New analysis from Denmark unpacks how adolescent substance use (even “simply” alcohol) can pave a harmful path to future psychological well being crises. Clinicians, take word.
Adolescent experimentation with medication is just not unusual, alcohol and tobacco are typically the 2 hottest (and legally obtainable) substances that younger individuals strive. A major minority will even strive illicit substances akin to hashish, cocaine and ecstasy for instance. There’s additionally knowledge suggesting younger persons are utilizing pharmaceutical medication akin to sedatives and tranquilisers and not using a prescription in what’s known as non-medical use of pharmaceuticals (EUDA, 2025).
Understanding how adolescent substance use patterns predict psychological well being problems is extremely related for clinicians working with younger individuals. There’s a generally held view by psychological well being professionals that there’s a connection between younger individuals’s drug use and the emergence of psychological well being issues. A brand new research in Lancet Public Well being sought to discover this hyperlink and set up if adolescent drug use is a danger issue for psychological well being issues that develop in maturity (Hansen et al, 2025).
Adolescent substance use is widespread and understanding its hyperlinks to later psychological well being problems would profit clinicians working with younger individuals.
Strategies
This analysis drew on data obtainable for younger individuals in Denmark from nationwide registers in 2014. The younger individuals have been between 15 and 19 years previous. The pattern was giant and population-based, with 68,301 individuals, of which 59.7% have been feminine and 40.3% have been male, and adopted up over eight years. Strong linkage with nationwide hospital and prescription registers strengthened the supply and objectivity of knowledge. The main target of the authors was on adolescent drug use and any consequent contact with psychological well being companies for a variety of issues together with consuming problems, melancholy, suicidal ideation and nervousness amongst others.
A spread of associated elements akin to parental substance use, socio-demographic standing and schooling have been additionally collected.
4 patterns of substance use have been characterised by the researchers:
- Alcohol use solely
- Frequent binge ingesting
- Experimental substance use
- Early-onset a number of substance use.
Outcomes
A small proportion (8.6%) reported no alcohol and drug use. For the 4 teams characterised by the authors, alcohol proved to be essentially the most used substance, which displays the findings of different research and surveys of younger individuals. For these characterised as early-onset a number of substance use, most had used alcohol and tobacco in addition to different illicit substances.
As could have been anticipated, a dose-response relationship was discovered between early drug use and psychological well being issues in maturity. That’s to say that the extra substances a youngster used the higher their danger of encountering companies later as a result of psychological well being issues. For instance, the hazard ratio for frequent alcohol use and later psychological well being difficulties was 0.87 and 1.58 for these within the early-onset a number of substance use group, in contrast with the alcohol-only group.
One putting discovering with direct medical implications is that adolescents within the early-onset a number of substance use group had a markedly larger danger of suicidal behaviour (HR 3.20) in comparison with the alcohol-only group. Clinicians may additionally word with warning that adolescents participating in frequent binge ingesting confirmed a barely decrease danger of psychological or behavioural problems in comparison with the alcohol-only group, although their alcohol use nonetheless warrants concern (HR 0.87).
The gender variations reported on this research are fascinating. For instance, opposite to what many might imagine, younger ladies have been extra more likely to drink alcohol than younger males, 52.2% versus 43.8%. Though younger males have been extra more likely to experiment with medication than their feminine friends, 22.9% versus 11.8%.
The research confirmed a dose–response relationship between adolescent substance use and later psychological well being issues, with early-onset a number of substance use strongly linked to larger dangers, together with suicidal behaviour.
Conclusions
This is a vital research that builds on earlier analysis suggesting a transparent hyperlink between adolescent publicity to substances and encountering psychological well being issues sooner or later.
There’s a widespread notion that younger males are extra possible to make use of substances than their feminine counterparts, this analysis gives some attention-grabbing insights that problem this view.
For clinicians, these outcomes spotlight the significance of early identification and tailor-made intervention for adolescents displaying high-risk substance use patterns, which might assist forestall extreme psychological well being outcomes later.
Figuring out and addressing high-risk substance use in adolescents might forestall severe psychological well being challenges in maturity.
Strengths and limitations
It’s encouraging to see gender included within the knowledge and reported within the evaluation. Though this may occasionally seem to be a fundamental piece of knowledge it’s sadly not all the time included. Regardless of many journals and tutorial our bodies saying they encourage together with knowledge on gender this continues to be an ambition reasonably than the norm (Bibb, 2022).
The authors acknowledge some limitations to their analysis. As they relied on follow-up knowledge drawn from hospital contacts, they might have missed much less extreme or milder psychological well being issues. In addition they didn’t accumulate knowledge on ethnicity so have been unable to discover this necessary demographic element. This implies clinicians ought to stay alert to cultural and ethnic variations in substance use patterns that this research couldn’t seize.
Taking these limitations under consideration, the authors assert that they might have underestimated the extent of the connection between teenage drug use and grownup psychological well being issues.
I’ll sit on the fence relating to the statistical strategies and reporting, a number of of those have been used. Some might imagine that is legitimate, however I discovered it a bit complicated when it got here to unpicking the outcomes because it was troublesome to match completely different variables and outcomes.
This analysis could have underestimated milder circumstances and lacked ethnic subgroup analyses related for various medical settings.
Implications for observe
This research gives essential intelligence for practitioners because it factors to the dangers that early substance use poses to later psychological well being. Particularly, the higher and extra frequent use of drugs and psychological well being issues. I’m certain many psychological elves may have been conscious of this, however it’s helpful to have additional proof.
Clinicians working with adolescents might contemplate incorporating routine screening for early substance use patterns, with particular deal with age of first use and varieties of substances tried. These outcomes additionally assist advocating for insurance policies that delay the initiation of alcohol and drug use amongst younger individuals, akin to larger minimal authorized ingesting ages or tighter promoting restrictions.
For me one of the crucial helpful findings is on gender variations, or the shortage of distinction in some circumstances. Conference says that younger males are extra vulnerable to danger taking together with experimenting with substances, whereas that is still partly true, this research gives some fascinating insights about the place that is reversed, as it’s younger ladies who’re at a higher danger. Highlighting not solely that gender issues, however trying past the headline findings can also be necessary.
Findings spotlight the significance of prevention methods and coverage advocacy to delay substance initiation at younger age.
Hyperlinks
Main paper
Elisabeth R Hansen, Sofie Kruckow, Sarah W Feldstein Ewing, Merete Nordentoft, Kristine Rømer Thomsen, Janne S Tolstrup. 2025. Adolescent substance use patterns and subsequent danger of psychological and behavioural problems, substance use, and suicidal behaviour: a cohort research. Lancet Public Well being;10: e578-87.
Different references
Bibb, L.A., Adkins, B.D., Sales space, G.S., Shelton, Ok.M. and Jacobs, J.W., 2022. Evaluation of intercourse and gender reporting insurance policies in preeminent biomedical journals. JAMA Community Open, 5(8), pp.e2230277-e2230277.
European Union Drug Company, 2025. New ESPAD survey outcomes: Teen substance use down, however new dangers rising. https://www.euda.europa.eu/information/2025/new-espad-survey-results_en
