How to tell if you have a problem, and what you can do.

Fast Facts:

  • Your brain is the last organ in your body to finish developing, and doesn’t mature until you’re in your mid- to late-20s.
  • 9 out of 10 people who abuse or are addicted to nicotine, alcohol or other drugs began using before they turned 18.
  • People who began using before age 15 are nearly 7 times more likely to develop an abuse or addiction problem than those who wait until they are age 21 or older.

Substance Abuse and Addiction

You probably know people who drink alcoholic beverages, smoke cigarettes, vape, use drugs or smoke weed.  They might be adults, young people your age, or both. You may have tried some of these yourself. Is substance abuse and addiction something you should worry about? What can you do if you think you have a problem?

Can I get addicted?

When you’re in your teens, your brain is still developing and is different from an adult’s. It’s the last organ in your body to finish developing, and doesn’t really mature until your mid- to late-20s. Your brain is learning at a faster rate and rewires itself, making neural connections quickly. A teen’s brain more rapidly creates connections in the reward centers of the brain, which are stimulated by drugs or alcohol. So it is easier and faster for a teen to become addicted than an adult. And substance abuse and addiction have a stronger grip on teens.

The last part of your brain to fully develop is the pre-frontal cortex. It’s the center that controls executive functioning: of judgment, reasoning, self-control, planning, emotional regulation, and other areas that are part of the brain’s executive functioning. Different people develop at different rates, but this slower development means a teen or young adult may be more impulsive.  That means you may not think about the consequences of actions as much as an adult would. So when someone offers you a drink or a hit, you may think about the potential pleasure instead of the risk.

Nine out of 10 people who abuse or are addicted to nicotine, alcohol or other drugs began using before they turned 18, according to the Center on Addiction. People who began using before age 15 are nearly 7 times more likely to develop an abuse or addiction problem than those who wait until they are age 21 or older.

What’s so bad about feeling good?

Most drugs of abuse—nicotine, cocaine, marijuana, and others—affect the brain’s “reward” circuit, which is part of the limbic system. Normally, the reward circuit responds to feelings of pleasure by releasing the neurotransmitter dopamine. Dopamine creates feelings of pleasure. Drugs overwhelm this system, causing large amounts of dopamine to flood the system. This flood of dopamine is what causes the “high” or intense excitement and happiness (sometimes called euphoria) linked with drug use.

After repeated drug use, the brain starts to adjust to the surges of dopamine. Neurons may begin to reduce the number of dopamine receptors or simply make less dopamine. The result is less dopamine signaling in the brain—like turning down the volume on the dopamine signal. This leads to needing more and more of a drug to get the same response. The consequence can be toxic to brain tissue and lead to brain cell injury and death.

As a result, the ability to feel any pleasure is reduced. The person may feel flat, lifeless, and depressed, and is unable to enjoy things that once brought pleasure. Now the person needs drugs just to bring dopamine levels up to normal, and more of the drug is needed to create a dopamine flood, or “high”—an effect known as “tolerance.” (Source: National Institute on Drug Abuse (NIDA); National Institutes of Health; U.S. Department of Health and Human Services.)

Physical and psychological addiction

Physical addiction means your body is dependent on a substance and has built tolerance to it. Someone who is physically addicted to a substance and stops using it may go into withdrawal. Withdrawal symptoms can be really unpleasant and even dangerous. For example, withdrawal from alcohol can cause dangerous symptoms like seizures or hallucinations. Some people become psychologically addicted to a drug, feeling they need and want the drug. Whether the addiction is physical or psychological, an addicted person depends on the drug and feels like they have no choice but to take it.

It’s possible to die from a drug overdose, especially from opioids like prescription pain relievers, heroin, or man-made opioids like fentanyl. Alcohol, when it’s abused, can cause people to have car wrecks, get into fights, become violent, or have alcohol poisoning. And there are long term effects of smoking, which can cause cancer and chronic obstructive pulmonary disease (COPD).

How do I know if I have a problem?

There’s no way to predict when you’ll become addicted to drugs or alcohol. Some teens become addicted on their first try, while others don’t. If you have a family history of addiction you may be at greater risk of becoming addicted yourself. But if you answer “yes” to any of these, a problem may be developing, according to NIDA:

  • Have you ever ridden in a car driven by someone (or yourself) who had been using alcohol or drugs?
  • Do you use alcohol or drugs to relax, feel good or fit in with your friends?
  • Do you drink or use drugs when you are alone?
  • Have you blacked out or not remembered things you did while using alcohol or drugs?
  • Do family or friends ever tell you that you need to cut down on your use of alcohol or drugs?
  • Have you ever gotten into trouble at school, with your family or with the police while you were using alcohol or drugs?

Where can I get help?

If you think you have a problem with substance abuse or addiction, find an adult you trust to talk to. If you can’t talk to your parents, try speaking with a school counselor, relative, teacher, your doctor, someone in your religious community, or another adult who is supportive. Young people who are 10-22 years old and live in the New York City area can come to Mount Sinai Adolescent Health Center, and we will help you find the resources you need.

Most people need professional help to treat a drug or alcohol problem. There are treatment programs and support groups developed especially for teens and young adults to help you break the habit and stay clean. Some resources are listed below to help you find treatment and support.

What if my parent is addicted?

Living with a parent or guardian who abuses drugs or alcohol can be difficult or even dangerous. Your home may be unstable and you may be neglected. You probably have a lot of complicated feelings. It’s natural to feel angry or depressed when someone you love is not taking care of you, or even harms you. You may end up taking care of younger sisters and brothers because your parent isn’t. Your parent may be physically, emotionally or sexually abusive.

The most important thing to remember is that their substance abuse or addiction is NOT your fault. You can’t change their behavior or control it. But you can get help.

Tell a responsible adult like a teacher, school counselor, or a relative that you trust what’s going on, and ask them to help you. Find people you can turn to when you need help, like a friend or a friend’s parents. You may be afraid to tell someone about your parent’s addiction, or worry about losing your home. But staying in a situation where substance abuse is happening can put you in danger. Call a relative or friend and ask for help. Leave immediately if your parent becomes aggressive or violent. If you feel you’re in immediate danger, call 911.


SAMHSA’s National Helpline: 1-800-662-HELP (4357): a confidential, free, 24/7/365 information service in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organization. Also visit their online treatment locators.

Alateen has support groups for young people whose parents abuse alcohol.

Alcohol and Drug Information Hotline: 800-729-6686

Alcoholics Anonymous has local meetings and online support groups, including groups for teens. Click here to search for a meeting near you.

Narcotics Anonymous has local meetings.

National Institute on Drug Abuse (NIDA): information on what to do if you have a problem with drugs, for teens and young adults, and what to do if an adult friend or loved one has a problem with drugs.

The National Suicide Prevention Lifeline 1-800-273-8255: The trained counselors on this line have experience with substance abuse as well as suicide intervention and can direct you to local resources.

National Council on Alcoholism and Drug Dependence: NCADD has resources for addicts, people in recovery and their family and friends.

This information is not intended to provide medical advice, professional diagnosis, opinion, treatment or services, only general information for education purposes only.