Maybe it’s May: A Time and a Reason to Talk to Your Teens About Substance Use

What do Mother’s Day, National Prevention Week, and Mental Health Awareness Month all have in common? This isn’t the start of a corny punch line, but it could be an important facet in teen substance use prevention. Follow along for this piece in “The PEER Review” to learn more!

Maybe it’s May

May is a big month for celebration and awareness. With over 100 national celebrations, there’s 3x more holidays than there are days in the month. There are times to honor others like Memorial Day, nurse and teacher appreciation weeks, and Pacific Islander heritage month, and times to honor memorable events in history like Cinco de Mayo, Kentucky Derby Day, and (most importantly) Intergalactic Star Wars Day. May has something for almost all of us to celebrate amid the rebirth of warmer spring weather.

May also hosts an assortment of holidays in the realm of substance use prevention as well. The whole month of May is dedicated to mental health awareness; there’s National Fentanyl Awareness Day on 9th, and National Prevention Week that runs from May 7-13th; and of course, there’s Mother’s Day on May 13th. Wait – did I just say Mother’s Day has a common link with prevention celebrations? Okay, this might be a bit of a stretch, but hear me out: Mother’s Day is yet another very important holiday in May that might not come to mind when thinking about teen substance use prevention. It turns out though that mothers, fathers, grandparents, guardians, and caregivers as a whole all play an essential role in preventing adolescent and teen substance use.

In this month’s PEER Review, we’ll unpack recent data reports that show the link between parent approval/disapproval and teen substance use. Could something as simple as sharing your disapproval of teen alcohol, nicotine, and cannabis use prevent the youth in your life from developing addiction to these substances? We’ll answer this and more questions like what the role of a parent is in substance use prevention. Then we’ll wrap up by providing evidence-based tips on how and when to talk to your teens about substance use.

What We Know

There’s no denying that parents have an influence over their teen’s perception and behavior around substance use and experimentation. A quick Google Scholar search shows that this has been a topic of discussion for decades, with targeted publications leading all the way back to the 1990s. It’s been long established that perceived parent perspective (meaning what teens think that their parent feels about something or expects from them) is one of the highest indicators of whether or not they choose to engage in substance use. In 1999, researchers Anne Fletcher and Brandi Jefferies published one of the first scientific articles on their work that explored the link between teen substance use and perceived parental authoritativeness (acceptance of and/or response to). They found that, “Perceived authoritative parenting was associated with lower levels of substance use.” 1 And it is no surprise that since then, dozens of research teams have been attempting to better understand this relationship:

“Parental Monitoring, Negotiated Unsupervised Time, and Parental Trust: The Role of Perceived Parenting Practices in Adolescent Health Risk Behaviors” (Borawski, E. A., et. al. 2003)

“What Should Parents Do to Emphasize Their Disapproval of Adolescents’ Substance Use?” (Bacikova-Sleskova, M., et. al. 2019)

“Alcohol-Specific Communication and Emerging Adult Offspring’s Perceived Parental Approval and Drinking in the Context of Parent Alcohol Expectancies” (Ramer, N., et. al. 2020)

Wait a May Minute

While all of the conclusions of this research are powerful, we acknowledge that as best practices develop in research, the scientific conclusions become more valid. For example, some of the older research lacks diversity among their subjects. Since substance use and mental health are often closely tied to an expansive composite of demographics including culture, gender and orientation, religion, race, geographic location, and socioeconomic status, not having a diverse sample does not provide an accurate perspective on what is happening in the population at large. This is what’s known as “generalizability” in the world of research and is something to always keep in mind when considering the validity of a scientific publication.

All this to say, I’ve chosen to explore a publication today from 2022: an article within the NIH National Library of Medicine entitled “Does parental permissiveness toward cigarette smoking and alcohol use influence illicit drug use among adolescents?”4

Note: For those under the age of 21 in the state of Illinois, all substances including alcohol, cannabis, and tobacco and nicotine products are illegal for consumption. Illicit substances, however, are not defined specifically in this article and thus we will follow the definition of an illicit drug described by the US Centers for Disease Control (CDC) as:

“Illicit drug use includes any use of marijuana or hashish, cocaine, crack, heroin, hallucinogens, inhalants, or methamphetamine, as well as misuse of prescription psychotherapeutic drugs including pain relievers, tranquilizers, stimulants, and sedatives.” 2

Centers for Disease Control (CDC)

It might be worth noting that this study did take place in 7 countries throughout Europe by the European Drug Addiction Prevention trial, but the methods and conclusions within this longitudinal research endeavor are sound and up to date with the same standards now practiced across the globe. Furthermore, their research was called to action from prevalence rates of lifetime illicit drug use among 15–16-year-olds. The European School Survey Project on Alcohol and Other Drugs (ESPAD) found this prevalence of lifetime use to be around 17%,4 and their measurement is an equivalent to the US National Survey on Drug Use and Health (NSDUH) which gauged 16-17-year-old lifetime illicit drug use at roughly 16%.3 Thus, the similarities are relatively comparable for an audience in the US.

Because the link between perceived parental approval and teen substance use has already been establish, the researchers in this study4 took their exploration one step further and posed the question parents for generations have been wondering: “Do parental norms and attitudes towards legal substance use, like cigarettes and alcohol, impact illicit substance use among their children?” Spoiler alert: yes.

Researchers in this study worked with 3,171 participants ages 12-14 for 6 months to assess the links between these parental norms and illicit substance use. At the start of the study, participants were asked questions regarding their home environment, parental attitudes towards substance use, and their own illicit substance use within their lifetime. Within just 6 months, researchers were able to note the significant difference between the baseline illicit drug usage reports and follow-up usage reports in teens with parents that had permissive attitudes towards cigarettes and alcohol.4 It was not just a small difference either, the teens were 3x more likely to report illicit drug use if their parent(s) approved of either cigarette or alcohol use compared with those whose parents did not.4

How Will I Know?

Assessing how your teen perceives parental approval of substance use can vary by substance. In fact, a publication from the 2018 European Journal of Public Health notes that parental approval for smoking was correlated with parents that were smokers themselves, while approval regarding teen alcohol use was associated more strongly with no-use alcohol communications from their parents rather than parental alcohol engagement.5

“With regard to smoking experience, having non-smoking parents and perceiving parental non-approval significantly decreased the probability of adolescent smoking. On the other hand, not parental behavior rather alcohol specific communication and perceived parental non-approval decreased the probability of alcohol consumption experience.”

(Bacikova-Sleskova, 2018)

So how do you know if your teen thinks that you believe substance use, whether by legal or illicit nature, is okay? This is a tough one…. Just talk to them! Sure, it’s undoubtedly a great idea to try and set a good example for the youth in your life through your own behaviors, but you don’t have to be a perfect parent (no one is!) to set expectations about substance use. Teens rely on your input, and it has a bigger impact than you think, but you have to start these conversations early.

Talk to Teens Now – Yes, Really! Now!

In the realm of prevention, this is where we almost always find the most hesitation from parents who struggle with sparking conversations with their children before a problem ever arises. There can be a lot of reluctance when translating the evidence into recommended practices, especially around the topic of substance use. We get it – these conversations can be awkward and hard, and it takes a mindful effort to seek prevention assistance verses treatment assistance. Substance use is also highly stigmatized, and everyone hopes that their children will live a life with the best health and wellness possible, free from struggles with substance use.

The reality is though, that 21% of 8th graders in the United States have tried some form of illicit drug, and by the time that students are in 12th grade, almost 50% have, too.6 This means that almost 1 of 2 students in the US will try an illicit drug before they graduate high school – an extremely dangerous notion in leu of brain development and addiction potential in this age population in particular.6 Opioid deaths among 15–24-year-olds since 1999 have risen over 500%, accounting for more than 5,000 beautiful lives unnecessarily lost to overdose deaths in one year alone.6 Furthermore, 90% of individuals with substance use disorder began using substances when they were a teen.7

Who, What, WHEN?

When can you talk to your teens? You could talk to them in the car after school, after helping them with homework, during an inning switch at the Cubs game, over tacos for Cinco de Mayo, or while celebrating one of the hundreds of holidays going on this May. The point is that the time to talk to your teens is now, before a problem onsets. I recently stumbled upon this under-used and under-rated anonymous quote in a lifestyle and fitness Facebook board, and I think it applies to substance use and mental health disorders, too:

“If you don’t make time for your wellness now, you’ll be forced to make time for your illness later.”

Being Resourceful

Feeling compelled but nervous or uncertain about talking to your teen? We’ve got you covered. Breaking through the silence or being more interesting than whatever is on social media right now can be difficult. Luckily, there are so many resources out there for parents just like you. You can check out some of the following options below!

Marijuana: Talking Points for Parents and Teens

Talking to Youth and Young Adults to Prevent E-cigarette Use

Make a Difference: Talk to Your Child About Alcohol – Parents

Mayo Clinic: Help Your Teen Avoid Prescription Drug Abuse

In Conclusion,

We know it’s hard being a parent, a caregiver, a grandparent, a father, and a mother – even on Mother’s Day. But if we can gift you with one thing to all the mothers, parents, and anyone in between on this holiday, I hope it’s the comfort in knowing that (believe it or not!!) your teens are truly listening to you and you are impacting their lives for the better. Thanks for reading another post from The PEER Review!

Sources Cited

1.Fletcher, A. C., & Jefferies, B. C. (1999). Parental Mediators of Associations between Perceived Authoritative Parenting and Early Adolescent Substance Use. The Journal of Early Adolescence, 19(4), 465–487. 2. National Centers for Disease Control. Aug. 12, 2022. Health, United States. “Illicit Drug Use.”,and%20misuse%20of%20illegal%20and%20controlled%20drugs. 3. Centers for Disease Control. 2020. Table SubUse. Use of selected substances in the past month among people aged 12 years and over, by age, sex, and race and Hispanic origin: United States, selected years 2002–2019. 4. Mehanović, E., Vigna-Taglianti, F., Faggiano, F., Galanti, M. R., & EU-Dap Study Group (2022). Does parental permissiveness toward cigarette smoking and alcohol use influence illicit drug use among adolescents? A longitudinal study in seven European countries. Social psychiatry and psychiatric epidemiology57(1), 173–181. 5. M Bacikova-Sleskova, L Hricová, O Orosová, Parents and their role in adolescents’ risk behaviour, European Journal of Public Health, Volume 28, Issue suppl_4, November 2018, cky214.131, 6. National Center for Drug Abuse Statistics. 2023. Drug Use Among Youth: Facts and Statistics. 7. Partnership to End Addiction. June 2011. “Adolescent Substance Use: America’s #1 Public Health Problem.” Adolescent Substance Use – Partnership to End Addiction (

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