Impact of Alcohol and Drug Use on Adolescents


There are complicated, even dangerous, connections between the use of drugs and alcohol and sexual behaviours. Yet the effects of most drug prevention efforts have been modest at best. Risky behaviours are not going away, and neither is our responsibility to face them squarely. Perhaps now is the time for educators to try new strategies to counter the ever-increasing challenges of teen alcohol and drug abuse and the impact on their sexual risk-taking behaviour. Some experts advocate programs that offer comprehensive and realistic information about the effects of alcohol and other drugs … along with the assumption that young people can be trusted to make responsible decisions to stay safe.


Drugs are chemical substances that have a direct effect on the structure or function of the body. A drug is any substance that causes a physical or mental change in the body. Some of the common types of drugs and their effects are listed below:

Type of DrugExamplesIntoxication Effects
NarcoticsOpium, Heroin, MorphinePain relief, euphoria, drowsiness
DepressantsValium, Quaaludes, Alcohol, Rohypnol
Reduced pain and anxiety; feeling of well-being; lowered inhibitions; slowed pulse and breathing; lowered blood pressure; poor concentration
StimulantsCocaine, Tobacco, Caffeine, Diet Pills, EcstasyIncreased heart rate, blood pressure, metabolism; feelings of exhilaration, energy; increased mental alertness

Hallucinogens (or psychedelics)
LSD, MescalineAltered state of perception and feeling; nausea
CannabisMarijuana, Hashish
Euphoria; slowed thinking and reaction time; confusion; impaired balance and coordination
InhalantsGlue, Poppers, Nitrous Oxide
Stimulation, loss of inhibition; headache, nausea or vomiting; slurred speech; loss of motor coordination; wheezing

More detailed descriptions and health effects of various substances can be found on many websites, (see Websites to Check Out, below) including the National Institute on Drug Abuse: and The Do It Now Foundation, a non-profit organization committed to drug abuse prevention:

Overview of the Issues

Sexual activity can be risky behaviour for teens. Unintended pregnancy, STIs including HIV, non-consensual sex, and the potentially negative emotional consequences are a few of the risky outcomes teens experience when they become sexually active. However, sexual activity under the influence of drugs, including alcohol, can raise the stakes even higher. Consider the following:

  • Teens often drink or use other drugs when they engage in sexual activity. So perhaps it’s not surprising that many young people lose their virginity while drunk. Unfortunately, many teens who get drunk and have sex also become pregnant because they aren’t thinking about or able to use protection at the time. (National Campaign to Prevent Teen Pregnancy’s “Fact Sheet: Sobering Facts on Alcohol and Teen Pregnancy,” April, 2000)
  • Thirteen percent of teens say they’ve done something sexual while using alcohol and other drugs that they might not have done if they had been sober. (“National survey of teens: Teens talk about dating, intimacy, and their sexual experiences,” Kaiser Family Foundation and YM Magazine, 1998)
  • Teens who drink and smoke are more likely to hang out with teens they perceive to be sexually “advanced” — which usually results in a higher level of sexual activity among those teens themselves. (Whitbeck, et al., 1993)

What Educators Can Do

Drug and alcohol education has been practised by educators in schools and other youth settings for decades. However, despite the $2.1 billion spent on “prevention,” (abstinence from drugs) in 1999, government surveys indicate that many teenagers still experiment with drugs.

Marsha Rosenbaum, PhD, of the Drug Policy Alliance — an institute dedicated to broadening the debate and advancing a harm reduction perspective regarding drugs, drug abuse, and drug policy — believes that abstinence-only drug education is unrealistic. She and others fear an abstinence-only approach leaves teachers and parents with little to say to the 50% of teens who, despite admonitions, have tried marijuana, and the 80% of teens who use alcohol by the time they graduate from high school.

Rosenbaum offers an alternative, a safety-first approach to drug education, which requires reality-based assumptions about drug use. Safety-first drug education stresses abstinence from drugs, but it doesn’t stop there. It also includes a fallback strategy for risk reduction. This strategy consists of providing students with information and resources so they do the least possible harm to themselves and others.

Safety-first drug education assumes that teenagers can make responsible decisions if given honest, science-based drug education. Another assumption of safety-first drug education is that total abstinence may not be a realistic alternative for all teenagers. One more assumption of safety-first drug education is that the use of mind-altering substances does not necessarily constitute abuse. With sexual activity and alcohol use, for example, teenagers must understand the importance of context so that they can make wise decisions, control their use, and stay safe and healthy.

Rosenbaum’s “How To’s” of safety-first drug education include the following:

  • Communication is key in safety-first drug education. The channels of communication must be open, and listening to what teens have to say is crucial. Rosenbaum is insistent in her belief that, if adults become indignant and punitive, teenagers will stop talking.
  • Discussions of drugs in safety-first drug education must include observations and experience of the teens themselves if the program is to be credible. Teens should feel safe from negative repercussions for their input and honesty.
  • Safety-first drug education should be age-specific, beginning in middle- school, when teens are actually confronted with drugs. It should engage students in the broad study of how drugs affect the body and mind. They should also learn about the social context of drugs in America.
  • Safety-first drug education teaches students the legal consequences of drug use in America, acknowledging illegality as a risk factor in and of itself. There are real, lasting consequences of using drugs and being caught, including expulsion from school, denial of college loans, a criminal record, and lasting stigma.
  • The goals of realistic drug education focus on safety. Safety-first education separates the real from the imagined dangers of substance use.
  • A comprehensive, reality-based drug education curriculum will equip students with information they trust, which is the basis for making responsible decisions.

As the demand for reality-based drug education grows, programs are being developed in the U.S. and abroad. A listing of such programs can be found at the website of the Drug Policy Alliance:

According to Rosenbaum, it’s our responsibility as parents and teachers to engage students and provide them with credible information so they can make responsible decisions, avoid drug abuse, and stay safe. To download pdf versions of Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education, in four different languages or order up to 50 copies in English or Spanish, go to:

Web Sites to Check Out

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