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Alcohol and Substance Use Disorder in Teens


Recent statistics suggest that a growing number of adolescents struggle with alcohol or substance use disorder. The numbers are alarming: 1.3 million adolescents aged 12-17, and 5.8 million young adults aged 18-25, met the clinical criteria for alcohol use disorder. And, even more worryingly, there is a significant treatment gap for this age group, with only 5.8% of the first group, and only 8% of the second, receiving treatment.

This data paints a concerning picture for several reasons.

First, the negative effects of alcohol on the brain are well-known. While ethical considerations prevent a large-scale study of the effects on the still-developing brains of adolescents, researchers can draw conclusions from studies using animal models. Based on these studies, researchers theorize at a minimum, heavy use of alcohol during the teen years adversely affects memory and learning. This makes sense, since the adolescent brain is still developing, undergoing structural and functional changes.

Second, data suggests the memory-impairment effects of alcohol are more severe in adolescents than in adults. Habits formed early in life tend to stick. The earlier a person starts drinking, their chances of developing alcohol use disorder, and alcohol-related health problems later in life increase.

Finally, the health risks of alcohol abuse are serious and compound over time. These include elevated risk of liver disease and various cancers, as well as increased risk of accident, injury, or alcohol-related automobile fatalities.

Treatment Works

It’s important to remember, though, that there is hope.

Teens can and do build healthy habits, no matter their circumstances. Teens who are struggling with substance or alcohol use disorder can and do recover. Because teens often can’t get there on their own, however, the importance of intervening when they do struggle with alcohol use disorder becomes clear. Intervention, treatment, and recovery before habits form can prevent a lifetime of associated challenges.

Barriers to Treatment

For most adolescents, connecting with the proper treatment for alcohol use involves additional obstacles. Teens may hide even moderate alcohol use from parents and other trusted adults. And if parents haven’t initiated frank conversations about alcohol, it can be difficult for teens to develop an understanding of what good habits around alcohol look like. They may internalize problematic cultural models from television or popular culture. Additionally, many adults – parents included — themselves struggle with disordered alcohol or substance use, and this may make it difficult to recognize a problem, let alone to intervene.

Even if an adolescent or young adult recognizes their problematic alcohol use, most don’t have the resources to connect with help on their own. This creates one more barrier between teens and the care and treatment they need to embrace sobriety, or build moderate habits and healthier attitudes toward alcohol.

Specialized Treatment for Teens

Programs adapted to the particular needs of adolescents provide things like peer support, specialized counseling, sober activities for teens and young adults, and other special resources.

Of those teens who need treatment for alcohol abuse disorder, however, only a small fraction connect with the specialized care they need. This is problematic, since evidence indicates programs geared specifically to the needs of adolescents can have lasting impact. Treatment for alcohol and substance use disorder is never one-size-fits-all. In all age groups, characteristic mental health concerns that co-occur with substance use disorder, and this is true for adolescents and young adults. Teens benefit from a treatment paradigm that prioritizes the concerns specific to their peer group and developmental stage.

What can we conclude from this data on treatment?

First, doctors should screen teens for alcohol use, and schools should educate teens regarding the damaging effects of alcohol and risks of heavy use. Since teens won’t and often can’t seek treatment on their own, adults must be watchful and concerned with getting them the resources they need. Second, doctors should screen and recommend treatment for co-occurring mental health concerns as well.  Finally, parents should know the best approach to treatment is tailored to the individual needs of the teen. A combination of medication, therapy, and group support is typically the ideal solution to support lasting and positive behavioral change.

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