Intern Lily Deware: The Normalization of Substance-Use

Over the past two decades, a notable shift has occurred with regard to underage substance use and substance use in general. Although society likes to frame it as becoming more accepting and adapting to new social norms, many would disagree and feel as though a 15 year old having alcohol on a regular basis should not be normal. As a matter of fact, about 30% of 15 year olds have had more than one sip of alcohol, and by age 18 nearly 70% of people report having had alcohol. Although an argument can be made about the frequency of underage populations consuming alcohol because of their lack of access to it, this has only led to episodes of binge drinking and heightened substance use when it is available. Not only has alcohol consumption increased recently, but marijuana use as well. In the past 10 years, underage marijuana usage has nearly doubled and 44% of high school seniors report using products containing marijuana regularly.

One study looking at the social norms in the development of adolescent substance use found that a combination of individual and social norms were at play in influencing underage substance use. Along with this, addressing the social norms within the school setting could be useful in the prevention of underage substance use. This may be because of the exaggerated perceptions of social and school norms in combination with the want to be ‘cool’ and ‘fit in.’ Although many would agree that using potentially harmful substances is not ‘cool,’ it is often perceived otherwise. This may be because of the idealization of going to parties, drinking, and using other substances portrayed in many tv shows, movies, and other forms of media. In most tv shows/movies that revolve around teenagers, there is usually at least one party scene where underage people are depicted drinking, using substances, and appear to have fun while doing so. Because of this, underage populations are likely to model these behaviors because they want to be like the people they watch.

Underage substance use has been linked to higher rates of substance use in adulthood. As a normalization of use has set in, these higher rates of use have skyrocketed. As a matter of fact, excessive alcohol consumption has been shown to kill more than 95,000 Americans every year. This equates to about 261 deaths every day. This number has increased by 7,000 deaths per year, and a sustained increase in binge drinking over the past two decades has been shown as well. Along with this, alcohol related admissions into emergency departments from 2006 to 2014 has increased more than 60%. By controlling the increased normalization of underage substance use, these numbers have the potential of decreasing dramatically.

Statistics make a strong argument for an increased normalization of use, but I was curious as to why this might be. Because everyone is different, statistics cannot definitively provide this answer, so I decided to ask some of my peers. Their thoughts included, ‘it is seen so much in movies and tv shows that it has become normal,’ ‘it is done to be cool,’ and ‘parents condone it and supply it to be cool.’ All three of these crossed my mind when I considered why this might be, but the third thing said really stood out to me because it addressed the actions taken by parents rather than those taken by adolescents. Oftentimes, societal issues such as these blame directly at who is affected when in reality another party could be the real instigator.

Although societal normalization cannot be reversed, it is important to educate both adolescents and adults of the risks of underage substance use and the complications that come with it.



  • American Public Health Association
  • Eisenberg, Marla E et al. “Social norms in the development of adolescent substance use: a  longitudinal analysis of the International Youth Development Study.” Journal of Youth and Adolescence vol. 43,9 (2014): 1486-97.
  • National Institute on Drug Abuse. “Monitoring the Future Study: Trends in Prevalence of Various Drugs.” National Institute on Drug Abuse, 6 Aug. 2020,
  • Nelson, Randi. “Blurred Lines: Teen Alcohol Abuse, Mental Health and Behavioral Issues.” Teen  Mental Health Hospital, 16 May 2020,
  • Sofia Gruskin, Karen Palfker, and Allison Smith-Estelle, 2001: Understanding and Responding  to Youth Substance Use: The Contribution of a Health and Human RRights Framework.  American Journal of Public Health 91, 1954_1963,