U.S. teens who use drugs and alcohol often cite stress and anxiety as the primary reason. And half of those who misuse prescription drugs say they do so alone.

That’s among findings from a new Centers for Disease Control and Prevention report issued Thursday that looks at use of alcohol, marijuana and other drugs among youths ages 13-18 who are being assessed for substance use disorder treatment. The study covers the years 2014-2022 and the authors say it is not generalizable to all adolescents.

The study is based on data from the National Addictions Vigilance Intervention and Prevention Program and includes self-reports from just under 16,000 teenagers. As NBC News reported, “The findings do not reflect why teenagers might experiment with drugs for the first time; all were flagged for substance use disorder and subsequent treatment.”

Mental health challenges dominated when the youths were asked why they used substances. The top motivation was “to feel mellow, calm, or relaxed” (73%), “to stop worrying about a problem or to forget bad memories” (44%) and “to help with depression or anxiety” (40%). Half said they used substances to “to have fun or experiment,” the report said.

The majority of adolescents reported using substances with friends (81%) or using alone (50%).

Misusing prescription drugs while alone “presents a significant risk for fatal overdose, especially given the proliferation of counterfeit pills resembling prescription drugs and containing illegal drugs” such as illegally manufactured fentanyl, the report said.

Dr. Leslie Walker-Harding, chief academic officer and senior vice president at Seattle Children’s Hospital, told NBC News that 75% of young people with a substance use disorder also have a mental health condition.

“We know that the two go together,” she said. “If you have a kid who you think might not be using very much, but say they’re using to feel less depressed or to stop worrying, that’s a really big warning sign” intervention is needed.

Similar findings, different study

The CDC suggests that stress reduction and focus on mental health concerns could both help reduce underage substance use. The agency also notes that teaching young people about the danger of using drugs while alone and how to recognize and react to an overdose can reduce fatal overdoses.

The findings are similar to those published in late January in JAMA Pediatrics. That study, by researchers at the University of Minnesota and Harvard University, said adolescents who use substances “have more psychiatric symptoms than peers who do not use.”

Per The New York Times, that study linked substance use to “an array of symptoms and conditions including anxiety, depression, hyperactivity and suicidal ideation. These findings suggest that asking adolescents about substance use may provide a powerful screening tool when looking for underlying mental health issues,” researchers said.

A 2020 study in the Journal of Substance Use & Addiction Treatment looked at why young adults use nonprescription drugs. The main reasons were recreation and self-treatment. According to the findings, men were more likely to cite recreation, while women were more likely to cite self-treatment as a driving force. For those using stimulants, being enrolled in college was a significant factor.

All three studies suggest the need for mental health treatment that targets teens.

Alcohol and teens

The CDC calls underage drinking “a significant public health problem” in the U.S. and says excessive drinking causes more than 3,900 deaths and 225,000 years of potential life lost among those under age 21 every year. It also costs the country billions of dollars.

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The 2021 Youth Risk Behavior Survey found that within the 30 days before the survey, among high school students:

  • Twenty-three percent drank alcohol.
  • Eleven percent binge drank.
  • Five percent of drivers drove after consuming alcohol.
  • Fourteen percent rode with a driver who’d been drinking alcohol.

The underage drinking report notes that youths who consume alcohol are more likely to have trouble in school and in relationships, as well as problems with both health and the legal system. Alcohol can impair normal growth or sexual development and lead to physical and sexual violence. It can create memory problems and long-term effects on brain development, among other issues.

“Universally screening for psychiatric symptoms in the context of all types of substance use is what we think might be most important,” Brenden Tervo-Clemmens, assistant professor of psychiatry at the University of Minnesota and lead author of the JAMA Pediatrics paper, told The New York Times.

“All the symptoms of mental health we examined, be it depression, suicidal thoughts, ADHD, were elevated no matter what the substance was,” he added.

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