Living Well / Reducing Substance Use

Living Well / Reducing Substance Use2020-09-19T08:19:10+00:00

The majority of those who have a substance use disorder started using before age 18 and developed their disorder by age 20.1

Substance use has a major impact on individuals, families, and communities. Children and adolescents who use substances at an early age are more likely to face problems with substance use as adults.2 The effects of youth alcohol and other drug use are cumulative, significantly contributing to a wide range of costly physical and mental health problems.3 Substance use has been linked to risky health behaviors (e.g., unprotected sex, smoking), injuries, motor vehicle accidents, impaired cognitive functioning, poor academic performance, physical violence, and suicide attempts.4

This indicator tracks the percentage of public school students who have used alcohol or drugs (excluding tobacco) in the previous 30 days.

Indicator Highlights

Youth Substance Use

Use of alcohol and drugs by youth increases dramatically from grade 7 to grade 11.5

Nearly one in five 11th graders had either driven when they had been drinking, or had ridden with a driver who had been drinking, at least once in their lifetimes.4

One in five 11th graders reported having used prescription pain medications to get high.5

Treatment Access and Utilization

About 2.7 million Californians met criteria for substance use disorder in the past year, but only 10% received any type of treatment.5

74% of adults participating in a substance abuse treatment program initiated alcohol or drug use before the age of seventeen.2

Addiction is a Health Condition Which Can Be Treated

Like other chronic diseases, substance use disorders can be prevented, treated, and managed. Treatment approaches include a range of behavioral therapies, medication-assisted treatment, and recovery support services. 5

Fewer than 10% of youth who need substance use disorder services receive them. Reasons include lack of easy access, lack of a workforce trained to work with youth, stigma, and family and cultural barriers.5

Social Norms Influence Attitudes and Behaviors

Often, youth overestimate the number of their peers who are engaging in substance use.

Using a social norms approach can help correct this misperception through a focus on the healthy norm: that most people do not engage in a risky behavior.6


Mental Health and Wellbeing

For adolescents, mental illnesses and substance use disorders often occur together.

As many as 60% to 75% of adolescents with substance use disorders are estimated to have a co-occurring mental illness. In some cases, substance use may begin as a strategy for self-medicating to manage psychiatric symptoms.7


Data Snapshot: Trends & Disparities

Substance use was reported at higher levels by female students; students whose parents did not finish high school; and gay, lesbian and bisexual students.4

Lack of connectedness is a risk factor for adolescent substance use. 35% of students using substances reported low connectedness, compared who 16% who reported high connectedness.4

Emergency department (ED) visits due to alcohol and other drug diagnoses vary geographically, with the Northern and Sierra region experiencing rates substantially above the state average.5

Lifetime marijuana use among California 11th graders was 64% overall, and ranged from 45% to 74% across counties with data.4

Adolescents who are homeless, in the child welfare and juvenile justice systems, living in rural areas, or who are lesbian, gay, bisexual, and/or transgender were least likely to receive mental health services.7

Percentage of Public School Students Who Have Used Alcohol or Drugs (Excluding Tobacco) in the Previous 30 Days, by Demographic Category

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Percentage of Public School Students Who Have Used Alcohol or Drugs (Excluding Tobacco) in the Previous 30 Days, by County

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Indicator Name: Substance Use

Indicator Description: Weighted estimated percentage of public school students in grades 7, 9, 11, and non-traditional programs who have used alcohol or drugs (excluding tobacco) in the previous 30 days (e.g., in 2013-2015, an estimated 23.2% of 9th graders in California had used alcohol or drugs in the previous month).

Data Limitations: Survey data is based solely on student responses and not corroborated by other data. Data for certain counties have been suppressed because the sample was too small to be representative.

Indicator Source: WestEd, California Healthy Kids Survey. California Department of Education (Jul. 2017).

Indicator Calculation Methodology: See indicator description.

Data Collection Methodology:

Program URL Link:

Reporting Cycle: Annual survey, but results aggregated into 2-year intervals.

Reporting Lag: Four years

1. National Institute of Drug Abuse, Principles of Adolescent Substance Use Disorder Treatment;

2. Substance Use and Mental Health Services Administration (SAMHSA), Link between Underage Substance Use and Problems in Adulthood;

3. Healthy People 2020;

4. Kids Data;

5. California HealthCare Foundation Substance Use Disorder Almanac, Substance Use in California: A Look at Addiction and Treatment;

6. Griesse, R. & Sullentrop, K. (2017). Using a Social Norms Approach to Prevent Youth Substance Use. Washington, DC: Administration on Children, Youth and Families, Family and Youth Services Bureau.

7. California HealthCare Foundation, Mental Health and Substance Use: A Crisis for California’s Youth;


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