[5 min read]
- Drug abuse among teens and adolescents is a significant public health concern. Discussing the topic with your kids can be challenging.
- The explosion of opioid abuse is a frightening reality, with fentanyl a major factor in some 69% of drug overdose deaths in the United States.
- A Swedish expert has some guidance for talking about drugs and alcohol in ways that build family connections and support your kids in making better decisons about substance use.
Talking to your kids about drugs and alcohol can feel overwhelming. Parents often worry about saying the wrong thing, starting the conversation too early, or unintentionally sparking curiosity. Others assume their child isn’t exposed yet. But the reality is that kids and teens are being exposed to alcohol and drugs earlier and more often — through friends, social media, and even counterfeit prescription pills that look harmless but can be deadly.
While the National Institute on Drug Abuse reports that drug use among teens remains relatively low, the risk remains present. In 2023, about 15% of eighth graders and 7.2% of teens between the ages of 12 and 17 reported using an illicit substance in the past month, according to national survey data. Alcohol remains the most commonly used substance among teens, with many first exposures happening well before high school and significant numbers of teens reporting binge drinking. At the same time, opioid overdose deaths among individuals between the ages of 15 and 24 years old increased by an astonishing 700% betweeen 2019 and 2022. Opioids are a factor in some 76% of overdose deaths.
Fentanyl has transformed navigating the drug landscape for kids and parents. The synthetic opioid is extremely powerful — up to 50 times stronger than heroin — and is increasingly found in fake prescription pills sold online or shared among peers. Teens often don’t realize what they’re taking, often assuming they were using something else entirely. For parents, this means that even one experiment can have deadly consequences.
These realities make early, ongoing conversations critical, which may seem counterintuitive to some parents who are nervous about sparking curiosity or introducing a topic their kids may not be ready for. But research consistently shows that delaying the start of substance use — by as little as one year — can significantly reduce a child’s risk of developing long‑term substance use problems. Early intervention also helps protect the developing brain, build decision‑making skills, and strengthen the parent‑child relationship before risky situations arise.
Experts emphasize that most effective conversations aren’t one‑time lectures — they’re age‑appropriate, honest and rooted in trust. Talking about drugs and alcohol won’t make kids more likely to try them. But avoiding the topic can leave them unprepared in a world where the stakes are higher than ever. Alex Chang, Ph.D., a psychologist at Providence Swedish South Lake Union Primary Care has some guidance for parents on starting the conversation early, and how to keep it going so you and your kids have powerful tools to make healthy decisions about drug and alcohol use.
My kids are still pretty young. When is it too early to begin talking about drugs and alcohol with them?
Kids are naturally curious, and drugs and alcohol are often prominent in culture. If they see someone smoking or drinking on TV, or when walking around, they will naturally have questions. Using these natural opportunities to have conversations about substance use is a great way to talk about safety at any age! The earlier and more frequently we have these conversations, the more informed any kid’s decision will be.
I’m worried that the discussion will prompt their curiosity and experimentation. Should I be concerned?
It sounds backwards, but research finds that more conversations lead to less substance misuse! When kids feel safe asking questions about substances, it is easier for them to get answers without experimentation. You don’t have to know all the answers immediately either! Looking for these answers in a safe setting together helps kids learn problem solving skills, feel more bonded to their parent, and understand the consequences of substance use.
We drink socially and occasionally use marijuana, but I don’t want my kids trying these substances until they are older. Is this reasonable? What’s the best approach to this conversation? Is a hard “NO” ever acceptable?
That’s totally understandable, as there is research that earlier use is correlated with later misuse. Having set expectations for experimentation including this is how you earn this privilege; this is the age; and these are the substances that are allowed or acceptable can be helpful. A hard no without conversation is often counterproductive, so coming to the table with reasoning for why you would like them to wait and when would be appropriate is a good start. However, if there is concern that they will start trying immediately anyways, discussions about how to do so safely and with supervision reduce the risk.
What are some good parameters to keep in mind if my kids ask me or my spouse about our own history with drugs and alcohol?
Honesty is the best policy! This kind of disclosure can really help a kid feel safe and comfortable with parents. While we don’t want to talk up how great substances are or say that everyone is doing it (teens statistically overestimate substance use in their peers), opening up about mistakes and dangers of substance use encourages kids to tell us when they make mistakes. As much as we would like to eliminate risk entirely, kids frequently do things we don’t want them to. If they feel like they can tell us when they do, they will be safer in the long run, because we can intervene when necessary. A kid using but telling their parents is safer than a kid using in secret!
Are there OTC drugs I should be concerned about my kids experimenting with?
The most common OTC for misuse is cough syrup, which is also why some stores have begun putting cough syrup in locked cabinets. Dextromethorphan (DXM), the ingredient in cough syrup that kids are looking for to get a high, is also sometimes present in cold medicine. Again, conversations about the risks involved can be preventative as many teens report not thinking of OTC drugs as dangerous. As a general rule, though, OTC drugs should be kept out of reach of small children and not easily accessible to teens. If they need medication, they can ask!
One of my kids shared that they feel pressure to drink/drug in certain social groups. What’s the healthiest way to address their anxiety without just advising them to avoid the group/kids?
This is already a great sign that they are comfortable talking to you! Help them develop a plan for what to do when they feel uncomfortable, such as a code word they could text or call so that they can be picked up, and practice what they can say when they feel pressured. You can also help them find new activities that have opportunities for new friends so that they may naturally begin to shift groups.
Can you share some thoughts about the fentanyl epidemic and why the drug is so dangerous?
It’s scary to see how fentanyl is how accessible fentanyl is. It’s relatively low cost and can now be bought pretty much anywhere. There are people essentially selling fentanyl over social media, which makes it accessible to pretty much any teen. Kids who are experimenting with other drugs can be fooled into buying a pill that actually has lethal amounts of fentanyl. Fentanyl also disproportionately affects kids from lower socio-economic backgrounds, due to less access to mental health and educational resources. The more space we can create for conversations, both public and private, about substance use, the better. Limiting fentanyl use is a societal effort!
Are there worrisome trends you see in your practice in terms of young people and substance use?
National data indicates that substance use in teens has largely held steady since the pandemic, which saw a significant drop due to less accessibility to drugs. However, how teens use is changing. Alcohol and cocaine use are down, while marijuana and hallucinogens are up, and the rise of fentanyl has led to more overdoses than in the past. Research also shows that kids who see substance use on social media are more likely to use the substance themselves. With social media now a prominent part of life, being careful about what is presented to kids can be a preventative step.
What should I do if I think my child might be hiding a substance use issue from me?
Try to have more open conversations about substance use! Research shows that the most effective way we currently must reduce risk is education. Teens are also typically using for a reason, such as fitting in socially or emotional distress; if we can help them find other ways to meet those needs, they are less likely to use. Establishing that experimentation happens and that you are there to help them can create space.
Learn more and find a physician or advanced practice clinician (APC)
If you or someone you love need help with substance use, support is available from our caring experts at Providence Swedish Behavioral Health. Visit our website to find care near you.
If you require an in-person visit or want to consult a doctor virtually for your health concern, Providence Swedish is here for you. Contact Swedish Primary Care to schedule an appointment with a primary care physician. You can also connect virtually with your doctor to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual, you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.
Information for patients and visitors
Additional resources
Narcan: a lifesaving tool you should know about
The dangers of fentanyl — one mother’s story
A brighter future for pregnant people with substance use disorders
Mindful drinking – how much alcohol is too much?
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Follow us on Facebook, Instagram and X.
The Providence app offers world-class health care with human connection
About the Author
More Content by Swedish Behavioral Health Team
