Teen Substance Use

Danielle M. Dick, Ph.D.

I direct one of the largest addiction research centers in the country, and I study substance use in adolescence. Here’s what every parent needs to know about adolescent substance use:

1. Adolescence is the time when most kids initiate substance use.

It’s when they establish regular patterns of use, that many start to experience consequences. About 15 percent of the population will meet the criteria for a substance use disorder at some point in their lives, meaning that substance use is causing significant harmful consequences. The average age of onset for problems is in the early 20s, so most problems start in adolescence. That’s why we focus so much substance use prevention programming on teens.

2. Adolescents have brains that are wired for risk-taking.

This is a result of the fact that the brain doesn’t develop evenly. The part of the brain that is highly attuned to experiencing reward is fully developed in adolescence. That’s a product of evolution—if our brains didn’t respond positively to food, social interactions, and sex, as a species, we wouldn’t survive very long. Those things make us feel good, and we seek out more of them.

But as we all know, too much of a good thing can lead to trouble. The part of our brain that helps us weigh the consequences of our actions and think about long-term implications isn’t fully developed until the mid-20s. So, teenagers are like race cars without fully functional brakes. Using drugs is a novel experience that adolescent brains crave—and then drugs hijack the reward system by producing feel-good effects. It’s a big part of the reason why most adolescent substance use is risky adolescent substance use. Teens don’t have a glass of wine with dinner; if one drink is good, their reward-primed brains tell them, five drinks must be better! Of course, there is a lot of individual variability in this trait, but developmentally, teenage brains are at a high point for risk-taking.

3. The drugs available to kids today are more dangerous than in the past.

Vaping has risen tremendously in popularity, with one in four youths reporting that they have vaped. Vapes come in fun flavors and are easy to hide; most youth (and parents) do not realize that a single vape can contain as much nicotine as a pack of cigarettes.

Cannabis use is on the rise as most states have legalized marijuana for either medicinal or recreational purposes. Up to 11 percent of youth report using cannabis daily. This is the drug most of us who study adolescent substance use are most worried about presently.

The marijuana available today is nearly 10 times stronger than the marijuana that was available in the 70s, 80s, 90s, and up through the 2000s. Early research is showing potent adverse effects on memory and motivation in kids who use them regularly. The level of THC, the psychoactive ingredient in marijuana, was about 3 percent until the early 2000s; it is now close to 25 percent in the marijuana available today, and up to 90 percent in edibles like gummies! Many parents are unaware of just how different and dangerous this drug is compared to how they remember marijuana. Parents, think of it this way: If marijuana use in your youth was the equivalent of having a beer when your kids use marijuana, it’s more like drinking a liter of vodka.

Fentanyl, a powerful synthetic opioid which can be produced far more cheaply than other opioids, has flooded the drug market as a result of the opioid epidemic. It is the top cause of accidental overdoses, which have grown exponentially over the past several years. The concern now is that it’s not only opioids that are laced with fentanyl; it’s other drugs as well. Increasingly, cocaine, ecstasy, and other street drugs also contain fentanyl, leading to accidental overdoses in youth who experiment.

4. Alcohol remains the most widely used drug in youth.

It is the most available drug, so it continues to be the one most kids use recklessly, leading to injuries, fights, unwanted sexual behavior and assaults, accidents, and death. Well-meaning parents have asked me if, due to the increasing availability of more dangerous drugs, they should instead encourage their child to take the “least-worse” path and stick to alcohol.

There are two reasons this isn’t a good idea. First, it assumes that all kids will use alcohol or other drugs, which is not the case. We don’t want to inadvertently normalize substance use in our kids. Many youth choose not to drink. Rates of alcohol use have fallen steadily over the past decade, with national data showing that only 55 percent of high school seniors report using alcohol in the past year.

Secondly, there is no evidence that when youth use alcohol it deters them from using other drugs. In fact, the opposite is true. Youth who use alcohol are more likely to try other drugs as well. When the novelty of alcohol wears off (remember they have sensation-seeking brains!), they move on to trying other drugs.

5. Parents can make a difference.

Parents, don’t despair! There are actions you can take to reduce the likelihood your teen will initiate substance use or use in risky ways.

  • Monitor your kids. Know who they are with, where they are going, what they are up to. Remove easy access to alcohol in your house. Parental monitoring is the number-one thing that research shows reduces substance use in teens. Kids can’t use alcohol and other drugs if they don’t have access. You can make it harder for them to get access. Remember, their brains aren’t in a place to help them make the best choices; you have to make up the difference.
  • Talk to your kids about alcohol and other drugs. Ask your child questions about substance use in their school and among their friends. Ask what they think about using alcohol or other drugs. Use this as an opportunity to have a conversation about substance use. Be clear about the rules and expectations in your house, and—this part is key—outline and implement consequences if they are broken. It’s normal for teens to push boundaries, and the unfun part of being a parent is that we have to serve as the referees. But unfortunately, this isn’t a game; your child’s life is at stake.


Nicotine vaping now one of the top forms of substance use among teens. (2022). University of Michigan News.

Marijuana and hallucinogen use among young adults reached all time-high in 2021. (2022). National Institute on Drug Abuse.

Synthetic Opioid Overdose Data | Drug Overdose. (2021). Centers for Disease Control and Prevention.

Miech, R. A., Johnston, L. D., Patrick, M. E., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2023). Monitoring the Future National Survey Results on Drug Use, 1975–2022: Secondary School Students. Ann Arbor: Institute for Social Research, The University of Michigan.

Parents & Educators. (2020). National Institute on Drug Abuse.

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