By Mayo Clinic Staff

Teenagers are at risk of drug misuse because of the way their brains develop. And in turn, drugs can affect brain development. Typical changes in social interactions, family life and independence during the teen years add to these risks. As a result, teenagers face a particular risk of drug misuse.

It's important for parents to understand the effect of drugs, including alcohol, on the teenage body and the risks of drug use. This information can help you work with your child to make healthy choices and prevent drug and alcohol misuse.

The brain is still developing during the teenage years and into the mid-20s. Different regions of the brain develop at different rates. And like all growth, it happens at different rates among individuals.

The parts of the brain that develop first control physical activity, emotions and motivation. The part of the brain responsible for controlling impulses and making good judgments develops later.

As a result, it is typical for teens to be driven by emotions, curiosity and risks. Teens are often open to new experiences. These motivations have positive effects on personal and social development. But they also may make it hard for teens to make sound decisions about risky behaviors or their outcomes.

Many factors can influence a teen's choice to use drugs or alcohol:

• Family habits with alcohol, nicotine and other drugs set an example.
• Some substances are easy to get, such as alcohol, nicotine products, prescription medicines and household products that can be inhaled.
• Social settings are common places to try drugs or alcohol. A teen may use a substance to fit in or feel more confident.
• Teens may use drugs or alcohol to cope with stress, anxiety, loneliness or trauma.

Using drugs or alcohol — even once in a while — creates particular risks for teenagers. Using frequently or in large doses only increases the risks, which include:

• Drug or alcohol use disorders during teenage years or later in life.
• Poor judgment about risk taking that can cause:
  • Accidents, violence or injury.
  • Impaired driving or riding with an impaired driver.
  • Unplanned or unsafe sex.
  • Illegal activity or encounters with the criminal justice system.
• Lack of interest, frequent absences or poor performance at school.
• Lack of coping skills to deal with typical problems.
• Worsening mental health conditions.
• Changes in personality, unusual irritability and big mood swings.
• Suicide or suicide attempts.

Drug and alcohol use disorders have a group of symptoms based on:

• The inability to control when and how much a substance is used.
• The impact on a person's ability to fulfill responsibilities and engage with other people.
• Risky use when it's hazardous or even if physical or psychological harm is expected.
• High tolerance of the substance and withdrawal symptoms.

Substance use disorders can range from mild to severe. It's not easy to predict if a teen who uses drugs or alcohol will develop a substance use disorder. But there are several factors that increase the risk. These include:

• Alcohol or drug use before age 15.
• A family history of substance use disorder.
• A mental or behavioral health condition, such as depression, anxiety, attention-deficit/hyperactivity disorder (ADHD) or an eating disorder.
• Impulsive or risk-taking behavior.
• Low self-esteem or feelings of social rejection.
• A history of traumatic events, such as ongoing family conflict, violence, abuse, a death in the family or natural disasters.
• Homelessness.
• Stigma about identity, such as lesbian, gay, bisexual, transgender, nonbinary or other nonconforming identity.

There are health risks linked to the use of drugs and alcohol. These may be caused by one-time use or regular use. There is a risk of overdose with many drugs. Other health risks affecting teens include the following:

• Alcohol. Alcohol overdose, also called alcohol poisoning, impairs the brain's ability to support basic life functions.
• Tobacco. Smoking during the teen years can cause worsening asthma, other breathing problems and poor pregnancy outcomes. Because tobacco products are highly addictive, they increase the lifelong risks of heart disease, cancer and other conditions.
• Electronic cigarettes. Vaping can result in nicotine addiction and increase the risk of cigarette smoking or marijuana use. Toxic chemicals, metals and tiny particles can damage the lungs.
• Inhalants. Household products that are inhaled can damage the brain, heart, lungs, liver and kidney.
• Marijuana. The short-term effects of marijuana include challenges with memory, learning, problem-solving, concentration and coordination. Long-term use in teens increases the risk of depression, anxiety, schizophrenia and other mental health conditions that cause hallucinations, delusions and paranoia.
• Cocaine. Possible health effects of cocaine use are paranoia, panic attacks, psychosis, heart attack, stroke and seizures.
• Ecstasy. Ecstasy increases the heart rate and blood pressure. It can result in confusion, depression, paranoia, memory problems and other conditions.
• Heroin. Regular use can cause an increased sensitivity to pain and severe breathing problems. There is a high risk of overdose and death.
• Methamphetamines. These drugs increase the risk of heart disease, stroke, mental health conditions that cause delusions and paranoia, poor thinking skills, and tooth decay. There is a high risk of overdose and death.

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 not likely to be interrupted. That means you both need to set aside phones.

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

When parents aren’t prepared to answer questions, they might let teens know that they can talk about the topic later. 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.
• Avoid arguments. Rather than arguing about a difference of fact or opinion, respond with, "Tell me more about that."
• 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 and alcohol use seem common 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 or alcohol.
• Be ready to discuss your own drug use. Think about how you'll respond if your teen asks about your own drug and alcohol use. If you chose not to use drugs, explain why. If you did use drugs, share what the experience taught you.

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. Offer your own home as a place for your teen's friends to spend time together.
• Know your teen's friends. Learn about what they're interested in and how they spend their time. Encourage those friendships that share your own family's values and expectations. If your teen's friends use drugs, your teen might feel pressure to experiment too.
• 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 alcohol or drugs. Plan check-ins and be available to pick up your teen from an event. Explain the consequences of breaking rules. If your teen does break the rules, consistently enforce consequences.
• Keep track of medicines at home. Keep track of all prescription medicines in your home, as well as medicines you can buy without a prescription.
• Provide support. Offer praise and encouragement when your teen succeeds. Set aside time to spend with your teen. Eat meals together once a day even if there isn't a lot of conversation. 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. Have family time and social events that don't include alcohol. Use prescription drugs as directed. Don't use illicit drugs.

Be aware of possible red flags, such as:

• Dropping or changing friends in a notable way.
• Losing interest in favorite activities.
• Changing sleep or eating habits.
• Showing little interest in appearance.
• Skipping school, missing assignments or getting lower grades.
• Having unusual or more frequent conflict with family members.
• Getting in trouble at school or with law enforcement.

Resources are available for parents to help them talk to their teens about drug and alcohol use, improve communication skills, and find treatment options. These include the following:

• Partnership to End Addiction has information on its website about teenage drug and alcohol use, ideas for supporting your teen, online support groups and helpline, and tools to find treatment options.
• National Institute on Drug Abuse has a resource section for parents and educators on its website.

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.

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.

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.

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.