Teen Substance Use: A Guide for Parents

As a parent, you just want what’s best for your kid. Mantras like “stay in school, don’t do drugs” have almost become a worn-out refrain in today’s households. However, the sentiment rings true, and with nearly one in seven teens reporting illicit substance use in the past month, for many, this message is seemingly falling on deaf ears.¹

Teen substance use poses unique challenges, both in how it impacts the developing brain and in why adolescents are particularly susceptible to addiction. If your teen tries a substance and falls into substance use patterns, it may show differently than an adult struggling with the same issue. This is why catching signs of substance use early and giving your teen the support they need can change — or even save — their life.

Here’s your guide to understanding teen substance use, recognizing its effects, and finding effective treatment to help your teen heal.

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What Is Teen Substance Use? Understanding the Scope

Having insight on why teens try substances or continue to use them despite the risks can offer insight into how you can support them.

Defining substance use vs. experimentation vs. addiction

Substance use is often confused with experimentation and addiction, but each represents different patterns of behavior along the spectrum of one’s relationship with alcohol and drugs. Here’s a breakdown of these three distinct terms:

Experimentation: This is when your teen tries a substance once or twice out of curiosity, often motivated by peer pressure or not wanting to feel left out at a party. There are no patterns of regular use, and they can stop without difficulty.
Substance use: This represents a pattern where your teen may be using substances for recreational use or as a way to self-medicate. At this point, they may experience minor substance-related struggles such as brain fog or hangovers, and may begin to prioritize substances over some responsibilities. Stopping is more difficult — though much easier than with addiction.
Addiction: Regular substance use can turn into addiction, which is a physical and psychological dependence on substances. Addiction significantly interferes with your teen’s daily life as they have minimal — if any — control over stopping, experiencing withdrawal symptoms when they do.

Even if you suspect your teen is only experimenting with substances, it’s important to have an honest conversation with them, as every addiction starts with experimentation. The saying “an ounce of prevention is worth a pound of cure” is particularly true in this instance, as prompt intervention can prevent the need for more intensive treatment down the road.

Current trends in adolescent substance use

The good news? In 2024, teen substance use remained at unprecedented lows for the fourth year in a row following the COVID-19 pandemic. This is in part thanks to prescription opioid use at an all-time low and cocaine and heroine use at extreme relative lows.²

However, here lies the dangerous paradox: Despite historical lows in teen substance use, teen overdose deaths remain more than double pre-pandemic levels.³ This is because many of today’s substances are contaminated with dangerously potent chemicals such as fentanyl — with seven out of ten counterfeit pills containing potentially lethal doses. Additionally, the rates of teen marijuana use are at a 30-year high, in part due to increased availability of edibles and vapes.⁴

The unique vulnerability of the teenage brain

The developing adolescent brain faces a dual vulnerability to substance use. For one, teens are susceptible to experimentation and addiction due to several factors, including:

Underdeveloped impulse control.
Limited decision-making skills
Poor risk assessment.
Increased exposure to peer pressure.
Heightened reward sensitivity.

Second, substances can permanently damage the adolescent brain — stunting prefrontal cortex growth, dysregulating dopamine production, impairing memory formation, and even increasing the risk of schizophrenia and psychosis.⁵

Find Treatment: Mental Health Treatment for Teens

Why Teens Use Drugs: 3 Primary Risk Categories for Teen Substance Use

Breaking down what pushes teens to substance use and addiction can give you the insight you need to step in promptly.

“Adolescent substance use often reflects efforts to manage stress, impulsivity, social pressures, or symptoms of underlying mental health issues,” according to Kelly Hobbs, psychiatric mental health nurse practitioner (PMHNP) for Neuro Wellness Spa in Pasadena. “Early use can interfere with ongoing brain development and reinforce maladaptive coping patterns that may persist into adulthood. Understanding the reasons behind a teen’s substance use offers valuable insight into the types of support and interventions that may help them most.”

The three primary risk factors include:

Individual factors like mental health problems, low self-esteem, personality traits, or early behavioral problems increase susceptibility to experimenting with or misusing substances. For example, many adolescents may turn to prescription drugs in an attempt to relieve distressing feelings such as anxiety, social discomfort, or depression, while others may experiment with illicit drugs for similar reasons.
Family factors include family dysfunction, which can range from your teen feeling unheard to emotional unrest due to intense shifts in family dynamics. Having a family history of substance use can make your teen more predisposed to substance use, and lack of parental monitoring can make it easier for them to experiment.
Social factors like peer influence and school environment are significant. Whether it be experimenting with substances to fit in or to be perceived as cool, conforming to peer pressure can have long-term consequences.

Recognizing the Signs: How To Identify Teen Substance Use

Spotting warning signs of teen substance use can be difficult as you balance respecting their growing independence while ensuring their safety. Understanding what to look for can help you maintain that balance.

Physical and behavioral warning signs

Warning signs that may indicate substance use include:

Poor hygiene, such as not showering or brushing teeth.
Sleep pattern changes — either sleeping too much or not enough — and appearing groggier than usual.
Appetite changes that cause dramatic, unintended weight loss or gain.
Academic performance declines or school refusal behaviors.
Changing social circles or self-isolation from friends and family.

While these signs might seem like regular developmental struggles, the main difference is their persistence — they don’t improve after a week or less.

Emotional and psychological red flags

Young people will naturally experience emotional ups and downs due to varying factors like academic stress, social challenges, familial conflict, and bodily changes. While this is common, extreme mood swings or completely new emotional patterns could be cause for concern. This is especially true if you notice your teen being more aggressive or showing dramatic personality changes, which could include increased irritability during withdrawal symptoms.

When to seek professional help

If you notice your teen exhibiting these warning signs, it may be time to seek help from a mental health professional or addiction specialist:

Lying or being extremely secretive about substance use.
Intense mood swings, personality changes, or displays of aggression.
School refusal or chronic truancy.
Your consequences and conversations aren’t helping.
Substance use is significantly disrupting family life.
Frequent nosebleeds, burns on fingers or lips, persistent and poorly explained coughing, or sneaking out at night.
Your missing money or prescription medication.
Deleted browser history, hidden text conversations, or new contacts under code names.

Additionally, these signs require immediate medical attention:

Any signs of overdose.
Expressing thoughts of suicide, self-harm, or harming others.
Driving under the influence or receiving a DUI.
Experiencing withdrawal symptoms.
Getting suspended, expelled, or arrested for substance-related incidents.
Engaging in risky behavior while intoxicated.

If you’re debating reaching out for professional support for your teen’s substance use, trust your instincts. It’s better to reach out too soon than too late, and prompt intervention could be life-saving.

Related: Gaming Addiction in Teens

The 5 Major Effects of Substance Use on Youth

Substance use disorder (SUD) can show up in different ways in your teen’s life, so knowing what to look for can help ensure their struggles don’t escalate.

Physical health consequences

Prolonged substance use can come with both immediate and long-term physical impacts, including:

Liver damage from alcohol.
Frequent illness resulting from a weakened immune system.
Respiratory issues from inhaling substances, including cigarettes and vaping.
Nutritional deficiencies from poor appetite or eating habits.
Cardiovascular complications such as irregular heartbeat or high blood pressure.
Increased risk of accidents or injuries from impaired judgment.
Overdose.

Academic and cognitive consequences

Issues arising at school are common when a teen begins prioritizing substance use, including:

Declining school performance, whether that’s frequent absences, suspension, expulsion, or declining grades.
Reduced cognitive processing speed and impaired short-term memory — though research on whether marijuana directly causes IQ decline is mixed, with some studies suggesting family and environmental factors may play a larger role than the substance itself.^6,7
Struggles with problem-solving, communication, and time management.

As a teen falls into substance use patterns, many of their relationships may suffer. They may withdraw from their non-using friend group as they gravitate toward peers who use substances, or experience increased conflict as loved ones push back on their substance use.

Additionally, family dynamics can deteriorate as trust is broken and younger siblings are potentially influenced. And if your teen is in a relationship, they are at a higher risk of experiencing intimate partner violence — whether they are the victim or perpetrator ⁸— sexual disease transmission due to impaired decision-making, and codependence if their partner is also using.

Mental health complications

Substance use can both exacerbate existing mental health disorders and be perpetuated by them. This is underscored by research showing that about half of all people with a substance use disorder will experience a mental health condition during their lives, and vice versa.⁹

The most common mental health conditions that co-occur with SUD include:

Anxiety disorders.
Depressive disorders.
Bipolar disorder.
Attention-deficit/hyperactivity disorder (ADHD).
Post-traumatic stress disorder (PTSD).
Borderline personality disorder (BPD).
Antisocial personality disorder.

Legal and behavioral consequences

Adolescent substance use is associated with increased involvement in the criminal justice system, including:

Higher rates of arrest and incarceration.
Increased risk of violent behavior.
Legal conflicts and criminal activity.
Difficulty reintegrating into school or work after legal problems.

To learn more about the impacts of substance use and the link between addiction and mental health, here’s a Q&A video by Paula Martin, PMHNP for Neuro Wellness Spa in North Torrance:

Related: Types of Medication for Addiction

Treatment Options: Comprehensive Approaches to Teen Recovery

When you suspect — or know — that your teen is misusing substances, many questions may arise. First and foremost being, “How can I help my child?” For those who resonate with these concerns, you should know that varying levels of care are available, and healing is possible.

Evidence-based therapeutic approaches for addiction

Teen-focused addiction therapy is typically a core component of treatment, regardless of the level of care your child requires. Some of the key benefits of therapy include:

Reduces substance use and prevents relapse by teaching healthy coping skills and helping them reframe negative thought patterns regarding substance use. Beneficial modalities include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and motivational interviewing (MI).
Provides peer support where your teen can relate to others’ lived experiences and lean on peers who understand their struggles throughout recovery.
Rebuilds damaged relationships through modalities such as family therapy, which helps strengthen family bonds, improve communication, and provide substance use and addiction education for the whole family.
Improves treatment efficacy and outcomes by maintaining engagement in recovery and teaching medication adherence strategies when applicable.
Treats co-occurring disorders by addressing both substance use and mental health conditions simultaneously, which research shows is more effective than treating each separately.¹⁰

Outpatient vs. residential treatment considerations

If your teen needs more intensive recovery options, there is outpatient and residential treatment. Each one is based on the intensity level of care that they may need determined by an assessment.

In summary, outpatient care is less intensive and is when your teen lives at home with the family while receiving scheduled treatment sessions at a facility after school. Residential treatment is when you live at the center 24/7, receiving support and maintaining a structured schedule while learning skills that will help them overcome their addiction.

Beyond the fundamentals, key differences include:

Feature	Outpatient treatment	Residential treatment
Living arrangement	Lives at home with family or guardians.	24/7 living.
Treatment schedule	Scheduled sessions after school, which can last anywhere from one to 20 hours per week.	Full-time.
Supervision level	Limited to session times.	24/7 monitoring and medical supervision.
Best for	Mild to moderate SUD with a stable home environment.	Severe SUD, need to detox, or unsafe home environment.
Daily life impact	Continues school, job, hobbies, and family routines.	Pauses daily responsibilities to focus entirely on recovery.
Duration	Ongoing for weeks to months.	Much longer than outpatient; can last 30 days to a year or more.
Trigger exposure	Learn to cope with real-world triggers as they continue to encounter them.	Protected from real-world triggers initially as they build foundational skills.
Cost	More affordable; insurance may be able to partially or fully cover the cost.	Most expensive; insurance may be able to partially or fully cover the cost.

Related: Therapy for Alcoholism

How Neuro Wellness Spa Can Help Teens Recover From Substance Use

If your teen is struggling with substance use, Neuro Wellness Spa and our sister organization, Clear Behavioral Health, offer comprehensive support throughout every stage of recovery to support their well-being.

Clear Behavioral Health specializes in addiction treatment programs, including:

Residential treatment programs.
Intensive outpatient programs (IOP).
Partial hospitalization programs (PHP).
Parental support groups.
Family therapy.

Neuro Wellness Spa provides ongoing adolescent psychiatry and therapeutic support, including:

Individual therapy to address underlying mental health conditions.
Medication management when clinically appropriate.
Goal-oriented treatment planning that helps build protective factors for long-term addiction recovery.
Support for co-occurring disorders that often accompany substance use.
Transcranial magnetic stimulation (TMS) therapy, which can treat underlying mental health conditions that may be driving addiction.

Neuro Wellness Spa and Clear Behavioral Health work in tandem to provide a seamless transition of care. Typically, teens begin their recovery journey with Clear Behavioral Health’s intensive treatment programs, then transition to Neuro Wellness Spa for continued psychiatric support, therapy, and innovative approaches like TMS therapy as they maintain their recovery.

If your teen is struggling with substance use, don’t wait. Contact us today to learn how we can help change the trajectory of their life.

FAQ: Teen Substance Use

Here are your answers to some frequently asked questions about teen substance use.

What are three things that put a teenager at risk for substance use?

There are several factors that put teenagers at risk for substance use, and the reasons that drove your teenager to this behavior may differ from others. However, in general, three major risk factors are pre-existing mental health conditions, family and environmental factors, and social factors such as peer pressure.

What is the most widely used drug among teenagers?

According to a report by the National Center for Drug Abuse Statistics (NCDAS), alcohol is far-and-away the most misused substance among both teens and young adults. Approximately 49% of teenagers have misused alcohol by the time they reach 12th grade. Marijuana is also among the most commonly used substances.¹¹

What age is most affected by drugs?

The developmental period from adolescence to young adulthood — ages 12 to 25 — is uniquely vulnerable to both the effects of substance use and its consequences. This is due to various factors such as susceptibility to experimentation, underdeveloped impulse control, ongoing brain development, and developmental stressors that may lead some to self-medicate.