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Topics In Brief

All Topics In Brief

Impact of Alcohol and Drug Use on Adolescents

This edition of ReCAPP focuses on the impact of alcohol and other drugs on teen pregnancy. This month's edition of Topic in Brief includes: This edition concludes with an FYI: a link to a New York Times article about parents and sex education.


There are complicated, even dangerous, connections between the use of drugs and alcohol and sexual behaviors. Yet the effects of most drug prevention efforts have been modest at best. Risky behaviors are not going away, and neither is our responsibility to face them squarely. Perhaps now is the time for educators to try new strategies to counter the ever increasing challenges of teen alcohol and drug abuse and the impact on their sexual risk-taking behavior. Some experts advocate programs which offer comprehensive and realistic information about the effects of alcohol and other drugs ... along with the assumption that young people can be trusted to make responsible decisions to stay safe.


Drugs are chemical substances that have a direct effect on the structure or function of the body. A drug is any substance that causes a physical or mental change in the body. Some of the common types of drugs and their effects are listed below:

Type of Drug
Intoxication Effects


Opium, Heroin, Morphine

Pain relief, euphoria, drowsiness
Depressants Valium, Quaaludes, Alcohol, Rohypnol
Reduced pain and anxiety; feeling of well-being; lowered inhibitions; slowed pulse and breathing; lowered blood pressure; poor concentration
Stimulants Cocaine, Tobacco, Caffeine, Diet Pills, Ecstasy
Increased heart rate, blood pressure, metabolism; feelings of exhilaration, energy; increased mental alertness

Hallucinogens (or psychedelics)

LSD, Mescaline Altered state of perception and feeling; nausea
Cannabis Marijuana, Hashish
Euphoria; slowed thinking and reaction time; confusion; impaired balance and coordination
Inhalants Glue, Poppers, Nitrous Oxide

Stimulation, loss of inhibition; headache, nausea or vomiting; slurred speech; loss of motor coordination; wheezing

More detailed descriptions and health effects of various substances can be found on many websites, (see Websites to Check Out, below) including the National Institute on Drug Abuse: and The Do It Now Foundation, a non-profit organization committed to drug abuse prevention:

Overview of the Issues

Sexual activity can be risky behavior for teens. Unintended pregnancy, STIs including HIV, non-consensual sex, and the potentially negative emotional consequences are a few of the risky outcomes teens experience when they become sexually active. However, sexual activity under the influence of drugs, including alcohol, can raise the stakes even higher. Consider the following:

  • Teens often drink or use other drugs when they engage in sexual activity. So perhaps it's not surprising that many young people lose their virginity while drunk. Unfortunately, many teens who get drunk and have sex also become pregnant because they aren't thinking about or able to use protection at the time. (National Campaign to Prevent Teen Pregnancy's "Fact Sheet: Sobering Facts on Alcohol and Teen Pregnancy," April, 2000)

  • Thirteen percent of teens say they've done something sexual while using alcohol and other drugs that they might not have done if they had been sober. ("National survey of teens: Teens talk about dating, intimacy, and their sexual experiences," Kaiser Family Foundation and YM Magazine, 1998)

  • Teens who drink and smoke are more likely to hang out with teens they perceive to be sexually "advanced" — which usually results in a higher level of sexual activity among those teens themselves. (Whitbeck, et al., 1993)

What Educators Can Do

Drug and alcohol education has been practiced by educators in schools and other youth settings for decades. However, despite the $2.1 billion spent on "prevention," (abstinence from drugs) in 1999, government surveys indicate that many teenagers still experiment with drugs.

Marsha Rosenbaum, PhD, of the Drug Policy Alliance — an institute dedicated to broadening the debate and advancing a harm reduction perspective regarding drugs, drug abuse, and drug policy — believes that abstinence-only drug education is unrealistic. She and others fear an abstinence-only approach leaves teachers and parents with little to say to the 50% of teens who, despite admonitions, have tried marijuana, and the 80% of teens who use alcohol by the time they graduate from high school.

Rosenbaum offers an alternative, a safety-first approach to drug education, which requires reality-based assumptions about drug use. Safety-first drug education stresses abstinence from drugs, but it doesn't stop there. It also includes a fallback strategy for risk reduction. This strategy consists of providing students with information and resources so they do the least possible harm to themselves and others.

Safety-first drug education assumes that teenagers can make responsible decisions if given honest, science-based drug education. Another assumption of safety-first drug education is that total abstinence may not be a realistic alternative for all teenagers. One more assumption of safety-first drug education is that the use of mind-altering substances does not necessarily constitute abuse. With sexual activity and alcohol use, for example, teenagers must understand the importance of context so that they can make wise decisions, control their use, and stay safe and healthy.

Rosenbaum's "How To's" of safety-first drug education include the following:

  • Communication is key in safety-first drug education. The channels of communication must be open, and listening to what teens have to say is crucial. Rosenbaum is insistent in her belief that, if adults become indignant and punitive, teenagers will stop talking.

  • Discussions of drugs in safety-first drug education must include observations and experience of the teens themselves if the program is to be credible. Teens should feel safe from negative repercussions for their input and honesty.

  • Safety-first drug education should be age-specific, beginning in middle- school, when teens are actually confronted with drugs. It should engage students in the broad study of how drugs affect the body and mind. They should also learn about the social context of drugs in America.

  • Safety-first drug education teaches students the legal consequences of drug use in America, acknowledging illegality as a risk factor in and of itself. There are real, lasting consequences of using drugs and being caught, including expulsion from school, denial of college loans, a criminal record, and lasting stigma.

  • The goals of realistic drug education focus on safety. Safety-first education separates the real from the imagined dangers of substance use.

  • A comprehensive, reality-based drug education curriculum will equip students with information they trust, which is the basis for making responsible decisions.

As the demand for reality-based drug education grows, programs are being developed in the U.S. and abroad. A listing of such programs can be found at the web site of the Drug Policy Alliance:

According to Rosenbaum, it's our responsibility as parents and teachers to engage students and provide them with credible information so they can make responsible decisions, avoid drug abuse, and stay safe.

To download pdf versions of Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education, in four different languages or order up to 50 copies in English or Spanish, go to:

Web Sites to Check Out

Recommended Books

  • From Chocolate to Morphine: Everything You Need to Know About Mind-Altering Drugs (Updated)
    Andrew Weil, MD, & Winifred Rosen
    Houghton Mifflin Company, New York, 1993

  • Marijuana Myths, Marijuana Facts: A Review of the Scientific Evidence
    Lynn Zimmer & John P. Morgan
    BookWorld Companies, 1997

  • The Great Brain Robbery . . . What everyone should know about teenagers and drugs
    Tom Scott & Trevor Grice
    The Publishing Trust
    Wellington, New Zealand, 1996

More Information/Resources

  • The Center for Educational Research and Development, an innovative non-profit organization devoted to the healthy development of young people and their families through programs, evaluation, research and policy consultation, has a web site ( containing several related articles including:

    "Listen to the Kids: When it comes to drug education, students confirm what research says," by Joel H. Brown (

    "Students and Substances: Social Power in Drug Education," by Joel H. Brown, Marianne D'Emidio-Caston, & John Pollard (

    "In Their Own Voices: Students and Educators Evaluate California School-Based Drug, Alcohol, and Tobacco Education (DATE) Programs," a report written by Joel H. Brown et al. (
  • Youth risk behavior surveillance. National Alternative High School Youth Risk Behavior Survey, United States, 1998. Journal of School Health, 2000 Jan; 70 (1): 5-17, National Library of Medicine PubMed
  • "Unprotected sex as a function of alcohol and marijuana use among adolescent detainees." Kingree JB, Braithwaite R, Woodring T Rollins School of Public Health of Emory University, Atlanta, GA. PubMed Services
  • National Survey of teens: Teens talk about dating, intimacy, and their sexual experiences. Kaiser Family Foundation and YM Magazine, 1998
  • National Youth Crisis Hotline (operates 24 hours, seven days a week)
    1-800-422-HOPE (4673)
  • National Adolescent Health Information Center Division of Adolescent Medicine University of California, San Francisco 1388 Sutter Street, Suite 605A, San Francisco, CA 94109 (415) 502-4856


Check out a New York Times article recently published about the Kaiser Family Foundation survey which found that parents favor more detailed sex education for their teens: