Risk-taking is a key part of adolescent development. It helps young people develop their identity, build experience and gain peer approval. And for some young people, risk-taking will mean experimentation with alcohol and other drugs. To help keep Australian teenagers safe, conversations about substance use (and potential abuse) are important.
Substance use is common among young people, and for teenagers across Australia, alcohol is the most common substance used. But with one study showing alcohol use among Victorian teenagers had dropped, and a separate study showing that a growing number of young Australians are drinking less, there is some positive news.
For others, though, problems with substance abuse remain, including the adverse outcomes associated with excessive substance use. They include:
- In the short-term, excessive alcohol consumption increases the risk of physical injury from falls, violence and road accidents
- Long-term harms include liver and cardiovascular disease, cancers, obesity, as well as increased risk of mental illness
- Young drinkers have also been found to be particularly at risk of memory loss, violence, and unwanted sexual activity, as a result of alcohol use
- Substance use (cannabis use in particular has been researched in a number of studies) poses a risk for delayed social and academic development, and may also impact on brain development among adolescents
A substance can be anything that is ingested in order to produce a high, alter one’s senses, or otherwise affect mood, perception and consciousness. There are nine separate classes of drugs identified in the DSM-5 (1) that can involve in a substance use disorder: alcohol; cannabis; hallucinogens; inhalants; opioids; sedatives, hypnotics, and anxiolytics; stimulants (amphetamine-type substances, cocaine, and other stimulants); tobacco; and other (or unknown) substances.
Individuals have different patterns of use (bingeing, occasional or continual) and reasons for use (for example as an ‘experiment’, for ‘fun’ or to ‘escape’, to ‘join in’ with peers, or to get through a certain situation- such as the desire to stay awake). Where use is prolonged, heavy, or creating social or personal problems, it may meet a diagnosis for a substance use disorder.
Onset, prevalence, and burden of substance use
Substance use disorders are among the most common of mental health disorders experienced by young people. In Australia, 12.7 per cent of people aged 16-24 are estimated to have a substance use disorder, with higher rates among young men than young women (around 16% of males and 10% of females) (3). Harmful use of alcohol was the most commonly reported substance use disorder (at around 9%).
Studies have consistently demonstrated that the prevalence of substance use and abuse increases with age during adolescence and peaks in early adulthood. Overall, about half of people with substance use disorders first experience substance use issues by the age of 20 years.
Despite the high prevalence, people with substance use disorders often don’t recognise or seek help for the problem. They also may not be screened for substance use when they seek treatment for other health conditions, which means that substance use disorders are often under-recognised and under-treated. An Australia survey found that despite disproportionately high rates of substance use disorders in young people, there was a very low rate of help-seeking associated with these, particularly in young men.
In those aged 10-24 years, alcohol use is the fourth leading contributor to the burden of disease in males. The burden from substance abuse is more than three times as high in males as in females.
There is a close relationship between substance use disorders and other mental disorders, and use of some substances may increase the risk of developing certain disorders. However it is often unclear whether one issue causes the other. An Australian survey found high rates of comorbidity in those with substance use disorders. One in five Australians with a substance use disorder also met criteria for an affective disorder and one in three met criteria for an anxiety disorder.
Like adults, young people will use drugs for many reasons, these reasons might include to:
- feel good
- relax
- get high
- cope with stress, anxiety or feelings of depression
- deal with emotional pain or a history of trauma
- experiment
- stay awake
- fall asleep
- increase confidence
- lose weight
- enhance social experiences – such as partying.
While we know there can be negative consequences associated with alcohol and other drug use among young people, we also know simply telling a young person to stop using because it’s risky isn’t effective.
Why do young people use alcohol and other drugs?
The reality is that while many young people will experiment with alcohol and other drugs, the majority won’t develop a dependence or experience any significant harm from their use. For young people who do develop issues, it is more likely to be because of other factors, such as:
- traumatic life events/childhood experiences
- poor parental supervision
- mental health issues
- family violence or sexual abuse
- disengagement from family, school and/or peers
- easy access to alcohol or drugs
- poor academic performance
- family history of alcohol or drug use problems.
Risk factors
A number of factors can increase the likelihood that a young person will develop a substance use disorder (14-16). They include the following:
Related to the individual:
- Being male
- Tendency for disinhibited behaviour (e.g. engaged in risk-taking behaviours in childhood)
- Early age of first use (e.g. risk of alcohol dependence is four times higher for people who first tried alcohol before the age of 15 years, compared to before the age of 20 years)
- Personal beliefs (e.g. beliefs that substance use does not have a negative impact on health, or lack of belief in conformity or moral order)
- Low self-esteem
- Underachievement at school or low commitment to school
- Traumatic experiences (e.g. abuse as a child, or being bullied)
- Childhood ADHD or conduct disorder
- Other mental disorders (e.g. depression, anxiety)
- Poor coping skills (e.g. responding to interpersonal conflicts in an aggressive manner)
Related to the family:
- Parents or family members have a substance use disorder (heritability of substance dependence is estimated at 30-60 per cent)
- Parental attitude towards drugs and alcohol and parental role-modelling (e.g. seeing parents engaging in drug use)
- Low parental monitoring or discipline
- Poor family cohesion
- Patterns of negative communication in the family
Related to the community and society:
- Peers use drugs or alcohol
- Drugs or alcohol are readily available
- Acceptability of substance use
How young people use alcohol and other drugs
There are different ways young people use alcohol or drugs – we’ve listed some of the common ones below. But, there’s no typical use or progression, and not all drug use leads to problematic use or dependence.
- Experimental – alcohol or drugs are tried because a young person is curious, wants to fit in, or their friends are using.
- Recreational – alcohol or drugs are used socially, often to enhance experiences like clubbing or at festivals.
- Situational – alcohol or drugs are used to cope with the demands of a specific situation, such as using amphetamines to stay awake and study during exams.
- Intensive – alcohol or drugs are used to get relief or cope in multiple situations and settings – use is heavier and more frequent.
- Dependent – alcohol or drug use takes control. The brain is physically dependent on the substance, causing a preoccupation with drug-seeking/drug-taking behaviour often to the exclusion of everything else.
It’s important to note that even if a young person does experience these risk factors, it doesn’t mean they will necessarily develop an alcohol or drug dependence.
Protection factors
There’s also protective factors that can reduce a young person’s risk of developing an alcohol or other drug use problem. These include:
- good connections to family, school and community
- parental support and involvement
- good coping and problem-solving skills
- engagement in extracurricular activities
- high self-esteem.
What to look for
People tend to start drinking or using drugs for various reasons. Some may seek to self-medicate due to feeling isolated, depressed, or anxious. Others may use substances to relieve pain, escape from problems, attain ecstatic states, or feel more socially or spiritually connected. Adolescents often experiment with drugs because of peer pressure or wanting to fit in.
Because addiction can cause so much suffering, prevention is critical in order to avoid problems to begin with. As early as possible, parents need to try to educate their children about the serious potential consequences of drinking and abusing drugs. There are many helpful videos available online that parents can use to show their children some of the harmful effects associated with substance use.
In addition, parents need to be on the lookout for any warning signs that their child may have started drinking or using drugs. Some of the red flags that should be taken seriously include:
- Unusual behaviour. If your child has started acting in ways that are out of the ordinary, this could indicate there might be a problem. Some substances, for example, can cause an increase in aggression; others might cause agitation or lethargy. Any changes in normal behaviour should be explored with your child.
- Physical signs. If you suspect your child may be drinking or using drugs, be on the lookout for signs that might indicate this, such as red eyes, dilated pupils, slurred speech, unsteady gait, or appetite changes.
- Lower grades. Becoming involved with substance use may affect your child’s grades at school, so this should be a warning sign as well. If your child appears to be struggling academically, try talking to them to find out if they may be experiencing any problems you are not aware of, such as bullying, relationship issues, or feeling socially isolated.
- Changes in mood. If your child appears to be struggling with depression, anxiety, or feelings of inadequacy, they may be more prone to use substances as an unhealthy way to try to cope with their feelings.
- Family use of substances. Children are much more likely to use substances if someone else in the family has a drinking or substance abuse issue. Alcohol and/or drugs tend to be more accessible when used by another member of the family and may be seen by the child as an acceptable way of dealing with problems.
Keeping young people safer
The best way to connect with a young person is to step back and have non-judgmental and curious conversations about their use of alcohol or other drugs.
These conversations can allow you to understand why they are using, and the role it plays in their lives.
In many cases. your young person may see their substance use as something that’s needed or beneficial to them. Identifying this can help you work out what’s going on, and then find the best ways to support them.
For example, if your young person uses cannabis to help them sleep, you can help support their sleep by suggesting they try reducing their screen time, develop bedtime routines or avoid coffee and energy drinks in the afternoon/evening.
If they’re using a substance to help with stress, then together you could explore other alternatives for stress relief.
Supporting your young person and staying connected through open and honest conversations is important, regardless of whether they choose to reduce or stop their alcohol or drug use.
While there are always risks involved in using alcohol or other drugs, you can help reduce these by talking to your young person about minimising harms while using. Sharing these tips are a good start:
- make your own limits
- eat before using
- start slow and stay hydrated
- learn as much as you can about the substance you are taking, including harm reduction tips. Our drug facts pages are a good place to start
- remember you can never be entirely sure what’s in a drug
- avoid mixing drugs, including alcohol
- stay connected – never leave a friend on their own, and don’t head off with someone you don’t know
- don’t drink or take drugs on your own
- tell friends what you have taken in case you have a bad reaction
- know what to do if you have a bad drug reaction or drug-related emergency
- alcohol or drugs can make people less worried about danger – watch out for risks
- heading home – taxi, rideshare, public transport, parent or a friend who has not taken anything
- never drink or take drugs and drive, or travel with a mate that’s been drinking or taking drugs
- if you are worried, call 000 for an ambulance – they do not have to involve the police.
Help is at hand
If you discover that your child has a substance abuse problem, obtaining treatment as early as possible is extremely important. Treatment recommendations include individual therapy, as well as family therapy (which can be helpful to learn to understand the addiction and to repair any damages to relationships that may have occurred).
Attending a 12-step meeting, such as Alcoholics Anonymous or Narcotics Anonymous, can also be beneficial for ongoing support with sobriety. For some types of addiction, medical detoxification in a hospital setting may be needed prior to seeking out other forms of treatment.
If you’re worried about the amount of alcohol or drugs a young person is using, or the level of risk or harm they are being exposed to, it’s worth talking to a professional. We have some links to some excellent support services below.
Support services
headspace: 1800 650 890
Youth-specific mental health service specialising in engaging young people with concerns relating to mental health, physical health (including sexual health), alcohol and other drugs or work and study support. headspace offers ‘face to face’ counselling as well as e-counselling.
DrugInfo: 1300 85 85 84
Free, confidential and non-judgmental telephone and email information, advice and referral service for alcohol and other drug-related enquiries.
National Alcohol and Other Drug Hotline: 1800 250 015
24-hour phone line that offers telephone counselling, information, support and referral to treatment services for anyone seeking help for their own, or another person’s, alcohol or drug use.
Positive Choices: Parenting advice and information to help you talk to your children about drugs and alcohol.
