Substance Use
and
Mental Illness:

Intertwined Issues
Affecting California’s Youth

Adolescence is when mental illness often first presents and when drug and alcohol use typically starts. Risk of developing a substance use disorder is greater for people who start use during adolescence.1 For adolescents, mental illness and substance use disorder often occur together.2

THE USE OF ALCOHOL AND DRUGS begins for many in junior high and accelerates in high school.

13% of 7th graders used alcohol to get drunk, increasing to 52%by grade 11.
8% of 7th graders used marijuana to get high, increasing to 38%by grade 11.
44% of 11th graders used cold/cough medicine and 22% used prescription pain medications to get high four or more times in their lives.

THE RATE OF SUBSTANCE USE DISORDER is highest among young adults.

2x The rate of substance use disorder among 18- to 25-year-olds (15%) is nearly twice the overall state average.
2/3 of 18- to 25-year-olds who used alcohol reported binge drinking in the prior month.3

MENTAL ILLNESS AMONG ADOLESCENTS is widespread and undertreated. Like substance use disorder, it typically presents early in life.

About50% of all mental illnesses appear by the mid-teens and about 75%by the mid-twenties.4
12% of teens reported experiencing a major depressive episode, but only about a third of them received any treatment.
In 2015,1 IN 12 high school students reported that they had attempted suicide.

There are effective treatments for mental illnesses and substance use disorders, and early intervention often leads to good outcomes. Most adolescents who need help, however, do not receive it.

Notes: All data are from CHCF’s Substance Use in California: A Look at Addiction and Treatment and Mental Health in California: For Too Many, Care Not There unless otherwise noted. Binge alcohol use, unless otherwise defined, is drinking five or more drinks for males, or four or more drinks for females, on the same occasion (i.e., at the same time or within a couple hours of each other) on at least one day in the past 30 days.

1. The TEDS Report: Age of Substance Use Initiation Among Treatment Admissions Aged 18 to 30, Substance Abuse and Mental Health Services Administration, July 17, 2014.

2. Co-Occurring Disorders, youth.gov, accessed October 30, 2018.

3. 54% of all 18- to 25-year-olds reported alcohol use in the past month.

4. Ronald C. Kessler et al., “Age of Onset of Mental Disorders: A Review of Recent Literature,” Current Opinion in Psychiatry 20, no. 4 (July 2007): 359–64, doi:10.1097/YCO.0b013e32816ebc8c.

2018 California Health Care Foundation