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Adolescent Substance Abuse

November 13, 2014

For more than 35 years, The Meadows has explored the underlying issues of patient trauma. Clinicians and professionals trust us more than any other treatment program because of our impeccable reputation for quality, integrity, and long-term recovery. The Monitoring the Future (MTF) survey measures drug, alcohol, and tobacco use and related attitudes among 8th, 10th, and 12th graders. ASAP, the Adolescent Substance Abuse Program summarizes the MTF survey for parents and professionals each year.

Parents play a critical role in their children’s lives, and worrying about the risk factors for adolescent substance use disorder in adolescents can be a significant concern. Adolescent substance abuse can impact children’s health and wellbeing, and teens are at greater risk for substance abuse the earlier they start. 

The American Academy of Pediatrics (AAP) collaborated with The Centers for Disease Control and Prevention (CDC) to develop a guide to implementing substance abuse screening in pediatric practices. This guide helps pediatricians address substance use concerns, especially early on. Due to the prevalence of drug addiction in teens, the AAP recommends that individuals start screening at nine years old. 

Illicit Drug Use

Illicit teenage drug use remains high, primarily due to the increasing popularity of marijuana. Marijuana use by adolescents declined from the late 1990s until the mid-to-late 2000s but has been rising since then. In 2013, 7.0 percent of 8th graders, 18.0 percent of 10th graders, and 22.7 percent of 12th graders used marijuana in the past month, up from 5.8 percent, 13.8 percent, and 19.4 percent in 2008. Daily use has also increased, with 6.5 percent of 12th graders now using marijuana every day, compared to 5 percent in the mid-2000s.

Rising marijuana use reflects changing perceptions and attitudes. Historically, as the perception of risks goes down, service goes up (and vice versa). Teens abusing drugs show less disapproval of marijuana use and decreased perception that marijuana is dangerous. The growing perception of marijuana as a safe drug may reflect recent public discussions over “medical marijuana” and movements to legalize the drug for adult recreational use in some states.

New synthetic drugs are a cause for concern, but their use is not increasing. Synthetic marijuana refers to herbal mixtures laced with synthetic chemicals similar to THC, the primary ingredient in marijuana. It was added to the MTF survey in 2011 when 11.4 percent of high school seniors reported using it in the past year; in 2013, it had dropped to 7.9 percent. These mixtures could be obtained legally until 2012 and are still wrongly perceived as a safe alternative to marijuana. The synthetic stimulants, known as “bath salts,” were added to the survey in 2012. In 2013, 0.9 percent of seniors had used these drugs in the past year.

Nonmedical use of prescription and over-the-counter medicines remains a significant part of the teen drug problem. In 2013, 15.0 percent of high school seniors used a prescription drug non-medically in the past year. The survey shows continued abuse of Adderall, commonly used to treat attention deficit hyperactivity disorder, or ADHD, with 7.4 percent of seniors reporting taking it for non-medical reasons in the past year.

However, only 2.3 percent of seniors say they abuse Ritalin, another ADHD medication. Misuse of the opioid pain reliever Vicodin has shown a marked decrease in the last ten years, now measured at 5.3 percent for high school seniors, compared to 10.5 percent in 2003. In addition, 5 percent of seniors report the abuse of cough products containing dextromethorphan, down from 6.9 percent in 2006, the first year it was measured by the survey.

Positive trends in the past several years include reduced use of inhalants and less use of cocaine, especially crack cocaine. Past-year inhalant use by younger teens continued a downward trend in 2013, with 5.2 percent of 8th graders and 3.5 percent of 10th graders reporting use. Five-year trends of past-year cocaine use across all teens abusing drugs showed a drop. Other drugs, such as heroin, methamphetamine, ecstasy (MDMA), and hallucinogens, are relatively steady.

Alcohol Use

Alcohol use among teens remains at historically low levels. In 2013, 3.5 percent of 8th graders, 12.8 percent of 10th graders, and 26 percent of 12th graders reported getting drunk in the past month, continuing a downward trend from previous years. Significant declines include sharp drops from earlier years in daily alcohol use by 10th and 12th graders (0.9 percent and 2.2 percent, respectively, in 2013). In 2013, 22.1 percent of high school seniors reported binge drinking (defined as five or more drinks in a row in the past two weeks)—a drop of almost one-third since the late 1990s.

Tobacco Use

Fewer teens smoke cigarettes than smoke marijuana. Cigarette smoking by high school students peaked in 1996–1997 and has continuously declined since then. In 2013, 16.3 percent of 12th-grade students surveyed by MTF were current (past-month) cigarette smokers—the lowest teen smoking has been in the survey’s history. By comparison, 22.7 percent were current marijuana smokers.

However, other forms of smoked tobacco are becoming popular. The use of hookah water pipes and small cigars has raised public health concerns and has recently been added to the MTF survey. In 2013, 21.4 percent of 12th graders had smoked hookah in the past year, increasing from 18.3 percent in 2012. Additionally, 20.4 percent had smoked a small cigar.

Risk Factors for Substance Use Disorder in Adolescents

There are two categories of risk factors for adolescent substance use disorder: societal and cultural and individual.

Societal and Cultural

Shifts in cultural norms, the legal definitions of specific behaviors, and economic factors are associated with changes in drug-using behaviors and the prevalence of drug abuse. Laws and societal norms,  drug availability, extreme economic deprivation, and neighborhood disorganization can influence adolescents. 

Lower legal drinking ages and alcohol tax can also contribute to teenage substance abuse. Drug availability is also contingent on geographical areas, so adolescents are more likely to use substances in communities where drugs are more readily available. 


Specific characteristics of individuals and their environments can put them at greater risk for substance abuse. Individuals who experience behavioral problems early, including aggressiveness, negative moods, impulsivity, and withdrawal, are more likely to use substances. Having an existing mental health condition or learning disorder, problems in your family or at school, and associating with peers who use drugs result in a higher risk of substance abuse in adolescence. 

Adolescent Addiction Treatment at The MeadowsThe Meadows’ drug and alcohol addiction treatment program can help you create a recovery, peace, and healing life. We’ve helped over 45,000 clients through workshops and inpatient treatment programs. Call us at (800)-244-4949 to learn more about our groundbreaking, intensive, experientially-based, inpatient treatment program for emerging adults ages 18-26 who struggle with emotional trauma, addiction, or dual diagnosis concerns.