Substance Use
Drug & Alcohol Use
While substance use among teens is lower now that it has been in decades, many high schoolers experiment with drinking and illicit drug use. Early experimentation with drugs and alcohol can permanently damage teenagers’ brains. Teens who use drugs and alcohol are also more likely struggle with addiction later in life.
Risk Factors
For decades, researchers have tried to determine how the cycle of drug abuse begins and who is most at risk for developing an addiction. The question remains, why do some kids use alcohol or drugs? And of those kids, why do some develop addictions while others don’t? The bottom line is that there is no one specific reason. Factors that influence whether someone becomes addicted include genetics and family environment.
Growing up, certain risk factors may be more influential at different stages. During early childhood, aggressive behavior, lack of parental supervision, poverty, undiagnosed mental health issues, and child abuse should be addressed with appropriate interventions.
Not all youth will develop problems with drugs or alcohol, but mounting stressors may make it more likely. Some adverse childhood experiences (ACEs), such as child abuse or divorce, may affect individuals well into adulthood. Clinicians may ask about their patients’ adverse childhood experiences in order to assess the impact of early trauma on their lives. Examples of ACEs include:
Witnessing domestic violence in the home.
Growing up with family members who abuse drugs or alcohol.
Experiencing physical, verbal, or sexual abuse.
Being physically or emotionally neglected.
Seeing a parent treated violently.
Mental illness in the household.
Experiencing a divorce.
Having a family member incarcerated.
Adverse childhood experiences have been identified as contributing factors in more than half of all serious problems with drug use in adulthood. A study published in 2017 found that the rate of prescription drug abuse increased by 62% for every additional ACE experienced.
Protective factors such as a strong parent-child bond or a positive student-teacher relationship can be extremely powerful and have a huge impact on reducing the risk of teen substance abuse. Examples of protective factors include:
High self-esteem.
Clear expectations for behavior.
Healthy peer groups.
Ability to make friends.
Secure attachment with parents or other caregiving figures.
Supportive relationships with family members.
Consequences of Adolescent Substance Use
There are many consequences of using drugs at a young age, including accidents, injuries, unprotected sex, homicide, suicide, and intoxicated driving. The association between substance use and negative outcomes isn’t limited to just illegal drugs. In fact, alcohol is one of the biggest threats to adolescent safety. According to the DAWN Report, between 2010 and 2013, emergency room visits where alcohol was the only substance involved accounted for 78.8% of all underage visits.
While teen illicit drug use is declining, overdose rates continue to be concerning. According to the Centers for Disease and Control:
Between 2014 and 2015, teen drug overdose rates increased by 19%.
The drug overdose rate among youth ages 15 to 19 doubled between 1999 and 2007, declined from 2007 to 2014, and rose again in 2015 to 3.7 deaths per 100,000 people.
Of all the drug overdoses among youth ages 15 to 19, 80.4% were unintentional and 13.5% were suicide attempts.
Academic Effects
Research shows that the brain continues to develop into adulthood (up to age 25). Drug use may change the way your brain processes and retains information and can have an effect on how well you can think, focus, concentrate, and remember. High school students who abuse drugs tend to:
Have lower grades.
Have higher rates of missing class.
Be more likely to drop out of school.
Overall, the changes to brain functioning differ by the substance abused.
For example:
Heavy drinking can lead to decreased performance on tasks that require attention, spatial skills, memory, and executive functioning.
Using marijuana can affect your attention, memory, and ability to learn. These effects can last for days or weeks, even after you stop taking the drug.
Schools have the potential to be a safe environment where teachers can work with parents, health care professionals, and community members to implement effective drug and alcohol prevention strategies. They can also identify students who show risks for drug-related problems and make the appropriate referrals for support services. A student who is dealing with drug or alcohol treatment deserves privacy, and supportive school officials should be mindful that the details of a student’s situation be limited to their parents, doctors, and treatment specialists.
Talking to Your Teen About Drug Use
As a parent, caregiver, coach, or teacher, you are in a unique position to notice subtle alterations in a teen’s life (e.g., changes in personality, appearance, school performance, or social activities). These changes could indicate that they are dealing with substance use issues. Teens who are abusing drugs often exhibit problem behavior such as lying about what they are doing or where they are going, stealing money or prescriptions, asking for money, or withdrawing from family activities.
It can be intimidating to think about broaching the subject of substance abuse with your child. But, the best way to prevent further drug use is to talk to your child and build trust with them. To prepare for the conversation, you can visit online resources, including the Partnership for Drug-Free Kids, which offers free helplines, blogs, and forums for parents. You can call their helpline Monday through Friday from 9 am to 5 pm to speak with a counselor about how to talk to your teen. Depending on your situation, the Partnership for Drug-Free Kids also offers Parent Coaching to teach parents about Community Reinforcement and Family Training (CRAFT). The hotline number is 1-855-378-4373.
Dos and Don'ts
Having open conversations about suspected drug use is a powerful tool that all parents have. Below are some dos and don'ts when talking to your child:
Do:
Show you care.
Establish open communication.
Ask open-ended questions.
Take deep breaths and control your emotions.
Keep an open mind.
Show them that you will support them in getting help.
Avoid:
Reacting to what your child shares with anger.
Telling your child they are wrong.
Interrupting your child while they are speaking.
Teasing or criticizing your child.
Setting unrealistic expectations.
Inconsistently enforcing consequences for breaking rules or not making those consequences clear.
Before starting the conversation, take some time to think about what you want to discuss with your child. Choose to talk when you have time and you are free from distractions. Keep in mind that you don’t have to cover everything in one conversation or come to any type of resolution. If your child feels like they are being forced to confess something or that you don’t trust them, they may be less likely to open up honestly in the future.
Getting Teens the Help They Need
Adolescents with substance use disorders differ from their adult counterparts and have different treatment needs. Treatment requires taking into account the teen’s individual experience and how it affects the severity or nature of their drug use.
Depending on the nature of the addiction, the teen may start with detoxification (e.g., if they have been abusing alcohol or prescription drugs like opioids or benzodiazepines). During this time, they may be prescribed medication to manage any uncomfortable withdrawal symptoms. Once fully stabilized, they should transition into the next tier of treatment—rehabilitation—which can take place in a number of settings, including:
Residential treatment program. In a residential rehab, the child lives on-site at the facility while they receive care. Residential programs offer 24-hour supervision. Programs vary in length but typically last for 30-90 days or more. Depending on the teen’s specific needs, the treatment center may offer services to address any co-occurring eating or mental health disorders, family therapy services, and more. You can also find a center that caters to a specific gender, age range, or substance abused.
Intensive outpatient program: These are designed for adolescents who do not require inpatient treatment yet need more than one or two visits a week with a therapist. These centers offer comprehensive approaches designed to help teenage boys and girls break free of harmful thought patterns that fuel addiction. Depending on the program, the teen may engage in a number of therapy groups including individual therapy, group therapy with other young people, education groups, and family therapy groups.