Substance Misuse Risk Factors, Signs and Prevention

First published March 2018
Updated April 2026

During the teenage years, the areas in the brain responsible for decision making, impulse control, and emotion regulation are still developing. At the same time, the brain’s reward system is highly active which can increase risk-taking behaviors. Using substances can have lasting effects on how an adolescent’s body and brain develop.

The teenage years can be difficult. Teens deal with academic pressure, friendships, identity exploration, and increased independence. Teens who use substances may begin relying on them to cope with this stress instead of developing healthy coping skills.

Risk factors and Signs

There is not one single reason why a teenager may use substances, but several factors can increase risk.

• Family factors such as low parental supervision and monitoring, ongoing family conflict or family history of mental health or substance use may increase risk.
• Individual factors include but are not limited to impulsivity, anxiety and depression.
• Peer influence plays a large role, especially if substance use appears normal among social circles or on social media. A lack of engagement in positive and structured activities can further increase exposure and opportunity.

Signs that an adolescent has begun using substances may not be immediately obvious. But sudden changes in friend groups or activities, a decline in grades, poor grooming, changes in sleep and eating patterns and significant mood shifts may be cause for concern.

Prevention

The best way to reduce the chances that your teen will misuse substances is to nurture a strong relationship with them. Having regular conversations about what’s important to them will allow you to understand their view of the world, and it’s never too early to start this practice. The Kids Mental Health Foundation has tips on how to start conversations that will create a safe space and help with your child’s healthy growth and development.

Begin talking about substance use by asking questions about what they see at school or on social media. Be non-judgmental in your responses and encourage openness and questions. Verbally share your family values around substances and role model healthy behavior.

Adolescents may still be exposed to substance use in social situations. Work with your teen to create a plan for how they will manage those challenges and how they can use you for support.

Parenting a teenager can feel overwhelming at times, especially when it comes to topics like substance use. You may not be able to control every choice your teen makes, but your presence, your consistency, and your willingness to listen truly matter.