Alcohol and Drug Use in Young People

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Topic Overview

For many young people, using alcohol, drugs, or other substances like cigarettes is just part of growing up. Many of them try these substances only a few times and stop, while others may continue to use them on a more regular basis.

Young people may try a number of substances, including alcohol, household chemicals (inhalants), prescription and over-the-counter medicines, illegal drugs, and cigarettes. They use alcohol more than any other substance. Marijuana is the illegal drug that young people use most often.

Young people use these substances for many of the same reasons that adults do—to relax or feel good. But they may also have other reasons for using substances. For example, they may want to know what it feels like to get high. Or they may want to rebel against their parents or fit in with their friends.

Using alcohol or drugs can affect young people's general health, physical growth, and emotional and social development. It can also change how well they make decisions, how well they think, and how quickly they can react. And using alcohol or drugs can make it hard for young people to control their actions. For some young people, alcohol or drug use may turn into a substance use problem.

Parents can play a key part in teaching their children about alcohol and drug use by talking honestly and openly about the effects that alcohol and drugs can have on their children's health, schoolwork, and relationships.

Facts About Alcohol and Drug Use in Young People

Substance use still remains a leading cause of injury and death in young people. It also causes social and health problems.footnote 4

Even casual use of certain drugs can cause severe health problems, such as an overdose or brain damage. Many illegal drugs today are made in home labs, so they can vary greatly in strength. These drugs also may contain bacteria, dangerous chemicals, and other unsafe substances. There is no quality control for illegal drugs like that required for prescription drugs.

What happens when young people use alcohol or drugs?

Alcohol and drugs target a part of the brain that allows people to feel pleasure. This causes the brain to release certain chemicals that make people feel good. At first, these substances may make a person feel happy, energetic, social, self-confident, and powerful. But after the "high" from the alcohol or drug wears off, he or she may feel the opposite effects. Depending on the substance used, a person may feel tired, anxious, or depressed after the substance wears off. Or he or she may be more sensitive to pain, have sleep problems, lose interest in everyday activities, or withdraw from family and friends.

Since the pleasure only lasts a short time, people crave more of the substance to get the good feeling back. Over time, the brain adjusts to the substance by making less of the "feel good" chemicals. With less of these chemicals, the brain can't function as well, and it becomes harder to feel pleasure. So people use alcohol or drugs to get the good feeling back.

Alcohol and drugs also affect the parts of the brain that deal with judgment, decision-making, problem-solving, emotions, learning, and memory. They change how the cells in the brain send and process information. These changes in the brain make it harder for people to think and make good choices. And they may be less able to control their actions.

What substances do young people use?

Young people use alcohol more than any other substance. Marijuana is the illegal drug that they use most often.

Below is a list of the type of substances young people may use and what problems they may cause.

Alcohol

In many cases, a young person tries alcohol for the first time when he or she is about 16 years old. Most young people have used alcohol by the time they are in their mid-20s. Many of them have had a recent episode of heavy drinking (5 or more drinks on one drinking occasion).footnote 2

The leading cause of death for young people is car crashes related to alcohol. Drinking also can lead young people to have unprotected sex. This raises the chance of pregnancy and infection with sexually transmitted infections, such as herpes, chlamydia, and HIV.

Drinking too much alcohol can harm the liver, pancreas, heart, brain, and nervous system. It can also cause some cancers. If used during pregnancy, alcohol can harm a developing baby (fetus).

Alcohol can also cause mood swings and affect young people's sleep and their ability to think, learn, reason, remember, and solve problems.

Young people should wait at least until they are in their late teenage years to drink alcohol. They should follow the laws for the legal drinking age where they live. If you allow your teenagers to drink, make sure that they drink no more than 1 or 2 standard drinks and no more than once or twice a week and are under your supervision.

Marijuana

In many cases, a young person tries marijuana for the first time when he or she is about 16 years old. Many young people have used marijuana by the time they are in their mid-20s.footnote 2 Marijuana can affect young people's ability to think, learn, reason, remember, and solve problems. It can also cause mood swings, anxiety, and depression.

Cocaine

Some young people have used cocaine by the time they are in their mid-20s.footnote 2 Cocaine can cause abnormal heartbeats, which may cause a deadly heart attack, seizure, or stroke. Its use can also increase the risk of car crashes and violent behaviour. The chance of these things happening increases when cocaine is combined with alcohol.

Other substances

Other substances young people use include:

  • Inhalants (glues, aerosol sprays, gasoline, paints, and paint thinners). These are some of the substances most frequently used by junior high students, because they don't cost much and are easy to get. They contain poisons that can harm the brain. They can also damage the liver, kidneys, blood, or bone marrow.
  • Club drugs, like ecstasy (MDMA) and date rape drugs such as gamma-hydroxybutyrate (GHB), flunitrazepam (Rohypnol), and ketamine. These drugs are often used at all-night dances, raves, or trances. The number of young people using these drugs is small compared with those using cigarettes, alcohol, and marijuana. But these drugs can be dangerous, especially in overdose or when combined with alcohol or other drugs. Some of these drugs can cause a person to have trouble breathing, to pass out, or to be conscious but unable to move. Some of them can also lead to thought and memory problems, anxiety, depression, overdose, and date rape.
  • Methamphetamine (commonly called meth, crank, or speed). Methamphetamine can cause seizures; stroke; serious mental health issues, including paranoia, hallucinations, and delusions; and long-term health problems.
  • Hallucinogens, including LSD, mescaline, psilocybin, PCP (phencyclidine), and ketamine. Serious and lasting problems such as psychosis or hallucinogenic flashbacks can occur after a young person uses LSD.
  • Opioids, such as heroin, morphine, and codeine. Young people who are dependent on these drugs may steal, prostitute themselves, or resort to other dangerous or illegal behaviour to buy drugs. Some of these drugs can cause lung problems, harm the liver and kidneys, cause infections like hepatitis and HIV if the person uses shared injection equipment and fluids, and lead to overdose.
  • Prescription drugs, such as diazepam (for example, Valium) and methylphenidate (Ritalin). Young people misuse these drugs as well as non-prescription medicines such as cough syrups and cold pills to get high.
  • Anabolic steroids , which young people use to build muscle tissue and decrease body fat. Steroids can cause liver cancer and increase the risk of heart attack and stroke.
  • Energy drinks, such as Red Bull, Monster, or Rockstar. Many young people consume these drinks to help them stay awake, feel more energized, and perform better in school and sports. These drinks contain high levels of caffeine and other stimulants, which can cause anxiety, abnormal heartbeats, high blood pressure, dehydration, and other serious problems. When energy drinks are combined with alcohol or drugs, the effects can be even more harmful. For example, many young people mistakenly think that stimulants such as caffeine can undo the effects of alcohol or sober them up before driving, but this is not the case. So they may drink more than they normally would have, and be more likely to engage in risky behaviours such as drinking and driving.

Young people also use tobacco. In many cases, a young person tries cigarettes for the first time between the ages of 12 and 14.footnote 2 About 14 out of 100 people ages 15 to 19 smoke cigarettes.footnote 1 And about 8 out of 100 of them smoke cigarettes almost every day.footnote 1 And more than 90 out of 100 teenagers who smoke may develop a lifelong habit of regular smoking.footnote 3

Because the effects of cigarettes are felt right away, they may be the most habit-forming substance available. Smoking can cause cancer and heart and lung problems. Smokeless tobacco like chew or snuff can cause dental problems and cancers of the mouth.

Why Some Young People Use Alcohol and Drugs

For many young people, using alcohol or drugs is just part of growing up. They may use substances for many reasons. They may want to:

  • Fit in with friends or certain groups.
  • Be social and have fun.
  • Feel good.
  • Seem more grown up.
  • Rebel against parents.
  • Escape problems. For example, they may use a substance to try to:

Young people tend to try new things and take risks, so they may use alcohol or drugs because it seems exciting.

Health Risks of Alcohol and Drug Use

When young people use alcohol or drugs, they may be putting their health and safety at risk.

Young people's risk of harm increases with:

  • Each drink that they have or drug that they use.
  • How often and for how long they drink or use drugs, whether they use these substances only now and then or on a more regular basis.
  • The type and strength of the drug used. Different drugs harm the body in different ways. Even casual use of certain drugs can cause severe health problems, such as an overdose or brain damage. Many illegal drugs today are made in home labs, so they can vary greatly in strength. These drugs also may contain bacteria, dangerous chemicals, and other unsafe substances. There is no quality control for illegal drugs like that required for prescription drugs.
  • How they use alcohol or drugs.
    • If they smoke a drug or inject it into a vein, they are more likely to overdose and become dependent on the drug than if they swallowed it.
    • If they share needles, syringes, and other equipment (such as cookers, cotton, cocaine spoons, or eyedroppers), they are more likely to get hepatitis, HIV, or other serious infections.
    • If they combine alcohol with drugs, they are more likely to engage in high-risk behaviours and have serious health problems. The use of alcohol with drugs may increase the effects of each.

Using alcohol or drugs can affect young people's general health, physical growth, and emotional and social development. It can also change how well they make decisions, how well they think, and how quickly they can react. And it can make it hard for them to control their actions.

Alcohol or drug use can:

  • Make car crashes more likely. If young people drink and drive, or if they drive while they are high, they can easily hurt themselves or others.
  • Lead to unprotected sex and/or sexual assault. This can lead to pregnancy and sexually transmitted infections, including HIV.
  • Increase the risk of injury and death.
  • Cause young people to do things they wouldn't usually do. They may say things that hurt their friends or do something illegal that could result in paying a large fine, losing your driver's licence, or other legal problems.
  • Affect schoolwork and cause young people to lose interest in school and their future. Poor grades or lack of focus may make it harder for them to reach their dreams.
  • Change how young people feel about their life. It can lead to depression and suicide.
  • Cause mood swings and affect young people's sleep and their ability to think, learn, reason, remember, and solve problems.
  • Harm many organs and systems in the body, such as the liver, pancreas, heart, brain, and nervous system.
  • Cause some cancers.
  • Cause harm to a developing baby (fetus) if alcohol or drugs are used during pregnancy.

For some young people, alcohol or drug use may turn into a substance use problem. This means that they have a strong need, or craving, for alcohol or drugs. This craving makes it hard for them to control how much alcohol or drugs that they use and may make it hard for them to stop. So they continue to use alcohol or drugs even though they know that their use is causing problems in their life.

Is Your Child Using Alcohol or Drugs?

It can sometimes be hard to tell if your child is using alcohol or drugs. Parents may worry that their child is involved with alcohol or drugs if he or she becomes withdrawn or negative. But these behaviours are common for young people going through challenging times.

It's important not to accuse your child unfairly. Try to find out why your child's behaviour has changed. Tell him or her that you are concerned.

Experts recommend that parents look for a pattern or a number of changes in appearance, behaviour, and attitude, not just one or two of the changes listed here.

Change in appearance

  • Less attention paid to dressing and grooming
  • Loss of appetite or unexplained weight loss
  • Red and glassy eyes and frequent use of eyedrops and breath mints

Change in behaviour

  • Decreased attendance and performance at school
  • Loss of interest in school, sports, or other activities
  • Newly developed secrecy, or deceptive or sneaky behaviour
  • Withdrawal from family and friends
  • New friends, and reluctance to introduce them
  • Lying or stealing

Change in attitude

  • Disrespectful behaviour
  • A mood or attitude that is getting worse
  • Lack of concern about the future

It's important to remember that drugs can include more than illegal drugs. Young people could also have problems with medicines a doctor prescribes or medicines they can buy without a prescription.

What should you do if you find out that your child is using alcohol or drugs?

If you think that your child is using alcohol or drugs, one of the most important things you can do is to talk honestly and openly with him or her. Urge your child to do the same. This may be a hard conversation to have. Try not to use harsh, judging words. Be as supportive as you can. Let your child know that you were his or her age once and can understand how hard it can be to say "no" when someone offers alcohol or drugs.

When talking with your child about alcohol or drug use:

  • Ask about use. Find out what substances your child has tried, what effects the substances had, and how he or she feels about substance use. Listen carefully to what your child liked about using the substance and why.
  • Share concerns. Talk about your concerns, not only about your child's alcohol or drug use but also about other problems that may be going on, such as problems at school or with friends.
  • Review expectations. Talk with your child about family rules concerning substance use and what might happen when rules are broken.

If you think your child may have a substance use problem, talk with your doctor or a counsellor. Or call your local alcohol or drug helpline to find out what resources are available in your area that can help your child manage his or her alcohol or drug problem.

Finding the Right Care for Your Child

Keep in mind that most young people who use alcohol or drugs don't develop a substance use problem. Most who want to cut back on or stop using alcohol or drugs are able to do so on their own. But others may need help.

If your child wants to cut back on or stop using alcohol or drugs and needs some support, encourage your child to talk to someone he or she trusts. That person might be you or someone else in your family, your doctor, a school counsellor, an adult relative, a minister or clergy member, or a friend's parents. Or your child might find it helpful to call a helpline and talk to someone about his or her alcohol or drug use. Some schools have programs for students that provide support and alcohol and drug education.

If you're worried that your child is having a hard time cutting back on or stopping alcohol or drugs on his or her own, talk with your doctor. This is especially important if your child is having withdrawal symptoms when he or she tries to cut back on or stop using alcohol or drugs. Symptoms of withdrawal may include sweating and feeling sick to the stomach, feeling shaky, and feeling anxious.

Talk to your doctor about whether your child may need treatment. You and your doctor can decide what treatment approach is best for your child.

Some treatment approaches may involve:

  • Outpatient or inpatient care to help young people cut back on or stop using alcohol or drugs. These programs provide education and individual, family, and group counselling. They may also provide medical care to help reduce cravings for alcohol or drugs and manage withdrawal symptoms.
  • Counselling that helps young people to:
    • Learn to change the thoughts and actions that make them more likely to use alcohol or drugs. A counsellor teaches them ways to deal with cravings and cut back on or stop using alcohol or drugs. This is called cognitive-behavioural therapy.
    • Resolve mixed feelings about cutting back on or stopping alcohol or drugs and getting treatment. A counsellor helps them find personal motivation to change. This is called motivational interviewing.
    • Set goals on how to cut back on or stop using alcohol or drugs. This is done in short counselling sessions, called brief intervention therapy.
    • Identify talents and strengths. These can be used to find healthy interests, hobbies, and jobs.
    • Learn ways to say "no" when someone offers them alcohol or drugs.
  • In-home medical care. In some provinces, young people may be able to get medical care at home to help reduce cravings for alcohol and manage withdrawal symptoms.
  • Medicines. They can help reduce cravings for alcohol or drugs and manage withdrawal symptoms.

If your child needs help, look for a program with the components he or she needs. These may include a school program or opportunities for parents to get involved in their child's care.

If you feel that your child has an alcohol or drug use problem, get help. The earlier your child gets help, the easier it will be for him or her to cut back on or stop using alcohol or drugs.

Prevention Strategies

Young people who don't use alcohol, drugs, or cigarettes are less likely to have problems with them as adults. Efforts to prevent substance use should begin early in life with education, encouragement of healthy behaviours, and good family bonds.

Positive self-esteem, a supportive family, and positive role models help children gain confidence to make good choices.

If you live in a high-risk neighbourhood or your child is at high risk for having a substance use problem, a community program can help your child learn skills to avoid substance use.

By age 9, your child will have opinions about substance use. So start early to help your child learn the skills needed to avoid substance use.

Be a role model, and stay connected

  • Be a role model. As a parent, your attitude toward alcohol, drugs, or cigarettes is one of the greatest influences on whether your child will use these substances. If you have a substance use problem, get help. If you quit, your child is more likely to get help early if he or she starts using a substance.
  • Share your beliefs. Even though they may not act like it, most children listen to what their parents tell them. Talk with your child about the effects of substances on emotions, schoolwork, and health. If you have a family history of substance use problems, talk with your child about his or her increased risk for the same problems.
  • Stay connected.
    • Know who your child's friends (and the friends' parents) are.
    • Know where your child is at all times and what your child does in his or her spare time. This doesn't mean you should grill or nag your child. Instead, show interest and demonstrate that you care about his or her general well-being.
    • Set times when the family is expected to be together, such as at mealtimes. Plan family outings or other family fun activities.
  • Be fair and consistent. Set firm, fair, and consistent limits for your child. Help him or her understand the immediate and long-term effects of substance use, such as falling grades and poor health.
  • Encourage activities. Keep your child busy with meaningful activities, such as sports, church programs, or other group involvement. Children who feel good about themselves are less likely to use alcohol and drugs.
  • Get informed. Learn about the substances commonly used by young people. Find out how the drugs work, what their street names are, and what the signs of being under the influence are.

Talk about personal and legal consequences

  • Personal consequences. Explain that some behaviours, such as unsafe sex, can lead to problems that last a lifetime. Talk about how the use of substances while trying to develop adult skills—graduating from high school, going to college, getting a job—can affect your child's future.
  • Legal consequences. Remind your child that it is illegal for him or her to purchase and use illegal drugs. It's also illegal for your child to purchase alcohol if he or she is under the legal drinking age. Talk about the increased risk of car crashes, violence, and arrests because of substance use.

Harm-Reduction Strategies

It's important for young people to remember that drinking alcohol or using drugs isn't risk-free. Their risk of harm increases with each drink that they have or drug that they use, how often and for how long they drink or use drugs, the type and strength of the drug used, and the method of use. For more information, see Health Risks of Alcohol and Drug Use.

It's also important for young people to know that it's illegal for them to purchase and use illegal drugs. It's also illegal for them to purchase alcohol if they are under the legal drinking age.

Although there is no amount of alcohol or drug use that is safe, there are some things a young person can do to reduce his or her risk of serious health problems and injuries caused by alcohol or drug use.

Ways to reduce harm from substance use

Reducing harm from any substance:

  • Avoid risky situations and activities. Don't drink or get high and drive, and don't get in a car with a driver who has been drinking or using drugs.
  • Make a plan to get home safely. For example, choose a designated driver, have money to pay for a taxi or bus fare, or call a loved one for a safe ride home.
  • Don't take over-the-counter or prescription medicines that interact with alcohol. And don't take these medicines with illegal drugs or other harmful substances.
  • Don't mix alcohol with illegal drugs or other harmful substances.
  • Be aware at all times of your surroundings and the people around you.
  • Limit how much you use alcohol or other substances. The more you use, the greater the risk of getting sick, hurt, or in trouble.

Reducing harm from alcohol

  • Have a meal or a snack with a drink. Don't drink on an empty stomach.
  • Drink slowly. Don't have more than 2 standard drinks in any 3-hour period.
  • Have a glass of water or non-alcoholic, caffeine-free beverage (such as a soft drink or fruit juice) between drinks.

Reducing harm from drugs

  • Don't share needles, syringes, and other equipment (such as cookers, cotton, cocaine spoons, or eyedroppers) with others if you use drugs.
  • Don't leave your beverage unattended or accept a drink from an open container.

Helping someone who is using alcohol or drugs

If you know someone who puts himself or herself in situations where risky drinking or drug use is going to occur (such as at a bar or party), here are some things you can do to help reduce that person's risk of harm. You can:

  • Take the person's car keys so he or she won't drive after drinking or while high on drugs.
  • Remove sharp objects and glassware from dance and party locations so the person won't hurt himself or herself or others.
  • Provide water so the person doesn't get dehydrated.

Know when to call for help

Don't be afraid to call for help if you or someone you know needs medical care. The reason for seeking medical care won't be reported to the police.

Call 911 or other emergency services immediately if:

  • A person passes out or has trouble breathing after drinking alcohol or taking drugs.
  • A person who has been drinking alcohol or using drugs threatens to hurt himself or herself or someone else.
  • A person who suddenly stops using alcohol or drugs has trembling, hallucinations, seizures, or other severe withdrawal symptoms.

Other Places To Get Help

Organizations

Canadian Students for Sensible Drug Policy
www.cssdp.org
National Anti-Drug Strategy (Canada)
www.healthycanadians.gc.ca/anti-drug-antidrogue/index-eng.php?utm_source=vanity_url&utm_medium=url_en&utm_content=redirect_justice_nationalantidrugstrategy.gc.ca&utm_campaign=pidu_14

References

Citations

  1. Health Canada (2010). Canadian Tobacco Use Monitoring Survey (CTUMS) 2010. Available online: http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/research-recherche/stat/_ctums-esutc_2010/ann_summary-sommaire-eng.php.
  2. Health Canada (2011). Canadian Alcohol and Drug Use Monitoring Survey. Available online: http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/_2011/summary-sommaire-eng.php.
  3. Heart and Stroke Foundation (2012). Statistics. Available online: http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3483991/k.34A8/Statistics.htm.
  4. Johnston LD, et al. (2012). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2011. Ann Arbor: Institute for Social Research, The University of Michigan. Available online: http://monitoringthefuture.org/pubs/monographs/mtf-overview2011.pdf.

Other Works Consulted

  • American Academy of Child and Adolescent Psychiatry (2005). Practice parameter for the assessment and treatment of children and adolescents with substance use disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 44(6): 609–621.
  • Bukstein OG (2009). Adolescent substance abuse. In BJ Sadock et al., eds., Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3818–3834. Philadelphia: Lippincott Williams and Wilkins.
  • Moeller FG (2011). Drug abuse and dependence. In EG Nabel, ed., ACP Medicine, section 3, chap. 6. Hamilton, ON: BC Decker.
  • Stager MM (2011). Substance abuse. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 671–685. Philadelphia: Saunders.
  • Substance Abuse and Mental Health Services Administration (2012). Results From the 2010 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-42, DHHS Publication No. SMA 11-4667). Available online: http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm.
  • Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality (2011). The DAWN Report: Emergency Department Visits Involving Energy Drinks. Rockville, MD. Also available online: http://www.samhsa.gov/data/2k11/WEB_DAWN_089/WEB_DAWN_089.htm.

Credits

ByHealthwise Staff
Primary Medical ReviewerPatrice Burgess, MD - Family Medicine
Brian D. O'Brien, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical ReviewerChristine R. Maldonado, PhD - Behavioral Health

Current as ofNovember 16, 2016