The study, based on a 2022–2023 survey of over 15,000 Massachusetts high school students, identified a link between substance use and psychiatric symptoms, including suicidal thoughts, depression or anxiety, psychotic experiences, and attention deficit hyperactivity disorder (ADHD) symptoms. Moreover, the frequency of substance use was connected to increased psychiatric symptoms, with daily or near-daily use showing a consistent association with moderate increases in symptoms.
“We show that these trends emerge at even low levels of use, which was quite remarkable,” says Randi M. Schuster, senior author of the study and an associate professor of psychology at MGH. The researchers confirmed their findings using data from a national survey conducted in 2021.
However, Dr. Christopher J. Hammond, an associate professor of child and adolescent psychiatry at Johns Hopkins University School of Medicine, points out that the study does not consider the combined use of multiple substances that is common among adolescents, which makes it difficult to draw conclusions comparing the effects of different substance types to each other.
Dr. Maria H. Rahmandar, a co-author of the American Academy of Pediatrics clinical report on suicide and suicide risk in adolescents, underscores that while the study does not clarify the relationship between substances and mental health disorders, it contributes to our understanding of how the frequency of alcohol, cannabis, or nicotine use may be connected to suicidal thoughts or mental health conditions.
Rahmandar says that addressing substance use, particularly in youth with mental health concerns, is crucial. Conversations about substance abuse should start early. Parents should begin talking to their kids about substance abuse — especially “gateway drugs” like alcohol and nicotine — at an age-appropriate level. If a child expresses thoughts of suicide, parents should take it seriously and stay calm to encourage open communication. If you or someone you know is experiencing suicidal thoughts, call 911, the 988 Suicide & Crisis Lifeline at 988 or 1-800-273-8255, or text HOME to the Crisis Text Line at 741741.
