The Truth About Drug and Alcohol Abuse in High School
How to Help My Addicted Child
Research shows that illicit drug use among high school students is on the decline. However, adolescent substance abuse remains a problem and a major concern for parents. There are a number of risk factors that place young people in a vulnerable position for experimenting and becoming hooked on drugs and/or alcohol. For any parent watching helplessly as drugs or alcohol change their child, the worry and pain are all-consuming. This page will explore the trends of adolescent substance use, risk factors for use, protective factors that help to prevent problematic drug use, and how to find help for teens who need it.
How Many Students Are Using Drugs?
According to the 2016 Monitoring the Future (MTF) Study, across the board, the rates of illicit drug use among adolescents is the lowest it has been in the past 5 years. In 2016, 14.3% of high school seniors reported using an illicit drug (other than marijuana), compared to 17.8% in 2013.1
There have been significant decreases in the use of prescription opioids among high school students. While the rest of the country is in the midst of an opioid epidemic, the rate of opioid use among 12th graders was 4.8%, down dramatically from their peak of 9.5% in 2004. The use of Vicodin, in particular, is the lowest it has ever been—teens reported a 45% drop in use compared to 5 years ago. Among 12th graders, 2.9% reported misusing Vicodin in 2016, compared to 10% of 12th graders in 2006.1
The use of marijuana has superseded tobacco cigarette smoking for the first year since the MTF study first started surveying 8th, 10th and 12th graders in 1991, not because the rates of marijuana smoking have gone up but because cigarette smoking rates have gone down. In 1991, 10.7% of 12th graders reported smoking half a pack or more of cigarettes a day. In 2016, that rate dropped to just 1.8%.1
Alcohol use has also been going down. The 2016 rates are the survey’s lowest rates ever. In 2016, 37.3% of 12th graders reported being drunk in the past year, while in 2001, the rate was 53.2%. 1
While the decline in substance abuse rates is encouraging, researchers are committed to sustaining education and prevention efforts to ensure that these rates remain low (or ideally drop even further) and that the adolescents who do need help receive it.
For decades, researchers have tried to determine how the cycle of drug abuse begins and who is most at risk for developing an addiction. The question remains, why do some kids use alcohol or drugs? And of those kids, why do some develop addictions while others don’t? The bottom line is that there is no one specific reason. Factors that influence whether someone becomes addicted include genetics and family environment. But even 2 people exposed to the same risk factors may have completely different experiences—one may get addicted while the other can use substances like alcohol in moderation and never develop a problem.1
Growing up, certain risk factors may be more influential at different stages. During early childhood, aggressive behavior, lack of parental supervision, poverty, undiagnosed mental health issues, and child abuse should be addressed with appropriate interventions. Without early intervention, some of these situations could escalate and lead to more problems down the line for young students, including trouble in school, hardships in making friends, and isolation, all of which can put a child at risk of experimenting with drugs or alcohol later in life.2
Not all youth will develop problems with drugs or alcohol, but mounting stressors may make it more likely. Some adverse childhood experiences (ACEs), such as child abuse or divorce, may affect individuals well into adulthood. Clinicians may ask about their patients’ adverse childhood experiences in order to assess the impact of early trauma on their lives. A higher number of adverse childhood experiences can have a direct effect on an individual’s behavioral health. Examples of ACEs include:3
- Witnessing domestic violence in the home.
- Growing up with family members who abuse drugs or alcohol.
- Experiencing physical, verbal, or sexual abuse.
- Being physically or emotionally neglected.
- Seeing a parent treated violently.
- Mental illness in the household.
- Experiencing a divorce.
- Having a family member incarcerated.
Adverse childhood experiences have been identified as contributing factors in more than half of all serious problems with drug use in adulthood. A study published in 2017 found that the rate of prescription drug abuse increased by 62% for every additional ACE experienced.4
Protective factors such as a strong parent-child bond or a positive student-teacher relationship can be extremely powerful and have a huge impact on reducing the risk of teen substance abuse. Examples of protective factors include:5
- High self-esteem.
- Clear expectations for behavior.
- Healthy peer groups.
- Ability to make friends.
- Secure attachment with parents or other caregiving figures.
- Supportive relationships with family members.
Consequences of Adolescent Substance Use
There are many consequences of using drugs at a young age, including accidents, injuries, unprotected sex, homicide, suicide, and intoxicated driving. The association between substance use and negative outcomes isn’t limited to just illegal drugs. In fact, alcohol is one of the biggest threats to adolescent safety. According to the DAWN Report, between 2010 and 2013, emergency room visits where alcohol was the only substance involved accounted for 78.8% of all underage visits.6
While teen illicit drug use is declining, overdose rates continue to be concerning. According to the Centers for Disease and Control:
- Between 2014 and 2015, teen drug overdose rates increased by 19%.
- The drug overdose rate among youth ages 15 to 19 doubled between 1999 and 2007, declined from 2007 to 2014, and rose again in 2015 to 3.7 deaths per 100,000 people.
- Of all the drug overdoses among youth ages 15 to 19, 80.4% were unintentional and 13.5% were suicide attempts.
- Females have higher rates of suicide by drug overdose. In 2015, 21.9% of female overdose deaths were suicide compared to 8.7% of male overdose deaths.7
Teens who inject drugs expose themselves to other serious dangers, such as the transmission of HIV/AIDS, Hepatitis B and C, or other sexually transmitted diseases. Although the rates of AIDS diagnoses are relatively low among young people compared to other age groups, the virus has a long latency period before symptoms appear. It is likely that many people who are diagnosed in their 20s or 30s actually contracted the virus in their teen years. The U.S. Office of National AIDS Policy estimates that half of all new HIV infections occur in people under the age of 25 and that half of these occur among people between the ages of 13 and 21.8
In addition to the risk of contracting bloodborne illnesses, routine injections can lead to collapsed veins, abscesses, pneumonia, liver or kidney disease, and infections of the heart.9
Substance abuse among youth is also strongly linked to consequences with arrest and the juvenile justice system. Studies find that more than 2/3 of young people who are incarcerated are addicted to at least one substance. And juvenile delinquency is a risk factor for future substance use and problems with the law.
Research shows that the brain continues to develop into adulthood (up to age 25). Drug use may change the way your brain processes and retains information and can have an effect on how well you can think, focus, concentrate, and remember. High school students who abuse drugs tend to:10
- Have lower grades.
- Have higher rates of missing class.
- Be more likely to drop out of school.
Overall, the changes to brain functioning differ by the substance abused.11
- Heavy drinking can lead to decreased performance on tasks that require attention, spatial skills, memory, and executive functioning.
- Using marijuana can affect your attention, memory, and ability to learn. These effects can last for days or weeks, even after you stop taking the drug.
Almost 1/3 of students who dropped out of school cited alcohol or other drug use as a contributing factor for that decision.
Graduating from high school is a milestone for many students, but substance abuse may affect a teen’s likelihood of graduating, and vice versa. A study of teens between 16 and 18 years of age showed that:12
- Kids who dropped out of school prior to graduation were more likely to have engaged in cigarette smoking, as well as alcohol, marijuana, and illicit drug use than students who stayed in school.
- Almost 1/3 of students who dropped out of school cited alcohol or other drug use as a contributing factor for that decision.
- Binge drinking alcohol among dropouts was higher than for those in school (31.8% vs. 22.1%).
- Students who dropped out were more likely to be marijuana users than those in school (15.6% vs. 9.5%) and also more likely to be non-medical users of prescription drugs (9.5% vs. 4.6%).
Schools have the potential to be a safe environment where teachers can work with parents, health care professionals, and community members to implement effective drug and alcohol prevention strategies. They can also identify students who show risks for drug-related problems and make the appropriate referrals for support services. A student who is dealing with drug or alcohol treatment deserves privacy, and supportive school officials should be mindful that the details of a student’s situation be limited to their parents, doctors, and treatment specialists. 13
Talking to Your Teen About Drug Use
As a parent, caregiver, coach, or teacher, you are in a unique position to notice subtle alterations in a teen’s life (e.g., changes in personality, appearance, school performance, or social activities). These changes could indicate that they are dealing with substance use issues. Teens who are abusing drugs often exhibit problem behavior such as lying about what they are doing or where they are going, stealing money or prescriptions, asking for money, or withdrawing from family activities.
According to research studies, only about 20% to 33% of parents who know about their child’s substance abuse are able to get them into treatment without outside help.14 Before starting a conversation about substance use with your teen, you can reach out to a licensed interventionist. These professionals are experienced in helping parents and other family members prepare for confronting loved ones about drug and alcohol use. They can help you feel confident and ready to communicate effectively and compassionately, which can help prevent problems down the line.
It can be intimidating to think about broaching the subject of substance abuse with your child. But, the best way to prevent further drug use is to talk to your child and build trust with them. To prepare for the conversation, you can visit online resources, including the Partnership for Drug-Free Kids, which offers free helplines, blogs, and forums for parents. You can call their helpline Monday through Friday from 9 am to 5 pm to speak with a counselor about how to talk to your teen. Depending on your situation, the Partnership for Drug-Free Kids also offers Parent Coaching to teach parents about Community Reinforcement and Family Training (CRAFT). The hotline number is 1-855-378-4373.
CRAFT is an evidence-based approach that supports loved ones of addicted individuals in reaching out to a person who is abusing substances. CRAFT provides training on how to talk about entering treatment, the consequences of continued use, and how to set healthy boundaries. Studies show that CRAFT can help decrease parent stress, improve the parent-child relationship, and help effectively address problem behavior. Compared to other intervention programs, CRAFT produces better rates of positive psychological and social outcomes for the addicted individual over the long-term.14
Dos and Don’ts
Having open conversations about suspected drug use is a powerful tool that all parents have. Below are some dos and don’ts when talking to your child:15
- Show you care.
- Establish open communication.
- Ask open-ended questions.
- Take deep breaths and control your emotions.
- Keep an open mind.
- Show them that you will support them in getting help.
- Reacting to what your child shares with anger.
- Telling your child they are wrong.
- Interrupting your child while they are speaking.
- Teasing or criticizing your child.
- Setting unrealistic expectations.
- Inconsistently enforcing consequences for breaking rules or not making those consequences clear.
Before starting the conversation, take some time to think about what you want to discuss with your child. Choose to talk when you have time and you are free from distractions. Keep in mind that you don’t have to cover everything in one conversation or come to any type of resolution. If your child feels like they are being forced to confess something or that you don’t trust them, they may be less likely to open up honestly in the future.
Getting Teens the Help They Need
Adolescents with substance use disorders differ from their adult counterparts and have different treatment needs. Treatment requires taking into account the teen’s individual experience and how it affects the severity or nature of their drug use. Before entering a treatment program, a teenager should receive a clinical assessment from a doctor who specializes in treating addiction to determine how to best address their unique developmental needs. In addition, factors such as ethnicity and culture, gender, sexual orientation, and age can significantly affect treatment. For example, older adolescents are more likely to rebel than younger adolescents. Girls are more likely than boys to have co-occurring internalizing disorders such as depression, while boys are more likely to have externalizing disorders such as conduct disorders.16
Depending on the nature of the addiction, the teen may start with detoxification (e.g., if they have been abusing alcohol or prescription drugs like opioids or benzodiazepines). During this time, they may be prescribed medication to manage any uncomfortable withdrawal symptoms. Once fully stabilized, they should transition into the next tier of treatment—rehabilitation—which can take place in a number of settings, including:
- Residential treatment program. In a residential rehab, the child lives on-site at the facility while they receive care. Residential programs offer 24-hour supervision. Programs vary in length but typically last for 30-90 days or more. Depending on the teen’s specific needs, the treatment center may offer services to address any co-occurring eating or mental health disorders, family therapy services, and more. You can also find a center that caters to a specific gender, age range, or substance abused.
- Intensive outpatient program: These are designed for adolescents who do not require inpatient treatment yet need more than one or two visits a week with a therapist. These centers offer comprehensive approaches designed to help teenage boys and girls break free of harmful thought patterns that fuel addiction. Depending on the program, the teen may engage in a number of therapy groups including individual therapy, group therapy with other young people, education groups, and family therapy groups.
Completing School in Recovery
For teenagers, high school can be full of triggers for relapse. The period of time right after completing treatment (the first 60 days), when a young person returns to their family, peers, neighborhood, and school, is the time when a student faces the greatest risk of relapse. In fact, one study found that nearly every young person returning to their old school reported being offered substances on the first day they returned from treatment. Schools that have high rates of drug and alcohol abuse are major threats to a student’s recovery. For many young people, school is not only a place where friend groups who use are found, but they are also places of emotional stress. For students addicted to substances, they may turn to drugs and alcohol as a coping mechanism. One option for decreasing risk of relapse is attending a private school while receiving treatment, although this may be cost-prohibitive for many parents.17
To avoid relapse, students can also look into transitioning into a recovery high school immediately after leaving residential treatment or completing an intensive outpatient program. A recovery high school is a school designed specifically for students recovering from substance abuse or dependence. These institutions provide academic services and post-treatment support. They are designed to encourage bonding between students and reduce risk factors associated with relapse. In recovery high school, a student can attend to their academic endeavors while also building a sober and clean social network.
Recovery schools are prepared to handle the unique needs of this student population, and they have full- or part-time licensed counselors on staff.17 You can find a recovery school in your area by searching online.
Addiction is complex, and without early treatment, it can spiral out of control. Entering a program with highly trained staff provides the opportunity to focus on your health, look inward, and make a life transformation. If you or your child needs help, explore your options today. Taking the first step is scary, but it can be lifesaving.
- National Institute on Drug Abuse. (2016). Teen substance use shows promising decline.
- National Institute on Drug Abuse. (2016). What are risk factors and protective factors?
- Substance Abuse and Mental Health ServicesAdministration. (2016). Adverse Childhood Experiences.
- Forster, M., Gower, A. L., Borowsky, I. W., & McMorris, B. J. (2017). Associations between adverse childhood experiences, student-teacher relationships, and non-medical use of prescription medications among adolescents. Addictive behaviors, 68, 30-34.
- Youth.gov. (n.d.). Risk & Protective Factors.
- DAWN Report. (2017). Emergency Department Visits Involving Underage Alcohol Misuse: 2010 to 2013.
- Centers for Disease and Control and Prevention. (2017). Drug Overdose Deaths Among Adolescents Aged 15–19 in the United States: 1999–2015.
- University of California, San Francisco. (2002). HIV Transmission and Prevention in Adolescents.
- National Drug Intelligence Center. (2004). Teens and Drugs Fast Facts.
- Drug Enforcement Administration. (n.d.). How Does Drug Use Affect Your High School Grades?
- Squeglia, L. M., Jacobus, J., & Tapert, S. F. (2009). The Influence of Substance Use on Adolescent Brain Development. Clinical EEG and Neuroscience?: Official Journal of the EEG and Clinical Neuroscience Society (ENCS), 40(1), 31–38.
- Drug Enforcement Administration. (n.d.). How Does Drug Use Affect Your High School Grades?
- Mears, C. J., & Knight, J. R. (2007). The role of schools in combating illicit substance abuse. Pediatrics, 120(6), 1379-1384.
- Kirby, K. C., Versek, B., Kerwin, M. E., Meyers, K., Benishek, L. A., Bresani, E., … Meyers, R. J. (2015). Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents. Journal of Child & Adolescent Substance Abuse, 24(3), 155–165.
- National Institute on Alcohol Abuse and Alcoholism. (2009). Make A Difference: Talk to Your Child About Alcohol.
- Solof, B. (2013). A Therapist’s Guide to Addiction Medicine: A Handbook for Addiction Counselors and Therapists. Central Recovery Press.
- Moberg, D. P., & Finch, A. J. (2008). Recovery High Schools: A Descriptive Study of School Programs and Students. Journal of Groups in Addiction & Recovery, 2, 128–161.