Substance Abuse in Adolescence and Counseling


The particularities of human development across the lifespan are significant, influential factors in the emergence of multiple mental health issues. Various developmental models are applied to psychological conditions to mitigate risk factors, prevent, and treat a disorder. Alterations in the normal developmental processes from childhood to senior age imply the possibilities for comorbid conditions in the consecutive developmental stages. One such issue is substance abuse, which emerges as a severe problem in multiple age groups and is influenced by many determinants. Despite the undoubted severity of substance use disorder’s harmful effect on personality at any developmental stage, adolescents are particularly vulnerable to developing this condition. Teenagers are predisposed to acquiring new behavioral, psychological, and social skills and, therefore, are more susceptible to developing adverse habits alongside positive ones. At the same time, this vulnerability is commonly impacted by the abnormalities in the development at the early stages of the lifespan, which predetermine an individual’s inclination to addictive behaviors. In this paper, substance abuse as an addictive behavior in adolescents is explored from the perspective of the connections to developmental factors; counseling strategies to address this issue are introduced.

Adolescent Substance Use Disorder

Substance Use Disorder

The overall problem of addiction is multifaceted and influenced by many factors that might vary depending on the personal characteristics and experience of an individual. In the scholarly literature on psychiatry, development, and counseling, substance use disorder is commonly described as a severe condition that entails a vast number of comorbidities and endangers human health, duration, and quality of life (Afuseh et al., 2020; Gray & Squeglia, 2018; McCrory& Mayes, 2015). When defining substance use, one should emphasize that it is a complex phenomenon characterized by an individual’s dependence on the regular use of alcohol, tobacco, marijuana, and drugs that cause health or social complications (Gray & Squeglia, 2018). People of all ages might be exposed to the risk factors contributing to the development of a substance use disorder. As the scholarly literature sources show, the factors determining the inclination toward alcohol, tobacco, or drug misuse are of a psychological, social, cultural, experiential, and developmental nature (Afuseh et al., 2020; Jones et al., 2016). The contribution of these factors to the problem varies depending on the individual characteristics and severity of manifestation.

Indeed, one of the most influential determinants is physical or emotional trauma, which ultimately leads to depression as a cause of addictive substance consumption. As Afuseh et al. (2020) state, “depression and poor coping skills due to emotional trauma are strong indicators of potential substance misuse” (p. 4). Another factor for this condition development is chronic health problems in either mental or physical dimensions that expose vulnerable people to seeking solutions in addiction to substances (Jones et al., 2016). Environmental factors of peer influence, work or education conditions, as well as family history, have been identified as the triggers of substance use disorder.

In addition, social determinants, such as socioeconomic status, gender, race, or sexuality, play an important role in vulnerable or minority populations’ substance use inclinations (Jones et al., 2016). However, one of the factors that best apply to the issue at hand is the experience of abuse and the developmental alterations in early childhood. Research shows that “any form of abuse, neglect or other traumatic experience that occurs to persons younger than 18 years of age constitutes adverse childhood experience,” which is linked to “risky health behaviors, including substance use” (Afuseh et al., 2020, p. 3). Thus, adolescents are at a particular level of risk of being addicted to drinking, smoking, or taking drugs.

Substance Use Disorder in Adolescence

Some of the above-mentioned risk factors for developing substance use disorder are of particular relevance to adolescents since this age group undergoes social and psychological changes. Therefore, emotional regulation issues, emotional and physical trauma, peer pressure, self-perception crisis, and other pressures experienced by individuals in adolescence become triggers for using substances (McCrory & Mayes, 2015). The emotional and physical susceptibility of young individuals to the adverse effects of substances amplifies the risks of comorbidities and ultimate life-threatening behaviors that might follow.

Statistics might be a valuable source of evidence demonstrating the rates of substance abuse manifestations. According to Gray and Squeglia (2018) and Yoon et al. (2017), statistical data on the prevalence of substance use among American teenagers demonstrates that alcohol is the most frequently used substance that leads to addictive consumption. On the list of most often consumed substances, alcohol is followed by cigarette or electronic cigarette smoking, marijuana, and more severe drugs (Gray & Squeglia, 2018; Yoon et al., 2017). In particular, among the participants of the study, “at age 16, 21.6% of adolescents reported drinking alcohol, 17.4% reported smoking cigarettes, and 15.4% reported using or trying marijuana in the past year” (Yoon et al., 2017, p. 278). Despite such a prevalence rate, the behavioral patterns and attitudes toward adolescent substance use emerge with individual differences and their consequences, which is related to the evolution of substance abuse perception under the influence of “adult and peer behaviors, public policy, media messaging, substance availability, and other variables” (Gray & Squeglia, 2018, p. 618). Thus, risky health behaviors in general and addiction to substances, in particular, are of significant concern for adolescents.

Adolescent Substance Use Disorder Viewed from the Developmental Perspective

The developmental nature of adolescent substance abuse is related to the developmental particularities of individuals in the age between childhood and early adulthood. The factors that expose teenagers to risky health behaviors are based on the experiences and developmental patterns from their early childhood and “spill over into other domains of functioning and into subsequent developmental periods” (Jones et al., 2016, p. 721). As research shows, despite the proven relevance of social environments to “both maladaptive and adaptive functioning,” they do not eliminate the crucial impact of developmental features (Jones et al., 2016, p. 721). Moreover, the patterns of adaptive social functioning primarily depend on the beliefs, ties, and behaviors that are shaped by earlier developmental periods and continue to determine human life in the consecutive stages of the lifespan.

Adolescent substance abuse is of critical importance to healthcare and counseling professionals field because it imposes a significant threat to public health. Its inherent dependence on developmental factors increases the level of threat and allows for identifying the consequential relationships between the behavioral patterns within different developmental stages in the lifespan. On the one hand, adolescent substance abuse is significantly influenced by developmental problems in early childhood. According to Yoon et al., (2017), “39.9% of youth in 8th, 10th, and 12th grades reported drinking alcohol, 20.2% reported using cigarettes, and 23.7% reported using marijuana in the past year” (p. 272). Importantly, it has been validated that the highest rates of substance use in adolescence were reported by individuals who have been subjected to maltreatment in early childhood (Jones et al., 2016; Yoon et a;., 2020). Thus, such adolescents are at higher risk of developing more severe forms of addiction and consequent comorbid conditions.

Other evidence that serves as a demonstration of the developmental nature of adolescent substance use is the adverse childhood experiences research. It suggests that individuals who have been exposed to adverse childhood experiences are more likely to become addicted to substances across their lifespan (Afuseh et al., 2020).In addition to alcohol, tobacco, and drug misuse, individuals who have been subjective to childhood maltreatment are at risk of developing such behavioral health conditions as depressive disorders, anxiety disorders, as well as suicide (Afuseh et al., 2020). Therefore, the analyzed condition is significantly influenced by the experiences in the earlier stages of development.

On the other hand, risky addictive behaviors in adolescents present an increased potential for developing a severe dependence in the later developmental periods. According to a study, “substance use during adolescence has been found to be a strong predictor of the subsequent development of substance abuse or dependence over a lifespan” (Yoon, 2017, p. 271). The heterogeneity of adolescent substance use is also addressed as a factor that complicates the issue and contributes to its multifaceted effects on the lifespan.

Indeed, there are positive and negative patterns in alcohol or drug use; not all youth who try substances become addicted to them. However, according to research, the prevalence of those who become dependent is high, “with 15% of youth meeting diagnostic criteria for alcohol abuse and 16% for drug abuse by age 18” (Gray & Squeglia, 2018, p. 619). This statistical data is more representative of developmental relations at the later stages of lifespans when viewed from the perspective that most adults with substance addiction started using before they were 18 years old (Gray & Squeglia, 2018). Thus, the issue of substance abuse is commonly induced by the experiences of early childhood maltreatment, incept in adolescence, and develops into a severe comorbid problem at the later stages of the lifespan.

The issue is of significant relevance to the counseling practice because of the scope of comorbidities and irreversible consequences of adolescent substance addiction in the later developmental stages of the lifespan. Commonly observed co-occurrence of substance abuse and mental health conditions and physical health comorbidities amplify the acute nature of the issue and require an informed and professional addressing by counselors (Jones et al., 2016). Therefore, it is vitally important to identify the risk factors and indicators of substance use tendencies in adolescents to address them in a timely manner. When tackled by professional at the onset stage, the issue might be prevented and competently treated, which will ultimately minimize the possibility of the young individuals to develop severe dependencies and comorbidities that are likely to lead to a high level of mortality in the later stages of the lifespan.

Particularities of the Adolescence-Related Developmental Issues

Relevant to Counselors

Given the scope of factors contributing to and the range of consequences of substance abuse in adolescence, counselors must consider several important particularities that must be addressed by therapy strategies. Firstly, the connections between child maltreatment and substance abuse are very strong and have been validated by research (Jones et al., 2016; Yoon et al., 2017). Secondly, as informed by the developmental traumatology theory, “adverse psychological reactions that result from a highly traumatic and stressful event, including posttraumatic stress and other internalizing problems and externalizing problems, connect childhood adversities and adolescent substance use” (Yoon et al., 2017, p. 273). Thirdly, according to the social development model, the mechanisms of socialization in the family, among peers, and in educational settings lead to either prosocial or antisocial behavioral patterns (Jones et al., 2016). Thus, the nature of the social environment and the quality of an individual’s response to its influence determines the adaptive or maladaptive behavioral pattern, including substance misuse.

Finally, neurobiological mechanisms that dominate the adolescent development include the transformations in grey and white brain matter that predetermine cognitive advancement in adulthood. As Gray and Squeglia (2018) state, healthy development of the neurobiological mechanisms in the brain is vital due to its core importance in healthy functioning within emotional, cognitive, and social domains. However, when impacted “the exposure of neurotoxins during adolescence, particularly alcohol and other drug use,” brain neurodevelopment might be impaired and cause significant “cognitive problems into adulthood, conferring functional consequences throughout life” (Gray & Squeglia, 2018, p. 620). All these issues should be incorporated and properly addressed by counselors throughout their work with adolescent clients experiences substance use disorders.

Practical Counseling Considerations to Treat and Prevent Substance Use Disorder in Adolescents

The complexity of the issue’s nature, its determinants, and consequences require combined methods of therapy and an individualized approach to each client case. Ecological interventions might be applied to treat and prevent substance use in adolescents. According to Juntunen and Schwartz (2016), being informed about the environment within which the client lives might contribute to the scope of techniques of the counselor’s influence. The inclusion of the representatives of these environments, including family members, schools, and peers within specific programs, will provide multiple benefits for the elimination of adverse health behaviors.

Another important therapy option that is capable of addressing the tentative issues related to substance abuse in adolescence is family system interventions. It incorporates a set of therapeutic techniques involving family members of the client in order to provide support, eliminate risk factors, and ensure the sustainable effects of therapy (Juntunen & Schwartz, 2016). Behavioral interventions can also contribute to the scope of methods used by counselors for treating and preventing teenage substance misuse. Within the realm of this approach, a counselor might stimulate healthy behaviors and strong coping strategies for the clients regarding their individual particularities and needs (Juntunen & Schwartz, 2016). Overall, evidence-based, individualized, and combined therapy approach will facilitate the anticipated results of the counseling and ensure positive client outcomes.


The combination of the multiple factors determining the development of substance use disorder in adolescents necessitates a well-informed personalized approach in counseling. Mental health professionals should pay particular attention to the analysis of the client’s individual characteristics, experience, cultural background, family relations, and health history. The analysis and synthesis of all influential factors pertaining to the client’s condition will ensure the validation of all triggers that need to be addressed during the counseling sessions. The complexity and heterogeneity of the issue in such a difficult developmental stage as adolescence requires the application of a combined therapy approach that would incorporate the interventions addressing critical contexts of the client’s life, including environmental particularities, family systems, and behavioral patterns.


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Gray, K. M., & Squeglia, L. M. (2018). Research review: what have we learned about adolescent substance use?. Journal of Child Psychology and Psychiatry, 59(6), 618-627. Web.

Jones, T. M., Hill, K. G., Epstein, M., Lee, J. O., Hawkins, J. D., & Catalano, R. F. (2016). Understanding the interplay of individual and social-developmental factors in the progression of substance use and mental health from childhood to adulthood. Development and Psychopathology, 28(3), 721-741. Web.

Juntunen, C. L., & Schwartz, J. P. (2016). Counseling across the lifespan: Prevention and treatment (2nd ed.). Sage Publications.

McCrory, E. J., & Mayes, L. (2015). Understanding addiction as a developmental disorder: an argument for a developmentally informed multilevel approach. Current Addiction Reports, 2(4), 326-330. Web.

Yoon, S., Kobulsky, J. M., Yoon, D., & Kim, W. (2017). Developmental pathways from child maltreatment to adolescent substance use: The roles of posttraumatic stress symptoms and mother-child relationships. Children and Youth Services Review, 82, 271-279. Web.