Teenage Drug Use: The Most Common Substances Used By Teens

Medically reviewed by Elizabeth Erban, LMFT, IMH-E
Updated May 31, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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Teen substance use is not a new phenomenon, but it's certainly a cause for concern. Although raising a teen who is struggling with substance use can be a frightening time for parents, there are many addiction treatment options available for adolescents who are engaging in the use of alcohol and illegal drugs.

Teens use drugs for many reasons, from seeking a way to fit in with peers to coping with stress and anxiety. As teenagers are more likely to succumb to peer pressure and risk-taking behaviors, it’s important for parents to talk openly with their children about the dangers of substance use. It’s also important for adolescents to be aware of their own family history and risk factors so they can be better prepared to make healthy choices.

Read on to learn about teen drug use, the most commonly used drugs by teens, the mental health issues surrounding adolescent substance use, and how to get professional treatment.

Is your teen acting irritable, withdrawn, or out of character?

What are the warning signs of addiction in teens?

The warning signs of teenagers' substance use can include irritability, a loss of motivation, and unexplained appetite increases.

Determining the difference between standard age-associated behavior and symptoms of substance use can be difficult. Many adolescents begin acting more irritable and discreet as they grow up. However, when drug and alcohol use is involved, the signs can become more pronounced.

It is important to watch for physical changes such as red eyes or dilated pupils, a lingering smell of drugs and alcohol on clothing, sudden weight loss or gain, frequent nosebleeds (a symptom of cocaine use), and an increased body temperature. Behavioral changes can include a sudden drop in grades, skipping school or activities, neglecting responsibilities, avoiding eye contact, change in friends, and using cash rather than an ATM card.

Adolescents may also develop patterns of substance use that can be difficult to spot: they might hide drugs where it is difficult to find them or take drugs with others in social settings. It is important to note that drugs used by teens are often more dangerous than those used by adults. In teens, drug use can cause permanent damage to the central nervous system and lead to becoming addicted faster than in adults.

It is crucial for parents and guardians to be aware of the signs of substance use in order to prevent their children from becoming addicted or experiencing adverse effects of alcohol use or other drug-related issues. If communication is challenging, family therapy or parent therapy through online counseling could help improve the family unit’s mental health as a whole.

Although adults are certainly not immune to substance use, the high school age group seems to be particularly susceptible to the lure of addiction. Mental health, hormone surges, and environmental pressures, such as their families and living situation, can all play a role in a teenager’s decision to partake in alcohol and/or drug consumption, particularly prescription pain medications. Teens are at increased risk for addiction due to their developing brains and lack of life experience.

Even if teens are not using their own prescription or illicit drugs, they may take them from family and friends. This can be very dangerous and can quickly develop into an addiction.

Pharmaceutical use: Prescription supplements

The most common pharmaceuticals or prescription drugs that teens use are Adderall and Vicodin, both common drugs that may initially be prescribed for adolescents and young adults. Adderall is most known and prescribed for attention-deficit/hyperactivity disorder (ADHD) formerly called attention deficit disorder or (ADD) and is one of the many stimulant drugs used to boost academic performance. Stimulants are one of the most common drugs prescribed to children and adults with ADHD to help improve their attention, alertness, and focus.

Vomiting, uncontrolled shaking, and difficulty sleeping are all symptoms of Adderall use, and because it's an amphetamine, drug addiction is possible. Addiction treatment for Adderall could be handled through therapy and medical intervention, or it may require in-patient facilitation such as a teenage rehabilitation program.

Vicodin is the second most common prescription pharmaceutical teenagers use. Vicodin is one of many prescription painkillers, and overuse of it can lead to dizziness and fainting spells. As an opioid, Vicodin is highly addictive, and even short-term use of opioid drugs can have serious consequences, though often the perceived risk is low since it can be prescribed. Vicodin has limited availability compared to other common drugs, but still, overdose is a common source of danger associated with Vicodin. Overdose symptoms include a weak pulse, confusion, and inadequate air intake. Similar to heroin, Vicodin can be snorted or injected, increasing the risk of addiction and overdose. Addiction treatment programs range from an inpatient facility with follow-up treatment to pharmaceutical use therapy and lifestyle interventions.

A third common and highly dangerous substance that high schoolers use might not seem like a substance at all– inhalants. Some teenagers will misuse inhalants because they give a very quick buzz; however, there's no safe way to use inhalants, and every time an inhalant is used, the user is risking death. Inhalants are used frequently because they are very easy to acquire, being common household objects. It's important for parents to be aware that some common household products teens misuse, as it could lead to serious health complications or death. Inhalants can include whipped cream, spray deodorant, or even nail polish remover fumes. Treatment for inhalant use includes support groups, drug use therapy, and potentially in-patient facilitation.


The number one drug used by high schoolers

So, when it comes to teen substance use, a common question is: “What is the number one drug used by teens?”

Well, it might not come as a huge surprise to some people due to their availability, but alcohol and tobacco are consistently the most used drugs, followed by cannabis. According to the CDC, 16.5% of high school students reported using any tobacco product in the past month. The most common tobacco product high school students employ is electronic cigarettes, also known as vapes. In 2022, approximately one of every seven high school students (14.1%) reported using electronic cigarettes in the past 30 days.

Although recreational marijuana use has been legalized in some areas, recreational use requires that individuals be an adult, and is not available to individuals under the age of 21. Consequently, if marijuana is being smoked or ingested by anyone under the age of 21, it's still considered illegal, which is very similar to laws in the U.S. regarding purchasing and drinking alcohol. The National Institute on Drug Abuse found that marijuana use exceeded all other substances; of the high school seniors using illicit substances, 22% of high school students in 2019 reported using the psychoactive drug marijuana within the past 30 days.

According to the National Institute on Drug Abuse, the most common means of consuming marijuana among teenagers is smoking or ingesting synthetic cannabinoids, called K2 or Spice. Although marijuana is not necessarily safe for teens to smoke or ingest, K2 and Spice actually present more dangers than the natural compounds found within marijuana. Initially created in a lab to study the effects of marijuana, K2 and Spice were co-opted by dealers, and a spike in these dangerous narcotics occurred in 2011, launching it to become one of the most common drugs used by teens.

While marijuana smoking or ingestion is not ideal, it does not present with many of the same concerns that synthetic cannabinoids do, including physical effects like the presence of a racing heart, seizures, psychosis, hallucinations, paranoia, shortness of breath, and chest pain. These synthetic compounds were linked to fatal symptoms in Connecticut in 2018, wherein users experienced bloody noses, bloody urine, coughed-up blood, and internal bleeding.

Although they are marketed as “synthetic marijuana,” to link to the same effects of marijuana, K2 and Spice are synthetic chemical cocktails with no control or consistency and these drugs can present a very real hazard to teenagers.

Risk factors of teen drug use

Although being an adolescent or young adult is, on its own, a risk factor for substance use, there are additional factors that could play a role in the development of drug use behaviors and addiction, including:

  • People, especially teens, who have greater reach to illicit compounds (including pharmaceuticals) are more likely to struggle with use or addiction
  • Teenagers who live or grow up in poverty have a higher likelihood of substance use and declining mental health
  • If a parent has struggled with substance use (and alcoholism in particular), their child is more susceptible to developing the same addiction
  • Trauma has been linked to addiction in people of all ages and backgrounds, and teenagers who have been exposed to trauma are far more likely to use alcohol and narcotics, take unnecessary risks, and potentially require addiction treatment (treatment of the trauma itself may lessen this risk factor, as this risk factor may be directly related to mental health and mental health needs).

While risk factors might initially seem frightening, they are not guaranteed; young adolescents, older teens, and adults who possess all the above risk factors are not resigned to addiction or permanent brain damage. Nevertheless, these risk factors can alert parents to the possible likelihood of addiction and encourage preventative measures. It may be wise to keep drug tests in case of concern.

Is your teen acting irritable, withdrawn, or out of character?

Addiction treatment for adolescents

Teen substance use and teenage drinking in the US are now becoming a cause of concern. The number one killer of teenagers is accidents. Drug poisoning is a subcategory under accident and alcohol consumption is a significant factor in motor vehicle accidents. Substance use is frightening and can be difficult for parents and teenagers to discuss freely and openly amongst each other and with a neutral person, such as with school counselors or other licensed mental health professionals.

Addiction treatment ranges significantly in its scope, duration, and setting. In some cases, addiction can be treated through therapy, such as the online therapy provided through BetterHelp. In other cases, substance use has grown significant enough (such as with misused prescription medications) to require the intervention of an addiction treatment facility. Whatever the case, teenagers' substance use and addiction are treatable, and parents, young adults, and adolescents alike can begin seeking treatment options now.

Can online therapy help teens overcome substance use?

Teens experiencing challenges with drug use may find online therapy to be a valuable resource. At times, they may feel judged or misunderstood by their parents, and talking to a neutral party might help them better understand the negative impacts that drug use can have on their cognitive development and future opportunities. With flexible scheduling, online therapy platforms like TeenCounseling enable adolescents to schedule appointments from the comfort of their own rooms. This feature may help them feel a greater sense of agency, especially if they feel smothered by their parents (who are likely very concerned and well-intentioned in their response).

Several recent studies exploring the efficacy of online therapy interventions for teens engaging in risky drinking and drug-use behaviors show promise. In one study, a web-based and text messaging-based intervention was successful in reducing risky single-occasion drinking in young people (drinking at least five standard drinks on a single occasion for young men and four on one occasion for young women). In a different study analyzing the impact of a web-based motivational intervention for adolescents at risk for substance use, researchers found that the intervention was effective in reducing teen drinking risks and existing substance use concerns.


Supporting a teen who is having trouble overcoming substance use can be challenging, especially when parents and other compassionate caregivers are unfamiliar with the symptoms of commonly used drugs like Adderall, Vicodin, inhalants, and synthetic cannabinoids. Knowing what the influence of these substances feels like is not as important as being there for a struggling teen. Where you, as a parent, may not be the most qualified to provide treatment, there are trustworthy and reliable resources like TeenCounseling that you can recommend to help your teenager make decisions that serve them.
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