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Teens & Addiction

Risk-taking behavior and experimentation are normal developmental stages for teens, and this can often include drug and alcohol abuse. Teenage substance abuse can be especially risky, however, as drugs and alcohol can interfere with brain development and lead to a range of social, emotional, behavioral, and physical problems.

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Alcohol, nicotine, and cannabis are the most used substances by adolescents. Parents can play a big role in teen substance use, helping to prevent it, recognizing when a problem exists, and helping to minimize the potential damage drug and alcohol abuse and addiction can cause.

Key Facts About Teens & Addiction

Key Facts

  • Alcohol is the most commonly abused substance by teens, and nearly a third of high school students (29.2 percent) are classified as current users of alcohol, and 15 percent had their first sip of alcohol before the age of 13.
  • Nearly all, close to 90 percent of adult smokers who smoke daily tried smoking before the age of 18. While tobacco use had been trending down for years, the rise in vaping and e-cigarettes has teen nicotine use on the rise.
  • More than a third (36.8 percent) of high school students report using marijuana at least once in their lives, while close to a quarter (21.7 percent) currently use marijuana, according to the 2019 Youth Risk Behavior Survey.
  • In 2020, approximately 1.6 million (6.3 percent) adolescents between the ages of 12 and 17 had a substance use disorder involving alcohol and/or drugs.
  • Teens commonly have misconceptions regarding the dangers of prescription drugs. In 2014, more than 5,700 youth abused a prescription painkiller for the first time.
  • Fortunately, teen drug use is declining. In 2021, the Monitoring the Future (MTF) survey (which studies 8th, 10th, and 12th graders) found that lifetime prevalence of any illicit drug was 27 percent — a drop from 34 percent in 2020.

The Timeline of Teens & Substance Abuse Experimentation

Teens often experiment with drugs and alcohol, often as a form of risk-taking. Usually, they will start with things that they perceive to have the least amount of risk and that are the most readily available. Teens who live in a house where the parents drink regularly and have easy access to alcohol with little supervision are most likely to also drink alcohol, for example. 

Teens are likely to start experimenting with alcohol, tobacco, and marijuana, as these are often thought to be less “risky” substances. Teens also commonly see prescription drugs as “safer” than illicit ones since they are initially prescribed by a medical professional. Younger teens can even start out using household products to try and get “high” sniffing or huffing inhalants. 

Adolescents are generally going to start with what is easy and seems safest before moving on to “harder” substances. It’s important to make your teens aware of the dangers of these more easily accessible substances like alcohol.

The average age that teens start experimenting with drugs and alcohol is declining in recent years, with studies showing the mean age adolescents first start using drugs or alcohol is around 17. That being said, 15 percent of teens tried alcohol before the age of 13, and 5.6 percent tried marijuana before age 13. 

Teens are usually closer to 18 years old before they try illicit drugs, such as cocaine, ecstasy, methamphetamine, or heroin. The more “success” teenagers have with alcohol, marijuana, inhalants, prescription pills, and tobacco, and the more often they use them, the more likely they are to move on to other substances, often in an attempt to feel something more intense and take the experimentation even further.

What Are the Most Commonly Used Drugs by Teens?

The most commonly used substances by teenagers include alcohol, marijuana, and tobacco, often in the form of vaping. Younger teens also regularly experiment with inhalants. 

Prescription medications are common drugs of abuse in adolescence, including pain relievers, sedatives, tranquilizers, and stimulants. Cocaine, opioids, methamphetamine, MDMA/Molly, and hallucinogens are also used by teens.


In the United States, alcohol is the most commonly used substance by young people even though the legal drinking age is 21. Underage drinking is a major public health problem that is responsible for nearly 4,000 deaths each year. More than a tenth of all the alcohol consumed in the United States is through underage drinkers. 

Alcohol is often easiest and cheapest for teens to get, and the perception of risk for drinking is commonly low among teens. Alcohol is also glorified in the media and heavily advertised. Lack of parental supervision or enforcement of underage drinking laws coupled with parents who drink regularly can increase the risk for teen alcohol use.

According to the 2019 Youth Risk Behavior Survey, close to 30 percent of high school students were classified as current drinkers of alcohol, which means they drank alcohol in the past month. Nearly 14 percent binge drank. Binge drinking is a problematic pattern of drinking alcohol that raises your BAC (blood alcohol concentration) up to 0.08 percent g/dL, which can mean consuming between three and five drinks in about two hours. 

Teens are more likely to engage in harmful and dangerous episodes of drinking, which can lead to a variety of problems, including increased risks for injury, accident, driving under the influence, alcohol poisoning and death, trouble at school, and disruption of brain development.

Tobacco & Vaping

Nearly a quarter of high schoolers have tried cigarette smoking, close to 8 percent first tried it before the age of 13, and 6 percent were considered current smokers at the time of 2019 Youth Risk Behavior Study. 

While traditional cigarette smoking is declining among teens, the use of electronic cigarettes, or e-cigarettes/vaping is increasing. More than half (50.1 percent) of high school students have ever used an electronic vapor product, and nearly a third are current users. Since 2014, e-cigarettes have been the most commonly used tobacco product by teens.

Vape pen cartridges contain a variety of toxic chemicals in addition to nicotine and tobacco. They are often marketed in “fun” flavors that appeal to a younger audience, like teenagers. 

These products typically contain a higher concentration of nicotine than traditional cigarettes, which can damage the developing adolescent brain and also increase the risk for nicotine addiction. This higher level of nicotine can more than triple the odds that the teen will smoke traditional cigarettes later in life. 

Research on vaping is ongoing, but it is well established that these products are incredibly damaging, especially to teens.


Marijuana is one of the most commonly used drugs by teens. It comes in many forms. It can be smoked in a joint or bong, consumed as an edible, or vaped in an e-cigarette. 

The 2021 MTF survey found that nearly a third of 12th graders, close to 20 percent of 10th graders, and around 10 percent of 8th graders had used marijuana in the past year. Most claim it is easy to get, and the perception of its risk with regular use goes down with age. The 2019 Youth Risk Behavior Survey indicates that close to 4 out of every 10 high school students have ever used marijuana, and nearly a quarter currently use it.

Marijuana has been legalized in many states for recreational use for adults. As a result, the drug is often considered to be “safe” by youth. 

In reality, use of marijuana before the brain is fully developed at age 25 can be extremely harmful. It can cause the following issues:  

  • Increase the risk for mental health issues and addiction
  • Cause problems with decision-making, learning, memory, focus, and coordination 
  • Interfere with school performance and social life

Prescription & OTC Medications (Painkillers, Sedatives, Tranquilizers, DXM & Stimulants)

Prescription medications are also commonly abused by teens, as they are often viewed as “safer” since they are intended for medical use. 

These medications can include opioid pain relievers (like OxyContin, Vicodin, and morphine), sedatives and tranquilizers such as benzodiazepines (like Valium and Ativan), and stimulant ADHD medications (like Adderall and, Ritalin). 

Over-the-counter (OTC) medications, particularly DXM (dextromethorphan) which is contained in many cough and cold medications, are also abused by teens. DXM is often mixed with alcohol when abused. 

All of these medications are habit-forming and addictive. They are also mind-altering, causing intoxication and a “high.”

The 2019 Youth Risk Behavior Survey shows that 14.3 percent of high school students have ever misused a prescription medication, and 7.2 percent of high school students were currently abusing prescription medications. Any use of a prescription medication without a valid prescription or in a way other than it as prescribed is considered abuse. 

The Drug Enforcement Administration (DEA) reports that after alcohol and marijuana, prescription medications are some of the most commonly abused substances by teenagers. These drugs have high overdose death rates, and regular abuse can easily lead to addiction.


Inhalants are a class of substances that are found in common household products, including spray paint, glue, aerosol cans, solvents, nitrites, and gasses. Teens will sniff, snort, huff, or bag these items to abuse them for a short-lived “high.” 

At the time of the 2019 Youth Risk Behavior Survey, 6.4 percent of high school students reported ever having used an inhalant. Inhalant use is most common in younger teens, and most of the time, teens will try them between 6th and 10th grade

These products can be extremely dangerous. They can lead to sudden sniffing death with even one use in an otherwise healthy individual. Inhalant use may also cause lasting organ and brain damage.

Other Illicit Drugs

Teens experiment with and abuse other illicit drugs at the following rates, according to the 2019 Youth Risk Behavior Survey:

  • About 7 percent of high schoolers had ever used a hallucinogen, such as LSD, PCP, acid, mushroom, mescaline, or angel dust.
  • Nearly 4 percent of high school students reported using cocaine at least once.
  • About 3.6 percent of high schoolers reported using ecstasy, or MDMA, at least once in their lifetime. However, this may be underreported since many teens are unaware that Molly also contains MDMA.
  • Over 2 percent of high schoolers have ever used methamphetamine.
  • About 1.8 percent of high school students have used heroin at least once.

Is It Normal for Teens to Experiment With Drugs & Alcohol?

Adolescence is a time of great change, and teens are often going through a lot of new and different emotions. Experimentation with drugs and alcohol is completely normal during this time as teens try to figure out their place in their social circle and the world. 

Developing brains do not have a fully formed prefrontal cortex, which means that it is difficult for them to make fully thought-out decisions or control their impulses. It can be difficult for them to truly understand the consequences of their actions. Peer pressure and a desire to fit in can play major roles in teen alcohol and drug use.

It is important to keep the lines of communication open, talk to your teen about drug and alcohol use, and keep your eyes out for potential issues. Some experimentation is to be expected, but when caught early, it can often be easily turned around and managed. Early intervention can help to catch teen drug or alcohol use quickly before it becomes an issue.

When Should You Begin to Worry About Experimentation Becoming a Problem?

Many teens will try drugs or alcohol once or a few times and then stop. When drug or alcohol use becomes more regular, experimentation starts moving beyond substances that are easily accessible, and moves into repeated drug use or use of illicit substances, this can be cause for concern. 

Any underage drug and alcohol use can be harmful to developing brains and bodies. While experimentation with these substances is normal, early drug and alcohol use can have more significant problems later in life, raising the risk for physical and mental health issues and addiction.

What Are the Signs of Teen Substance Abuse?

It’s helpful to spot the signs of teen substance abuse as early as possible. These signs can include changes in behavior, social life and relationships, physical health and appearance, emotional state, and activities. 

Look out for the following signs of drug and alcohol use in teens:

  • Significant mood swings
  • Speech changes (either sluggish and slow speech if on depressants, or rapid and explosive speech when using stimulants)
  • Persistent cough
  • Bloodshot eyes
  • Coordination and balance issues
  • Changes in pupil size (either dilated or pinpoint pupils)
  • Frequent absences at school and declining grades
  • Changes in appetite (either loss of appetite with stimulants or increased appetite with marijuana)
  • Difference in friend group
  • Changes in energy levels (either sluggish, drowsy, and listless from depressants or hyperactive from stimulants)
  • Increasing secrecy and lying
  • No longer participating in activities that were a priority or important before
  • Paying less attention to physical appearance and personal hygiene
  • Lack of worry about the future
  • Disrespectful behavior and attitude
  • Stealing
  • Withdrawal from family and friends

How to Talk to Your Teenager About Substance Abuse

If you suspect your teen is using drugs or alcohol, it is important to have empathetic, loving, and nonjudgmental conversations with them. This can often mean several small talks instead of one “big talk,” which can be overwhelming. 

It can be helpful to reference the media, such as TV shows or movies that depict issues with substance abuse. Ask open-ended questions and avoid lecturing or “talking at” your teen. 

Let them know how you feel about substance abuse and its dangers for adolescents. Talk openly with your teen, and encourage honesty from them in response. 

It can also be beneficial to seek help with this conversation. Talk to your child’s doctor, a mental health professional, or a counselor for ideas on how to move forward.

Support for Teen Substance Abuse

There is a lot of support for teen substance abuse and addiction, and many resources that can help. Family doctors, school counselors, and mental health professionals can all often provide resources and information on support for your teen.

Support groups that are specifically directed at teens can offer peer support in a safe and nonjudgmental environment. Groups and 12-step programs, such as Alcoholics Anonymous (AA), often have teen-specific groups to offer mutual self-help. 

AA provides a Teen Corner and has Alateen. Alateen involves teen-focused Al-Anon meetings, designed for teenagers who are impacted by a loved one’s alcohol use. Al-Anon is directed at families that are seeking support for a loved one’s drinking problems. There are both family groups and meetings and teen-specific ones.

SMART Recovery (Self-Management and Recovery Training) is another self-help program that has a Teen and Youth Support Program, providing resources and tools to help teens take control of their lives back from drugs or alcohol. This program offers a space where teens can meet and work together to explore harmful behaviors, including drug and alcohol use, and learn how to change these behaviors in a positive manner.

Group and individual therapy and counseling can support teens with substance abuse and related issues. Counseling sessions can provide advice and support for positive lifestyle changes, which can include developing a relapse prevention plan and working toward an overall improved quality of life. Family counseling and therapy sessions can help the entire family work together to learn how to best support the teen who is struggling.

There are a variety of different therapy options that can benefit teens with substance abuse concerns, which typically include behavioral therapies such as cognitive behavioral therapy (CBT). Behavioral therapies seek to explore potentially harmful patterns of thinking and how emotions and triggers can lead to destructive actions, such as drug and alcohol use. With CBT, teens can learn how to recognize stressors and develop coping mechanisms and tools for managing them.

Treatment Options for Teens

There are two main forms of treatment for teenage addiction: inpatient and outpatient treatment programs. No two treatment plans are alike, and each person will have specific needs and circumstances that will dictate the type of treatment that will be most beneficial. 

Both inpatient and outpatient centers provide counseling and therapy sessions. Many programs use medications to help manage addiction, specific withdrawal symptoms, or co-occurring mental health issues. Support groups, life skills training, and relapse prevention programming are also part of most addiction treatment programs.

Outpatient programs can vary in their structure, but the main component of all of them is that the teen will return home after their sessions and remain living at home for the duration of the program. For less significant substance abuse concerns, this can allow flexibility to still attend school and keep up with some of their daily life. 

Generally, with teen addiction, it is optimal to stay in an inpatient center to get a complete life reset without outside influences. Inpatient care can also assure parents that their teens don’t have access to substances of abuse when they are not in treatment sessions.

Inpatient addiction treatment can provide around-the-clock monitoring and supervision as well as a high level of support in an extremely structured environment. The teen will have a strict schedule and be able to focus completely on healing and recovery without any outside life stressors or triggers. 

Families are still highly involved in these programs and will commonly attend family and group sessions with their teen. Medication management and treatment for any co-occurring mental health or medical conditions can be managed at the same time. 

There are many treatment programs that are specifically directed at and designed for teens. These programs often offer tutors and in-house schooling when needed as well as a safe, healthy, and sober environment. 

Addiction is a highly treatable condition. A comprehensive treatment program can address the mental health, social, behavioral, physical, and interpersonal aspects to promote a lasting recovery. The sooner a teen can get help, the better their chances of a sustained recovery and a bright future.

Updated October 16, 2023
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