Teen drug and alcohol use linked to mental health problems

The findings: drug use as self-medication

The article found that the link between substance use and mental health existed even at low levels of drug and alcohol use. Dr. Tervo-Clemmens said that adolescents with low substance use may be self-medicating and that their relatively modest substance use would likely not cause underlying mental health problems.

But the study also found that the most frequent and intensive users of the substances experienced the most severe psychological symptoms. In these cases, said Dr. Tervo-Clemmens, adolescents may experience worsening of their symptoms even if they use substances for self-medication.

Specifically, the study found that daily or near-daily – but not weekly or monthly – use of substances was associated with a moderate increase in symptoms. Researchers described the association as “dose dependent,” because the level of use was related to the intensity of symptoms.

Background: two strong data sets

The strength of the study came from the use of two data sets that yielded similar findings.

One sample used survey data from 15,600 Massachusetts high school students with an average age of about 16 years. The second sample used similar self-reported data from 17,000 respondents to the national Youth Risk Behavior Survey.

In both groups, the study authors noted, “alcohol, cannabis, and nicotine use each had significant, moderate, dose-dependent associations with worse psychiatric symptoms, including suicidal ideation.”

Another important finding was that there was a link between multiple symptoms and between multiple substances. “It's not just cannabis, it's not just alcohol, it's not just nicotine,” said Dr. Tervo-Clemmens. “It seems like it's regardless of the content.”

What's new: a generational change

Compared to previous generations, today's adolescents experience more mental health problems, but declining drug and alcohol use. Binge drinking and cigarette smoking in particular have plummeted, affecting a smaller portion of the adolescent population.

These broad trends may support the idea that asking teens about substance use could be a way to screen for mental health problems, Dr. Tervo-Clemmens said. This is because the group of regular substance users is smaller than before and may be more closely linked to individuals who self-medicate or otherwise deal with mental health problems.