Shivani and Justin have two teenage daughters, aged 13 and 17. Over the past six months, they’ve noticed worrying changes in their eldest daughter. Not only does she seem depressed and withdrawn, but they recently found drug paraphernalia in her room. Shivani and Justin are concerned and try to approach their daughter about her behavior, but she often gets defensive and refuses to talk. This leads Shivani and Justin to feel scared, helpless, and unsure about what to do next.

This fictional story is an example of how many parents feel when their teenage kids are abusing drugs and alcohol. Many parents feel unequipped to deal with such pressures, especially if their teen also has an underlying mental health condition. Fortunately, there are ways to help teens who develop problems with substance abuse, ranging from therapy to rehab.

Prevalence and Causes of Addiction Among Teenagers

While teenage substance abuse is still a problem in the U.S, rates have thankfully declined somewhat over the years. Below are statistics about the current state of alcohol and drug use in this age group:

  • The 2018 Monitoring the Future survey indicates that recreational use of prescription opioids among teenagers has declined dramatically over the years (from 9.2% in 2009 to 4.8% in 2018).
  • Vicodin use, for example, has dropped by over 60% among high school students. Only 30% say it is easy to obtain, compared to 50% ten years ago.
  • The same survey indicates that cannabis use among 10thto 12th graders has also declined.
  • Alcohol use is also declining, but it is still an ongoing problem. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 7.7 million Americans aged 12-20 have reported consuming alcohol in the past 30 days.
  • Worryingly, the NIAAA also states that people in this age group consume more than 11% of all alcohol in the country, 90% of which is consumed in the form of binge drinking.

Substances Commonly Abused by Teenagers

Teenagers are known to abuse a range of substances. Below are the most common.


Alcohol is the substance most commonly abused by teenagers. This is unsurprising, given the widespread accessibility of alcohol and the social acceptance of drinking in most cultures. While the legal drinking age in most countries is between 18 and 21, many adolescents below this age can still access alcohol.

One of the biggest concerns when it comes to alcohol use among teenagers is binge drinking. According to some studies, roughly 20% of 12th graders have reported binge drinking in the last year. Research suggests that the reason teenagers binge drink is that they haven’t yet developed impulse control. At this age, they also haven’t learned what their limits are. Binge drinking, if done in excess, can lead to addiction and long-term health issues.


Cannabis is another commonly abused drug by teenagers. In fact, most individuals who smoke cannabis are reported to have started during adolescence. Some studies indicate that more than 20% of teens have used cannabis at least once in the past month. This is also partially because perceptions of cannabis use are changing, especially following the legalization of medical marijuana.

Prescription Drugs

Teenagers are no stranger to the illicit and intoxicating effects of some prescription drugs. These range from stimulants, to pain medications, to anti-anxiety medications. It is estimated that nearly 40% of adolescents who abuse prescription drugs obtain them from their parent’s medicine cabinet. Teens gain access by taking drugs prescribed to their friends or obtaining a prescription themselves.

The most commonly abused prescriptions drugs include:

  • Opioids (e.g., OxyContin, Vicodin): pain medications that produce euphoric effects.
  • Benzodiazepines (e.g., Xanax, Valium): anti-anxiety medications that have sedating and euphoric effects.
  • Stimulants (e.g., Adderall, Ritalin): often used as study aids, these drugs are also abused for their stimulating effects.

Over-the-Counter Medications

Adolescents also abuse over-the-counter medications because they are legal and easily accessible. Substances such as cough syrups or cold and flu medications, for example, are sometimes consumed by teens because they contain dextromethorphan (DXM), a substance that produces psychoactive and intoxicating effects in high doses. This poses a further risk of overdoses.

Other substances commonly abused by adolescents include:

  • Cocaine
  • Ecstasy (MDMA)
  • Methamphetamines
  • Synthetic marijuana (e.g., “Spice”)
  • Inhalants (e.g., glue, aerosols)
  • Anabolic steroids

Co-Occurring Disorders Among Teenagers

Mental illness is common in the U.S., not just among adults, but among teenagers, as well. Those who have an underlying condition while abusing substances require specialized help, such as dual diagnosis treatment.

This type of program not only targets their co-occurring mental health condition, but also helps them wean off substances at the same time. Without this kind of specialized treatment, relapses are likely, and their mental health issues may worsen. Some of the common co-occurring conditions among teenagers include:


Depression is a condition that is diagnosed when a person has consistently low moods, low energy, and feelings of hopelessness for two weeks or more. More than just the “blues,” depression can be debilitating and make it difficult to carry out daily tasks. The Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that in 2014 alone, 2.8 million teens between 12 and 17 had an episode of major depression.


Anxiety is a chronic condition characterized by worried thoughts, feelings of tension, and physical changes to heart rate and blood pressure. In the U.S., more than 18% of adults suffer from anxiety, while 7.1% (4.4 million) people aged 3 to 17 are diagnosed with anxiety.

Attention Deficit Hyperactivity Disorder (ADHD)

Attention-deficit hyperactivity disorder (ADHD) is a condition that is exemplified by impulsive behaviors, hyperactivity, and attention difficulties. According to the Centers for Disease Control (CDC), roughly 6.1 million children in the U.S. (9.4%) between the age of 2 and 17 are estimated to have ADHD.

Bipolar Disorder

Bipolar disorder is a mental health condition characterized by intense shifts in mood, behavior, and energy levels. These shifts cause “mania” and “depressive” states where a person goes from feeling highly energized and confident to then crashing into states of sadness and despair. The National Institute on Mental Health (NIMH) reports the lifetime prevalence of bipolar disorder among U.S. teens aged 13-18 is 2.9% — 2.6% of which have severe impairment.

Causes of Substance Abuse Among Teens

There are many causes and contributing factors to substance abuse among teenagers. These include:

  • Biology and genetics
  • Family environment and/or history
  • Experimentation
  • Peer pressure
  • Mental health issues
  • Family history
  • School pressures
  • Low self-esteem or confidence

Recognizing the Signs and Symptoms of Addiction in Teenagers

Substance misuse among teenagers can come with an array of signs and symptoms. Below are a few to watch out for:

  • Self-isolation
  • Exhibiting feelings of hopelessness or worthlessness
  • False beliefs or delusional thinking
  • Unjustified fears
  • Unexpected changes in weight or appetite
  • Mood swings
  • A preoccupation with death or dying
  • Sleeping too much or too little
  • Neglecting personal hygiene
  • Restlessness or agitation
  • Bloodshot eyes
  • Loss of interest in activities
  • Poor hygiene
  • Avoiding eye contact
  • Frequent hunger or “munchies”
  • A smell of smoke on breath or clothes
  • Secretive behavior
  • Unusual tiredness
  • Having friends or romantic partners who use substances
  • Oversleeping
  • Declining academic performance
  • Money suddenly disappearing
  • Lethargy
  • Routinely finishing prescriptions prematurely
  • Changes in physical appearance or behavior

What Parents Can Do

As a parent, you’ll want to do everything you can to help your teenager overcome their addiction. While it can feel overwhelming, frustrating, and scary, there are ways to manage the process so that you can work together towards the best outcome.

One of the first things to do is talk to your teen. Open communication is the first step towards providing support and letting them know that you’re there for them. While it can be tempting to nag them or make them see things from your point of view, it’s important not to judge them. Otherwise, they may clam up and refuse help. Some of the best ways to open communication are:

  • Listen first and hear their side
  • Speak compassionately
  • Be empathetic
  • Share observations, rather than judgments
  • Calmly discuss the dangers of substance abuse
  • Describe the benefits of sobriety
  • Set boundaries
  • Establish realistic goals for treatment

Remember that the tone of voice and how you approach the conversation will make a huge difference. If they feel like they are going to be lectured, judged, or punished, you will likely not get the outcome that you want.

In the end, try to find common ground and establish ways to get treatment in a manner that makes them feel safe, supported, and comfortable. The idea of rehab or therapy can be scary, especially to a teen, so bear in mind that they need as much support as possible.

Treatment and Support Options for Teenagers

When you do reach a point where you can explore treatment options, it’s good to know that many facilities offer teen-specific rehab. Numerous centers exist which are designed solely for adolescents and young adults.

Teen substance abuse requires specific types of therapy that meet their individual needs, so it’s a good idea to explore your options first. Teens have access to traditional rehab programs that range from inpatient to outpatient. These take the form of:

  • Residential or inpatient treatment
  • Intensive outpatient programs
  • Regular outpatient programs
  • Partial hospitalization programs

Like most traditional programs, treatment usually begins with detox, followed by inpatient or outpatient treatment. While no two centers are alike, many of the teen programs consist of individual and group therapy, experiential therapy, motivational techniques, and 12-Step programs, as well as sessions focused on topics like coping skills, anger management, peer pressure, trauma, etc.


If you or a loved one are struggling with substance abuse, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Centers for Disease Control (CDC). (2020). Teen Substance Use & Risks.

Centers for Disease Control (CDC). (2021). Data and Statistics on Children’s Mental Health.

Mayo Clinic. (2021). Teen drug abuse: Help your teen avoid drugs.

National Institute on Drug Abuse (NIDA). (2018). Monitoring the Future 2018 Survey Results.

Medical Disclaimer

At, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on