The adolescent may run away, withdraw, or act out at home and at school. They withdraw from family and community activities. Problems with the police and school officials increase and become serious. The adolescent may become verbally abusive to parents and more rebellious to authority figures. Life begins to center around alcohol or drugs.
Daily use begins and the patient begins to use to maintain rather than to escape.
The adolescent makes attempts to cut back or quit but they are unable to stay clean and sober. Physical deterioration begins. Hiding and lying about drugs becomes more common. The adolescent feels more intensely isolated and alone. Parents, teachers, and even peers now openly express concern.