Teen Alcohol and Drug Abuse

Topic Overview

What is teen substance abuse?

Many teens try alcohol, tobacco, or drugs, but using these substances is not safe or legal. Some teens try these substances only a few times and stop. Others can't control their urges or cravings for them. This is substance abuse.

Teens may try a number of substances, including cigarettes, alcohol, household chemicals (inhalants), prescription and over-the-counter medicines, and illegal drugs. Marijuana is the illegal drug that teens use most often.

Why do teens abuse drugs and alcohol?

Teens use alcohol and other drugs for many reasons. They may do it because they want to fit in with friends or certain groups. They may also take a drug or drink alcohol because they like the way it makes them feel. Or they may believe that it makes them more grown up. Teens tend to try new things and take risks, and they may take drugs or drink alcohol because it seems exciting.

Teens with family members who have problems with alcohol or other drugs are more likely to have serious substance abuse problems. Also, teens who feel that they are not connected to or valued by their parents are at greater risk. Teens with poor self-esteem or emotional or mental health problems, such as depression, also are at increased risk.

What problems can teen substance abuse cause?

Substance abuse can lead to serious problems such as poor schoolwork, loss of friends, problems at home, and lasting legal problems. Alcohol and drug abuse is a leading cause of teen death or injury related to car accidents, suicides, violence, and drowning. Substance abuse can increase the risk of pregnancy and sexually transmitted diseases (STDs), including HIV, because of unprotected sex.

Even casual use of certain drugs can cause severe medical problems, such as an overdose or brain damage. Many illegal drugs today are made in home labs, so they can vary greatly in strength. These drugs also may contain bacteria, dangerous chemicals, and other unsafe substances.

What are the signs of substance abuse?

It’s important to be aware of the signs that your teen may be abusing alcohol, drugs, or other substances. Some of the signs include:

  • Red eyes and health complaints, such as being overly tired. If your teen often uses over-the-counter eyedrops, he or she may be trying to cover up red eyes caused by smoking marijuana.
  • Less interest in school, a drop in grades, and skipping classes or school altogether.
  • New friends who have little interest in their families or school activities.
  • Chemical-soaked rags or papers, which may mean that your teen is inhaling vapors. Another sign of using inhalants is paint or other stains on your teen’s clothing, hands, or face.

What should you do if you find out that your teen is using alcohol, tobacco, or drugs?

If your teen is using alcohol, tobacco, or drugs, take it seriously. One of the most important things you can do is to talk openly with your teen about the problem. Urge him or her to do the same. Try not to use harsh, judging words. Be as supportive as you can during this time. In most cases, a hostile, angry face-to-face meeting pushes your teen away from the family. If you do not know what to do or if you feel uncomfortable, ask for help from a pediatrician, psychologist, or a psychiatrist.

The type of treatment your teen needs depends on the level of substance abuse. For example, if a teen has tried drugs or alcohol only a few times, talking openly about the problem may be all that you need to do to help your teen stop his or her substance use. But if a teen has a substance abuse problem, then he or she needs to be seen by a doctor and/or by a counselor. If your teen is addicted to a drug or alcohol, he or she may need to have detoxification treatment or a treatment that replaces the substance with medicine. Medicine works best if it is combined with one-on-one or family counseling, or both.

Returning to substance abuse, called relapse, is common after treatment. It is not a failure on the part of your teen or the treatment program. Recovery from addiction is hard and takes time. Know that there may be setbacks that your teen will need to overcome one step at a time.

Can teen substance use and abuse be prevented?

Talking openly and honestly with your teen and keeping a healthy home life may prevent your teen from trying alcohol and drugs.

You can help prevent substance use by using these tips:

  • Talk to your child early about what you expect in his or her behavior toward alcohol, tobacco, and other drugs. If your teen thinks that you will allow substance use, he or she is more likely to try drugs or alcohol.
  • Keep your teen busy with meaningful activities, such as sports, church programs, or other groups.
  • Expect your teen to follow the household rules. Set reasonable penalties for bad behavior, and consistently carry them out.
  • Keep talking with your teen. Praise your teen for even the little things he or she does well.
  • Know your child’s friends. Having friends who avoid cigarettes, alcohol, and drugs may be your teen’s best protection from substance abuse.

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  Substance abuse: Dealing with teen substance use

Facts About Teen Drug and Alcohol Abuse

Abuse of alcohol and other drugs is a major threat to the health and well-being of teenagers. According to a 2004 U.S. Centers for Disease Control and Prevention (CDC) survey of high school students:1

  • About 10% of teens smoke cigarettes frequently (more than 20 days a month). Tobacco use has serious long-term health consequences and is highly addictive. A teen who uses tobacco for more than a year has more than an 80% chance of becoming dependent on it.2
  • About 75% of high school students have tried alcohol. More alarming, about 28% of teens have had a recent episode of heavy drinking (more than 5 drinks within a couple of hours). The leading cause of death for teens and young adults is auto accidents related to alcohol. Drinking also lowers inhibitions, which can lead teens to have unprotected sex, increasing the chance of pregnancy and infection with sexually transmitted diseases, such as herpes, chlamydia, and HIV.
  • About 40% of teens have tried marijuana one or more times. About 22% of teens currently use marijuana. Teen use is troubling because marijuana can hinder memory, problem-solving, and learning. It can also cause mood swings, anxiety, and depression.
  • About 9% of teens have tried cocaine, while 4% use it currently (one or more times in a month). Cocaine is an addictive drug. It is especially dangerous because it can cause abnormal heartbeats, occasionally resulting in a life-threatening heart attack, seizure, or stroke.

Other substances teens abuse include:

  • Inhalants (glues, aerosol sprays, gasoline, paints, and paint thinners). Inhalants are one of the substances most frequently abused by junior high students because they are inexpensive and easy to get. These substances are extremely dangerous because they contain poisonous materials, such as lead and toluene, which can cause brain damage or, in rare cases, even death with the first use.
  • Club drugs, including ecstasy (MDMA) and date rape drugs such as gamma-hydroxybutyrate (GHB) or flunitrazepam (Rohypnol). These drugs are often used at all-night dances, raves, or trances. Although the number of teens abusing these drugs is small compared with cigarettes, alcohol, and marijuana, these drugs can be dangerous, especially in overdose or when combined with alcohol or other drugs. Use of ecstasy can lead to depression, sleep problems, and severe anxiety that may last for weeks after taking the drug. Over time, use of ecstasy can lead to liver damage and thought and memory problems.
  • Methamphetamine (commonly referred to as meth, crank, or speed). Methamphetamine is highly addictive. In addition, it can cause seizures; stroke; serious mental problems, including paranoia, hallucinations, and delusions; and long-term health problems.
  • Hallucinogens, including LSD (lysergic acid diethylamide), mescaline, psilocybin, PCP (phencyclidine), and ketamine. Serious and lasting psychiatric conditions such as psychosis or hallucinogenic flashbacks can develop after using LSD.
  • Opiates, such as heroin, morphine, and codeine. Use of opiates can lead to strong physical and psychological addiction. Teens who use addictive drugs may steal, prostitute themselves, or resort to other dangerous or illegal behavior to buy drugs.
  • Prescription drugs, such as diazepam (for example, Valium), methylphenidate (Ritalin), hydrocodone bitartrate and acetaminophen (Vicodin), and oxycodone (OxyContin). Nonprescription medicines, such as cough syrups or cold pills, are also abused by teens.
  • Anabolic steroids, which teens use to build muscle tissue and decrease body fat. Anabolic steroids can cause liver cancer; reduced sperm count; male-pattern balding; irritability and rage; and increased cholesterol and blood pressure, resulting in heart attack and stroke.

In recent years teen substance use rates (except for the use of inhalants and prescription opiates) have been dropping overall, but substance use still remains a leading cause of injury and death in young people, as well as causing long-term social and health problems. Annual studies such as the Monitoring the Future Survey track trends in teen drug, alcohol, and tobacco use and attitudes across the United States.

Because alcohol and drugs change the way the brain functions, specifically the areas that control decision-making and emotions, teen growth and development can be affected by their use. Teens who abuse these substances may have difficulty establishing their identity, developing relationship skills, gaining emotional stability, and preparing for an independent and productive future. Substance abuse can affect memory and learning, which can harm a teen's performance in school. Perhaps the most significant danger of teen substance use is that it can progress, sometimes rapidly, from experimenting or occasional use to abuse and addiction in teens at risk.

Why Some Teens Abuse Alcohol and Drugs

Personal, family, and community factors increase a teen's risk for using substances and possibly developing a substance abuse problem.

Personal risk factors

These include:

  • Genetics. People with alcohol and drug abuse problems often have a family history of substance abuse. Studies show that when this genetic predisposition for abuse is combined with environmental factors, the person is more likely to develop a substance abuse problem.
  • Temperament and personality. Rebelliousness, resistance to authority, feelings of failure, and failure to form close relationships are factors that may lead a teen to seek the effects of alcohol or drugs. Also, sensation-seeking and a tendency to take risks increase a teen's likelihood of developing an abuse problem.2
  • Certain diseases or conditions. Teens who have untreated attention deficit hyperactivity disorder (ADHD), conduct disorder, depression or long-term depressed feelings (dysthymia), post-traumatic stress disorder, or an anxiety disorder are more likely to use alcohol or drugs. Also, alcohol and drug abuse behaviors may make these conditions worse.3
  • Drug expectations. A teen develops an expectation of what taking a substance will be like from parents, peers, the media, and personal experience. Teens often have misconceptions about the harmful effects of alcohol, cigarettes, and drugs. And they often think that "everybody does it" and so should they.
  • Early age at first use. Using alcohol or other drugs at a young age greatly increases a teen's risk for developing an abuse problem. One study found that teens who had their first alcoholic drink at age 14 or younger were 4 to 5 times more likely to develop alcohol abuse problems.3

Family risk factors

These include:

  • Parent’s use of alcohol. Teens are more likely to start using alcohol if their parents use alcohol.3
  • A parent or teen with a mental illness, with depression, anxiety or attention deficit hyperactivity disorder (ADHD).
  • Teen’s view of parent’s attitude. Teens are more likely to start using alcohol if they think their parents approve of drinking.3
  • Parent's abuse of substances. Teens whose parents abuse alcohol or drugs are more likely to develop an abuse problem.
  • Parent's attitudes toward alcohol, cigarettes, and drugs. Teens whose parents believe that alcohol and drug experimentation is expected and normal are more likely to use alcohol, cigarettes, and drugs. In addition, teens may interpret their parents' ambivalent attitude toward substance use as approval of the behavior.
  • Lack of connectedness. Teens from families with frequent conflict, physical or sexual abuse, or psychological stress are more likely to try alcohol and drugs. Without feelings of closeness, a teen may look to alcohol or drugs to compensate for emotional pain.
  • Lack of consistent parent involvement. Lack of consistent parent involvement in a child's life and lack of appropriate supervision increase a teen's risk for abusing alcohol, cigarettes, or other drugs. Harsh or inconsistent punishment or permissiveness also increase a teen's risk for alcohol and drug abuse.

Community risk factors

These include:

  • Access to substances. Easy access to cigarettes, active drug trading, substance-abusing role models, or substance use that is accepted and tolerated in the community can contribute to a teen's likelihood of using substances. Having cigarettes, alcohol, or other drugs in the home also increases the chances that a teen will use them.
  • Peer influence. A teen's peers heavily influence the choice to use substances. This can result when a teen wants to fit in with a group and then chooses a group that uses substances.
  • Promotion of alcohol, cigarettes, and drugs by the media. The entertainment and other media portray alcohol and cigarette use as "cool." Ads portray alcohol use as a way to gain popularity, success, and sex appeal. Music and movies also portray cigarettes and other drugs as glamorous. Pharmaceutical company advertisements promote the use of prescription or nonprescription drugs with an implicit message that drugs improve your life.

Is Your Teen Using Alcohol or Drugs?

Sometimes it's difficult to tell if your teen is using alcohol or drugs. Parents may worry that their teens are involved with drugs or alcohol if they become withdrawn or negative, although these behaviors are common for teens going through challenging times. It is important not to accuse your teen unfairly and to try to discover why your teen's behavior has changed by telling him or her that you are concerned.

Typically, experts recommend that when alcohol or drug use is suspected, parents look for a pattern or a number of changes in appearance, behavior, and attitude, not only one or two changes. Substance abuse may be a possibility if several of the following signs are present:

  • Less attention paid to dressing and grooming
  • Loss of appetite or unexplained weight loss
  • Red and glassy eyes and frequent use of eyedrops and breath mints
  • Decreased attendance and performance at school
  • Loss of interest in school, sports, or other activities
  • Newly developed secrecy, or deceptive or sneaky behavior
  • Withdrawal from family and friends
  • New friends and reluctance to introduce them
  • Lying or stealing
  • Disrespectful behavior
  • A mood or attitude that is getting worse
  • Lack of concern about the future

Prevention Strategies

Teens who do not use alcohol, cigarettes, and other drugs are less likely to use them as adults. Efforts to prevent teen substance abuse should begin early in a child's life with drug education, encouragement of healthy behaviors, and good family communication. While teens are more likely to use alcohol or drugs if their parents do, a parent's attitudes towards substance use also influence teen behavior. Believing that parents will allow drug use increases the likelihood that the teen will try alcohol, cigarettes, or other drugs.

Having positive self-esteem, supportive family relationships, and positive role models and learning communication and problem-solving skills all help teens gain confidence to make good choices.

By age 9, your child will have established an attitude toward substance use. Therefore, start early in helping your child develop the skills needed to avoid substance abuse. Try the following:

  • Be a role model. As a parent, your attitude toward alcohol, cigarettes, and drugs is one of the greatest influences on whether your child will use cigarettes, drugs, or alcohol. Being a good role model is an excellent way to show your child and teen how to act responsibly. If you have a substance abuse problem, get appropriate help. If you quit, your teen is more likely to get help early if he or she starts abusing a substance.
  • Share your beliefs. Children need to know what their parents believe about issues that are important. Even though they may not act like it, most children are greatly influenced by what their parents tell them. Use TV programs, news broadcasts, and other media as springboards for discussions about substance use. Talk with your teen about the effects of substances on physical growth, emotional development, school performance, and health. If you have a family history of substance use problems, talk with your teen about his or her increased risk for alcohol and drug use problems.
  • Stay connected. Staying involved may be difficult during the teen years, because teens usually want privacy and independence. Provide adequate supervision, know your teen's friends, and know where your teen is at all times. Set times when the family is expected to be together, such as at mealtimes. Plan family outings or other family fun activities. Let your teen know that he or she is valued and contributes to the family.
  • Be fair and consistent. Extremes of discipline are a risk factor for teen substance abuse. Set reasonable consequences for unacceptable behavior and consistently carry them out. Praise your teen for his or her accomplishments, and expect your teen to follow the household rules.
  • Encourage activities. Keep your teen busy and engaged emotionally with meaningful activities, such as sports, church programs, or other group involvement. Teens who feel good about themselves are less likely to use alcohol and drugs.
  • Get informed. Don't rely only on your own experiences or what you have heard. Educate yourself about the substances commonly abused by teens. There is a lot to learn, because so many substances are being used by teens today and none are totally harmless. Talk with a doctor about information on commonly abused substances and groups of drugs. Find out how the drugs work, what their street names are, what the signs of being under the influence are, what indicates overdose and what to do, and how the drugs affect a teen's growth and development.

Some communities have prevention programs for high-risk teens. If you live in a high-risk neighborhood or your teen is at high risk for substance abuse, a community prevention program can help your teen develop skills to avoid substance abuse.

When to See a Health Professional

If you think that your teen is using alcohol or drugs, gather all the information you can before taking your teen to a health professional. This will help ensure an accurate diagnosis of your teen's involvement with substances. Health professionals who can diagnose and treat substance abuse problems include medical doctors (such as a general practitioner, pediatrician or psychiatrist), a physician assistant, or a nurse practitioner. Professional counseling for addiction, either individually or in a group setting, can be provided by a psychiatrist, psychologist, social worker, or licensed mental health counselor.

If the health professional believes your teen may have a substance abuse problem, he or she will do a medical history and a physical exam. The health professional will ask questions about your teen's attitude toward substance use, history of use, and any effects of drug use. To gather this information, the health professional will want to talk with your teen in private.

Urine, blood, or hair drug analysis (toxicology testing) or a blood alcohol test is not usually done to diagnose abuse problems. Health professionals generally will not do these tests without the teen's awareness and consent. Parental consent is not sufficient unless there is a medical or legal reason for testing.

Because psychiatric conditions such as attention deficit hyperactivity disorder (ADHD), conduct disorder, depression, long-term depressed mood (dysthymic disorder), anxiety disorders, and post-traumatic stress disorder are common in teens who abuse substances, the health professional may evaluate your teen for one or more of these conditions. These conditions can make treatment for substance abuse more difficult, so evaluations need to be done as soon as possible to provide treatment that addresses the condition along with substance abuse.

If your teen is thought to have a substance abuse or dependence problem, the health professional will refer you to a professional who is experienced in teen alcohol and drug problems for a full evaluation. A full evaluation is used to plan treatment appropriate for your teen's level of abuse or dependence.

Early detection

Ideally, when your child is about 9 years old, your child's health professional will begin asking about his or her attitudes toward alcohol, cigarettes, and drugs. As your child grows, the health professional will continue to discuss this issue during medical visits. This allows the opportunity to prevent substance abuse or to intervene early, if necessary. Intervention at an early age is very important, because early substance use increases the likelihood that your child will participate in other risky behaviors.

A health professional who suspects that you or another family member has a substance abuse problem will discuss treatment. Getting treatment early for yourself (or another family member) decreases your child's risk of developing a substance abuse problem. In addition, your child will be more likely to get treatment early if he or she does develop a substance abuse problem.

Finding the Right Treatment for Your Teen

Most teens do not make a conscious decision to quit abusing a substance before they go into treatment for substance use problems. So it is very important that treatment be based on a thorough assessment and fit the teen's level of substance use.

Appropriate treatment for level of use

  • If your teen has started experimenting with alcohol, cigarettes, inhalants, or drugs, education about the harmful effects of substances through a school or community program may be all that is needed. Some schools have programs for students with alcohol and drug use problems that provide support and drug education. At this level of substance use, encouraging your teen to be involved in healthy activities (such as sports, hobbies, or church), spend time with the family, and participate in a healthy peer group may help him or her develop the skills needed to avoid substance abuse. You can also pay attention to your teen's activities and peers who might be using substances. It can help to set up clear rules about the use of substances. For example, if your teen continues to use drugs or alcohol, you could take away privileges such as driving.
  • If your teen is abusing a substance regularly (at least weekly), some form of treatment is usually needed. At this level of substance use, it is important to pay close attention to your teen's concerns, which may be related to emotional or self-esteem problems. Finding activities that your teen can substitute for substance use is important for him or her to be able to remain alcohol- and drug-free. Treatment in an adolescent outpatient or hospital program is recommended. The focus of treatment should be on helping the teen gain motivation to stop using and skills to refuse drugs in the future. Because substance abuse problems affect the whole family, family counseling should also be a part of treatment.
  • If your teen is dependent on alcohol or drugs, he or she will need treatment in a structured program and may need medical attention for withdrawal symptoms. For example, if your child is addicted to heroin or another opiate, he or she may be referred to a methadone treatment program. These programs use the medicines methadone, buprenorphine, or antidepressants such as bupropion (Wellbutrin) to help people cope with the withdrawal symptoms caused by opiate use. Also, a teen needs to learn coping skills to deal with the anger, frustration, sadness, and disappointment that are often associated with substance abuse and recovery. Again, family involvement is important to your teen's success in remaining substance-free.
  • If your teen is dependent on cigarettes or other tobacco products, he or she needs to quit to prevent serious health problems. For more information, see the topic Quitting Smoking.

Types of programs

There are several types of teen substance abuse treatment programs.

  • Inpatient programs are highly structured, closely supervised programs located within a hospital or treatment facility. The teen stays day and night during treatment, which normally lasts about 4 weeks. These programs usually have an aftercare program that provides support and encouragement after treatment.
    • Inpatient programs provide education and individual, family, and group counseling. They are often based on the principles of Alcoholics Anonymous and Narcotics Anonymous.
    • Another type of inpatient program is the therapeutic community, which is not based in a hospital. In a therapeutic community program, the teen accomplishes a series of tasks with constant feedback from his or her peers. Therapeutic community programs may last as long as 2 years, and some teens choose to stay and work in the program after treatment.
    • Wilderness challenge programs combine a wilderness experience and some form of treatment to help troubled teens communicate better with their family, control their anger, and build healthy relationships. A variety of programs are available, and their quality varies greatly. Wilderness challenge programs are expensive and tend to limit contact with parents. Talk with a health professional, and ask him or her questions if you are considering sending your teen to a wilderness program.
  • Outpatient programs range from very structured programs with psychotherapy and family therapy to drop-in centers.
    • Outpatient day treatment programs require that the teen spend 8 hours or more during the day at the facility, but the teen is home at night. Day treatment programs usually have the same components (individual, group, and family counseling) as inpatient programs, but day treatment normally costs less.
    • Less intensive outpatient programs are designed for young people who do not need residential, hospitalization, or intensive day treatment. Treatment includes individual or group counseling and family therapy, and some settings use 12-step programs. Programs vary in how many days and hours a week are required.

Whatever type of treatment program you choose, it should consider teen developmental issues and characteristic problems, such as peer pressure and the need to test the limits. The treatment also needs to provide a way for your teen to continue his or her education. Some teens need remedial help to return to school after treatment. It may boost your teen's self-confidence and self-esteem if he or she can accomplish even small academic tasks during treatment. Your teen should be involved in an aftercare program following treatment.

Substance abuse affects all family members. Often family counseling is part of the treatment program, but family members may want to attend support group meetings such as Al-Anon, Nar-Anon, Alatot, or Alateen meetings as well. These support groups can help you and your family deal with how your teen's substance use has affected the family and how each family member can stop contributing to the teen's use.

What to do if your teen relapses

Getting a teen to stop using alcohol, cigarettes, or other drugs is only the first step. Substance use fills an emotional need. Identifying and satisfying that need in a healthy way is crucial to the teen being able to stay off the substance.

Returning to substance use (having a relapse) after treatment is common and is not considered a treatment failure. Most relapses occur within the first 3 months after treatment. Most often, teens need to go through treatment more than once and follow a long recovery process to remain substance-free.

Your teen is less likely to relapse if:

  • The treatment program helps the teen develop motivation to stop using, and skills needed to deal with drug cravings, high-risk situations, and relapse.
  • Your teen can commit to being substance-free for 12 to 24 months.
  • Your teen has or finds a healthy hobby or interest. He or she may replace time formerly spent using the substance with time for the new activity.
  • Your teen receives treatment for any other psychiatric conditions, such as attention deficit hyperactivity disorder (ADHD), depression or long-term depressed mood (dysthymia), post-traumatic stress disorder, or an anxiety disorder. This will help prevent him or her from using the substance to treat the symptoms of the condition.
  • Your teen is involved in an aftercare program or case management.

What to Do When Your Teen Is Using

Families have a strong influence on whether a child will use cigarettes, alcohol, or other drugs. Here are some ideas to help you recognize and deal with this issue.

Work with your teen

Before any substance use has occurred, discuss:

  • Your teen's risk. Talk with your teen about his or her risk for developing substance dependence (addiction). Discuss the family history of substance abuse or addiction, the influence of peers, and substances available in your community.
  • The personal consequences. Explain that some behaviors, such as unsafe sex, can lead to consequences that last a lifetime. Talk about how the use of substances while trying to develop adult skills—graduating from high school, going to college, getting a job—can affect his or her future. Remember that teens live for today, so discussing long-term health consequences of drug use does not help prevent a teen from using substances.
  • The legal consequences.Remind your teen that it is illegal for teens to use any substances, including alcohol and cigarettes. Talk about the increased risk of auto accidents, violence, and arrests related to substance use.
  • Expected behaviors. Talk about what to do in social situations involving alcohol or drugs. Be very clear about what action you want your teen to take in these situations. Discuss your expectations regarding all-night dances (raves) and the drugs that may be available at these events. Use a parent-teen contract to write down expected behaviors and consequences if the plan is not followed.

Take quick action

Any use of alcohol, cigarettes, or drugs in childhood or the teen years should be considered a problem, unless it turns out to be only an isolated incident. If you suspect or see signs that your teen is using substances, check it out. Don't wait for it to become a significant problem.

Note: One home urine drug screening test has been approved by the U.S. Food and Drug Administration (FDA). The test provides immediate preliminary information about whether the urine sample contains particular drugs (amphetamine, methamphetamine, opiate, marijuana, and cocaine). But it does not indicate which drug has been used. The test strip has to be sent to a laboratory for confirmation and to identify the drug used. Don't use this kind of testing to identify substance abuse. Sometimes this test is used during treatment or during the continued structured support program (aftercare program) to monitor a teen. It is best not to use this test without your teen's consent, and it needs to be done under the supervision of a health professional.

Use the following information to help you recognize and deal with substance use in your teen.

Click here to view an Actionset. Dealing with teen substance use

If treatment is needed

If your teen needs treatment for a substance abuse problem:

  • Get appropriate treatment. Talk with a health professional about treatment options in your area. Adult programs do not meet the needs of teens because they usually stress long-term health and relationship effects of substance abuse, which is not a concern for teens. If your teen needs to be placed in a structured inpatient or outpatient program, look for a program with the components he or she needs, such as a school program or opportunities for parental involvement.
  • Be involved in the treatment and aftercare program. Let your teen know that you are supportive. It may take a long time for your teen to reestablish trust, to be forgiven by you, and to forgive himself or herself.
  • Get help for your family. Talk with a health professional about help for you and your family. Substance abuse affects the physical, psychological, social, and spiritual aspects of the person and his or her family. Your family members need to know that they did not cause the disease but their behavior can contribute to the continuation of the disease process. Family therapy is an important factor in whether your teen will be able to remain substance-free after treatment. Support groups such as Al-Anon and Alateen may be very helpful for family members.
  • Help establish a direction. Establishing a sense of direction in life is important for your teen to remain drug-free. Treatment for teen substance abuse usually includes help to identify talents and strengths that can be used to find healthy interests, hobbies, and occupations. Teens who develop a sense of purpose in life are better able to avoid substance use.
  • Plan for relapse. Most teens relapse after treatment. This does not mean that the treatment failed. Relapse is high because addiction is a long-term disease. If your teen relapses, respond with empathy because it is very hard to remain substance-free. Allow your teen the opportunity to explore his or her feelings of ambivalence toward abstinence and relapse. Try to help him or her see relapse as an opportunity to improve motivation and keep working on skills to avoid substance use.

Other Places To Get Help


Alcoholics Anonymous (AA) World Services, Inc.
P.O. Box 459
New York, NY  10163
Phone: (212) 870-3400
Web Address: http://www.aa.org/

AA is a support group and self-help program for recovery from alcohol use problems as well as other substance abuse problems. Meetings are available in most communities at various times. Meetings can be "open" (for the person and his or her family) or "closed" (for the person only). Special groups for women, teens, and gay/lesbian people may be available in some areas. AA provides written information on the program of recovery. Phone numbers for local offices are listed in local area phone books.

National Institute on Alcohol Abuse and Alcoholism: The Cool Spot
5635 Fishers Lane MSC 9304
Bethesda, MD  20892
Phone: (301) 443-3860
Web Address: www.thecoolspot.gov or www.niaaa.nih.gov

The National Institute on Alcohol Abuse and Alcoholism created thecoolspot for 11- to 13-year-olds. It's meant to give preteens and young teens a picture of alcohol use among their peers. Accurate information is given about how much teens their age drink. And thecoolspot has information not only to help teens learn skills to resist the pressure to drink but also to give them reasons not to drink.

National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH)
6001 Executive Boulevard, Room 5213
Bethesda, MD  20892-9561
Phone: (301) 443-1124
E-mail: information@nida.nih.gov
Web Address: www.drugabuse.gov

This organization provides information for the public on drugs. It contains information about how certain drugs affect the brain.

NIDA for Teens, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH)
6001 Executive Boulevard, Room 5213
Bethesda, MD  20892 9561
Phone: (301) 443-1124
E-mail: information@nida.nih.gov
Web Address: www.drugabuse.gov/students.html

This organization provides information on drugs. It provides information on different drugs and teen drug use.

Partnership for a Drug-Free America
405 Lexington Avenue
Suite 1601
New York, NY  10174
Phone: 1-866-281-9945 (toll-free helpline)
(212) 922-1560
Fax: (212) 922-1570
Web Address: www.drugfree.org

The Partnership for a Drug-Free America is a nonprofit organization whose mission is to reduce illegal drug use in the United States. The organization provides a large range of materials on prevention and treatment targeted to parents and teens.



  1. Centers for Disease Control and Prevention (2006). Youth risk behavior surveillance—United States, 2005. MMWR, 55(SS-5): 1–98.
  2. Ammerman SD (2008). Tobacco. In LS Neinstein, et al., eds., Adolescent Health Care: A Practical Guide, 5th ed., pp. 888–907. Philadelphia: Lippincott Williams and Wilkins.
  3. Anderson MM, Neinstein LS (2008). Alcohol. In LS Neinstein, et al., eds., Adolescent Health Care: A Practical Guide, 5th ed., pp. 878–887. Philadelphia: Lippincott Williams and Wilkins.

Other Works Consulted

  • American Academy of Child and Adolescent Psychiatry (2005). Practice parameter for the assessment and treatment of children and adolescents with substance use disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 44(6): 609–621.
  • Committee on Substance Abuse, American Academy of Pediatrics (2001). Alcohol use and abuse: A pediatric concern. Pediatrics, 108(1): 185–189.
  • Committee on Substance Abuse, American Academy of Pediatrics (2005). Tobacco, alcohol, and other drugs: The role of the pediatrician in prevention, identification, and management of substance abuse. Pediatrics, 115: 816–821. Also available online: http://www.pediatrics.org/cgi/content/full/115/3/816.
  • Griswold KS, et al. (2008). Adolescent substance use and abuse: Recognition and management. American Family Physician, 77(3): 331–336.
  • Hopfer C, Riggs P (2007). Substance use disorders. In A Martin, FR Volkmar, eds., Lewis's Child and Adolescent Psychiatry, 4th ed., pp. 615–624. Philadelphia: Lippincott Williams and Wilkins.
  • Jenkins RR, Hoover A (2007). Substance abuse. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 824–834. Philadelphia: Saunders Elsevier.
  • Kaminer Y (2008). Adolescent substance abuse. In M Galanter, HD Kleber, eds., Textbook of Substance Abuse Treatment, 4th ed., pp. 525–535. Washington, DC: American Psychiatric Publishing.
  • Kaul P, Coupey SM (2002). Clinical evaluation of substance abuse. Pediatrics in Review, 23(3): 85–94.
  • Kaul P, Stevens-Simon C (2007). Substance abuse. In WW Hay Jr et al., eds., Current Pediatric Diagnosis and Treatment, 18th ed., pp. 144–162. New York: McGraw-Hill.
  • Sadock BJ, et al. (2007). Adolescent substance abuse. In Kaplan and Sadock's Synopsis of Psychiatry, Behavioral Sciences/Clinical Psychiatry, 10th ed., pp. 1294–1298. Philadelphia: Lippincott Williams and Wilkins.
  • Schuckit MA (2007). Drug abuse and dependence. In DC Dale, DD Federman, eds., ACP Medicine, section 13, chap. 11. New York: WebMD.
  • Simkin DR (2005). Adolescent substance abuse. In BJ Sadock, VA Sadock, eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 8th ed., vol. 2, pp. 3470–3490. Philadelphia: Lippincott Williams and Wilkins.
  • Substance Abuse and Mental Health Services Administration (2007). Results From the 2006 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293). Available online: http://oas.samhsa.gov/nsduhlatest.htm.


Author Caroline Rea, RN, BS, MS
Author Jeannette Curtis
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer Yifrah Kaminer, MD - Child and Adolescent Psychiatry
Last Updated August 27, 2008

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