Low Self-Esteem May Lead to Drug Abuse in Boys

What is the connection between low self esteem and drug abuse?

Eleven year-old boys who displayed evidence of low self-esteem were more likely to be dependent upon drugs at age 20 than boys who didn't have low self-esteem, according to a study conducted at Florida State University.

Sociology professors studied a sample of over 870 boys from diverse racial and ethnic groups for a period of nine years to try to identify potential early warning signs for drug dependence. They asked the boys to rate the truthfulness of statements such as "I feel like I am a failure" and other measures of low self-esteem. The researchers also asked the boys to rate the level of approval their close friends had for people who smoked cigarettes, used marijuana or cocaine, or drank alcohol.

Boys were first interviewed when they were in either sixth or seventh grade, and the participants were subsequently interviewed three more times over a nine-year period. The final follow-up interview took place when most of the boys were between 19 and 21 years old.

What does drug dependency mean?

The researchers classified "drug dependency" according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Essentially, the APA defines someone as drug-dependent if he or she exhibits three or more symptoms of dependence, such as using larger and larger amounts of a drug over time, has failed at attempts to stop the drug use, or withdraws from family and friends because of drug use.

Boys who had very low self-esteem in the sixth or seventh grade were 1.6 times more likely to meet the criteria for drug dependence nine years later than other children. Those who believed that their peers approved of alcohol, tobacco, or drug use were also more likely to be drug-dependent later in life. Overall, 10% of those in the study were found to be drug-dependent.

How can we prevent boys from using drugs?

While it is already known that low self-esteem is correlated with drug use in adolescents, this study is important because it suggests that early, measurable factors (low self esteem and belief that their peers approve of drug use) can identify boys at future risk for drug dependence as early as age 11. Early intervention and prevention efforts could target potential at-risk boys before they reach their teens, when experimentation with drugs is most likely to begin. Both parents and teachers can be on the lookout for signs of low-self esteem and can even use a simple questionnaire to identify feelings of low self-esteem.

Girls were not included in this study, but it has been shown that low self-esteem in girls is more strongly associated with the risk of depression and eating disorders than with the risk of drug abuse or addiction.

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Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics


Taylor J, Lloyd DA, and Warheit GJ. Self-Derogation, Peer Factors, and Drug Dependence Among a Multiethnic Sample of Young Adults. Journal of Child and Adolescent Substance Abuse 2006: 15 (2) 39-51.