Teen Substance Use & Risks



Parents play a critical role in their children’s lives. As their children grow to pre-teens and teens, parents worry about new risks they may experience. One such risk is the use of substances, such as alcohol, marijuana, tobacco, and other drugs. Parents can help by talking to their teen’s pediatrician about screening for substance use. 

Substance use by teens can have a big impact on their health and well-being. The American Academy of Pediatrics (AAP), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC), developed a guide for implementing substance use screening in pediatric practices to help pediatricians address substance use concerns. The AAP recommends screening for substance use in children, starting at 9 years of age.

Substance Use Among Teens

The guide highlights the most commonly used substances and the extent of the problem, such as:

  • Alcohol, marijuana, and tobacco are substances most commonly used by adolescents.1
  • By 12th grade, about two-thirds of students have tried alcohol.1
  • About half of 9th through 12th grade students reported ever having used marijuana.2
  • About 4 in 10 9th through 12th grade students reported having tried cigarettes.3
  • Among 12th graders, close to 2 in 10 reported using prescription medicine without a prescription.1

Although it is illegal for people under 21 years of age to drink alcohol, the findings show that people from 12 to 20 years of age consume about one-tenth of all alcohol consumed in the United States.

Risks of Substance Use

The guide also highlights the risks of substance use among teens. Substance use can do the following:

  • Affect the growth and development of teens, especially brain development.
  • Occur more frequently with other risky behaviors, such as unprotected sex and dangerous driving.
  • Contribute to the development of adult health problems, such as heart disease, high blood pressure, and sleep disorders.

Finally, the earlier teens start using substances, the greater their chances of continuing to use substances and developing substance use problems later in life. When teens begin drinking at an early age, they increase the chance of becoming addicted to or continuing to abuse substances later in life.

Guide for Pediatricians

Pediatricians can help teens avoid and reduce substance use by talking with them about their use. The guide, Substance Use Screening and Intervention Implementation Guide: No Amount of Substance Use Is Safe for Adolescents[3 MB]https://www.cdc.gov/Other/disclaimer.html, provides helpful information for pediatricians to implement substance use screening and brief counseling in their practices. In addition, it provides guidance on protecting patient privacy and other key issues.

CDC Activities

CDC has conducted fetal alcohol spectrum disorders (FASD) research, identification, and prevention efforts since 1991. Key activities include

  • Monitoring how much and how often alcohol is consumed by women of reproductive age;
  • Supporting the implementation, adoption, and promotion of effective interventions, including
  • Promoting effective treatments for children, adolescents, and young adults living with FASDs and their families;
  • Enhancing healthcare provider education on preventing FASDs and identifying and treating people with FASDs;
  • Providing free online training courses on preventing FASDs and diagnosing and caring for people with FASDs; and
  • Offering FASD-related educational information and materials for women of reproductive age, healthcare providers, and the public.


  1. Johnson LD, O’Malley PM, Bachman JG, Schulenberg JE, Miech RA. Monitoring the Future national survey results on drug use, 1975-2013: Volume 1, Secondary school students. Ann Arbor, MI: Institute for Social Research, University of Michigan, 2014: 32-36.
  2. The PartnershipTM at Drugfree.Org. 2012 Partnership Attitude Tracking Study: Teens and Parents. 2013. 
  3. Kann L, Kinchen S, Shanklin SL, et al. Youth risk behavior surveillance–United States, 2013. MMWR Surveillance Summaries. 2014(63): 17-20.