Back to Blog

Talking to your teen: Mental health and substance abuse

Published on Jan. 14, 2022

The use of illicit substances in adolescents is a significant and often unrecognized problem that can be a great burden on not only the individual, but also their loved ones and the greater community. According to the 2020 National Survey of Drug Use and Health (NSDUH), 20.9% of teenagers aged 12 to 17 admitted to using illicit drugs (marijuana, cocaine, heroin, PCP, LSD, ecstasy, inhalants, methamphetamines, and/or prescription pain relievers) in their lifetime, with more than 17% reporting use in the past year. Nearly 23% of adolescents reported alcohol use at some point in their life, with 18.5% having used within the past year.

Although the types of illicit substances that adolescents use have shifted over the past several years, the consumption of alcohol has decreased and the use of electronic cigarettes, marijuana, ecstasy and opioids (e.g, fentanyl, heroin) has increased. Regardless of these changes, the result is still the same: substance use remains a significant issue.

When and how do I start talking to my child about drugs and alcohol? 

As parents and caregivers, the most important thing you can do is start by having open and honest conversations. It is crucial to start these conversations early, in grade school, because most children that age have not begun to use any illicit substances, and parents are still the most powerful influence in their child’s life. Talk honestly and openly with your child. Ask your child what they heard or what they know about drugs. Remember to ask in a non-judgmental way, use open-ended questions and listen. This way, you are likely to get an honest response. Talk about healthy choices, risky behaviors and the negative effects of drug and alcohol use.

"I would know if my child is using drugs or alcohol, right?"
According to the Mott Poll Report, parents are often unaware of their child’s drug or alcohol use. According to the poll, only 10% of parents of teens 13 to 17 years old believed their child had consumed alcohol in the past year, while 5% believed their teens had used marijuana in the last year. The same teenagers self-reported that 52% of them drank alcohol and 28% had used marijuana.

What are some signs that my child might be using drugs or alcohol? 

  • Withdrawing from friends/family members
  • Decreased interest in personal hygiene and overall appearance
  • Physical changes such as sunken eyes, bloodshot eyes, weight loss
  • Poor memory, difficulty finding words when speaking
  • Sudden behavioral problems, poor or falling grades in school
  • Getting in trouble with the law

Drug use in teenagers is usually precipitated by significant events, which can include: 

  • Peer pressure, especially if the child is spending time with peers who use drugs
  • Trauma including sexual, emotional, physical abuse 
  • Family conflict (e.g., parental divorce, worry about family finances)
  • Recent death in the family
  • Pre-existing depression or anxiety

While some teens may use drugs and alcohol to get high, others may be using drugs and alcohol to manage or cope with academic, social, emotional, or physical stress.

Because drug use can be associated with increased risk of poor grades, violence, homicides, suicides and habitual drug use in adulthood, it is important to recognize the signs and intervene early.


Are there ways to help my child say no to drugs?

Have a discussion with your child about how to say no to drugs. One of the best ways to say no to drugs is to make up excuses or be honest and confident. These are only some of the examples you can teach your children.

  • “My parents are picking me up in a few minutes, and they would kill me if they ever found out.”
  • “I’ve smelled that before, and I bet it tastes nasty!” (e.g. when referring to alcohol or marijuana)
  • “I’m actually not into that kind of stuff.”
  • “Thanks, but I don’t drink/use drugs. I’ve got an important test/competition/meet/performance coming up and I need to do my best/be at the top of my game.”

It may be helpful to role play with your child to help them become more comfortable saying no.

I think my teenager is using. Now what? 

Finding out that your teen may be using drugs or alcohol can be very scary. Any conversation you have is likely to be uncomfortable, and could end in frustration and anger. Before you have a conversation, prepare yourself – because the more informed you are, the better the outcome will likely be. There are many resources available for teenagers and parents to help guide you through this difficult time. These include: 

  • Online resources:
    •  Partnership to End Addiction,, is a great  resource for prevention, education, support, and intervention.
    • SAMHSA (Substance Abuse and Mental Health Services Administration) has a national help line which is a free, confidential, 24/7/365 referral and information service: 1-(800)-662-HELP (4537) or online at SAMHSA also has free publications to download on substance use disorders and mental health:
  • School support: Talk with school counselors. Most schools have counselors trained to guide teenagers struggling with drug or alcohol use. They can help by discussing the availability of therapy and educational intervention. 
  • Individual therapy: Talk to your teenager’s pediatrician about getting established with individual therapy, particularly cognitive behavioral therapy (CBT). Talking things out can really help work out what your child is going through. 
  • Family-based therapy: It may also be helpful for families to undergo family behavior therapy (FBT) together. This allows families to address behaviors and co-existing conditions, learn new coping skills, and apply those strategies.
  • If you are concerned about a prescription medication, safeguard your prescriptions by counting pills and keeping them locked up.
  • Visit Valley Children's 360me site, which provides strategies for parents to discuss mental health with their children.


You are your child’s greatest ally. The discussions you have with your child about drugs and alcohol may not always be easy, but they are a way to create a space for them to honestly discuss drug and alcohol use and the pressures they may face to do so. By taking a non-judgmental and open approach, you can help your child develop the skills to navigate growing up drug- and alcohol-free.


About the Author

Dr. Krystal Jin is a second-year pediatric resident with Valley Children’s Pediatric Residency Program. She is an advocate for mental health, especially for at-risk and underserved youth.