Sports are designed to be competitive. So, naturally, athletes are always competing; against their opponents, against the odds, and against the people they were just yesterday. Athletes are continually striving to be the very best that they can be.

high school addiction

However, the unrelenting pressure that comes with sports performance can leave a severe impact on athletes, especially when they are still teenagers. In fact, high school student-athletes face an above-average risk of mental health issues- including substance use disorder (SUD). 

The High School Athlete Demographic

According to an annual survey conducted by the National Federation of State High School Associations (NFHS), the number of high school students participating in sports is at an all-time high. In fact, the school year of fall 2017 to summer 2018 marked the 29th consecutive year of steady growth in school sports participation.

During this time, the number of teenage girls participating in high school sports was almost 3.5 million (3,415,306). For teenage boys, the number was over 4.5 million (4,565,580). Overall, the number of high school students participating in sports from 2017 to 2018 was just shy of 8 million nationwide.

The consistently most popular sports among girls in high school include:

  • Competitive spirit (i.e., cheerleading)
  • Outdoor track and field
  • Swimming and diving
  • Fast-pitch softball
  • Cross-country
  • Basketball
  • Volleyball
  • Lacrosse
  • Soccer
  • Tennis

For boys in high school, the most popular sports are:

  • Outdoor track and field
  • Swimming and diving
  • 11-player football
  • Cross-country
  • Basketball
  • Wrestling
  • Baseball
  • Soccer
  • Tennis
  • Golf

Drug and Alcohol Addiction Among High School Athletes

Teenagers who drink alcohol or use drugs do so for a variety of reasons. They may use substances to fit in, express independence, or simply to feel good. And, of course, most parents encourage their teenage children to find healthier means of accomplishing these things- like participating in sports.

However, recent studies have shown that participation in school sports may influence or even increase the risk of substance abuse and addiction in some teenagers. 

In fact, student-athletes are statistically more likely than their non-athletic counterparts to engage in alcohol abuse, prescription drug abuse, and illicit drug use. Performance-enhancing drugs like steroids are a problem for student-athletes as well.

High School Athletes and Alcohol Abuse

In the U.S., alcohol has been and will likely remain the most popular addictive substance among teenagers. One survey from Monitoring the Future revealed that more than 33 percent of high school seniors (grade 12) and almost 20 percent of high school sophomores (grade 10) had used alcohol in the month before the survey in 2017. 

While this survey did not highlight the percentage of student-athletes using alcohol, other similar studies have found that those who participate in high-contact sports are more likely than their peers to use or abuse alcohol.

In other words, students who participate in sports like football, wrestling, and lacrosse have a statistically higher likelihood of developing an alcohol use disorder.

High School Athletes and Prescription Drug Abuse

“If prescription pain relievers are overprescribed? [then] their use may trickle down to adolescents? Use of narcotic pain relievers may become a habit with some adolescent athletes.”

-Bryan Denham, Professor of Communication, Clemson University

Student-athletes are not immune to the effects of the ongoing opioid crisis. In fact, a 2014 study that was was sponsored by the National Institute on Drug Abuse (NIDA) and published online in the Journal of Child & Adolescent Substance Abuse reveals that high school student-athletes face a higher-than-average risk of forming an addiction to painkillers.

In this survey, nearly 2,300 high school student-athletes who participated in a separate study from Monitoring The Future in 2009 came forward to discuss prescription drug abuse. 

Of these 2,300 students, about 12 percent of male student-athletes and 8 percent of the female student-athletes admitted to abusing prescription painkillers. Popular drugs of choice included codeine and morphine. 

Other studies seem to support the numbers behind these drug use trends. For example, one study found that high school students who participate in high-contact and high-injury sports are as much as 50 percent more likely than their peers to abuse prescription opioids like OxyContin or Vicodin.

Similar findings from the University of Michigan reveal that roughly 11 percent of high school student-athletes nonmedically use narcotic pain relievers or opioids. In other words, one in nine student-athletes abuse prescription painkillers.

High School Athletes and Illicit Drug Abuse

Marijuana is the most popular illicit drug among high school students in the U.S. It’s also the second most popular drug in general, behind alcohol. 

high school rehab

In 2017, the survey from Monitoring The Future found that marijuana use among teenagers is on the rise again after years of fluctuation. The investigation revealed that 22.9 percent of seniors and 15.7 percent of sophomores had used marijuana in the previous month.

According to NIDA for Teens, the nation’s recent public discussion about the medical benefits of cannabis products and the ongoing debate over the legality of marijuana in certain states have led teenagers to believe that the drug is not as harmful as other illicit substances.

In fact, more and more teenagers are using the drug under the assumption that, since it is plant-based, it is natural and, therefore, safe to use.

It’s worth noting, however, that plant-based substances are not always harmless. Cigarettes, cocaine, and even heroin also come from plants (tobacco, coca, and poppy, respectively). 

These particular drugs also have high rates of abuse among both student-athletes and teenagers in general. In fact, most teenagers turn to heroin when they no longer have access to addictive painkiller prescriptions like OxyContin or Vicodin.

High School Athletes and Performance-Enhancing Drug Use

Performance-enhancing drug use has surged in recent years. Although this type of drug use is a more significant issue in the world of professional sports, high school student-athletes may use performance-enhancing drugs to try to get ahead of the competition.

In fact, one study shows that up to 12 percent of high school students use performance-enhancing drugs to improve their athletic prowess, their physical appearance, or both. 

Popular performance-enhancing drugs include steroids, growth hormones, and even certain kinds of stimulants.

Contributing Factors for Addiction Among High School Athletes

Teenagers who participate in sports during their time in high school often face challenges that their peers do not. For instance, those who hope to build a career in professional sports tend to feel more pressure regarding schoolwork, potential college scholarships, the expectations of their teammates, families, and coaches.  

As a result, student-athletes may turn to substances to cope with these and other stressors. Some may turn to alcohol to cope with feelings of depression, while others turn to illicit drugs to stave off feelings of stress or anxiety.

In any case, substance use is very closely tied to mental health issues. This is especially true for teenagers. 

Mental Health Disorders Among High School Athletes

“[A mental disorder is] a clinically significant disturbance in cognition, emotional regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental process underlying mental functioning? Mental disorders are usually associated with significant distress in social, occupational, or other important activities.”

-Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

Mental health issues are common in the U.S. In fact, 20 percent of Americans- or one in every five of our population- have at least one mental health condition. However, some demographics are more prone to the development of mental health issues than others. 

Student-athletes are an example of the former.

Various studies have shown that student-athletes are statistically more likely to struggle with mental health issues like stress, anxiety, and depression than non-student-athletes. One census statement from the Journal of Athletic Training stated:

“The types, severities, and percentages of mental illnesses are growing in young adults aged 18 to 25 years… Given that mental illnesses being reported in the 18- to 25- year-old age group may well start before or during adolescence and given the overall numbers of student-athletes at the secondary school level, clinicians are certain to encounter student-athletes with psychological concerns.”

This statement has plenty of backing, as many other studies have shown that nearly half of our young population experiences a mental health condition by age 14– the average age of freshman year high school students.

Certain factors can increase the risk of developing a mental health disorder or perhaps even worsen an already present issue. These factors include non-athletic academic pressure, sports-related injuries, and conflicts with coaches, teammates, teachers, parents, and friends.

High School Athletes and Stress

High school sports can sometimes have a negative effect on mental health. In many cases, student-athletes label their athletic prowess and performance as their sole source of self-worth. 

To some student-athletes, sports is their whole identity during their time in high school.

So, any athletic failures can impact self-esteem and, as a result, cause significant stress.

High School Athletes and Anxiety

High school is an environment ripe with anxiety. In fact, more students are using anti-anxiety medications today than ever before. This includes athletes.

According to the National Institute of Mental Health (NIMH), the prevalence of anxiety disorders among adolescents aged 13 to 18 is 38.0 percent for girls and 26.1 percent for boys. Of those that have at least one anxiety disorder, an estimated 8.3 percent of adolescents aged 13 to 18 have a severe impairment.

These trends have not gone unnoticed, either. According to Angela D. Pellant, MD, roughly 85 percent of Certified Athletic Trainers (ATC) have seen anxiety in their student-athletes. Moreover, most student-athletes in high school cite pressure from coaches, teachers, parents, and peers as the most common reasons why they struggle with anxiety.

High School Athletes and Depression

Depression and anxiety disorders may be different, but those who struggle with depression-especially teenage athletes- often experience symptoms similar to those of an anxiety disorder. Such symptoms include:

  • Fatigue
  • Irritability
  • Nervousness
  • Restlessness
  • Sleeplessness
  • Sad or “empty” mood
  • Trouble concentrating
  • Difficulty making decisions
  • Changes in appetite and weight
  • Suicidal thoughts, actions, or attempts
  • Feelings of hopelessness, helplessness, worthlessness, etc.

It’s also worth noting that many people who struggle with depression have also struggled with an anxiety disorder at some point.

Moreover, having an untreated mental illness increases the likelihood of developing a SUD and, therefore, a dual diagnosis.

The High School Athlete Demographic and Co-Occurring Disorders (Dual Diagnosis)

The co-occurrence of addiction and another mental health issue is called a dual diagnosis, and it is far more common than most people think.

Those who struggle with undiagnosed or untreated mental health issues are much more likely to turn to drugs or alcohol to cope. In fact, many people who end up developing SUDs do so to self-medicate. Substance abuse can also exacerbate pre-existing mental health issues, which only perpetuates the cycle of use, abuse, and addiction.

Now, due to the stigma surrounding mental health as it relates to sports performance, student-athletes are significantly less likely than non-athletes to receive treatment for mental health conditions. 

As a result, student-athletes in high school often face their mental health issues without help, which could easily lead to substance abuse and, eventually, the development of a SUD.

Increasing Demand for Drug and Alcohol Rehab for High School Athletes

Thanks in part to the recent public discussions about mental health and substance abuse in sports, more coaches and families are taking the time to ensure both the mental and physical health of their athletes. This is especially true for high school athletes. 

While staying informed and taking action is a step in the right direction, it may not be enough for those who have already been affected by SUD or dual diagnosis. This is why more and more people are demanding specialized treatment options for high school student-athletes.

Drug and Alcohol Treatment Options for High School Athletes

As of right now, there are very few treatment options that cater specifically to the recovery needs of teenage athletes. However, the four primary levels of care in addiction treatment have a long history of effectiveness for people of all ages, races, and walks of life.

high school

For the most part, addiction treatment professionals suggest that anyone who has a SUD or dual diagnosis should utilize all four levels of addiction and recovery care, which are: 

Patients who undergo all four levels of care during their treatment programs tend to have more success getting and staying sober.

Outcomes for High School Athletes in Recovery

For more information about rehab and drug recovery options for high school athletes, please contact us here or call us at (833) 369-6443.


Dandoy, C., & Gereige, R. S. (2012, June). Performance-enhancing drugs. Retrieved from

Denham, B. E. (2014). High School Sports Participation and Substance Use: Differences by Sport, Race, and Gender. Journal of Child & Adolescent Substance Abuse, 23(3), 145-154. DOI:10.1080/1067828x.2012.750974

National Alliance on Mental Illness (NAMI). (n.d.). Teens & Young Adults. Retrieved from

National Institute of Mental Health (NIMH). (n.d.). Any Anxiety Disorder. Retrieved from

National Institute on Drug Abuse for Teens (NIDA for Teens). (2019, March 01). Marijuana. Retrieved from

NFHS News. (n.d.). High School Sports Participation Increases for 29th Consecutive Year. Retrieved from

The Anxiety and Depression Association of America (ADAA). (n.d.). Symptoms. Retrieved from

The Monitoring the Future study, the University of Michigan. (n.d.). Trends in 30-Day Prevalence of Use of Various Drugs in Grades 8, 10, and 12 (Table 3). Retrieved from, P. T., Boyd, C., & McCabe, S. E. (2013, May). Playing through pain: Sports participation and nonmedical use of opioid medications among adolescents. Retrieved from