Other Youth Topics


  1. Youth Topics
  2. Substance Use/Misuse
  3. Prevalence of Substance Use, Abuse, and Dependence

Prevalence of Substance Use, Abuse, and Dependence

Evaluating the prevalence rates of substance use, abuse, and dependence is important because these rates document patterns of problems among youth.


Alcohol use among youth is more widespread than use of tobacco or illicit drugs. While alcohol use has been gradually declining among youth since the 1980s, and reached historically low levels in 2011, it continues to be a significant problem.1 According to the 2009 National Survey on Drug Use and Health (NSDUH), about 10.4 million youth ages 12 to 20 (27.2 percent) reported drinking alcohol in the past month.2

While findings suggest that youth drink less frequently than adults, they binge drink (defined as drinking five drinks or more in about two hours on at least one occasion) more than adults.3 According to the 2009 NSDUH, 6.9 million youth (18.1 percent of youth between the ages of 12 and 20) reported binge drinking and 2.1 million youth (5.4 percent of youth between the ages of 12 and 20) reported heavy drinking (defined as drinking five or more drinks on the same occasion on each of five or more days in the past 30 days).4  These rates are higher for youth and young adults than for any other age group and are higher for youth enrolled in college than their peers.5

Binge drinking and heavy drinking can lead to a number of health risks including overall development and specific effects on the brain, liver, and endocrine system. Individuals who reported starting to drink before the age of 15 were four times more likely to also report meeting the diagnostic criteria for alcohol dependence at some point in their lives. The younger youth are when they start to use alcohol, the more likely they will be to engage in harmful behaviors, such as using other drugs, having sex with six or more partners, and earning grades that are mostly Ds and Fs in school.6


Smoking cigarettes is the leading cause of preventable disease and death in the U.S and is most often initiated during adolescence. While the number of students reporting that “they had smoked within the past month” declined from 1972−2011, the number of youth who have tried cigarettes and those who reported daily use remains higher than the number of youth who have tried any other illicit drug. Also, teens report that it is “very easy” or “fairly easy” to get cigarettes. Among 8th, 10th, and12th graders in 2011, 27.8 percent had tried cigarettes in their lifetime and 11.7 percent reported that “they had smoked within the past month”.7

In addition to smoking cigarettes some youth, almost exclusively males, use smokeless tobacco, including snuff, snus, and chew, which can lead to disease, death, and dependence.8 The reported rate of smokeless tobacco use among youth has been declining, and 30-day prevalence is about half of the reported rate at peak levels in 1994 for all grades. 

Illicit Drug Use and Prescription Drug Abuse

Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type pain relievers, tranquilizers, stimulants, and sedatives used nonmedically.9 Learn more about commonly abused drugs.

While illicit drug use among youth is lower than tobacco and alcohol use, youth and young adults between the ages of 12 and 25 were more likely to be current illicit drug users than adults 26 and older.10 Marijuana is the most widely used of all illicit drugs among youth and many youth report that it is highly accessible.11 Studies report that the degree to which teens disapprove of marijuana use and the perceived risk associated with use, even regular use, has recently begun to decline. Changes in these beliefs and attitudes can be associated with driving changes in use.12 Painkillers are one of the most commonly used drugs by teens after tobacco, alcohol, and marijuana.13 The most popular prescription drugs are opioids and stimulants. Opioids, which include pain relievers such as OxyContin and Vicodin, are central nervous system depressants that are often used to treat anxiety and sleep disorders. Stimulants are often used to treat attention-deficit hyperactivity disorder and narcolepsy.14

Overlap Between Alcohol, Tobacco, and Illicit Drug Use and Abuse

Studies have found a connection between youth who use alcohol and tobacco, and those who use illicit drugs. Of the youth who reported heavy drinking (defined as drinking five or more drinks on the same occasion on each of five or more days in the past 30 days), 69.9 percent also reported they had used an illicit drug. In comparison, illicit drug use for those who were not current alcohol users (used alcohol within the past month) was reported at 5.2 percent.15  Youth who smoke tobacco are nine times more likely to meet the medical criteria for alcohol abuse and 13 times more likely to meet the medical criteria for illicit drug abuse and dependence. Neurological research suggests that nicotine can cause structural and chemical changes in teenage brains, increasing the risk of alcohol, marijuana, and opioid use.16

View the data section to find federal surveys and reports with more detailed and up-to-date prevalence rates for alcohol, tobacco, and illicit drug use and abuse.

Note: Getting accurate estimates of the prevalence of substance use and abuse among youth is difficult. These difficulties may occur for the following reasons: many national studies survey only students, but many at-risk youth do not regularly attend school, excluding them from these estimates; health care professionals may use procedure codes for treating associated symptoms of substance abuse, such as fatigue, irritability, weight loss, headache, abdominal pain, or depression; and surveys tend to rely on self-report, and youth may be less likely to report the truth for fear of getting in trouble. As a result, existing prevalence data likely is underestimated.


National Institute for Drug Abuse
The National Institute for Drug Abuse (NIDA) provides strategic support and conducts research across a broad range of disciplines and ensures the rapid and effective dissemination and use of the results of that research to significantly improve prevention, treatment, and policy as it relates to drug abuse and addiction.

NIDA for Teens: The Science Behind Drug Abuse
The goal of this site is to educate adolescents ages 11 through 15 and youth-serving organizations (as well as parents and teachers) on the science behind drug abuse. The site delivers science-based facts about how drugs affect the brain and body so that youth will be armed with better information to make healthy decisions. It uses elements such as animated illustrations, quizzes, and games to clarify concepts, test the visitor's knowledge, and make learning fun through interaction.

1 Johnston, O’Malley, Bachman, & Schulenberg, 2012
2 U.S. Department of Health and Human Services, 2010
3 National Institute on Alcohol Abuse and Alcoholism, 2007
4 U.S. Department of Health and Human Services, 2010
5 U.S. Department of Health and Human Services, 2010; SAMHSA, Center for Behavioral Health Statistics and Quality, 2012
6 Alcohol Alert, National Institute on Alcohol Abuse and Alcoholism, 2006
7 Johnston, O’Malley, Bachman, & Schulenberg, 2012
8 Johnston, O’Malley, Bachman, & Schulenberg, 2012
9 U.S. Department of Health and Human Services, 2010
10 U.S. Department of Health and Human Services, 2010
11 Johnston, O’Malley, Bachman, & Schulenberg, 2012
12 Johnston, O’Malley, Bachman, & Schulenberg, 2012
13 U.S. Department of Health and Human Services, 2010
14 National Institute on Drug Abuse, 2009
15 U.S. Department of Health and Human Services, 2010
16 National Center on Addiction and Substance Abuse, 2007

Youth Briefs

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Research links early leadership with increased self-efficacy and suggests that leadership can help youth to develop decision making and interpersonal skills that support successes in the workforce and adulthood. In addition, young leaders tend to be more involved in their communities, and have lower dropout rates than their peers. Youth leaders also show considerable benefits for their communities, providing valuable insight into the needs and interests of young people

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Statistics reflecting the number of youth suffering from mental health, substance abuse, and co-occurring disorders highlight the necessity for schools, families, support staff, and communities to work together to develop targeted, coordinated, and comprehensive transition plans for young people with a history of mental health needs and/or substance abuse.

Young Adults Formerly in Foster Care: Challenges and Solutions

Nearly 30,000 youth aged out of foster care in Fiscal Year 2009, which represents nine percent of the young people involved in the foster care system that year. This transition can be challenging for youth, especially youth who have grown up in the child welfare system.

Coordinating Systems to Support Transition Age Youth with Mental Health Needs

Research has demonstrated that as many as one in five children/youth have a diagnosable mental health disorder. Read about how coordination between public service agencies can improve treatment for these youth.

Civic Engagement Strategies for Transition Age Youth

Civic engagement has the potential to empower young adults, increase their self-determination, and give them the skills and self-confidence they need to enter the workforce. Read about one youth’s experience in AmeriCorps National Civilian Community Corps (NCCC).