DENVER — Colorado teenagers are getting a clearer message about the dangers of fentanyl, counterfeit pills and prescription drug misuse, but alcohol, marijuana, vaping and nicotine increasingly occupy a different place in teens’ lives — familiar substances whose risks can be overshadowed by their social visibility and accessibility.
Those are among the central findings of the 2026 Rise Above Colorado Youth Survey, the tenth statewide assessment of Colorado teens conducted on behalf of the prevention nonprofit Rise Above Colorado.
Compared with results from the previous survey in 2024, attitudes toward prescription drug misuse have become substantially less permissive, while awareness of the risks of fentanyl, counterfeit pills and prescription pain relievers has increased sharply.
The results are especially striking around pills and overdose prevention:
• Agreement that prescription drugs are safer than illegal drugs fell from 27% in 2024 to 16% in 2026, while the percentage agreeing that prescription pain relievers are not addictive dropped from 25% to 8%.
• Seventy-seven percent of teens now see “great risk” in trying fentanyl once or twice, up from 51% in 2024.
• Among teens who have not misused prescription pain relievers, curiosity about trying them fell from 35% to 17%.
• Ninety-one percent of teens say they would be at least somewhat likely to stop a friend from taking a drug or pill that might contain fentanyl, including 72% who say they would be very likely to intervene.
Yet the survey also shows a remaining gap in overdose preparedness: The share of teens who had thought about carrying naloxone to reverse overdoses declined from 33% in 2024 to 19% in 2026.
"The progress on fentanyl and prescription drug misuse shows what can happen when we invest in prevention, give young people accurate information, and empower them to look out for themselves and their friends,” said Colorado Attorney General Phil Weiser. “Colorado has invested enormous energy in helping young people understand the danger of fentanyl, counterfeit pills and prescription drug misuse, and we are seeing meaningful changes in what teens believe and how they say they would respond. The challenge now is to bring that same prevention focus to alcohol, marijuana and nicotine.”
Familiar does not mean harmless
The progress around pills has not yet produced broad declines in current substance use. Past-30-day prescription drug misuse declined, but alcohol and vaping remain significantly above 2022 levels and statistically unchanged from 2024, while marijuana use is comparatively stable.
At the same time, perceptions of risk are moving in the wrong direction for several more familiar substances, a concerning indicator that can be a precursor for future use. The percentage of youth who view alcohol use as a great risk declined from 25% to 15%, while perceived risk also declined significantly for marijuana and vaping.
That creates what the survey identifies as a central prevention challenge: young people increasingly understand which substances can seriously harm them, but may see alcohol, marijuana, vaping and nicotine
as more ordinary parts of adolescent life. This trend towards normalization of substances, which are both harmful and illegal for teens, is concerning.
"’Familiar’ should not be confused with ‘safe,’” said Rise Above Colorado Executive Director Kent MacLennan. “Prevention efforts must continue giving teens accurate information about risks of misusing all substances while also addressing why a young person might turn to a substance in the first place.”
Colorado teens are experiencing significant stressors
The survey’s open-ended responses underscore that stress is at the root of their concerns. Teens most often identify school and academic pressure, belonging, uncertainty about their future, and competing demands as the challenges they face — not substance use itself. The report concludes that for some teens, substance use may become a way of coping with those pressures.
Only 20% of Colorado teens strongly agreed that their schoolwork is meaningful, down from 40% in 2024. Forty-three percent report spending at least three hours a day on social media, and teens who spend three or more hours on social media report substantially more poor mental-health days. Sleep also worsened, with the estimated number of poor nights of sleep increasing from 4.3 to 5.6 per month. Insufficient sleep is closely correlated with poor mental health, and it also is associated with increased social media use.
Teens appear to be seeking coping mechanisms which include AI chatbots. Fifty percent report using AI chatbots for social interaction, entertainment or emotional support in a typical day, with older teens spending 30-60 minutes chatting with AI per day.
“Colorado’s young people are telling us what they need—strategies to cope,” continued MacLennan. “We don’t want youth feeling stress turning to substances as a solution. Now more than ever we need to empower them with healthy coping strategies so they can support themselves and their peers.”
Most Colorado teens are still making healthy choices
Despite concerns around declining perceptions of risk, the survey confirms that the vast majority of youth are not using substances. More than three in four youth did not use the most prevalent substances—alcohol and vaping—in the past 30 days, providing an important reminder that perceptions of teen behavior often do not match reality.
The science of positive community norms shows that teens are more likely to make healthy choices when they know most of their peers are doing the same. Yet youth typically overestimate how many of their peers are engaging in risky behaviors, so correcting these misperceptions is key.
The 2026 findings suggest that accurate norms remain important but are only part of the solution. Teens also need practical ways to manage stress, refuse substances without sacrificing social connection, respond when a friend is in danger, and find healthy ways to belong.
The survey found encouraging movement in several of those protective factors. Seventy-nine percent of youth said they feel supported by friends, up from 66% in 2024, while 67% feel welcomed and accepted at school, up from 59%.
“This is why prevention is such a powerful long-term investment,” MacLennan said. “We don’t have to wait until a young person develops a substance use disorder to help them. We can strengthen the things that protect young people now — connection, trusted adults, accurate information, healthy coping skills, and confidence in their own choices. The gains we’re seeing around pills show us that attitudes and behaviors can change. Our job is to build on that progress.”
About the survey
The online survey of 700 Colorado teens ages 12–17 was conducted by HealthCare Research between April 14 and June 30, 2026. It is the tenth statewide assessment commissioned by Rise Above Colorado, following surveys conducted in 2009, 2010, 2011, 2013, 2016, 2018, 2020, 2022 and 2024. The report states a maximum sampling margin of error of plus or minus 3.7 percentage points for the full sample; question bases vary.
The biennial survey helps Rise Above Colorado and its partners understand changing youth attitudes, perceptions and behaviors and identify opportunities for prevention. The 2026 survey was conducted with funding support from a variety of sources, including the Colorado Department of Public Health and Environment and the Office of the Colorado Attorney General.
Comprehensive survey results and supportive resources are available at Rise Above Colorado’s website: www.riseaboveco.org.
About Rise Above Colorado
Rise Above Colorado is a statewide substance misuse prevention organization that empowers youth to make healthy connections, decisions and change. Rise Above works with teens, educators, community leaders and prevention partners to provide credible, teen-centered information and resources at riseaboveco.org.