typical, which can cause a flushed skin appearance, increased body temperature that appears as profuse sweating, heart palpitations or chest pain.
  • Body and hand tremors or shaking.
  • A “crash” after the high that leads to extreme fatigue, heightened anxiety, symptoms of depression, and inability to focus.

Hallucinogens

Drugs that impact the user’s perception and mental state are considered hallucinogens. They are predominantly illegal, with very few exceptions for religious purposes. Hallucinogens can be manufactured in a chemical form or found naturally occurring in plants and fungi.

Hallucinogens can include:

  • Ecstasy/MDMA is a synthetic drug that acts like a cross between a hallucinogen and amphetamines, and it can have an intense effect on a user.[34] It comes in the form of tablets that are frequently crushed and snorted, as well as a powdered form. It is frequently mixed with other substances like alcohol and is commonly referred to as a “club” or “party” drug. High dosages can cause overheating and heart failure.
  • LSD, another synthetic drug, is colorless and odorless in most forms. It appears as a tablet, liquid, or capsule and dosages can be applied to absorbent paper squares for oral ingestion. These tissue squares are often decorated with colors, writing, or characters from pop culture. LSD has an intense effect on the user that extends long after the drug is out of the person’s system.
  • Psilocybin or “magic mushrooms” is a naturally occurring chemical found in certain species of mushrooms. The mushrooms are consumed orally, either fresh or dried, by themselves, in recipes, or brewed in teas.[35] As there are thousands of mushroom species throughout the world, it is possible to ingest psilocybin via wild mushrooms that contain the chemical accidentally.
  • Peyote/Mescaline comes from a species of cactus and is legal only for religious ceremonies by Native American tribes. The top or crown of the cactus is used and can be dried or kept fresh. The pieces look like buttons and can be soaked in water for drinking, chewed, or smoked.

The effects of hallucinogens are mostly psychological, with few physical effects.  Teachers can identify instances of use by students based on their behavior. Some hallucinogen effects include [36]:

  • A loss of appetite, nausea, and vomiting.
  • Detachment from the environment or the Self, which may manifest physically as a lack of coordination or slowed movements.
  • Auditory and visual hallucinations that the student may be interacting with by gestures, talking, or bizarre behaviors.
  • Increases in breathing and heart rate, as well as body temperature that may lead to sweating, hyperventilating, and a flushed appearance.
  • A sense of panic or paranoia, which frequently manifesting as a sudden intense distrust of others.
  • Distorted thoughts and perceptions, and a mixing of senses like seeing sounds, or a complete detachment from reality.
  • Flashbacks to a previous use of the hallucinogen and memory problems that can persist years after use have been noted.

Marijuana

While marijuana is similar to depressants in that it can produce a relaxed sensation, marijuana is not a depressant. It is a naturally occurring plant found throughout the world with psychoactive properties. The leaves of the plant are usually removed, dried, and then used.[37]The most common uses of marijuana are by smoking in a pipe or bong, as a “joint” cigarette, or a “blunt” (similar to the size of a cigar). The dried leaves can be mixed into food and consumed, or it can be brewed as a tea

Marijuana is the most commonly used drug. It has restricted legal use in some states and countries, and it can be used for recreational or medical treatment.[38] It is one of the very few—if not the only—drugs to have no known overdose effects and of which there has never been an overdose death.[39] Most of its effects include:

  • Altered senses and perceptions, especially to time.
  • Mood changes.
  • Changes in coordination and movement, which are often slowed.
  • Altered thought processes, problem-solving abilities, and marked short term memory impairment.
  • Dizziness, lightheadedness, or a loss of coordination.
  • Lack of inhibition, which may make the student suddenly more social with others, impulsive behaviors, or possible inappropriate behaviors.
  • An obvious sense of relaxation and calmness that may not be typical.
  • Coughing from throat and lung irritation.

Changes in appetite, which can be a decrease, but most often is a marked increase referred to as the “munchies”

Actions to Take

When a teacher suspects a student is using drugs or alcohol, in or outside of the classroom, they may not know how to approach the situation. Some are afraid of making a false accusation which may bring harm to the student—legally, academically, socially, or other effects. There are some conditions in which prescribed medications may have similar effects to some of the substance abuse situations discussed here, making it possible to misidentify a student’s behavior as drug or alcohol use. However, there is greater concern regarding a student’s potential drug or alcohol use than making a mistake if they actually have a substance use problem. Action should be taken carefully and quickly, but not in a rush.

Before taking any action, first, determine what made you think a student is using drugs or alcohol. Document observations for future reference: what you observed, when it took place, the name of the student or students involved, and so on. Instances of possession of illicit substances or active substance use will often be enough to alert parents and administration. Behaviors may require more evidence, such as the symptoms of particular drug or alcohol use. Look for changes in the student’s behavior like sudden absences or a decline in their academic performance.[40] Keep in mind that stress and illness can also cause noticeable changes, so be reasonable in your conclusions (e.g., one bad grade does not equal drug use).

Once an educator has clearly determined that a student is likely abusing drugs or other substances, the teacher should notify the administration of the school (principal, guidance counselors, etc.), the student’s parents or legal guardian, and/or police.[41] Even if you did not witness their active usage, this could lay the ground work for further assistance and help. In cases where it is evident that the student is using illicit substances, such as smoking marijuana on campus, steps should be taken immediately. Action should be taken should a student approach you with suspicions of a friend or classmate’s drug or alcohol use.

Should a student who is abusing drugs or alcohol approach you with their use, then you can notify administration, parents, and others with some restraint. Chances are the student wants help to stop their substance use and have approached you because they trust you. Immediately calling the police can destroy that trust and make it all the harder for them to willingly seek help again. In some cases, a teacher can act as a moderator for the student to talk with their parents about their substance use. Teachers can be a source of support at school during the student’s recovery. Information about a student’s substance use cannot be shared with other students. If you want to offer help to other students, do not refer to any other student you helped in the past.

It may be possible for a teacher to encounter drug abuse at school without the presence of the student. If you encounter drugs or alcohol, contact the proper authorities (administration, police) to handle their disposal and document the situation. The authorities may ask questions around how and where you found the substance, whom it belongs to, and more. They may also check the area where it was located for other substances and criminal evidence. Avoid disposing of a drug on your own, as you may accidentally expose yourself or cause damage like to the septic system if flushed. Avoid touching the substance(s), as police may collect evidence like fingerprints.

Each school has a set procedure in place for addressing drug and alcohol abuse on or off campus to address use by students. Educators should refer to this guide as an additional resource. Such information may be available in resources like an employee or student handbook. Do not go against school policy, procedure, laws, or any other rules and regulations in place to avoid harming yourself or the student(s).

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