Substance Misuse and Abuse

Angry teen girl People can develop substance abuse or misuse issues in different ways – by trying things experimentally or recreationally, or through “self-medication.”

Both adults and young people may attempt to deal with their stress, anxiety, depression, or other mental health issues through self-medication. Self-medication refers to the practice of using alcohol, legal or illegal drugs without a doctor’s orders to deal with a problem. In addition, many people may incorrectly believe that prescription and/or over-the-counter drugs are a “safer” way to get high than illegal drugs.


According to the Centers for Disease Control and Prevention (CDC), alcohol is one of the most widely used drug substances in the world. Though legally not permitted to drink until age 21, many youth use and abuse alcohol. According to data from the CDC’s 2013 Youth Risk Behavior Surveillance survey, 39 percent of high schools students report that they currently use alcohol, and 22 percent report episodic heavy or binge drinking (binge drinking is defined as five or more drinks on a single occasion for men or four or more drinks on a single occasion for women, generally within about two hours).

Many people incorrectly believe that prescription and over-the-counter drugs are a “safer” way to get high than illegal drugs.

Underage drinking is a serious problem, not only because it is illegal but also because of its serious short and long term effects. In the short term, the use of alcohol among youth has been linked to physical fights, risky sexual behaviors, poor school and work performance, illegal behavior and an increased risk of fatal and nonfatal injuries, including car accidents. According to the CDC, in 2013 8 percent of high school students reported driving a car or other vehicle during the past 30 days when they had been drinking alcohol. Overall, alcohol is a factor in approximately 41 percent of all deaths from motor vehicle crashes.

Red wineIn the long-term, regular alcohol use is associated with liver disease, cancer, cardiovascular disease, and neurological damage as well as psychiatric problems such as depression, anxiety, and antisocial personality disorder. Research has also shown that youth who use alcohol before age 15 are five times more likely to become alcohol dependent than adults who begin drinking at age 21. Excessive alcohol consumption is associated with approximately 75,000 deaths per year.

To learn more about alcohol use, abuse and strategies to help prevent underage drinking visit the U.S. Department of Health and Human Services websites for adults and teens.

Prescription Drugs

Prescription drugs are a huge problem in America todayAccording to the CDC, the United States is in the midst of a prescription painkiller overdose epidemic. While there has not been an increase in the overall pain reported by the U.S. population, the number of pain-killers prescribed since 1999 has quadrupled.

Commonly misused or abused prescription medications include opioids (e.g., Vicodin® and OxyContin®) and benzodiazepines (e.g., Xanax®, Valium® and Ativan®).

Consider the following:

  • Nearly two million Americans, aged 12 or older, either abused or were dependent on opioids in 2013.
  • Over 16,000 people in the U.S. died from prescription drug overdoses in 2013.
  • According to Monitoring the Future, 7.4 percent of teens have reported the non-medical use of a prescription drug.
  • Every day for the first time, an average of 2,000 teenagers use prescription drugs without a doctor’s guidance.
  • 1 in 4 teenagers report that they have taken a prescription drug not prescribed to them by a doctor at least once in their lives.
  • 20 percent of high school students have reported that they have taken a prescription drug without a doctor’s prescription.

Additional Information

Additional information about the problem of prescription drug abuse and what we do about it can be found at The Partnership at and the National Council on Patient Information and Education.

To help educators and others address this problem, NEA Healthy Futures has developed Rx for Understanding, a standards-based teaching resource. A guide for middle school and a guide for high school are available for download.