What substances do pre-teens and teenagers use most often?
Over the past decade, alcohol and cannabis have become teens’ and pre-teens’ most frequently used substances.
A concerning trend is that more teens are now also using e-cigarettes (or ‘vaping’). In recent research, more teens reported vaping than smoking a cigarette over the previous year.
Teens also seek to ‘get high’ with over-the-counter cold medications and prescription medications, including painkillers, ADHD medications and sedatives.
When do children and teens begin to try substances?
Research indicates that the average age of first use of alcohol is 15.8 years. For cannabis, the average age of first use is 15.4 years.
A smaller percentage of younger teens report using substances. For example, an Ontario school-based study shows that, over the previous year, one in 10 grade 7 students (about age 12) reported drinking alcohol and one in 50 grade 7 students used cannabis.
Binge drinking (having five or more drinks at one time) is common among teens and often takes place during drinking games. In a recent Ontario study, almost 40 per cent (two in five) of grade 12 students reported binge drinking in the previous month.
Some children may try a small amount of alcohol or tobacco at a younger age as part of their family’s cultural or religious practices. There is little evidence to say that drinking at a younger age either prevents or promotes future problematic substance use.
At what point should I become concerned that my child has a substance use disorder?
The more regularly a teen uses a substance, the more likely they are to experience related problematic signs and symptoms.
Firstly, regular substance use can be associated with a range of physical and mental health problems, difficulties at school and at home and trouble with the law. The health risks of substance use increase when a person uses more than one substance at a time, especially with alcohol.
Secondly, substance use can lead to dependence. When someone is physically dependent on a substance, they build up a tolerance to it and must use more of it over time to get the same effect. If they stop or try to use less of the substance, they experience physical symptoms (also known as withdrawal symptoms). The level of dependence is based on the substance, the amount your child or teen takes and how frequently they use it.
In addition, teens who have substance use disorders:
- miss school, work or other responsibilities due to substance use
- crave whatever substance(s) they are using
- fail to quit using despite trying to.
Does anything make a substance use disorder more likely?
A substance use disorder is more likely to develop if:
- a child or teen has a mental health condition (see below)
- there is a family history of addiction
- there is a history of abuse or other adverse childhood experience (also referred to as ACE)
- a child or teen identifies as LGBTQ2+
- a teen is street-involved (homeless).
Do issues with substance abuse occur with other mental health conditions?
About one-third to half of young people with a mental health condition such as depression, anxiety or ADHD will also develop a substance use disorder. This is called as a concurrent disorder. Of teens with a substance use disorder, one third to half will develop a concurrent mental health condition.
What should I do if I am concerned that my child or teen has a problem with substance use?
Monitor your child's behaviour and have an open conversation with them about anything you have observed and your concerns that they might be using drugs or alcohol. When addressing substance use with your child or teen, focus your concerns on their health and wellbeing.
When to see a doctor or health professional for specific help
If you have any concerns about problematic substance use, encourage your teen to see, or bring your teen for an assessment by, a health professional or another helping professional such as a guidance counsellor.
Let your teen know that you understand they may not want to share certain things with you as their parent or caregiver but that they can get information about their health and raise any concerns privately with their doctor.
As teens are generally healthy as a group, they may not see the need for an annual check-up. But it is a good idea to encourage your teen to have a check-up with their doctor or nurse practitioner to review their general physical, mental and social health. The check-up is an opportunity to identify the factors that might put your teen at risk for problematic substance use. It also allows a teen to talk to their health-care provider about any aspect of their health.
Please visit our teen mental health learning hub for information on substance use and substance use disorder.
References
Boak, A., Hamilton, H.A., Adlaf, E.M., & Mann, R.E. (2017). Drug use among Ontario students, 1977-2017: Detailed findings from the Ontario Student Drug Use and Health Survey (OSDUHS). CAMH Research Document Series No. 46. Retrieved from https://www.camh.ca/-/media/files/pdf---osduhs/drug-use-among-ontario-students-1977-2017---detailed-findings-from-the-osduhs.pdf?la=en&hash=2B434CDAAD485834497E3B43F2264BDEB255F29F
Canadian Centre on Substance Use and Addiction (n.d.). The Real Deal on Youth and Drugs. Retrieved from http://www.ccsa.ca/Eng/topics/Children-and-Youth/Real-Deal-on-Youth-and-Drugs/Pages/default.aspx
Canadian Centre on Substance Use and Addiction (2016). Marijuana: Fact and Fiction. Retrieved from http://www.ccdus.ca/Resource%20Library/CCSA-Marijuana-Fact-and-Fiction-Infographic-2016-en.pdf
Canadian Centre on Substance Use and Addiction (2017). Canadian Drug Summary: Alcohol. Retrieved from http://www.ccsa.ca/Resource%20Library/CCSA-Canadian-Drug-Summary-Alcohol-2017-en.pdf
Health Canada (2018). Canadian Student Tobacco, Alcohol and Drugs Survey 2016-2017. Retrieved from https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey.html