Teen Space

Revised June 2019

Your Brain

Conceptual image of a man from side profile showing brain and brain activity©Shutterstock/ Triff

Your brain is who you are. It’s what allows you to think, breathe, move, speak, and feel. It’s just 3 pounds of gray-and-white matter that rests in your skull, and it is your own personal “mission control.”

The brain is always working, even when you’re sleeping. Information from your environment makes its way to the brain, which receives, processes, and integrates it so that you can survive and function under all sorts of changing circumstances and learn from experience. This information comes from both outside your body (like what your eyes see and skin feels) and inside (like your heart rate and body temperature).

The brain is made up of many parts that all work together as a team. Each of these different parts has a specific and important job to do. When drugs enter the brain, they interfere with its normal tasks and can eventually lead to changes in how well it works. Over time, drug use can lead to addiction, a devastating brain disease—when people can’t stop using drugs even when they really want to, and even after it causes terrible consequences to their health and other parts of their lives. (Learn more about the brain-body connection.)

Drugs affect mostly three areas of the brain:

  • The brain stem is in charge of all the functions our body needs to stay alive—breathing, moving blood, and digesting food. It also links the brain with the spinal cord, which runs down the back and moves muscles and limbs. It also lets the brain know what’s happening to the body.
  • The limbic system links together a bunch of brain structures that control our emotional responses, such as feeling pleasure when we eat chocolate or kiss someone we love. The good feelings motivate us to repeat the behavior, which can be good because things like eating and love are critical to our lives.
  • The cerebral cortex is the mushroom-shaped outer part of the brain (the gray matter). In humans, it is so big that it makes up about three-fourths of the entire brain. It’s divided into four areas, called lobes, which control specific functions. Some areas process information from our senses, allowing us to see, feel, hear, and taste. The front part of the cortex, known as the frontal cortex or forebrain, is the thinking center. It powers our ability to think, plan, solve problems, and make decisions.

How does your brain communicate?

Nuerons: Building Blocks of the Brain. The brain is made up of billions of nerve cells, also known as neurons. Neurons communicate with other neurons through a process known as neurotransmission.

The brain is a complex communications network of billions of neurons, neurotransmitters, and receptors. Networks of neurons pass messages back and forth thousands of times a minute within the brain, spinal column, and nerves. These nerve networks control everything we feel, think, and do. For example, when you want to go up the stairs, this message system will tell you to lift your foot onto the first step and so on. Understanding these networks helps scientists learn how drugs affect the brain. The networks are made up of:

  • Neurons
    Your brain contains about 100 billion neurons—nerve cells that work nonstop to send and receive messages. Within a neuron, messages travel from the cell body down a nerve fiber called an axon in the form of electrical impulses. From there, the message is sent to other neurons.
  • Neurotransmitters—The Brain’s Chemical Messengers
    To help those messages travel from one neuron to another, the brain creates chemical messengers called neurotransmitters. Branches of the axon, called axon terminals, release neurotransmitters into the space between two nerve cells, called a synapse. The axon terminal is like the bus or train terminal – a transportation hub of activity.
  • Receptors—The Brain’s Chemical Receivers
    A cartoon depiction of how brain cells communicate.

    To send a message, a nerve cell releases a chemical (neurotransmitter) into the space separating two nerve cells, called the synapse. The neurotransmitter crosses the synapse and attaches to proteins (receptors) on the receiving nerve cell. This causes changes in the receiving nerve cell, and the message is delivered.

    As the neurotransmitter approaches the nearby neuron, it attaches to a special site on that neuron called a receptor. A neurotransmitter and its receptor operate like a key and lock— a very specific mechanism makes sure that each receptor will forward the right message only after interacting with the right kind of neurotransmitter.

  • Transporters—The Brain’s Chemical Recyclers
    Once neurotransmitters do their job, they are pulled back into their original neuron by transporters. This recycling process shuts off the signal between the neurons.

How do drugs affect your brain?

Drugs are chemicals. When someone puts these chemicals into their body, either by smoking, injecting, inhaling, or eating them, they tap into the brain’s communication system and tamper with the way nerve cells normally send, receive, and process information. Different drugs—because of their chemical structures—work differently. We know there are at least two ways drugs work in the brain:

  • Imitating the brain’s natural chemical messengers
  • Overstimulating the “reward circuit” of the brain

Some drugs, like marijuana and heroin, have chemical structures that mimic a neurotransmitter that naturally occurs in our bodies. In fact, these drugs can “fool” our receptors, lock onto them, and activate the nerve cells. However, they don’t work the same way as a natural neurotransmitter, and the neurons wind up sending abnormal messages through the brain, which can cause problems both for our brains and our bodies.

Other drugs, such as cocaine and methamphetamine, cause nerve cells to release too much dopamine, a natural neurotransmitter, or prevent the normal recycling of dopamine. This leads to exaggerated messages in the brain, causing problems with communication channels. It’s like the difference between someone whispering in your ear versus someone shouting in a microphone.

The “High” From Drugs/Pleasure Effect

Scientists used to assume that the rush of dopamine alone caused the feeling of euphoria (happiness) during drug use, but they now know it is more complicated than that. Many drugs—nicotinecocainemarijuana, and others—affect the brain’s “reward” circuit, which is part of the limbic system. Normally, the reward circuit responds to healthy, pleasurable activities by releasing the neurotransmitter dopamine, which teaches other parts of the brain to repeat those activities. Drugs take control of this system, releasing large amounts of dopamine—first in response to the drug but later mainly in response to other cues associated with the drug—like being with people you used drugs with, or being in places where you used drugs. The brain remembers this feeling and sends out an intense motivation to seek and use the drug again. So dopamine does not cause the rush of feelings; instead it reinforces the desire to use drugs.

The Repeat Effect

Our brains are wired to make sure we will repeat survival activities, like eating, by connecting those activities with feeling good. Whenever this reward circuit is kick-started, the brain notes that something important is happening that needs to be remembered, and teaches us to do it again and again, without thinking about it. Because drugs come in and “hijack” the same circuit, people learn to use drugs in the same way.

After repeated drug use, the brain starts to adjust to the surges of dopamine. Neurons may begin to reduce the number of dopamine receptors or simply make less dopamine. The result is less dopamine signaling in the brain—like turning down the volume on the dopamine signal. Because some drugs are toxic, some neurons also may die.

As a result, the ability to feel pleasure is reduced. The person feels flat, lifeless, and depressed, and is unable to enjoy things that once brought pleasure. Dopamine encourages the brain to repeat the pleasurable activity of drug taking to feel good again. Now the person needs drugs just to feel normal, an effect known as tolerance.

Watch our video Why Are Drugs So Hard To Quit? to learn more.

Long-Term Effects

Drug use can eventually lead to dramatic changes in neurons and brain circuits. These changes can stay even after the person has stopped taking drugs. This is more likely to happen when a drug is taken over and over again.

What is drug addiction?

Addiction is a chronic brain disease that causes a person to take drugs or alcohol repeatedly, despite the harm they cause. The first time a person uses drugs, it’s usually a free choice. However, repeated drug use can change the brain, driving a person to seek out and use drugs over and over, despite negative effects such as stealing, losing friends, family problems, or other physical or mental problems brought on by drug use. This is addiction.

What factors increase the risk for addiction?

Although we know what happens to the brain when someone becomes addicted, we can’t predict how many times a person must use a drug before becoming addicted. A combination of factors related to your genes, environment, and your personal development increases the chance that taking drugs will lead to addiction. These include:

  • Home and family. Parents or older family members who use alcohol or drugs, or who are involved in criminal behavior, can increase a young person’s risk for developing a drug problem.
  • Peers and school. Friends and acquaintances who use drugs can sway young people to try drugs for the first time. Academic failure or poor social skills can also put a person at risk for drug use.
  • Early use. Although taking drugs at any age can lead to addiction, research shows that the earlier a person begins to use drugs, the more likely they are to progress to more serious use. This may reflect the harmful effect that drugs can have on the developing brain. It also may be the result of early biological and social factors, such as genetics, mental illness, unstable family relationships, and exposure to physical or sexual abuse. Still, the fact remains that early drug use is a strong indicator of problems ahead—among them, substance use and addiction.
  • Method of use. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense “high” can fade within a few minutes, and the person no longer feels good. Scientists believe that this low feeling drives people to repeat drug use in an attempt to recapture the high pleasurable state.

Learn more about what puts you at risk, view our video Anyone Can Become Addicted to Drugs.

Can you die if you use drugs?

Yes, deaths from drug overdose have been rising steadily over the last decade, largely due to increases in misuse of opioids. In 2017, more than 70,200 people died from a drug overdose, significantly more than the 63,000 people who died the year before. More than three out of five of those drug overdose deaths involved some type of opioid, either prescription pain reliever, heroin, or human-made opioids like fentanyl. Among young people ages 15-24, just over 5,400 deaths from a drug overdose occurred in 2017.1 Young males were two times more likely to die from a drug overdose than were females.

In addition, death can occur from the long-term effects of drugs. For example, long term use of tobacco products can cause cancer, which may result in death. Learn more about drug overdoses in youth

1 Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2017 on CDC WONDER Online Database, released 2018. Available at http://wonder.cdc.gov.

Are there effective treatments for drug addiction?

Yes, there are treatments to help manage addiction, but there is no cure. It is considered a chronic disease, meaning it lasts a long time and needs to be managed with regular treatment. If people follow treatment plans, they can go for many years leading healthy lives. It can be similar to other chronic conditions that people learn to manage, like diabetes or heart disease. Scientific research has shown that 13 basic principles are the foundation for effective drug addiction treatment. Find out more in Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.

Types of Treatment

Treatment will vary for each person, depending on the type of drugs used and the person’s specific circumstances. Generally, there are two types of treatment for drug addiction:

  • Behavior change— helping people learn to change behaviors that trigger drug use
  • Medications— helping people manage cravings for some drugs, such as tobacco, alcohol, heroin, or other opioids

Length of Treatment

Most people who have become addicted to drugs need long term treatment and, many times, repeated treatments—much like a person who has asthma needs to constantly watch the effects of medication and exercise. Even when someone relapses and begins using drugs again, they should not give up hope— they might need to change to a different treatment plan. In fact, setbacks are likely. Even people with diabetes may go off their diet or miss an insulin injection, and their symptoms will recur—that’s a cue to get back on track, not to view treatment as a failure.

Motivation for Treatment

Most people go into drug treatment either because a court ordered them to do so or because loved ones wanted them to seek treatment. Many people are tired of addiction and its problems, and chose to go into treatment. Others are ordered into treatment by a judge or under pressure from family members.

How do I know if someone has a drug problem?

The signs listed below may suggest a developing problem, which you should discuss with an adult you trust:

  • hanging out with different friends
  • not caring about your appearance
  • getting worse grades in school
  • missing classes or skipping school
  • losing interest in your favorite activities
  • getting in trouble in school or with the law
  • having different eating or sleeping habits
  • having more problems with family members and friends

Questions to Ask: Do You Have a Problem? 

Answering yes to any of the following questions may indicate a problem:

  1. Have you ever ridden in a car driven by someone (including yourself) who had been using alcohol or drugs?
  2. Do you ever use alcohol or drugs to relax, to feel better about yourself, or to fit in?
  3. Do you ever use alcohol or drugs when you are alone?
  4. Do you ever forget things you did while using alcohol or drugs?
  5. Do family or friends ever tell you to cut down on your use of alcohol or drugs?
  6. Have you ever gotten into trouble while you were using alcohol or drugs?

What should I do if someone I know needs help?

If you, or a friend, are in crisis and need to speak with someone now: 

  • Call the National Suicide Prevention Lifeline at 1-800-273-TALK (they don’t just talk about suicide—they cover a lot of issues and will help put you in touch with someone close by)

If you want to help a friend, you can:

If a friend is using drugs, you might have to step away from the friendship for a while. It is important to protect your own mental health and not put yourself in situations where drugs are being used.

How to Quit Vaping

Quitting vaping can be easier when you prepare in advance and have a plan. Find out what steps you can take to get ready to quit vaping.

Know Why You’re Quitting

There are many good reasons to stop vaping. Do you want to feel healthier? Save money? Knowing why you want to quit vaping can help you stay motivated and focused on your goal to become vape-free.

Think about the things in your life that are important to you. Does vaping get in the way of what’s important? If you’re not sure, try asking yourself these questions:

  • Is vaping controlling my life?
  • How does vaping affect the way I think and feel?
  • How does vaping affect my relationships with my friends, parents, boyfriend/girlfriend, or other people important to me?
  • How does vaping or thinking about vaping interfere with my schoolwork or grades?
  • Are there activities that I used to enjoy that I don’t enjoy anymore because of vaping?
  • Am I spending a lot of money to keep vaping?
  • What am I looking forward to the most after quitting?

Your answers to these questions can help you see how vaping is affecting your life, maybe in ways you hadn’t thought about before. Make a list of all the reasons that you want to quit vaping and put it in a place where you will see it often. It might help to keep the list on your phone. When you have the urge to vape, look at the list to remind yourself why you want to stop vaping. Frequently reminding yourself why you want to quit can keep you focused on quitting vaping.

Quit Tobacco Completely

Some people who vape also use cigarettes or other tobacco products. If you smoke cigarettes or use other tobacco products besides vapes, now is a good time to quit those too.

We know it can seem challenging to quit smoking or using other tobacco products at the same time as quitting vaping, but becoming completely tobacco-free is the best thing you can do for your health.

Remember: There are tools available to help you quit. Download the quitSTART app or try SmokefreeTXT by signing up online or texting QUIT to 47848.

Set Your Quit Date

The first step to giving up vaping is to choose a date to quit. Here are some tips to help you pick a quit date:

  • Give yourself time to get ready. Getting ready can help you feel confident and give you the skills you’ll need to stay quit.
  • Don’t put it off for too long. Picking a date too far away gives you time to change your mind or become less interested in quitting. Choose a date that is no more than a week or two away.
  • Set yourself up for success. Try not to pick a quit date that will be stressful, like the day before a big test.

Have you picked your quit date? Circle it on your calendar or set an alert on your phone, and make sure you have a plan for what you will do on the big day.

Know What Challenges to Expect

The first few weeks of quitting vaping are usually the hardest. Take it one day at a time. You may face some challenges along the way, but knowing what to expect and being prepared can help.

Learn your triggers. Certain people, feelings, or situations can cause you to want to vape. It’s important to know your triggers. It may be best to avoid situations that can trigger you to vape when you’re in the early stages of your quit.

Prepare for cravings and withdrawal. Think about how you will fight cravings and deal with withdrawal symptoms. Knowing what to expect and having strategies for handling thoughts about vaping or uncomfortable feelings will help you succeed and stay with your quit in those tough moments.

Resist temptations. Avoid places and situations where others are vaping. If you can’t avoid being around vaping, plan for how you will handle these situations. Maybe that means you take a temporary break from friends you vape with and think about what you will say if somebody offers you a vape.

Imagine Your Vape-Free Self

It might be hard to imagine your life without e-cigarettes – especially if vaping is something you do a lot throughout the day. You might feel like a piece of yourself is missing when you first quit. It can take time to get used to the new vape-free you, but over time this will become your new normal. Here are some strategies that can help:

  • Make the mental shift. Start thinking of yourself as someone who doesn’t vape. This will help separate you from vaping and give you the confidence to quit and stay quit.
  • Focus on the positive. Make a list of all the positive things about yourself that don’t involve vaping and put it somewhere you can see often, like on your bedroom wall or phone. It will remind you that vaping does not define who you are.
  • Picture the future you. Think about who you want to be in the future. Compare that with who you are now. Ask yourself: How are they different? How does vaping get in the way of what you want for the future? The answer to this can help motivate you to stick to your decision to quit.

Build Your Team

Surrounding yourself with supportive people can make it easier to quit vaping. Friends, family, co-workers, and others can be there to listen, boost your mood, and distract you from using your vape.

Ask for help. You don’t have to do it alone. If you feel comfortable, tell your friends and family that you’re quitting vaping and that you will need their support. Here are some ways to ask for the support you need.

  • Be specific. Whether you need tough love or something softer, tell your friends and family what type of support you want, and how often you want their help. For example, if you are feeling stressed or anxious after school, ask a friend to help keep you distracted.
  • Say thank you. Tell your support team you appreciate them. A thank-you can go a long way – and it doesn’t take much time. Research also shows that being grateful can improve physical health, mental health, and self-esteem.
  • Support others. Support is a two-way street. Check-in with your friends and ask them what you can do to help them. Or, do something to brighten someone’s day.

Talk to a doctor. Talk to your doctor or another health care professional about how to quit vaping. Ask how they might be able to help you. They can offer support and resources.

Talk to a tobacco cessation counselor. Get free, personalized support from an expert. Call 1-800-QUIT-NOW or 1-877-44U-QUIT to talk with a tobacco cessation counselor. You can also chat online using the National Cancer Institute’s LiveHelp service.

Dealing with people who don’t get it. Some important people in your life may not understand your decision to quit. It can be frustrating or discouraging when someone in your life is not as supportive as you’d like. Try one of these strategies:

  • Distance yourself. You may need to take a break from unsupportive people when you first quit. Let them know that you need to make quitting vaping your priority right now.
  • Recommit to quitting. Remind yourself why you are quitting and why being vape-free is important to you.
  • Ask them to respect your decision. Not everyone will know how to be supportive, and that’s okay. Ask them not to vape around you or offer you to use their vape.
  • Lean on positive people. Spend time with people who make you feel good about your decision and who want you to quit.

Source: Smokefree.gov

X-ray of a damaged lung©iStock.com/stockdevilMarijuana smoke can hurt your lungs and cause some of the same coughing and breathing problems faced by people who smoke cigarettes.

These are just some of the problems marijuana can cause:

Memory Problems

Marijuana makes it hard to remember things that just happened a few minutes ago. That makes it hard to learn in school or to pay attention to your job.

Heart Problems

Using marijuana makes the heart beat fast and raises your risk of having a heart attack.

Coughing and Breathing Problems

People who smoke marijuana can get some of the same coughing and breathing problems as people who smoke cigarettes. Marijuana smoke can hurt your lungs.

Drugged Driving

Driving when you’re high on marijuana is dangerous. It is similar to driving drunk. Your reactions to traffic signs and sounds are slow. It’s hard to pay attention to the road. And it’s even worse when you’re high on marijuana and alcohol at the same time.

Not Caring about Life

Over time, people who use marijuana can get “burnt out.” They don’t think about much or do much. They can’t concentrate. They don’t seem to care about anything but smoking marijuana.

Overdose

An overdose happens when a person uses enough of a drug to have a very bad reaction or death. People can overdose on marijuana when they take too much of it. This can cause very uncomfortable side effects. In recent years, emergency room doctors are seeing more overdoses in people who eat marijuana edibles (gummies, lollipops and other foods). It takes longer to feel high from edibles than from smoking. Because of this, sometimes people eat too much because they think it isn’t working.

Signs of marijuana overdose are: 

  • a lot of anxiety (feeling very worried) 
  • panic attacks 
  • paranoia (thinking people are out to get you) 
  • hallucinations (seeing things that aren’t there) 

We do not know of any person who has died from using just marijuana.

Addiction

Although some people don’t know it, you can get addicted to marijuana after using it for a while. Over time, it can change the way your brain works. If you stop using it, your body can get confused and you can start to feel really sick. This makes it hard to stop. This is called addiction.

This is more likely to happen to people who use marijuana every day or who started using it when they were teenagers. They might need to smoke more and more of it to get the same high.

People who are trying to quit using marijuana can:

  1. be in a bad mood 
  2. feel nervous 
  3. have trouble sleeping

They will feel a strong need to take the drug.

Fortunately, there is counseling that can help someone with a marijuana addiction.

Remember that even if you get treatment, it can be hard to stay off the drug. People who stopped using marijuana can still feel strong cravings for the drug, sometimes even years later. This is normal. This is also why it’s important to stay in treatment for as long as your doctor suggests.

You’ve got your whole future ahead of you. Why limit the possibilities?

Jobs and Career

You can handle that interview. But using marijuana can get you fired from your job or prevent you from getting hired in the first place. THC (the main active chemical in marijuana) can stay in your system and show up on a drug test for several days or weeks. And, a marijuana conviction could even prevent you from joining the military or getting the job you really want later in life.

Source: NIDA (2016).

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Driving and Riding

You can enjoy the open road. But driving high or riding with a high driver isn’t just risky, it’s potentially deadly. And for teen drivers, testing positive for any amount of marijuana means getting a DUI, which could mean losing your license and paying thousands of dollars in fines and legal fees.

Source: Washington State Liquor and Cannabis Board, 2016.

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Relationships

You can be there for your friends and family. And since the majority of Washington teens (83 percent) don’t use marijuana, chances are your friends don’t. Getting caught with marijuana could mean losing the trust and respect of your parents, as well as friends, teachers, and coaches. Even if you don’t get caught, marijuana can hurt your relationships by making you withdraw from the people you care about most.

Source: The 2016 Washington State Healthy You Survey

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School & Beyond

You can go further. Whether it’s getting a job or going to school, marijuana can knock you off course. Besides making it harder to learn, getting caught with marijuana can get you into trouble at school–including suspension or expulsion–messing with your ability to graduate or get the grades you need for your next step.

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Sports and Extracurriculars

You can do what you love. But marijuana could stop you from taking your skills to the next level. Apart from affecting coordination, movement, and reaction times, marijuana use can make you ineligible for the sports teams, clubs, and other extracurricular activities you enjoy.

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Financial Aid

You can invest in yourself. But a marijuana charge can make you ineligible for federal student aid grants and loans, which are needed for some people to afford to go to college.

Source: U.S. Department of Education

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Cost of Marijuana

You can be smart with your money. Spending on marijuana is a waste. Besides being illegal, purchasing marijuana can be expensive, especially if you develop a habit. And if you get caught, fines and legal fees can add up to thousands of dollars.

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Source Information: YouCan.org

How To Recognize a Substance Use Disorder

How do I know if I have a drug use problem?

Samhsa.gov treatment locator

Addiction can happen at any age, but it usually starts when a person is young.  If you continue to use drugs despite harmful consequences, you could be addicted. It is important to talk to a medical professional about it—your health and future could be at stake.

Have friends or family told you that you are behaving differently for no apparent reason—such as acting withdrawn, frequently tired or depressed, or hostile? You should listen and ask yourself if they are right—and be honest with yourself. These changes could be a sign you are developing a drug-related problem. Parents sometimes overlook such signs, believing them to be a normal part of the teen years. Only you know for sure if you are developing a problem because of your drug use. Here are some other signs: 

  • hanging out with different friends
  • not caring about your appearance
  • getting worse grades in school
  • missing classes or skipping school
  • losing interest in your favorite activities
  • getting in trouble in school or with the law
  • having different eating or sleeping habits
  • having more problems with family members and friends

There is no special type of person who becomes addicted. It can happen to anyone. (See NIDA’s video below)

Thanks to science, we know more than ever before about how drugs work in the brain, and we also know that addiction can be successfully treated to help young people stop using drugs and lead productive lives. Asking for help early, when you first suspect you have a problem, is important; don’t wait to become addicted before you seek help.  If you think you are addicted, there is treatment that can work. Don’t wait another minute to ask for help.

Why can’t I stop using drugs on my own?

Repeated drug use changes the brain. Brain imaging studies of drug-addicted people show changes in areas of the brain that are needed to learn and remember, make good decisions, and control yourself. Quitting is difficult, even for those who feel ready. NIDA has an excellent video (below) that explains why drugs are so hard to quit (hint: it’s all about the brain). If you aren’t sure you are addicted, it would be helpful for you to look at this brief video. It helps explains why your inability to stop using drugs does not mean you’re a bad person, just that you have an illness that needs to be treated.

Why Are Drugs So Hard to Quit?

I don’t feel well when I stop using drugs. Do treatment centers force people to stop taking drugs immediately?

Treatment is always based on the person’s needs. However, if you are still using a drug when you are admitted to a treatment program, one of the first things addiction specialists need to do is help you safely remove drugs from your system (called “detox”). This is important because drugs impair the mental abilities you need to make treatment work for you.

When people first stop using drugs, they can experience different physical and emotional withdrawal symptoms, including depression, anxiety, and other mood disorders, as well as restlessness and sleeplessness. Remember that treatment centers are very experienced in helping you get through this process and keeping you safe and comfortable during it. Depending on your situation, you might also be given medications to reduce your withdrawal symptoms, making it easier to stop using.

I tried rehab once and it didn’t work—why should I try it again?

If you have already been in rehab, it means you have already learned many of the skills needed to recover from addiction, and you should try it again. Relapsing (going back to using drugs after getting off them temporarily) does not mean the first treatment failed. People with all kinds of diseases relapse; people with other chronic diseases such as high blood pressure and asthma—which have both physical and behavioral components—relapse about as much as people who have addictions.

Treatment of all chronic diseases, including addiction, involves making tough changes in how you live and act, so setbacks are to be expected along the way. A return to drug use means treatment needs to be started again or adjusted, or that you might need a different treatment this time.

I don’t like lying to my parents but, they don’t understand me and my problems. If we talk about drugs, they will just yell at me. How can I avoid a fight?

First of all, remember that they were teens once, and they understand teen life more than you think. Secondly, when you first tell them about your problem, they might get angry out of fear and worry. They might raise their voices because they are very, very worried about you and your future. Try to stay calm and simply ask for help. Repeat over and over again that you need their help.

Parents do get angry when they find out their kids have been lying to them. You’d do the same! Be honest with them. Let them know you want to change and need their help.

I am also afraid my parents will take away the car keys—what can I do about that?

The single most responsible thing you can do is stop driving until you get help for your drug use. This might be inconvenient, but if you do drugs and drive, you could end up not only killing yourself but killing others as well. That could lead to a lifetime in prison. This is no different than drinking and driving. For more see our DrugFacts on drugged driving.

If you tell your parents that you are willing to give up your driving privileges, they will know you are serious about getting help.

What are effects of Drugs on Driving?

Taking drugs helps me feel less depressed—what’s wrong with that?

The relief you feel is only temporary and can cause more problems down the road, as your brain and body start to crave more and more drugs just to feel normal.  It is very possible you need to find treatment for your depression as well as for your drug use. This is very common. It is called “comorbidity” or “co-occurrence” when you have more than one health problem at the same time. For more information, see Drug Facts for Teens Co-Occurring Substance Use and Other Mental Health Issues

Be certain to tell your doctor about your drug use, as well as any depression or anxiety you feel, or any other mental health issues you are experiencing. There are many nonaddictive medicines that can help with depression or other mental health issues. Sometimes doctors do not talk to each other as much as they should. For example, a therapist you might be seeing for depression does not always consult with your pediatrician. So you need to be your own best friend and advocate—and make sure all of your health care providers know about all of the health issues that concern you. You should be treated for all of them at the same time.

Note: If you ever feel so depressed that you think about hurting yourself, there is a hotline you can call: 1-800-273-TALK (8255). This is called the National Suicide Prevention Lifeline, and you can share all of your problems with them. A caring, nonjudgmental voice will be on the other end, listening.