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Association Between Substance Use and Suicidal Behavior in Adolescents

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

Adolescence is a critical period in life, characterized by drastic physical, mental, and psychological changes. Young people between the ages of 13 and 19 begin to gain a sense of independence and determine their place in the world. These developmental years typically set the stage for the remainder of their lives.

It’s also a time when peer pressure, experimentation, and testing boundaries are prevalent. Teenagers learn about sex, romance, and relationships. The symptoms of mental health disorders may also start to appear. Adolescents may start to use drugs or alcohol, which increases risk of other serious problems, such as addiction, depression, and suicidal behavior. With the increase in teenage experimentation with substances over the past decade, it’s crucial to consider the association between substance use and suicidal behavior in adolescents.

This article will address the following questions:

Does substance use increase the chances of suicidal ideation and behavior among adolescents?

Is the problem more prevalent than parents realize?

How can you help your child if you notice signs of substance use or you’re concerned about their mental health?

Rates of Adolescent Substance Use

Drug and alcohol use by young people can negatively impact brain growth and development. The earlier a person starts using substances, the more likely they will experience substance user problems later in life. It also increases their chances of risky behaviors such as unprotected sex, reckless driving, and/or self-harm.

Unfortunately, teenage substance use is an ongoing problem. Alcohol, marijuana, and tobacco are substances most often used among adolescents.1 Studies show some alarming facts about substance use in 9th- to 12th-grade students:

  • Two-thirds of students have tried alcohol by their senior year of high school
  • 50% have used marijuana
  • 40% have tried smoking cigarettes
  • 20% of 12th graders have used prescription medication without a prescription

Fortunately, most adolescents remain at experimental levels with their substance use. However, some young people report problems with their alcohol and drug intake.2 According to the National Survey on Drug Use and Health:

  • 6.3% of adolescents have a substance use disorder (1.6 million young people)
  • 2.8% of adolescents have an alcohol use disorder (721,000 young people)
  • 4.9% of adolescents have an illicit drug use disorder (1.2 million young people)

Suicide Among Adolescents

Suicide is a growing problem among adolescents. Extensive research shows that self-harm, suicidal ideation, and suicide attempts have become major public health concerns for people between the ages of 12 and 19.3

The National Survey on Drug Use and Health reveals that 3.0 million young people aged 12 to 17, or 12% of the adolescent population, reported thoughts of suicide in 2020. Among these adolescents, 1.6 million experienced suicidal thoughts only, 1.3 million had a plan, and 629,000 made a suicide attempt.2

Additionally, a report from The Trust for America’s Health showed that suicide rates nearly doubled for youth 17 years and younger over the last 10 years. The report also notes that rates tripled among girls ages 10 to 14.4

These gut-wrenching statistics prove that suicidal ideation and behavior among adolescents is a pressing problem. And it’s even more alarming when evidence shows connections between suicidal behavior and substance use in adolescents.

The Relationship Between Substance Use and Suicidal Behavior

Researchers are concerned by the increased numbers of adolescents who use substances and experience suicidal ideation. Systematic reviews of existing research reveal a nlink between substance use, suicidal ideation, and suicide attempts.5 Research also shows that the risk increases as substance use increases. Additionally, the more dangerous the substance, the greater the likelihood the user will experience suicidal behavior.

Early intervention in an adolescent’s substance use is vital to ensure their behavior doesn’t escalate. Other studies suggest that ongoing substance abuse is associated with more frequent and repetitive suicide attempts, more lethal  methods of suicide, an increased seriousness of intent, and greater rates of suicidal ideation.6

How to Keep Your Teen Safe

It may feel like a terrifying time to raise kids. With so much pressure coming at them from all angles, how can you, as a parent, keep them safe? While you can’t protect them from every danger that life presents, there are a few ways you can look out for your child.

Maintain Open Communication

The best way to keep your teen safe is to maintain an open line of communication with them. Teenagers aren’t the easiest to talk to as they work their way toward independence. But learning to communicate with your teen and letting them know you are a safe place to turn is crucial. The more your teen feels like they can speak with you honestly, the more likely they are to talk with you about problems they experience with substances, mental health struggles, and more.

Monitor Technology Use

The increased time kids spend on screens today, especially on social media apps, has many harmful effects. Social media is moderately associated with increased risk of mental health problems, lower self-esteem, shorter attention spans, a decrease in life satisfaction, and more.7 Left to their own devices, teenagers might establish an unhealthy relationship with technology. Monitor their device usage to ensure they aren’t spending too much time online.

Make Sure They Get Outside

Along with monitoring their technology use, make sure your teen spends time outside. Kids play outside far less often than they did in decades past, but exercise and time in the sun are linked to improvements in mental health.8 Get them involved in a sport or some other outdoor activity, so they have dedicated time outside of the house and away from devices.

Finding Help for Your Child

If your child shows signs of using alcohol or drugs or engages in suicidal ideation, help is available. Adolescent mental health and substance abuse treatment offers help, healing, and hope for struggling teens and their families. Programs like those at Evolve Treatment Centers take a dedicated interest in the complex needs of adolescents.

To learn more about the programs we offer, please call us today or submit an insurance verification form. We’re here to help every step of the way and are waiting to hear how we can best meet your teen’s needs.


  1. Centers for Disease Control and Prevention. (2020). Teen Substance Use & Risks.
  2. Substance Abuse and Mental Health Services Administration. (2021). 2020 National Survey on Drug Use and Health.
  3. JAMA. (2019). Suicide Rates Among Adolescents and Young Adults in the United States.
  4. Trust for America’s Health. (2021). Pain in the Nation: The Drug, Alcohol and Suicide Crises and Need for a National Reslience Strategy.
  5. Milligan Digital Repository. (2021). The Association Between Adolescent Substance Abuse and Suicidality.
  6. JAMA. (1990). Substance abuse and adolescent suicidal behavior.
  7. Mayo Clinic. (2022). Teens and social media use: What’s the impact?.
  8. Harvard School of Public Health. (2022). Boost your mental health by spending time outside.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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