By the time they reach their junior year of high school, about 52 percent of kids in California have had an alcoholic drink at least once, while 43.5 percent, 40 percent, 22 percent and 6 percent have gotten high at least once using cold or cough medicine, marijuana, prescription pain medicine, and cocaine or amphetamines, respectively. Nationally, 16.5 percent of high school seniors say they binge drink, and 24 percent of youth in eighth through 12th grades use marijuana.
A number of factors can make it more likely for teens to use or abuse drugs and alcohol — ranging from psychiatric illness, a history of trauma or neglect, and hanging out with drug-using peers to genetics, availability and coming from a low socioeconomic background. However, unrealistic expectations and lack of accurate information are often strong contributors, says Kara Bagot, M.D., a child and adolescent psychiatrist at Rady Children’s Hospital-San Diego and an assistant professor within University of California San Diego School of Medicine’s Department of Psychiatry. She continues to explain that a large part of misinformation stems from using search engines, or even social media, to research substances. “They are frequently directed to other sites, forums or chats that have inaccurate or misleading information on drugs. Studies have found that incorrect information increases the risk of adolescents trying substances they may not otherwise have tried.”
To help offset this, parents or caregivers can be great fact-checkers. Not sure how to broach the topic? Use Drug and Alcohol Facts Week (Jan. 22 through 27) as a starting point. “Substance use initiation is early, especially among [kids] at high risk,” Dr. Bagot says. “As such, these conversations should occur during childhood. Parents can approach the subject by acknowledging that their children will likely be exposed to [alcohol and drugs], that some of their friends will be using, and discussing the age-appropriate consequences of use. Establishing an open dialogue … about these issues, where children feel as if they can approach their parents about concerns without fear of repercussion, is important.” If you’re still feeling a bit uncomfortable with such a heavy topic, don’t sweat it, and you’re not alone. “Pediatricians can also be very helpful in initiating discussions,” suggests Dr. Bagot.
Talking about drugs and alcohol can also happen over multiple conversations, so if it seems like too much to cover at once, consider starting with the most common substances — alcohol; nicotine, especially through “vaping;” and marijuana. With fun packaging and tasty-sounding flavors, vape products are primed for teen consumption, and for many young users, appearances are very deceiving — more than 60 percent of youth think the inhaled vapor is simply a flavor and not harmful or addictive. In addition, with many states legalizing or decriminalizing marijuana, teens may underestimate its effects and be more inclined to use at an early age. For example, many adolescents don’t believe that different potencies and strains of marijuana cause different levels of cognitive and motor impairment, or that marijuana is addictive. There are also climbing rates of adolescents driving under the influence of marijuana, and about 30 percent of teens believe being high actually improves their driving abilities.
So, how can you respond if you discover your child has started or has been using alcohol or drugs? Keep the conversations on risks and safety going. It’s also important to take note of signs that differentiate use from abuse — while neither is good for teens’ well-being and should be addressed, “significant consequences of use distinguish the two groups,” says Dr. Bagot. She notes that “legal trouble or juvenile justice involvement, trouble at school, and negative health or mental health consequences” are significantly more likely in teens who regularly and heavily use substances, versus teens who may occasionally partake or experiment. Per the National Institute on Drug Abuse, any of the following may indicate a child is facing a substance addiction and needs professional help:
- Exhibiting sudden, unexplained changes in behavior, such as fatigue, depression or hostility
- Changing friend groups
- Neglecting grooming or personal hygiene
- Skipping school or performing poorly in classes
- Losing interest in hobbies
- Changing sleeping or eating patterns
- Allowing relationships to deteriorate
Keeping youth informed about substances from an early age can also help keep them safe and healthy. For more information on talking to your kids about drugs and alcohol, visit the Rady Children’s website.
 Gregory Austin et al, School Climate, Substance Use, and Well-Being Among California Students, 2013 – 2015: Results of the Fifteenth Biennial Statewide Student Survey, Grades 7, 9, and 11, WestEd Health & Human Development Program, 2016, surveydata.wested.org (PDF).
 Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use: 1975-2017: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.
 National Institute on Drug Abuse: https://www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes. Accessed 12/20/2018.
 D’Amico et al. Understanding Rates of Marijuana Use and Consequences among Adolescents in a Changing Legal Landscape. Curr Addict Rep, 2017; 4(4):343-9.