Mental Health and Substance Use Disorder in Teens and Young Adults

Substance use disorders frequently occur alongside other serious mental health issues. Understanding the root of SUDs is key to recovery.

What is substance use disorder?

Substance use disorder is a complex but curable condition defined by uncontrolled drug or alcohol use. Previously referred to as addiction or drug abuse, substance use disorder (SUD) can have harmful consequences for teens and young adults—affecting brain development, contributing to chronic health issues, and paving the path for other risky behaviors. 

Some of the most common substance use disorders in the U.S. involve alcohol, opioids, stimulants, and cannabis. Research shows that alcohol is the most frequently abused substance among U.S. youth—with 1.19 million 12-17-year-olds and 11.72 million 18-25-year-olds reporting binge drinking in a given month. That’s not the only substance that teens are using; the data also show that drug use among 8th graders increased by 61 percent between 2016 and 2020.

Teen alone feeling sad dealing with substance abuse issues

Types of substance use disorder in young adults and teens

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5), there are 10 classes of drugs that are linked to substance use disorders. It’s possible to be develop a substance use disorder with only one substance, or to have something called polysubstance disorder where you use multiple substances, such as: 

  • Alcohol
  • Caffeine 
  • Cannabis
  • Hallucinogens
  • Inhalants
  • Opioids
  • Sedatives
  • Stimulants
  • Hypnotics and anxiolytics
  • Tobacco

SUD and other mental health disorders

Substance abuse problems can affect anyone and they often co-occur with other mental health conditions. In fact, approximately half of people who struggle with a substance use disorder will also experience a co-occurring mental disorder, including:

Research also shows a strong link between suicide attempts and the risk of a substance use disorder—specifically for females. A recent study found that approximately one in five females who attempted suicide eventually developed a SUD, and females with one attempt were nearly six times more likely to develop SUD than females with no suicide attempts.

Signs of substance use disorder

LIke other mental health conditions, there are often telltale signs that someone is struggling with a SUD if you know what to look for. So how do you know if your consumption signifies a substance abuse problem? Below are several common signs of SUD:

  • Changing friend groups to spend more time with those who drink or do drugs
  • Missing class or skipping school 
  • Losing interest in activities you typically enjoy
  • Changes in eating or sleeping patterns
  • Changes in personal appearances, such as a lack of personal hygiene
  • Growing disconnected from family and friends
  • Engaging in suspicious and secretive behaviors
  • Asking for money
  • Mood swings or irritability

Four stages of SUD

There are multiple factors that predispose a teen or young adult to developing a substance use disorder, but most experts agree that substance use disorders tends to follow a pattern. More specifically, there are four stages of substance use disorder: 

1. Experimentation

The experimentation phase is when a person first tries a drug but doesn’t yet experience any of the consequences. For example, maybe you decide to try marijuana at a party on the weekend, or you start a new job and drinking is part of the culture. Research shows that teens, in particular, are likely to first try drugs due to curiosity, peer pressure, or for social acceptance.

2. Regular use‍

Stage two is a pivotal point in a teen or young adult’s journey with a substance use disorder. While many people can continue to have a beer at a party or happy hour without developing a substance use disorder, it’s at this point that others face an increased risk of developing a substance use disorder. Regardless of why a person first started using a substance, it’s at this point that use turns from recreational to regular.

3. High-risk use‍

At this point, young people may become so consumed using a substance that they start to neglect their life outside of their SUD. The biological and psychological cravings set a person up for the next stage: disordered habits and behaviors.

4. Disordered relationship

At this point, it will seem impossible for them to live life without the substance with which they have a disordered relationship. At this point, a person will spend most of their time using substance(s) or seeking ways to continue to use.

Therapist conducting therapy session with a teen through her laptop

Risk factors for substance use disorder

Substance use disorder can affect anyone, but there are several risk factors that may increase a person’s chance of developing a substance use disorder. 

  • Having a blood relative, like a parent or sibling, with alcohol- or drug-related substance use disorder
  • Physical, sexual, or emotional abuse
  • Exposure to trauma
  • Peer pressure to try drugs or alcohol
  • Ability to easily access substances 

Consequences of substance use disorder

Regardless of what drug a person uses or how they got hooked, substance use disorder can have some serious consequences for teens and young adults. Like other untreated mental health disorders, substance use disorder can lead to:

  • Problems at school or work
  • Accidents, such as drunk and impaired driving
  • Family conflict 
  • Violence 
  • Worsening mental health
  • Suicide

If you’re experiencing suicidal thoughts, please know that help is always available. For immediate support, visit your local emergency department or crisis center, or call one of the following resources: The National Suicide Prevention Lifeline (1-800-273-8255) or The Crisis Text Line (text HOME to 741741).

Treating substance use disorder

While substance use disorders are serious mental health issues, they are highly treatable with a combination of talk therapy, medication management, and support groups.

There are two main approaches to treating substance use disorders:

  1. Abstinence
  2. Harm reduction


Abstinence for substance use refers to the complete avoidance or cessation of all drug or alcohol consumption. It is a goal-oriented approach where individuals commit to refraining from using any substances with the aim of achieving sobriety and eliminating the associated risks and negative consequences of substance abuse. Abstinence is often a central component of traditional addiction treatment programs and recovery models, emphasizing a drug-free lifestyle as the ultimate objective.

Harm reduction

Harm reduction for substance use, on the other hand, is a public health approach that focuses on minimizing the negative consequences of drug or alcohol use without necessarily requiring abstinence. It involves a range of strategies, such as needle exchange programs, supervised injection sites, and access to overdose-reversal medications, aimed at reducing the health and social harms associated with substance use, while also offering support and resources to individuals to make safer choices and seek treatment if they choose to do so.

The best therapy for treating SUD

Cognitive-behavioral therapy (CBT) in particular is an effective treatment for substance use disorders and their co-occurring mental health conditions—such as major depression and anxiety disorders. 

Research shows that online mental health treatment can be another effective treatment option for substance use disorders, especially if your treatment calls for more than traditional once-a-week therapy sessions.

Social support can also help to heal and reduce loneliness, while combating the shame surrounding substance abuse. Group therapy and family therapy facilitate open communication and help nurture healthy relationships, while support groups offer a chance to meet other people facing the same challenges. Some examples of support groups include: 

Seeking mental health support takes courage and a strong support system. Charlie Health is here to listen to your needs, answer your questions, and match you with an appropriate treatment plan. Learn more today

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