Adolescent Substance Abuse

Being a teenager and raising a teenager are enormous challenges. For many teens, illicit substance use and abuse become part of the landscape of their teenage years. Although most adolescents who use drugs do not progress to become drug abusers, or drug addicts in adulthood, drug use in adolescence is a very risky proposition. Even small degrees of substance abuse (for example, alcohol, marijuana, and inhalants) can have negative consequences. Typically, school and relationships, notably family relationships, are among the life areas that are most influenced by drug use and abuse. One of the most telling signs of a teen's increasing involvement with drugs is when drug use becomes part of the teen's daily life. Preoccupation with drugs can crowd out previously important activities, and the way the teen views their self may change in unrealistic and inaccurate directions. Friendship groups may change and relationships with family members can become more distant or conflictual. Further bad signs include more frequent use or use of greater amounts of a certain drug, or use of more dangerous drugs, such as cocaine, amphetamines, or heroin. Persistent patterns of drug use in adolescence are a sign that problems in that teen's environment exist and need to be addressed immediately.

What causes adolescent substance abuse?

There is no single cause of adolescent drug or alcohol problems. Substance abuse develops over time; it does not start as full-blown abuse or addiction. There are different pathways or routs to the development of a teen's substance abuse problem.

Some of the factors that may place teens at risk for developing substance abuse problems include:

  • Insufficient parental supervision and monitoring
  • Lack of communication and interaction between parents and kids
  • Poorly defined and poorly communicated rules and expectations against substance use
  • Inconsistent and excessively severe discipline
  • Family conflict
  • Favorable parental attitudes toward adolescent alcohol and drug use, and parental alcoholism or drug use

It's also important to pay attention to individual risk factors, including:

  • High sensation seeking
  • Impulsiveness
  • Psychological distress
  • Difficulty maintaining emotional stability
  • Perceptions of extensive use by peers
  • Perceived low harmfulness to use

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If you or someone you know is experiencing distress, therapy with a marriage and family therapist (MFT) can help.

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How do you know when to seek help?

The earlier one seeks help for behavioral or drug problems, the better. How is a parent to know if their teen is experimenting with or moving more deeply into the drug culture? Simply stated, a parent must be a good and careful observer, particularly of the little details that make up a teen's life. Overall signs of dramatic change in appearance, friends, or physical health may be signs of trouble.

If a parent believes a child may be drinking or using drugs, here are some things to watch for:

• Physical evidence of drugs and drug paraphernalia
• Behavior problems and poor grades in school
• Emotional distancing, isolation, depression, or fatigue
• Change in friendships or extreme influence by peers
• Hostility, irritability, or change in level of cooperation around the house
• Lying or increased evasiveness about after school or weekend whereabouts
• Decrease in interest in personal appearance
• Physical changes such as bloodshot eyes, runny nose, frequent sore throats, rapid weight loss
• Changes in mood, eating, or sleeping patterns
• Dizziness and memory problems

What kind of treatment will work?

Evidence shows that certain forms of family therapy are the most effective treatments for substance abuse problems. A qualified marriage and family therapist can evaluate and assess a teen's substance abuse problem, and will then provide appropriate treatment for the adolescent, which may include outpatient therapy or therapy in a residential treatment facility. Therapy will focus on a number of important life areas of the teen, in addition to his or her relationships with parents. It is essential for parents to be involved in the teen's treatment. Relationships are a critical ingredient to combat a teen's substance abuse problems.

How can I help my teen avoid substance abuse?

Parents and guardians need to be aware of the power they have to influence the development of their kids throughout the teenage years. Adolescence brings a new and dramatic stage to family life. The changes that are required are not just the teen's to make; parents need to change their relationship with their teenager. It is best if parents are proactive about the challenges of this life cycle stage, particularly those that pertain to the possibility of experimenting with and using alcohol and drugs. Parents cannot be afraid to talk directly to their kids about drug use, even if they have had problems with drugs or alcohol themselves. An excellent resource on how to talk to kids about drugs is: Parents - The Anti-Drug. Parents are encouraged to give clear, no-use messages about smoking, drugs, and alcohol. It is important for kids and teens to understand that the rules and expectations set by parents are based on parental love and concern for their well-being. Parents should also be actively involved and demonstrate interest in their teen's friends and social activities. Spending quality time with teens and setting good examples are essential. Even if problems such as substance abuse already exist in the teen's life, parents and families can still have a positive influence on their teen's behavior.


  • Parents - The Anti-Drug: Provides advice, information, and resources for parents who are battling adolescent drug abuse.
  • Teen Drug Use and Abuse Prevention:Gives parents information on drugs, as well as how to talk to their teens about certain substances.
  • Tips 4 Youth:Details reasons why smoking is such a health risk, as well as how youth can find help to quit smoking.
  • Talking with Kids about Tough Issues:Provides instructions and information for parents when talking to their children about issues such as drug and alcohol use, HIV and AIDS, violence, and sex.

Written by Keith Klostermann, PhD, LMHC