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Substance Use Disorders

TeenThreads Substance Awareness Guide

20 Common Substances Ranked by Danger (Education-Only)

⚠️ Disclaimer: This is educational information only. It is not medical advice, and it should never replace professional help. If you or someone you know is struggling, please reach out to a trusted adult or professional.

1. Fentanyl

  • Pros (medical use): Powerful pain relief in hospital settings.
  • Cons: Extremely potent; tiny amounts can be fatal. Major driver of teen overdoses.
  • What teens need to know: Street pills often contain fentanyl without warning.
  • Support actions: Friends/teachers should emphasize never taking unknown pills. Counselors can run awareness workshops.
  • Socio-economic impact: Rising healthcare costs, devastated families, strain on emergency services.
  • Resource: [SAMHSA Helpline: 1-800-662-HELP]

2. Counterfeit Prescription Pills

  • Pros: None — fake pills are unpredictable.
  • Cons: May contain fentanyl, meth, or other contaminants.
  • What teens need to know: “Looks like Adderall/Xanax” ≠ safe.
  • Support actions: Schools can teach pill safety, parents should lock meds.
  • Impact: Fake pill trade thrives on social media, fueling teen deaths.

3. Heroin / Illicit Opioids

  • Pros (medical opioids only): Pain relief.
  • Cons: High overdose risk, rapid dependence.
  • What teens need to know: Street heroin is often mixed with fentanyl.
  • Support actions: Peer support groups, naloxone training.
  • Impact: Families face financial ruin, communities face crime spikes.

4. Methamphetamine

  • Pros: None for teens.
  • Cons: Severe brain/mental health damage, violent behavior.
  • What teens need to know: Addiction develops quickly.
  • Support actions: Teachers can spot sudden aggression/weight loss.
  • Impact: Long-term unemployment, healthcare burden.

5. Cocaine

  • Pros: None for youth.
  • Cons: Heart attacks, strokes, paranoia.
  • What teens need to know: Crack form is even more addictive.
  • Support actions: Counselors should highlight risks of “party drugs.”
  • Impact: Expensive habit → financial ruin, crime involvement.

6. Benzodiazepines Misused

  • Pros (medical use): Anxiety treatment.
  • Cons: Dangerous when mixed with alcohol/opioids.
  • What teens need to know: Withdrawal can be life-threatening.
  • Support actions: Teachers can flag sudden drowsiness.
  • Impact: ER visits, lost productivity.

7. Prescription Opioids Misused

  • Pros (medical use): Pain relief.
  • Cons: Addiction, overdose.
  • What teens need to know: Misuse = same risk as heroin.
  • Support actions: Parents should monitor prescriptions.
  • Impact: Contributes to opioid epidemic.

8. Inhalants

  • Pros: None.
  • Cons: Sudden death possible even first use.
  • What teens need to know: Household products ≠ safe.
  • Support actions: Teachers should watch for chemical smells.
  • Impact: Brain damage → lifelong disability.

9. Synthetic Cannabinoids (“Spice/K2”)

  • Pros: None.
  • Cons: Unpredictable, seizures, psychosis.
  • What teens need to know: Far riskier than cannabis.
  • Support actions: Counselors should stress unpredictability.
  • Impact: ER costs, mental health crises.

10. Alcohol

  • Pros (adult use): Social relaxation.
  • Cons: Poisoning, accidents, violence.
  • What teens need to know: Underage drinking is illegal and dangerous.
  • Support actions: Friends should never leave drunk peers alone.
  • Impact: Car crashes, lost academic potential.

11. MDMA / Ecstasy

  • Pros (adult research use): Some therapeutic trials.
  • Cons: Overheating, dehydration, adulteration.
  • What teens need to know: Pills often contain meth/fentanyl.
  • Support actions: Teachers can educate about “party drug” myths.
  • Impact: ER visits, risky sexual behavior.

12. Ketamine

  • Pros (medical use): Anesthetic.
  • Cons: Memory loss, accidents.
  • What teens need to know: Street ketamine often contaminated.
  • Support actions: Counselors can highlight dissociation risks.
  • Impact: School dropouts, accidents.

13. Nitrous Oxide

  • Pros (medical use): Dental anesthesia.
  • Cons: Blackouts, nerve damage.
  • What teens need to know: “Whippets” can cause paralysis.
  • Support actions: Teachers should watch for canisters.
  • Impact: Neurological disability.

14. Nicotine Vapes

  • Pros: None for teens.
  • Cons: Highly addictive, harms brain development.
  • What teens need to know: Vapes ≠ safe alternative.
  • Support actions: Schools can ban vape devices.
  • Impact: Long-term health costs.

15. Cigarettes

  • Pros: None for teens.
  • Cons: Cancer, lung disease.
  • What teens need to know: Smoking remains deadly.
  • Support actions: Peers can encourage quitting.
  • Impact: Billions in healthcare costs.

16. Cannabis

  • Pros (medical use): Pain relief, seizure treatment.
  • Cons: Memory loss, motivation decline, psychosis risk.
  • What teens need to know: High-THC strains are riskier.
  • Support actions: Counselors can stress brain development risks.
  • Impact: School failure, unemployment.

17. Prescription Stimulants Misused

  • Pros (medical use): ADHD treatment.
  • Cons: Heart problems, anxiety.
  • What teens need to know: Misuse ≠ safe studying.
  • Support actions: Teachers should monitor pill misuse.
  • Impact: ER visits, academic dishonesty.

18. DXM Cough Medicine Misuse

  • Pros (medical use): Cough relief.
  • Cons: Confusion, hallucinations.
  • What teens need to know: High doses = dangerous.
  • Support actions: Parents should monitor medicine cabinets.
  • Impact: ER visits, risky behavior.

19. Hallucinogens (LSD, Mushrooms)

  • Pros (research use): Some therapeutic trials.
  • Cons: Panic, unsafe behavior.
  • What teens need to know: Trips can cause accidents.
  • Support actions: Teachers can stress unpredictability.
  • Impact: ER visits, accidents.

20. High-Caffeine/Energy Products

  • Pros: Alertness.
  • Cons: Anxiety, heart issues.
  • What teens need to know: “Energy drinks” can be harmful in excess.
  • Support actions: Schools can limit sales.
  • Impact: Sleep problems, academic decline.

🧑‍🤝‍🧑 How Friends, Teachers, Counselors, Authorities Can Help

  • Friends: Don’t normalize drug use; encourage safe choices.
  • Teachers: Spot warning signs (behavior changes, grades).
  • Counselors: Provide confidential support and resources.
  • Authorities: Focus on prevention and treatment, not punishment.

🌍 Socio-Economic Impact

  • Lost academic potential → lower lifetime earnings.
  • Families face financial strain from healthcare/legal costs.
  • Communities suffer from crime, unemployment, and healthcare burdens.

📞 Trusted Helplines & Resources

  • SAMHSA National Helpline: 1-800-662-HELP
  • National Suicide Prevention Lifeline: 988
  • Partnership to End Addiction: drugfree.org
  • CDC Teen Substance Use Resources: cdc.gov

🧪 TeenThreads Quiz Bank: Fentanyl Awareness

Multiple Choice

  1. Fentanyl is approximately how many times stronger than morphine?
    a) 10x
    b) 50x
    c) 100x
    d) 500x
  2. Which of the following is a major risk of fentanyl use?
    a) Dehydration
    b) Sudden overdose from tiny amounts
    c) Mild headaches
    d) Increased appetite
  3. Counterfeit pills often contain fentanyl because:
    a) It’s cheap and easy to mix
    b) It makes pills taste better
    c) It reduces addiction risk
    d) It’s FDA-approved for teens

True / False

  1. Fentanyl can be fatal even in amounts smaller than a grain of rice. (True/False)
  2. Prescription fentanyl patches are safe for anyone to use without a doctor’s supervision. (True/False)
  3. Naloxone (Narcan) can reverse a fentanyl overdose if given quickly. (True/False)

Short Answer

  1. Why is fentanyl contamination in counterfeit pills especially dangerous for teens?
  2. Name one medical situation where fentanyl is legitimately used.
  3. What should you do if you suspect a peer has overdosed on fentanyl?

Scenario-Based

  1. A friend shows you a pill they bought online that looks like Adderall. What’s the safest response?
  2. You see someone collapse at a party after taking a pill. What immediate steps should you take?
  3. A peer says fentanyl is “safe if you only take a little.” How would you respond?

Critical Thinking

  1. Why do counterfeit pill dealers mix fentanyl into fake Xanax or Adderall?
  2. How does fentanyl misuse affect families and communities beyond the individual user?
  3. What role can schools play in preventing fentanyl-related tragedies?

📚 How to Use This Quiz

  • Classroom discussions: Teachers can use these questions to spark conversations.
  • Peer groups: Friends can challenge each other with quick quizzes.
  • Counselors: Can adapt scenario-based questions for roleplay workshops.
  • Online (TeenThreads): You can format these into interactive polls or gamified quizzes.

Johannes, this is the first set (Fentanyl). If you like this structure, we can replicate it across all 20 substances — building a full quiz bank of 300+ questions.

👉 Do you want me to move next to Counterfeit Pills and create their quiz set, so we start building the series step by step?

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