Adolescents’ Substance Use, Psychological Distress, and Suicidal Thoughts and Attempts

D. Imelda Padilla-Frausto, PhD, MPH and Daniel Eisenberg, PhD

View

Policy Brief Press Release Infographic

photo of boy drinking and girl smoking and illustration of boy with substances studying

Highlights

Adolescents currently use marijuana, alcohol (binge drinking), and e-cigarettes more than cigarettes.

Adolescents who use substances are more likely to experience psychological distress and suicidal thoughts or attempts than adolescents who do not use substances.

Adolescents with both substance use and psychological distress are nearly six times as likely to have suicidal thoughts and attempts as those with substance use alone.

Summary

Published Date: May 18, 2026

This study uses 2022–2024 California Health Interview Survey (CHIS) data to examine substance use among California adolescents ages
12–17 and its links to psychological distress and suicide risk.

Findings: Nine percent of California adolescents currently use substances, most commonly marijuana/other THC (6%), alcohol (binge drinking) (4%), or e-cigarettes (3%). Adolescents who use substances are significantly more likely to have experienced serious (46%) or moderate (21%) psychological distress or to have thought about or attempted suicide in the past year (28%) than adolescents who did not use substances (27%, 13%, and 8%, respectively). Adolescents with both substance use and psychological distress had the highest risk of past-year suicidal thoughts and attempts (47%) compared to adolescents with psychological distress alone (24%) and adolescents with substance use alone (8%). Taken together, these trends emphasize the need for prioritizing youth-centered prevention, early intervention, and treatment for adolescents who have both substance use and psychological distress.

Data Points

9%

California adolescents currently use substances, most commonly marijuana/other THC, alcohol (binge drinking), or e-cigarettes.

Nearly half

Adolescents who use substances have experienced serious psychological distress in the past year (46%) compared with adolescents who did not use substances (27%).

47%

Adolescents with both substance use and psychological distress had thoughts of suicide and attempts in the past year compared with adolescents with substance use alone (8%).