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Youth substance use is a challenge in communities across the United States. Persistent substance use among youth can lead to a string of long-term negative health, social and financial outcomes for individuals, families and communities. Although national data points to an overall decrease in alcohol, tobacco and drug use among high schoolers, approximately 30 percent of high school students are still currently using alcohol, 20 percent report binge drinking and 20 percent report marijuana use. Nearly 12 percent of high school students report using illicit or injectable drugs (i.e. cocaine, inhalants, heroin, methamphetamines, hallucinogens or ecstasy) and of all the alcohol consumed in the U.S., 11 percent is by youth ages 12 to 20. More recently, with electronic cigarettes and vaping entering the market, alternative tobacco products now threaten this age group. In the 2018 National Youth Tobacco Survey, adolescent vaping has nearly doubled from 2017 rates.

While the overall decrease in substance use among youth indicates that young people are increasingly making positive choices, the remaining prevalence and complexity of substance use among youth requires robust prevention, intervention and treatment strategies. Consequently, public health systems, primary care providers, community and behavioral health services and addiction centers - many of which are operated or supported by county governments - must be prepared to respond.