Stress is a key factor driving some teens to drugs and alcohol, CDC study warns

Supporting and improving mental health could have a direct impact on substance use among teens in the United States, according to a new study from the US Centers for Disease Control and Prevention.

Teens who were being assessed for treatment for substance use disorder were asked to identify their motivations for using drugs and alcohol. About 9,500 responses were collected between 2014 and 2022.

The most common reason that teens said they turned to drugs and alcohol was to feel mellow, calm or relaxed, with nearly three-quarters citing this reason. Many other top reasons were related to methods to cope with stress, with 44% saying they use substances to stop worrying about a problem or forget bad memories and 40% said they use substances to help with depression or anxiety.

About half of teens also said they use substances to have fun or experiment, and more than two in five said they use substances to sleep better or fall asleep.

Substance use often begins in adolescence, which can put children at risk for fatal overdose and substance use disorders in adulthood, according to the CDC report. It can also have negative impacts on brain development.

The mental health of children in the US has become a key concern in recent years. Leaders in youth health declared a national state of emergency in child and adolescent mental health in 2021, and US Surgeon General Dr. Vivek Murthy has named youth mental health a key priority.

“The challenges today’s generation of young people face are unprecedented and uniquely hard to navigate. And the effect these challenges have had on their mental health is devastating,” Murthy wrote in an advisory from 2021. The Covid-19 pandemic “exacerbated the unprecedented stresses young people already faced.”

Another CDC report from May showed signs of improvement in the mental health of children and adolescents — with a dip in emergency department visits for mental health-related reasons — but it’s still considered a “substantial public health problem,” especially among teen girls.

A recent KFF analysis found that 1 in 5 adolescents have reported symptoms of anxiety or depression, and many are not getting the treatment that they need.

In 2021 and 2022, 21% of adolescents reported experiencing symptoms of anxiety in the past two weeks and 17% reported experiencing symptoms of depression, according to the KFF analysis of a federal survey with direct responses from adolescents. But in those same years, only 20% of adolescents reported receiving mental health therapy and 14% reported taking prescription medication.

While teens said they were most likely to use substances with friends, about half of teens have used drugs and alcohol alone, according to the new CDC study. This is a particularly concerning trend for the teens who use prescription drugs, as the “proliferation of counterfeit pills” that contain highly-potent fentanyl presents “significant risk for fatal overdose,” the report said.

“Educating adolescents on harm reduction practices, including the risks of using drugs alone and ensuring they are able to recognize and respond to overdose (e.g., administering naloxone), could prevent fatal overdoses,” according to the CDC report, and “reducing stress and promoting mental health among adolescents might lessen motivations for substance use.”

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