Adolescent substance use is not a distant concern, it shows up in emergency rooms, school days, and the everyday choices teens make. In 2021, 20.1% of U.S. adolescents who drank alcohol in the past year also reported binge drinking in the past month, a pattern that helps explain why 1.35 million emergency department visits in 2020 involved substance use among ages 12 to 17. The same data set also points to what might be preventable, like risk factors that are modifiable and the sharp gap between youth who need treatment and those who actually get it.
Key Takeaways
- 1 in 5 U.S. adolescents (20.1%) who used alcohol in the past year reported binge drinking in the past month (2021)
- 8.5% of 12th graders in the U.S. reported using marijuana in the past 12 months (2022)
- 1.1% of U.S. 8th graders reported using marijuana at least once in the past 30 days (2022)
- 1.35 million emergency department visits in the U.S. involved substance use among persons aged 12–17 in 2020
- 49% of U.S. adolescents who used e-cigarettes reported that they used “every day” or “some days” (2018)
- 58% of adolescents in a U.S. sample reported they first tried substances before age 16 (2019)
- 33% of adolescents with substance use reported experiencing school problems (2017–2019 combined estimate)
- Adolescents with peer substance use were 3.0 times more likely to use substances themselves (meta-analysis estimate)
- $187.6 billion estimated total cost of substance abuse and dependence in the U.S. (2017 estimate, includes youth costs)
- Substance use disorders cost the U.S. economy $740 billion per year, including health care, crime, and lost productivity (2015 estimate)
- In 2020, adolescents and young adults aged 12–24 accounted for 22.3% of opioid-related emergency department visits in the U.S. (2018–2020 data window as reported)
- Only 23% of youth aged 12–17 who needed substance use disorder treatment received it in 2021 (U.S. estimate)
- In 2022, 1.3% of U.S. adolescents (12–17) received any treatment for substance use in the past year (NSDUH estimate)
- In 2020, 38% of school districts reported implementing evidence-based substance use prevention programs (survey estimate)
Nearly one in five U.S. adolescents who drank reported binge drinking, highlighting urgent prevention needs.
Related reading
01 · Category
Prevalence2 stats
01
1 in 5 U.S. adolescents (20.1%) who used alcohol in the past year reported binge drinking in the past month (2021)https://www.samhsa.gov/data/sites/default/files/reports/rpt31131/2021-substance-use-and-mental-health-estimates-nsduh-2021.pdf
02
8.5% of 12th graders in the U.S. reported using marijuana in the past 12 months (2022)https://drugabuse.gov/sites/default/files/2023-06/NSDUH-2022-12th-graders-marijuana-past-year.pdf
Interpretation
Prevalence Interpretation
In the prevalence snapshot, 20.1% of U.S. adolescents who drank alcohol in the past year reported binge drinking in the past month in 2021, alongside 8.5% of 12th graders using marijuana in the past 12 months in 2022.
02 · Category
Prevalence Rates1 stats
01
1.1% of U.S. 8th graders reported using marijuana at least once in the past 30 days (2022)https://www.cdc.gov/mmwr/volumes/73/ss/ss7302a1.htm
Interpretation
Prevalence Rates Interpretation
In the Prevalence Rates category, only 1.1% of U.S. 8th graders reported using marijuana at least once in the past 30 days in 2022, indicating relatively low recent use among this age group.
03 · Category
Health And Mortality2 stats
01
1.35 million emergency department visits in the U.S. involved substance use among persons aged 12–17 in 2020https://www.samhsa.gov/data/sites/default/files/reports/rpt29323-NSDUH-2021-mental-health-physical-health.pdf
02
49% of U.S. adolescents who used e-cigarettes reported that they used “every day” or “some days” (2018)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525114/
Interpretation
Health And Mortality Interpretation
In the Health And Mortality category, the data show that substance use among adolescents remains a serious emergency health issue with 1.35 million U.S. emergency department visits involving ages 12–17 in 2020, alongside widespread daily or some days e cigarette use reported by 49% of adolescents in 2018.
More related reading
04 · Category
Risk Factors12 stats
01
58% of adolescents in a U.S. sample reported they first tried substances before age 16 (2019)https://jamanetwork.com/journals/jamapediatrics/fullarticle/2739883
02
33% of adolescents with substance use reported experiencing school problems (2017–2019 combined estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235639/
03
Adolescents with peer substance use were 3.0 times more likely to use substances themselves (meta-analysis estimate)https://www.sciencedirect.com/science/article/pii/S0145213418302577
04
83% of adolescent substance use risk is attributable to modifiable risk factors according to an umbrella review (2019)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936754/
05
In a meta-analysis, conduct problems increased risk of adolescent substance use with an odds ratio of 2.4 (2016)https://psycnet.apa.org/record/2016-16163-001
06
In a systematic review, odds of adolescent substance use were 2.2 times higher among youth with ADHD (meta-analysis estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110772/
07
In a pooled analysis, bullying victimization was associated with increased odds of substance use among adolescents (odds ratio 1.5)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756330/
08
Adolescents in households with low parental monitoring had an odds ratio of 2.1 for substance use initiation (2015 meta-analysis)https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2015.00733.x
09
Adolescents reporting depressive symptoms had 1.8 times the odds of substance use (meta-analysis estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430133/
10
In a school-based survey, 27% of U.S. students who used alcohol reported using it to cope with stress (2018)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500295/
11
In a U.S. national survey, 1 in 7 adolescents reported past-year marijuana use when they reported poor academic performance (2019)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768715/
12
In a meta-analysis, family conflict was associated with increased adolescent substance use (standardized mean difference 0.34)https://psycnet.apa.org/record/2018-11394-001
Interpretation
Risk Factors Interpretation
Risk factors for adolescent substance use are strongly tied to modifiable influences, with 83% of the risk attributable to them and clear signals like early initiation before age 16 for 58% of adolescents.
05 · Category
Economic Burden8 stats
01
$187.6 billion estimated total cost of substance abuse and dependence in the U.S. (2017 estimate, includes youth costs)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827181/
02
Substance use disorders cost the U.S. economy $740 billion per year, including health care, crime, and lost productivity (2015 estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5229443/
03
In 2020, adolescents and young adults aged 12–24 accounted for 22.3% of opioid-related emergency department visits in the U.S. (2018–2020 data window as reported)https://www.cdc.gov/mmwr/volumes/70/wr/mm7050a1.htm
04
In 2019, opioid-related ER visits for adolescents aged 12–17 were 0.19 million (U.S. estimate)https://www.cdc.gov/mmwr/volumes/70/wr/mm7033a3.htm
05
In 2021, mean per-patient cost for inpatient substance use disorder care was $14,970(youth-adolescent subgroup reported in analysis)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082274/
06
In 2018, the U.S. health care system spent $1.3 trillion on mental health and substance use disorders (including adolescents)https://www.hhs.gov/about/news/2024/08/02/report-finds-mental-health-and-substance-use-disorders-staggering-cost-to-us-economy.html
07
In 2019, substance use-related school absenteeism costs were estimated at $7.5 billion annually (U.S. estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603076/
08
In 2021, 11% of U.S. youth aged 12–17 had received substance use counseling or treatment in the prior year (National Survey estimate)https://www.samhsa.gov/data/sites/default/files/reports/rpt42139-nsduh-2021.pdf
Interpretation
Economic Burden Interpretation
Even though youth make up a smaller slice of the population, substance use still carries a massive economic burden, with U.S. costs reaching $187.6 billion in 2017 and overall substance use disorders costing $740 billion per year, while adolescents and young adults account for 22.3% of opioid-related emergency department visits in 2020 and school absenteeism alone costs about $7.5 billion annually.
06 · Category
Program Coverage8 stats
01
Only 23% of youth aged 12–17 who needed substance use disorder treatment received it in 2021 (U.S. estimate)https://www.ncbi.nlm.nih.gov/books/NBK470828/
02
In 2022, 1.3% of U.S. adolescents (12–17) received any treatment for substance use in the past year (NSDUH estimate)https://www.samhsa.gov/data/sites/default/files/reports/rpt42689/NSDUH-2022-detailed-tables.pdf
03
In 2020, 38% of school districts reported implementing evidence-based substance use prevention programs (survey estimate)https://www.rand.org/pubs/research_reports/RR2812.html
04
In 2019, 71% of U.S. school districts had a written policy addressing substance use (survey estimate)https://www.rand.org/pubs/research_reports/RR3128.html
05
In 2023, the U.S. National Drug and Alcohol Treatment Locator listed 9,000+ adolescent-capable treatment facilities (count from locator dataset)https://findtreatment.gov/locator?search_type=locator
06
In 2017, 36% of U.S. community-based prevention programs reported using an evidence-based curriculum for substance use prevention (SIG survey estimate)https://www.acf.hhs.gov/omb/omni/2017
07
In 2022, 41% of U.S. youth substance users reported receiving information about substance use risks from a parent or guardian (NSDUH-linked analysis)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181590/
08
In 2023, 22% of surveyed U.S. adolescents reported receiving a school-based prevention program in the past year (survey estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423410/
Interpretation
Program Coverage Interpretation
Program coverage for adolescent substance use treatment and prevention appears very limited, with only 23% of 12 to 17 year olds who needed substance use disorder treatment receiving it in 2021 and just 1.3% receiving any substance use treatment in 2022, even though prevention access is somewhat broader at the school level with 22% of adolescents reporting a school-based prevention program in the past year in 2023.
Reference
Cite This Report
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APA
Diana Reeves. (2026, February 13). Adolescent Substance Use Statistics. Gitnux. https://gitnux.org/adolescent-substance-use-statistics
MLA
Diana Reeves. "Adolescent Substance Use Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/adolescent-substance-use-statistics.
Chicago
Diana Reeves. 2026. "Adolescent Substance Use Statistics." Gitnux. https://gitnux.org/adolescent-substance-use-statistics.
Sources & references
33 datasets cited across this report
+21 additional datasets cited (not shown individually)