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Substance Use and Abuse in Teens: What parents can do to help stop teens from starting alcohol, tobacco and drug use

by Richard Gallagher, PhD

Underage teen girl drinking from a red plastic cup

Summer is a great time for teens to have fun and engage in learning experiences outside of school, but recent findings tell us that it's also a great time for teens to get involved in substance use. Surveys with teens indicate that more teens take their first steps in experimenting with substance use in June and July than during the school year. Freedom from classes, more unscheduled time, and less adult supervision all contribute to many teens trying all forms of substances for the first time. Although this may seem like a fairly innocent rite of passage, other studies tell us that even experimentation is especially risky for teens, because of how teens' brains develop.  

Adolescence, by definition, is a time of risk taking—brain imaging has shown us that teens are hard-wired to take more chances as the parts of the brain that generate ideas and make decisions continue to mature and grow. Many aspects of this phase of brain development are beneficial, allowing teens to be creative and flexible in their thinking, and helping them to hone in on the pursuits they are passionate about. On the flip side, this risk-taking phase of development also makes teens vulnerable in ways that have the potential for harm and long-term problems.

Substance use is one area where the adolescent tendency to take risks often plays out, and adults who care need to be informed about those risks. The adolescent brain is not only wired to try out new actions; unfortunately, it is also more susceptible to quick addiction. Although substance use and abuse in teens is a long-term, ongoing problem, communities, schools and parents can play a crucial role in helping teens avoid cigarette, alcohol, and drug use. Adults can help by being well informed about teen substance use, monitoring teens' actions, setting clear expectations, and reducing access to substances.  

Parents need to stay informed about the possibility of substance use during the teen years. There are several patterns that parents should be aware of.

Three main substances account for the majority of substance use and abuse by teens

Tobacco (in the form of cigarettes), alcohol, and marijuana have long been the substances most widely used by teens. During the last several years, the use of each of these substances has declined, but substantial minorities of teens try these substances and engage in current use. In 2008, one third of adolescents ages 12 to 17 had used alcohol in the past year; one fifth used an illegal drug; and one sixth smoked cigarettes.

In July 2012, SAMHSA (the U.S. government's Substance Abuse and Mental Health Services Administration) released new data showing that kids are significantly more likely to try drugs or alcohol for the first time during the summer months, in June and July. For example, on an average day in June or July, 11,000 adolescents ages 12 to 17 use alcohol for the first time. December is the only other comparable month; other months average 5000 to 8000 first-time users per day. This means parents need to be especially vigilant regarding possible substance use over summer vacations from school.

Significantly, teens usually start with tobacco, followed shortly by alcohol, and then marijuana, with kids starting to experiment around 11 years of age. For many preteens, tobacco experimentation is a gateway to other substance use. However, given recent restrictions on tobacco use, patterns seem to be shifting and some preteens may jump right into alcohol use.  

The research data suggest that all parents, even those who have "good" kids, need to be alert to the possibility that their children will try substances and may move on to regular use.

Substance use follows trends

Kids' clothing choices and music go in and out of style, and so do the substances they use. Cocaine, crack, heroin, and club drugs such as ecstasy have been prevalent at times. More recently, young people are abusing prescription drugs, most notably painkillers, but also some psychiatric medications used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) and anxiety and depressive disorders.

Additionally, some kids seem ready to try any item or activity that promises new sensations or an altered mental state. Some recent examples include inhaling cleaning fluids or paint, self-induced oxygen deprivation by choking oneself for short periods of time or getting the breath squeezed out by someone else, and using pressurized air (used to clean electronic equipment) to knock out oxygen. All of these items or activities either add a substance to the body that creates a changed mental state, or deprive the brain of oxygen, which also creates a changed mental state. The Internet and word of mouth help kids find out about these trends and often encourage their use.

It's not necessary to become an expert in all of the new things kids try. Instead, just be aware that teens are prone to seek excitement. Many kids are easily tempted to try new ways to alter their experiences, either by peers directly or by the biased reports they hear that the "new thing" is great.  

Reasons teens turn to substances

In the early teen years, teens try substances for two main reasons: curiosity and peer pressure. Opportunities to try substances generally come up when kids are spending time together in small groups. Some in the group are likely to enjoy taking risks and to seek sensations that are exciting. These kids are often the ones who seek out and obtain substances from older teens or from supplies they find at home or from relatives. Other kids who are in the social cluster get exposed to substance use through the actions of their sensation-seeking friends. The teens who are observing may be motivated to try substances out of curiosity, or not wanting to feel left out. They may want to know how it feels to be high or drunk or what cigarettes taste like. Others in the group may feel pressured to participate by friends prodding them, or because they don't want to stand out.

After just one try, the brief altered state associated with substance use is often enough to make teens want to continue. Many teens enjoy being high or drunk and will look for chances to repeat the experience. Once teens are aware of these experiences, they may seek them out as a way to escape problems and find pleasure they're not getting from other parts of their lives. In the case of tobacco, initial experiences are rarely pleasant, so peer pressure or the belief that smoking is a status symbol, a sign of rebellion or being "cool" are often what keep teens involved. Soon after initial exposures, however, teens are very prone to addiction to nicotine, alcohol, and drugs. The growing teen brain is significantly more susceptible than the adult brain to a rapid course of psychological dependency and addiction, making even first-time use and casual experimentation risky.  

Risk Factors

As indicated above, many teens will experiment with substances. The factors below increase the likelihood of persistent and continued use.

  • Monetary resources: Teens from well-off neighborhoods or those with jobs are more likely to use.
  • Challenges with school, such as learning disabilities—especially if they result in school failure, or have gone undiagnosed.  
  • Disconnection from school: Students who feel alienated from the life of their school are more prone to use. A sense of connection can come from academics, friends, sports, or extracurricular activities.
  • Mental health issues, especially depression, whether diagnosed or not, can put kids at higher risk. Teens with social anxiety may find substances ease their tension, especially marijuana and alcohol. Teens with ADHD are more susceptible to tobacco use, possibly as a means of improving their concentration, which nicotine does do. Those with ADHD are more prone to early alcohol use as well.  
  • Relatives that use or have had substance abuse disorders
  • A perception that substance use is acceptable among a teen's peers, community, and/or family members
  • A history of physical or sexual abuse
  • Recent life changing events, such a divorce or death of a loved one
  • A chaotic family life, such as one in which a parent has an untreated mental illness or substance abuse problem, or families with a lack of parent-child attachment

Warning signs

It should be noted that all of these signs may be attributable to other causes, but all warrant closer attention.

Physical signs:

  • Red eyes
  • Persistent runny nose
  • Sores around the nose or mouth
  • Persistent cough
  • Sudden weight loss
  • Change in sleep habits

Psychological and behavioral signs:

  • Decline in academic performance
  • Truancy or persistent lateness
  • Change in friends, or social isolation
  • Dropping out of extracurricular activities
  • Mood swings
  • Withdrawal from family life
  • Ignoring family and other responsibilities
  • Breaking curfew, staying out all night
  • Stealing household items or cash from family members, shoplifting
  • Deterioration, or radical changes, in physical appearance or personal hygiene
  • Arrest

What Parents Can Do

A large body of research suggests that there are active steps parents can take to decrease the likelihood that their children will use substances.

1. When kids see adults using substances, they learn that use is acceptable. Diminish your children's uncontrolled exposure to substance use. This doesn't mean you should never have a drink in front of your children. Controlled exposure to moderate use will help kids learn what's appropriate for adults.

2. Be ready to talk about any substance use that your kids observe. Parents need to discuss substance use with their children, and make it clear how they expect kids to respond when offered substances.

3. Remember that children receive messages from what they see. In the case of tobacco, even legal use by adults should be accompanied by a clear statement of your expectations that you do not want your children to use these products, ever.

4. The use of tobacco, alcohol, and drugs is depicted in movies, television shows, music videos, even certain video games, and comes up in news reports. Take advantage of these instances to express your views on substance use and talk about them with your children.

5. Without resorting to scare tactics, tell your kids about the very real dangers associated with the most commonly used substances. While research shows that teens are not highly influenced by such information, discussion of potential risks and negative consequences does have some impact on the decisions teens make.

6. Teens use substances that are available, so do what you can to limit your kids' access. Teens report that they take cigarettes from relatives, sneak alcohol from home stocks, and obtain marijuana from people they know well.

7. Clearly state what actions you expect your teen to take when confronted with substance use. Teens who know what their parents expect of them are much less likely to use substances. One strategy many teens find helpful is using parents as an out: "My mom waits up for me and she'll smell alcohol on my breath/smoke on my clothes, and then I'll be grounded for the rest of high school."

8. Keep track of where and with whom your teen is and what he or she is doing after school and during other free times when you are not present. Help your teen find things to do and places to go where substance use won't be possible (i.e., after-school programs at a local Y).

What if my teen has a substance problem?

One counselor has a simple rule of thumb: three tries is experimentation; more than that is use. Abuse is characterized by the need to have the drug (whether it is marijuana, cocaine, prescription drugs, alcohol, tobacco or any other substance) and preoccupation with getting it.

Once you know that your child needs help, the most crucial step is getting the right help. You must determine what kind of intervention is best for your particular child and what is available close to home. The right help at the right time can get your child back on track. You may not know where to turn first. You can begin by using your local phone book. Start with a call to one or more of these:

  • Your family doctor
  • Hot line: usually listed under Alcoholism Treatment or Drug Abuse Information and Treatment in the yellow pages
  • Community Services: often in the white pages
  • An agency specializing in treating drug/alcohol abuse and related problems: often listed in the yellow pages under Drug Abuse
  • A local counseling or mental health center: often in the yellow pages
  • A community-based storefront counseling center
  • A social worker, psychologist, or drug counselor
  • The school guidance department or student assistance service
  • A police youth officer
  • A clergyman
  • A relative, particularly one in a helping profession
  • Web resources also provide guidance. Check out the White House Office of National Drug Control Policy, the Partnership (for a Drug-Free America), the National Institute of Health, and the Centers for Disease Control.  

Protective Factors

Not all kids try alcohol and drugs. Among those who do, many do not go on to become regular users or engage in abuse. Here are some factors that have been associated with decreased risk for substance use and abuse:

  • Strong family bonds
  • Strong ties to school, community organizations, religious organizations, or other groups that provide positive social support while discouraging use
  • Academic success
  • Reasonably high academic standards from parents
  • Participation in sports or other activities that discourage use
  • Effective parenting, in which parents are active participants in kids' lives, providing consistent, daily guidance, interaction, support, and love
  • Parents who are not afraid to be "uncool." Make sure to provide guidance and expectations for your children, including setting reasonable rules about behavior. Don't be afraid to use age-appropriate punishments, such as grounding your child. A parent who is only a "friend" to her or his child is not being a good friend in the long run, or a good parent.