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Co-occurring Disorders

Estimated rates of co-occurring mental illness among adolescents with substance use disorders range from 60 to 75 percent.1 Among adolescents with no prior substance use, the rates of first-time use of drugs and alcohol in the previous year are higher in those who have had a major depressive episode than in those who did not.2 Other commonly documented co-occurring mental disorders include conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, anxiety, and post-traumatic stress disorder.3

  • Youth who experience a major depressive episode were twice as likely to begin using alcohol or an illicit drug, compared to youth who had not experienced a major depressive episode.4
  • Youth who experienced serious depression were twice as likely to use alcohol as their peers who had not been seriously depressed. Over 29 percent of youth who had not used alcohol previously initiated alcohol use following a major depressive episode within the past year, compared with 14.5 percent of youth who had not experienced a major depressive episode in the past year.5
  • Similarly, many more youth who had not previously used illicit drugs did so after a major depressive episode. Sixteen percent of youth who had not used an illicit drug in the past year initiated illicit drug use after a major depressive episode, compared with 6.9 percent of youth who had not experienced a major depressive episode in the past year.6

There is always much speculation about what presents first in the youth’s life, the substance use or the mental health challenges.  It can happen either way and what we do know is that undiagnosed mental health problems can lead to self-medicating with substances.

Learn more about mental health and substance use for youth. 

Resources

Blamed and Ashamed The Treatment Experiences of Youth with Co-occurring Substance Abuse and Mental Health Disorders and Their Families (PDF, 70 pages)

This report presents the findings of a two-year project intended to document and summarize the experiences of youth with co-occurring mental health and substance abuse problems and their families. The purposes of this study were to offer youth and their families the opportunity to reflect on and give voice to their experiences, to identify their successes and concerns, and to formulate recommendations so that a national audience might learn from their experience and improve services. The work was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. Department of Health and Human Services and conducted by two family-run organizations — the Federation of Families for Children’s Mental Health, Alexandria, Virginia, and Keys for Networking, Inc., Topeka, Kansas.

Youth Risk and Behavior Survey: Data Summary and Trends Report, 2007 - 2017

This Centers for Disease Control and Prevention report provides data summary and trend information on varying topics, including coccurring disorders.

Be Prepared to Have the Difficult Conversation (PDF, 1 page)
This data visualization flyer illustrates the correlation between alcohol use and other substance use to inform parents/guardians and communities.

1 Turner, Muck, Muck, Stephens, & Sukumar, 2004; Hoffmann, Bride, MacMaster, Abrantes, & Estroff, 2004
2 Substance Abuse and Mental Health Services Administration [SAMHSA], 2010
3 Turner et al., 2004; Hoffman et al., 2004; Shrier, Harris, Kurland, & Knight, 2003
4 SAMHSA, 2010
5 SAMHSA, 2010
6 U.S. Department of Health and Human Services, 2007

Youth Briefs

How Individualized Education Program (IEP) Transition Planning Makes a Difference for Youth with Disabilities

Youth who receive special education services under the Individuals with Disabilities Education Act (IDEA 2004) and especially young adults of transition age, should be involved in planning for life after high school as early as possible and no later than age 16. Transition services should stem from the individual youth’s needs and strengths, ensuring that planning takes into account his or her interests, preferences, and desires for the future.

Youth Transitioning to Adulthood: How Holding Early Leadership Positions Can Make a Difference

Research links early leadership with increased self-efficacy and suggests that leadership can help youth to develop decision making and interpersonal skills that support successes in the workforce and adulthood. In addition, young leaders tend to be more involved in their communities, and have lower dropout rates than their peers. Youth leaders also show considerable benefits for their communities, providing valuable insight into the needs and interests of young people

How Trained Service Professionals and Self-Advocacy Makes a Difference for Youth with Mental Health, Substance Abuse, or Co-occurring Issues

Statistics reflecting the number of youth suffering from mental health, substance abuse, and co-occurring disorders highlight the necessity for schools, families, support staff, and communities to work together to develop targeted, coordinated, and comprehensive transition plans for young people with a history of mental health needs and/or substance abuse.

Young Adults Formerly in Foster Care: Challenges and Solutions

Nearly 30,000 youth aged out of foster care in Fiscal Year 2009, which represents nine percent of the young people involved in the foster care system that year. This transition can be challenging for youth, especially youth who have grown up in the child welfare system.

Coordinating Systems to Support Transition Age Youth with Mental Health Needs

Research has demonstrated that as many as one in five children/youth have a diagnosable mental health disorder. Read about how coordination between public service agencies can improve treatment for these youth.

Civic Engagement Strategies for Transition Age Youth

Civic engagement has the potential to empower young adults, increase their self-determination, and give them the skills and self-confidence they need to enter the workforce. Read about one youth’s experience in AmeriCorps National Civilian Community Corps (NCCC).