As we begin another year of uncertainty, more teen boys are turning to alcohol and drugs to self-medicate worry and isolation. The high levels of stress and collective trauma are contributing to an increased risk of male substance abuse. While teen girls are also abusing drugs and alcohol as forms of self-medication, teen boys are able to hide their behavior more easily, and thus don’t get the treatment they need.
It’s true that today’s teens are less likely to adhere to old gender stereotypes. However, research shows that some typical assumptions about boys still hold true. For one, boys tend to withdraw rather than talking about their feelings with parents or siblings, and they are often less vocal about their emotional struggles than girls are. As a result, signs of mental health and substance use disorders in teen boys can be difficult to detect.
The Differences in Teen Substance Abuse in Boys vs. Girls
Overall, teen boys tend to have higher rates of teen substance abuse than females. However, the gender gap has been closing, according to the most recent Monitoring the Future study. The data from that study shows that about 50 percent of teens use illicit drugs, regardless of gender. Alcohol and marijuana abuse, including marijuana vaping, are the most common types of teen substance abuse.
Furthermore, the study found that gender differences in teen substance use become more pronounced as teenagers get older. For example, in 8th grade, females have higher rates of use for inhalants and amphetamines, among other drugs. By the time they reach 12th grade, usage has gone up for both boys and girls, but male substance abuse increases more sharply.
Research shows other differences regarding female vs. male substance abuse, including the following statistics.
- Teen boys are more likely to binge drink, due to higher levels of sensation seeking, lower inhibitions, and social norms that accept and even encourage this behavior.
- Male teens are at a higher risk of using over-the-counter drugs, compared with female teens.
- As compared to girls, boys are more likely to become dependent on multiple substances, according to a joint study conducted by Johns Hopkins University, the University of Minnesota, and the Bloomberg School of Public Health.
- Boys are at greater risk of committing crimes, such as vandalism, stealing, arson, and assault, as a result of male substance abuse, and consequently more likely to experience legal issues.
Mental Health and Male Substance Abuse
Because mental health and substance abuse in teens are closely linked, an examination of male substance abuse should encompass a general understanding of mental health in boys. In the last 20 years, the suicide rate among teen boys has spiked, along with rates of depression, trauma, and anxiety. Rates in girls have also increased.
However, these issues manifest differently in teen boys vs. girls. Girls with a substance abuse disorder (SUD) are more frequently diagnosed with co-occurring depression, PTSD, or other mental health disorders. Boys with SUD, on the other hand, are less likely to have received a mental health diagnosis, but more likely to have conduct, behavioral, and learning problems. Rather than expressing sadness, hopelessness, or lack of self-worth, as girls do, boys tend to exhibit anger, aggression, risk-taking behavior, and substance abuse. In other words, on the whole, girls tend to internalize mental health problems, whereas boys externalize them in disruptive behaviors.
In addition, teen boys are less apt to receive effective help for mental health issues. A study in the Journal of Adolescent Health reviewed a large body of research and found that teen boys are more likely than girls to
- Disconnect from healthcare services during adolescence
- Have lower “mental health literacy”—the ability to recognize, manage and prevent symptoms—than female peers
- Experience what’s known as alexithymia, the inability to recognize and describe emotional states
- Report difficulties disclosing emotions in therapy
- Be exposed to stigma around mental health concerns, which prevents them from seeking help
- Feel more shame about experiencing mental health symptoms, driving them into hiding their struggles
- Be influenced by societal norms around masculinity that discourage vulnerability, weakness, and emotional expression.
Consequently, teen boys are less likely to reach out for help and therefore more likely to self-medicate, accounting for the high rates of male substance use.
“Adolescent boys and young adult men [are] a neglected group within health policy and intervention domains. They have also been somewhat blamed for their relatively poor help-seeking attitudes and behaviors rather than being proactively engaged by systems that are designed to assist them.”
—Journal of Adolescent Health
Signs of Drug Use in Teens
Because teen boys are at high risk for mental health and substance abuse disorders, parents need to be aware of the red flags that may indicate their son is abusing drugs. Watching for mental health issues is one of the most important ways to prevent or expose male substance abuse. In addition, here are some of the common physical and behavioral signs of drug use in teens:
- Acting withdrawn or hostile, avoiding eye contact and communication
- Changes in sleep habits; fatigue
- Spending time with a new friend or peer group
- Poor grooming and hygiene
- Declining academic performance, missing classes or skipping school
- Loss of interest in activities they used to enjoy
- Staying in their room all the time
- Change in eating habits, such as compulsive eating, weight loss, or frequent hunger
- Deteriorating relationships with family members and friends
- Bloodshot eyes, eyes drifting and non-focused
- Runny nose
- Chronic coughing
- Smell of smoke on breath or clothes
- Mood swings
- Secretive behavior, hiding things
- Extended and unexplained use of bathrooms
- Stealing, asking for money, kleptomania
- Unseasonal clothing, such as long sleeves in summer to hide needle marks.
How to Talk to Your Son About Drugs
Ideally, parents should talk to their teens about substance abuse before they are exposed to drugs and alcohol. Start the conversation early, and create an environment of trust and love that encourages kids and teens to speak openly about what they may hear from peers or older relatives. Parents can share with their sons (and daughters) why drinking and teen substance abuse are dangerous and life threatening. Moreover, it’s important to discuss peer pressure regarding drug use.
Furthermore, in order to counteract societal norms around stigma and masculine expectations, parents can explain the link between mental health and substance abuse. Talk to your teen boys about why how abusing alcohol and drugs is a manifestation of trauma, anxiety, or depression. Encourage them to share what they’re feeling in whatever ways are most comfortable for them, whether that’s through writing, talking, or even texting with parents if face-to-face conversations are difficult for them.
Ultimately, maintaining nonjudgmental and accepting communication with teen boys goes a long way toward preventing male substance abuse. Research shows that an open and loving relationship between parents and children reduces the risk of substance abuse in teens.
Treatment for Male Substance Abuse
Treatment for drug addiction should always include treatment for mental health issues, as substance abuse is a manifestation of underlying trauma, attachment wounds, anxiety, and/or depression. Longer-term residential care yields the most successful outcomes for substance abuse in teens. Furthermore, gender-specific environments provide the most effective approach for this age group, allowing teens to cultivate positive peer and mentor relationships and speak more honestly about their struggles.
If your son is exhibiting signs of drug use in teens, Newport Academy can help your teen and your family get on the path to healing. Contact us today to learn more about our locations and our treatment approach.
J Child Psychol Psychiatry. 2018 Jun; 59(6):618–627
J Adol Health. 2018 Mar;62(3):S9–S17.
Front Psychiatry. 2017 Dec; 8:289.
Drug Alcohol Depend. 2015 Dec; 157:129–135.