Adolescent Substance Use

Research documented in Partnership to End Addiction’s reports, Adolescent Substance Use: America’s #1 Public Health Problem (2011) and Addiction Medicine: Closing the Gap between Science and Practice (2012), affirms that addiction is a brain disease that typically originates with substance use in adolescence.

In the U.S., 9 out of 10 people who meet clinical criteria for a substance use problem started smoking, drinking or using other drugs before age 18. The earlier substance use begins, the greater the likelihood of developing a substance problem. Individuals who first use any addictive substance before age 15 are 6 1/2 times as likely to develop a substance problem as those who delay first use until age 21 or older; yet the average age that high school students report starting to use an addictive substance is between 13 and 14 years.

Given that three-fourths (76%) of all high school students report having used an addictive substance in their lifetime and almost half (46%) have done so in the past month, it is critical to understand the link between adolescent substance use and addiction and address it accordingly. 1 in 8 high school students meets clinical criteria for a substance problem and, among those who have used an addictive substance in the past month, 1 in 3 already has a disorder.

The combination of several factors makes adolescence the critical period of vulnerability for beginning to use addictive substances and for developing the disease of addiction:

• Because the parts of the brain responsible for judgment, decision-making, emotion and impulse control are not fully developed until early adulthood, adolescents are more likely than adults to take risks, including experimenting with addictive substances
• Because these regions of the brain are still developing, they appear to be more vulnerable to the negative impact of addictive substances, further interfering with brain development and increasing the risk of addiction
• Compounding these biological vulnerabilities is the fact that adolescents are exposed to a constant stream of messages from friends, family, advertising and the entertainment media promoting and glamorizing substance use at a time of peak susceptibility to social influences. Some teens may also have genetic or biological conditions or personal experiences such as abuse or other trauma that when combined with these factors further increase their risk of addiction and substance use

Adolescent substance use not only increases the risk of addiction, it also has profound social and financial costs. It is directly linked to the three leading causes of death among adolescents—accidents, homicides and suicides—and is implicated in poor academic performance, cognitive impairment and school dropout; unprotected sex and unintended pregnancies; mental health problems; violence and criminal involvement; and numerous potentially fatal medical conditions.

Adolescent substance use is our country’s largest preventable and ultimately most costly health problem. To address it, the public, health professionals and policymakers must recognize it as a health problem rather than a normal rite of passage, help young people delay substance use for as long as possible, be vigilant for signs of risk and intervene appropriately as we do for any other health condition.