- Substance use disorders (SUDs) most commonly begin during adolescence and are the leading causes of premature death and health problems worldwide [1,2]. Overdose mortality among adolescents has risen dramatically in the wake of the COVID pandemic  and alcohol and drugs also contribute to motor vehicle crashes, suicides, and homicides—three of the leading causes of death in adolescents [1,4,5]. SUDs in adolescents are also associated with other adverse physical health outcomes, including transmission of human immunodeficiency virus, hepatitis C virus, and sexually transmitted infections [1,6,7]; mental health problems, such as depression [1,6,8]; and risk for addiction throughout the life course [9,10].
- Recent statistics from the Centers for Disease Control point to a potential slowing of the number of opioid overdose deaths in the U.S. for the first time since 1990 . Although this suggests that we may at last be seeing positive impacts of some of the public health measures deployed across the country, several important gaps remain to be filled. For instance, although the number of prescriptions for naloxone—currently the only proven and readily accessible overdose reversal medication —has increased tremendously, it remains 69 times lower than the number of high-potency opioid prescriptions filled .
- Marijuana legalization is arguably one of the most polarizing and thought-provoking issues of our time and has generated substantial discussion in the scientific community. One of the observed effects of legalizing marijuana for ‘medical’ and ‘recreational’ use in jurisdictions that have chosen this path has been changes in the perceived riskiness of the substance. Historically, perceived riskiness has been shown to be associated with rates of use of different substances such as tobacco and alcohol, where lower perceived riskiness generally meant higher frequency and intensity of use .