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Teenage Drug Abuse

Teen drug abuse remains a problem for today’s youth, even though rates of drug abuse among this demographic are dropping. At the peak of adolescent drug use in 2001, around 21% of high school seniors reported using illicit drugs in the prior 12 months, but that number has since dropped to approximately 14% in the 2016 surveys.1 Accompanying this encouraging downward trend in teenage drug abuse numbers, an estimated 800,000 adolescents underwent treatment for alcohol or drug abuse in 2014 and 2015. However, despite the large numbers of people seeking recovery help, a significant percentage of teens who needed treatment for substance abuse did not get it.2

Why Teens Use Drugs & Alcohol

While these numbers might lead you to believe a lot of teens do drugs, in fact, most do not. Still, we might wonder what leads some teens to abuse drugs while others do not. Several risk factors predispose teens to use, but, generally speaking, most of the factors can be attributed to family, individual, or environmental problems.3

Family factors that can influence the likelihood of teen drug use include:3

  • Poor parental supervision.
  • Family conflict.
  • Parents or other adults in the family who abuse drugs and alcohol.
  • Divorce.
  • Communication issues.
  • Discipline that is either lax or extremely strict.

Individual risk factors include:3

  • High levels of impulsiveness.
  • Mental illness.
  • Emotional problems.
  • Academic difficulties.
  • Mental illness.
  • Being male.
  • Being Caucasian.
  • Having a history of physical or sexual abuse.
  • Having a history of being aggressive in early childhood.

Environmental risk factors include:3

  • Living in an area where drugs are easily available.
  • Having a low socioeconomic status.
  • Peer-group pressure.

These risk factors alone don’t explain all the cases of teen drug abuse; other reasons may include:4

  • Wanting to fit in with peers who use drugs.
  • Enjoying the high from drugs.
  • Looking for help to cope with depression, anxiety, or stress.
  • Wanting to do better in school (e.g., taking stimulant drugs like Adderall to try to improve school performance).
  • Wanting to experiment and seeking novel experiences or thrills.

What Drugs Do Teens Abuse Most?

In one study that assessed teenage drug use, 35% used marijuana, 10% abused amphetamines and other stimulants, 5% took some form of hallucinogen (such as mushrooms or LSD), 3% had used cocaine, and 1% had used heroin. Alcohol use is also an ongoing issue for teenagers, with 22% reporting they drank in the last month.5

Interestingly, about 2/3 of teens surveyed stated it was easier to get marijuana than alcohol.5 And while marijuana use dropped to a 2-decade low for 8th and 10th graders, it did not decline for 12th graders. This might be due to a decline in the perception that marijuana is harmful or dangerous, with many pointing to its purported medical benefits.1 In fact, a recent study of social media postings showed positive statements about marijuana outnumbered negative statements 15:1.6

Most frequently, teens get drugs from friends, people in their neighborhoods, or people that their parents know. Many of them buy their drugs online from so-called rogue pharmacies in which other countries sell prescription drugs without a valid prescription. Teens report easily accessing drugs such as Ritalin, Xanax, steroids, and painkillers this way. Another place kids say they find drugs is their parent’s medicine cabinets.7

Parents frequently report being caught off guard by their teen’s drug use. In truth, drug abuse and drug dependence often happen gradually in teens, with many parents missing the early signs.3 In the beginning stages, drug experimentation is a choice. However, over time, chronic drug use can lead to persistent changes in the brain, essentially impairing functionality in ways that make drug use less of a choice and more of a compulsion. As addiction develops, teens may begin to use drugs even when faced with serious consequences, such as:8

  • Legal charges.
  • Family disruption.
  • Failing in school.
  • Losing a job.
  • Getting physically sick.

The urge to use drugs is so powerful that these types of consequences no longer matter to them.

Teen-Specific Treatment Options for Addiction

Once a teen has developed a drug addiction, treatment can help. Many rehab programs are geared specifically to teens because their needs may differ somewhat from those of adults in treatment.

Both drug detox and ongoing substance abuse treatment for adolescents has changed dramatically over the years.

Even though the first adolescent-specific treatment center was opened in 1952 in New York City, teens were mostly still placed in the same treatment programs as adults through the 1980s.9 Even worse, some teens who abused drugs were locked up in detention facilities instead of getting treatment.9 Youth-specific drug treatment evolved slowly through the 1990s and continues to shift and change as we understand more about how addiction affects this age group.

It developed from the old confrontational style favored in many treatment programs to more therapeutic interventions—usually some form of cognitive behavioral therapy (CBT), which helps teens connect the dots between their thoughts, feelings, and actions. The learn how to replace negative thought patterns with positive ones and discover new ways to cope with stress, communicate needs, and handle drug use triggers.

Because the family is such a powerful influence on teens, most detox and treatment also involves parents, siblings, and other family members who may live in the same house. Lack of family involvement is a major factor contributing to teen relapse post-treatment. The entire family unit benefits from this type of intervention as they learn to communicate better, and parents discover how to become an active and helpful part of their child’s recovery.9

Adolescents benefit from treatment programs geared specifically to their developmental needs because:9

  • They are less likely than adults to see drug use as a problem.
  • Teens are more likely to use drugs on binges.
  • They are more likely to have a co-occurring mental health disorder than adults.
  • Teens are more susceptible to peer influences around using drugs and getting treatment than adults.

A recent research project showed that detox and treatment programs that successfully treat teens have several common factors, including:9

  • Screenings and thorough assessments that provide a clear picture of the extent of the drug abuse and related issues.
  • Wide-ranging services that not only address their substance abuse problem, but medical, mental health, family, or education issues as well.
  • Involving the family in treatment. Parental involvement in detox and treatment increases the chances a teen will stop doing drugs and stay sober.
  • Treatment approaches geared expressly toward adolescents.
  • Strategies to engage teens in treatment and help them see the value of getting help for drug abuse.
  • Having qualified staff who understands teens and has experience working with teens specifically.
  • Programming that incorporates cultural and gender differences.
  • Aftercare for ongoing support once formal detox and treatment end.
  • Gathering data on outcomes to ensure the program is effective and to find ways to keep improving.


Treatment typically starts with detoxification. Medically supervised detox programs are essential for teens with addictions to alcohol or benzodiazepines (e.g., Xanax or Valium) since the withdrawal symptoms associated with these substances can be dangerous and even fatal. While substances like marijuana and stimulants may not be associated with markedly unpleasant or complicated withdrawal syndromes, they often still trigger cravings, which can make it difficult to stop using on their own.10 A qualified detox program can provide support, increased accountability, and, when needed, interventions to ease uncomfortable withdrawal symptoms.

When a teen first enters detox, they are assessed for the following factors: 4

  • Level of intoxication and potential for withdrawal
  • Presence of other medical conditions
  • Presence of other emotional, behavioral, or cognitive conditions
  • Readiness or motivation to change
  • Risk of relapse or continued drug use
  • Recovery environment (family, peers, school, legal system)

Depending on the results of the assessment, some teens may not need to go through formal, inpatient detox, but could attend an outpatient program. However, others may require an inpatient program if they have a significantly severe addiction, major emotional or behavioral issues, or other related issues.

Ongoing treatment requires continued support beyond a few days of detox. Having completed a detox program simply means the drugs are out of a teen’s system. Continuing treatment, then, focuses on getting to the root of the addiction, providing counseling to begin to heal underlying issues, and teaching healthy coping skills and behaviors.


  1. National Institute on Drug Abuse (2016). Monitoring the future survey: High school and youth trends.
  2. Substance Abuse and Mental Health Services Administration (2016). National survey on drug use and health.
  3. Ali, S., Mouton, C. P., Jabeen, S., Ofoemezie, E. K., Bailey, R. K., Shahid, M., & Zeng, Q. (2011). Early detection of illicit drug use in teenagersInnovations in Clinical Neuroscience, 8(12), 24–28.
  4. National Institute on Drug Abuse (2014). Principles of adolescent substance use disorder treatment: A research-based guide.
  5. Michigan News: University of Michigan. (2016). Compared with Europe, Americans teens have high rate of illicit drug use.
  6. Cavazos-Rehg, P. A., Krauss, M., Fisher, S. L., Salyer, P., Grucza, R. A., & Bierut, L. J. (2015). Twitter chatter about marijuanaJournal of Adolescent Health, 56, 139–145.
  7. Byxbe, F. R. & Urbina, M. G. (2014). The global epidemic of prescription drug abuse. The American ExperienceInternational Journal of Liberal Arts and Social Science, 2(5), 208–216.
  8. The National Institute on Drug Abuse Blog Team. (2017). Brain and Addiction.
  9. Winters, K. C., Botzet, A. M., & Fahnhorst, T. (2011). Advances in adolescent substance abuse treatmentCurrent Psychiatry Reports, 13(5), 416–421.
  10. Substance Abuse and Mental Health Services Administration (2006). Detoxification and substance abuse services: Physical detoxification services for withdrawal from specific substances. 
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