Teenagers with suspected substance use problems say they turn to drugs because of a crushing need to relax and escape worries, according to research published Thursday by the Centers for Disease Control and Prevention.
The new findings follow reports of rising anxiety and depression among the nation's youth, including unprecedented levels of hopelessness.
Because those conditions are often linked to substance use in adolescence, said Sarah Connolly, lead author of the new report and an epidemic intelligence service officer within the CDC's Division of Overdose Prevention, "it might make sense that teens are looking for ways to reduce stress and anxiety."
Connolly's study, the first of its kind, expands on limited research previously done on why kids use drugs. It is based on data from the National Addictions Vigilance Intervention and Prevention Program. It includes self-assessments from 15,963 teenagers, ages 13 to 18, who answered questions online about their motivations for drug and alcohol use from 2014 through 2022.
The findings do not reflect why teenagers might experiment with drugs for the first time; all were flagged for substance use disorder and subsequent treatment.
Nearly three-quarters — 73% — said they used "to feel mellow, calm or relaxed." Forty-four percent used drugs, such as marijuana, as sleep aides.
The same percentage cited drug use as a way to "stop worrying about a problem or forget bad memories." And 40% said they used to cope with depression or anxiety.
Dr. Leslie Walker-Harding, chief academic officer and senior vice president at Seattle Children's Hospital, said that 75% of young people with a substance use disorder also have a mental health condition.
"We know that the two go together," she said. "If you have a kid who you think might not be using very much, but say they're using to feel less depressed or to stop worrying, that's a really big warning sign" that they need help.
The findings are consistent with previous research and point to an ongoing need for mental health services that target kids.
It's important to understand why teens use or misuse drugs, so the right resources and education can help them, Dr. Nora Volkow, director of the National Institute on Drug Abuse, wrote in an email.
"Early prevention interventions are crucial to support teens who may turn to drug use to cope with stress, anxiety or depression," Volkow said. Neither Volkow nor Walker-Harding were involved with the new research.
The majority — 84% — used a form of marijuana. This comes amid growing evidence linking cannabis use and psychotic disorders.
Less than half (49%) said they drank alcohol and 19% of surveyed teens reported misusing prescription drugs like pain relievers and sedatives.
"We worry about kids using cannabis, alcohol and nicotine because we know long term, it's going to take a toll on their mental health and their physical health," said Dr. Sharon Levy, chief of the Division of Addiction Medicine at Boston Children's Hospital. "What's really scary is the opioids, because the consequences of opioid use are immediate and can be fatal." Levy was not involved with the CDC report.
Half of the teens said they did drugs by themselves, without anyone else around — greatly increasing their risk for deadly overdoses, "especially given the proliferation of counterfeit pills resembling prescription drugs and containing illegal drugs," the study authors wrote.
"Parents need to know this," Walker-Harding said. "A lot of kids, when they die and overdose in their home, they're in their room and nobody saw it happening."
Addiction experts, including those at the CDC, urge parents and caregivers to educate kids about the risks of using drugs alone. That includes providing naloxone to reverse opioid overdoses.
"Sometimes people perceive that this is a hard conversation. It's only hard because of our own internal difficulty with it," Walker-Harding said. "Kids will talk if they think somebody's willing to listen."
Levy advised examining the culture of drugs and alcohol in the U.S.: "If you're happy, drink to celebrate. If you're stressed, drink to relax. Oh my gosh, this candidate that I don't like is winning. I better go have a drink."
"You hear that all the time. This is the soup kids are swimming in," she said. "Parents are one of the very few potential places for counterbalance."
