The rise of the opioid epidemic has shed a stark light on the risk of drug use for teens of all demographics, but it also raises the question of vulnerability based on different risk factors. Social determinants — the environmental factors that affect how and where people live, learn, eat, work and thrive — create unique vulnerabilities for teenagers. In the infographic below, Nursing@USC’s online Family Nurse Practitioner (FNP) program breaks down several of these social determinants and examines the impact that each one has on the lives of high school students in the United States.

Many parents don’t realize how easily teenagers can access substances. Further, of all the places teens may encounter drugs and alcohol, the most likely place is at home. In fact, roughly 56 percent of teenagers say it’s easy to get prescription medications from their parents’ medicine cabinets. And when left unsupervised, teens have the independence to obtain substances from variety of places. For example, in most states teens can purchase over-the-counter (OTC) cough medicine containing dextromethorphan (DXM) at pharmacies, gas stations and grocery stores without raising red flags from parents, doctors or store clerks. While certain states have prohibited the sale of OTC medicine containing DXM, this medicine is often sold and used without discretion, so it can be harder for parents to keep tabs on the quantities of OTC medicine at home.

Being on a school campus can also present opportunities for teens to access substances, as many students source drugs and alcohol from their friends and classmates. Almost 43 percent of high school students say they know a classmate who sells drugs. And 81 percent of 12th-graders in one study said it’s easy to obtain marijuana. Students in both public and private schools say that they find it easy to obtain substances, and in many cases, private schools see higher drug use problems in their student populations. This can be linked to a variety of factors, including socio-economic status, access to health care and proximity to pharmacies.

In terms of academic achievement, the assumption has long been that low-performing students are more susceptible to drug use. However, many studies show that high-performing students also experiment with drug use. Across the board, students of all academic achievement levels report that peer pressures and social media influence their decision to use drugs and alcohol — even from simply seeing online pictures of their peers partying and using substances.

The pervasiveness of digital peer pressure, even unintentional pressure, highlights the critical need for parental and administrative involvement to curb drug use. It is critical for parents to understand that all children are vulnerable to being exposed to peer pressures and risky behaviors. School nurses and family nurse practitioners can also help to educate parents about teen vulnerabilities and the risks of substance abuse. At the end of the day, it’s important for all of us to share our knowledge with others in our communities to keep our children safe and prevent substance abuse.

Halah Flynn is the community manager for Nursing@USC, the online FNP program at the University of Southern California. A dedicated storyteller for all things public health and social justice, she writes about health literacy and patient advocacy. Halah is an alumna of the School of Media and Journalism at the University of North Carolina at Chapel Hill. You can connect with Nursing@USC on Facebook and Twitter.