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Key Takeaways:

  • Substance use or abuse in teens refers to the harmful use of psychoactive substances, such as alcohol and illicit drugs.
  • There are many signs of substance use, including behavior, appearance, and physical well-being.
  • Substance use is treated in a multitude of ways but often involves parents or guardians and the community.

Parents and guardians do their best to protect their teenagers from outside pressures, but at times, these social norms can be very influential. It may be considered “normal” to experiment with substances in our teen years, and others even see it as a rite of passage. However, substance abuse in teens is all too common. Understanding what constitutes substance abuse can help not only parents and guardians but also teens themselves, as they can make more informed choices.

Substance Abuse in Teens

When we talk about substance abuse in teens, we are referring to the harmful use of psychoactive substances, such as alcohol and illicit drugs. This is often considered a type of behavior that is to be expected during the teen years, similar to mood swings or rebellion.

While dabbling in substances is not uncommon, it would not be prudent to consider it as a normal characteristic of teenage years. Rethinking our perception of norms is helpful here as we challenge the idea that “everyone smokes” or “everyone drinks.”

Substance abuse can have a major impact on a teen’s life. It is during this time that the teen brain is developing and in the process of maturing. A teenager’s brain is more focused on seeking rewards and taking risks than the adult brain [*]. At the same time, teenagers try to attain more freedom as they explore different facets of their personality.

As they go through the challenges of their adolescence, teenagers may sometimes find excuses or reasons for substance abuse. Understanding these reasons is essential to keep teenagers healthy and safe.

Causes of Teen Substance Use

There are several causes of teen substance abuse.

  • To cope with stress, trauma, pain, or other mental health symptoms.
  • Social norms, including the behavior of other adults and posts on social media
  • Popular culture
  • Pressure from peers
  • To experiment
  • To feel good

Knowing the underlying cause is essential in addressing the problem of substance abuse in teenagers.

Signs of Substance Use in Teenagers

Identifying the early signs of teen substance abuse is crucial for treatment success. As with several other conditions and disorders, substance abuse is easier to treat when we recognize it early on. Adults need to watch for indicators suggesting that experimentation has turned into an addiction. Here are some common signs:

Behavioral changes

One of the most apparent warning signs for teen substance abuse is sudden behavior change. While teens’ moods normally change drastically daily, recognizing troubling trends is essential. Some behavior changes that may point to substance abuse include the following:

  • Unusually happy
  • Inability to focus
  • Lack in motivation
  • Acting suspicious
  • Breaking rules
  • Loss of interest in usual activities
  • Overly high energy
  • Avoiding eye contact
  • Unusually silent
  • Coordination is off


Appearance can also change when an individual has a substance abuse problem. Some common changes in appearance may include:

  • Having a red or flushed face
  • Smelling of substances, like smoke or alcohol
  • Lack of usual hygiene
  • Marks on arms and fingers

Physical well-being

The most obvious signs that your teen may have a substance abuse problem are changes in their physical well-being. Adults may notice the following physical signs in a teen:

  • Slurred speech
  • Dramatic weight loss or gain
  • Vomiting
  • Lethargic
  • Consistently sick

Types of Substances Abused by Teens

Teens typically abuse several types of substances. These include:

  • Depressants - Alcohol
  • Stimulants - Tobacco, Cocaine, Methamphetamine, Adderall
  • Hallucinogens - Psilocybin mushrooms, LSD, Ecstasy, Marijuana, PCP
  • Opiates/Opioids - OxyContin, Vicodin, Fentanyl, Heroin
  • Benzodiazepines/tranquilizers - Valium, Xanax

Younger adolescents, on the other hand, are more likely to abuse substances such as:

  • Cough syrup
  • Household cleaners (inhalation)
  • Glue
  • Varnish

Effects of Substance Abuse on Teenagers

Substance abuse can pose many risks for adolescents in various ways. It may lead to academic difficulties, physical health problems, relationship challenges, and even legal involvement. Teen substance use can also lead to negative consequences for the family, community, and society.

Teens who use substances are also at higher risk of mental health problems. Recreational drugs and alcohol may temporarily alleviate symptoms of mental health conditions such as anxiety and depression since they affect the same brain regions of these disorders. However, teens may end up feeling worse when not using drugs or alcohol. Substance abuse also undermines treatment by reducing a teen’s engagement in therapy. It may also hamper the effect of any prescription medications they may be taking or increase their non-compliance with taking said medications.

There are also other ways that substance abuse can affect teenagers, such as the following:

Effects on the brain

Mental health and neurological development can be affected by substance abuse. Conditions like depression, personality disorders, and anxiety can occur. Substance abuse can also cause developmental delays [*]. Research has shown that using marijuana can impair an individual’s short-term memory and learning abilities, particularly during intoxication [*].

Effect on the body

Substance misuse can lower inhibitions and impair judgment, leading to risky behaviors like driving under the influence or engaging in unsafe sexual practices [*]. As a result, teens can significantly increase their risk of death from accidents, illnesses, suicide, and homicide.

Effect on social life

While alcohol is commonly referred to as a “social lubricant,” it can be detrimental to the social life of teens. Adolescents may feel the need to cope with peer pressure that influences them to use substances. As such, engaging in substance use becomes a means for acceptance and ease of interaction with peers. However, it is common for teens who partake in substance use regularly to disengage from school activities [*], which can lead to social alienation and stigma.

Treatment and Support for Teenagers

Providing treatment and support for teenagers who engage in substance use starts with an active role from the parents or guardians. The following strategies can help when navigating substance use with teens:

  • Do not minimize experimentation. Do not foster an environment where your teen can occasionally use substances. Instead, set expectations that such activities will not be encouraged. Promote other activities instead for them to have fun and be social.
  • Be honest about your own substance use. Setting a good example for your teenager is essential. For instance, if you have developed a habit of drinking alcohol to unwind after work, be transparent. Try to manage your own substance use so that your teen can emulate the behaviors you wish to see.
  • Quickly respond to changes in behavior. If you notice any of the behavioral red flags mentioned above, then it is time to act swiftly and appropriately. Have direct conversations with your teen, and, if needed, address their behaviors with a doctor or mental health professional.
  • Do not ignore risk factors or mental health issues. If your teen is using substances, then the cause of it may have started much earlier. Observe your teen’s behavior. Perhaps they may be experiencing difficulties with mental health, such as anxiety or depression.
  • Be flexible. Helping your teen quit substances is a process, and setbacks and relapses may be part of it. Be patient with your teen and be flexible with their substance use recovery journey.
  • Reduce access to substances at home. Keep alcohol and your medications away from your teen.
  • Get help. If you feel that your teen is struggling with substance use or mental health issues, then intervene and get support as soon as possible.

Community Involvement and Support

Getting the community involved in cases of substance abuse can help teens overcome it. Depending on the severity of the substance use, different treatment options may be suitable for different teenagers. Parents can consult their physician or a counselor to choose the best treatment plan for their teen.

Many schools and community centers have educational programs that teach teens about the consequences of substance use. These places will also inform parents about access. There may be mentoring programs that help teens connect and get help with their issues and concerns to prevent them from turning to substance use in the first place.

If intervention is required, there are several types of treatment programs readily available to teens and their families. Parents and guardians can consult with their primary care physician for referrals and check what their health insurance policy may cover.

Treatment options for teen substance abuse include the following:

  • Self-help groups. There are programs like Alcoholics Anonymous that hold group sessions. This may help your teen connect to others who have had similar experiences.
  • Outpatient therapy. This involves seeing a specialist on a regular basis, often weekly. It is best to consult a therapist who is experienced in treating patients with substance use issues. They can address why a teen feels the need to turn to substances and how to replace this with something more healthy and productive.
  • Intensive outpatient programs (IOP). IOP programs typically take place two to five days per week and involve therapy and treatment appointments.
  • Residential treatment centers (RTC). Patients in this type of program typically stay in a treatment facility for about 30 days. Here, they will have individual and group therapy to treat their mental health and urgent need for substance use. There are specific treatment centers for specific substances.
  • Partial hospitalization programs (PHP). PHPs are more intense therapeutic programs that last for several hours a day, several days a week. Patients undergoing this program will spend most of their day at the facility to receive treatment and then return home in the evening. PHPs can last between 10 to 12 weeks and may sometimes replace school.
  • Attachment-based family therapy. Attachment-based family therapy can be effective for teens who use substances in order to cope with traumatic family experiences. It uses an evidence-based approach to treat anxiety and depression in teens by repairing any damage in the family system. This type of therapy also aims to rebuild trust within the parent-child relationship.

The Bottom Line

It is never too soon to start discussing substance use with your teens. If your child is struggling with substance use and mental health, it may be helpful to refer to some of our handouts for more information on good mental health. The conversations you have now will help your teens make healthier decisions in the future.


  1. Galván A. The Teenage Brain: Sensitivity to Rewards. 16 April 2013.
  2. Squeglia LM, Jacobus J, Tapert SF. The Influence of Substance Use on Adolescent Brain Development. 1 January 2009.
  3. Schoeler T & Bhattacharyya S. The effect of cannabis use on memory function: an update. 23 January 2013.
  4. Davis-Stober C, McCarty K, McCarthy D. Decision Making and Alcohol: Health Policy Implications. 8 March 2019.

Adachi-Mejia A, Gibson Chambers J, Li Z, et al. The relative roles of types of extracurricular activity on smoking and drinking initiation among tweens. May 2014.

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