Substance Use

Youth Substance Use Impacts Long-Term Health Outcomes

School health providers are concerned about youth substance use because it impacts a student’s long-term health outcomes and their academic performance. Substance use is linked to lower grades, student absenteeism, and higher rates for high school dropout.1 Adolescent substance use is also highly predictive of adult substance abuse because the adolescent brain is still developing making it more susceptible to addiction. Nine out of ten people meeting the clinical criteria for a substance use disorder began using one or more addictive substances before the age of 18.2 Schools, school-based health programs, and school support services are ideally positioned to educate, prevent, and intervene early in youth substance use, preventing experimentation from escalating to misuse or addiction.

Nationwide, 14% of high school students have misused an opioid prescription.3 In California, 20% of 9th graders and 29% of 11th graders used alcohol or drugs at least once in the last month.4 Risk factors such as trauma, mental health conditions, and environmental factors can increase a young person’s likelihood of substance use.

School-Based Health Centers Help Prevent and Treat Substance Use

School-based health centers (SBHCs) are ideal places to identify these youth and provide evidence-based services that inform them about the health risks associated with alcohol and drug use, motivate them to change their behaviors, and support them in addressing the concerns that may be underlying their substance use.

At the same time, SBHCs are ideally positioned to address the underlying risks that contribute to substance use and strengthen protective factors by improving school climate and implementing trauma-informed practices.

Resources for Practice

For tools to help you start and run school school substance use programs, see Substance Use Resources.

(1) D’Amico, E.J., et al. (2016). Alcohol and Marijuana Use Trajectories in a Diverse Longitudinal Sample of Adolescents: Examining Use Patterns from Age 11 to 17. Addiction, 111(10), 1825–1835; Engberg J., Morral A.R. (2006). Reducing substance use improves adolescents’ school attendance. Addiction, 101(12), 1741-1751.
(2) The National Center on Addiction and Substance Abuse (CASA) at Columbia University. (2011). Adolescent Substance Use: America’s #1 Public Health Problem. New York: CASA.
(3) Kann L., McManus T., Harris W. A., et al. (2018). Youth Risk Behavior Surveillance — United States, 2017. MMWR Surveill Summ 2018, 67(SS-8), 1–114. Retrieved from:
(4) California Healthy Kids Survey. (2017). Alcohol/drug use in past month, by grade level [data file]. Retrieved from