Alcohol, cannabis, pills and hidden substances

Alcohol, cannabis, tablets, powders and other substances affect children differently depending on age, body size, tolerance, mental state, other substances taken and whether the product is genuine. Children may not know what they have taken, and peers supplying the product may be uncertain too. Unknown pills and unregulated vapes deserve particular caution because they can contain unexpected or dangerous ingredients.

Staff should not assume a child is safe because they are talking, laughing or insisting they feel fine. Intoxication can deteriorate quickly. A child who has mixed substances, taken an unknown pill or presents very differently from usual may need urgent clinical assessment or emergency care.

Substance concerns that need a careful response

• Alcohol: watch for vomiting, unsteadiness, reduced responsiveness and aspiration risk.
• Cannabis: watch for panic, confusion, collapse or unusual agitation.
• Unknown tablets or powders: treat the uncertainty itself as a danger.
• Hidden medicines: prescribed and over-the-counter products can still cause harm if misused or shared.
• Mixed use: combining substances can increase risk sharply.

If the product is unknown, the risk is not lower because the label is missing. The risk is higher.