Substance Abuse

Substance Use

Substance use is the use of alcohol or illicit drugs. While the majority of children and adolescents who experiment with substances do not develop a substance use disorder, even occasional use can have serious consequences. Substance use increases the risk of fatal injury, especially in motor vehicle crashes.

Substance use disorders in children and adolescents are undertreated in the United States. In 2001, about 1.1 million American teens ages 12 through 17 met the criteria for substance abuse treatment, but fewer than 100,000 actually received treatment.1 Primary care providers should be able to identify and intervene with children and adolescents at risk for harm from substance use.2

Key Facts:

  • Thirty-one percent of 15- to 20-year-old drivers who were killed in motor vehicle crashes in 2006 had been using alcohol before the crash occurred.3
  • In the 2008 national Monitoring the Future study, 24.6 percent of high school seniors indicated that they had engaged in binge drinking (having at least five drinks in a row) in the 2 weeks preceding the survey.4
  • Nearly 43 percent of U.S. students have used marijuana and 25 percent have used an illicit drug other than marijuana by the end of high school.4
  • Sixteen percent of eighth-grade students and 43 percent of 12th grade students indicated that they had used alcohol in the last month.4
  • About 24 percent of those who die from suicide show evidence of alcohol intoxication.5


  1. Griswold, K. S., Aronoff, H., Kernan, J. B., & Kahn, L. S. (2008). Adolescent substance use and abuse: recognition and management. American Family Physician, 77 (3), 331-336.
  2. Rogers, P. D., & Heyman, R. B. (2002). Addiction medicine. Pediatric Clinics of North America, 49 (2), 245-246.
  3. National Highway Traffic Safety Administration. (2010). Teen Drivers - Additional Resources. Retrieved June 30, 2010, from NHTSA website:
  4. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2009). Monitoring the Future, National Results on Adolescent Drug Use: Overview of Key Findings, 2008. Bethesda, MD: National Institute on Drug Abuse.
  5. Crosby, A. E., Espitia-Hardeman, V., Ortega, L., & Clavel-Arcas, C. (2009). Alcohol and suicide among racial/ethnic populations -- 17 States, 2005-2006. Morbidity and Mortality Weekly Report, 58, 637-641.