Teens Who Misuse Drugs More Likely To Get Long Term Substance Misuse Problems

Published On: October 4, 2023

Research led by Dr Beth Han of the US National Institute for Drug Abuse (NIDA) shows that an adolescent (age 12-17) who encounters illegal drugs in their lifetime will more likely develop a substance misuse disorder than a young adult.

National Surveys of Drug Use and Health

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The paper used data from the annual National Survey of Drug Use and Health (NSDUH) that looks at substance misuse among adults and children from the age of 12.

Some 70,000 people are surveyed annually across the United States in in-person interviews, and those selected for interviews are chosen to make up a nationally representative dataset.

Those 17 and under who live with their parents have parental consent.

One of the drawbacks of this research is this only looks at people who have a fixed civilian address are surveyed. This leaves those who are not in such accommodation out of the survey.

These include those who:

  • Are in prison
  • Psychiatric hospital
  • Or who are street homeless

Given the very high known substance misuse rates of those who are in these situations, research that excludes them can be skewed.

Given that almost 1% of the US population is either incarcerated or homeless, and the substance misuse rates are far higher than those who have a fixed abode outside, such limitations need noting.

Another point of note is that the research is self-reported so is open to bias. Someone may play down their consumption if they think it is too high for example.

This can skew overall results, though, in the research we look at, statistical regressions were made for confidence as to the actual results.

The Research

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Out of the surveys, data for this research letter was collected by looking at lifetime substance use and substance misuse rates of those surveyed in a 36-month period between 2015-2018. The data was analysed in 2020.

The substances assessed included:

  • Tobacco
  • Alcohol
  • Cannabis
  • Methamphetamine
  • Heroin
  • Cocaine
  • Prescription stimulants such as methylphenidate (Ritalin among other brand names) used for no medical purpose
  • Prescription opioids such as morphine used for no medical purpose

Among these substances, there wasn’t sufficient data available for the research team to analyse methamphetamine, heroin and cocaine use among the teens surveyed.

However, there was good data for tobacco, alcohol, cannabis and prescription opioids and stimulants.

What the Research Found

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The research showed in terms of having ever tried a substance in their lifetime:

  • 3% of adolescents had encountered alcohol
  • This rose to 79.9% of young adults
  • 4% of teens had tried tobacco, as against
  • 55% of young adults had tried tobacco
  • 4% of adolescents had tried cannabis and
  • 5% of young adults had tried cannabis

Adolescents were more likely to develop substance misuse problems than young adults with:

  • Cannabis
  • Prescription stimulants
  • Prescription opioids

Meanwhile, young adults were more likely to develop a substance misuse disorder with the two legal substances, tobacco and alcohol in the 36 months from the beginning of the survey than the adolescents surveyed.

As discussed earlier on in the article, there wasn’t sufficient data among the 70,000 people surveyed to assess the lifetime or substance misuse rates of methamphetamine, cocaine or heroin among teens.

This could be for a variety of reasons, not least that a survey done with the permission of a parent could lead to a child playing down their experiences to ensure family harmony!

Conclusions from the Research

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The headline conclusion from this research is that teens who discover illegal drugs such as cannabis, prescription opioids, or prescription stimulants as they grow up are more likely to develop dependence or addiction.

Conversely, legal drugs (alcohol and tobacco dependence) were more likely in young adults.

Though the raw data in this research data was not published for the two datasets on prescription medications, it is clear that dependence rates are far higher (by around 9%) for prescription stimulants among teens than among young adults.

This disparity is almost as big as the difference between young teens and young adults who have used cannabis (9.8%).

Teens and Substance Misuse

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With regard to cannabis use, this has implications for public health policy, as well as countries and states looking to legalise cannabis use.

Supply needs to be heavily restricted to those of older age, ultimately to prevent children from developing cannabis dependence.

This might include a legal crackdown on the black market at the same time as legalisation.

With regard to the opioid and stimulant situation, this does reflect a broader social issue in the US where certain drugs are over-prescribed and easily available both in schools and the community.

They do come from the black market like cannabis, and this suggests that their accessibility and ultimately misuse stems from access to the black market on the part of the teens.

Growing up in the modern world is one where people can experience a lot of pressure. That stimulant are a major issue suggests that these might be considered performance-enhancing for situations like academic exams.

At the same time, the perceived calming effects of cannabis could also be seen as a means of tuning out the pressures that a teen can face.

What is clear is that those who encounter recreational drugs at an early age often start using them to excess and develop longer-term problems with them.

Both stimulant and cannabis misuse are associated with a range of mental health issues including psychosis, anxiety and depression – some of the commonest mental health issues in these age groups.

Given that these mental health conditions stem from life in general as well as from substance misuse, it is likely these work hand in hand to make things more difficult for the adolescent.

This would also show that children who present to drug and alcohol services will have concurrent mental health issues that are known as ‘dual diagnosis’. This is a difficult issue to treat as, at the time of presentation it is difficult to assess whether the mental health condition was caused by underlying events or the substance misuse itself.

Social Acceptability


The fact that young adults are more likely to develop tobacco and alcohol problems than adolescents who encounter them is probably down to a question of access.

Given that tobacco and alcohol are available to those over 21 in the United States, these are seen as socially acceptable drugs of abuse. Both can be very addictive substances.

That just 15% of adolescents had tried cannabis, as against over a quarter trying alcohol shows that alcohol is the more socially acceptable drug even for teens. Nearly 80% of young adults had tried alcohol, as against just over half, cannabis.

This would suggest that as more and more states and countries legalise cannabis, the accessibility of it to teens may rise as the drug becomes more acceptable.

The NSDUH research is an annual programme so may well show what has happened as more and more states in the US legalise cannabis. Will the rates of teens trying cannabis increase as it becomes more socially acceptable?

This is a case put by opponents to such legal moves, and given the research letter we look at in this article, there is a possibility that cannabis misuse problems are set to grow among younger people in the US.

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