Today’s teens are experimenting with a wide range of substances, primarily driven by a combination of social pressures, mental health challenges, and the pervasive influence of technology. For healthcare providers and clinicians dedicated to the well-being of children, understanding these trends is crucial for effective intervention and support.
Commonly Used Substances
Dr. Srinivasa Gokarakonda, known as Dr. G to his patients, is the medical director of the UAMS Health Six Bridges Clinic. The clinic treats children and adolescents for alcohol, opioid, and marijuana dependency and fills an existing gap in adolescent behavioral health and addiction recovery services in Arkansas (and across the U.S.).
Patients typically come in with dependency on nicotine, alcohol, and marijuana, but a surge in over-the-counter cough syrups is raising alarms within his clinic, too. “Recently, in our clinic, I have been consistently seeing more patients who abuse over-the-counter cough syrups. Regular screens don’t test for this. But now, we have testing that can scan for nearly every commonly used substance, so we’re catching it more frequently,” Dr. G says.
The active ingredient in cough syrups, dextromethorphan, is increasingly appealing to teens due to its easy accessibility, available both in stores and via delivery services.
A Decline in Smoking, but a Rise in Other Troubling Areas
While nicotine and alcohol use remain prevalent among adolescents, there’s been a notable decline in traditional cigarette smoking. Vaping has surged in popularity, driven by a wide selection of flavors and targeted advertising on social media. According to the Centers for Disease Control and Prevention, tobacco companies often use marketing tactics to increase youth interest in tobacco products.
Schools have tried to curtail vaping among adolescents by implementing “no vape” policies on school grounds. However, Dr. G says students are still finding creative ways to get their fix, including sharing with friends and vaping in the car. “They’ll go to the car, take a few puffs, go back to class, and repeat the process,” he says.
Despite widespread uncertainty about exactly how much harm vaping causes, researchers agree vaping is dangerous. A growing number of severe lung illness cases related to e-cigarettes and vaping products has caused concern in the medical community.
“The vaporized liquid in vapes contains harmful components we haven’t fully learned about yet,” Dr. G warns. THC-based e-cigarettes and vapes commonly contain vitamin E acetate, which may be a primary cause of E-Vaping Associated Lung Injury (EVALI).
With the long-term consequences of vaping largely unknown, the potential for lung injury poses a significant risk, particularly when many vapes are laced with marijuana and nicotine. Some e-cig packaging does not explicitly state how much nicotine or marijuana they contain. Teens and adolescents might not be familiar with health labels or the terminology often used for marijuana and other substances, like THC, nicotine, or cannabis. “Teens may get high without even realizing it,” Dr. G says.
Medical Marijuana in Arkansas
The medical marijuana regulations in Arkansas may also play a huge role in the current uptick in adolescent marijuana use. Patients can be prescribed specific amounts of marijuana for medical use. If not stored properly, however, children could mistake it for food, candy, or other substances.
“Kids have a tendency to explore, and they may eat something they’re not supposed to, such as a gummy laced with THC,” Dr. G says. This opens the door to accidents such as acute marijuana intoxication, which can have long-term effects on children.
Treatment and Prevention for Adolescent Substance Use
The UAMS Health Six Bridges Clinic celebrated its one-year anniversary on March 18, 2025. The clinic serves as a bridge to adolescent substance use treatment and recovery. The clinic sees individuals aged 12–21 and offers comprehensive psychiatric evaluations to address underlying issues like depression or anxiety. Each patient undergoes a 13-panel urine drug screening, with personalized treatment plans developed based on individual needs. The clinic takes an interdisciplinary approach, involving a team that includes a social worker, nurse, and medical assistant.
Due to the thoroughness of the assessment process, initial appointments can take 2–3 hours. Dr. G notes, “I don’t want to rush through appointments when we have so much critical information to collect.” Follow-up visits are shorter, allowing patients to take action based on their assessment results, and family involvement is emphasized throughout the process.
In addition to outpatient care, which includes weekly individual therapy, family therapy, and medication management, the clinic has introduced monthly group therapy sessions. Patients are expected to provide urine samples for drug screening at each visit to monitor substance use.
Dr. G also mentioned plans for preventive education, stating, “We want to collaborate with other groups working on substance abuse issues in teens and education projects across the state.” Collaborations with the Arkansas Department of Education will aim to provide substance abuse prevention training in schools, targeting both teens and parents.
Prevention Starts with Education
As clinicians, it is imperative that we educate families on the risks associated with accessible substances in the home and at school. The UAMS Six Bridges Clinic has taken proactive measures by developing educational materials for parents, children, and healthcare providers focused on medical marijuana and its consequences if used unsafely.
Addressing the growing trend of substance abuse among teens requires a multifaceted approach that combines education, prevention, and access to appropriate care. The UAMS Health Six Bridges Clinic stands at the forefront, dedicated to providing the specialized support that adolescents need to navigate these challenges and fostering an environment of open dialogue; we can work together to promote healthier choices for our youth in Arkansas.
