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What to Do When You Suspect Your Teen Has Been Drinking

If you suspect your teen has been drinking, check their safety first and watch for alcohol-poisoning signs. Have the real conversation when they're sober, then consider a clinician's confidential screen.

Talk to a clinician

Dr. Elena Ruiz, MD — Pediatrician (Adolescent Medicine)

Confidential CRAFFT/S2BI screening after a suspected drinking incident, ruling out depression or anxiety, and SBIRT-based next steps with school coordination. Gale can match you with a licensed clinician for a visit.

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First, check safety

Before anything else, make sure your teen is physically okay. Can you wake them easily? Are they breathing normally and able to talk? Alcohol poisoning is a medical emergency, and the signs — confusion, vomiting while drowsy or unresponsive, slow or irregular breathing, cold or bluish skin, or being unable to wake up — mean you call 911 immediately rather than 'letting them sleep it off.' Never leave a heavily intoxicated teen alone to sleep. Safety comes before any conversation about consequences.

Wait for a sober, calm moment

A teen who has been drinking can't have a useful conversation, and neither can a parent who is frightened or furious. Once you know they're safe, table the discussion until everyone is sober and calm — often the next day. When you do talk, describe what you noticed without name-calling, ask what happened, and listen before you respond. The goal is to understand whether this was a one-time experiment or part of a pattern, because those call for very different responses. Occasional experimentation is statistically common, and national data show adolescent substance use has held at historically low levels in recent years — useful perspective for keeping your reaction proportionate 1.

Decide whether this needs more than a talk

A single incident usually warrants a clear, calm conversation and a refreshed safety plan. Signs that it may be more than a one-off — and worth professional input — include drinking to cope with stress or sadness, drinking alone, repeated use, or use that's affecting school, mood, or friendships. Adolescence is the developmental window when substance use disorders most often begin, so patterns that repeat deserve a closer look rather than a wait-and-see 2. You don't have to make that call alone.

When a clinician helps

This is a good moment to involve your teen's pediatrician. They can use a brief, validated screen built for teens — the CRAFFT, where a score of 2 or higher signals a substance-related problem worth addressing 3, or a single-question screen like the S2BI that sorts use into clear risk levels 4. Because the screen is confidential, teens often answer more honestly with a clinician than with a parent. The clinician can also rule out depression, anxiety, or other causes feeding the behavior, and — if the screen flags something — deliver a brief intervention and referral to treatment, the SBIRT approach the American Academy of Pediatrics recommends for adolescents 5. They can help you set proportionate next steps and coordinate with school when that's appropriate. Asking the office for a confidential substance-use screen at the next visit turns a scary night into a concrete plan.

Reset the relationship and the safety plan

After the conversation, restate your expectations clearly and reaffirm the safety net: your teen can always reach you for a ride if they or a friend have been drinking, no questions asked that night. Pairing clear consequences with a preserved relationship is what makes a teen more likely to come to you next time instead of hiding it.

Common questions

Should I punish my teen right away?

Handle safety first and wait until everyone is sober and calm before discussing consequences. Reacting in the heat of the moment tends to escalate things and shut down the conversation. Clear, proportionate consequences land better the next day.

Is it ever safe to just let them sleep it off?

Not if you're unsure how much they drank. Watch for alcohol-poisoning signs — trouble waking, vomiting while drowsy, slow or irregular breathing, cold or bluish skin — and call 911 if any appear. Don't leave a heavily intoxicated teen alone.

Do I need to involve a doctor after one incident?

A confidential screen is reasonable even after one incident, because it can tell experimentation apart from a developing problem and catch related issues like depression early. Your pediatrician can do this privately at a routine visit.

Talk to a clinician

Dr. Elena Ruiz, MD — Pediatrician (Adolescent Medicine)

Confidential CRAFFT/S2BI screening after a suspected drinking incident, ruling out depression or anxiety, and SBIRT-based next steps with school coordination. Gale can match you with a licensed clinician for a visit.

Find care →

Alcohol poisoning is an emergency

  • —Can't be woken or is only briefly responsive
  • —Vomiting while drowsy, asleep, or unresponsive
  • —Slow, shallow, or irregular breathing
  • —Cold, clammy, pale, or bluish skin
  • —Confusion, seizures, or a very slow heart rate

If your teen shows any sign of alcohol poisoning, call 911 immediately and do not leave them alone or 'let them sleep it off.'

This article is general education and not a diagnosis or emergency instruction; when in doubt about safety, call 911.

References

  1. 1.National Institute on Drug Abuse (NIDA), NIH; conducted by University of Michigan (Monitoring the Future) (2024). Reported use of most drugs among adolescents remained low in 2024 (Monitoring the Future survey). National Institute on Drug Abuse (NIH). link ✓National Monitoring the Future data show adolescent use of most substances has held at historically low levels.
  2. 2.National Institute on Drug Abuse (NIDA) (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide. National Institute on Drug Abuse (NIH). link ✓Adolescence is a key developmental window for the onset of substance use disorders.
  3. 3.Knight JR, Sherritt L, Shrier LA, Harris SK, Chang G (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent Medicine. doi:10.1001/archpedi.156.6.607 ✓A CRAFFT score of 2 or higher is the optimal cut point for identifying substance-related problems in adolescents.
  4. 4.Levy S, Weiss R, Sherritt L, Ziemnik R, Spalding A, Van Hook S, Shrier LA (2014). An electronic screen for triaging adolescent substance use by risk levels. JAMA Pediatrics. doi:10.1001/jamapediatrics.2014.774 ✓The S2BI single past-year frequency question discriminates among no use, use without disorder, and mild/moderate vs severe substance use disorder.
  5. 5.Levy SJL, Williams JF, AAP Committee on Substance Use and Prevention (2016). Substance Use Screening, Brief Intervention, and Referral to Treatment. Pediatrics. doi:10.1542/peds.2016-1211 ✓The AAP recommends pediatricians routinely screen adolescents for substance use and deliver SBIRT as part of preventive care.

5 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.