A Guide to Addiction and Recovery for Teens

Teens may use drugs due to peer pressure, curiosity, or to do better in school. Drug misuse can lead to unprotected sex, mental health problems, overdose, and damaged relationships. Many rehab programs are designed specifically for teens, including recovery high schools and wilderness therapy programs. Some families turn to interventions to help get their adolescents into treatment.

Teen Addiction

What begins as experimentation can turn into addiction for many teenagers. In 2020, about 1.6 million adolescents aged 12 to 17 needed treatment for a substance use disorder (SUD), but only 7.6%, received it.¹

When you fear that your child or your friend is misusing drugs or alcohol, panic may take over. The first step is to try to find out if the person is indeed misusing drugs and then seek help. As a parent, loved one, or friend, learning about teen drug use, addiction, and treatment can help you discover whether a teen has a problem and what recovery programs are available based on the extent of the problem, any mental health issues, and other factors.

Why Do Teens Misuse Drugs?

It is normal for teens to try things and test boundaries. Teens are wired to try new experiences and to take risks while finding their own identity. According to Nora Volkow of the National Institute on Drug Abuse (NIDA), “The adolescent years are a key window for both substance use and the development of substance use disorders.”²

In the midst of self-discovery and exploration come choices, both good and bad. These decisions can include trying drugs, cigarettes, or alcohol. Common reasons teens misuse drugs include:

• Peer pressure. Peer pressure is the influence from others in your peer group. Even though peer pressure can be positive, it can also lead to negative activities such as the use of cigarettes, alcohol, or drugs, or involvement in illegal activity.
• Social acceptance. Closely related to peer pressure is the desire to fit in socially. Many teens will try a drug solely because their friends are doing it. They may try the drug to be part of what they perceive as a cool group.
• Curiosity. Sometimes teens will experiment with drugs to satisfy a curiosity, seek a thrill, or avoid boredom. Wondering what it feels like to be drunk or high may cause the teen to take their first drink, pill, or drag. This desire to push the envelope is a natural part of life for many teens.
• Feelings of pleasure. Drugs and alcohol can produce feelings of pleasure and euphoria. These feelings of pleasure can vary depending on the type of drug in the system and the method of ingestion.² Some teens like the way the drug makes them feel and will use it again to experience that same feeling of pleasure.
• Athletic or academic performance boost. Stimulants increase certain processes throughout the central nervous system. Common desired effects include increased ability to focus, increased energy, and elevated mood. These effects are sought because they might seem to help with studying or give a boost to athletic performance in the short term.

Development of a substance use disorder is influenced by a variety of individual, familial, genetic, and social risk factors.³ Factors that have been identified as contributing to the risk of teens experimenting with and using drugs include:

• Family history. Having a family member who has a history of drug misuse and addiction increases the risk of developing addictive behaviors with alcohol or drugs.
• Mental health issues. Psychological disorders, such as attention-deficit hyperactivity disorder (ADHD) or depression, increase the risk of addiction.
• Past abuse. Emotional, physical, or sexual abuse is another risk factor that increases the likelihood of drug misuse and addiction.
• Family turmoil. A teen who has experienced a family conflict may be more likely to turn to drugs and alcohol to escape that reality and numb the pain.
• Transitions. Stressful times, such as changing schools, divorce, or moving can lead to experimenting or regularly using illegal substances.

Which Drugs Are Commonly Misused by Teens?

According to the National Institute on Drug Abuse Monitoring the Future survey (2022), adolescents most commonly reported use of alcohol, nicotine vaping, and cannabis, and levels of use of these substances generally held steady with those reported in 2021.⁴

The choice of drug depends upon what is most available to the teen and what is used by friends or peers.

Some of the most common substances used by teens include:

• Marijuana. Marijuana (cannabis) is the most commonly used illicit substance by teens.⁵ Marijuana is legal in many states throughout the U.S., and is often thought to be somewhat harmless, but it can be addictive.⁶ One study showed that nearly 13% of those with a substance use disorder began using marijuana by the time they were 14 years old.²
• Alcohol. The appeal of alcohol is often the ease of access. Alcohol is also glamorized by the media and thought to be less dangerous since it is legal for adults to purchase and consume. Many teens do not understand the power of alcohol and its impact on decision-making. Drinking can lead to risky behaviors such as driving while intoxicated.
• Tobacco. Tobacco comes in the form of cigarettes; smokeless products, such as chewing tobacco; or for use in water pipes. Cigarettes contain many chemicals, including nicotine, which is the primary addicting substance in tobacco. The National Institute on Drug Abuse for Teens warns, “Tobacco use is the leading preventable cause of mortality in the United States.”⁷ Quitting cigarette smoking may be just as difficult as quitting any other addictive drug.
• Electronic cigarettes or e-cigarettes. These devices have gained popularity over the past few years. Powered by batteries, e-cigarettes deliver nicotine with flavorings and do so without the tobacco.
• Prescription drugs. Prescription and over the counter (OTC) drugs are commonly misused substances by Americans 12 and older. These drugs have a medical purpose, but when taken in large quantities, snorted, or injected into veins, the possibility of overdose and even death is significantly higher. Estimated numbers of adolescents aged 12 to 17 who misused cough and cold medicines in 2020 were 223,000.¹

Commonly misused prescription and nonprescription drugs by teens are:^5,8

• Painkillers (e.g., Oxycodone) – When taken in large doses or used by alternative methods of consumption, such as snorting or injection, these drugs come with a high likelihood of addiction.
• Stimulants (e.g., Adderall, Ritalin) – Commonly used to treat attention-deficit hyperactivity disorder (ADHD), these drugs are taken to stay awake longer, elevate mood, and increase performance in school and sports.
• Tranquilizers/sedatives – Used to decrease the symptoms of anxiety and depression, these drugs can cause euphoria and lead to addiction if misused.
• Nonprescription cough medicine – Dextromethorphan (DXM) is a common ingredient in both prescription and OTC cough medicines. When taken in large quantities, it delivers a feeling of intoxication. Taking large quantities of the drug can lead to nausea, vomiting, and other central nervous system side effects.
• Synthetic drugs – Also known as designer drugs, these are manmade drugs that mimic other drugs. Many of these drugs evade regulation by the Food and Drug Administration (FDA) by being labeled “not for human consumption.” Two common manmade cannabinoids are K2 or Spice. These drugs are created to mimic the effects of marijuana. Bath salts are a manmade drug that mimics the effects of amphetamines without the legal implications or cost.

In addition, inhalants are found in products commonly used around the house, so they are legal to buy and convenient to access. Inhalants are ingested by:

• Sniffing or snorting.
• Huffing, which means soaking a rag in the chemical and then putting it in the mouth or near the nose to inhale the fumes.
• Spraying the chemicals directly into the nose or mouth.
• Bagging, which is spraying the chemical into a paper or plastic bag and then sniffing the fumes.
• Filling a balloon with the chemical and then inhaling from the balloon into the lungs.

According to the National Institute on Drug Abuse for Teens, there are 4 types of inhalants most commonly used by teens:⁹

• Volatile solvents: Substances that become gas at room temperatures. Common volatile solvents include nail polish remover, dry-cleaning fluid, gasoline, and contact cement. Products used in arts and crafts or around the office, such as felt-tip marker fluid and correction fluid, are also commonly used.
• Aerosols: Aerosols are sprays that contain propellants and chemicals. Common aerosols are spray paint, spray deodorant, and vegetable oil sprays.
• Gases: Gases are found in products used around the household and in the medical field. The most common gases used are butane from lighters, propane tanks, whipped cream cans, and nitrous oxide cartridges or canisters (laughing gas).
• Nitrites: Nitrites are used for their ability to increase sexual drive and enhance the experience. These chemicals are less common around the home and include amyl nitrite and butyl nitrite.

What Are the Risks of Drug Use?

The National Institute on Drug Abuse states that the physical effects of drug misuse in teens are not the only negative effects. Once a teen begins taking drugs for recreational use, the likelihood of them making poor decisions and being involved in high-risk activities increase significantly.

Drug use can be the precursor to unprotected sex, driving while intoxicated, assault, violence, and arrests for other illegal behavior. Regular drug misuse can lead to poor academic performance, damaged relationships, impaired memory, increased risk of contracting HIV, mental health problems and possible overdose.²

Drug misuse may ultimately lead to long-term impairment in brain development and addiction.²

How Do You Identify Addiction?

Teens tend to be moody, sleep a lot, and change friends frequently even when life is good. This may make it difficult for parents or friends to know when to be concerned about drug misuse. The following is a list of signs that may potentially indicate drug use:²

These signs are not specific to drug misuse. They may also indicate a mental health disorder and should be monitored and discussed with your child’s family doctor for appropriate medical treatment.

How Do You Get Someone into Treatment?

Parents often feel that even healthy teen children do not want to talk or receive advice from them. Research shows that this is actually not true. Your child does want to talk to you and values your opinions on decisions they make.

Starting these conversations can be difficult and intimidating. The best principle to use when speaking to your teens is honesty. Here are a few tips:^10,11

• Don’t confront them when they are intoxicated, high, or angry. This will only lead to arguments and words being said out of emotion. Choose a time that is neutral for everyone involved.
• Speak in private. There should be minimal interruptions and few other family members. Respect the fact that this is a struggle for your teen, even if they won’t admit it at the time.
• Have a plan for your next step. Research possible treatment options and consider the use of an interventionist.
• Avoid accusations. Blaming your teen will not make them stop the unwanted behaviors, and they may not actually be misusing drugs.

You might want to consider an intervention, which is a planned meeting where you speak to the person about suspected drug or alcohol misuse and get them to agree to treatment.

If you have any fears of how your teen will react, do not do this alone. Instead, consider using a skilled interventionist. An interventionist, psychiatrist, psychologist, or social worker can help you talk to your teen and create a post-intervention treatment plan.

It’s true that teens under 18 can be sent to rehab by a parent or legal guardian against their will. However, treatment may progress more smoothly and have more of an impact if the child can accept the need for treatment. Once they are a legal adult, they have the right to decline treatment.

What Kinds of Treatment Programs Are Available?

The National Institute on Drug Abuse lists 6 issues to consider when choosing the type of treatment for your teen:²

• The severity of the drug use, addiction, and risk of unpleasant or dangerous withdrawal.
• The presence of other physical diseases and disorders that may require treatment.
• The presence of mental health disorders that may require treatment.
• The teen’s commitment to change.
• The risk of relapse or continued drug use.
• The recovery environment, including the presence of family, peers, school, and the legal system.

There are several types of treatment programs available:

• Inpatient teen programs. An inpatient program is best for teens who have a significant history of abuse, addiction, and/or other physical and mental health problems that require 24-hour attention by health professionals.
• Outpatient teen programs. An outpatient program is best for teens with mild to moderate addictions, few to no mental health problems, and a supportive home living environment.
• 12-Step programs. Some of these programs include Teen Addiction Anonymous, Narcotics Anonymous (NA), and Alcoholics Anonymous (AA). 12-Step programs are community-based support systems that link teens with others who are on the same journey to recovery.
• Wilderness therapy programs. This adventure-based program helps build self-esteem and social skills in teens through activities such as rock climbing, hiking, and swimming.
• Recovery high schools. This educational setting combines the teens’ educational needs with their recovery needs. One such high school is Hope High School in Indiana, which not only offers teens academics, but combines education with group therapy sessions. This provides the students with a sense of community along with their recovery. There are currently 35 other recovery high schools across the United States.¹³
• Sober dorms at colleges. Some colleges have entire dorms dedicated to following the laws related to alcohol and drug use while in college, such as no drinking under the age of 21. This allows students to focus on academics and not be tempted with peer pressure to drink and use legal or illegal drugs. One college dedicated to this mission is Rutgers University in New Jersey. In 1988, the school founded Recovery House, providing a drug- and alcohol-free dorm for young adults who struggle with addiction.
• Drug courts. As an alternative to traditional courts, drug courts require the teen to receive intensive treatment, meet their obligations to the court, submit to regular drug testing, and appear in court regularly to review progress.¹⁴

While in a treatment program, your teen may engage in different types of behavioral therapy, such as:

• Cognitive behavioral therapy (CBT). Based on the idea that learning plays an important role in decision-making, cognitive behavioral therapy helps teens anticipate problems and develop effective coping strategies.²
• Motivational interviewing. This type of therapy is used to enhance a teen’s level of motivation toward rehab. Motivational interviewing is usually combined with other types of therapy.²
• Contingency management (CM). CM rewards teens for abstaining from drugs, attending therapy, participating in the treatment plan, or achieving other specific goals. The rewards in a contingency management program could be cash vouchers or food, clothing, or other desired items.²
• Family therapy. Family therapy works with both the teen and the family to discuss family dynamics, reasons for use, and how the family can support the teen going forward.
• Group therapy. Group therapy allows observation of others’ recovery processes, preps people for real world encounters, and strengthens social skills. It can be done in various settings.
• 12-Step facilitation therapy. This type of therapy is used with groups such as Teen Addiction Anonymous, NA, and AA. All 12-Step programs are designed to build motivation and provide support for recovery.²

When choosing a program, think about the specific needs of the teen. Programs should allow teens to complete their schoolwork while in rehab. Treatment for mental health disorders such as ADHD, depression, or eating disorders needs to be considered. Teens may also need assistance with other issues, such as low self-esteem, body image, trauma, abuse, and peer pressure.

What Happens After Treatment?

Addiction can be a lifelong battle, which means that your teen may need to take part in community-based programs or group therapy even after treatment. Many teens choose to participate in Teen Addiction Anonymous, NA, or AA programs to receive ongoing support, be reminded of why they quit using, and help others.

This type of aftercare treatment can help prevent relapse. Other forms of aftercare include sober living homes, individual therapy, and group therapy.

How Can You Prevent Drug Misuse in Adolescents?

The main reason kids do not use drugs is their parents’ positive influence and the fear of disappointing people they look up to. The National Crime Prevention Council recommends speaking early and often to your child about drug use.¹⁵

Below is a list of ways the council suggests to keep the conversation going and prevent your child from trying drugs or alcohol:

• Establish and maintain good communication – talk to your child every day, ask questions that require more than a yes or no answer, and include them in decisions.
• Get involved in your child’s life – spend time with your child every day and attend events and activities that are important to your child.
• Set clear rules and enforce them consistently – discuss rules and consequences in advance, and if a rule is broken, enforce the consequences.
• Be a positive role model – demonstrate ways to solve problems, have fun, and manage stress without drugs or alcohol.
• Talk to your child about drugs – ask them what they know, how they feel, and what they think about the issue, and educate yourself about alcohol, tobacco, and drug use.

Protective factors, such as being active in faith-based organizations or athletic organizations and spending time around people who don’t use drugs, can also prevent drug misuse in teens.

Find Drug and Alcohol Addiction Treatment for Teens

If you, a friend, or your teenage child is struggling with addiction, help is available. Call to speak with a member of the American Addiction Centers compassionate admissions team, who can help you find the right treatment program and/or verify your insurance coverage. Addiction and recovery can be a challenge, but help is available for you and your loved ones.

Helpful Resources for Teens:

• NIDA for Teens: This website offers information on drug and alcohol use through videos and games.
• Above the Influence: As a partner of Drug-Free Kids, this site supports anti-drug messages in our media.
• National Suicide Prevention Lifeline: The National Suicide Prevention line offers free 24/7, confidential support for those in crisis.
• Boys and Girls Clubs: Boys and Girls Clubs of America is a nonprofit organization offering assistance for young people in need.
• National Runaway Safeline: This hotline offers 24/7 support for teens who are considering running away and the parents and family members of these teens.

Helpful Resources for Parents:

• Al-Anon Family Groups: Al-Anon Family Groups offer local groups for the parents and family members of teens with drug and alcohol addictions.
• MADD: MADD stands for Mothers Against Drunk Driving and offers education on drunk driving and driving under the influence of other drugs.
• NIDA: The National Institute on Drug Abuse is a federally funded site offering support and education on drug and alcohol addiction.
• NIAAA: National Institute on Alcohol Abuse and Alcoholism is a division of the National Institutes of Health (NIH) and offers education and support for those suffering from alcohol abuse and their families.
• Partnership at Drug Free.org: DrugFree.org features education materials for parents about drug use in teens, a toolkit, and a blog that covers a variety of abuse issues.
• SAMHSA’s Behavioral Health Treatment Services Locator: The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a treatment center locator and information on different types of centers.