Substance Abuse among Youth and Adolescents: Epidemiology, Psychosocial Determinants, Prevention Strategies, and Public Health Implications in India

Abstract

Background: The problem of substance abuse is gaining growing importance as a public health challenge both internationally and in India, due to the serious physical, mental, emotional, social and academic consequences associated with this behaviour among young people. Adolescence is a particular vulnerable period of development, marked by increased exploration, identity maturation and changes that belies other associated physical systems yet deteriorating emotional stability needing social peer support and driven impulsive behavioural response such as substance use. The substances that commonly abuse can be divided the age group of adolescents such as alcohol, tobacco, nicotine products like vape pens (e-cigarettes), cannabis, opioids (prescription painkillers and heroin), inhalants (substances that are temporarily sniffed or inhaled to achieve a short-term high)All drugs or steroids which includes amphetamines, cocaine-like stimulants known by common brand names including Vicodin. The increasing substance use among adolescents can be attributed to multiple factors like rapid urbanization, attitudinal change in the society, peer pressure, dysfunctional family life, higher rate of academic stress and digital media exposure along with ineffective coping strategies.

Results: The available epidemiological evidence shows that alcohol and tobacco are still the most used psychoactive substances among adolescents, followed by cannabis, inhalants, opioids and other emerging substances. The results of this review indicate a strong association between adolescent substance abuse and various sociopsychological risk factors such as peer influence, dysfunctional family environment, emotional problems, adverse childhood experiences, inadequate parental control, low self-esteem, mental illnesses in adolescence and social media. Neurobiological findings show that robust immature executive functioning and heightened dopaminergic reward sensitivity during adolescence increases the likelihood of experimentation and addiction. On the path less covered substance use in adolescents is a contribution factor to dropping out of school, poor academic performance, school absenteeism, violence risk behaviours including risky sexual behaviour and driving under influence of substances. Public health evidence strongly reinforces concerns on the easy availability of psychoactive substances and insufficient knowledge in youth populations, especially for low- and middle-income settings like India.

Discussion: A holistic, multidisciplinary and youth-specific approach encompassing prevention, early identification, mental health promotion, psychosocial counselling, rehabilitation and community engagement is warranted to address adolescent substance use. Certainly, school-based education, parental involvement, access to adolescent-friendly health services, behavioural counselling and life-skill training, community peer support services and public health awareness programs are key components for reducing vulnerability and preventing a well-established pattern of substance use and long-term addiction. Enhancing regulatory policies, improving access to mental healthcare, reducing stigma and implementing culturally relevant interventions are quintessential to avert the increasing menace of substance abuse among adolescents. The findings provide the first evidence, drawn from multiple sites across eight countries on three continents, for a significant and dose-response association between suicidal ideation in adolescence and medium- to long-term health and social outcomes, supporting early prevention and coordinated public health action as core mechanisms to promote positive adolescent development.

DOI: 10.24321/2349.2880.202608

How to cite this article:
Mukherjee A, Sharma R, Bharadwaj I. Substance Abuse Among Youth and Adolescents: Epidemiology, Psychosocial Determinants, Prevention Strategies, and Public Health Implications in India. Ind J Youth Adol Health. 2026;13(2):29-37.