September 2011

Alcohol and Illicit Drug Use in Adolescence

It goes without saying that adolescents shouldn't use alcohol or illicit drugs. Both activities are illegal and dangerous to adolescents' health and safety. Still, by the time they reach their senior year of high school, 71 percent of adolescents have tried alcohol and nearly half have tried an illicit drug at least once.1,2 Although not all of the adolescents who try or use alcohol and drugs will develop an addiction, some will. In fact, more than one in 10 (12.5 percent) of youth ages 18 to 20 have an alcohol dependence, the highest rate of any age group.3,4

September is National Recovery Month, a time to spread the positive message to adults involved with adolescents that strategies to prevent substance use work, that treatment can help, and that young people can and do recover. The best way for adolescents to avoid addiction is to never use alcohol or drugs. However, if an adolescent does develop an addiction, early intervention can help them to avoid carrying that problem into adulthood.

Alcohol and Illicit Drug Use in Adolescence

The most common and harmful form of alcohol use among all adolescents is "binge drinking" (having four or more drinks for women and five or more drinks for men within a couple of hours).5 Although the percentage of high school students who binge drink has declined in recent years, about one in four high school seniors surveyed in 2010 had binged within the past 30 days of the time the survey was taken.5

In terms of illicit drug use, marijuana is the drug tried and used most often by adolescents, followed by prescription drugs without medical supervision, and then by inhalants and hallucinogens. After years of declining use, adolescents increased their use of marijuana between the mid-2000's and 2010.6

Two federal initiatives have set goals and specific targets for preventing and reducing alcohol and illicit drug use in adolescence: the U.S. National Prevention Strategy (a comprehensive plan to increase the number of Americans who are healthy at every stage of life) and Healthy People 2020 (the federal government's 10-year health agenda). Specifically, efforts are focused on reducing the number of high school seniors who have engaged in binge drinking and on reducing the number of adolescents, ages 12 to 17, who have used an illicit drug in the last 30 days.

Several factors influence whether an adolescent will develop an addiction to alcohol or illicit drugs. These include genetics (for example, whether their parents had a substance abuse problem), as well as the age that they start using alcohol or illicit drugs (the earlier in life they use substances, the higher their chances are of addiction).7,8

In a positive trend, the percentage of adolescents identified as having a substance dependency declined between 2002 and 2010. Still, in 2009 a substantial number (about eight percent) of all adolescents ages 12 to 17 required specialty treatment for problems with alcohol and illicit drugs.9 This includes 1.1 million adolescents suffering from alcohol dependency, and 1.2 million with an illicit drug problem. Of those youth in need, less than 10 percent received treatment. This low number is a result of a variety of reasons; however, the majority of adolescents with dependencies did not make an effort to get help, or did not think that they needed help.10

Healthy People 2020 aims to increase access to services and increase the proportion of adolescents that receive treatment for dependency issues by 10 percent by 2020, in addition to improving prevention and screening activities for other adolescent substance abuse issues. More information on substance abuse prevention and intervention programs proven to work can be found in SAMHSA's National Registry of Evidence-Based Programs and Practices (NREPP).

Did you know?

The more risk (likelihood of harm) that adolescents believe is associated with a substance, the less likely they are to use it. Unfortunately, between 2002 and 2010, the percentage of adolescents ages 12 to 17 who perceived "great risk" from using heroin, cocaine, LSD, and marijuana actually decreased. At the same time, the percentage of youth that perceived great risk in binge drinking increased.11

Additional Adolescent Health Resources: Preventing and Recovering from Addiction

1 Substance Abuse and Mental Health Services Administration. (2011). Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Available at

2 Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2010). Monitoring the Future: National results on adolescent drug use: Overview of key findings, 2010. National Institute on Drug Abuse.

3 Galson, S.K. (2009). Surgeon General's Perspective: Preventing and Reducing Underage Drinking. Public Health Reports. January - February 2009, Volume 124. Available at

4 Hingson, R. (2010). Recent Trends and Findings Regarding the Magnitude and Prevention of College and Underage Drinking Problems. Presentation at the 2010 conference of the National Institute on Alcohol Abuse and Alcoholism. Available at

5 Centers for Disease Control and Prevention. (2010). 1 in 4 high school students and young adults report binge drinking. 60 percent of high school students who drink, binge drink. Press release available at

6 See SAMHSA, 2011. Figure 8.4. Past Month Marijuana Use among Youths in National Survey Drug Use and Health, Monitoring the Future, and Youth Risk Behavior Survey: 1971-2010.

7 Lynskey M.T., Heath A.C., Bucholz KK, Slutske WS, Madden PAF, Nelson EC, Statham DJ, Martin NG Escalation of drug use in early-onset cannabis users vs co-twin controls. JAMA 289:427-33, 2003

8 U.S. Department of Health and Human Services. (2007). The Surgeon General's call to action to prevent and reduce underage drinking. Rockville, MD: Office of the Surgeon General. Retrieved September 8, 2011, from

9 See SAMHSA, 2011.

10 See SAMHSA, 2011.

11 See SAMHSA, 2011.

Last updated: March 10, 2016