Key takeaways
- Among California adolescents (ages 12–17) who currently use drugs or alcohol, 46% experienced serious psychological distress in the past year.
- Adolescents who use drugs or alcohol reported serious suicidal thoughts or attempts at more than triple the rate of adolescents who do not use them.
- Adolescents who use drugs or alcohol and have psychological distress are nearly six times as likely to have suicidal thoughts and attempts as those who use drugs or alcohol but don't have any psychological distress.
Adolescents who use drugs or binge drink alcohol are more likely to experience psychological distress and have seriously thought of or attempted suicide, according to a new study from the UCLA Center for Health Policy Research (CHPR).
Data from the 2022–2024 California Health Interview Surveys (CHIS) show that 9% of California adolescents ages 12–17 currently use one or more substances, which for this study included marijuana/THC, binge drinking alcohol, e-cigarettes and cigarettes. Current use was defined as having used any of the four substances in the past month.
The study also showed that 46% of adolescents who currently use substances had experienced serious psychological distress in the past year compared with 27% of adolescents who do not currently use substances. In this study, psychological distress encompassed serious and moderate levels of distress, which ranged from serious diagnosable mental health challenges to clinically relevant distress that warrants mental health intervention.
When looking at how the combination of substance use and psychological distress was associated with suicidal thoughts and attempts, the numbers were stark. Nearly half (47%) of adolescents who experienced psychological distress and currently use substances reported suicidal thoughts or attempts in the year prior to being surveyed, compared with 1 in 4 (24%) adolescents who experienced psychological distress but did not use drugs or alcohol.
Overall, 10% of California adolescents said they had seriously thought about or attempted suicide in the past year.
"Substance use combined with psychological distress is a dangerous mix," said Imelda Padilla-Frausto, a research scientist at the UCLA CHPR and lead author of the study. "The study demonstrates the importance of prevention, early intervention and treatment for adolescents who have both substance use and psychological distress."
Research has demonstrated that early, frequent or heavy substance use can harm brain development and can have a negative effect on mental health.
To conduct this study of substance use and its associations with psychological distress and suicide risk, Padilla-Frausto examined data from nearly 3,000 interviews with adolescents conducted as part of the 2022, 2023 and 2024 California Health Interview Surveys.
Among adolescents who did not experience psychological distress, but who currently use substances, 8% reported suicidal thoughts or attempts. This was four times the percentage of similar adolescents who do not currently use substances who reported suicidal thoughts or attempts (2%).
And adolescents who had ever used drugs or drank alcohol were more than three times as likely to report suicidal thoughts and attempts as those who never used substances (20% versus 6%).
Policy recommendations
Recognizing the seriousness of adolescent mental health and substance use, the report contains several policy recommendations, including tailored early intervention efforts for adolescents who are at high risk for both substance use and mental health issues, as well as locating mental health and substance use services and treatments in the same place.
"We're all bombarded every day with the glamorization of using drugs and alcohol in ads, movies, music and social media, so is it a big surprise that adolescents use them?" Padilla-Frausto said. "We need to invest in more prevention efforts, early interventions, and make treatment more youth-centered and accessible. In addition to that, we could more strongly enforce regulations and restrictions that were meant to keep adolescents from accessing these substances."
