speech on drug abuse among youth

Speech on Drug Abuse in English in Simple and easy Words

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Speech on Drug Abuse: Drug abuse has become the most common thing these days and many youth are destroying their lives by getting addicted to drugs. It’s very important to sensitize our youth on the subject of drug abuse. They are ruining the lives of our youth and putting their future in a great darkness. The use of drugs is making their lives vulnerable and prone to destruction. Therefore, it becomes very important to raise awareness about it amongst our youth and prevent them from succumbing to it. The International Day against Drug Abuse and Illicit Trafficking is celebrated annually on June 26th it serves as a significant platform for raising awareness and addressing the critical issue of substance abuse. You can even prepare a speech on drug abuse and deliver it on various occasions and platforms.

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Long and Short Speeches on Drug Abuse in English

For your help, we have posted below some short speech on drug abuse as well as long speech on drug abuse, which will give you a comprehensive understanding of the subject matter and help you create an impressive brief to impress upon your audience and bring a change in society.

Speech on Drug Abuse – Speech 1

Dear Students – Warm Greetings to all of you! I welcome everyone to the school seminar hall.

Today, we are here to discuss about the fatal consumption of drugs and how it is destroying the lives of our youth. But before the discussion begins, I would like to deliver a short speech on drug abuse and would like to enlighten our students on this sensitive subject matter.

Drugs, as we all know, are an illegal matter which some people drink, smoke, inject or eat for the mental as well as physical effects that it leaves. There are several students who consume drugs out of fun or for various other reasons. People who deal in the selling of drugs create a network and mainly target students in order to make them addicted to drugs. Initially, the drugs are sold to the students for free and gradually when they get addicted to it, they start buying and consuming it. In fact, the students also eventually become a part of their network and start dealing in it.

It is observed that students start consuming drugs out of stress or unfair expectations of their teachers as well as parents. Lack of emotional support and disorder in their families make them vulnerable and increase their dependency on drugs. They use it in order to calm down their state of mental agitation. Other than this, it is poverty that compels some students to become a part of the selling and dealing network of drugs and derive their pocket money. Therefore, it becomes like a vicious circle of the drug addicted students from which they seem to find no escape unless the society comes for their rescue.

Sadly, the students fail to realize that the consumption of drugs has a severe impact on their physical and mental health, such as they start experiencing mental disorder, their intelligence level decreases, experience deadly diseases and untimely death. When one completely succumbs to the temptation of drugs, it gets very difficult for him/her to recover from its impact except in the centers for drug rehabilitation where they gain a new life, but which involves a high cost. In fact, there are many cases too where even rehabilitation centers fail because of the worst condition of the patients.

I, therefore, request all the students to refrain themselves completely from the consumption of drugs before it destroys their health, future and takes away their lives. Don’t even try to touch or come close to them. Drugs can even destroy a complete generation. So think wise and act smart. Shape your future which seems bright and full of achievements. The drugs that doctor prescribes to his/her patients must only be taken in order to combat a specific disease otherwise the government must take strict measures to ban its illegal trade in the market and save our youth from destruction.

I want to conclude by saying that drug abuse should be an absolute ‘No’ for all and I sincerely hope that our students will never ever try to consume drugs and will completely stay away from its use. Remember that our country needs you as you are its future and harbinger of progress.

Also Read: Essay on Drug Abuse

Speech on Drug Abuse – Speech 2

Good Morning Friends – Welcome to the 77 th campaign for drug addiction ban.

It feels extremely great to see how the members of our organization are working hard in order to make every day count and reach out to the masses for spreading awareness about the drug addiction or drug abuse. Since day one and today it’s the 77 th campaign of our organization – we haven’t really ever thought that we will grow this big, i.e. currently we have more than 200 people working for us and have gained a mass appeal. The response so far has been really good and we have been able to transform the life of the people for good, who earlier have been living under the influence of drugs.

So today I would further like to appeal to the masses to refrain themselves from using drugs and live a healthy life. Drug addiction or drug abuse is described as an excessive dependency on a substance, which inevitably becomes the compulsive need of the person using it. This need becomes so compulsive that without that substance the person cannot live his life like a normal person does. And, when such a substance is stopped being available in the market then that person is believed to be suffering from substance withdrawal.

The addiction of drugs has become one of the serious social problems in many developing as well as developed countries and it undeniably proves to be the principal obstruction in the all-round development of the people, society, country and the world at a large. Our country is a progressing country and it is already afflicted with so many other grave problems, such as unemployment, poverty and illiteracy that the problem of Adolescence and Drug abuse makes the situation even worse here as it further makes our economy regressive by destroying the lives of its youth.

Even sadder is the fact that several drug addicts cannot afford to make a purchase of expensive drugs so much so that in the end they have to resort to such activities as theft in their homes. These people are not born thieves, but their addiction to drugs makes them heinous and propels them to commit crimes in order to feed their body with drugs.

People can become addicted to drugs because of various reasons, some of which are mentioned below:

1. In order to de-stress themselves

When a person is under the influence of drugs, he/she forgets everything and enters into a trance-like state. However, it is only later that people realize that the use of drugs is only aggravating the problem and not really helping them in getting rid of the stress.

2. Out of peer pressure

Many times, people start taking drugs because their friends are addicted to them. However, once they start taking it, it becomes really difficult for them to get rid of this habit.

3. Style Statement

Many teenagers these days think that the habit of drinking, smoking and even drug addiction is what helps them look cool and create a style statement in the front of others. However, it’s only when these people get trapped in its vicious circle that they realize the irreparable they have caused to their lives.

Teenagers and every person for that matter must understand that the habit of drug abuse not only greatly affects their body and mind, but also finishes their bright future. So we should strictly say ‘No’ to drugs and save our lives as well the lives of our loved ones by spreading awareness in our surroundings.

Also Read: Speech on Adult Education

Speech on Drug Abuse – Speech 3

Respected Principal, Vice Principal, Teachers and My Dear Fellow Students – Warm Welcome to all of you! Today, standing in the prayer hall I would like to take this opportunity to deliver a brief speech on Drug Abuse.

I request our principal and teachers to kindly allow me to speak on this subject as it is a high time to enlighten our youth about the dangerous habit of drug abuse. In the present times, there are many factors that push a man to resort to drug addiction and make his/her life miserable. The most glaring factors are rapid industrialization and urbanization, which have given birth to a new kind of behavior among the youth of today, i.e. individualism and permissiveness. People these days prefer nuclear families and in many cases both parents are working, as a consequence of which they become less forbearing in comparison to their previous generations. People are living their lives in isolation and avoid getting social because the stress in the modern times has become way too much to make them withdrawn figures in their personal lives.

In the end, such people become involved in the habit of drinking, smoking, drug addiction, etc. Besides, when a child doesn’t feel satisfied at home or when he/she is deprived of love, affection and care of his/her parents, a feeling of discontentment comes in and such children become prone to drug addiction and ruin their lives completely. What is more painful to see that if the drug addicted people are not allowed the use of drugs, then he/she suffers from bouts of depression, painful and uncontrollable convulsions as well as vomiting!

It is an obvious fact that the addiction of drugs is ruining the path of progress of many individuals and our nation as a whole so much so that proactive measures need to be taken in order to keep a check on this destructive habit of our youth. The most significant step in this direction would be about spreading awareness amongst the people on a national scale.

Our Indian government has in fact formulated various campaigns and even has been able to gain success in this direction. The individuals whose family and friends suffer from the addiction of drugs are requested to approach the rehabilitation institutions and camps in order to provide treatment to the addicts.

Drug abuse should not be tolerated and be completely banned as a taboo. However, it is not advised to torture the addict or treat him/her inhumanely for this habit because if you try and convince the person about its treatment then he/she may willingly choose to opt for it and get rid of this addiction by admitting himself/herself at the rehabilitation centers.

A person who has become the victim of drug abuse is forced by his/her bodily conditions to carry on with the addiction, but sooner they realize the bad impact of this habit. All that these people need is a helping hand and therefore we should provide encouragement as well as support to these people in making these addicts come back to their normal lives and lead a healthy life.

Speech on Drug Abuse – Speech 4

Hon’ble Principal, Vice Principal, Fellow Colleagues and My Dear Students – Warm Greetings to one and all!

Firstly, I would like to extend a note of thank you to our respected Principal and Vice Principal for gracing this speech ceremony with their presence and giving their approval too. And, to all the fellow teachers – as without your support this event wouldn’t have been possible. I would also like to congratulate our dear students for making the desired arrangement on a short notice.

The topic for today’s speech is Drug Abuse! I have chosen to speak on this topic because these days I observe many campaigns being run on Drug Abuse in order to teach the people about its ill effects. As a teacher, it also becomes my responsibility to help them spread the message wherever we can and most importantly beginning from our very own school.

Drug abuse is considered one of the banes of our so called civilized society. It has affected all the sections and regions of our society. People with the illicit use of drug are found everywhere, i.e. in urban and rural regions, among men and women, among rich and poor. But it is exceedingly practiced by our young girls and boys living in hostels in nearly all technical and educational institutions.

The grave situation of drug abuse is prevalent across the world and unfortunately our very country India is more strongly affected by it. Our country is a transit country because it is placed between the Golden Triangle consisting of Burma, Thailand and Cambodia, including Golden Crescent consisting of Afghanistan, Pakistan and Iran – the places where most of the drugs, chiefly heroin and opium are produced. Pakistan is undeniably the nucleus of the world when it comes to any unlawful activity and as far as the drug production is concerned – it is the hub. In fact, a big proportion of drugs go by India in order that it can be exported to other countries.

This happens through the network of drug mafia who further has connections with formidable smugglers as well as terrorists. In the process, unfortunately several young men as well as women become victims to this diabolic activity. Pakistan with the help of ISI is involving itself in a proxy war in the region of Kashmir against India through money earned with the help of drug mafia. Thus, terrorism and drugs share very strong connections.

This addiction to drug is so deadly that people fall prey to its use and become almost a slave. If a person doesn’t get its regular dose, then that person starts feeling a lack of it and becomes depressed with severe pain which even leads to a lack of sensation in arms and legs. Drugs are of various kinds, such as heroin, opium, charas, ganja, etc.

There are some injections too which lead to a state of severe drowsiness. In case, a drug-addict is not able to receive the required dose of drug when needed, then he/she would be ready to do anything for it even by resorting to unfair means, such as theft or may be hurting someone physically, etc.

I therefore request everyone to strictly say ‘No’ to drugs and get such people admitted to rehabilitation centers where their conditions can be improved before it gets horrible and proves fatal for that person.

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Speech on Drug Abuse Faq’s

What is the topic of drug abuse day.

Drug Abuse Day focuses on raising awareness about the harmful effects of drug misuse and addiction.

What is drug abuse in the English language?

Drug abuse in English refers to the harmful and improper use of drugs, often leading to health and social problems.

How can we say no to drugs?

We can say no to drugs by staying informed, making healthy choices, and seeking support from friends and family when faced with drug temptations.

How to write an essay about drugs?

To write an essay about drugs, start with an introduction, discuss the impacts, causes, and solutions, and conclude with your viewpoint on the topic.

What is drugs summary?

A drugs summary is a brief overview of key information about drugs, including their effects, risks, and uses.

What is drug abuse in a short introduction?

Drug abuse is when people misuse drugs, causing harm to themselves and society. It's a serious problem that needs attention.

What are a few lines on addiction?

Addiction is a strong, harmful craving for something, like drugs, that can be very difficult to control. It can lead to serious problems.

We can say no to drugs by being strong, confident, and making choices that keep us safe and healthy.

Addiction is a powerful need for something that can be harmful, like drugs or alcohol. It can affect a person's life in many negative ways.

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The Domino Effect: Youth and Substance Abuse

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Youth Voices on Substance Abuse: A Guide to Empowerment and Action

18 August 2017 - The Youth Voices on Substance Abuse: A Guide to Empowerment and Action program engaged over one hundred upstate New York high school students in studies of key human rights documents, like the Universal Declaration of Human Rights and the Sustainable Development Goals, followed by readings and classroom discussions exploring the causes and results of potentially addictive substance use.

Working with their teachers, with informed health and policy experts, and with resources and guidance by project organizer Gertrude Noden, from Words Into Deeds and Global Education Motivators , participants developed fact-based perspectives, then designed outreach projects to raise awareness among their peers and also provide direct support for local service organizations.

On April 20, 2017, eighteen of these students presented their perspectives on the opioid pandemic and recommended approaches to dealing with this health crisis at a briefing held under the auspices of the UN Department of Public Information, NGO Relations Section. Students were joined by Ithaca Mayor Svante Myrick, whose Ithaca Plan: A Public Health and Safety Approach to Drugs and Drug Policy advocates expanded supportive and recovery services, and Michelle McElroy from Southern Tier Aids Program , which supports regional counseling and needle exchange programs. Also presenting were Yu Ping Chan from the UN Office of Drugs and Crime, who provided a global perspective, and Jeff Brez, Chief, NGO Relations, Advocacy and Special Events.

At the briefing, several students shared very personal accounts of the effects of drugs on families. Students emphasized that scare tactics and just say no approaches are ineffective. Educators need to provide factual information about the range and effects – both positive and negative – of potentially addictive substances, beginning during elementary years and reinforced frequently. This allows youth to make decisions based on authentic information rather than misinformation from peers and others.

In their assessment of the Youth Voices program , students shared these comments:

Being at the UN is one of the best things I have ever had the opportunity to do. It was empowering, and it made me feel important, like I could make a difference.

Through this process my biases have been shattered and my unconscious stereotypes irrevocably changed for the better.

Everyone is so afraid to talk about addiction that we end up hiding the truth about it from children. We are not helping anyone by keeping them in the dark.

I learned the importance of fighting for human rights in my town and globally.

This project taught me what it is to be a global citizen and how to take action to help your community.

One audience member shared this reflection: The poise and grace with which they held themselves in front of a worldwide audience was amazing to witness. If these students are representative of our future leadership, we are in good hands!

Following the conference, students continued their outreach through interviews with reporters from print and radio media. The program culminated in a community celebration held at a local theater in Ithaca, NY. In addition to student presentations and posters, the event featured artists whose performances were based on Human Rights advocacy and experiences with substance abuse.

About the author

Gertrude Noden is the founder of Words Into Deeds.

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current events conversation

How Teens Think Adults Should Talk to Them About Drugs

Be honest. Don’t judge. Tell us how to be safe. Share your experiences.

By The Learning Network

“In the age of fentanyl and other illegally manufactured synthetics, the danger associated with trying drugs is greater than ‌ever‌‌,” Maia Szalavitz, a contributing Opinion writer, writes in the guest essay “ How to Talk to Kids About Drugs in the Age of Fentanyl .”

Rather than using scare tactics and focusing only on abstinence, as popular 20th-century drug programs like DARE and Just Say No did, Ms. Szalavitz recommends being honest with young people and offering strategies for harm reduction.

We asked teenagers how they want adults to talk to them about drug use. An overwhelming majority agreed with Ms. Szalavitz’s advice. As one student put it: “Kids need to be cared for and not by lying to their faces or making a situation terrifying but by telling them the truth.”

They told us how parents, teachers and other adults have talked to them about drugs and shared what has worked and what hasn’t. Several even offered their own ideas for how to approach the conversation. You can read a selection of their responses below.

Thank you to all those who joined the conversation on our writing prompts this week, including students from Akron, Ohio ; Charles W. Baker High School in Baldwinsville, N.Y. ; and Maury High School in Norfolk, Va.

Please note: Student comments have been lightly edited for length, but otherwise appear as they were originally submitted.

‘Honesty Is the Best Policy.’

I feel like a lot of kids and teens have access to the internet and are exposed early to what drugs can and can’t do for them. When they go to class and hear false statements (like the thing with colored fentanyl) from campaigns stating “Just say no” they can call out their bluff. When drugs get brought up people always lie and beat around the bush when they explain, but I think adults just need to be honest. Yes drugs aren’t all that great but they’re more common than kids are told. When you have surgery and are prescribed pain killers they can lead to an unexpected and harsh addiction. They’re told that drugs are only sold in dark alleys or illegally when they can be sold by a doctor or pharmacist. Parents, family, teachers or any other adult figure always preach honesty and trust when they can’t even correctly inform children about an epidemic. And when they finally get the guts to sit down and talk they don’t even know what they’re talking about. The only tactic they have to talk about drugs is to completely scare us away from even looking at drugs. Honesty is the best policy even when it comes to drugs.

— Kendall, Baldwinsville, New York

Teens can see through the ads and adults that make horrifying scenes. Teens don’t want to be lied at, teens are both smart and curious to try something new. Young people need to see, feel, and hear the truth of drugs. If they are just told what to say and not told what is the product of being a drug abuser or an addict, their undeveloped minds think it’s all a joke. Kids need to be cared for and not by lying to their faces or making a situation terrifying but by telling them the truth.

— Janet, Glenbard West HS, IL

Focus on Harm Reduction.

Social stigmas around drug use only cause more problems. And more problems don’t help drug abusers to reach the path of recovery. If you talk to your children about drugs without using shameful language and fear tactics, your child may be more open to sharing their experiences about it with you down the road. While you should always warn your kids about the dangers of drug abuse, you should also remind them that if they do use drugs, It’s not the end of the world and there are preventative measures they can take before they reach a level of addiction. It should also be taught that there are safe ways to use drugs so that you have a lesser risk of overdose and psychological damage. Many adults don’t discuss it any further than “don’t do drugs. End of discussion.” If more parents were open with the conversation and answered their children’s questions, they would feel less curiosity to try it for themselves and find out. The article mentions the need for accuracy over hype, stressing the importance of sharing truthful information instead of exaggerated stories. I agree with this because I think — no, I know — that personally I’d feel more comfortable talking about using drugs with my parents if they didn’t share such dramatic tall tales.

— Allie, Union High School

We are faced with a drug crisis that feels out of control. The one hope is adults can educate teens about the danger of fentanyl-laced drugs. It is unrealistic to think that every teen will listen to the adults around them when they are informed of the risks of drugs. Most teens cannot comprehend that being laced with fentanyl could happen to them or someone they know. The reality is that teens don’t always listen to adults, and adults are not always around when something bad happens. We have to accept this reality and prepare kids for the worst-case scenarios. At my school, Narcan, an anti-overdose drug that counters narcotic overdoes, is available in school counselors’ offices for emergency purposes. They also provide fentanyl testing strips. Educating teens about the fentanyl crisis is critical due to the fear that one might unknowingly encounter the fatal drug.

— Annabelle, Los Angeles, CA

Start Conversations Early.

I think that adults should be speaking more honestly about drugs. In 5th grade, my class had this drug avoidance program. Although they did at least tell us a little about drugs, they didn’t go in depth enough to teach us all the things we need to know. I didn’t know that drug addictions can even come from prescribed medicine and I didn’t know their effects on the body. A lot of teen addictions start when they are 12 and 13, which is before we start to go more in-depth. Lots of kids experience drugs before they know anything about them. If kids can learn about the dangers of drugs young, then the teens doing drugs will not be as much of a problem.

— Charles, Glenbard West HS Glen IL

Only teachers in my life have really educated me about drugs. My parents are prone to glossing over taboo topics, so I’m not surprised that they don’t talk about drugs often. I have had honest dialogue about drug use with teachers in health class, and I know that I, personally, don’t want to participate in any kind of drug use. I think that better education on drugs should happen much earlier on though. Kids who already do drugs aren’t going to listen to teachers about the dangers of it, since they aren’t afraid of it anymore.

— Cate, Bville

Help Kids Understand the Risks.

Overall I think the best way to teach kids about drugs is to tell them about it honestly and what it does to them, as well as letting them research it on their own. This could be done in a sort of guided research assignment to have them look up statistics, effects, and maybe cases of misidentified drugs that resulted in overdoses. When the article mentions how “the danger associated with trying drugs is greater than ‌ever” and then explains how drugs are being mislabeled, it does make me see an even further risk in experimenting with drugs. While I was not planning on trying any, it does make me realize that a drug advertised as minor could very well be lethal and that makes it much more threatening.

— Alexander, Cary High School

I believe children should learn about drugs more in terms of the consequences. Relationships can be ruined, you’re career dreams could be out of the picture, and worst of all you can end up dying. Children need to understand their actions involving drugs will seriously effect their lives. I think it’s better if they knew less about the feeling as many say it made them happy or calm for a bit. This can make kids believe that the consequences may not apply to them so they just might take the chance with drugs to see what it is like.

— Anne, New York

Programs such as “DARE” that try to scare teens out of doing drugs should be replaced with honest conversations. Ideally, the goal of this is to get adolescents to stay away from drugs completely. However, realistically that will not always work. Teenagers should be taught which drugs are most dangerous, the dangers of laced drugs, and how to recover from addiction or overdosing. Teenagers should be told the truth and speak to past addicts and past fentanyl drug dealers so they can understand the dangers of drugs instead of being lied to.

— Mariana, Biotechnology High School

Share Your Personal Experiences.

My mom and dad have both talked to me about drugs. My mom always said that she never cared for vapes and didn’t want my brother or me to get into those kinds of things. But as for other drugs such as weed, on the other hand, she has said that she has no problem with us using it when we get older, as long as we aren’t abusing it. My father on the other hand has a bad history and so does the rest of the family so that influenced me to stay away.

— a.g., Bville

One of my parents works in an ER and sees first hand the effects of drugs on people and what it can do to them, ever since I was little he talked to me about the dangers of drug use. I think this shaped the way I view the conversation today because to me this is an important topic to talk about openly. It doesn’t matter how much someone says to say no to drug use simply saying that will not stop it from occurring. Instead it is important to educate people on everything about drugs and not only what it does to you physically but also emotionally.

— Kayla, NY

Talk to Teens in ‘Ways That They Like to Listen.’

I think the best way to talk to a teenager about this issue is in ways that they like to listen to such as: on social media, promoting video games, etc. This is a good way because it will make a bigger impact because it’s something they enjoy, so when they see it pop up they will pay more attention to the idea. Discussing drugs to young teens today is a very important thing that should happen, but needs to be done in ways that will leave the biggest impact.

— Landry, Sullivan High School

Throughout the first 13 years of my life when spoken to about drugs by any adult in my life the conversation always ultimately stated to never do drugs. When entering high school I felt completely unprepared for the realities of drug use in social situations. As a result of this I was introduced to Generation SOS, which is a teen peer support group which welcomes open and honest conversations regarding drug and alcohol abuse. The conversations that Generation SOS holds opened up the open conversation about drugs that I hadn’t been exposed to prior. I have been able to start a Generation SOS club at my high school and allow sober speakers to share their experiences with drugs and alcohol. These conversations have changed the stigma surrounding addiction within my school environment and allowed for students to find a comfortable space for honest conversations. These honest conversations about drugs have been far more effective in connecting to my high school, because stories and vulnerability speak far louder than statistics.

— Danielle, Miami Country Day School

Most of the time when kids go to a public school, they will end up learning about drugs on their own but if you don’t want them to learn from somewhere else other than you, just sit ‘em down and talk to them. I do think that the abstinence method is completely irrelevant as shown by dare and other programs from the 20th century, kids aren’t going to care what adults think they should do if they’re told not to do it. However, I do think the modern method of exposing kids to what the dangers are from drug dealers/former drug users is a much better method because they already seem so much more trustworthy in an “anti-drug” promotion to kids than a cop.

— Phanece, Crest High School

Make a Safe Space to Ask Questions.

My mom has talked to me about drugs and so did my 7th grade health teacher when we were going over the subject. I remember them telling me that they are not good for you. Also you should never take someone else’s prescribed pills and you should never take a pill if someone offers you it, and I remember them telling us about the different types of pills. Yes, I was able to ask questions and they had made it a safe place to talk about it and like how it is not good for you if you play sports or even if you don´t. This has shown me that to always be careful and never do anything with drugs that are not prescribed or needed.

— Julianna, New York

I think it’s important for adults to let children know about the dangers of drugs. The adults should tell them the truth instead of trying to sugarcoat it. Although they should be brutally honest about drugs, it should also be a nonjudgmental conversation — not shaming anyone who uses drugs. The adults should educate the children about drugs in a way that isn’t shaming anyone that uses drugs, but should still talk about the dangers that they can inflict … Adults should also create a safe environment when enlightening kids on what drugs can do. They should make the environment safe enough for the child to want to ask questions and for the conversation to be an open and honest one.

— Griffith, Glenbard West High school, Glen Ellyn, IL

For Some Young People, Scare Tactics Can Work.

Adults should not hesitate to make drugs sound as bad as possible. The reason I think this is because drug use can seem harmless to kids at first but it is the opposite. Adults should also talk a lot about peer pressure because it is a huge reason why teens start doing drugs. Once someone does a drug once they can already become hooked. Overall, a lot of people’s lives can and have been ruined by drug use.

— Dan Trouesdale, Baker High

I sincerely think kids should be taught everything about drugs. Kids are young and don’t have the ability to distinguish what’s the right thing, and they may be lured to do drugs. What’s more, the bad influence on your mind and body is permanent, and it’s not something you can easily quit. So it’s essential and critical for adults to teach things about drugs and keep kids away from it.

— Lisa, Taipei

How to Have a Conversation About Drugs With a Teen, According to a Teen

There comes a time where you have to teach your child about drugs, or else, there’s a chance they’ll fall into it. The best time to start confronting your kid about drugs is when you’re ready for it, or most or best case, when they’re becoming a teenager, or they’re changing, like from cute to mature and stupid. What you would do in my way is: First, greet your kid and hang out, because your kid will go along with you. Before you straight up talk about drugs, because that’ll destroy the immersion, start slowly, introduce and present the idea of being a teenager, some benefits such as being able to act “like” an adult, being able to handle their own life, then some disadvantages like being more troublesome and aggressive, intense attitudes, and drugs. Now you can move aside with the teenager talk and make drugs be the big topic. Educate them by telling why people do drugs, how it started, the impact it gives, the consequences of it physically, mentally and emotionally, and how drugs doesn’t make you cool, but it makes you look stupid. And even suggest some things to do to prevent it, like mention about having sports and clubs, be with friends who are kind and bring good influence, or having a hobby. And there that’s how you talk to your kid about drugs.

— Albert, Baker High School

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Teen drug abuse: Help your teen avoid drugs

Teen drug abuse can have a major impact on your child's life. Find out how to help your teen make healthy choices and avoid using drugs.

The teen brain is in the process of maturing. In general, it's more focused on rewards and taking risks than the adult brain. At the same time, teenagers push parents for greater freedom as teens begin to explore their personality.

That can be a challenging tightrope for parents.

Teens who experiment with drugs and other substances put their health and safety at risk. The teen brain is particularly vulnerable to being rewired by substances that overload the reward circuits in the brain.

Help prevent teen drug abuse by talking to your teen about the consequences of using drugs and the importance of making healthy choices.

Why teens use or misuse drugs

Many factors can feed into teen drug use and misuse. Your teen's personality, your family's interactions and your teen's comfort with peers are some factors linked to teen drug use.

Common risk factors for teen drug abuse include:

• A family history of substance abuse.
• A mental or behavioral health condition, such as depression, anxiety or attention-deficit/hyperactivity disorder (ADHD).
• Impulsive or risk-taking behavior.
• A history of traumatic events, such as seeing or being in a car accident or experiencing abuse.
• Low self-esteem or feelings of social rejection.

Teens may be more likely to try substances for the first time when hanging out in a social setting.

Alcohol and nicotine or tobacco may be some of the first, easier-to-get substances for teens. Because alcohol and nicotine or tobacco are legal for adults, these can seem safer to try even though they aren't safe for teens.

Teens generally want to fit in with peers. So if their friends use substances, your teen might feel like they need to as well. Teens also may also use substances to feel more confident with peers.

If those friends are older, teens can find themselves in situations that are riskier than they're used to. For example, they may not have adults present or younger teens may be relying on peers for transportation.

And if they are lonely or dealing with stress, teens may use substances to distract from these feelings.

Also, teens may try substances because they are curious. They may try a substance as a way to rebel or challenge family rules.

Some teens may feel like nothing bad could happen to them, and may not be able to understand the consequences of their actions.

Consequences of teen drug abuse

Negative consequences of teen drug abuse might include:

• Drug dependence. Some teens who misuse drugs are at increased risk of substance use disorder.
• Poor judgment. Teenage drug use is associated with poor judgment in social and personal interactions.
• Sexual activity. Drug use is associated with high-risk sexual activity, unsafe sex and unplanned pregnancy.
• Mental health disorders. Drug use can complicate or increase the risk of mental health disorders, such as depression and anxiety.
• Impaired driving. Driving under the influence of any drug affects driving skills. It puts the driver, passengers and others on the road at risk.
• Changes in school performance. Substance use can result in worse grades, attendance or experience in school.

Health effects of drugs

Substances that teens may use include those that are legal for adults, such as alcohol or tobacco. They may also use medicines prescribed to other people, such as opioids.

Or teens may order substances online that promise to help in sports competition, or promote weight loss.

In some cases products common in homes and that have certain chemicals are inhaled for intoxication. And teens may also use illicit drugs such as cocaine or methamphetamine.

Drug use can result in drug addiction, serious impairment, illness and death. Health risks of commonly used drugs include the following:

• Cocaine. Risk of heart attack, stroke and seizures.
• Ecstasy. Risk of liver failure and heart failure.
• Inhalants. Risk of damage to the heart, lungs, liver and kidneys from long-term use.
• Marijuana. Risk of impairment in memory, learning, problem-solving and concentration; risk of psychosis, such as schizophrenia, hallucination or paranoia, later in life associated with early and frequent use. For teens who use marijuana and have a psychiatric disorder, there is a risk of depression and a higher risk of suicide.
• Methamphetamine. Risk of psychotic behaviors from long-term use or high doses.
• Opioids. Risk of respiratory distress or death from overdose.
• Electronic cigarettes (vaping). Higher risk of smoking or marijuana use. Exposure to harmful substances similar to cigarette smoking; risk of nicotine dependence. Vaping may allow particles deep into the lungs, or flavorings may include damaging chemicals or heavy metals.

Talking about teen drug use

You'll likely have many talks with your teen about drug and alcohol use. If you are starting a conversation about substance use, choose a place where you and your teen are both comfortable. And choose a time when you're unlikely to be interrupted. That means you both will need to set aside phones.

It's also important to know when not to have a conversation.

When parents are angry or when teens are frustrated, it's best to delay the talk. If you aren't prepared to answer questions, parents might let teens know that you'll talk about the topic at a later time.

And if a teen is intoxicated, wait until the teen is sober.

To talk to your teen about drugs:

• Ask your teen's views. Avoid lectures. Instead, listen to your teen's opinions and questions about drugs. Parents can assure teens that they can be honest and have a discussion without getting in trouble.
• Discuss reasons not to use drugs. Avoid scare tactics. Emphasize how drug use can affect the things that are important to your teen. Some examples might be sports performance, driving, health or appearance.
• Consider media messages. Social media, television programs, movies and songs can make drug use seem normal or glamorous. Talk about what your teen sees and hears.
• Discuss ways to resist peer pressure. Brainstorm with your teen about how to turn down offers of drugs.
• Be ready to discuss your own drug use. Think about how you'll respond if your teen asks about your own drug use, including alcohol. If you chose not to use drugs, explain why. If you did use drugs, share what the experience taught you.

Other preventive strategies

Consider other strategies to prevent teen drug abuse:

• Know your teen's activities. Pay attention to your teen's whereabouts. Find out what adult-supervised activities your teen is interested in and encourage your teen to get involved.
• Establish rules and consequences. Explain your family rules, such as leaving a party where drug use occurs and not riding in a car with a driver who's been using drugs. Work with your teen to figure out a plan to get home safely if the person who drove is using substances. If your teen breaks the rules, consistently enforce consequences.
• Know your teen's friends. If your teen's friends use drugs, your teen might feel pressure to experiment, too.
• Keep track of prescription drugs. Take an inventory of all prescription and over-the-counter medications in your home.
• Provide support. Offer praise and encouragement when your teen succeeds. A strong bond between you and your teen might help prevent your teen from using drugs.
• Set a good example. If you drink, do so in moderation. Use prescription drugs as directed. Don't use illicit drugs.

Recognizing the warning signs of teen drug abuse

Be aware of possible red flags, such as:

• Sudden or extreme change in friends, eating habits, sleeping patterns, physical appearance, requests for money, coordination or school performance.
• Irresponsible behavior, poor judgment and general lack of interest.
• Breaking rules or withdrawing from the family.
• The presence of medicine containers, despite a lack of illness, or drug paraphernalia in your teen's room.

Seeking help for teen drug abuse

If you suspect or know that your teen is experimenting with or misusing drugs:

• Plan your action. Finding out your teen is using drugs or suspecting it can bring up strong emotions. Before talking to your teen, make sure you and anyone who shares caregiving responsibility for the teen is ready. It can help to have a goal for the conversation. It can also help to figure out how you'll respond to the different ways your teen might react.
• Talk to your teen. You can never step in too early. Casual drug use can turn into too much use or addiction. This can lead to accidents, legal trouble and health problems.
• Encourage honesty. Speak calmly and express that you are coming from a place of concern. Share specific details to back up your suspicion. Verify any claims your child makes.
• Focus on the behavior, not the person. Emphasize that drug use is dangerous but that doesn't mean your teen is a bad person.
• Check in regularly. Spend more time with your teen. Know your teen's whereabouts and ask questions about the outing when your teen returns home.
• Get professional help. If you think your teen is involved in drug use, contact a health care provider or counselor for help.

It's never too soon to start talking to your teen about drug abuse. The conversations you have today can help your teen make healthy choices in the future.

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• Dulcan MK, ed. Substance use disorders and addictions. In: Dulcan's Textbook of Child and Adolescent Psychiatry. 3rd ed. American Psychiatric Association Publishing; 2021. https://psychiatryonline.org. Accessed Jan. 24, 2023.
• 6 parenting practices: Help reduce the chances your child will develop a drug or alcohol problem. Partnership to End Addiction. https://drugfree.org/addiction-education/. Accessed Jan. 24, 2023.
• Why do teens drink and use substances and is it normal? Partnership to End Addiction. https://drugfree.org/article/why-do-teens-drink-and-use-substances/. Accessed Jan. 24, 2023.
• Teens: Alcohol and other drugs. American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/aacap/families_and_youth/facts_for_families/fff-guide/Teens-Alcohol-And-Other-Drugs-003.aspx. Accessed Dec. 27, 2018.
• Drugged driving. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/drugged-driving. Accessed Jan. 24, 2023.
• Marijuana talk kit. Partnership for Drug-Free Kids. https://drugfree.org/drugs/marijuana-what-you-need-to-know/. Accessed Jan. 24, 2023.
• Drug guide for parents: Learn the facts to keep your teen safe. Partnership for Drug-Free Kids. https://www.drugfree.org/resources/. Accessed Dec. 12, 2018.
• Vaping: What you need to know and how to talk with your kids about vaping. Partnership to End Addiction. https://drugfree.org/addiction-education/. Accessed Jan. 24, 2023.
• How to listen. Partnership for Drug-Free Kids. https://www.drugfree.org/resources/. Accessed Dec. 12, 2018.
• Drug abuse prevention starts with parents. American Academy of Pediatrics. https://publications.aap.org/patiented/article/doi/10.1542/peo_document352/81984/Drug-Abuse-Prevention-Starts-With-Parents. Accessed Jan. 24, 2023.
• How to talk to your kids about drugs if you did drugs. Partnership for Drug-Free Kids. https://www.drugfree.org/resources/. Accessed Dec. 12, 2018.
• My child tried drugs, what should I do? Partnership to End Addiction. https://drugfree.org/article/my-child-tried-drugs-what-should-i-do/. Accessed Jan. 24, 2023.
• Gage SH, et al. Association between cannabis and psychosis: Epidemiologic evidence. Biological Psychiatry. 2016;79:549.
• Quick facts on the risks of e-cigarettes for kids, teens and young adults. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html. Accessed Jan. 30, 2023.
• Distracted Driving
• Piercings: How to prevent complications
• Talking to your teen about sex
• Teen suicide
• Teens and social media use
• Mayo Clinic Minute: Weight loss surgery for kids

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High-Risk Substance Use Among Youth

Why is CDC addressing youth high-risk substance use?

Although most youth are in good health, some youth are at an increased risk for behaviors that can lead to poor health outcomes, such as high-risk substance use. The majority of adults who meet the criteria for having a substance use disorder started using substances during their teen and young adult years. 5

Youth with substance use disorders also experience higher rates of physical and mental illnesses, diminished overall health and well-being, and potential progression to addiction.

What is high-risk substance use?

For the purposes of addressing HIV and STD prevention,  high-risk substance use is any use by adolescents   of substances with a high risk of adverse outcomes  (i.e., injury, criminal justice involvement, school dropout, loss of life).

This includes:

• misuse of prescription drugs,
• use of illicit drugs (i.e., cocaine, heroin, methamphetamines, inhalants, hallucinogens, or ecstasy), and
• use of injection drugs which have a high risk of infection of blood-borne diseases such as HIV and hepatitis.

• 15% of high school students reported having ever used select illicit or injection drugs (i.e. cocaine, inhalants, heroin, methamphetamines, hallucinogens, or ecstasy) 1 , 2
• 14% of students reported misusing prescription opioids. 1 , 2
• Injection drug use places youth at direct risk for HIV, and drug use broadly places youth at risk of overdose. 2
• Youth opioid use is directly linked to sexual risk behaviors. 2
• Students who report ever using prescription drugs without a doctor’s prescription are more likely than other students to have been the victim of physical or sexual dating violence. 4
• Drug use is associated with sexual risk behavior, experience of violence, and mental health and suicide risks. 2

Risk Factors for High-Risk Substance Use

Risk factors for youth high-risk substance use can include:

• Family history of substance use
• Favorable parental attitudes towards the behavior
• Poor parental monitoring
• Parental substance use
• Family rejection of sexual orientation or gender identity
• Association with delinquent or substance using peers
• Lack of school connectedness
• Low academic achievement
• Childhood sexual abuse
• Mental health issues

High-Risk Substance Use Prevention

Research has improved our understanding of factors that help buffer youth from a variety of risky behaviors, including substance use.

These are known as protective factors. Some protective factors for high risk substance use include:

• Parent or family engagement
• Family support
• Parental disapproval of substance use
• Parental monitoring
• School connectedness

What is CDC Doing?

• Using surveillance data to explore risk and protective factors for youth substance use.
• Conducting research on the topic of youth substance use and its association with a variety of risks and behaviors.
• Conducting an analysis of local and state policies on youth substance use prevention.
• Conducting a pilot project in high-risk rural communities called Teens Linked to Care (TLC).
• Drug Basics
• Making the Connection: Drug Use and Academic Grades [PDF – 452 KB]
• Monitoring Your Teen’s Activities: What Parents and Families Should Know
• NIDA for Teens
• Parent Engagement: Overview Brochure
• Substance Use and Sexual Risk Behaviors Among Youth
• Teen Health Services and One-On –One Time with a Healthcare Provider: An Infobrief for Parents
• Teens Linked to Care
• Youth Risk Behavior Surveillance System (YRBSS)
• Youth Risk Behavior Survey Data Summary and Trends Report 2009-2019 [PDF – 31 MB]
• CDC. Youth Risk Behavior Surveillance—United States, 2019 .  MMWR Suppl  2020;69(1):1-83.
• CDC, Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Youth Risk Behavior Survey Data Summary & Trends Report, 2009–2019 [PDF – 31 MB] . Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office of Infectious Diseases, NCHHSTP; 2020.
• Clayton, H.B, Lowry, R., August, E., & Jones, S.E. Nonmedical use of prescription drugs and sexual risk behaviors. Pediatrics .2016; 137 (1),e20152480
• Clayton, H.B, Lowry, R, Basile, K.C., et al. Physical and Sexual Dating Violence and Nonmedical Use of Prescription Drugs. Pediatrics .2017; 140 (6): e20172289
• U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS , November 2016.

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2191 mowry ave. #600c, fremont ca 94538, mon-fri: 8:45 am – 5pm, sat/sun/holiday: call at 8 am for appointment, speaking to teenagers about substance abuse.

Having said all the above, most of you may skip reading the rest of this article thinking that your teen would never do drugs and that you don’t have to worry about this conversation. We urge you to read the statistics below, followed by techniques and recommendations on how to speak to your preteen or teenager about drugs. Please feel free to refer at-risk families to this article as well. This is a topic that every parent needs to be familiar with and in this section, we will try to help you navigate the first step. Of course, you can always call our office and make an appointment if more help is needed.

Before we proceed on how to start the “dreaded conversation” let’s discuss some facts:

• According to the Monitoring the Future study (2008), an NIH funded study, 72% of adolescents drink, 55% have gotten drunk, 47% have tried an illicit drug, and 25% have tried an illicit drug, other than marijuana, by the time they reach senior year in high school.
• One in four Americans, who begin using any addictive substance before age 18, have addiction problems later in life, compared with one in 25 Americans who started using at age 21 or older. Delaying the use of addictive substances for as long as possible should be a high priority for parents.
• The Partnership for a Drug-Free America’s annual “Partnership Attitude Tracking Study,” the largest survey on drug-related attitudes in the United States, sampled the opinions of approximately nine thousand youngsters aged nine to eighteen. Three-quarters of the fourth-graders said that they wanted more information about drugs from their parents. Hint: 4th grade may be a good age to start the conversation.
• Research shows that parents are central to preventing teen drug use. In fact, kids themselves say that losing their parents’ trust and respect are the most important reasons not to use drugs. As a parent, your actions matter. When you suspect or know, that your child has been drinking or using drugs, take action to stop it as soon as you can. It may be the most important step you ever take.
• According to the 1998 survey, the stronger and more frequent the antidrug messages at home, the less likely a child is to become a user. Only 26 percent of adolescents who said their parents had taught them “a lot” about the dangers of drugs had smoked marijuana. But among youngsters who claimed to have learned “a little” or “nothing” from their families, the rates of pot use were progressively higher: 33 percent and 45 percent, respectively. That pattern remained consistent for other drugs, too. Overall, boys and girls whose parents ignored the issue were about two times more likely to use drugs than teens who learned “a lot” at home.
• Individual negative risk factors include male gender, school failure, ADHD, learning disability, and other mental disorders such as anxiety and depression. Too many of our adolescents are self-medicating their anxiety and mood disorders with marijuana!
• Negative family risk factors include genetic risks, a family member who is abusing alcohol/drugs, parent-child conflict, permissive or authoritarian parenting style, and divorce.
• Substance using peers is also considered a strong community risk factor for drug use.
• Individual protective factors include high self-esteem, emotional well-being, resilient temperament, and school achievement.
• Family protective factors include frequent communication about alcohol and drug use, good parental modeling, eating meals together regularly as a family and involvement in your teenager’s activities.

Sign and symptoms of substance abuse can be very nonspecific, but here are some potential clues:

• Declining school performance.
• Change in dress and friends.
• Sudden mood swings, either depression or euphoria.
• Diluted or missing alcohol from parent’s home supply.
• Stealing, lying, or missing money.
• Increase in borrowing money
• Use of incense, room deodorant or perfume to hide smoke or chemical odors
• Increased secrecy about possessions or activities
• Evidence of drug paraphernalia, such as pipes, rolling papers
• New use of mouthwash or breath mints to cover up the smell of alcohol

There is one more step before you start the conversation with your child; it is very important that you talk to your spouse first. As parents you need to have a strategy and some “ground rules” that you both agree on. It is crucial for both parents to be on the same page before talking to your teenager. Here are the important topics that need to be addressed:

Leave no doubt as to where you stand: “You are not to use any drug, including tobacco or alcohol, under any circumstances.” Then explain why:

• Because we love you.
• Because drugs are dangerous, and we don’t want to see you harm yourself.
• Because it is against the law.

As when setting any limit, clearly spell out the consequences for defying the rules: What will the punishment be and how it will be implemented? Make sure the new rules and consequences are reasonable and enforceable — such as a new, earlier curfew, no cell phone or computer privileges for a period of time, or less time hanging out with friends. You may want to get them involved in new or other activities that will keep them busy and help them meet new people.

Don’t hesitate to aim for the emotional jugular : Remind your teen that you would be deeply disappointed in his behavior if he were to disobey you on this matter. Research shows that when a child is deciding whether or not to indulge, a key consideration is, “What will my parents think?”

When discussing the dangers of drugs, emphasize the immediate consequences: Keep in mind the developmental status of your child. Younger teens tend to think mainly in terms of today, tomorrow and the next day. It’s not until much later in adolescence that teens begin to contemplate how their actions could impact their lives down the line. Teenagers are also still at a stage of thinking that they are invincible. Therefore, warnings that cigarette smokers are more than ten times as likely to die of lung cancer than nonsmokers are probably going to elicit little more than a shrug from a thirteen-year-old, or a twenty-year-old, for that matter.Instead, stress how smoking tobacco causes bad breath, hoarseness and a hacking cough, stains teeth yellow, impairs athletic performance, and in general makes other people not want to be around the smoker. In an American Cancer Society survey, eight in ten boys and seven in ten girls aged twelve to seventeen said they wouldn’t date someone who smoked.

Remind your teenager that smoking, drinking and drugging aren’t just harmful, they’re expensive: A youngster with a pack-a-day cigarette habit sees close to a thousand dollars a year go up in smoke. Surely your son or daughter could find better ways to spend all that money, whether it’s buying CDs and clothing or saving up for a car and college.

Appeal to an adolescent’s natural independent streak by praising his determination to avoid using drugs: “I admire the way you’ve stuck to your principles and refused to use drugs. It takes courage to not always go along with the crowd, and I’m proud of you.”

Explain to your child that once people start using drugs, they may not be able to stop: Addiction is poorly understood, by both substance abusers themselves and those who care about them. The young person with an addiction tells himself and everyone around him, that he can quit whenever he wants. But with prolonged use, the addictive substance triggers long-lasting changes in the chemical composition of the brain. At that point professional treatment is required to cure him of his compulsive behavior. Even then, many tobacco users, alcoholics and drug abusers will relapse and revert to their old ways.

Give them the words to avoid temptation . The peer pressure to try drugs is no less intense than the sexual pressure that so many adolescents face. As with any situation that could conceivably lead to trouble, we need to prepare our kids to refuse offers of alcohol and other drugs—preferably without alienating their peers, although sometimes that isn’t possible. “Just say no?” It’s a start, but few teens bent on enticing a peer to try drugs will let the matter rest there. In fact, substance abusers tend to view converting the “straight” kid as an irresistible challenge, if not their civic duty, and they can be exasperatingly persistent:

“C’mon, dude, you’ll love the buzz from this stuff! It’s kickin’.”

Role-play this scene with your youngster. The repertoire of possible replies includes:

• A firm but friendly “No thanks!” There’s no need for self-righteousness, along the lines of “Getting drunk? That’s for losers.” Let’s encourage teens not to label other people as good or bad, only their behavior. Using drugs is wrong, but that doesn’t necessarily make the drug abuser a bad person.
• Change the subject. “No thanks. Hey, what did you think of that test yesterday in social studies?”
• Suggest a change of plans. “I was hoping to get you guys to shoot some hoops down at the school. How about it?”
• Say no repeatedly: “ Wanna party with us? This weed rocks!” “No thanks.” “Aw, c’mon, man! It’s killer stuff!” “Sorry, not interested.” “Not even one toke?” “Not even one.”
• Teach your child respect for her body. “No thanks, I don’t drink. Besides, the girls’ swim team has a meet tomorrow, and I need to be in top shape.”
• Then there’s always this standby: “My parents would kill me if they found out that I got high, and they always manage to find out!”

Now that you have educated yourself about how to talk to your teen, all you need to do is sit him/her down and just start talking. You can go directly to the topic at hand or during a random conversation about friends or while watching a show on TV, just steer the subject to drugs and there you go! Do not fear that introducing the topic of drugs will put ideas into your children’s heads to use drugs. It will not do this any more than talking about traffic safety might make them want to jump in front of a car. You’re letting them know about potential dangers in their environment so that when they’re confronted with them, they’ll know what to do and they will know you care. If you hear something you don’t like (perhaps a friend smokes marijuana or your teen confesses to trying beer at a party), it is important not to react in any way that cuts off further discussion. If he seems defensive or assures you that he doesn’t know anyone who uses drugs, ask the question in a different manner. For example, ask him why he thinks people use drugs and carry on from there.

Tell yourself that you won’t “lose it” with your child . Be sure to have the conversation when all of you are calm and have plenty of time. Your feelings may range from anger to guilt, or you may feel that you have “failed” because your teen is using drugs. This isn’t true. This isn’t an easy task. By staying involved, you can help them stop using drugs and make choices that will make a positive difference in their lives. Anger and hostility won’t get you anywhere in this conversation. Stay as calm as possible. Remember, you are the parent and you are in charge. Be kind, simple, and direct in your statements to your child. Above all, remember to tell your child that you love him or her! The conversation will not be perfect – no conversation ever is. Know that you are doing the right thing for your child. That’s what matters most!

Parents are sometimes afraid that they will push their children away by talking to them about drug use. You may be worried that your child will get in trouble with the law and that it may affect his or her ability to qualify for scholarships or get a job. But teens who make a choice — one or more times — to use drugs or alcohol are at a crossroads and need your help. Overcoming your own fears is an important step in getting help for your child.

Be prepared for your teen to deny using drugs . Don’t expect them to admit they have a problem. Your child will probably get angry and might try to change the subject. Maybe you’ll be confronted with questions about what you did as a teenager. If you are asked, experts agree that it is best to be honest. Answering deceptively can cause you to lose credibility with your teen if they ever find out that you’ve lied to them.

Here are some final tips to keep in mind when you talk to your child:

• Tell your son or daughter that you LOVE him/her, and you are worried that he/she might be using drugs or alcohol;
• Let them know that you KNOW that drugs may seem like the thing to do, but doing drugs can have serious consequences;
• Tell them it makes you FEEL worried and concerned about them when they do drugs;
• Remember you are there to LISTEN to them;
• Encourage them to be a part of the solution;
• Tell your teen what you WILL do to help them.
• KNOW that you will have this discussion many, many times. Talking to your teens about drugs and alcohol is not a one-time event.

Adapted directly from the American Academy of Pediatrics ( www.healthychildren.org ), and www.antidrug.com created by the National Youth Anti-Drug Media Campaign.

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"Talk. They Hear You."® Campaign

About the Campaign

The “Talk. They Hear You.” campaign aims to reduce underage drinking and other substance use among youths under the age of 21 by providing parents and caregivers with information and resources they need to address these issues with their children early and often.

Parent & Caregiver Resources

Parents and caregivers have a significant influence on their children’s decisions about using alcohol and other drugs. Check out these "Talk. They Hear You." campaign resources to help you start talking with your kids about these issues at a young age.

School & Educator Resources

Find "Talk. They Hear You." campaign resources to help student assistance professionals, school leaders, and families work together to support the needs of students who may be struggling with substance use, mental health, or school-related issues.

"Talk. They Hear You." celebrated its 10th anniversary by hosting a campaign relaunch event during National Prevention Week 2023! Watch the May 8 event and check out the newest suite of products here .

Community Partner Resources

Prevention Partners: Looking for resources to share in your community? Download these customizable “Talk. They Hear You.” campaign resources to support your underage drinking and other substance use prevention efforts.

SAMHSA Store

Order (quantities pending) and download “Talk. They Hear You.” campaign resources from the SAMHSA Store to support your underage drinking and other substance use prevention efforts.

Last Updated

Last Updated: 01/18/2024

Start A Conversation: 10 Questions Teens Ask About Drugs and Health

At the National Institute on Drug Abuse (NIDA), our goal is to help people get accurate, science-based information about drugs and health. To help you start a conversation about drugs and health, we’ve compiled teens' 10 most frequently asked questions from more than 118,000 queries we’ve received from young people during  National Drug and Alcohol Facts Week ® . It’s okay if some of this information is news to you—lots of other people are asking, too!

Every day we make choices that affect our health. People take drugs for a lot of different reasons, like to deal with life’s challenges, to escape from reality, to relieve pain, or to try to fit in—just to name a few.

Some people can be aware of the negative effects of drugs on their health and in their life and still struggle to stop using them. This is because repeated drug use can lead to changes in the brain that make it hard to stop using them, even when people want to stop. When this happens, the person is experiencing a medical problem known as substance use disorder. Addiction is a severe form of substance use disorder.

All addictive drugs cause the brain to release the chemical dopamine. Dopamine is usually released after pleasurable and satisfying activities. Dopamine causes the brain to remember rewards, like food and sex, and reinforces the desire to seek them out again. Repeatedly using a drug floods the brain with more dopamine, which can change the way the brain responds to that drug.

With repeated use, a greater quantity of drug is needed to produce the same pleasurable effect. When the drug is not available, people may experience the negative symptoms of withdrawal, which may include stress, anxiety, depression, and sometimes physical symptoms such as sweating, vomiting and pain. Repeated cycles of drug use and withdrawal can disrupt brain function to the extent that people may have difficultly experiencing pleasure in their daily lives. At this point, many people continue drug use to avoid the lows caused by withdrawal rather than seek the highs they once experienced.

Fortunately, treatment can help people with a substance use disorder counteract these disruptive effects and lead healthier lives. The sooner a person receives treatment, the better the chance that they will recover.

Xanax® and Percocet® are both brand names of prescription drugs. Both can help treat certain medical conditions when used as directed by a doctor, but they have the potential to be misused. They work in the brain in different ways:

Xanax®, or alprazolam, is a  prescription depressant  that helps produce a calming effect. Many people experience anxiety disorders and have difficulty sleeping, and prescription depressants can help treat these symptoms.

Percocet® is prescribed to treat severe pain from serious injuries or after surgery. It contains the analgesics (pain relievers) acetaminophen (the same drug as in Tylenol®) and oxycodone, which is an opioid analgesic. Opioids affect the brain's reward circuit, causing euphoria (the high), and flooding the brain with the chemical messenger (dopamine) which reinforces the brain to seek out the drug again.

Xanax® and Percocet® can cause severe adverse health effects, including overdose, if taken in large quantities or if taken with certain other drugs. Large doses of acetaminophen in Percocet® can also cause life-threatening liver damage. If you are prescribed these drugs, carefully follow your clinician’s instructions, and do not share them with others.

When teens ask us about bath salts , we understand that they’re probably not referring to Epsom salt for a relaxing time in the tub. They’re talking about synthetic cathinones, which are stimulants made in labs. Bath salts and similar drugs cause extreme wakefulness and elevated heart and breathing rates. Many people seek out these drugs because they are viewed as a cheaper substitute for stimulants like methamphetamine and cocaine.

Using bath salts can cause severe intoxication, hallucinations, paranoia, panic attacks, and addiction. Serious health effects including dehydration and kidney problems can also occur. An additional danger of taking these synthetic drugs is that they might contain other substances with their own harmful effects, including life-threatening overdoses.

Bath salts are usually white or brown crystal-like powder that are ingested in several ways, though snorting or injecting these drugs further increases the risk of harmful effects.

Despite their health risks, some of these drugs are sold legally in stores or online in small plastic or foil packages with the words, "Not for human consumption." In addition to "bath salts," synthetic cathinones are sometimes labeled as "plant food," "research chemicals," or "glass cleaner."

Many teens who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD) take prescription stimulants like Adderall® or Ritalin® to help treat their symptoms. When taken as directed, these medications can be helpful and safe, and have a very low risk for addiction. If your doctor prescribes stimulants, it’s important to follow the instructions and to discuss any concerns about addiction or dependence.

Sometimes people who don’t have ADHD take drugs like Adderall® or Ritalin® in an attempt to get high, to stay awake longer, or to stay focused while studying. According to the Monitoring the Future annual survey on teen drug use, there was a significant increase in the misuse of the ADHD medicine Adderall® among 8th graders from 2015 to 2020.

This can be especially harmful because people often take these medications at a higher dose or through a different route than prescribed. Misusing ADHD medications can cause headaches, nausea, feeling anxious, and sleeping problems. Misusing prescription stimulants can also lead to addiction. These drugs can also make you feel paranoid, cause your body temperature to get dangerously high, and make your heart beat too fast. While stimulants may help with a lack of focus in some people, they may diminish other skills (like creative thinking).

It can be. Research shows that many teens and young adults don’t realize that the flavors they use actually can contain nicotine, an addictive compound found in tobacco . Many vapes also contain propylene glycol, glycerin, chemical flavorings, and other compounds with unknown health effects. As a result, people who vape—even just flavoring—may inhale and ingest potentially harmful chemicals.

Recent studies showed that students who had already used any type of e-cigarette by the time they started 9th grade were more likely than others to start smoking cigarettes and other smokable tobacco products within the next year. And we know that cigarette smoking is a leading cause of cancer and other illnesses. According to the Centers for Disease Control and Prevention (CDC) , cigarettes cause more than 480,000 premature deaths in the United States each year—from smoking or exposure to secondhand smoke. This represents about 1 in every 5 U.S. deaths, or 1,300 deaths every day.

Other vaping products can also cause harm. In 2020, thousands of people got sick and dozens died from an illness called EVALI, which stands for e-cigarette or vaping-use associated lung injury. Vitamin E acetate, an additive in some THC-containing vaping products, is strongly linked to EVALI. When heated and inhaled, vitamin E acetate can damage the lungs.

Asking how to help someone who may have a substance use disorder to stop taking drugs is one of the most common things we hear from both adults and teens. Fortunately, there are resources to help people affected by a friend or family member’s substance use or substance use disorder.

NIDA’s Step-by-Step Guides have resources and information on how to recognize a substance use disorder and how to find help. NIDA for Teens has additional resources to find help for teens.

Supporting a loved one through a struggle with substance use can be difficult for adults and teens alike. This process can be especially complicated when someone is resistant to getting help. While you may not have control over someone else's substance use, support is available to cope with how that substance use may affect you.

The Substance Abuse and Mental Health Services Administration ( SAMHSA ) operates the National Helpline 1-800-662-HELP (4357). This is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish). SAMHSA has resources available online for families coping with mental and substance use disorders and also provides a confidential online treatment locator .

If someone is experiencing an overdose, mental health crisis, or another emergency, call 9-1-1.

Pregnancy is an important time to maintain or adopt healthy behaviors. Decades of research show exposure to certain substances can be unsafe for the health of the woman and the baby. Many drugs, including opioids, alcohol, and stimulants, have been associated with harm to the developing fetus. Using or being exposed to some substances can increase the risk of miscarriage and can cause migraines, seizures, or high blood pressure in the mother. A 2013 study found the risk of stillbirth was 2 to 3 times greater in women whose blood tests showed exposure to tobacco and about 2 times greater in women whose blood tests showed exposure to cannabis, stimulants, or prescription pain relievers.2 Pregnant women should refrain from drinking alcohol and talk with their health care provider before using any medicines or drugs.

Although the medical use of marijuana is legal in many states, the U.S. Food and Drug Administration (FDA) has not determined that the marijuana plant is safe and effective for treating any disease or condition and has not approved it as a medicine. 

Although the marijuana plant has not been approved as medicine, the FDA has approved formulations of two of the components of marijuana—THC and CBD—as medicine for specific conditions. THC, which stands for delta-9-tetrahydrocannabinol, is responsible for marijuana’s “high”, the euphoric and addictive effects of the drug. CBD, or cannabidiol, does not produce a high and has not been shown to lead to addiction.

CBD derived from the marijuana plant has been approved for seizures associated with specific disorders, and laboratory-made THC has been approved to help with appetite in people with AIDS and to treat nausea associated with chemotherapy for people with cancer. Although not available in the United States, a combination of plant-derived THC and CBD has been approved in multiple countries to treat some symptoms of multiple sclerosis.

The National Institutes of Health, including NIDA, continue to support research on the potential medical uses of marijuana and its components. Currently, however, marijuana products (including CBD) are being marketed as treatments for many conditions for which there is insufficient or no evidence of their safety or effectiveness.

Nicotine in any form is highly addictive, and many who start using one form of nicotine transition to another.

NIDA’s 2020 Monitoring the Future survey showed that the number of teens who say they vape nicotine has leveled off but remains high . The number of teens who say they smoked cigarettes in the past month declined significantly since the mid-1990s and is now at or near the lowest it ever has been. Because both smoking and vaping are so addictive, it is helpful to speak with a doctor when trying to quit either. A good strategy is never to start.

And the question we receive most often from teens is …

It’s only natural to want to know what’s best or worst, good or bad. That’s why we love these types of lists! But in the case of drugs and alcohol, there isn’t a “worst” just as there isn’t a “best” drug.

We don’t define drugs as most or least harmful. All drugs have the potential to produce negative health effects or lead to a dangerous situation in the short or long term. Whether a drug causes a serious health issue—like a life-threatening overdose—can depend on how much a person uses, how they consume it, and other factors.

However, some drugs are so potent that a life-threatening overdose can occur the first time a person uses them. For example, the synthetic opioid fentanyl is 100 times more potent than morphine and 50 times more potent than heroin. Because fentanyl is often mixed with other drugs, such as heroin, cocaine, methamphetamine, and MDMA (Molly), fentanyl may be ingested unknowingly at unknown quantities, which can lead to overdose. Injecting potent drugs can be particularly dangerous because this route delivers the compounds more directly to the brain than ingesting or snorting drugs. Injection also carries the risks of injury and infection.

Similarly, some drugs are more frequently associated with addiction and dependence than others. For example, more than half of people who regularly use cigarettes meet the criteria for a tobacco use disorder, while only about 1 in 11 people who regularly use marijuana (cannabis) meet the criteria for a cannabis use disorder. Certain drugs can have a stronger effect on the brain than others. Research has shown that methamphetamine , in particular, may damage cells and structures within the brain that can cause long-term problems with emotion and memory.

Certain physical or mental illnesses, as well as family health history, also influence someone's chances of developing an addiction or other negative health effects of drug use. Age is an especially important factor when calculating the risks of substance use. Because the brain develops through a person’s mid-twenties, teens and young adults tend to be more vulnerable to negative health effects of many drugs. All of this means certain substances may pose different risks to different people in different situations.

Going by the numbers, determining the deadliest drug also depends on perspective.

In 2021, an estimated 106,699 people died from a  drug overdose  in the United States. The most common drugs associated with these fatal overdoses were synthetic opioids, including highly potent illicitly made  fentanyl .

However, the long-term health effects of cigarette smoking are responsible for more than 480,000 deaths per year. That’s about 1,300 deaths every day.

And alcohol is the substance most frequently involved in deadly car crashes. Nearly one person died every 52 minutes from drunk driving crashes in 2019.

To put it simply, what's the "worst" drug isn't an easy question to answer, and it’s important to understand the risks of any substance. NIDA supports research to help us understand the effect of drugs on the brain, how to prevent people from starting to use drugs, and how to help them if they have substance use disorder. 

References:

• Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700-707. doi:10.1001/jama.2015.8950
• Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/news/releases/pages/121113-stillbirth-drug-use.aspx . Published December 11, 2013. Accessed January 31, 2018.
• Centers for Disease Control and Prevention, Office on Smoking and Health. Smoking and Tobacco Use, Fast Facts. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm#:~:text=Cigarette%20smoking%20is%20responsible%20for,or%201%2C300%20deaths%20every%20day.&text= On%20average%2C%20smokers%20die%2010%20years%20earlier%20than%20nonsmokers .
• United States Department of Transportation, National Highway Traffic Safety Administration. Risky Driving, Drunk Driving. https://www.nhtsa.gov/risky-driving/drunk-driving
• WONDER. Multiple Cause of Death 1999-2021. Centers for Disease Control and Prevention, National Center on Health Statistics. Released January 2023. Accessed January 2023.

• Open access
• Published: 26 July 2022

The challenges, opportunities and strategies of engaging young people who use drugs in harm reduction: insights from young people with lived and living experience

• M-J Stowe 1 , 2 ,
• Orsi Feher 3 ,
• Beatrix Vas 4 , 5 ,
• Sangeet Kayastha 6 &
• Alissa Greer 7  

Harm Reduction Journal volume  19 , Article number:  83 ( 2022 ) Cite this article

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The meaningful inclusion of young people who use or have used drugs is a fundamental aspect of harm reduction, including in program design, research, service provision, and advocacy efforts. However, there are very few examples of meaningful and equitable engagement of young people who use drugs in harm reduction, globally. Youth continue to be excluded from harm reduction programming and policymaking; when they are included, they often face tokenistic efforts that lack clear expectations, equitable work conditions, and are rarely afforded agency and autonomy over decision-making. In this commentary, we identify and discuss issues in youth engagement, and offer recommendations for the future of harm reduction.

Introduction

Globally, engaging people who use drugs (PWUD) from key populations, including people who inject drugs, women who use drugs, people living with HIV, transgender people and people who identify as LGBTQI+, is fundamental to harm reduction [ 1 ]. Grassroots organizing, along with “peer” engagement initiatives, have paved the way for the active participation of PWUD in harm reduction policy making, research, programming, advocacy, and service provision [ 2 ]. This inclusionary approach is characterized by a bottom-up, inclusive, and community-led approach to decision-making. It has the potential to facilitate equitable access to harm reduction services by promoting communication, developing trust and rapport, increasing knowledge, and reducing stigma and discrimination [ 3 ]. Despite the increasing support for engaging PWUD across various populations and countries [ 4 ], there is limited evidence and focus on the engagement of young PWUD in harm reduction [ 5 ].

In this commentary, we offer a much-needed perspective and discussion on the importance and value of youth engagement in harm reduction. We, the authors of this commentary, are young PWUD and allies from five countries. We draw on our lived-experiences, experiential knowledge and expertise to identify and discuss the key challenges, opportunities, and recommendations for the future of youth engagement in harm reduction.

Youth and harm reduction

Youth is an elastic category; it encapsulates multiple age groups and refers to the various stages in a person's life when they are not children but not yet entirely autonomous adults [ 6 ]. It is a period of one’s life that might be thought of as minors under 18–19 years old, young adults up to age 35, or even soon after childhood (10–13 years of age). Different cultures mark the end and the beginning of this phase differently, as is recognized across the United Nations [ 7 ], but it is uniformly considered formative years, when certain aspects of life and issues are more relevant than others [ 8 ]. One’s identity and positioning in the world are formed during this time. People in this period develop greater independence and agency, which includes confidence in their abilities to independently think and make decisions.

Although the term “youth” is loosely defined across various literature and policy making, most researchers and practitioners agree that initiation into drug use typically occurs in the late teens but can occur at much younger or older ages [ 9 ]. The age that someone first uses drugs can have a major impact on their drug use trajectories and the harms experienced [ 8 ]. Studies show that initiating drug use at a younger age is predictive of developing health and social issues later on [ 6 , 10 ].

Given the risks and potential harms associated with drug use at a younger age [ 6 ], it is concerning that many young PWUD experience stigma, discrimination and barriers to accessing health and harm reduction services due to their age [ 11 ]. For example, we have experienced age restrictions when trying to access basic healthcare services, such as HIV testing or counselling, and health workers who are reluctant to provide us with services, particularly opioid substitution treatment and other medication therapies. Our experiences are not isolated and are corroborated in the literature (e.g. [ 9 ]). Considering the importance and clear deficiencies in services for young PWUD, engaging youth from a multitude of intersecting identities and backgrounds in the development, implementation, and evaluation of services is imperative in the design of efficient, accessible services.

The benefits of youth engagement in harm reduction

In our experiences of working in and alongside various not-for-profit organizations internationally, most young PWUD are practical, action-oriented and possess a diversity of skills. The next generation of PWUD are natural experts on the emerging trends in drug use behaviour [ 3 ], and can offer unique insights on the realities of drugs and their use, particularly because of their experiential knowledge, connection to the community, and access and literacy with new technologies [ 12 ]. Young PWUD are able to provide insights and access to the places and spaces where young people use drugs and provide essential harm reduction “where they’re at”. Young PWUD are already present in spaces occupied by youth in various physical environments and social contexts, including places like festivals, schools, and various groups or communities. In these environments, social media and other technologies and communication channels can be leveraged to disseminate information in real-time [ 12 ]. These characteristics and attributes equip young PWUD with experiences and expertise to effectively respond to the true needs of their peer groups.

Young PWUD are often at a higher risk for HIV and viral hepatitis infection, as well as higher rates of fatal and non-fatal overdoses in certain contexts [ 13 , 14 ], while engagement across key populations face multiple and intersecting challenges due to their social positioning [ 15 ]. Yet, reaching young people who inject drugs, live with HIV and/or hepatitis C, are sex workers, and who identify as a racial or ethnic minority and/or part of the LGBTQI+ community, is critical to effectively promoting access to healthcare services and evidence-based information. In our experience, this is most successfully done by well-prepared peers and by leveraging dynamic social networks [ 16 , 17 ].

Key challenges and issues

There are relatively few examples in the literature of harm reduction interventions that have effectively and meaningfully involved young PWUD as peer educators, mentors, programme designers, and evaluators while ensuring their agency and autonomy over decision-making processes. While some studies report encouraging outcomes on the inclusion of young PWUD [ 16 , 18 ], most harm reduction interventions and programmes remain largely developed, studied, and funded to focus on adults, with little regard to the specific needs of younger PWUD [ 12 ].

Below, we offer our insight on several key issues related to youth engagement in harm reduction, including: (1) youth exclusion from harm reduction programming; (2) youth exclusion from key drug policies and reforms; (3) tokenism in youth engagement. Following this, we offer several recommendations to mitigate these issues.

Youth exclusion from harm reduction programming

In our experiences, spaces that are meant for young PWUD, but are controlled by older peers, are an obstacle that can be addressed through youth engagement. A sense of top-down, age-based hierarchy can create aversion and resistance in young PWUD to both access and partake in services—thus, alienating the group that services are intended for.

The marginalization of youth can occur in several ways. For example, when adults use their authority to design and implement interventions that they deem appropriate for young people, such as school-based drug education programming, without any input from youth. Not engaging youth in the design and implementation process may result in decreased up-take of young PWUD and an increased stigma around seeking help [ 13 ]. Instead, youth engagement may empower young people by centring their voices in the design, decisions, delivery, and advocacy of harm reduction interventions and programmes.

Young PWUD are a diverse and heterogeneous population. While young PWUD face unique age-related barriers, lack of autonomy and agency over decision-making in harm reduction, this occurs within a broader societal context where youth are disproportionately affected by a number of socioeconomic, political, cultural and racial factors. Youth who face marginalization on the basis of racism, gender discrimination, poverty, ableism, and other positioning face overlapping barriers to services. Harm reduction programming for young people cannot be a one-size-fits-all solution that treats young PWUD as a homogenous group. It is imperative that inputs from young PWUD are centred in all its diversity in all aspects of harm reduction.

Youth exclusion from drug policy reform

Drug policy reform is an important part of harm reduction. Currently, reigning drug policies that criminalize young PWUD are responsible for some of the most severe harms associated with drug use. The consequences of the prohibitionist approach include greater relative harms for young PWUD that can have a lasting impact long into adulthood. To be able to effectively craft policies that “leave no one behind” (as is the motto of the United Nations Office on Drugs and Crime) and initiatives that are “harnessing the transformative power of youth” [ 19 ], it is critical that youth and their lived experience are meaningfully included in drug policy reform activities, globally.

Young PWUD are at the forefront of advocating for progressive drug policy reform. Youth-led organisations are spearheading the global drug policy reform movement. Such organizations, often with minimal funding or support from “adult” peers, are promoting the voices, experiences, and expertise of young PWUD at both high-level government forums, as well as the important work of non-governmental committees.

However, young PWUD still face challenges and barriers to engaging in drug policy reform. While most policy makers justify their decisions with the important aim of protecting the youth, there is concerning evidence that young people are being excluded from both the decision-making process and policies themselves [ 12 ]. For example, in British Columbia, Canada, decriminalization efforts have not only excluded youth from the process, but policies do not apply to young people altogether, keeping young PWUD as “minors”, like alcohol and tobacco policies. In addition, the authors have personally experienced difficulties in engaging decision-makers and people in positions of decision-making when it comes to the design of international guidelines for service provision and youth inclusion. These challenges can range from national representatives actively ignoring individuals to blatant verbal abuse while our colleagues present their findings on the floor of the Commission on Narcotic Drugs at the UN. This exclusion of young PWUD is at the root of inefficient and, at times, harmful policies. Importantly, crafting drug laws and policies that are equitable and reflect the true needs and interests of young people requires youth engagement throughout the policymaking process.

Tokenism in youth engagement

The marginalization of young PWUD can continue to occur when engagement efforts are tokenistic. Tokenism occurs when service providers selectively choose or “cherry-pick” youth representatives based on, for example, agreeability to deliver a pre-crafted message on behalf of other young PWUD. In our experiences, we have seen examples of tokenism in programmes where young PWUD are recruited to advise on content or deliver services that they had no meaningful engagement in—where they did not have the opportunity to shape or influence the initiatives. Tokenistic youth involvement only ticks the boxes of inclusivity and participation, but entails no meaningful engagement of young PWUD.

There is an assumption that young people can only be experts on “youth topics” and thus a tendency to limit involving young PWUD solely in initiatives or aspects of projects that are “youth-focused”—which tokenizes them for only parts of their identities. Initiatives often put youth in uncomfortable situations where they are expected to share personal details that might be sensitive in work or professional contexts, such as disclosing illicit or illegal acts. Further, the context and details of how their contributions will be used is sometimes withheld, for example, being asked to speak on behalf of an organization at an event, and being introduced as a young person who uses drugs when it was not discussed beforehand if they are comfortable disclosing that information.

In addition to limited agency and autonomy over decision-making, young PWUD are often only included in consultative roles, to provide comments and feedback on pieces of writing, projects or programmes, that have already been largely developed without their direct involvement. This severely limits the meaningful and transparent impact that young PWUD’s perspectives, often based on their lived experiences or expertise otherwise could have been gained.

PWUD, regardless of their age, possess a specific expertise and unique knowledge, the sharing of which should be compensated fairly—as with any other particular skill in any other field. When young people are solicited for work, they should be presented with transparent and accurate information about what is expected of them and be allowed space to negotiate the conditions in which they engage.

Recommendations for the future of youth engagement in harm reduction

Despite the challenges, there are a number of opportunities to promote equitable and meaningful youth engagement in harm reduction. Kimmel et al. [ 12 ] developed principles of harm reduction for young people who use drugs, including that services are available and tailored towards youth. We echo these principles and underscore the value of an inclusive, meaningful, and equitable approach to harm reduction for youth. Such principles underpin our suggestions for the future of engaging youth in harm reduction. Here, we offer several recommendations to promote greater, meaningful engagement of young PWUD:

Ageist and exclusionary programming and processes in health and harm reduction programming must be urgently addressed—globally. Youth should not be excluded due to their age. Rather, this feature, along with other identities that youth are positioned in, is a valuable area of expertise for harm reduction.

The ability of young PWUD to self-organize and engage other youth as equal counterparts, building youth capacity and advocacy from the bottom up, must be incorporated into programme design and service delivery.

Harm reduction engagement efforts should draw on the leadership of autonomous youth-led organizations. Youth-led organizations allow for self-governing, self-determined agendas, and independent organization that prioritizes the interests and empowerment of youth above all else. Engaging youth through youth-led organizations can promote equity, diversity, and inclusion.

Youth engagement efforts must be informed by intersectionality and the lived-experiences of young PWUD across key populations, including those who identify as LGBTQI+ and racial and ethnic minorities. These efforts must not be tokenistic.

Young PWUD require pay and work equity in harm reduction. Learning from areas of research and advocacy, we know that young people are often expected to volunteer their time, work in informal roles, and are not given as much decision-making power. By providing young PWUD with paid employment opportunities, they can build work experience and be included as equals alongside other paid professionals working in harm reduction—including as paid collaborators in research (e.g. funding applications), decision-makers in policy, and service providers in programs.

Digital technologies offer an area of opportunity to communicate and connect with young people. However, for digital technologies to be effective, they will require young PWUD to be involved in the design, implementation, and evaluation of these tools. Young PWUD can and are the ones that most effectively leverage new ways of communication technologies to shift ideologies around the risks and benefits of drugs, including novel and new psychoactive substances. For example, the application “TripApp” was developed by and continues to grow its database through the contributions of young PWUD, showcasing the unparalleled position of young people as they are native to digital solutions and have their finger on the pulse on the realities and trends among their demographic. However, such technology should be available across both developed and developing countries, and more marginalized young people who may not have access to digital devices.

To support the above recommendations, adequate funding and resources—and the engagement of youth in the development and implementation of funding—are required. Major funders are yet to provide meaningful and adequate opportunities specifically to support youth engagement and youth-based harm reduction initiatives. Youth-based organizations should be funded directly, with core funding, as autonomous entities so they have the ability and opportunity to act in the best interest of their communities.

In this commentary, we have highlighted several challenges and areas for improvement in youth engagement in harm reduction. As young PWUD and allies, we recognise that engagement in harm reduction comes with a unique set of challenges, but we believe that institutions could and should prioritize and create capacity for youth engagement and leverage the unique position of young PWUD in the field.

Engagement with young PWUD is critically needed to reduce individual- and population-level health and social outcomes.

Young PWUD are champions in health promotion and harm reduction, both for themselves and the broader community. Their meaningful inclusion and engagement will continue to be a key driver of effective planning, service delivery, and evaluation of harm reduction interventions and programs. However, while the engagement of PWUD is increasingly the norm in harm reduction initiatives, young people are often still an excluded and/or marginalized group in harm reduction contexts. Organizers of both established and emerging harm reduction programs, policies, and research should ensure that initiatives are, if possible, youth-centred—that is, ensuring that youth are meaningfully engaged in all aspects, including governance, programme planning and implementation, evaluation, building partnerships, and communication.

Moving forward, we hope that this commentary serves as a catalyst for young PWUD to take ownership of a coordinated and radical approach, grounded in racial and social justice, whereby youth inclusion is no longer tokenistic but we are given agency and autonomy over decision-making processes, and shape the future of harm reduction, globally. This commentary is a call for more intentional, meaningful, and greater efforts to actively and equitably engage young PWUD in harm reduction. The next generation is depending on it.

Availability of data and materials

Not applicable.

Abbreviations

People who use drugs

United Nations

Human immunodeficiency virus

Lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual

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Smyrnov P, Broadhead RS, Datsenko O, Matiyash O. Rejuvenating harm reduction projects for injection drug users: Ukraine’s nationwide introduction of peer-driven interventions. Int J Drug Policy. 2012;23(2):141–7.

Marshall BD, Green TC, Yedinak JL, Hadland SE. Harm reduction for young people who use prescription opioids extra-medically: obstacles and opportunities. Int J Drug Policy. 2016;31:25–31.

United Nations Office on Drugs and Crime. Strategy 2021–2025. https://www.unodc.org/unodc/strategy/index.html . Accessed 28 May 2022.

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The open access fee for this paper was covered through a Youth RISE project which was part of the 4Youth Consortium and funded by the Robert Carr Fund. Additional funding was provided by the Vancouver Foundation.

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Stowe, MJ., Feher, O., Vas, B. et al. The challenges, opportunities and strategies of engaging young people who use drugs in harm reduction: insights from young people with lived and living experience. Harm Reduct J 19 , 83 (2022). https://doi.org/10.1186/s12954-022-00663-z

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5 Ways to Empower the Youth Against Drug Abuse

Published by admin on June 27, 2023 June 27, 2023

In the shadows of society, a perilous menace silently thrives, gripping the lives of individuals, families, and entire communities.

This menace is drug abuse , a destructive force that rips apart dreams, erodes health, and corrodes the very fabric of society. But what lies beneath the surface of this seemingly invisible enemy? What fuels its relentless spread, leaving countless lives in ruins?

Drug abuse, simply put, is the harmful and excessive consumption of substances that alter the mind and body.

These substances, both legal and illegal, possess the power to induce euphoria, numb pain, or offer temporary escape from the burdens of reality.

However, when abused, they unleash a sinister cycle of addiction, leading individuals down a treacherous path where their lives become tangled in the web of illicit trafficking.

The detrimental impact of drug abuse and illicit trafficking on young individuals cannot be underestimated, making it crucial to prioritize their mental health and overall well-being.

Empowering Youth for a Drug-Free Future

Youth development plays a pivotal role in shaping the future of societies worldwide. However, the rise in drug abuse and illicit trafficking has emerged as a major setback, impeding the growth and potential of young individuals.

Addressing this issue requires a multifaceted approach, focusing on prevention, education, and support systems.

Prevention through Education

Education remains a cornerstone in the fight against drug abuse and illicit trafficking. Empowering young people with knowledge about the risks and consequences associated with substance abuse equips them to make informed decisions.

Schools and educational institutions should integrate comprehensive drug education programs that emphasize the physical, psychological, and social ramifications of drug abuse.

Creating Support Systems

Building robust support systems is essential to ensuring that young individuals facing drug-related challenges receive the help they need.

Governments, NGOs, and communities must collaborate to establish accessible and confidential helplines,counseling services, and rehabilitation programs.

By creating a safe space for open dialogue and support, we can encourage young people to seek assistance and embark on a journey of recovery.

Promoting Mental Health

Mental health is a vital aspect of youth development, and addressing it is crucial in combating drug abuse and illicit trafficking. Investing in mental health services, raising awareness about mental well-being, and reducing stigma are essential steps.

By fostering resilience, coping mechanisms, and emotional intelligence, we empower young individuals to navigate the complexities of life without resorting to substances.

Engaging Youth as Agents of Change

Young people possess immense potential to drive change in their communities. Engaging them in anti-drug campaigns, peer support networks, and advocacy initiatives allows them to become active participants in the fight against drug abuse and illicit trafficking.

By amplifying their voices and providing platforms for expression, we can harness their energy, creativity, and passion to make a lasting impact.

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INTRODUCTION

Alcohol use, misuse, abuse, and dependence, hazards of use of alcohol, factors that contribute to hazardous use, genetic and familial factors, other factors, adolescent developmental and neurobiological factors, national call to prevent and reduce underaged drinking, role of the pediatrician, recommendations, aap resources, suggested internet resources, self-help and advocacy group resources, committee on substance abuse, 2007–2008, alcohol use by youth and adolescents: a pediatric concern.

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

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Committee on Substance Abuse; Alcohol Use by Youth and Adolescents: A Pediatric Concern. Pediatrics May 2010; 125 (5): 1078–1087. 10.1542/peds.2010-0438

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Alcohol use continues to be a major problem from preadolescence through young adulthood in the United States. Results of recent neuroscience research have substantiated the deleterious effects of alcohol on adolescent brain development and added even more evidence to support the call to prevent and reduce underaged drinking. Pediatricians should be knowledgeable about substance abuse to be able to recognize risk factors for alcohol and other substance abuse among youth, screen for use, provide appropriate brief interventions, and refer to treatment. The integration of alcohol use prevention programs in the community and our educational system from elementary school through college should be promoted by pediatricians and the health care community. Promotion of media responsibility to connect alcohol consumption with realistic consequences should be supported by pediatricians. Additional research into the prevention, screening and identification, brief intervention, and management and treatment of alcohol and other substance use by adolescents continues to be needed to improve evidence-based practices.

Alcohol use and heavy drinking are common during adolescence and young adulthood, although the minimum legal drinking age across the United States is 21 years. Some individuals may start hazardous alcohol consumption earlier in childhood. The prevalence of problematic alcohol use continues to escalate into the late adolescent and young-adult age range of 18 to 20 years. Drinking by college-aged students remains a major issue. Results of recent research that have demonstrated that brain development continues well into early adulthood 1   and that alcohol consumption can interfere with such development 2 , 3   indicate that alcohol use by youth is an even greater pediatric health concern.

Use of alcohol at an early age is associated with future alcohol-related problems. 4 , – , 6   Data from the National Longitudinal Alcohol Epidemiologic Study 4   substantiated that the prevalence of both lifetime alcohol dependence and alcohol abuse show a striking decrease with increasing age at onset of use. For those aged 12 years or younger at first use, the prevalence of lifetime alcohol dependence was 40.6%, whereas those who initiated at 18 years was 16.6% and at 21 years was 10.6%. Similarly, the prevalence of lifetime alcohol abuse was 8.3% for those who initiated use at 12 years or younger, 7.8% for those who initiated at 18 years, and 4.8% for those who initiated at 21 years. The contribution of age at alcohol use initiation to the odds of lifetime dependence and abuse varied little across gender and racial subgroups in the study. Early alcohol initiation has been associated with greater sexual risk-taking (unprotected sexual intercourse, multiple partners, being drunk or high during sexual intercourse, and pregnancy) 7   ; academic problems; other substance use; and delinquent behavior in mid- to later adolescence. 8   By young adulthood, early alcohol use is associated with employment problems, other substance abuse, and criminal and violent behavior. 8   Independent of genetic risk, exposure to alcohol or other drug use disorders of parents predicts substance use disorders in children. 9  

Adolescent drinking behaviors cover the alcohol use spectrum, from primary abstinence to alcohol dependence. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) 10   defines alcohol abuse as a maladaptive pattern of use that leads to clinically significant impairment or distress, as manifested by 1 or more of the following within a 12-month period:

recurrent alcohol use that results in a failure to fulfill major role obligations at work, school, or home;

recurrent alcohol use in situations in which it is physically hazardous;

recurrent alcohol-related legal problems;

continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the alcohol; and

the symptoms have never met the criteria for alcohol dependence.

Alcohol dependence is defined as a maladaptive pattern of use that leads to clinically significant impairment or distress, as manifested by 3 or more of the following within the same 12-month period:

withdrawal;

alcohol is often taken in larger amounts or over a longer period than was intended;

there is a persistent desire or unsuccessful efforts to cut down or control use;

a great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects;

important social, occupational, or recreational activities are given up or reduced because of use; or

alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

Because these diagnostic criteria were developed largely from research and clinical work with adults, there are limitations to applying these definitions to classify alcohol use and associated risks to adolescents. 11 , – , 13   As defined by the DSM-IV-TR , alcohol abuse or dependence may not have had time to develop in an adolescent, especially a younger one, and yet the adolescent may be engaging in very risky behavior. Applicability is also potentially limited in that several of the criteria, such as withdrawal, are not typically experienced by adolescents, and other criteria, such as tolerance, have low specificity for adolescents. Tolerance can be anticipated as a developmental process that will occur over time in most adolescents who drink. 11  

Alcohol misuse can be defined as “alcohol-related disturbances of behavior, disease, or other consequences that are likely to cause an individual, his/her family, or society harm now or in the future.” 14   Because the term “alcohol misuse” encompasses earlier stages of problematic alcohol use as well as alcohol dependence that do not meet diagnostic criteria, it may be a more useful concept clinically in pediatrics and when developing alcohol use primary prevention programs for youth.

In examining the use of drugs by US youth, the annual Monitoring the Future Study (sponsored by the National Institute on Drug Abuse and implemented by the University of Michigan) 15   has consistently reported that the drug most commonly used by youth is alcohol, exceeding the use of tobacco and illicit drugs. The 2009 survey of more than 46000 8th-, 10th-, and 12th-grade students in more than 380 schools nationwide revealed that the prevalence of alcohol use in the previous 30 days had declined by more than one-third since most recently peaking in 1996 but that less of a decline was found for older students. The prevalence of being drunk at least once in the previous month was 5.4% for 8th-graders, 15.5% for 10th-graders, and 27.4% for 12th-graders. Prevalence of use in the previous 30 days of the relatively new flavored alcoholic beverages, also known as “alcopops” or “malternatives,” decreased somewhat since initial inclusion in this survey in 2004. Alcopop use in the previous 30 days was reported by 9.5% of 8th-graders, 19.0% of 10th-graders, and 27.4% of 12th-graders in 2009. Recent “binge-drinking,” defined as the consumption of 5 or more drinks in a row on at least 1 occasion in the previous 2 weeks, has continued at a relatively stable level, with 7.8% of 8th-graders, 17.5% of 10th-graders, and 25.2% of 12th-graders reporting this activity. Since the start of this century, more than 90% of 12th-graders have reported that alcohol is “fairly easy” or “very easy” to get, and more than 60% of 8th-graders say the same. These epidemiologic statistics are corroborated by data reported from 2 other large surveys of youth alcohol use in the United States: the Youth Risk Behavior Survey 16   of the Centers for Disease Control and Prevention and the National Survey on Drug Use & Health (formerly the National Household Survey). 17  

When compared with use by adults, alcohol use by adolescents is much more likely to be episodic (binge) and heavy, which makes alcohol use by those in this age group particularly dangerous. Rapid binge-drinking, possibly related to a bet or dare, puts the teenager at even higher risk of alcohol overdose or alcohol poisoning, in which suppression of the gag reflex and respiratory drive can be fatal. The adult definition of binge-drinking (the consumption of 5 or more drinks in a row over approximately a 2-hour period) is often also used to describe adolescent or young-adult alcohol use. Recent literature, however, suggests that for 9- to 13-year-old children and girls aged 14 to 17 years, binge-drinking should be defined as 3 or more drinks. For boys, binge-drinking should be defined as 4 drinks or more for those aged 14 or 15 years and 5 or more drinks for those aged 16 or 17 years. 18  

Alcohol use is the primary contributor to the leading causes of adolescent death (ie, motor-vehicle crashes, homicide, and suicide) in the United States. 19   Motor-vehicle crashes rank as the top cause of death for US teenagers and young adults. The Youth Risk Behavior Survey in 2007 revealed that during the 30 days preceding the survey, 29.1% of students nationwide had ridden 1 or more times in a car or other vehicle driven by someone who had been drinking alcohol, and 10.5% of students had driven a car or other vehicle at least once when they had been drinking alcohol. 16   The impressive relationship of alcohol use and motor-vehicle crashes involving youth is also highlighted by the fact that after the legal drinking age was changed uniformly to 21 years across the United States, the number of motor-vehicle fatalities in individuals younger than 21 years significantly decreased. 20   Teenagers drink and drive less frequently than do adults, but their motor-vehicle crash risks are higher than those of adults when they do drink, especially at low and moderate blood alcohol concentrations. 21  

Lower minimum legal drinking ages in the United States have also been associated with higher youth suicide rates. 22   The research literature consistently reports the association of alcohol use or abuse with other risk-taking behaviors, including assault, sexual risk-taking, and other drug use. 12 , 13 , 23 , 24   Thus, alcohol use by adolescents is not safe, even when they are not driving.

Alcohol misuse and alcohol use disorders in adolescents are associated with many other mental and physical disorders. Alcohol use disorders are a risk factor for suicide attempts. 25   Psychiatric conditions most likely to co-occur with alcohol use disorders include mood disorders, particularly depression; anxiety disorders; attention-deficit/hyperactivity disorder (ADHD); conduct disorders; bulimia; and schizophrenia. 23   Associated physical health problems include trauma sequelae, 26   sleep disturbance, modestly elevated serum liver enzyme concentrations, and dental and other oral abnormalities, 27   despite relatively few abnormalities being evident on physical examination. 27 , 28  

Twin studies in adult populations have consistently demonstrated genetic influences on use and abuse of alcohol, 29 , – , 31   but less research has examined genetic influences on the adolescent age range. 32 , – , 34   Through a sibling/twin/adoption study of adolescents, Rhee et al 35   examined the relative contribution of genetics and environment on initiation, use, and problem use of substances. The results of this study demonstrated that for adolescents, compared with adult-twin study findings, the magnitude of genetic influences was higher and that of shared environmental influences was lower for problem alcohol or drug use than for initiation of use.

Families play an important role in the development of alcohol and other drug problems in youth. Drug use by parents or older siblings and permissive parental attitudes toward drug use by young people predict greater risk of youth drug and alcohol use. 36 , 37   Both parental monitoring of children's use and the convincing conveyance of household rules governing use aid in deterring alcohol use among youth. 38 , 39   In the United States, 7 million children younger than 18 years are children of alcoholic parents. Children of alcohol abusers are at increased risk of many behavioral and medical problems, including delinquent behavior, learning disorders, ADHD, psychosomatic complaints, and problem drinking or alcoholism as adults. 40  

Having friends who use alcohol, tobacco, or other substances is one of the strongest predictors of substance use by youth. Patterns of use in the community also predict individual substance use behaviors. Rates of use are higher in communities in which alcohol and other drugs are less expensive and easily obtainable. Other risk factors for substance abuse include poor school performance, untreated ADHD, and conduct disorder. 36  

Media influences on the use of alcohol by young people are substantial. Jernigan et al 41   examined boys' and girls' exposure to magazine advertising for alcohol compared with that of legal-aged adults and found that underaged youth saw 45% more beer and ale ads, 12% more distilled-spirit ads, and 65% more low-alcohol refresher beverage ads (for alcopops or lemonades, iced teas, or fruity beverages containing alcohol) as well as 69% less wine advertising than did people aged 21 years or older. Exposure to alcohol advertising was greater for girls than for boys. Other media, such as television, movies, billboards, and the Internet, are known to be very influential in promoting alcohol use through attractive portrayals of use without associated negative consequences. Considerable research has shown that media exposure can make children and adolescents more likely to experiment with alcohol. 42 , 43  

Over the past decade, great strides have been made in understanding the neurobiological basis of addiction. Studies investigating normal brain development have yielded information that elucidate the effects of alcohol and other drugs on the adolescent brain. As summarized by Sowell et al, 44   results of postmortem studies have shown that myelination, a cellular maturational process of the lipid/protein sheath of nerve fibers, begins near the end of the second trimester of fetal development and extends well into the third decade of life and beyond. Autopsy results have shown both a temporal and spatial systematic sequence of myelination, which progresses from inferior to superior and posterior to anterior regions of the brain. This sequencing results in initial brain myelination occurring in the brainstem and cerebellar regions and myelination of the cerebral hemispheres and frontal lobes occurring last. Converging evidence from electrophysiological and cerebral glucose-metabolism studies has revealed relatively late frontal lobe maturation, and results of neuropsychological studies have shown that performance on tasks that involve the frontal lobes continues to improve into adolescence.

Sowell et al 44   documented reduction in gray matter in the regions of the frontal cortex between adolescence and adulthood, which probably reflects increased myelination in the peripheral regions of the cortex. Gray-matter loss, with pruning and elimination of neural connections during normative adolescent development, seems to reflect a sculpting process that turns the immature brain into a mature one. 45   These changes are thought to improve cognitive processing in adulthood. Results of neuropsychological studies have shown that the frontal lobes are essential for functions such as response inhibition, emotional regulation, planning, and organization, all of which may continue to develop between adolescence and young adulthood. Conversely, parietal, temporal, and occipital lobes show little change in maturation between adolescence and adulthood. Parietal association cortices are involved in spatial relationships and sensory functions, and the lateral temporal lobes are associated with auditory and language processing, and these functions are largely mature by adolescence. Hence, the observed patterns of brain maturational changes are consistent with cognitive development. 44   Connections are being fine-tuned in adolescence with the pruning of overabundant synapses and the strengthening of relevant connections with development and experience. It is likely that the further development of the prefrontal cortex aids in the filtering of information and suppression of inappropriate actions. 45  

The effects of alcohol and other drugs on the adolescent brain are probably multiple, because the immaturity or plasticity of the brain developmental processes likely confers greater vulnerability to both the toxic and the addictive actions of drugs, and drug use itself may directly affect brain development. The use of alcohol and drugs during early adolescence, coupled with genetic predisposition to substance abuse and addiction, may increase the magnitude of risk-taking during adolescence. All substances of abuse that lead to dependence share 2 common effects during withdrawal: a decrease in dopamine 2 (D 2 ) receptors (which can lead to tolerance) and hypofunctioning of the prefrontal cortex. The effects of drugs and alcohol on an immature prefrontal cortex may increase the incentive to seek substances of abuse, especially to decrease the effects that are felt during withdrawal. 46 , 47   Continued use may impair an already immature prefrontal cortex and further affect decision-making once substance use begins.

Results of developmentally focused research on how alcohol affects the adolescent brain have started to demonstrate that adolescents with an alcohol use disorder use fewer strategies to learn new information and demonstrate significantly reduced memory skills that continue to deteriorate with continued alcohol use. In neuroimaging studies of patients with adolescent-onset alcohol use disorders, reduced hippocampal volumes and subtle white-matter abnormalities have been documented. 3   Research continues to explore these brain developmental processes that may confer greater vulnerability to the addictive actions of drugs, including alcohol. 2  

In 2007, The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking 48   was issued after being developed in collaboration with the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). This call to action identified 6 goals:

Foster changes in American society that facilitate healthy adolescent development and that help prevent and reduce underaged drinking.

Engage parents and other caregivers, schools, communities, all levels of government, all social systems that interface with youth, and youth themselves in a coordinated national effort to prevent and reduce underaged drinking and its consequences.

Promote an understanding of underaged alcohol consumption in the context of human development and maturation that takes into account individual adolescent characteristics as well as environmental, ethnic, cultural, and gender differences.

Conduct additional research on adolescent alcohol use and its relationship to development.

Work to improve public health surveillance on underaged drinking and on population-based risk factors for this behavior.

Work to ensure that policies at all levels are consistent with the national goal of preventing and reducing underaged alcohol consumption.

The Surgeon General's report outlined specific strategies for implementing these goals, including recommendations for parents and other caregivers; schools, colleges, and universities; communities; the criminal and juvenile justice systems and law enforcement; entertainment and media industries; the health care system; professional health care associations; and governments and policy makers.

Pediatricians and other health care providers who care for children and adolescents should help prevent, identify, and treat alcohol and other substance use by youth. The American Academy of Pediatrics guidelines for the health care of children and adolescents recommend that pediatricians discuss substance use as part of anticipatory guidance and preventive care. 49   Because of their understanding of family dynamics and long-standing relationships with families, pediatricians can identify substance-abusing families and facilitate their care. 50   Pediatricians can be involved in the primary prevention of alcohol misuse through educational and psychological interventions with youth. Although evaluation of such programs has revealed many methodologic weaknesses, there is some evidence to support the effectiveness of family-focused prevention programs and culturally focused skills training in the long-term prevention of alcohol misuse. 14   Pediatricians should support parenting programs that have been shown to reduce or prevent substance use by youth. The most effective programs emphasize active parental involvement and have components that emphasize development of social skills and promote a sense of personal responsibility among young people, as well as address issues related to substance abuse. 51   Pediatricians also have an important advocacy role in health systems' changes as well as legislative efforts, such as increasing alcohol taxes, 52   resisting efforts to weaken minimum-drinking-age laws, and implementing graduated-driver licensing. 21   A recent Cochrane review showed implementation of graduated-driver licensing to be effective in reducing the crash rates of young drivers and, specifically, alcohol-related crashes in most studies in the United States and internationally. 53  

The American Academy of Pediatrics recommends that pediatricians routinely screen and evaluate youth for substance use and provide office interventions and referrals for patients who are using alcohol or other substances. 49   The American Medical Association Guidelines for Adolescent Preventive Services (GAPS) 54   and the American Academy of Pediatrics Bright Futures guidelines 55   recommend that pediatricians and other health care providers who work with children and adolescents conduct routine annual substance use screening of all adolescents and use brief intervention techniques as indicated. In addition, it is recommended that pediatricians be familiar with community resources and refer patients with problematic use or a substance use disorder for treatment. 56   Despite these recommendations, primary care providers have reported many barriers to implementing alcohol and other drug use screening as a routine. Barriers to such screening have been identified to include insufficient time, lack of training to manage a positive screening, the need to triage competing medical problems, lack of treatment resources, tenacious parents who will not leave the examination room, and unfamiliarity with screening tools. 57  

Brief screening surveys for adolescent substance use are available and include the Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization, 58   the Problem Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse scale developed by the National Institute on Drug Abuse, 59   and the CRAFFT instrument, a 6-question, developmentally appropriate screening tool developed by Knight et al (see Table 1 ). 60   Although all 3 of these tools have acceptable sensitivity for identifying alcohol problems or disorders in 14- to 18-year-old adolescents, 61   the CRAFFT instrument has emerged as a quick, validated, reliable, and easy-to-use screening tool that can be administered in the primary care setting in verbal or written format and has good discriminative properties for determining substance use disorders in adolescents. 62   Test-retest reliability of the CRAFFT has been shown to be high, especially when the questions are prefaced with the phrase “in the past year” when office-based screening is performed. 63   Recently, the CRAFFT tool use was integrated into an adolescent substance use screening, brief intervention, and referral-to-treatment algorithm and tool kit to augment pediatricians' confidence and ability in responding effectively to screening results. 64  

CRAFFT Questions: A Brief Screening Test of Adolescent Substance Abuse

Two or more yes answers suggest a significant problem, abuse, or dependence. The CRAFFT questions were developed with grant support from the Robert Wood Johnson Foundation, the National Institute on Alcohol Abuse and Alcoholism, and the Substance Abuse and Mental Health Services Administration.

More research is still needed to aid in developing brief intervention strategies (ie, short, efficient, office-based techniques) that health care providers who work with adolescents can use to detect and intervene with alcohol misuse. Motivational interviewing is one of the most promising brief intervention strategies that can be used in an office-based setting. 65   Motivational interviewing is a patient-centered, directive counseling style that builds on the intrinsic motivation of an individual. When conducting a motivational interview, the pediatrician or counselor creates a partnership with the adolescent patient to explore and resolve his or her ambivalence about behavioral change. Motivational interviewing is often associated with the transtheoretical model described by Prochaska and DiClemente, 66   who identified what they called “stages of change,” a continuum of readiness to change behavior. In this model, change is facilitated by matching the counseling strategy to the stage of patient readiness to change behavior. The essential spirit of motivational interviewing comprises 3 elements: collaboration, or forming a partnership with the patient; evocation, or using open-ended questions and reflections to help the patient determine his or her own motivation to change; and autonomy, or accepting that it is the adolescent's responsibility to change his or her behavior and decide how the change will occur and that direct persuasion by a pediatrician or counselor is unlikely to be effective. Expressing empathy, developing discrepancy between goals and current behavior, “rolling” with the resistance a patient may have (ie, avoiding arguing for change), and supporting patient self-efficacy are the 4 principles of motivational interviewing. 67  

Results of research have shown that motivational interviewing as a counseling style has been effective in decreasing alcohol use in both younger and older adolescents. 68 , – , 71   The authors of a recent Cochrane review of primary prevention for alcohol misuse by young people noted that, although much research investigating the effectiveness of alcohol interventions was of poor quality, there was “strong design and consistent pattern of results indicating potential value of motivational interviewing.” 14   Further research is indicated to improve all aspects of adolescent substance abuse intervention and treatment. 72  

Specific recommendations regarding the best management tools and techniques for treatment will be available in a forthcoming statement from the American Academy of Pediatrics on substance use screening, brief intervention, and referral to treatment for pediatricians. For more information, please see the resources listed at the end of this statement.

Pediatricians and other health care providers who work with children and adolescents are recommended to:

Become knowledgeable about all aspects of adolescent alcohol, tobacco, and other substance use through participation in training-program curricula and/or continuing medical education that provide current best-practices training, including media-literacy training.

Obtain a complete family medical and social history at prenatal and health supervision visits to explore potential genetic and family influences regarding alcohol and other substance use.

Recognize risk factors for alcohol (as well as other drug) use among youth and be aware of coexisting mental health problems, such as depression, that may occur in this age group.

Regularly screen for current alcohol (as well as other drug) use by adolescents and young adults by using nonjudgmental, validated screening methods and appropriate confidentiality assurances.

Assess patients whose screening results are positive for alcohol use to determine the appropriate level of intervention.

Use brief intervention techniques in the clinical setting and be familiar with motivational interviewing techniques to work with patients who use alcohol but do not meet criteria for immediate referral. Offer referral to treatment when indicated.

Discuss the hazards of alcohol and other substance use with patients as part of anticipatory guidance and patient/parent education at health supervision visits as well as when relevant at acute-problem visits. Anticipatory guidance aligned with key school calendar events, such as proms and graduation, may be especially meaningful.

Strongly advise against the use of alcohol, tobacco, and other illicit drugs by youth.

Encourage parents to be good role models for healthy life choices and never allow underaged drinking at their home or other property. Empower parents with the realization that their involvement with their adolescents is a powerful deterrent of substance abuse.

Be familiar with local resources to which various pediatric-aged patients with alcohol use disorders, their parents, and other family members can be referred for developmentally appropriate treatment.

Support adolescents with substance use disorders throughout and after their treatment.

Serve as a resource and support for school and other community-based alcohol use prevention programs.

Support advocacy efforts to promote appropriate media modeling of alcohol consumption and consequences, including print media, television, film, and the Internet.

Support advocacy efforts to promote legislation that reduces alcohol-related morbidity and mortality, such as graduated-driver licensing; treatment parity from third-party payers; legal ramifications for parent sponsorship of adolescent drinking; increased alcohol excise taxes; and other prevention and treatment policies recommended in the Surgeon General's call to action. 48  

Support continuation of the age of 21 as the minimum legal drinking age, and support enforcement that decreases access to alcohol for minors.

Support further research into prevention, evidence-based screening and identification, brief intervention, and management and treatment of alcohol and other substance use by adolescents.

Alcohol: Your Child and Drugs (patient education brochure)

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Tobacco, Alcohol, and Other Drugs: The Role of the Pediatrician in Prevention, Identification, and Management of Substance Abuse 49   (policy statement)

Tobacco as a Substance of Abuse (technical report from Sims TH and Committee on Substance Abuse). Pediatrics. 2009;124(5):e1045–e1053

AAP District II, New York Chapter 2, Committee on Youth and Adolescence.

Teen Parties in Your Home: A Guide for Parents

www.ny2aap.org/teenparties.pdf

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College Drinking—Changing the Culture

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Janet F. Williams, MD, Chairperson

Marylou Behnke, MD

*Patricia K. Kokotailo, MD, MPH

Sharon Levy, MD, MPH

Tammy H. Sims, MD

Martha J. Wunsch, MD

Deborah Simkin, MD – American Academy of Child and Adolescent Psychiatry

Karen Smith

*Lead author

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision

attention-deficit/hyperactivity disorder

Competing Interests

Response to dr sascha meyer.

Dear Dr. Meyer: We thank you very much for your extremely thoughtful response to the Policy Statement "Alcohol Use by Youth and Adolescents: A Pediatric Concern". You provide information regarding alcohol use by children and adolescents in Europe that supports our policy statement well, and emphasize the worldwide need for further work in this area, especially in the development and implementation of short-term and long-term medical intervention strategies in order to prevent acute injury and the development of alcohol dependence at an early age. We appreciate your recommendation of employment of key personnel to screen in acute settings, and to implement effective referral pathways to adolescent mental health and alcohol services. We hope that these recommendations may be taken up worldwide to improve the health of children and adolescents.

Best regards, Patricia Kokotailo, MD, MPH

Conflict of Interest:

None declared

Pediatric alcohol abuse: The need for a holistic approach

Dear Editor,

We would like to comment of the paper “Alcohol use by youth and adolescents: A pediatric concern (Pediatrics 2010; 125:1078-1087) published by the Committee on Substance Abuse.

As alcohol consumption in the population as a whole is increasing steadily in many countries, the deleterious effects of alcohol on the individual and society are increasingly being recognised. Alcohol consumption and abuse in the young and in school children also seems to be on the rise. Of concern, data from the United States indicate that children of an increasingly younger age are consuming alcohol, and a substantive proportion of adolescents have difficulties with alcohol intoxication, self-poisoning or dependence [1-4]. In Australia, 90% of teenagers aged 15 to 16 years report having drunk more than two alcoholic beverages in their lifetime, and 29% describe drinking to the point of intoxication [5]. Similar data is available for European countries [6-8]. This is likely to lead to the development of alcohol dependence at an earlier age in a proportion of young drinkers, and the subsequent development of physical complications [9], thus increasing the burden of alcohol-related illnesses on the health-care system. As a consequence, reduction of alcohol consumption is one of the health priorities of the WHO [10-12].

As outlined by the Committee on Substance Abuse health care professionals must be able to identify children or adolescents who are having difficulties with alcohol abuse or dependence [13]. This problem may come to their attention when a child or adolescent with acute alcohol intoxication or self-poisoning presents to an emergency department, or other health care facilities. While some data exit on the number of children and adolescents presenting to emergency departments [14, 15], scant data are available on the number of paediatric patients requiring in -patient treatment ≥24 hours secondary to alcohol intoxication [16].

In a national German study, we demonstrated that the number of alcohol-intoxicated children and adolescents requiring in-patient hospital treatment (≥24 h) increased significantly in the years 2000-2002, the most prominent increase being seen in adolescents aged 13-17 years, and female patients [17]. Neither a rise in population and hospital admissions nor a change in age structure of the study population, nor differences in recording were likely to account for this increase. The increase in recorded acute alcohol intoxication admissions in our survey corresponds to an increase in alcohol consumption levels that has occurred over the same time period in children and adolescents in Germany as reported by the German Federal Centre for Health Education [18]. The high proportion of females in our study is in accordance with previous reports [14], and probably mirrors real changes in drinking patterns in girls.

The troubling aspects of the findings of our study are corroborated by the results from previous reports that demonstrated a substantial proportion of under-age drinkers seen in the accident and emergency departments [14]. In the study by O’Farrell et al. almost 10% of all hospital admissions for acute alcohol intoxication were under 18 years of age, and 3% were aged 10-14 years [16]. In Germany, in the year 2000 the overall rate of hospital admissions in children and adolescents aged 10-17 years secondary to acute alcohol intoxication was estimated to be 1 ‰ [19].

To tackle the pattern of excessive drinking in young people effective legislative measures as well as policies regulating availability through access, pricing and promotion, as recommended by various task forces on Alcohol [11, 20] are required to minimize the harmful affects of alcohol within this specific age cohort. It is also very important to take into consideration underlying risk factors for alcohol abuse in this age cohort, e.g. psychosocial problems, history of physical and/or sexual abuse as mentioned and biological factors as outlined by the Committee on Substance Abuse [13, 21-23].

Furthermore, the problem of drinking in children and adolescents requires the development and implementation of short-term and long-term medical intervention strategies in order to prevent acute injury and the development of alcohol dependence at an early age. In accordance with current paediatric and psychiatric literature it is recommended that once the child or adolescent presenting to the hospital with acute alcohol intoxication is medically stable, mental health and drug and alcohol issues (comprehensive assessment of alcohol and drug history, psychosocial risk factors, and treatment history) be explored and appropriate follow-up arranged [4, 24]. Although a large proportion of health promotion needs to be performed in primary care, hospitals and emergency departments can deliver effective early interventions [25]. Although the age group of 13- 17 year-old children and adolescents may represent a cohort which may be especially amenable to such interventions, often comprehensive assessment and adequate follow-up are not performed in the emergency department [14]. The employment of key personnel (e.g., alcohol specialist nurses trained in alcohol-related problems) and the implementation of effective referral pathways to adolescent mental health and alcohol services might be a promising approach to cope with the burden posed by alcohol intoxication in this age group on hospitals. Once realised, these intervention measures then mandate ongoing assessment as to whether they improve the outcomes of this group of children and adolescents.

With kindest regards Dr Sascha Meyer, Consultant Pediatrician, Consultant Intensivist (MD, PD) University Children´s Hospital of Saarland Department of Pediatrics/Poison Control Center 66421 Homburg Germany

Conflict of interest: The author has no conflict of interest to disclose.

References 1 Gilvarry E. Substance abuse in young people. J Child Psychol Psychiatry 2000; 41: 55-80

2 Halmandaris PV, Anderson TR. Children and adolescents in the psychiatric emergency setting. Psychiatr Clin North Am 1999; 22: 865-874

3 Ellickson PL, McGuigan K, Adams V, Bell RM, Hays RD. Teenagers and alcohol misuse in the United States: by any definition, it's a big problem. Addiction 1996; 91: 1489-1503

4 Bukstein O. Practice parameters for the assessment and treatment of children and adolescents with substance use disorders. American academy of child and adolescent psychiatry. J Am Acad Child Adolesc Psychiatry 1997; 36: 140-156

5 Australian Institute of Family Studies. Patterns and Predictors of Teenagers’ Use of Licit and Illicit Substances in the Australian Temperament Project Cohort Melbourne, Australia: University of Melbourne 2000

6 Hibell B, Andersson B, Bjarnason T, Kokkevi A, Morgan M, Naruk A. et al. The 1995 ESPAD Report: Alcohol and other drug use among students in 26 European countries Swedish council for information on alcohol and other drugs, Stockholm 1997

7 Hibell B, Andersson B, Ahlstöm S, Blakireva O, Bjarnason T, Kokkevi A. et al. The 1999 ESPAD Report: Alcohol and other drug Use among students in 30 European countries Swedish Council for Information on Alcohol and Other Drugs, Stockholm 2001

8 MacMiller P, Plant M. Drinking, smoking, and illicit drug use among 15 and 16-year-olds in the United Kingdom. Br Med J 1996; 313: 394-397

9 Leon DA, MacCambridge J. Liver cirrhosis mortality rates in Britain from 1950 to 2002: an analysis of routine data. Lancet 2006; 367: 452-456

10 World Health Organisation. Global Strategy for Health for All by the Year 2000 Geneva, WHO 1981

11 Saunders JB, Aasland OG, Babor TF, Fuente JRdela, Grant M. Development of Alcohol Use Disorders Identification List (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption - II. Addiction 1993; 88: 791-864

12 World Health Organization. International Guide for Monitoring Alcohol Consumption and Related Harm Geneva: Department of Mental Health and Substance Dependence, WHO 2000

13 Committee on Substance Abuse. Alcohol Use by Youth and Adolescents: A Pediatric Concern. Pediatrics 2010;125: 1078-1087

14 Woolfenden S, Dosseter D, Williams K. Children and adolescents with acute alcohol intoxication/self-poisoning presenting to the emergency department. Arch Pediatr Adolesc Med 2002; 156: 345-348

15 Felter R, Izsak E, Lawrence HS. Emergency department management of the intoxicated adolescent. Pediatr Clin North Am 1987; 34: 399-421

16 O’Farrell , Allwright S, Downey J, Bedford D, Howeell F. The burden of alcohol misuse on emergency in-patient hospital admissions among residents from a health board region in Ireland. Addiction 2004; 99: 1279- 1285

17 Meyer S, Steiner M, Mueller H, Nunold H, Gottschling S, Gortner L. Recent trends in the burden of alcohol intoxication on pediatric in- patient services in Germany. Klin Padiatr 2008; 220: 6-9

18 http://www.bzga.de/botpresse_251.html(accessed May, 4th, 2010)

19 Bundesministerium für Gesundheit und Soziale Sicherung Bonn. Wissenschaftliche Begleitung des Modellprogramms „Alkoholvergiftungen bei Kindern und Jugendlichen” Bundesweite Datenerhebung - Kurzanalyse 2004, p. 10-11

20 Department of Health and Children. Strategic Taskforce on Alcohol Interim Report Dublin, Ireland: Department of Health and Children 2002

21 Clark DB, Lesnick L, Hegedus AM. Traumas and other adverse life events in adolescents with alcohol intoxication/self-poisoning and dependence. J Am Acad Child Adolesc Psychiatry 1997; 36: 1744-1751

22 Lamminpaa A, Vilska J. Alcohol intoxication and psychosocial problems among children. Acta Psychiatr Scand 1990; 81: 468-471

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• v.14(11); 2022 Nov

Substance Abuse Amongst Adolescents: An Issue of Public Health Significance

1 School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND

Sonali G Choudhari

2 School of Epidemiology and Public Health; Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND

Sarika U Dakhode

3 Department of Community Medicine, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, IND

Asmita Rannaware

Abhay m gaidhane.

Adolescence is a crucial time for biological, psychological, and social development. It is also a time when substance addiction and its adverse effects are more likely to occur. Adolescents are particularly susceptible to the negative long-term effects of substance use, including mental health illnesses, sub-par academic performance, substance use disorders, and higher chances of getting addicted to alcohol and marijuana. Over the past few decades, there have been substantial changes in the types of illegal narcotics people consume. The present article deals with the review of substance abuse as a public health problem, its determinants, and implications seen among adolescents. A systematic literature search using databases such as PubMed and Google Scholar was undertaken to search all relevant literature on teenage stimulant use. The findings have been organized into categories to cover essential aspects like epidemiology, neurobiology, prevention, and treatment. The review showed that substance addiction among adolescents between 12 to 19 years is widespread, though national initiatives exist to support young employment and their development. Research on psychological risk factors for teenage substance abuse is vast, wherein conduct disorders, including aggression, impulsivity, and attention deficit hyperactivity disorder, have been mentioned as risk factors for substance use. Parents' attitudes toward drugs, alcohol, academic and peer pressure, stress, and physical outlook are key determinants. Teenage drug usage has a significant negative impact on users, families, and society as a whole. It was found that a lot has been done to provide correct intervention to those in need with the constant development of programs and rehabilitative centers to safeguard the delicate minds of youths and prevent them from using intoxicants. Still, there is much need for stringent policy and program guidelines to curb this societal menace. 

Introduction and background

Drug misuse is a widespread issue; in 2016, 5.6% of people aged 15 to 26 reported using drugs at least once [ 1 ]. Because alcohol and illegal drugs represent significant issues for public health and urgent care, children and adolescents frequently visit emergency rooms [ 2 ]. It is well known that younger people take drugs more often than older adults for most drugs. Drug usage is on the rise in many Association of Southeast Asian Nations, particularly among young males between the ages of 15 and 30 years [ 3 ]. According to the 2013 Global Burden of Disease report, drug addiction is a growing problem among teenagers and young people. Early substance use increases the likelihood of future physical, behavioral, social, and health issues [ 4 ]. Furthermore, recreational drug use is a neglected contributor to childhood morbidity and mortality [ 5 ]. One of the adverse outcomes of adolescent substance use is the increased risk of addiction in those who start smoking, drinking, and taking drugs before they are of 18 years. Moreover, most individuals with Substance Use Disorders begin using substances when they are young [ 6 ]. Substance use disorders amongst adolescents have long-term adverse health effects but can be mitigated with efficient treatment [ 7 ].

Childhood abuse is linked to suicidal thoughts and attempts. The particular mental behavior that mediates the link between childhood trauma and adult suicidal ideation and attempts is yet unknown. Recent studies show teens experiencing suicidal thoughts, psychiatric illness symptoms like anxiety, mood, and conduct disorders, and various types of child maltreatment like sexual abuse, corporal punishment, and emotional neglect that further leads to children inclining toward intoxicants [ 8 ]. Although teen substance use has generally decreased over the past five years, prolonged opioid, marijuana, and binge drinking use are still common among adolescents and young adults [ 9 ]. Drug-using students are more prone to commit crimes, including bullying and violent behavior. It has also been connected to various mental conditions, depending on the substance used. On the other hand, it has been linked to social disorder, abnormal behavior, and association with hostile groups [ 10 ]. Adolescent substance users suffer risks and consequences on the psychological, sociocultural, or behavioral levels that may manifest physiologically [ 11 ]. About 3 million deaths worldwide were caused by alcohol consumption alone. The majority of the 273,000 preventable fatalities linked to alcohol consumption are in India [ 12 ], which is the leading contributor. The United Nations Office on Drug and Crime conducted a national survey on the extent, patterns, and trends of drug abuse in India in 2003, which found that there were 2 million opiate users, 8.7 million cannabis users, and 62.5 million alcohol users in India, of whom 17% to 20% are dependent [ 13 ]. According to prevalence studies, 13.1% of drug users in India are under the age of 20 [ 14 ].

In India, alcohol and tobacco are legal drugs frequently abused and pose significant health risks, mainly when the general populace consumes them. States like Punjab and Uttar Pradesh have the highest rates of drug abuse, and the Indian government works hard to provide them with helpful services that educate and mentor them. This increases the burden of non-communicable illnesses too [ 15 ]. In addition, several substances/drugs are Narcotic and Psychotropic and used despite the act named ‘Narcotic Drugs and Psychotropic Substances Act, 1985. 

This review article sheds light on ‘substance abuse’ amongst adolescents as an issue of public health significance, its determinants, and its implications on the health and well-being of adolescents.

Methodology

The present article deals with the narrative review of substance abuse as a public health problem, its determinants, and implications seen among adolescents. A systematic literature search using databases such as PubMed and Google Scholar was undertaken to search all relevant literature on teenage stimulant use. The findings have been organized into categories to cover essential aspects like epidemiology, neurobiology, prevention, and treatment. Various keywords used under TiAb of PubMed advanced search were Stimulants, "Drug abuse", "Psychotropic substance", "Substance abuse", addiction, and Adolescents, teenage, children, students, youth, etc., including MeSH terms. Figure ​ Figure1 1 shows the key substances used by youth.

Reasons for abuse

People may initially choose to take drugs for psychological and physical reasons. Psychological issues, including mental illness, traumatic experiences, or even general attitudes and ideas, might contribute to drug usage. Several factors can contribute to emotional and psychosocial stress, compelling one to practice drug abuse. It can be brought on by a loss of a job because of certain reasons, the death of a loved one, a parent's divorce, or financial problems. Even medical diseases and health problems can have a devastating emotional impact. Many take medicines to increase their physical stamina, sharpen their focus, or improve their looks.

Students are particularly prone to get indulged in substance abuse due to various reasons, like academic and peer pressure, the appeal of popularity and identification, readily available pocket money, and relatively easy accessibility of several substances, especially in industrial, urban elite areas, including nicotine (cigarettes) [ 16 , 17 ]. In addition, a relationship breakup, mental illness, environmental factors, self-medication, financial concerns, downtime, constraints of work and school, family obligations, societal pressure, abuse, trauma, boredom, curiosity, experimentation, rebellion, to be in control, enhanced performance, isolation, misinformation, ignorance, instant gratification, wide availability can be one of the reasons why one chooses this path [ 18 ].

The brain grows rapidly during adolescence and continues to do so until early adulthood, as is well documented. According to studies using structural magnetic resonance imaging, changes in cortical grey matter volume and thickness during development include linear and nonlinear transformations and increases in white matter volume and integrity. This delays the maturation of grey and white matter, resulting in poorer sustained attention [ 19 ]. Alcohol drinking excessively increases the likelihood of accidents and other harmful effects by impairing cognitive functions like impulse control and decision-making and motor functions like balance and hand-eye coordination [ 20 ]. Lower-order sensory motor regions of the brain mature first, followed by limbic areas crucial for processing rewards. The development of different brain regions follows different time-varying trajectories. Alcohol exposure has adversely affected various emotional, mental, and social functions in the frontal areas linked to higher-order cognitive functioning that emerge later in adolescence and young adulthood [ 21 ].

Smoking/e-cigarettes

The use of tobacco frequently begins before adulthood. A worryingly high percentage of schoolchildren between 13 and 15 have tried or are currently using tobacco, according to the global youth tobacco survey [ 22 ]. It is more likely that early adolescent cigarette usage will lead to nicotine dependence and adult cigarette use. Teenage smoking has been associated with traumatic stress, anxiety, and mood problems [ 23 ]. Nicotine usage has been associated with a variety of adolescent problems, including sexual risk behaviors, aggressiveness, and the use of alcohol and illegal drugs. High levels of impulsivity have been identified in adolescent smokers.

Additionally, compared to non-smokers, smoking is associated with a higher prevalence of anxiety and mood disorders in teenagers. Smoking is positively associated with suicidal thoughts and attempts [ 24 ]. Peer pressure, attempting something new, and stress management ranked top for current and former smokers [ 25 ]. Most teenagers say that when they start to feel down, they smoke to make themselves feel better and return to their usual, upbeat selves. Smoking may have varying effects on people's moods [ 26 ]. Teenagers who smoke seem more reckless, less able to control their impulses, and less attentive than non-smokers [ 27 ].

Cannabis/Marijuana

Marijuana is among the most often used illegal psychotropic substances in India and internationally. The prevalence of marijuana usage and hospitalizations related to marijuana are rising, especially among young people, according to current trends. Cannabis usage has been connected to learning, working memory, and attention problems. Cannabis has been shown to alleviate stress in small doses, but more significant amounts can cause anxiety, emotional symptoms, and dependence [ 28 ]. Myelination and synaptic pruning are two maturational brain processes that take place during adolescence and the early stages of adulthood. According to reports, these remodeling mechanisms are linked to efficient neural processing. They are assumed to provide the specialized cognitive processing needed for the highest neurocognitive performance. On a prolonged attentional processing test, marijuana usage before age 16 was linked to a shorter reaction time [ 29 ]. Cannabis use alters the endocannabinoid system, impacting executive function, reward function, and affective functions. It is believed that these disturbances are what lead to mental health problems [ 30 ].

MDMA (Ecstasy/Molly)

MDMA (3,4-methylenedioxy-methamphetamine) was a synthetic drug used legally in psychotherapy treatment throughout the 1970s, despite the lack of data demonstrating its efficacy. Molly, or the phrase "molecular," is typically utilized in powder form. Serotonin, dopamine, and norepinephrine are produced more significantly when MDMA is used. In the brain, these neurotransmitters affect mood, sleep, and appetite. Serotonin also causes the release of other hormones that may cause emotions of intimacy and attraction. Because of this, users might be more affectionate than usual and possibly develop ties with total strangers. The effects wear off three to six hours later, while a moderate dose may cause withdrawal symptoms to continue for a week. These symptoms include a decline in sex interest, a drop in appetite, problems sleeping, confusion, impatience, anxiety, sorrow, Impulsivity and violence, issues with memory and concentration, and insomnia are a few of them. Unsettlingly, it is rising in popularity in India, particularly among teenagers [ 31 ].

Opium 

In addition to being a top producer of illicit opium, India is a significant drug consumer. In India, opium has a long history. The most common behavioral changes are a lack of motivation, depression, hyperactivity, a lack of interest or concentration, mood swings or abrupt behavior changes, confusion or disorientation, depression, anxiety, distortion of reality perception, social isolation, slurred or slow-moving speech, reduced coordination, a loss of interest in once-enjoyed activities, taking from family members or engaging in other illegal activity [ 32 ]. Except for the chemical produced for medicinal purposes, it is imperative to prohibit both production and usage since if a relatively well-governed nation like India cannot stop the drug from leaking, the problem must be huge in scope [ 33 ].

Cocaine is a highly addictive drug that causes various psychiatric syndromes, illnesses, and symptoms. Some symptoms include agitation, paranoia, hallucinations, delusions, violence, and thoughts of suicide and murder. They may be caused by the substance directly or indirectly through the aggravation of co-occurring psychiatric conditions. More frequent and severe symptoms are frequently linked to the usage of cocaine in "crack" form. Cocaine can potentially worsen numerous mental diseases and cause various psychiatric symptoms.

Table ​ Table1 1 discusses the short- and long-term effects of substance abuse.

Other cheap substances ( sasta nasha ) used in India

India is notorious for phenomena that defy comprehension. People in need may turn to readily available items like Iodex sandwiches, fevibond, sanitizer, whitener, etc., for comfort due to poverty and other circumstances to stop additional behavioral and other changes in youth discouragement is necessary [ 42 - 44 ]. 

Curbing drug abuse amongst youth

Seventy-five percent of Indian households contain at least one addict. The majority of them are fathers who act in this way due to boredom, stress from their jobs, emotional discomfort, problems with their families, or problems with their spouses. Due to exposure to such risky behaviors, children may try such intoxicants [ 45 ]. These behaviors need to be discouraged because they may affect the child's academic performance, physical growth, etc. The youngster starts to feel depressed, lonely, agitated and disturbed. Because they primarily revolve around educating students about the dangers and long-term impacts of substance abuse, previous attempts at prevention have all been ineffective. To highlight the risks of drug use and scare viewers into abstaining, some programs stoked terror. The theoretical underpinning of these early attempts was lacking, and they failed to consider the understanding of the developmental, social, and other etiologic factors that affect teenage substance use. These tactics are based on a simple cognitive conceptual paradigm that says that people's decisions to use or abuse substances depend on how well they are aware of the risks involved. More effective contemporary techniques are used over time [ 46 ]. School-based substance abuse prevention is a recent innovation utilized to execute changes, including social resistance skills training, normative education, and competence enhancement skills training.

Peer pressure makes a teenager vulnerable to such intoxicants. Teenagers are often exposed to alcohol, drugs, and smoking either because of pressure from their friends or because of being lonely. Social resistance training skills are used to achieve this. The pupils are instructed in the best ways to steer clear of or manage these harmful situations. The best method to respond to direct pressure to take drugs or alcohol is to know what to say (i.e., the specific content of a refusal message) and how to say it. These skills must be taught as a separate curriculum in every school to lower risk. Standard instructional methods include lessons and exercises to dispel misconceptions regarding drug usage's widespread use. 

Teenagers typically exaggerate how common it is to smoke, drink, and use particular substances, which could give off the impression that substance usage is acceptable. We can lessen young people's perceptions of the social acceptability of drug use by educating them that actual rates of drug usage are almost always lower than perceived rates of use. Data from surveys that were conducted in the classroom, school, or local community that demonstrate the prevalence of substance use in the immediate social setting may be used to support this information. If not, this can be taught using statistics from national surveys, which usually show prevalence rates that are far lower than what kids describe.

The role social learning processes have in teen drug use is recognized by competency-improvement programs, and there is awareness about how adolescents who lack interpersonal and social skills are more likely to succumb to peer pressure to use drugs. These young people might also be more inclined to turn to drug usage instead of healthier coping mechanisms. Most competency enhancement strategies include instruction in many of the following life skills: general problem-solving and decision-making skills, general cognitive abilities for fending off peer or media pressure, skills for enhancing self-control, adaptive coping mechanisms for reducing stress and anxiety through the use of cognitive coping mechanisms or be behavioral relaxation techniques, and general social and assertive skills [ 46 ].

Programs formulated to combat the growing risk of substance abuse

The Ministry of Health and Family Welfare developed Rashtriya Kishor Swasthya Karyakram for teenagers aged 10 to 19, with a focus on improving nutrition, sexual and reproductive health, mental health, preventing injuries and violence, and preventing substance abuse. By enabling them to make informed and responsible decisions about their health and well-being and ensuring that they have access to the tools and assistance they need, the program seeks to enable all adolescents in India in realizing their full potential [ 47 ].

For the past six years, ‘Nasha Mukti Kendra’ in India and rehabilitation have worked to improve lives and provide treatment for those who abuse alcohol and other drugs. They provide cost-effective and dedicated therapy programs for all parts of society. Patients come to them from all around the nation. Despite having appropriate programs and therapies that can effectively treat the disorder, they do not employ medication to treat addiction.

Conclusions

Around the world, adolescent drug and alcohol addiction has significantly increased morbidity and mortality. The menace of drugs and alcohol has been woven deep into the fabric of society. As its effects reach our youth, India's current generation is at high stake for the risk associated with the abuse of drugs like cannabis, alcohol, and tobacco. Even though the issue of substance abuse is complicated and pervasive, various stakeholders like healthcare professionals, community leaders, and educational institutions have access to a wealth of evidence-based research that can assist them to adopt interventions that can lower rates of teenage substance misuse. It is realized that while this problem is not specific to any one country or culture, individual remedies might not always be beneficial. Due to the unacceptably high rate of drug abuse that is wreaking havoc on humanity, a strategy for addressing modifiable risk factors is crucial. Because human psychology and mental health influence the choices the youth make related to their indulgence in drug misuse, it is the need of the hour to give serious consideration to measures like generating awareness, counseling, student guidance cells, positive parenting, etc., across the world. It will take time to change this substance misuse behavior, but the more effort we put into it, the greater the reward we will reap.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

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Pandemic influencing increased drug use among youth

The National Council on Drug Abuse (NCDA) is reporting that based on focus group discussions with teens, there is the perception that youth drug use is on the rise due to COVID-19.

Michael Tucker, executive director of the NCDA, told THE WEEKEND STAR that tobacco, ganja and alcohol, and increasingly vaping and ganja edibles are being used by youth to help them cope with the ongoing COVID-19 pandemic.

"We have not had the opportunity to conduct national studies that are representative of the youth population since COVID, so we cannot definitively say that there have been increases in use," he said. "But anecdotally, from focus group discussions held among fifth and sixth formers in March 2021 across five parishes, mainly given that they are using substances to cope with the difficulties they are facing which include social isolation, difficulties with virtual learning, chaotic home environment and lack of parental support and supervision," Tucker explained.

Tucker also noted that the participation at the Drug Treatment Court, which assists persons with rehabilitation, has declined since the pandemic. The Court was started in 2001, operating on the premise that persons who committed petty crimes often did so because they were trying to support their drug habits.

Currently, there are 39 persons enrolled in the programme but Tucker related that since the Dangerous Drugs Act was amended and cannabis was decriminalised, coupled with the COVID-19 pandemic, the number of participants has been on a steady decline. He said that 31.7 per cent of the participants graduated from the programme in 2020.

"For the period 2019 to 2020, there were 145 participants in the programme. The drug of impact reported by the current participants are 74 per cent for cannabis, 18 per cent for crack/cocaine and eight per cent for alcohol," he said.

Prior to COVID-19, the NCDA used multi-level prevention programmes in schools, communities, workplaces and homes, but that approach was significantly affected, as the pandemic forced limited interaction. However, Tucker assured that the council remains committed to reducing drug use and abuse among the nation's youth by providing screening, intervention and referrals to specialised drug treatment.

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MWAMISI: Normalisation of drug abuse among youths worrying

• It is imperative that the law serves as an equaliser to ensure fairness and progress within our society.
• By holding all individuals accountable regardless of their status or wealth, we can foster a more just and cohesive community.

Whilst beer and other alcoholic drinks are legal in Kenya and their use can only be regulated, hard drugs are, of course, illegal, and being caught with them, can have major consequences for one's future, such as many years in prison.

One of the things that often receive insufficient attention is the matter of hard drugs entering the country from abroad. Hard drugs are substances that are highly addictive, have strong psychoactive effects and are associated with serious health and social consequences. These substances often have a high potential for abuse and are illegal in most jurisdictions, including Kenya.

Common examples of hard drugs include: Heroin, derived from morphine found in poppy plants, is a highly addictive opioid often sold as a white or brown powder or as "black tar heroin." Its consumption can lead to severe physical and psychological dependence. Similarly, cocaine, a potent stimulant sourced from coca leaves, is typically ingested as a white crystalline powder. Despite inducing intense euphoria and energy, cocaine poses significant risks of addiction and various health complications, including cardiovascular problems and neurological disorders.

Methamphetamine, a synthetic stimulant affecting the central nervous system, manifests as a crystalline powder or rock form, known as "crystal meth" or "ice." Its consumption through smoking, snorting, injecting, or swallowing can result in severe physical and psychological harm, including tooth decay and cognitive impairments. Crack cocaine, processed into a rock crystal, delivers rapid and intense euphoria but is highly addictive, contributing to violence, crime, and social breakdown. MDMA, popularly known as ecstasy or molly, is a synthetic psychoactive drug consumed orally for its euphoric effects. However, prolonged use can lead to dehydration, hyperthermia, and cognitive deficits.

LSD, derived from ergot fungus, induces profound hallucinations and sensory distortions when consumed orally. Though not considered addictive, its potent effects can trigger long-lasting psychological disturbances. These drugs are heavily regulated or prohibited in many countries due to their significant risks to health and society. They are often associated with addiction, overdose, criminal activity, and a range of physical and mental health problems.

However, over the years, this issue has received waning attention, and the use of these drugs has become a lifestyle for youths in Kenya from as young as 12 up to 35. It used to be a problem primarily among children raised in affluent homes, but now even those from middle-class and lower-class backgrounds are involved in the devastating use of hard drugs.

The issue of drugs and alcoholism among youth and other third-world nations is a multifaceted problem with deep-rooted causes and far-reaching consequences. Many of these nations face significant socioeconomic challenges such as poverty, unemployment and lack of access to education. These factors can contribute to a sense of hopelessness and despair among the youth population, driving them towards substance abuse as a coping mechanism. It is commendable that the government of Kenya is paying serious attention to the education sector and pushing to ensure access to education for all and streamlining the sector.

Another factor exacerbating hard drug use is that third-world nations often have limited resources allocated to prevention and treatment programs for substance abuse. Governments may prioritise other pressing issues such as healthcare, infrastructure, and basic needs, leaving substance abuse programs underfunded and understaffed.

It is positive that the National Authority for the Campaign Against Alcohol and Drug Abuse, led by Dr Anthony Omerikwa, is beginning to have its presence felt, but much more can be done. A while back, speaking to heads of government agencies, the Chief of Staff and Head of Public Service Felix Koskei asked all agencies to do their work so that change can be felt in the country. Nacada's primary mandate includes policy formulation, prevention, education, treatment, rehabilitation and advocacy related to substance abuse issues.

In many third-world nations, drugs and alcohol are readily available and affordable, especially in urban areas where there may be little regulation or enforcement of drug laws. The lack of stringent regulations makes it easier for young people to access these substances, exacerbating the problem. Therefore, the new measures taken by the Ministry of Interior, led by Kithure Kindiki, are absolutely important and should be supported by all Kenyans of goodwill. Despite the temptation for profit, safeguarding our youth should remain paramount.

There is a growing cultural acceptance or normalisation of substance abuse among the youth, making it more difficult for young people to resist peer pressure and societal expectations. This normalisation can perpetuate the cycle of addiction and make it harder for individuals to seek help. Drug networks have infiltrated spaces they weren’t in before, such as local market centres.

As observed in a commentary last year, they are sold as small affordable pellets even at 10/-, which has made it easier for children of all backgrounds to start consuming. The fact that some drugs lack a smell, unlike alcoholic drinks, makes their consumption almost stealth.

Substance abuse may be used as a means of coping with trauma and mental health issues arising from these experiences. Children who have had difficult backgrounds or certain life disappointments are always strong candidates to get into drugs use. There may be a lack of education and awareness about the dangers of substance abuse in many third-world nations. Without proper education and information about drugs amongst youths, parents, teachers and other opinion leader in the society, attacking and rolling back drug abuse cannot be effective.

Individuals believed to be involved in drug trafficking and selling must be thoroughly investigated and held accountable for their actions. Among them are prominent figures, including politicians, who are suspected of profiting from drug trafficking and sales while leading lavish lifestyles.

It is imperative that the law serves as an equaliser to ensure fairness and progress within our society. By holding all individuals accountable regardless of their status or wealth, we can foster a more just and cohesive community, allowing us to move forward with integrity and stability.

Political commentator