Study: 1 in 4 Substance Users Under 18 Become Addicted

Published: June 28, 2011

NEW YORK—Nine out of 10 Americans who meet the medical criteria for addiction started smoking, drinking, or using other drugs before age 18, according to a national study released today by the National Center on Addiction and Substance Abuse (CASA) at Columbia University.

The report reveals that adolescence is the critical period for the initiation of substance use and its consequences. The CASA report finds 1 in 4 Americans who began using any addictive substance before age 18 are addicted, compared to 1 in 25 Americans who started using at age 21 or older.

Adolescent Substance Use at Epidemic Levels

The CASA report underscores the fact that addiction is a disease with adolescent origins. The underdeveloped teen brain makes it likelier that teens will take risks, including using addictive substances that interfere with brain development, impair judgment and heighten their risk of addiction.

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The CASA report reveals that:

  • 75 percent (10 million) of all high school students have used addictive substances including tobacco, alcohol, marijuana or cocaine; 1 in 5 of them meets the medical criteria for addiction.
  • 46 percent (6.1 million) of all high school students currently use addictive substances; 1 in 3 of them meets the medical criteria for addiction.
  • 72.5 percent have drunk alcohol;
  • 46.3 percent have smoked cigarettes;
  • 36.8 percent have used marijuana;
  • 14.8 percent have misused controlled prescription drugs; and
  • 65.1 percent have used more than one substance.

“Addiction is a disease that in most cases begins in adolescence so preventing or delaying teens from using alcohol, tobacco or other drugs for as long as possible is crucial to their health and safety,” said Susan Foster, CASA’s Vice President and Director of Policy Research and Analysis. “We rightfully worry about other teen health problems like obesity, depression or bullying, but we turn a blind eye to a more common and deadly epidemic that we can in fact prevent.”

American Culture Drives Teen Substance Use

The report finds that American culture, broadly defined, actually increases the risk that teens will use addictive substances. A wide range of social influences subtly condone or more overtly encourage use, including acceptance of substance use by parents, schools and communities; pervasive advertising of these products; and media portrayals of substance use as benign or glamorous, fun and relaxing. These cultural messages and the widespread availability of tobacco, alcohol, marijuana and controlled prescription drugs normalize substance use, undermining the health and futures of our teens.

Forty-six percent of children under age 18 (34.4 million) live in a household where someone 18 or older is smoking, drinking excessively, misusing prescription drugs or using illegal drugs.

Less than half (42.6 percent) of parents list refraining from smoking cigarettes, drinking alcohol, using marijuana, misusing prescription drugs or using other illicit drugs as one of their top three concerns for their teens; almost 21 percent say that marijuana is a harmless drug.

The report also finds that many teens with other challenges such as a family history including a genetic predisposition, a co-occurring health problem, or a victim of trauma are at even higher risk of substance use and addiction.

The CASA report contains a full list of recommendations that include:

  • Educating the public that teen substance use is a public health problem and addiction a medical problem that in most cases originates in adolescence.
  • Preventing or delaying the onset of substance use through effective public health measures.
  • Identifying teens most at risk through routine screenings.
  • Intervening early to prevent further use and consequences as with any other public health problem.
  • Providing appropriate medical treatment to teens for substance use disorders.

“The problem is not that we don’t know what to do, it’s that we are failing to act,” noted Foster. “It is time to recognize teen substance use as a preventable public health problem and addiction as a treatable medical disease, and to respond to it as fiercely as we would to any other public health epidemic threatening the safety of our children.”

Read the report

Read the press release

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