Today’s teenagers take drugs, tomorrow’s mental health struggle? What is the evidence
New research in Denmark reveals how adolescent substance use (even “only” alcohol) can pave the way for future mental health crises. Clinician, please be aware.
It is not uncommon to use drugs for teenage experiments, and alcohol and tobacco are often the two most popular (and legally available) substances that young people try. For example, an important minority will also try to use illegal substances such as marijuana, cocaine and ecstasy. There are also data that young people are using drugs such as sedatives and sedatives without prescriptions, while in so-called non-medical prescription drugs (Euda, 2025).
Understanding how adolescent substance use patterns predict mental health disorders is highly correlated with clinicians working with young people. Mental health professionals generally believe that there is a link between drug use in young people and the emergence of mental health problems. A new study on public health of the Lancet attempts to explore this link and determine whether drug use in adolescents is a risk factor for mental health problems in adulthood (Hansen et al., 2025).
Adolescent medication use is common and understanding its connection to later mental health disorders will benefit clinicians working with young people.
method
The study attracted information from young people in Denmark in 2014. Young people are between 15 and 19 years old. The sample was large and population-based with 68,301 participants, of which 59.7% were female and 40.3% were male, followed by eight years. A strong connection to national hospitals and prescription registration enhances the availability and objectivity of data. The authors focus on drug use during adolescence, and any ensuing contact with mental health services, including eating disorders, depression, suicidal ideation and anxiety.
A range of relevant factors were also collected, such as parental drug use, socio-demographic status, and education.
The researchers characterized four patterns of substance use:
- Use only alcohol
- Drink often
- Use of experimental substances
- Early attacks on multiple substance use.
result
A small percentage (8.6%) reported no alcohol and drug use. For the four groups characterized by the authors, alcohol was proven to be the most commonly used substance, reflecting findings from other studies and young people’s surveys. For those characterized by early multiple substance use, most people use alcohol and tobacco and other illegal substances.
As expected Dose response relationship was found between early adult drug use and mental health problems. That is to say, due to mental health issues, young people are more and more at risk of using services. For example, the hazard ratios of frequent alcohol consumption and later mental health difficulties in patients with early-stage multiple substance use groups were 0.87 and 1.58 compared with the alcohol-only group.
A surprising finding with direct clinical significance is that adolescents in the premature multi-substance use group had a significantly higher risk of suicide behavior than the only alcohol consumption group (HR 3.20). Clinicians may also be cautious about noting that teenagers who regularly overeat are slightly lower at risk for mental or behavioral disorders compared to the only alcoholic population, although their alcohol use is still worthy of attention (HR 0.87).
The gender differences reported in this study are fascinating. For example, contrary to what many might think, young women are more likely to drink alcohol than young men, 52.2% to 43.8%. Although young men were more likely to try the drug than their female peers, 22.9% versus 11.8%.
This study shows that there is a dose-response relationship between substance use and later mental health problems in adolescents, while multiple substances that occur early in the process are closely related to higher risks, including suicide behavior.
in conclusion
This is an important study based on previous research that shows a clear link between adolescents’ exposure to substances and their future mental health problems.
The widespread belief that young people are more likely to use substances than women, and this study provides some interesting insights that challenge this view.
For clinicians, these results highlight the importance of early identification and tailor-made interventions for adolescents showing patterns of high-risk substance use, which can help prevent severe mental health outcomes later.
Identification and addressing the use of high-risk substances in adolescents can prevent serious mental health challenges in adulthood.
Advantages and limitations
Encouragingly, gender is seen in the data and reported in the analysis. While this seems like a basic message, sadly it is not always included. Although many journals and academic institutions say they encourage the inclusion of data on gender, this is still an ambition rather than a norm (Bibb, 2022).
The authors acknowledge their research limitations. When they rely on follow-up data from hospital contact, they may miss serious or milder mental health problems. They also did not collect data on race and therefore could not explore this important demographic detail. This means that clinicians are wary of cultural and racial differences in substance use patterns that cannot be captured in this study.
Taking these limitations into account, the authors assert that they may underestimate the extent to which adolescent drug use and adult mental health problems are related.
When it comes to statistical methods and reports, I will sit on the fence, some of which have been used. Some people may think this is valid, but when it comes to the results, I find this a little confusing because it’s hard to compare different variables and results.
This study may underestimate mild cases and lacks racial subgroup analysis related to various clinical settings.
Impact on practice
This study provides practitioners with crucial intelligence as it points to the risks of mental health following early physical use posture. In particular, material and mental health issues are used more frequently. I’m sure many spiritual elves will realize this, but it’s useful to have further evidence.
Clinicians working with teenagers may consider merging Routine screening early drug use patternsspecial attention is paid to the early age and the type of substances tried. These results also support the promotion of policies to delay alcohol and drug use in young people, such as higher minimum legal drinking age or stricter advertising restrictions.
For me, one of the most useful findings is about gender differences, or in some cases lacking them. The Convention says that young people are more likely to risk taking, including trying substances, but this is partially correct, but this study provides some interesting insights into the position of reversal because it is young women at greater risk. Not only does it emphasize gender issues, but it is also important to go beyond title discovery.
The findings highlight the importance of prevention strategies and policy advocacy to delay material initiation at a young age.
Link
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 risk of mental and behavioral disorders, drug use and suicide behavior: a cohort study. Lancet Public Health; 10:E578-87.
Other references
Bibb, La, Adkins, BD, Booth, GS, GS, Shelton, KM and JACOBS, JW, 2022. Gender and Gender Reporting Analysis in Outstanding Biomedical Journals. JAMA Network Open,,,,, 5(8), pp.E2230277-E2230277.
EU Pharmaceuticals Agency, 2025. New ESPAD survey results: adolescent substance use, but new risks arise.
