Log in

The 3 Most Commonly Abused Drugs and Substances by Teens, and One To Watch For

With all the substances parents read about online and see on TV shows, it might be surprising to find out the ones most commonly abused by young people are the ones most commonly used by adults and are easily accessible.

Alcohol, tobacco, and marijuana are the top three substances teens are abusing right now1. SAMHSA has recently identified marijuana and e-cigarettes as substances of increasing importance2, in addition to Kratom, which I’ll discuss later in this article. Of course, there are others, but by far, these are the three that young people are using to fit in, calm their anxiety, escape life’s pressure and cope with the ups and downs of a pandemic, adolescence or young adulthood. The twist comes in the format and concentration of what they’re using, and it’s nothing to be complacent about.


Tobacco & vaping: (slang terms: e-cigs/e-hookahs/vape pens/vapes/tank systems/mods)

There is some good news when it comes to young people and smoking (traditional cigarettes) – only 7.6% of youth are smokers which is a number that has been consistently on the decline for over a decade.

However, if you’re the parent of a middle or high school student, you’re probably more concerned about vaping – and wondering what exactly it is, what substances kids are “vaping” and how dangerous it is. According to the CDC’s 2020 National Youth Tobacco Survey3, 1 in 5 high school students reported vaping in the past month, so the concern is real.

Vaping – what it is

Vaping – using e-cigarettes – is a way to inhale nicotine and marijuana. Marijuana vapes work by heating a liquid or oil that becomes a vapor the user inhales. Marijuana vaping devices often resemble e-cigarettes – vaping devices used for nicotine or other e-liquids, so parents need to know what they’re looking for.

And with the recent flavor ban for e-cigarettes, teens are switching to disposable vape pens like Puff Bar, Stig and Viigo which are designed for one-or several time use and are then thrown away. Traditional vape-pens are almost “old school” now for teens.

a collection of colorful vape pens

With these disposable pens, one bar has about 300 puffs and can contain about as much nicotine as two or three packs of cigarettes. And, research shows nicotine is addictive and harmful to adolescents’ developing brains. The aerosol emitted from these devices can also contain other harmful substances, including heavy metals like lead, volatile organic compounds, and cancer-causing agents.4

What can you do if you suspect or know your teen is vaping? Open a conversation – use tools like the ones available from Parents Against Vaping and the Truth Initiative which will give you a better understanding of this habit, and ways you can influence your son or daughter’s behavior.


Marijuana (slang terms: Weed, Herb, Pot, Grass, Bud, Ganja, Mary Jane)

One of the most confusing and concerning substances parents deal with is marijuana, and with 35.7% of high school seniors having used it in the past year5, it’s a real concern parents have to face. Because it’s legal for recreational use (for people over 21) in 15 states, teens and young adults often have an attitude of, “it’s just like alcohol, it’s legal!” But with a brain still undergoing development, legal doesn’t mean healthy.

headshot of young adult smoking weed

Depending on your age, you may picture a joint or bong when thinking about marijuana, but with the growing popularity of vaping devices, teens are now vaping THC (the ingredient in marijuana that produces the high), with nearly 4% of 12th graders saying they vape THC daily. They’re also smoking “blunts” (a cigar that has been hollowed out and filled with cannabis) and dabs – or dabbing – (also called honey oil, budder, crumble, and shatter) which is THC concentrate extracted from marijuana plants using butane, then consumed in e-cigarette vape pens.

When someone uses marijuana dabs out of an e-cigarette, it looks like they’re just vaping nicotine and water vapor – and any marijuana smell is easily disguised by flavors or scents. All of this can overwhelm already stressed moms and dads, and when you factor in a huge variety of edibles and even drinkable cannabis it can feel like it’s a hopeless fight against this substance.

The truth is, as prevalent as marijuana is, it has both short-and long-term effects on the brain – and especially the adolescent brain, so parents must be on top of this regardless of how innocuous it can seem to their kids.

When people begin using marijuana as teenagers, the drug may impair thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions6. There are also mental effects that long-term marijuana use has been linked to like:

  • temporary hallucinations
  • temporary paranoia
  • worsening symptoms in people with schizophrenia

It’s also been linked to other mental health problems, like depression, anxiety, and suicidal thoughts among teens. So where do you start and what do you say when you hear things like “I’m only doing it once in a while on weekends, it’s not a big deal,” or “Would you rather I drink alcohol? Weed is so much safer!”

A great place to start is with this toolkit from the Partnership to End Addiction, written specifically for parents. It’s important to remember that you are the most powerful influence in your child’s life, even if it may not seem so, right now. Educating yourself and not being afraid to have real, honest conversations with your son or daughter can go a long way in shaping their actions when it comes to marijuana and substance use overall.


Alcohol (slang terms: Booze, Firewater, Hooch, Juice, liquid courage)

Alcohol continues to be the most used substance among adolescents7, and young people often binge drink. Even though youth drink less often than adults do, when they do drink, they drink more. More than 90 percent of all alcoholic drinks consumed by young people are consumed through binge drinking, which is a pattern of drinking that brings blood alcohol concentration (BAC) to 0.08 percent or higher. Research shows that fewer drinks in the same timeframe result in the same BAC in youth; only 3 drinks for girls, and 3 to 5 drinks for boys, depending on their age and size.

For parents navigating this tricky time with their kids, it might be tempting to look at alcohol as the “lesser of all evils” substance compared to things like opioids, vaping or other drugs, but the statistics say that’s not the case.
Alcohol is a significant factor in the deaths of people younger than age 21 in the United States, and each year, approximately 5,000 young people under the age of 21 die as a result of underage drinking; this includes about 1,900 deaths from motor vehicle crashes, 1,600 as a result of homicides, 300 from suicide, as well as hundreds from other injuries such as falls, burns, and drownings.8

bar graph showing alcohol popularity vs tobacco and marijuana by ages: 12-13, 14-15, 16-17

Drinking can also lead to poor decisions about taking risks like unsafe sexual behavior, drinking and driving, and aggressive or violent behavior. It also increases the risk of physical and sexual assault.
Considering all the risks, parents shouldn’t shy away from talking to their teens about alcohol, as difficult as it can be. It’s also important to consider your own alcohol intake (especially during COVID) as kids watch and learn from what they see in their home. If you believe alcohol is a problem for your son or daughter and it’s impacting their daily life, getting help sooner than later is critically important.


A word about kratom9 (street names: Thom, Biak, Ketum, Kakuam, Ithang)

You may have heard about kratom and wondered if it’s a drug, an herb or something else. Kratom is a tropical tree native to Southeast Asia, with leaves that contain compounds that can have psychotropic (mind-altering) effects. It’s not currently an illegal substance and is easy to order on the internet or in some states it can be purchased at smoke shops. It’s sometimes sold as a green powder in packets labeled “not for human consumption” and is also sometimes sold as an extract or gum.

green photo of kratom in plant, tea and pills

People usually take kratom as a pill, capsule, or extract. Some people chew the leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food. The unusual thing about kratom is it can cause effects similar to both opioids (depressants) and stimulants.

Kratom produces sedation, pleasure, and decreased pain, especially when it’s consumed in large amounts. It also interacts with other receptor systems in the brain to produce stimulant effects. When kratom is taken in small amounts, people say it increases their energy, sociability, and alertness instead of sedation.

This all might sound ok, but the health effects of kratom aren’t. They include:

  • nausea
  • itching
  • sweating
  • dry mouth
  • constipation
  • increased urination
  • loss of appetite
  • seizures
  • hallucinations
  • some people have symptoms of psychosis


Is kratom addictive?

Like other drugs with opioid-like effects, kratom might cause dependence, which means people will feel physical withdrawal symptoms when they stop taking it. Some people have reported becoming addicted to kratom and the withdrawal symptoms mimic those of opioids including:

  • muscle aches
  • insomnia
  • irritability
  • hostility
  • aggression
  • emotional changes
  • runny nose
  • jerky movements

For parents, it’s important to know about kratom because it’s relatively easy for teens to get a hold of. It’s important to remember that just because something isn’t illegal and it’s available, it doesn’t mean it’s safe. This is especially true for young people who may also be consuming alcohol or other substances at the same time.
If you’re seeing unusual behavior or your teen or young adult child is having unexplained symptoms, it’s important to consider they may be using kratom. It’s also helpful to know kratom doesn’t show up on many standard drug tests like the SAMHSA-5, so a more detailed, 10-panel drug test would be required to detect it.


What’s the bottom line?

It takes work and energy to keep up with what’s going on with adolescents and substances, and at times, like during a global health pandemic, it can be tempting to let things slide with the thought of, “well, it’s a crisis, we’re all just trying to cope.” As parents though, we need to recognize that alcohol, nicotine and marijuana are just as damaging today as they will be when the pandemic is in the rear view mirror. If anything, this is a time to be more connected and in-tune with your teen or young adult, so you can help them find ways to cope with anxiety and stress that doesn’t include substances which can have harmful, long-term impacts.
It’s not easy, but there are resources to turn to and you may even find that having these conversations with your son or daughter can strengthen your relationship and ease some of the anxiety and unrest we’re all feeling. Read more to learn more about different types of teen addiction and recovery residential programs.



1.  NIDA. What drugs are most frequently used by adolescents?. National Institute on Drug Abuse website. June 2, 2020 Accessed December 10, 2020.
2.  SAMHSA: Urgent and Emerging Issues in Prevention: Marijuana, Kratom, E-cigarettes, SAMHSA Prevention Day 2019
4.  Centers for Disease Control and Prevention (CDC). (2018). Electronic cigarettes. Smoking & Tobacco Use. Retrieved from
8.  NIH Alcohol Alert


Brenda Zane

About the Author

Brenda Zane is a Mayo Clinic Certified health and wellness coach and certified parent coach whose work supports moms of kids struggling with substance misuse or addiction. Her mission is to help moms maintain their health and sanity as they navigate the frightening and exhausting experience of having an at-risk child. To fulfill her mission she serves parents through her podcast, Hopestream, a private, membership-based online community, The Stream, and through her free ebook HINDSIGHT: 3 Things I Wish I Knew When My Son Was Misusing Drugs.

Brenda writes for various publications and is available to speak on topics like parenting kids in addiction, purpose and transformation, self-care and coping strategies, and the impact of the opioid and fentanyl crises.