Chapter 37. Adolescent Substance Abuse

Yifrah Kaminer, M.D.
DOI: 10.1176/appi.books.9781585623440.360150



Childhood and adolescence are not only critical phases for normal development but also periods when various pathological behaviors or disorders including substance use disorders (SUDs) are first recognized. Substance use among American youth rose to alarming rates between 1992 and 1997. Since then it has decreased significantly for alcohol, tobacco, and all drug classes but prescription opiates, the use of which continues to increase (Johnston et al. 2006). There is a concern regarding the short- and long-term physical and mental health outcomes of adolescents who use psychoactive drugs. The use of alcohol and other drugs is a leading cause of morbidity and mortality among adolescents from motor vehicle accidents, suicidal behavior, violence, drowning, and unprotected sexual activity, including unplanned pregnancy and sexually transmitted diseases (Blum and Nelson-Mmari 2004). Lifetime diagnoses of alcohol and drug abuse among adolescents in different states in the United States range from 3% to 10% (Harrison et al. 1998; Lewinsohn et al. 1996). The National Survey on Drug Use and Health reported that 6% and 5.4% of youth ages 12–17 years were classified as needing treatment for alcohol use and illicit drug use, respectively (SAMHSA 2006). Due to lack of motivation among youth, limited resources, lack of a broad consensus on preferred treatment strategies, and inadequate age-appropriate programs, only a small segment of adolescents in need of treatment end up receiving services.

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Table Reference Number

Adolescents are not "miniature adults."

Developmental perspectives need to be addressed in the design of any intervention.

Treatment is clearly better than no treatment, yet no single treatment modality has been found to be superior.

Dual diagnoses need to be assessed and the conditions need to be treated simultaneously.

Active aftercare is necessary to prevent relapse.


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Substance abuse among adolescents differs from that in adults. Which class of drugs showed an increase in abuse by U.S. adolescents from 1992 to 1997?
Various psychological factors are associated with problematic substance abuse in adolescents. Which of the following characteristics is not associated with an increased risk of adolescent substance abuse?
In addition to character and psychological traits within the patient, external/social factors are associated with adolescent substance abuse. Which of the following is not associated with adolescent substance abuse?
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