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Teen Substance Use Is Near Historic Lows — but Fentanyl Has Changed the Risk

Published July 13, 2026 · The Empower Brief

There is genuinely good news about teen substance use in America. According to the most recent Monitoring the Future survey — an annual study conducted by the National Institute on Drug Abuse (NIDA) and the University of Michigan — adolescent drug and alcohol use remained at or near historic lows for the fifth consecutive year in 2025. But that progress exists alongside a newer danger: fentanyl-contaminated counterfeit pills that can be lethal even on a first use, and that young people are increasingly encountering through social media. Understanding both sides of this picture is essential for parents, educators, and anyone who cares about the next generation.

What the data shows: most teens are choosing not to use substances

The 2025 Monitoring the Future survey collected responses from more than 23,700 students across 270 schools nationwide. The headline finding is striking: approximately 91% of 8th graders, 82% of 10th graders, and 66% of 12th graders reported abstaining from marijuana, alcohol, and nicotine in the prior 30 days.

Looking at each substance individually:

• Marijuana: Past-year use was reported by about 8% of 8th graders, 16% of 10th graders, and 26% of 12th graders — holding steady from the prior year and far below pre-pandemic peaks.
• Alcohol: Past-year use was reported by about 11% of 8th graders, 24% of 10th graders, and 41% of 12th graders — also stable compared with 2024.
• Nicotine vaping: Past-year use was reported by about 9% of 8th graders, 14% of 10th graders, and 20% of 12th graders.
• Heroin and cocaine: Use remained low, with fewer than 1% of any grade group reporting heroin use in the prior year. Cocaine use remained uncommon but showed a slight increase among 8th and 12th graders compared with 2024, a trend worth watching.

Researchers caution that these numbers reflect self-reported use among enrolled students and are snapshots, not guarantees of permanent progress. But the five-year trend is meaningful and reflects the impact of prevention investments, awareness campaigns, and community-level work.

The fentanyl exception: why a single pill can be fatal

Here is where the good news becomes complicated. Even as overall teen drug use has fallen, overdose deaths among young people rose sharply between 2020 and 2022 before beginning to decline — and fentanyl is the reason. According to CDC data, roughly 75% of overdose deaths among youth ages 10–19 between 2020 and 2024 involved fentanyl, often hidden in counterfeit pills that looked like legitimate prescription medications such as Adderall, Xanax, or Percocet.

This matters because many of these young people were not regular drug users. They may have obtained what they believed was a single anxiety pill or a study aid from a friend or through social media — and encountered a lethal dose of illicitly manufactured fentanyl instead. The Drug Enforcement Administration found that in 2023, seven out of every ten counterfeit opioid pills seized contained a potentially deadly dose of fentanyl. Just two milligrams — an amount smaller than a few grains of salt — can be fatal.

Nearly half of teenagers are unaware that counterfeit prescription pills can contain lethal amounts of fentanyl, according to research cited by CDC. That knowledge gap is itself a public health problem — and closing it is one of the most important things adults can do.

Mental health is the missing piece

Substance use among young people rarely happens in isolation. The KFF estimates that approximately 19% of adolescents experience moderate to severe anxiety, and about 2 million adolescents in the U.S. have a substance use disorder. Research consistently shows that untreated anxiety, depression, trauma, and ADHD raise the risk of substance use as teens seek relief from difficult feelings.

This means prevention and early intervention are two sides of the same coin. Schools, pediatricians, and families who address mental health early — making it as routine to talk about as physical health — are also reducing the conditions that make substance use more likely.

What works: evidence-based prevention

Decades of research have identified specific approaches that reliably reduce youth substance use:

• Parent conversations. SAMHSA's "Talk. They Hear You." campaign emphasizes that parents and caregivers are among the most powerful influences in a young person's life. Even when teens seem to tune out adults, they do hear and internalize parental messages about drugs and alcohol. Starting those conversations early — before high school — and revisiting them over time makes a real difference.
• School-based programs. Programs like the Good Behavior Game and Classroom-Centered Intervention help students build social, emotional, and cognitive skills alongside accurate information about substances. The skills learned in these programs — managing stress, navigating peer pressure, making decisions under uncertainty — are protective far beyond substance use.
• Community coalitions. CDC's ENGAGE framework and programs like Communities That Care bring together community organizations, schools, and health systems to identify and address local risk factors. Tailored, community-driven approaches tend to be more effective than one-size-fits-all campaigns.
• Harm reduction education. Teaching young people that counterfeit pills are dangerous, that fentanyl test strips exist, and that naloxone (Narcan) can reverse an overdose doesn't encourage drug use — it saves lives. For teens who may use substances despite prevention efforts, harm reduction knowledge is critical.

What parents can do right now

• Talk early and often. You don't need to wait for a "drug talk" moment. Weave conversations about substances into everyday discussions — TV shows, news stories, things that come up naturally. Keep the tone curious and non-accusatory.
• Explain the counterfeit pill risk specifically. Make sure your teen knows that no pill obtained outside a pharmacy from a licensed pharmacist can be trusted. Even a single pill from a friend carries risk.
• Keep naloxone at home. Naloxone is available over the counter at most pharmacies and free through many state programs. Having it on hand — and making sure your teen knows where it is and how to use it — is a practical safety measure.
• Ask about mental health directly. "How are you really doing?" asked regularly and without pressure opens doors. If your teen is struggling with anxiety, depression, or stress, connecting them with a counselor or therapist early reduces downstream risk.
• Visit SAMHSA's "Talk. They Hear You." resource page for age-appropriate conversation guides, scripts, and tips: samhsa.gov — Talk. They Hear You.

At Empower Next Project, we believe that protection and hope go hand in hand. The data showing five years of declining teen substance use is a reminder that prevention works — and that the communities investing in young people are making a measurable difference. Our Empower Next Breath and Empower Next Steps programs extend this work into homes and communities across our region.

This article is educational and is not a substitute for professional medical or mental health advice. In an emergency, always call 911. For substance use and mental health support, call or text 988 or call SAMHSA's helpline at 1-800-662-4357.