Substance use in adolescents is a teen's use of alcohol, tobacco, and drugs (including prescription medicines without a prescription). Such use could be occasional experimenting or regular and ongoing.
Any substance use raises the risk of other problems. For example, adolescents who use substances are more likely to have car crashes, fights, unwise or unwanted sex, overdose, or other behavior problems Behavior Problems in Adolescents Adolescence is the time when children grow into independent adults. It usually begins at about age 10 years and lasts until the late teens or early 20s. But most people just think of adolescence... read more . Substance use is considered substance abuse when adolescents continue to use substances even after these behavior problems happen.
Adolescents who abuse substances are at a higher risk of having long-term problems. These problems include mental health problems, poor grades in school, and substance use disorders Substance Use Disorders Substance use disorders generally involve behavior patterns in which people continue to use a substance (for example, a recreational drug) despite having problems caused by its use. The substances... read more such as addiction and overdose.
It’s common for adolescents to try alcohol or other substances, but regular use is rarer
Alcohol is the most common substance used by adolescents—they often drink heavily and binge drink, which raises the chance of fights, car crashes, and other causes of injury
Parents, peers, and the media influence an adolescent's attitude toward substance use
What types of substances do adolescents use and abuse?
Adolescents use and abuse many substances, including over-the-counter medicines. The most common substances are:
Adolescents also abuse:
Prescription medicines, such as opioids Opioids Opioids, a class of drugs derived from the opium poppy (including synthetic variations), are pain relievers with a high potential for misuse. Opioids are used to relieve pain, but they also... read more , antianxiety drugs Misuse of Antianxiety Medications and Sedatives Antianxiety and sedative medications are prescription drugs used to relieve anxiety and/or help with sleep, but their use can result in dependency and a substance use disorder. Using prescription... read more , and stimulants
Over-the-counter (OTC) drugs, such as cough and cold medicines
Alcohol
Alcohol is the substance most often used by teens
Adolescents have a higher chance of a drinking problem if they start young or have family members with drinking problems
To prevent alcohol use, discourage your teen from drinking and set a good example yourself
Tobacco
Tobacco use includes smoking cigarettes, pipes, or cigars, chewing tobacco, putting tobacco between the lower lip and gum, and inhaling it into the nose
Most adults who smoke started smoking as adolescents
Adolescents are more likely to smoke if they have parents who smoke
To prevent tobacco use, don’t use tobacco in front of your children and talk to them about the effects of tobacco
If your child already smokes or uses tobacco, encourage quitting and help him or her find support
Electronic cigarettes (e-cigarettes, vapes) don't burn tobacco. They heat up a liquid that contains nicotine, which is the active ingredient in tobacco. The "smoke" that comes off e-cigarettes is just water vapor that contains nicotine. Because it's the smoke from burning tobacco that causes lung cancer Lung Cancer Lung cancer is cancer that starts in your lungs. Cancers that start growing in other organs may spread (metastasize) to the lungs. Cancers that have spread to your lungs aren't considered lung... read more and chronic lung disease (COPD Chronic Obstructive Pulmonary Disease (COPD) COPD is a disease in your lungs that makes it hard to breathe. It's hard to push air out of your lungs. Difficulty pushing air out is called chronic airflow obstruction. Smoking cigarettes is... read more 
), e-cigarettes have been promoted as a safer alternative to cigarettes. However, they aren't necessarily safe:
E-cigarettes contain nicotine, which is very addictive
Doctors don't know whether other substances mixed with the liquid nicotine may be dangerous
Most adolescents who use e-cigarettes also use tobacco products
What should I do if my adolescent is using or abusing substances?
Talk to your child and your child's doctor about substance abuse if you notice:
Unusual behavior
Depression or mood swings
A change in friends
Worse grades
Loss of interest in activities
Drugs or drug items, such as pipes, syringes, and scales
Your child's doctor will:
Ask your child in private about substance use
Help figure out if a substance use problem is likely
Refer your child for testing, if needed
Refer your child to treatment, if needed
Treatment for substance use disorders in adolescents is like treatment in adults. But adolescents should be treated by those who specialize in that age group and their needs.
