Personal, family, and community factors increase a teen's risk for using substances and possibly developing a substance abuse problem.

Personal risk factors

These include:

• Genetics. People with alcohol and drug abuse problems often have a family history of substance abuse. Studies indicate that when this genetic predisposition for abuse is combined with environmental factors, the person is more likely to develop a substance abuse problem.
• Temperament and personality. Rebelliousness, resistance to authority, feelings of failure, and failure to form close relationships are factors that may lead a teen to seek the effects of alcohol or drugs. Also, sensation-seeking and a tendency to take risks increase a teen's likelihood of developing an abuse problem.⁴
• Certain diseases or conditions. Teens who have untreated attention deficit hyperactivity disorder (ADHD), conduct disorder, depression or long-term depressed feelings (dysthymia), post-traumatic stress disorder, or an anxiety disorder are more likely to use alcohol or drugs. Also, alcohol and drug abuse behaviors may make these conditions worse.⁴
• Drug expectations. A teen develops an expectation of what taking a substance will be like from parents, peers, the media, and personal experience. Teens often have misconceptions about the harmful effects of alcohol, cigarettes, and drugs, and they often think that "everybody does it" and so should they.
• Early age at first use. Using alcohol or other drugs at a young age greatly increases a teen's risk for developing an abuse problem. One study found that teens who had their first alcoholic drink at age 14 or younger were 4 to 5 times more likely to develop alcohol abuse problems than teens who had their first drink at age 19 or older.⁵

Family risk factors

These include:

• Parental use of substances. One study found that teens with a parent who abuses alcohol or drugs are 3 times more likely to develop an abuse problem.⁶
• Parental attitudes toward alcohol, cigarettes, and drugs. Teens whose parents believe that alcohol and drug experimentation is expected and normal are more likely to use alcohol, cigarettes, and drugs. In addition, teens may interpret their parents' ambivalent attitude toward substance use as approval of the behavior.
• Lack of connectedness. Teens from families with frequent conflict, physical or sexual abuse, or psychological stress are more likely to try alcohol and drugs. Without feelings of closeness, a teen may look to alcohol or drugs to compensate for emotional pain.
• Lack of consistent parental involvement. Lack of consistent parental involvement in a child's life and lack of appropriate supervision increase a teen's risk for abusing alcohol, cigarettes, or other drugs. Harsh or inconsistent punishment or permissiveness also increase a teen's risk for alcohol and drug abuse.

Community risk factors

These include:

• Access to substances. Easy access to cigarettes, active drug trading, substance-abusing role models, or substance use that is accepted and tolerated in the community can contribute to a teen's likelihood of using substances. Having cigarettes, alcohol, or other drugs in the home also increases the chances that a teen will use them.
• Peer influence. A teen's peers heavily influence the choice to use substances. This can result when a teen wants to fit in with a group and then chooses a group that uses substances.
• Promotion of alcohol, cigarettes, and drugs by the media. The entertainment and other media portray alcohol and cigarette use as "cool." Ads portray alcohol use as a way to gain popularity, success, and sex appeal. Music and movies also portray cigarettes and other drugs as glamorous. Pharmaceutical company advertisements promote the use of prescription or nonprescription drugs with an implicit message that drugs improve your life.