Your Teenager Is Using Alcohol or Drugs: How to Talk to Them and Where to Get Help

Why Teenagers Start Using Alcohol and Drugs

Adolescence is a time when the brain is actively being rewired. The systems for seeking novelty and reward are already working at full strength, while the frontal lobes, responsible for self-control and weighing consequences, don’t fully mature until age 20–25. That’s why teenagers tend to be drawn to risk, want to try forbidden things and depend heavily on the opinions of their peers. This is a normal feature of development, but it also makes them vulnerable to alcohol, nicotine and drugs.

The reasons for first trying substances vary: curiosity, wanting to fit in with a group, rebellion against adults, or an attempt to cope with anxiety, loneliness or stress. It’s important to understand that regular use is often driven by serious difficulties: depression, an anxiety disorder, ADHD, bullying at school, abuse, parents’ divorce or the loss of a loved one. So the question “why are you doing this?” should be asked not as a reproach but with a sincere wish to understand.

Risk Factors

Addiction in relatives, early experiences with alcohol or nicotine, difficulties at school, impulsivity, anxiety or depression, lack of a close bond with parents, a social circle where substance use is considered normal, easy access to substances and a lack of clear family rules.

Protective Factors

A warm, trusting relationship with at least one adult, clear rules and consistent parents, an interest in school, sports or creative activities, a supportive group of peers, and the ability to cope with stress and talk about feelings. Protective factors can be strengthened at any time.

Why Substance Use Is Dangerous in Adolescence

The developing brain is especially sensitive to psychoactive substances. The earlier substance use begins, the higher the risk of addiction in adulthood. Alcohol and drugs impair memory, attention and the ability to learn, and interfere with emotional development and with building skills for coping with stress. In teenagers, cannabinoids are linked to an increased risk of psychotic disorders, and synthetic stimulants and “spice”-type smoking blends can cause acute psychosis after just a few episodes of use.

In addition, teenagers under the influence are more likely to end up in dangerous situations: poisoning, injuries, road accidents, risky sexual behavior and trouble with the law. They have less experience and lower body weight, so poisoning from alcohol or an unknown substance can develop faster than in adults. Combining substances — especially alcohol with pills — is particularly dangerous. All of this is a reason not to ignore even “one-off” episodes.

How to Talk to Your Teenager About Substance Use

The goal of the first conversation is not to get a confession or to punish, but to show that you’ve noticed, you’re worried and you’re ready to help. Choose a time when your teenager is sober and you’re both calm. Speak in the first person: “I’ve noticed you’ve been coming home late and sleeping very little, and I’m worried.” Ask open questions and listen carefully. Acknowledge their feelings, even if you don’t agree with their actions. Teenagers react strongly to condescension and moralizing.

State your position and rules clearly, and explain why the substance use worries you — in terms of safety and health, not morality. Agree on concrete steps, such as an appointment with a specialist. It’s important for your teenager to know that if they ever find themselves in a dangerous situation, they can call you and you will come and help, and the conversation about consequences will come later. This kind of safety rule saves lives.

What to Say

“I love you and I’m worried about you.” “Tell me what’s going on — I want to understand.” “We’ll get through this together.” “Let’s go see a specialist who knows how to deal with situations like this.” “If you ever feel unwell or unsafe, call me at any time.” These phrases lower defensiveness and open up a dialogue.

What Not to Say

“You’re a junkie,” “you’re disgracing the family,” “when I was your age…,” “do it one more time and you’re out of the house.” Labels and threats make teenagers defensive, push them to lie and drive them toward those who “understand” them — often the very group where they use. Comparisons with other children are harmful too.

What Parents Should Avoid

The natural reaction to finding out about substance use is fear, anger and the urge to take control of everything at once. But some actions that seem logical actually make the situation worse in practice. Below are common mistakes that are best avoided, even if you’re very frightened. If some of these have already happened, don’t blame yourself: what matters is not the past but how you act from now on. Admitting a mistake and apologizing to your teenager is also a powerful step that builds trust.

• Interrogating, shouting or making a scene immediately after a discovery or suspicion
• Secretly reading their messages, searching their room or tracking them without explanation
• Labeling them, shaming them in front of relatives or comparing them with other children
• Threatening to throw them out of the house or cut them off from friends completely
• Pretending nothing is happening or treating substance use as “just a normal phase”
• Drug testing them by force or without explaining why
• Letting them “try it at home under supervision,” believing this is safer
• Giving your teenager sedatives or sleeping pills on your own

Where to Get Help If Your Teenager Uses Substances

You can start with a consultation with an adolescent addiction doctor or psychiatrist, or with a psychologist experienced in addiction. The specialist will assess how serious the situation is: whether it was a one-time experiment, regular use or an addiction that is starting to form, and whether there is co-occurring depression, anxiety or another disorder. If your teenager refuses to go for now, parents can come to a consultation on their own — this is a common and useful practice.

Under the laws of the Republic of Kazakhstan, medical care for minors is provided with the consent of a legal guardian, and information about diagnosis and treatment is protected by medical confidentiality. This means the information is not passed on to the school without your consent, except in cases expressly provided for by law. For children and young people, the 150 helpline is available, which a teenager can call anonymously if they find it hard to talk to their parents. The school psychologist can also be a first point of support.

How Addiction Is Treated in Teenagers

Treatment for teenagers differs from treatment for adults. It is based on psychotherapy and work with the family, and medications are prescribed only when strictly indicated — for example, to treat co-occurring depression, anxiety, withdrawal or poisoning. Well-studied approaches include cognitive behavioral therapy, motivational interviewing and family-based approaches that involve parents in treatment and help change the atmosphere at home.

In severe cases, poisoning or marked addiction, inpatient care may be needed, where the teenager is monitored by doctors. After the main stage, long-term support is important: regular sessions with a psychotherapist, help returning to school, and finding new interests and a new social circle. Relapses along the way are not unusual, and they don’t mean failure — they are a signal to adjust the treatment plan.

How Narcology 24 Can Help

At Narcology 24, parents can get an anonymous consultation with an addiction doctor, psychiatrist or psychologist, including online, to understand the situation and prepare for a conversation with their teenager. Doctors assess the teenager’s condition and whether there is addiction or a co-occurring disorder, and put together a treatment plan that involves the family. In cases of poisoning or a severe condition, a doctor can come to your home around the clock, and inpatient care is offered if needed.

Addiction psychotherapy for teenagers is built on trust and motivation, not intimidation. Consultations for relatives are held in parallel: how to set rules, respond to relapses and take care of yourself. Care for minors is provided with the consent of a legal guardian and in accordance with the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System,” with medical confidentiality respected.

When to see a doctor

• Your teenager has used alcohol or drugs more than once
• You’ve found pills, baggies, smoking blends or paraphernalia for using
• Their mood, sleep, appetite or circle of friends has changed sharply, or their grades have dropped
• Your teenager seems depressed or anxious, or talks about life being meaningless
• They’ve developed strange ideas, suspiciousness, fear or visions
• Your teenager disappears from home, lies, or money or belongings go missing
• You don’t know how to start a conversation with your teenager and need support yourself

Questions and answers

Medically reviewed by

Olga Smirnova, MDAddiction psychiatrist · experience 27 years

Alcohol dependence, alcoholism in women, dual diagnosis, coding after assessment and family consultations.