1

Parent-Focused National 

Media Campaign

Fact Sheet

Approximately 88,000 Americans die 

from alcohol-attributed causes each 

year, making alcohol the third leading 

preventable cause of death in the United 

States.1 Additionally, another 64,000 

annual deaths are attributable to drug 

overdoses.2 The benefits of reducing 

underage drinking and substance use 

are substantial, including saving lives and 

dollars, and promoting the health of young 

people. The Substance Abuse and Mental 

Health Services Administration’s (SAMHSA) 

“Talk. They Hear You.”® Campaign’s 

goal is to provide parents and caregivers 

with the resources they need to address 

the issue of alcohol and other drugs with 

their children under the age of 21. The 

Campaign seeks to:

• Increase parents’ awareness of the

prevalence and risks of underage

drinking and substance use;

• Equip parents with the knowledge,

skills, and confidence to prevent

underage drinking and substance use; 

and 

• Increase actions by parents to prevent

underage drinking and substance use.

Adolescents Are Engaging 

in Underage Drinking and 

Substance Use

Alcohol continues to be the most widely 

used substance among America’s youth, 

with an estimated 7.4 million people 

younger than the age of 21 drinking 

alcohol in the past month.3

 Marijuana is 

also prevalent among adolescents. An 

estimated 1.2 million adolescents aged 

12 to 17 used marijuana for the first time 

in 2017, which translates to approximately 

3,300 adolescents each day.4

Additionally, more than one-third of 

adolescents are misusing prescription pain 

medications. Research indicates that 53 

percent of people aged 12 to 17 obtained 

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prescription pain relievers for the most 

recent nonmedical use from a friend or 

relative for free.5 

Underage Drinking and 

Substance Use Are Serious 

Problems

Underage Drinking

Some kids start drinking at a young 

age—Many young people start drinking

before the age of 15.6 Thirty-three percent 

of eighth graders in the 

United States said they tried 

alcohol at some time in their 

lives, and 65 percent of teens 

who do drink reported that 

they get drunk in a typical 

month.7,8

Alcohol can affect brain function—

Alcohol use can permanently impair 

brain function by affecting actual physical 

development of the brain structure as 

well as brain functioning. Negative effects 

include decreased ability in planning, 

executive functioning, memory, spatial 

operations, and attention.9

Alcohol can lead to other substance 

use—Alcohol use is associated with

a greater likelihood of using other 

substances, including marijuana, tobacco, 

and other drugs.10

Marijuana

Marijuana can harm adolescent brain 

development—Marijuana use distorts

how adolescent minds perceive the world, 

causing poor judgment and decisionmaking, including unprotected sex and 

driving while intoxicated. Marijuana 

use can cause a lack of balance and 

coordination (possibly increasing injury risk 

in activities such as driving and sports) in 

youth.11 It is also linked to earlier onset of 

psychosis in youth known to be at risk for 

schizophrenia.12

Marijuana is addictive—Nine percent

of people who try marijuana become 

addicted.13

Marijuana use can lead to use disorder—

Recent data suggest that 30 percent of 

those who use marijuana may have some 

degree of marijuana use disorder.14

Opioids

Prescription pain medication can be 

addictive—Even if a doctor prescribes

an opioid, there are still risks when taking 

them, including addiction and death. In 

2017, an estimated 2.1 million people ages 

12 or older had an opioid use disorder.15

Misusing prescription pain medication 

is unsafe and illegal—It is illegal to

take prescription medications without a 

doctor’s prescription. Taking prescription 

medications that aren’t prescribed to you 

(even just one time) can land you in the 

hospital or even cause death.

Mixing prescription medication with 

alcohol can be fatal—Mixing opioids with

other substances can cause dangerous side 

effects, including breathing trouble, coma, 

and even permanent brain damage or 

death.16

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The Consequences of 

Underage Drinking and 

Substance Use Can Be 

Devastating

The consequences of underage drinking 

and substance use can include: 

• Injury or death from accidents17;

• Unintended, unwanted, and

unprotected sexual activity18,19;

• Mental health challenges such as

depression and anxiety disorders20;

• Difficulty with attention, concentration,

problem solving, learning, and

memory21,22;

• Allergic reactions, breathing trouble,

coma, and even permanent brain

damage or death23; and

• Academic problems24.

Underage Drinking and 

Substance Use Is Not a Top-ofMind Concern Among Parents

Many parents with children under the age 

of 21 don’t believe underage drinking and 

substance use are issues to be concerned 

about and may not have conversations 

with their kids surrounding these topics. 

However, parents have a significant 

influence on their children’s decisions to 

experiment with alcohol or other drugs. 

Research suggests that one of the most 

influential factors when a child is growing 

up is a strong, open relationship with a 

parent.25 When parents create supportive 

and nurturing environments, children make 

better decisions. 

The “Talk. They Hear You.”® Campaign is 

designed to provide parents and caregivers 

with the information and resources they 

need to properly address underage 

drinking and substance use with their 

children.

“Talk. They Hear You.” 

Provides Parents With 

Knowledge, Resources, and 

Confidence

The Campaign uses social media; the 

website www.underagedrinking.samhsa.

gov; partnership outreach; and radio, 

television, and print public service 

announcements to help parents feel more 

confident when talking to their children 

about alcohol and other drugs. Campaign 

messages:

• Emphasize the importance of parents

talking to their kids about underage

drinking and substance use prevention

before they reach an age when they are

confronted with decisions about it;

• Offer advice to parents about preparing

children to deal with peer pressure that

may lead to alcohol and substance use;

• Focus on helping parents address

the issue of underage drinking and

substance use in a manner that

emphasizes their children’s ability to

make their own decisions; and

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• Model behaviors and situations when

parents can begin the conversation

about the dangers of alcohol and

substance use with their children.

References

1,6 Stahre, M., Roeber, J., Kanny, D., Brewer, R. D., & 

Zhang, X. (2014). Contribution of excessive alcohol 

consumption to deaths and years of potential life lost in 

the United States. Preventing Chronic Disease, 11, E109.

2

 National Institutes of Health, National Institute on Drug 

Abuse. (2017). Overdose death rates. From https://www.

drugabuse.gov/related-topics/trends-statistics/overdosedeath-rates (accessed June 19, 2018).

3

 Substance Abuse and Mental Health Services 

Administration. (2018). Key substance use and mental 

health indicators in the United States: Results from the 

2017 National Survey on Drug Use and Health (HHS 

Publication No. SMA 18-5068, NSDUH Series H-53). 

Rockville, MD: Center for Behavioral Health Statistics and 

Quality, Substance Abuse and Mental Health Services 

Administration.

4

 Substance Abuse and Mental Health Services 

Administration. (2018). Key substance use and mental 

health indicators in the United States: Results from the 

2017 National Survey on Drug Use and Health (HHS 

Publication No. SMA 18-5068, NSDUH Series H-53). 

Rockville, MD: Center for Behavioral Health Statistics and 

Quality, Substance Abuse and Mental Health Services 

Administration.

5

 Lipari, R. N., & Hughes, A. (2017). The CBHSQ Report: 

How people obtain the prescription pain relievers they 

misuse. Rockville, MD: Center for Behavioral Health 

Statistics and Quality, Substance Abuse and Mental 

Health Services Administration.

7

 Johnston, L. D., O’Malley, P. M., Bachman, J. G., & 

Schulenberg, J. E. (2012). Monitoring the Future: National 

results on adolescent drug use: Overview of key findings, 

2011. Ann Arbor, MI: Institute for Social Research, The 

University of Michigan.

8

 The National Center on Addiction and Substance 

Abuse at Columbia University. (2009). National survey of 

American attitudes on substance abuse XIV: Teens and 

parents. New York, NY: The National Center on Addiction 

and Substance Abuse at Columbia University.

9,22 Center for Behavioral Health Statistics and Quality. 

(2017). 2016 National Survey on Drug Use and Health: 

Detailed tables. Rockville, MD: Substance Abuse and 

Mental Health Services Administration.

10 Dupont, R. L., Han, B., Shea, C. L., & Madras, B. K. 

(2018). Drug use among youth: National survey data 

support a common liability of all drug use. Preventive 

Medicine, 113, 68–73.

11,13,18,21 Crane, N. A., Schuster, R. M., Mermelstein, R. J., 

& Gonzalez, R. (2015). Neuropsychological sex differences 

associated with age of initiated use among young adult 

cannabis users. Journal of Clinical and Experimental 

Neuropsychology, 37, 389–401.

12 McHugh, M., McGorry, P., Yung, A., Lin, A., Wood, 

S., Hartmann, J., et al. (2017). Cannabis-induced 

attenuated psychotic symptoms: Implications for 

prognosis in young people at ultra-high risk for psychosis. 

Psychological Medicine, 47(4), 616–626. doi:10.1017/

S0033291716002671.

14 Hasin, D. S., Saha, T. D., Kerridge, B. T., Goldstein, R. 

B., Chou, S. P., Zhang, H., et al. (2015). Prevalence of 

marijuana use disorders in the United States between 

2001–2002 and 2012–2013. JAMA Psychiatry, 72(12), 

1235–1242. doi:10.1001/jamapsychiatry.2015.1858.

15 Substance Abuse and Mental Health Services 

Administration. (2018). Key substance use and mental 

health indicators in the United States: Results from the 

2017 National Survey on Drug Use and Health (HHS 

Publication No. SMA 18-5068, NSDUH Series H-53). 

Rockville, MD: Center for Behavioral Health Statistics and 

Quality, Substance Abuse and Mental Health Services 

Administration.

16 National Institute on Drug Abuse. (2017). Drug facts: 

Prescription pain medications (Opioids). NIDA for 

Teens. From https://teens.drugabuse.gov/drug-facts/

prescription-pain-medications-opioids (accessed June 20, 

2018).

17 U.S. Department of Health and Human Services. 

(2007). The Surgeon General’s call to action to prevent 

and reduce underage drinking: A guide to action for 

educators. Washington, DC: U.S. Department of Health 

and Human Services, Office of the Surgeon General.

19 Tapert, S. F., Aarons, G. A., Sedlar, G. R., & Brown, S. A. 

(2001). Adolescent substance use and sexual risk-taking 

behavior. Journal of Adolescent Health, 28(3), 181–189.

20,24 Bonnie, R. J., & O’Connell, M. E. (Eds.). (2004). 

Reducing underage drinking: A collective responsibility. 

National Research Council and Institute of Medicine. 

Washington, DC: The National Academies Press. From 

https://www.nap.edu/read/10729/chapter/1 (accessed 

May 3, 2012).

23 National Institute on Drug Abuse. (2016). Misuse of 

prescription drugs: Is it safe to use opioid drugs with 

other medications? From http://www.drugabuse.gov/

publications/research-reports/prescription-drugs/opioids/

it-safe-to-use-opioid-drugs-other-medications (accessed 

June 20, 2018).

25 National Scientific Council on the Developing Child. 

(2004). Young children develop in an environment of 

relationships. Working Paper No. 1. Retrieved from 

http://www.developingchild.net (accessed June 20, 2018).

www.underagedrinking.samhsa.gov