Think Your Friend Might Be Using Drugs? Don’t Start With an Accusation

Photo: Ben White

Maybe your friend, roommate, or child has started disappearing from plans. Maybe they’re suddenly missing class, asking for money, sleeping at strange hours, or barely talking to anyone anymore.

Or maybe something just feels… off.

When a young adult’s behavior changes dramatically, it’s easy to jump to conclusions, especially when substance use is part of the concern. But many of the same behaviors can also be connected to depression, anxiety, other mental health conditions, sleep problems, or the general upheaval of young adulthood.

So what are you actually supposed to do?

Start by paying attention to the pattern, not trying to play detective.

1. Notice What’s Actually Changed

Everyone changes.

A young adult might get a new group of friends. They might stay out later. They might want more privacy from their parents or roommates. They might have a chaotic week because of exams or work pressure.

None of that automatically means something is wrong.

What matters more is a significant change from their usual behavior that sticks around.

Dr. Jesse Viner, MD, CEO and Chief Medical Officer at Yellowbrick, believes that social withdrawal, isolating from friends or family, a marked drop in school or work attendance, and failing to complete academic responsibilities can all merit attention, particularly when several changes happen together over an extended period.

Yellowbrick is a trauma-informed, neuroscience-based residential treatment program for adolescents and emerging adults ages 16-30s with bipolar disorder, depression, anxiety, PTSD, ADHD, eating disorders, and personality disorders, using an Open Therapeutic Community model since 2005.

Think of it as a pattern interrupt. You know what this person normally looks like. Pay attention when their everyday life starts looking substantially different.

2. Don’t Assume Every Red Flag Means Drugs

This one is crucial.

A person who is suddenly withdrawn may be using a substance.

They may also be depressed.

A person who can’t concentrate may be struggling with substance use.

They may also be exhausted, anxious, or dealing with another mental health issue.

A person whose sleep has completely changed may be dealing with a substance-related problem.

Or they may simply have an increasingly chaotic schedule or sleep disorder.

There isn’t a single behavior that can tell you what is happening. The Substance Abuse and Mental Health Services Administration (SAMHSA) notes that behavioral and physical signs often overlap significantly across substance use disorders, major depression, and high-stress life transitions, making individual symptoms unreliable on their own.

Jessup specifically cautions that changes such as secrecy, unexplained absences, new friendships, declining academic performance, mood swings, and withdrawal from family can indicate a more serious problem, but that problem is not necessarily drug-related.

The goal isn’t to diagnose someone.

It’s to notice that something may deserve attention.

3. Look at Responsibilities, Too

One of the biggest clues can be what happens outside someone’s social life.

• Are they still showing up to class or work?
• Are they turning in assignments?
• Are they paying bills or keeping commitments?
• Are they taking care of basic daily hygiene and routines?

Substance use can interfere with executive functioning and task initiation, making everyday responsibilities harder to manage.

But again, the important thing isn’t one missed assignment. It’s a sustained change in someone’s ability to function.

If a person who normally handles school or work suddenly can’t seem to get started on anything, and that change comes alongside isolation, secrecy, unexplained absences, or other concerning behavior, it may be time to check in.

4. Don’t Turn Money Into an Interrogation

Financial changes can also be part of the picture.

Maybe someone who rarely asks for money suddenly needs it constantly. Maybe their spending has changed dramatically. Maybe they’re being vague about where money is going.

That can understandably make people suspicious. But confronting someone with, “Where is all your money going?” or “I know you’re buying drugs,” can shut down the conversation before it begins.

Instead, start with what you’ve actually observed: “I’ve noticed you’ve been asking for money a lot lately, and I’m worried about you. Is everything okay?”

That’s very different from an accusation. It gives the other person somewhere to go besides immediate denial and defensiveness.

5. Your Tone Matters More Than a Perfect Script

This may be the hardest part.

When you’re worried about a friend, sibling, or child, you want answers immediately. You may want to list every strange thing they’ve done over the past month and finally tell them what you think is happening.

But Jessup says the way you approach the conversation matters enormously. “Tone is more important than picking the right words, asking the right questions, or having all the answers,” he says.

That means you don’t need a perfect script. You need curiosity. You can state what you’ve noticed, ask how they’re doing, give them space to respond, and then actually listen.

“Be curious and invite your young adult to share their experience,” Jessup says. “Be brief. iI’s usually better to listen than to lecture.”

So What If They Deny Everything?

You don’t have to solve the mystery in one conversation.

If someone insists they’re fine, you can still pay attention to what happens next:

• Are the changes continuing or getting worse?
• Are more areas of life being affected?
• Are they becoming increasingly isolated?
• Are school or work responsibilities continuing to fall apart?

If the concerning pattern persists, another conversation may be necessary, and professional support may be appropriate. Clinical guidance from the American Academy of Pediatrics emphasizes that early, non-judgmental conversations often lay the groundwork for a young adult to accept help later, even if their initial reaction is denial.

The important thing is to avoid turning the situation into a courtroom where you have to prove your theory. You are trying to understand what is happening, not win an argument.

The Goal Isn’t to Catch Someone

It can be tempting to think of substance-use concerns as a problem of detection: Find the signs. Catch the person. Make them admit it.

But that’s rarely a constructive approach. The bigger question is whether a young person’s relationship with substances, or whatever else may be happening, is interfering with their ability to live their life.

• Are they functioning?
• Are they maintaining relationships?
• Are they meeting responsibilities?
• Are they able to regulate their emotions?
• Are they becoming increasingly isolated?

Those questions can tell you far more than trying to identify one specific physical symptom. And they leave room for something equally important: the possibility that the underlying problem isn’t substance use at all.

Sometimes the First Intervention Is Just a Conversation

A concerned friend, roommate, or parent doesn’t need to have all the answers before saying something.

You can start with an observation. You can ask what has changed. You can listen without judgment. You can keep the door open.

Substance use can be complicated, particularly when it intersects with mental health, emotional regulation, and the challenges of becoming independent. The first conversation doesn’t have to fix everything, it just needs to make it a little easier for someone to stop dealing with everything alone.