Teen Substance Use Trends Report
Teen substance use has generally declined from the peaks seen in previous decades, but the picture is not uniformly reassuring. Alcohol, cannabis and nicotine vaping remain relatively common, while less prevalent drugs can carry disproportionate risks because counterfeit pills and powders may contain illegally manufactured fentanyl.
This report focuses primarily on United States data because the Monitoring the Future study, National Survey on Drug Use and Health and Youth Risk Behavior Survey provide large national datasets. They cover different age groups and reporting periods, so their percentages should not be treated as interchangeable. For broader context, see Addiction & Rehab Statistics 2026: The Complete Data Report.
Current teen use rates by substance category
The latest Monitoring the Future report surveyed US students in 2025. Past-year use increased with grade level across the three leading categories: alcohol, cannabis and nicotine vaping. These adolescent substance abuse trends do not mean that every student who reports use has developed an addiction, but they help parents understand which substances teenagers are most likely to encounter.
Percentage of US students reporting past-year use in 2025, Monitoring the Future
| Substance | 8th grade | 10th grade | 12th grade |
|---|---|---|---|
| Alcohol | 11% | 24% | 41% |
| Cannabis | 8% | 16% | 26% |
| Nicotine vaping | 9% | 14% | 20% |
Alcohol remained the most commonly reported substance in each grade. Cannabis was second among older students, while nicotine vaping was slightly more common than cannabis in 8th grade. These teen vaping and drug statistics also show why prevention should begin before high school rather than waiting for obvious signs of regular use. More detailed alcohol data are covered in Alcohol Use Disorder Statistics & Trends.
- Cigarette smoking is far less common than it was historically, but vaping has become the main way many adolescents use nicotine. In the 2024 NSDUH, 71.5% of 12-to-17-year-olds who had used a nicotine product in the past month reported vaping nicotine without using a tobacco product.
- Cocaine and heroin use remained uncommon in 2025, but Monitoring the Future recorded statistically significant one-year increases in heroin use across all three grades. Past-year heroin use reached 0.5% in 8th grade, 0.5% in 10th grade and 0.9% in 12th grade.
- Past-year cocaine use in 2025 was 0.6% among 8th graders, 0.7% among 10th graders and 1.4% among 12th graders. The increases were statistically significant in grades 8 and 12.
Low prevalence does not mean low danger
From 2020 through 2024, fentanyl was involved in 75% of overdose deaths among people aged 10–19, according to CDC. Teens should never take a pill that was not prescribed to them and supplied by a licensed pharmacy. If someone is unresponsive or breathing slowly or not at all, call emergency services immediately and give naloxone if available. Follow the dispatcher’s instructions and consult a doctor or clinical team about any withdrawal, medication or ongoing substance-use concern. See Overdose Warning Signs & Emergency Response for further guidance.
Trends over time — what’s rising and what’s falling
The long-term direction is mostly downward. Monitoring the Future found that past-year alcohol use among 12th graders fell from 75% in 1997 to 41% in 2025. Comparable declines occurred in 10th grade, from 65% to 24%, and in 8th grade, from 46% to 11%. CDC’s YRBS likewise found that current alcohol use among high school students declined from 35% in 2013 to 22% in 2023.
Falling over the long term
- Underage alcohol use
- Cigarette smoking
- Prescription opioid misuse
- Use of several illicit drug categories
Lower than the pre-pandemic period
- Cannabis use in all three grades
- Nicotine vaping after its 2017–2020 surge
- Overall past-year illicit drug use among students
Signals to watch
- The 2025 rise in reported heroin use
- One-year cocaine increases in grades 8 and 12
- Nicotine pouches and other changing delivery products
Cannabis followed a different path from alcohol. Rates were comparatively stable from 2000 to 2020, then dropped sharply after the start of the COVID-19 pandemic. Past-year use in 2025 reached three-decade lows of 16% in 10th grade and 26% in 12th grade; the 8th-grade rate was 8% and had remained near that level for four years.
Nicotine vaping surged after Monitoring the Future began measuring it in 2017, peaked around the beginning of the pandemic and then declined. Past-year use among 12th graders dropped from 35% in 2020 to 20% in 2025. The equivalent declines were from 31% to 14% in 10th grade and from 17% to 9% in 8th grade. Encouraging national averages should therefore be read alongside emerging products and local patterns rather than as evidence that the problem has disappeared.
Risk factors specific to adolescents
No single experience explains why a teenager uses substances. Risk usually develops through an interaction of individual health, family circumstances, peer relationships, school experiences and access to substances. Adolescence also involves greater independence, exploration and sensitivity to peer influence, making consistent adult support especially important.
- Mental health concerns: In the 2024 NSDUH, 32.6% of adolescents with a past-year major depressive episode reported past-year illicit drug use, compared with 11.8% of adolescents without one. This is an association and does not prove that one condition caused the other.
- Peer and family influences: CDC lists association with substance-using peers, parental substance use, favorable parental attitudes and poor monitoring among recognised risk factors.
- Disconnection from school: Low academic achievement and limited school connectedness are associated with greater risk, while supportive relationships with staff and peers can be protective.
- Trauma and instability: Childhood abuse, household substance use, violence, unstable housing and other adverse experiences may increase vulnerability.
- Availability and perceived acceptability: Easy access to alcohol, nicotine products, cannabis or pills can combine with the belief that a substance is harmless.
Mental health symptoms and substance use should be assessed together rather than treated as unrelated behaviour. The 2024 NSDUH estimated that 3.2% of adolescents aged 12–17 had both a major depressive episode and a substance use disorder during the previous year. Families exploring care may find the Co-Occurring Disorders: Addiction & Mental Health and Rehab for Teens vs Adults: Key Differences guides useful.
Prevention-program effectiveness data
Prevention can help, but results depend on the program’s content, intensity, timing and implementation. Information-only assemblies are not the same as structured programs that build decision-making skills, involve families, improve school climate and connect at-risk students with professional support.
What selected evidence reviews found
| Approach | Evidence finding | How to interpret it |
|---|---|---|
| Universal and targeted school programs | A 2022 review of 66 studies found little or no short-term effect for many universal programs and no or small benefits for targeted programs. | Schools should choose evaluated programs, deliver them consistently and monitor local outcomes rather than assuming any drug-education lesson will work. |
| Digital prevention programs | A meta-analysis found significant effects for alcohol, cannabis and tobacco, with standardised effect sizes of 0.4, 0.2 and 0.2 respectively. | Digital tools can extend access, although the average effects were generally small and should not replace human support when risk is already present. |
| Family programs addressing cannabis | A review of 22 randomised trials found an odds ratio of 0.72 for cannabis initiation in universal parent–child interventions. | Structured family participation may reduce initiation, but evidence was not equally strong for other illicit drugs. |
| Multilevel prevention | CDC’s 2025 ENGAGE framework combines school skills, supportive family environments, youth activities, community action, health-system involvement and early services. | Prevention is more credible when it addresses the environments surrounding teenagers rather than relying on personal willpower alone. |
The evidence is therefore best described as promising but mixed. Even small average effects may matter when a program reaches an entire school population, while a teenager already using frequently may need screening and individual care rather than universal prevention alone. Treatment may include approaches described in Types of Therapy Used in Addiction Treatment.
What parents and schools can actually do
Parents do not need to interrogate or frighten a teenager to reduce risk. Calm, repeated conversations are usually more useful than one high-pressure talk. CDC identifies family engagement, parental disapproval of underage use, monitoring and school connectedness as protective factors.
Practical steps for families and schools
- Ask what substances students are seeing, including vapes, nicotine pouches, cannabis products and pills sold through friends or social media.
- Set clear, age-appropriate expectations about alcohol, cannabis, nicotine and taking anyone else’s medication. Explain the reason for each rule.
- Know where teenagers are, who they are with and how they will get home, while gradually adjusting supervision as they demonstrate responsibility.
- Store alcohol, cannabis and prescription medication securely, and dispose of unused medication through an authorised collection option.
- Teach that a counterfeit pill can look identical to a legitimate medication and that appearance cannot confirm its contents.
- Make naloxone available where appropriate and train adults and older students to recognise and respond to a possible opioid overdose.
- Create confidential routes to school nurses, counsellors, psychologists and community clinicians without automatically treating help-seeking as misconduct.
- Watch for clusters of changes such as declining attendance, secrecy, impaired coordination, disappearing medication, new financial problems or worsening mental health.
- Arrange a professional assessment when use is repeated, escalating, unsafe or affecting health, relationships or education. Signs You (or a Loved One) Need Rehab: Self-Assessment can help families organise their concerns.
- If treatment is recommended, compare adolescent-specific options and the Levels of Care in Addiction Treatment: Detox to Aftercare rather than assuming every teenager needs residential care.
In 2023, 84% of high school students told the YRBS that parents or other adults in their family usually knew where they were going or who they would be with. The same survey found that only 55% felt close to people at school, highlighting an area where schools can strengthen belonging, inclusive policies and trusted-adult relationships.
If a conversation reveals frequent use, withdrawal symptoms, overdose history, suicidal thinking or pills obtained outside a pharmacy, seek prompt clinical advice. A doctor or adolescent treatment team can assess both substance use and mental health, discuss immediate safety and determine whether outpatient support or a more intensive setting is appropriate. Families preparing for that conversation can also consult How to Help a Loved One Get Into Rehab.
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Related Reading
Frequently Asked Questions
It is falling overall when viewed across several decades. US national surveys show major long-term declines in underage drinking, cigarette smoking and many forms of illicit drug use. Cannabis and nicotine vaping also remain below their pre-pandemic levels. However, the trend is not identical for every substance: Monitoring the Future recorded increases in heroin use across grades 8, 10 and 12 in 2025, plus increases in cocaine use in some grades. The safest summary is that overall use is lower, while emerging products, counterfeit pills and small increases in high-risk drugs still require attention.
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