National data confirm that for teens aged 12-17, use of any one substance -- alcohol, marijuana/THC, or cigarettes/nicotine -- dramatically increase the use of using the other two substances, and other illicit drugs. Similarly, not using any one substance dramatically decreases the likelihood of using the others. This means that for many teens, substance use comes down to making One Choice.

The Current Drug Scene

• Alcohol, Marijuana/Cannabis/THC and Nicotine are the most commonly used substances by youth because they are the most widely available
  

• It is in the financial interest of the alcohol, marijuana, and other drug industries to recruit and retain new users of their addictive products; profits are driven by heavy users. Consider the following:

  • Fruity flavorings of products, including alcohol products like alcopops and hard seltzers, appeal to teens
  • "Binge in a can" -- a 24 ounce can of malt beverage (e.g., FourLoko) can have the same amount of alcohol as an entire bottle of wine
  • The national explosion of the vaping industry (e-cigs, JUUL) which has marketed its products to underage users
  • A single vape pod can deliver as much nicotine as a pack of cigarettes
  • A growing number of high-potency products with over 90% THC have flooded the market as more states have legalized commercial marijuana/cannabis
  • THC products are largely unregulated or regulations go unenforced; just because a product is without a warning label does not make it safe

Alcohol

• Underage drinking is dangerous. NIAAA reports a range of risks and negative consquences because it:

  • Interferes with brain development
  • Causes many deaths among youth, including deaths from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides
  • Causes many injuries
  • Impairs judgment and can lead to poor decisions about taking risks, including unsafe sexual behavior, drinking and driving, and aggressive or violent behavior
  • Increases the risk of being the victim or perpetrator of physical and sexual assault
  • Can lead to other problems, including trouble in school or with the law.
  • Drinking alcohol also is associated with the use of other substances.
  • Increases the risk of alcohol problems later in life: Adults ages 26 and older who began drinking before age 15 are 5.6 times more likely to report having alcohol use disorder (addiction) in the past year then those who waited until age 21 or later to begin drinking

Marijuana/THC

• Marijuana/THC Produces Short- and Long-Term Adverse Health Effects (Volkow, et al.):

  • Effects of short-term use
    • Impaired short-term memory, making it difficult to learn and to retain information
    • Impaired motor coordination, interfering with driving skills and increasing the risk of injuries
    • Altered judgment, increasing the risk of sexual behaviors that facilitate the transmission of sexually transmitted diseases In high doses, paranoia and psychosis
      

  • Effects of long-term or heavy use
    • Addiction (in about 9% of users overall, 17% of those who begin use in adolescence, and 25 to 50% of those who are daily users)
    • Altered brain development
    • Poor educational outcome, with increased likelihood of dropping out of school
    • Cognitive impairment, with lower IQ among those who were frequent users during adolescence
    • Diminished life satisfaction and achievement (determined on the basis of subjective and objective measures as compared with such ratings in the general population)*
    • Symptoms of chronic bronchitis
    • Increased risk of chronic psychosis disorders (including schizophrenia) in persons with a predisposition to such disorders

Nicotine/Vaping

• Like cigarettes, nicotine delivery devices including vapes/e-cigarettes are unhealthy for youth

  • Nicotine, like other substances, harms the developing brain

  • Nicotine can also worsen anxiety symptoms and amplify feelings of depression.

Fentanyl

• Fentanyl is driving overdose deaths

  • Over 107,000 Americans died of a drug overdose in a 12-month period ending in December 2021, largely due to illicit Fentanyl

  • Criminal drug networks are mass-producing fake pills and falsely marketing them as legitimate prescription pills like oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®); or stimulants like Adderall®

  • Ironically, criminal drug networks are also mass-producing fake illicit drugs. The active ingredients in common illicit drugs like cocaine, MDMA, heroin, etc. are being replaced with Fentanyl. The entire business model of the illicit drug trade has changed because of how inexpensive Fentanyl is to manufacture and distribute.

  • Just one of these fake pills or one snort of fake illicit drugs can be deadly

  • Fake prescription pills and other illicit drugs are easily accessible and often sold on social media and e-commerce platforms, making them available to anyone with a smartphone, especially youth

Students in Prince George's County Public Schools in Maryland created a PSA in English and Spanish to warn their peers about fenanyl.

Misuse of Rx Drugs

• "Misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high)" - NIDA

  • Not only are legally prescribed medications diverted and misused, but illicitly produced fake pills are made to look like legal Rx drugs and in fact often contain illicit Fentanyl, which can be deadly

  • Take precautions in your own home by locking up medications and safely disposing of unused medications.

  • Find a safe disposal location near you

Support Our Work!

Support the One Choice prevention initiative of the Institute for Behavior and Health, Inc., a 501(c)3 non-profit organization, with a tax-deductible donation.

Know the risks of Youth Substance Use

• While no one starts using substances expecting to become addicted, 9 in 10 adults with a substance use disorder (addiction) began their use before age 18, many even earlier
• One of the best ways to reduce later risk of addiction is to delay first use
• Youth substance use a health issue, not a moral issue: substance use can change brain functioning and some changes may last even after a person has stopped using

• While it may not always feel like it, parents and caregivers have a powerful influence on teen behavior: what you say and do matters.
  • Develop clear expectations of no use of any alcohol, cannabis/marijuana, nicotine, or other drugs
  • Model healthy behaviors for your kids

• Talk about substance use as a health priority -- I care about your health and safety
  • Not using alcohol or other substances before age 21 is analogous to other health standards for youth. Parents/caregivers don't hesitate to set clear expectations about always wearing seat belts or bicycle helmets; why should substance use be different?

• Make sure your kids know they can count on you if they need to get out of a risky siutation and create a plan together (e.g., have a "code word" they can text you to say they need a ride)

• Don’t provide alcohol or other drugs to teens
  

Helpful Online links

• Partnership to End Addiction
• SAMHSA's Parents: Talk. They Hear You. Campaign
• Natural High
• National Council on Mental Wellbeing
• Parent Movement 2.0
• Operation Parent
• Addiction Policy Forum
• Drug Free America Foundation
• Community Anti-Drug Coalitions of America (CADCA)
• Drug Free Communities
• Substance-Free Athletics
• Parents Empowered
• Parents Helping Parents
• National Institute of Drug Abuse (NIDA)
• Every Brain Matters
• Johnny’s Ambassadors
• International Academy on the Science and Impact of Cannabis (IASIC)
• Smart Approaches to Marijuana (SAM)