Substance Use & Mental Health In Teens

In addition to dealing with the typical trials and tribulations of adolescence, today’s younger generations have also endured a global pandemic, financial instability for many families, significant cultural shifts, and the negative effects of social media. These and many other factors have led to increased concerns about substance use and mental health in teens.

At Hillcrest Adolescent Treatment Center, we help teens uncover the root causes of their struggles, adopt healthy coping mechanisms, and develop a sense of self-discovery that extends beyond traditional therapy. For additional information or to schedule a free assessment, contact us today.

Learn more about mental health and substance use treatment for teens in California or verify your insurance now.

The Link Between Substance Use & Mental Health in Teens

Experts often use the word “bidirectional” when discussing the relationship between substance use and mental health in teens. 

In other words, for some young people, feelings of anxiety, depression and other mental health concerns push them to use alcohol and other drugs. For others, the substance use occurs first and leads to the development of mental health problems.

Of course, other influences can play key roles in determining if a young person will have problems with substance use or mental health concerns in their teens or into adulthood. 

Two categories of particularly influential factors are adverse childhood experiences (ACEs), which can increase the likelihood that they will have these problems, and positive childhood experiences (PCEs) which can serve as protective factors to minimize their risk.

As described by the American Psychiatric Association (APA), examples of ACES include:

• Physical, emotional, and sexual abuse
• Physical and emotional neglect
• Loss of parent due to separation, divorce, abandonment, or death
• Incarceration of a parent
• Substance use by a member of the household
• Mental illness or suicide attempts involving a member of the household
• Violence within the household, including intimate partner violence or the abuse of siblings or other household members 

Positive childhood experiences (PCEs) can reduce a young person’s risk of teen substance abuse and mental illness. 

The APA’s list of positive childhood experiences (PCEs) includes:

• Viewing the family as a source of support
• Feeling that their family members look out for each other and stand together during trying times
• Feeling safe and protected by an adult in their home
• Having someone who will take them to the doctor if they need care
• Participating in enjoyable community traditions
• Having a sense of belonging in their school
• Feeling supported by their friends
• Having at least two adults in addition to their primary caregivers who take a genuine healthy interest in them

Teen Substance Use

Recent research into teen substance use in the U.S. has revealed some good news and some bad news.

The good news: According to the 2025 Monitoring the Future (MTF) survey, rates of past-year drug use among U.S. adolescents and teens have fallen significantly over the past five years, and are near the lowest they have been this century.

The bad news: The 2025 MTF survey found that one in three students in grades 10 and 12 used at least one illicit drug in the previous 12 months, while four of ten 12th graders and one in four 10th graders consumed alcohol during the same period of time. 

The Scope of the Problem

The statistics below are from the MTF report cited above.

General trends in teen substance use:

• 12th graders: In 2025, 31.7% of high school seniors said they had engaged in any type of illicit drug use in the previous 12 months. This marked the fifth consecutive year when past-year use of illicit drugs among 12th graders was between 31%-33%. It also represented a considerable decline from 2011-2020, when the rate ranged from 36.8%-40.1%.
• 10th graders: In 2020, 30.4% of 10th graders said they had used an illicit drug in the previous year. The next year, that rate plummeted to 18.4%. After a slight upswing in 2022, the rate has been below 20% for the past three years. In 2025, 19.1% of high school sophomores reported past-year illicit drug use.
• 8th graders: The prevalence of illicit substance use among 8th grade students dropped considerably between 2020-2021, falling from 15.6% to 10.2%. But the rate increased recently, reaching 13.6% in 2024 before declining to 12.9% in 2025.

Frequently used substances by adolescents and teens:

• Alcohol: Alcohol remains one of the most commonly used substances by young people in the U.S. In 2025, 41.1% of 12th graders, 23.5% of 10th graders, and 11.2% of 8th graders said they had used alcohol at least once in the previous 12 months.
• Cannabis: In 2025, the prevalence of past year marijuana use was 25.7% among seniors, 15.6% among sophomores, and 7.6% among eight graders. 
• Nicotine: Cigarette use remains quite low, with 8.2% of seniors, 3.2% of sophomores, and 1.6% reporting past-year smoking in 2025. But rates of past-year vaping are significantly higher, at 20% of 12th graders, 14.3% of 10th graders, and 8.5% of 8th graders.

Warning Signs of Teen Substance Use

The signs that a teen has been drinking or using other substances can vary depending on several factors, including which drug they’ve been using and how often they’ve been using it. Generally speaking, though, the best advice is to keep an eye out for significant changes in your teen’s mood and behaviors.

Potential signs of teen substance use include:

• Unexplained drop in grades
• Increased behavior problems at home and/or in school
• Sudden changes in mood and energy
• Lack of motivation
• No longer participating in activities that use to be important to them
• Strange smells on their breath or clothing
• Frequent use of mints, gum, and/or eye drops (to hide signs of substance use)
• Unintentional weight gain or loss
• Recurring periods of clumsiness or diminished coordination 
• Secrecy or deception about where they’ve been and who they’ve been with
• Withdrawing from family and preferring to spend time alone

Teen Mental Health

In 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association issued a joint declaration describing adolescent and teen mental health as a national emergency.

Some problems have improved a bit since then, but overall the status of teen mental health in the U.S. remains deeply concerning. 

Top Mental Health Concerns Among Teens

The 2023 Youth Risk Behavior Survey (YRBS) found that four of every 10 high school students had gone through periods of persistent sadness or hopelessness in the previous 12 months, and two of every 10 said they had seriously considered ending their life.

Teen mental health data from the 2023 YRBS:

• 40% of high school students in the U.S. said they experienced persistent sadness or hopelessness during the past year. This included 53% of girls, 28% of boys, and 65% of those who identified as LGBTQ+.
• 29% of students said they experienced poor mental health in the previous 30 days, including 39% of girls and 21% of boys.
• Past-month mental health problems were highest among LGBTQ+ students at 53%.
• 20% of students said they had seriously considered suicide in the previous year.
• Girls (27%) were nearly twice as likely as boys (14%) to have seriously considered suicide.
• LGBTQ+ youth (41%) were more than three times as likely as cisgender/heterosexual students (13%) to seriously consider suicide.
• 16% of students made a suicide plan and 9% attempted to end their life.

Warning Signs of Teen Mental Illness

From a parent’s perspective, major unexplained changes are often the first indications that a young person has begun to struggle with their mental health.

Warning signs of teen mental illness can include:

• Unexplained drop in grades
• Dramatic mood swings
• Increases or decreases in energy, motivation, and talkativeness
• Acting with uncharacteristic agitation, aggressiveness, or violence
• Outbursts of anger or crying that are excessive or have no apparent cause
• Limiting or ending their participation in extracurricular activities and other pursuits that used to be important to them
• Withdrawing from family and friends
• Difficulty focusing, concentrating, and making decisions
• Sleeping much more or much less than usual
• Eating much more or much less than usual
• Wearing long sleeves and long pants, even in warm weather (which can be an attempt to hide evidence of self-harm)
• Refusing to go swimming or change clothes in the presence of others (also to hide evidence of self-harm or an eating disorder)
• Stating they wish they had never been born, could go to sleep and never wake up, or simply disappear

None of the signs in today’s post are definitive proof of teen substance use or mental health problems. But the more signs a teen exhibits, the greater the likelihood becomes that they are nearing a crisis point.

Learn More About Mental Health & Addiction Treatment for Teens in California

Hillcrest Adolescent Treatment Center is a trusted source of personalized residential care for teens who have been struggling with a range of other mental and behavioral health concerns, including substance use and addiction. 

At our center in Agoura Hills, CA, young people ages 12-18 benefit from an innovative three-phased approach that combines evidence-based therapeutic practices with experiential activities and robust academic support. 

Our services also include family-focused programming to resolve communication breakdowns and address other issues that may have contributed to or been exacerbated by your teen’s struggles.

To learn more call 800-275-1707 or verify your insurance now.