Drug and alcohol use often begins in adolescence. Globally, over 25% of youth aged 15–19 consume alcohol [1] . In fact, WHO estimates 155 m...
Drug and alcohol use often begins in
adolescence. Globally, over 25% of youth aged 15–19 consume alcohol[1].
In fact, WHO estimates 155 million adolescents worldwide are current drinkers,
and about 13.6% of 15–19 year-olds engage in heavy episodic (binge)
drinking[1].
Cannabis is also common – roughly 4.7% of 15–16 year-olds have tried it[2].
These behaviors are not harmless: WHO warns that adolescent substance use is
linked to “neurocognitive alterations” that lead to later behavioral,
emotional, social and academic problems[2].
Recent surveys mirror these global trends. For example, in the United States a
2024 Monitoring the Future study found that 41.7% of high school seniors
reported past-year alcohol use, 21.0% had vaped nicotine, and 25.8%
had used cannabis in the past year[3][4].
In Europe’s WHO region, surveys of 15-year-olds found over half of girls and
around 40% of boys had consumed alcohol in the past month[5].
By contrast, many Asian and African countries show lower reported rates: one
analysis in sub-Saharan Africa found about 11% of school-going adolescents
reported current alcohol use[6],
while higher-income countries like Australia have seen sharp declines (only 31%
of 14–17 year-olds drank in 2022–23, down from 69% in 2001[7]).
In summary, teen substance use remains widespread globally, though trends vary
by region and are influenced by culture and policy.
Psychological Factors
Adolescence is a turbulent time of emotional change and identity
formation. Many teens experiment with drugs or alcohol as a way to cope with
stress, low self-esteem, or emotional pain. For instance, one young woman (now
22) described how she started drinking “because like any teenager, I wanted to
fit in. Going to parties and drinking alcohol was the norm… I discovered that
the euphoria from alcohol beat the adrenaline rush I used to get from things
like riding rollercoasters”[8]. In her words, alcohol “became a security
blanket” that covered up deep-seated self-confidence problems[8]. (The image below illustrates how even
outwardly well-adjusted teens can struggle with hidden problems.)
Many teens appear active and confident (as in the photo above), yet may
privately battle substance use issues. One former teen recalled how alcohol
first seemed to solve her confidence and peer-pressure struggles[8].
Mental health conditions are a major trigger. Depression, anxiety, ADHD
and trauma are strongly linked to teen substance use. For example, US data show
~20% of teens report anxiety or depression symptoms[9], and those with mental health issues are
more likely to misuse substances. Suicidal adolescents and those with emotional
disorders often self-medicate with drugs or alcohol. Adverse experiences (the
“ACEs” of childhood) also play a role. About 17% of teens report having
suffered emotional abuse from a parent[10], and such trauma is a known pathway to
later addiction. Conversely, protective psychological factors can help. Teens
with high self-control or coping skills are less likely to start using.
Research finds that impulsivity or sensation-seeking traits heighten risk,
while good social-emotional learning can reduce it[11]. In short, youths struggling
internally—whether through anxiety, low self-esteem or trauma—are
psychologically more vulnerable to trying substances.
Identity and peer pressure are also powerful. Adolescents are forming
identities and fitting in. A classic example: “Henry,” a 14-year-old in a UK
case study, moved to a new school and was quickly pressured by friends into
ketamine use: “It became my addiction. I left school with one GCSE”[12]. He later reflected, “when I was using,
it shut me off from the world. I had no emotions, no feelings”[13]. This story highlights how peer dynamics
(trying to belong) and seeking an escape from negative emotions can drive early
addiction. Teens often hear mixed messages about drugs from friends and media.
Social media and gaming further amplify this effect: one survey noted that an
average teen encounters ~85 drug-related messages per day via media or
peers[14]. These constant images can make substance
use seem normal or glamorous, increasing the likelihood that an insecure teen
will try it.
Social Factors
Peer influence and culture. Peer dynamics
heavily shape teen behavior. Research shows that teens often experiment because
“everyone else is doing it,” just like the student above said[8]. If a teen’s friends use substances, the pressure to fit in is
immense. Social scientists emphasize that peer pressure is not just overt but
also about perceived norms: even seeing social media posts of friends drinking
can make teens feel they “need to engage in similar risk-taking to gain
acceptance”[15]. This is compounded by popular culture: viral challenges on TikTok and
Instagram often involve drinking or vaping as fun dares[16]. In one study, U.S. teens widely reported seeing vape and alcohol ads
or peer posts online, which correlates with higher use[17][18]. Public health experts worry about this normalization: a UK study
warned that rising youth vaping “threatens to reverse positive trends” in
adolescent health[19], and called on policymakers to ban products like disposable vapes and
tighten alcohol sales to minors. Indeed, cultural norms vary widely: in some
European countries a majority of teens have tried alcohol, whereas in many
Asian or Muslim-majority societies teen drinking is taboo. Such norms shape use
rates. For example, a UNICEF report shows European teens have the world’s
highest underage drinking rates, while strictly alcohol-prohibiting cultures
report much lower rates (e.g. <10% of teens)[1].
Family and community environment. Teen
behavior also reflects broader social context. Socioeconomic factors (poverty,
urban violence) can foster substance use as an escape. Peer factors like
bullying are significant: roughly 1 in 3 adolescents report being
bullied at school[20], which correlates with higher drug use, especially among girls.
Conversely, strong community support can protect teens. CDC data show that
feeling “connected” at school and in the community sharply reduces substance
use and risk behaviors[21]. In 2021, 61.5% of U.S. high schoolers felt connected at
school, and those students had lower rates of marijuana and opioid misuse than
their disconnected peers[21]. Social institutions—family, school, religious groups—can thus either
shelter teens from or expose them to substance risks.
Familial Factors
The family is often the teen’s primary social world, and it shapes
addiction risk on multiple levels. Parental substance use. Children of
parents with addiction face both genetic and environmental risk. One study
found that when at least one parent had an alcohol problem, 64.7% of their
children later used substances, versus 37.5% from non-alcoholic
families[22]. Early conflict in alcoholic families
(parental fights or a parent’s anger) predicted adolescent substance abuse[23]. In short, “families in which at least one
parent has an alcohol problem face considerable disruptions in...
relationships,” which “plays a significant role in putting youth at risk for
using substances”[23]. Parental neglect or abuse is also a factor:
the stresses of a parent’s untreated addiction often lead to neglect, further
pushing a teen toward drugs for escape.
Parenting style and supervision. General
parenting approach has measurable effects. Cohort research shows that authoritative
parenting (warmth + firm rules) is linked to the best substance-use
outcomes in youth[24]. In one Swedish study, authoritative parents’
teens reported less alcohol, tobacco, and drug use than those with
authoritarian or neglectful parents[24]. Conversely, neglectful parenting (low warmth
and discipline) yields the worst outcomes[24]. This aligns with global reviews: consistent
evidence shows involved, communicative parenting (monitoring friends, setting
clear expectations, yet allowing autonomy) greatly reduces teen substance use[11][25]. For example, a meta-analysis found that
general positive parenting behaviors (monitoring and engagement) had a larger
protective effect on teen drinking than narrowly focusing on alcohol rules
alone[25].
Family structure and conflict. Divorce, single
parenting, or unstable homes can contribute to teen stress. Even without
parental addiction, a chaotic home can push a teen to self-medicate. Children
raised amid marital aggression or domestic violence are at higher risk.
Research confirms that early adverse family experiences (parental anger,
neglect, a parent’s mental illness or incarceration) predict substance use in
adolescence[10][23]. On the other hand, a supportive, stable home
with engaged caregivers provides a buffer. Family-focused interventions (like
positive-parenting workshops and family therapy) capitalize on this by
repairing relationships and strengthening supervision – approaches that experts
now consider first-line in preventing teen substance abuse[11][23].
Educational Factors
Schools are a major social environment for teens. Academic stress, peer
groups, and school culture all influence substance use. Academic pressure
and stress. In high-pressure educational systems, teens under intense
stress may turn to substances to cope. Studies associate high academic demands
(e.g. exam pressure) with higher anxiety and sometimes higher drinking in
youth. Also, a poor school environment (bullying, lack of engagement) can push
vulnerable students toward drugs.
School environment and support. Alternatively,
positive school climate can protect teens. As noted, students feeling “connected”
are significantly less likely to use drugs[21]. Schools that foster supportive
relationships with adults and classmates – through counseling, mentorship, and
inclusive policies – help at-risk teens find alternatives to drug use.
Prevention education also falls here. In many countries schools run drug-awareness
programs, sometimes mandated by government. Evidence on these is mixed: for
example, generic scare-tactic programs like the old D.A.R.E. curriculum showed
little long-term benefit, whereas life-skills training and interactive programs
(teaching refusal and coping skills) have demonstrated more success. Modern
best practices include Social Emotional Learning (SEL) curricula and peer-led
initiatives that build resilience.
Awareness and screening. Some schools
implement routine screening or brief counseling (SBIRT – Screening, Brief
Intervention and Referral to Treatment). Pilot programs (e.g. a “Just Say Know”
classroom module) report that over 90% of students found such education
helpful and said it influenced their views[26]. Likewise, training teachers and counselors
to spot early signs (declining grades, mood changes) allows timely referrals.
Research from the CDC underscores that integrated mental health services in
schools – providing on-site counselors – can reduce substance misuse by
addressing co-occurring anxiety or depression early.
Medical and Biological
Factors
Biology heavily shapes addiction risk in teens. Brain development.
The adolescent brain is not fully mature, making youth uniquely vulnerable.
Neuroimaging studies (like the NIH’s Adolescent Brain Cognitive Development
Study) show that teens who begin using substances often have subtle brain
differences. For example, early initiators of alcohol, nicotine or cannabis
tend to have slightly larger total and subcortical brain volumes and
differences in cortical thickness than non-users[27]. While it’s
unclear if these differences are cause or effect (or both), they underscore a
key point: the cortex (involved in decision-making, impulse control and
memory) is still developing in teenagers[28]. Because the
prefrontal cortex matures late, adolescents are biologically predisposed to
risk-taking and sensation-seeking. This means drugs can have stronger effects –
and cause more harm – in a still-maturing brain. Indeed, WHO notes that alcohol
and drug use in young people is linked to lasting neurocognitive changes and
health problems[2].
Genetics and predisposition. Addiction has a
substantial genetic component, and vulnerabilities can run in families.
Children of addicts inherit not only genes, but also brain chemistry that may
respond more to substances. One expert summary notes that substance use
disorders result from “complex interactions among multiple genes and
environmental factors”[29] (as
discussed by NIDA and NIH). Thus even before teens try drugs, inherited factors
(like how strongly they feel the drug’s reward or stress relief) can steer some
toward addiction. For example, a teen with a family history of alcoholism may
have a lower tolerance or different dopamine responses, making alcohol more
reinforcing.
Brain effects of use. Finally, the biology of
addiction means that substances themselves can hijack the teen brain. Nicotine
and alcohol are highly addictive, and early exposure promotes long-term
dependency. Heavy drinking in adolescence can disrupt memory and learning areas
(the hippocampus), and strong opiates or stimulants can rewire reward circuits.
Even cannabis, once thought benign, has been linked to measurable changes in
attention and motivation in youth. These biological effects feed back on the psychological
level: a teen’s brain becomes “hijacked” by cravings and habit, making quitting
extremely difficult and often leading to the cycle of addiction.
Case Studies of
Affected Teens
Real-world stories illustrate these factors. Consider Abbey Zorzi
(22), who shared her experience on NIDA’s “Just Think Twice” campaign. A
normally bright kid (“I had a loving family”), Abbey began drinking in high
school to fit in[8]. Before long
she was also misusing prescription pain pills, then heroin: “I would think, ‘I
want to feel this way all the time’[30].” Abbey’s
account highlights how peer norms (“everyone was doing it”[8]) and a few
early pain pills led to full addiction by late teens. She also felt deeply
conflicted (“I hated what I was doing to myself”[30]) but
struggled with the drug’s pull.
Another case, dubbed “Henry” by a UK restorative-justice
program, shows a different path. Henry (age ~14) had no severe problems at
home, but upon moving schools he was quickly drawn into a friend’s circle of
drug use: “At 14... a friend pressured me into trying ketamine for the first
time. It became my addiction”[12]. He then
struggled with theft and isolation to sustain his habit. Henry poignantly
stated, “When I was using, it shut me off from the world. I had no emotions, no
feelings”[13]. His story
underscores the power of peer pressure and the emotional numbing effect
addiction can produce. Although now in recovery, Henry’s case reminds us that
addiction can strike even seemingly “regular” kids when social circumstances
change abruptly.
These narratives, while individual, align with research. They reflect
how peer influence, identity struggles, parental context, and biology
intertwined in real teens’ lives. They also show hope: both Abbey and Henry
eventually sought help and turned their lives around, illustrating that
intervention and support can work if delivered in time.
Prevention and
Intervention Programs
A variety of prevention and intervention programs have been launched
worldwide, with mixed but increasingly promising results. School-based
prevention. Effective programs combine education with skills training. Life
Skills Training (LST), Project ALERT, and Unplugged (Europe)
curricula teach refusal skills and social coping, and have shown
small-to-moderate reductions in teen substance initiation. A 5-year follow-up
of a personality-focused LST program in Switzerland found lasting reductions in
tobacco and cannabis use. Conversely, older programs like DARE (Drug Abuse
Resistance Education) have proven largely ineffective in the long term【73†】, illustrating that mere fear-based talks are not enough.
Family interventions. Because family influence
is so strong, family-based therapies are well-supported by evidence. Treatments
that actively involve parents—such as Multidimensional Family Therapy
(MDFT), Brief Strategic Family Therapy and Multisystemic Therapy—have
been shown to improve outcomes. For example, one trial found that teens
receiving MDFT not only reduced substance use but also delinquent behavior more
than those in standard residential treatment[31].
Reviews note that family therapy is a first-line treatment for adolescent
substance use disorders[11]. For
prevention, programs like Strengthening Families or Nurturing Parenting train
parents in monitoring and positive communication, leveraging the protective
effect of authoritative parenting.
Community coalitions and policies. Many
countries invest in community coalitions to mobilize local action. In the
United States, the Drug-Free Communities (DFC) program funds local coalitions
to coordinate prevention efforts. A 2024 federal report found significant
positive impacts: in areas with active DFC coalitions, middle and high
school students reported decreases in alcohol, marijuana, tobacco and
prescription drug use[32]. These
coalitions work by raising awareness, organizing youth activities, and
promoting policy changes (e.g. enforcing underage sales laws). Similarly,
community- or faith-based programs in Europe and elsewhere have integrated drug
education into youth groups and camps with some success.
Culturally tailored initiatives have also been notable. For example,
the Cherokee Nation’s “Walking in Balance” program uses traditional
practices to engage Native youth. This coalition’s curriculum includes Cherokee
crafts and ceremonies to build self-respect and community identity.
Impressively, 75 out of 100 teens in one tribal community attended the program,
finding meaning in cultural learning[33]. Such
programs harness cultural pride and community bonds to steer teens away from
drugs.
Solutions and
Policy Recommendations
Addressing teen addiction requires multi-faceted solutions. Below are
evidence-backed best practices for education, parenting, community, mental
health, and policy – with adaptations for different settings.
- Education and
Schools: Integrate substance education early,
focusing on skills (peer resistance, emotional coping) not just facts.
Promote school connectedness: train teachers to support struggling
students. Implement social-emotional learning (SEL) programs and mental
health counseling in schools. Enforce strict no-drug policies, but balance
with support (e.g. peer support groups). Emerging evidence shows that
schools with comprehensive programs have lower teen use. (For example, CDC
data links high school connectedness to reduced marijuana/opioid use[21].)
- Parenting and
Family: Educate parents about the risks and
warning signs. Encourage open, authoritative parenting: consistent
supervision and warmth. Family support programs (counseling,
parent-training workshops) can teach parents to monitor teens’ activities
and communicate effectively. Research shows such general parenting
strategies (monitoring, emotional support) have a large preventive impact[25].
Intervention clinics should involve whole families – family therapy is a
first-line treatment for adolescent SUDs[11].
Parenting programs (like Strengthening Families) are effective universal
interventions in many countries.
- Community Support: Build coalitions of schools, health agencies, faith groups and
youth organizations to create “drug-free zones.” Community centers can
offer pro-social activities (sports, arts) as alternatives. Engage youth
as peer mentors to influence each other positively. Promote public
awareness campaigns tailored to local cultures. Low-income regions may
leverage existing community leaders or NGOs to spread prevention messages.
For example, mobilizing religious or village elders has worked in some
African and Asian communities to discourage underage drinking. Community
solutions also include making treatment accessible: subsidize youth rehab
programs and hotlines, and reduce stigma by publicizing success stories.
- Mental Health
Integration: Screen all adolescents for
depression, anxiety and trauma as part of routine school or clinic visits.
Integrate counseling and substance misuse education into adolescent health
services. Train pediatricians and school nurses to recognize signs of
substance use and comorbid mental illness. Since ~17–21% of teens report
depressive or anxiety symptoms[9],
addressing these can cut demand for substances. Early intervention for
mood or behavior disorders can prevent substance misuse down the line.
- Policy Measures
(High-, Middle-, and Low-Income Contexts): Enact
evidence-based policies appropriate to each country’s resources. In
high-income nations, sustain strong regulations: raise the legal age for
alcohol/tobacco, enforce strict advertising limits, tax sugary-drink
alternatives, and fund national prevention campaigns (e.g. “Don’t Drink
and Drive” PSA’s have reduced drunk driving among teens). Ensure school
curricula include up-to-date drug education. In middle-income countries,
balance regulation with education – for instance, restrict sales of cheap home-brewed
spirits if common, and train teachers in rural areas. In low-income
settings, prioritize broad public health measures: use schools and clinics
to deliver simple prevention messages, collaborate with community leaders,
and integrate addiction screening into maternal/child health programs.
Importantly, mental health parity is critical everywhere:
governments should integrate adolescent addiction treatment into primary
health care, not just into criminal justice. Many global experts (WHO,
UNODC) recommend a “health-centered” approach over punitive measures.
In all settings, evidence matters. Policies should be informed
by local data – surveying teens to find the most pressing issues (e.g. rise in
inhalant use vs. alcohol) – and then tailoring interventions. Successful models
like Brazil’s school programs, Australia’s youth-drug helplines, and Finland’s
community coalitions offer blueprints. International guidelines from WHO also
stress addressing social determinants (poverty, education, violence) alongside
specific drug policies.
By combining these strategies – empowering families, educating youths,
building supportive communities, and enacting smart policies – countries can
curb the troubling trend of teenage drug and alcohol addiction. The research
and case evidence strongly indicate that no single solution will suffice;
instead, layered prevention (in school, at home, and in society) integrated
with accessible treatment for youth can create lasting change.
Sources: Global and regional statistics and
trends are drawn from WHO and public health surveys[1][3];
peer-reviewed studies on risk factors and outcomes[6][23][11]; case
narratives from public campaigns[8][12]; and
evaluations of prevention programs and policies[32][21]. All
data reflect research and reports up to 2024.
[1]
[2] Adolescent and young adult health
https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions
[3]
[4]
Reported use of most drugs among adolescents remained low in 2024 | National
Institute on Drug Abuse (NIDA)
[5]
[19]
University of Glasgow - University news - Archive of news - 2024 - April -
Research finds concerning trends in adolescent substance use in the UK
https://www.gla.ac.uk/news/archiveofnews/2024/april/headline_1068056_en.html
[6]
Prevalence and correlates of substance use among school-going adolescents
(11-18years) in eight Sub-Saharan Africa countries - PubMed
https://pubmed.ncbi.nlm.nih.gov/37420290/
[7]
The Push's Submission to the Parliamentary Inquiry into the challenges and
opportunities within the Australian live music industry — The Push
[8]
[30]
Abbey Zorzi, 22 | Just Think Twice
https://www.justthinktwice.gov/true-stories/abbey-zorzi-22-heroin
[9]
[10]
[20]
Recent Trends in Mental Health and Substance Use Concerns Among Adolescents |
KFF
[11]
[25]
[31] Adolescent Substance Use Disorder Treatment:
An Update on Evidence-Based Strategies - PMC
https://pmc.ncbi.nlm.nih.gov/articles/PMC7241222/
[12]
[13]
Henry's story | Restorative Justice Council
https://restorativejustice.org.uk/resources/henrys-story
[14]
[15]
[16]
[17]
[18]
Social Media’s Role in Adolescent Substance Use - TYDE
https://tyde.virginia.edu/social-media-substance-abuse/
[21]
School Connectedness and Risk Behaviors and Experiences Among High School
Students — Youth Risk Behavior Survey, United States, 2021 | MMWR
https://www.cdc.gov/mmwr/volumes/72/su/su7201a2.htm
[22]
[23]
Parents, family relationships influence adolescent substance abuse, UB study
finds - UBNow: News and views for UB faculty and staff - University at Buffalo
https://www.buffalo.edu/ubnow/stories/2020/08/livingston-adolescent-substance-use.html
[24] Role of parenting styles in adolescent
substance use: results from a Swedish longitudinal cohort study - PMC
https://pmc.ncbi.nlm.nih.gov/articles/PMC4735309/
[26]
More teens than ever are overdosing. Psychologists are leading ...
https://www.apa.org/monitor/2024/03/new-approaches-youth-substance-misuse
[27]
[28]
Brain structure differences are associated with early use of substances among
adolescents | National Institute on Drug Abuse (NIDA)
[29]
New NIH study reveals shared genetic markers underlying ...
[32]
Drug-Free Communities Program Successes | Overdose Prevention | CDC
https://www.cdc.gov/overdose-prevention/php/drug-free-communities/program-success.html
[33]
Walking in Balance: Culture as Prevention in Cherokee Nation | Overdose
Prevention | CDC
No comments