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Psychiatric Times
Adolescent Substance Use Research: Honoring National Drug and Alcohol Facts Week
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March 17 through March 23 is National Drug and Alcohol Facts Week 2025.
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National Drug and Alcohol Facts Week 2025 occurs from March 17 through March 23. This annual event focuses on educating youth about drug use and addiction and making informed decisions about substances. Accordingly, we have gathered a selection of recent research concerning adolescents and substance use disorder (SUD).
School-Based Personality-Focused Prevention Program on Adolescent SUD
A recent study investigated the 5-year SUD outcomes following a selective drug and alcohol prevention program that targeted personality risk factors for adolescent substance abuse.1 Many school-based prevention programs are standardized and utilize testimonials, flyers, peer education, and alcohol- and drug-free activities; research proves these have weak positive or even negative effects.2 However, programs that promote general coping and drug refusal skills show higher success rates.3-5
Investigators sought to observe the efficacy of PreVenture—a 2-workshop, school-based cognitive behavioral program that focuses on building personality-specific skills and self-efficacy—in reducing youths’ desire to use substances to cope with challenges. Previous randomized trials have shown that the program is effective in reducing alcohol use, drug use, and mental health symptoms by a notable 30% to 80% among secondary students.6,7
Investigators used mixed-effects multilevel Bayesian models to estimate the effect of the PreVenture intervention on the year-by-year change in probability of SUD in a group of seventh-graders. Students included in the study reported elevated scores on 1 of 4 personality subscales of the validated Substance Use Risk Profile Scale, as this has been shown to identify 90% of all students who go on to develop substance use difficulties over a 2-year period.8
When baseline differences were controlled for, a time-by- intervention interaction revealed positive growth in SUD rate for the control group (SE = 0.143; OR, 3.97) and reduced growth for the intervention group (SE = 0.173; 95% CI, −0.771 to −0.084; OR, 0.655), indicating a 35% reduction in the annual increase in SUD rate in the intervention condition relative to the control condition. Secondary analyses revealed no significant intervention effects on growth of anxiety, depression, or total mental health difficulties over the 4 follow-up periods. This study showed for the first time that personality-targeted interventions might protect against longer-term development of SUD.
Prevalence by Substance Class, Severity, and Age
“There is a need to understand the epidemiological landscape of specific SUDs—including by severity—within the critical period ranging from early adolescence through emerging adulthood,” wrote study authors Adams et al.9 To address this need, investigators sought to describe the national prevalence and severity of DSM-5 SUDs among US adolescents and emerging adults by using age cohorts that represent short time bands across adolescence (ages 12-13, 14-15, 16-17) and that correspond to important early adulthood milestones (ages 18-20, 21-25). They asked participants to report their past year’s usage of substances like alcohol, cannabis, cocaine, heroin, methamphetamine, and misused prescription medications. SUDs were identified and then classified by DSM-5 defined severity: mild, moderate, and severe. A series of χ2 tests of independence were then used to describe (1) the prevalence of any past-year substance use across age cohorts, (2) the prevalence and severity of SUDs across age cohorts, (3) and the prevalence and severity of SUDs across age cohorts among those who endorsed past-year use of each substance.
Investigators found that in youth with past-year substance use, many met criteria for an SUD. Past-year rates for alcohol and cannabis use were higher overall as the age cohort increased. The prevalence of abuse and distribution of SUD severity did not differ across age cohorts among those who used alcohol and cannabis in the past year. The prevalence and severity of SUDs generally did vary across age groups among those who reported past-year use of less commonly used substances like heroin and methamphetamine. Identifying the scope of SUDs in specific detail concerning substance class and severity can help guide policy decisions, improve clinical services, and inform clinician decision-making.
Protective Factors Against Addictive Substances
Feeling ostracized may influence adolescent attitudes toward substance use. To explore this connection, investigators highlighted risk factors like ostracism and protective factors like self-control and hope in a cross-sectional data analysis of 787 students (52.50% boys, 47.50% girls; mean age of 15.69, SD = 1.12).10
Previous research links feelings of exclusion, alienation, and meaninglessness with harmful behaviors like substance use.11,12 Additionally, those with lower self-control are at a greater risk for abusing substances.13 However, hope can be a mitigating factor: Hope is associated with greater self-confidence, well-being, coping flexibility, and emotion regulation skills,14 and thus can be considered a protective factor in preventing substance use.
The results showed that ostracism had a significant positive predictive effect on self-control (P < .001) and hope (P < .001). Furthermore, ostracism (P < .05), self-control (P < .001), and hope (P < .001) had significant positive predictive effects on attitudes toward addictive substances.
“This study highlights individual risk and protective factors related to attitudes toward addictive substances and offers new perspectives on ways to prevent and reduce adolescents’ positive attitudes toward substance use,” shared the study authors. “School counselors and educators should help students strengthen skills such as hope and self-control to prevent them from developing positive attitudes toward substance use in the future.”
References
1. Conrod P, Stewart SH, Seguin J, et al. Five-year outcomes of a school-based personality-focused prevention program on adolescent substance use disorder: a cluster randomized trial. Am J Psychiatry. Published online January 15, 2025.
2. Sloboda Z, Stephens RC, Stephens PC, et al. The Adolescent Substance Abuse Prevention Study: a randomized field trial of a universal substance abuse prevention program. Drug Alcohol Depend. 2009;102(1-3):1-10.
3. US Department of Health and Human Services. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. November 2016. Accessed February 10, 2025. https://www.hhs.gov/sites/default/files/facing-addiction-in-america-surgeon-generals-report.pdf
4. Faggiano F, Galanti MR, Bohrn K, et al; EU-Dap Study Group. The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial. Prev Med. 2008;47(5):537-543.
5. Newton NC, Stapinski LA, Slade T, et al. The 7-year effectiveness of school-based alcohol use prevention from adolescence to early adulthood: a randomized controlled trial of universal, selective, and combined interventions. J Am Acad Child Adolesc Psychiatry. 2022;61(4):520-532.
6. Conrod PJ, Castellanos-Ryan N, Strang J. Brief, personality-targeted coping skills interventions and survival as a non-drug user over a 2-year period during adolescence. Arch Gen Psychiatry. 2010;67(1):85-93.
7. Conrod PJ, O’Leary-Barrett M, Newton N, et al. Effectiveness of a selective, personality-targeted prevention program for adolescent alcohol use and misuse: a cluster randomized controlled trial. JAMA Psychiatry. 2013;70(3):334-342.
8. Castellanos‐Ryan N, O’Leary‐Barrett M, Sully L, Conrod P. Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional, and behavioral problems: 18-month predictive validity of the Substance Use Risk Profile Scale. Alcohol Clin Exp Res. 2013;37(suppl 1):E281-E290.
9. Adams ZW, Dellucci TV, Agley J, et al. Estimated prevalence of substance use disorders among US adolescents and emerging adults by substance class, severity, and age, 2021. JAACAP Open. 2025. Published online January 22, 2025.
10. Cengiz S, Turan ME, Ҫelik E. Attitudes of adolescents toward addictive substances: hope and self-control as protective factors. Children (Basel). 2025;12(1):106.
11. Ali H, Hameed M, Abbasi MA, et al. Ostracism predicting suicidal behavior and risk of relapse in substance use disorders. Cureus. 2024;16(6):e61519.
12. Sprunger JG, Hales A, Maloney M, et al. Alcohol, affect, and aggression: an investigation of alcohol’s effects following ostracism. Psychol Violence. 2020;10(6):585-593.
13. Schaefer BP, Vito AG, Marcum CD, et al. Examining adolescent cocaine use with social learning and self-control theories. Deviant Behav. 2015;36(10):823-833.
14. D’Souza JM. The Unique Effects of Hope, Optimism, and Self-efficacy on Subjective Well-being and Depression in German Adults. Master’s thesis. University of Houston; 2019. Accessed February 10, 2025. https://core.ac.uk/download/pdf/276539773.pdf
