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 observe.
Adolescent experimentation with medicine is just not unusual, alcohol and tobacco are usually the 2 hottest (and legally obtainable) substances that younger folks attempt. A big minority will even attempt illicit substances similar to hashish, cocaine and ecstasy for instance. There’s additionally knowledge suggesting younger individuals are utilizing pharmaceutical medicine similar to sedatives and tranquilisers with out a prescription in what’s known as non-medical use of prescribed drugs (EUDA, 2025).
Understanding how adolescent substance use patterns predict psychological well being problems is extremely related for clinicians working with younger folks. There’s a generally held view by psychological well being professionals that there’s a connection between younger folks’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 frequent and understanding its hyperlinks to later psychological well being problems would profit clinicians working with younger folks.
Strategies
This analysis drew on data obtainable for younger folks in Denmark from nationwide registers in 2014. The younger folks had been between 15 and 19 years previous. The pattern was giant and population-based, with 68,301 individuals, of which 59.7% had been feminine and 40.3% had been male, and adopted up over eight years. Strong linkage with nationwide hospital and prescription registers strengthened the supply and objectivity of information. 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, despair, suicidal ideation and nervousness amongst others.
A spread of associated elements similar to parental substance use, socio-demographic standing and training had been additionally collected.
4 patterns of substance use had 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 probably the most used substance, which displays the findings of different research and surveys of younger folks. For these characterised as early-onset a number of substance use, most had used alcohol and tobacco in addition to different illicit substances.
As might 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 better their danger of encountering companies later resulting from 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 scientific implications is that adolescents within the early-onset a number of substance use group had a markedly increased danger of suicidal behaviour (HR 3.20) in comparison with the alcohol-only group. Clinicians may additionally observe with warning that adolescents partaking 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 had been extra prone to drink alcohol than younger males, 52.2% versus 43.8%. Though younger males had been extra prone to experiment with medicine 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 increased dangers, together with suicidal behaviour.
Conclusions
This is a crucial 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 frequent notion that younger males are extra doubtless to make use of substances than their feminine counterparts, this analysis offers some fascinating insights that problem this view.
For clinicians, these outcomes spotlight the significance of early identification and tailor-made intervention for adolescents exhibiting high-risk substance use patterns, which may assist stop extreme psychological well being outcomes later.
Figuring out and addressing high-risk substance use in adolescents may stop 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 will likely appear to be a primary piece of knowledge it’s sadly not all the time included. Regardless of many journals and educational our bodies saying they encourage together with knowledge on gender this continues to be an ambition slightly 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 may have missed much less extreme or milder psychological well being issues. Additionally they didn’t acquire knowledge on ethnicity so had been unable to discover this vital 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 may have underestimated the extent of the connection between teenage drug use and grownup psychological well being issues.
I’ll sit on the fence in the case of the statistical strategies and reporting, a number of of those had 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 tough to check completely different variables and outcomes.
This analysis might have underestimated milder instances and lacked ethnic subgroup analyses related for numerous scientific settings.
Implications for apply
This research offers essential intelligence for practitioners because it factors to the dangers that early substance use poses to later psychological well being. Particularly, the better and extra frequent use of gear and psychological well being issues. I’m certain many psychological elves could have been conscious of this, nevertheless it’s helpful to have additional proof.
Clinicians working with adolescents may contemplate incorporating routine screening for early substance use patterns, with particular give attention to 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 folks, similar to increased minimal authorized ingesting ages or tighter promoting restrictions.
For me probably the most helpful findings is on gender variations, or the shortage of distinction in some instances. Conference says that younger males are extra susceptible to danger taking together with experimenting with substances, whereas that continues to be partly true, this research offers some fascinating insights about the place that is reversed, as it’s younger ladies who’re at a better danger. Highlighting not solely that gender issues, however trying past the headline findings can be vital.
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
