Substance Abuse in Teenagers

Drug use, including alcohol and tobacco, is very common in teenagers. Parents have a major role in prevention, they are the strongest influence children have.  Talking to our children at an early age, such as grade school, can help prevent such use and abuse of drugs. To be able to talk to our children, we need to be informed.

Statistics

According to the CDC, updated 02/2020:

• Alcohol, marijuana, and tobacco are substances most commonly used by adolescents. 
• By 12th grade, about two-thirds of students have tried alcohol. 
• About half of 9th through 12th grade students reported ever having used marijuana. 
• About 4 in 10 9th through 12th grade students reported having tried cigarettes. 
• Among 12th graders, close to 2 in 10 reported using prescription medicine without a prescription. 
• Although it is illegal for people under 21 years of age to drink alcohol, the findings show that people from 12 to 20 years of age consume about one-tenth of all alcohol consumed in the United States.

Why do teenagers use drugs?

Multiple factors can lead teenagers to use or abuse drugs. Usually the first use is in a social setting and is alcohol or cigarettes. The continued use is commonly related to insecurities and social acceptance between peers. 

Common risk factors for drug abuse are:

• Family history of drug abuse 
• History of a traumatic events such as any child abuse including sexual abuse, car accident, parental death. 
• Mental health condition such as depression, attention deficit-hyperactivity disorder (ADHD), impulsivity and/or anxiety.
• Low self-esteem or feeling of social rejection.

What are the signs of substance abuse?

There are many different signs of drug use or abuse. It varies between teenagers and by the drug used.  Some common signs are:

• Change in behavior, secretive behavior
• Mood swings
• Increased tiredness
• Poor grades or decline in grades
• Poor hygiene and diminished personal appearance
• Bloodshot eyes
• Laughing for no reason
• “Munchies” or very hungry
• Odor: alcohol, marijuana

What drugs are used among teenagers?

The following are percentages for 12th graders’ drugs used in a lifetime by type:

• Alcohol - 58.5%
• Marijuana - 43.7%
• Vaping (any drug, including marijuana and nicotine) – 45.6%
• Cigarettes – 22.3%
• Amphetamines - 7.7%
• Hallucinogens/LSD – 6.9% 
• Tranquilizers - 6.1%
• Narcotics other than heroin - 5.3% (Heroin – 0.6%)
• Ecstasy - 4.9 %
• Inhalants – 5.3%
• Cocaine – 3.8%
• Steroids – 1.6%

What are the consequences of drug use?

• Drugs adversely affect the teenagers’ brain development
• Poor school performance
• Worsening of mental health conditions such as anxiety and depression.
• Higher levels of risky behavior such as impaired driving and unprotected sex.
• Long term health problems such as heart disease, sleep disorders, high blood pressure. 
• Higher chances of having addictions as an adult. 

Health effects of specific drugs:

1. Alcohol: risk of liver failure, heart failure, and dementia.
2. Marijuana: Risk of impairment of memory, learning, concentration. Risk of psychosis later in life with early and frequent use. 
3. Electronic cigarettes (vaping): Risk of lung damage depending on substance used, nicotine dependence.
4. Cocaine: Risk of heart attack, seizures and stroke.
5. Ecstasy: Risk of heart failure and liver failure.
6. Inhalants: Risk of damage to heart, lungs, liver and kidneys with long-term use.
7. Methamphetamine: Risk of psychotic behaviors from high doses and long-term use.
8. Opioids: Risk of respiratory distress, death from overdose.

What can I do as a parent?

It is very important to talk to grade school children and teenagers about drug and alcohol use. You might have multiple conversation about this through the years. Here are some tips that can help:

• Hear them. It can be helpful to let them do the talking first so it can give you a sense of where they are at about drugs, how much they know, what is their perception about them and if their friends are using or abusing drugs.
• Educate them. Let them know the damage drugs can do, immediate and long term. Not by scaring them but by educating them about these effects. 
• Social media. Ask them where do they hear about drugs, what they know and check what message social media is giving them about drugs. You can review these messages together and correct them if needed. 
• Peer pressure. This is a huge factor in drug use and it is important to discuss how to resist it. How to turn down drug offers. Saying NO is not being weak but strong. Discuss with them what would be ways to turn drugs down so they are prepared if they get to that point (which they all most likely will).
• What about you? Your teenager might ask you questions about your drug use and be ready to answer these questions. If you have not used them, explain why. If you have used them, explain your experience.

Other PREVENTIVE strategies:

• Set the example. We can talk to our teenagers, but most of what we teach is by example. If you drink, do it with moderation. Don’t use other drugs, or abuse prescription medication. 
• Know your teenager’s activities. Knowing his schedule, location, activities helps you know when these have changed (possible sign of drug use). Encourage adult-supervised activities that he enjoys.
• Friends. Know your teenager’s friends, their parents and environment. If their friend’s use drugs your teen might feel that pressure.
• Rules and consequences. Discuss rules and consequences. Place specific examples of family rules such as riding with someone under the influence, going to parties where drugs are used. If rules are broken, consequences are held.
• Track your prescription drugs.
• Positive reinforcement. When your teenager has handled difficult situations with drugs, or offerings, encourage and praise your teen.

A close bond and easy conversation with your teen are very important for drug use prevention.

If you have any questions about substance abuse in teenagers, please log into your account and send us your question. We are here to help.

Valerie Hines, MD FAAP