How we support young people struggling with substance use

Alcohol, drugs, medication, nicotine and other substances can become part of a young person’s life for many different reasons. We help young people to better understand their relationship with substances, what may be contributing to their use and what could help them make safer, healthier changes.

At a glance

Substance misuse is when alcohol, drugs, medication or other substances are being used in a way that causes harm or becomes difficult to control.

Substance use can start with curiosity, peer influence or social situations, or become a way of managing difficult feelings and experiences.

Over time, occasional use can sometimes become something a young person feels increasingly reliant on.

It can affect mood, behaviour, relationships, physical health, school and everyday life.

Therapy can help young people understand their substance use and can work alongside medical, drug and alcohol or other specialist support where needed.

Questions parents and carers often ask

Why is my child using drugs or alcohol?

How do I know if their substance use is becoming a problem?

Why do they keep using even when they say they want to stop?

Could anxiety, low mood or other difficulties be contributing?

Why don’t they think their substance use is a problem?

Can therapy help if they’re already working with a drug or alcohol service?

A closer look at substance misuse

Substance misuse is often viewed as simply making poor choices or breaking rules. But there’s rarely one simple explanation for why substance use becomes difficult.

It may begin through curiosity, socialising or peer influence. It can also become connected to anxiety, low mood, trauma, loneliness, low self-esteem, difficult relationships or other experiences a young person’s struggling with.

The pattern matters as much as the particular substance:

Changes in use | Using more frequently or in larger amounts, needing more to get the same effect, struggling to cut down or becoming increasingly focused on when they can next use.
Emotional and behavioural changes | Becoming more secretive, withdrawn or irritable, with noticeable changes in mood or a growing reliance on substances when things feel difficult.
Impact on everyday life | Problems with school, relationships, money or physical health, losing interest in activities that once mattered, or taking greater risks.

Substances can temporarily change how someone feels. They might reduce anxiety, create confidence, provide escape or help someone feel more connected to other people. If that effect becomes something they increasingly rely on, substance use can gradually become harder to control.

Substance use can involve physical as well as emotional and psychological factors. If there are concerns about dependence, withdrawal, overdose or physical health, specialist medical or drug and alcohol services may need to be involved.

This is one reason why simply asking someone to stop may not be enough. Understanding what’s changed, how the substance is affecting them and what keeps drawing them back to it can help identify the support they need – and therapy can often work alongside this support, with different professionals addressing different parts of a young person’s needs.

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How Teenage Mental Health approaches substance misuse

Young people can develop difficult relationships with substances for very different reasons. For us, an important question isn’t just what they’re using, but what role it has begun to play in their life. This helps us understand the wider picture, including their emotional wellbeing, relationships and experiences.

Therapy can provide a safe, independent place to talk honestly about substance use without judgement. We may help them to:

understand situations, thoughts or feelings connected to their substance use
recognise patterns around when and why they use
explore what substances might be providing, such as confidence, relief, escape or connection
develop other ways of managing difficult feelings or situations
think about the consequences their substance use is having on their life
make changes that feel realistic and sustainable

How we work depends on the young person, but broadly, our therapists draw on psychodynamic psychotherapy, integrative therapy and CBT-informed approaches.

grayscale photo of woman drinking water from can

We also recognise that change is rarely completely straightforward. A young person may reduce their use, stop for a period and then return to it. Rather than treating this as failure, therapy can help them understand what happened and what might help them respond differently in the future.

Parents and carers can understandably feel frightened, angry or unsure what to do when they discover substance use. We can help families better understand what their child may be experiencing and think about how best to support them while taking concerns about safety seriously.

Ultimately, the aim is to help a young person make safer choices and develop healthier ways of managing whatever has made that substance increasingly important in their life.

When extra support may be needed

Get help with support

It may be helpful to seek professional support if substance use is becoming more frequent, difficult to control or is beginning to affect your child’s wellbeing, particularly if they:

use alcohol, drugs or other substances regularly or increasingly often
struggle to reduce or stop their use even when they want to
become increasingly secretive, withdrawn or different in their behaviour
experience significant changes in mood, sleep, appetite or physical health
struggle with school, relationships or everyday responsibilities because of substance use
increasingly rely on substances to manage difficult feelings or situations
become involved in risky situations or are experience exploitation connected to their substance use
experience significant anxiety, low mood, self-harm or suicidal thoughts alongside their substance use

If you believe your child has taken an overdose, is unconscious, severely intoxicated or may be in immediate physical danger, seek urgent medical or emergency support.

Get help with support

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