Sarah Bagley: Hi, I'm Dr. Sarah Bagley. I'd like to talk to you today about the importance of addressing 

substance use in adolescence and adulthood. Teens and young adults are wired to take 

risks and to experiment. That means that teens and young adults are more likely to use 

drugs. Adolescents and young adults are susceptible to boredom, to peer pressure. And 

this puts them at a higher risk of using alcohol and other drugs. Adolescents and young 

adults may also be experiencing feelings of depression or anxiety or potentially bullying 

at school. And those are some reasons that they may decide to experiment with alcohol 

and other drugs.

While experimentation with drug and alcohol use during adolescence and young 

adulthood doesn't necessarily lead to addiction, we know that most people who 

develop an addiction later on started to use substances before they were 18 years old. 

Even for those adolescents and young adults who do not develop addiction there is still 

risks associated with using substances, such as engaging in unsafe sex practices, getting 

in motor vehicle accidents, and being vulnerable to other kinds of injuries. Alcohol and 

marijuana are the most commonly used substances by adolescents. According to 

Monitoring the Future, a national survey conducted every year with high school 

students, we know that about 55% of all 12th graders have used alcohol in the last year 

and about 36% of all 12th graders have used marijuana in the last year.

Importantly, although there is a high prevalence of alcohol and marijuana use in 

teenagers, we also know that these rates are the lowest that they have been in years. 

And that's really encouraging news. It means that the prevention programs that we have 

been implemented over the past decade or so are making a real difference. We also 

know that it means that when we're talking to teens who may say to us, "It feels like 

everyone is using," we can actually use data and statistics to tell them that not all of 

their friends are drinking and not all of their friends are smoking marijuana.

Adolescence is a critical time for brain development and we know that addiction is a 

brain disease. All drugs work a little bit differently, but there's a similarity. They all 

increase the amount of dopamine in our brain and dopamine is the chemical that affects 

our reward system and makes us feel good. It's normal to want to feel good and so our 

dopamine may increase if we eat or we do something that's enjoyable. It also increases 

if we use a drug or use alcohol. The adolescent brain, which is immature and is seeking 

sensations, responds really positively when the dopamine increases in their brain and 

they're at ... that adolescent is going to seek to repeat that experience and over time 

those repeated exposures can lead to addiction.

There are certain factors that we consider when treating adolescents and young adults 

who have substance use disorder. We're trying to prevent the downstream effects of 

addiction and development of other chronic medical problems associated with addiction 

and we have good treatments. And we know that if we intervene early, we engage 

adolescents and young adults in treatment, we can prevent those long-term effects. It's 

also important because it allows us to intervene and try to prevent any of the shortterm effects, like unwanted pregnancy, transmission of sexually transmitted infections, 

or other infections that might be associated with injection drug use.
It's important to understand that many adolescents and young adults who had 

substance use disorder also may have other mental health diagnoses, like anxiety or 

depression. When we treat adolescents and young adults, we have to consider the other 

diagnoses they may have and want to make sure that we're treating both of those 

conditions together. We know that adolescents and young adults who are treated for 

both their substance abuse and their mental health disorders do better. That means 

that they're able to go back to school, go back to jobs, and rejoin the lives that they 

want to have.