Study: High school students who use alcohol, cannabis or nicotine are at higher risk for mental health disorders. What parents should know.

A high school girl sits in a school hallway looking forlorn, with hand to head and phone in hand
What parents need to know about a new study linking cannabis, nicotine and alcohol use among high schoolers to suicidal thoughts. (iStock/Getty Images Plus)

High school students who reported using alcohol, cannabis or nicotine were more likely to have symptoms of mental health disorders than those who did not — even at low levels of usage, according to a new study published on Monday by researchers at Massachusetts General Hospital (MGH) and the University of Minnesota.

So what can you take away from this? Here’s what researchers learned about substance use in adolescents, what other experts in the field think about their findings — and what worried parents can do to help their teen navigate concerns about alcohol, cannabis or nicotine as well as mental health.

What the study says

The study, which used results from a 2022–2023 survey of over 15,000 Massachusetts high school students, found that using any of these three substances was linked to psychiatric symptoms, including suicidal thoughts, symptoms of depression or anxiety, psychotic experiences and attention deficit hyperactivity disorder (ADHD) symptoms.

Researchers also looked at whether how frequently adolescents used alcohol, cannabis or nicotine was associated with increased psychiatric symptoms. They found that daily or near-daily use “was consistently associated with moderate increases in symptoms,” and thoughts of suicide were about five times more prevalent among students who used substances daily or near-daily than those who did not.

But even among students with lower levels of use — i.e., students who had ever used substances or used them monthly or weekly — some increase in psychiatric symptoms was detected.

“We know, and have known for a while, that psychiatric symptoms tend to be more prevalent among young people who use substances,” Randi M. Schuster, senior author of the study and an associate professor of psychology at MGH, tells Yahoo Life. “We show that these trends emerge at even low levels of use, which was quite remarkable.”

The researchers were able to replicate their findings when they looked at responses from a national survey conducted in 2021.

What experts say

Dr. Christopher J. Hammond, an associate professor of child and adolescent psychiatry at Johns Hopkins University School of Medicine, points out that the study doesn’t take into account the use of multiple substances — which “is common among adolescents” — and how that might affect mental health symptoms.

“They do not control for effects of cannabis, for example, in their alcohol analyses —or vise versa,” Hammond tells Yahoo Life. “Given this, I think it is difficult to draw major conclusions comparing the effects of different substance types to each other,” he says.

Dr. Maria H. Rahmandar, a co-author of the American Academy of Pediatrics clinical report on suicide and suicide risk on adolescents, tells Yahoo Life that the study’s findings aren’t surprising since substance use has a known association with suicide and mental health conditions.

“Substance use could increase the risk of suicidality and mental health disorders, and the reverse can also be true — that suicidality and mental health disorders can increase the risk of using substances,” Rahmandar says.

But while this study doesn't help to clarify the relationship between substances and mental health disorders, Rahmandar does say it adds to our understanding of how the frequency of alcohol, cannabis or nicotine use may be connected to suicidal thoughts or mental health conditions.

“So it remains important to address substance use — particularly in youth with mental health concerns,” Rahmandar says.

What parents can do

Conversations around substance abuse can be tough to have, but it’s important to start early. As experts previously told Yahoo Life, parents should begin talking to their kids about substance abuse — particularly “gateway drugs” like alcohol and nicotine — no later than age 9. Parents can start in an age-appropriate way, gradually introducing topics like which medications are or are not OK to take, peer pressure and the risks posed by social media.

And if your child expresses thoughts of suicide, you should take it seriously even if they're young, with experts saying that a child is "never 'too young'" to take their own life. Parents should stay calm to encourage a child to keep communicating openly, and ask questions like, "What do you mean when you say you want to die?,” "What do you think would make things better?" and "What do you need from me?”

If you or someone you know is experiencing suicidal thoughts, call 911, or call the 988 Suicide & Crisis Lifeline at 988 or 1-800-273-8255 or text HOME to the Crisis Text Line at 741741.