Bullying & Substance Misuse

April 18, 2022

Table of Contents

Bullying and substance misuse are often related. Both bullies and victims show higher rates of substance misuse than other groups.

What Is Bullying?

Bullying refers to physical, mental, verbal, sexual, or emotional abuse (or some combination) carried out by one invidual or group onto another. Bullying affects everyone involved — the victims, bystanders , and even the bullies themselves. Bullying can happen in the home, in school, or at the workplace. 

Examples of bullying include:

  • Physical bullying, like punching, slapping, kicking, pinching, spitting, or other aggressive forms of physical contact
  • Verbal bullying, like calling names, insults, mockery, threats, or comments of a racist, homophobic, transphobic, or sexist nature
  • Social bullying, like excluding the victim from social events, starting rumors, encouraging others to bully the victim, and damaging their reputation
  • Cyberbullying, including leaving abusive text messages and social media comments, digitally manipulating pictures, posting private content in a public space, or stalking social media accounts
  • Sexual bullying, such as inappropriate touching, mockery of sexual orientation, victim-blaming, disseminating intimate pictures and details, and using extortion to gain sexual access

All bullying can lead to very deep trauma and can cause psychological damage. Victims of bullying can themselves become bullies as a form of coping. Bullying can cause misplaced aggression (the bullied become bullies), dropping out of school or work, risky sexual activity, and substance misuse.

Bullying By The Numbers 

Developmental psychologists have calculated that a student is bullied every seven minutes. Over 1.2 million high schoolers drop out of school because they are bullied. There are over half a million suicide attempts every year and over 5,000 suicides as a result of a person feeling bullied. As many as 60% of children experience bullying at some point during their childhoods. Research has discovered that upwards of 75% of people who carry out school shootings were either bullies or the victims of bullies.[3] 

Why Do Certain Individuals Become Bullies? 

Bullying is often the result of learned and observed behaviors. The teenager who bullies someone else (whether the victim is physically smaller, of a different gender, racial or sexual minority, or any other factor) often does so because they have either seen the adults in their own life engage in similar behavior. Children who bully may have family environments where a parent is verbally or physically abusive and where they may witness their own parents engaging in substance misuse.[2] Learned behavior that can lead to bullying includes neglect and abuse (verbal, physical, emotional, and sexual) as well as general dysfunction in the household. These adverse childhood experiences are linked to both teenage bullying and substance misuse.[9]

The Link Between Bullying & Substance Misuse

A 2017 study in Frontiers of Psychology noted that students involved in bullying “had a higher risk for substance use.”[4]. Children who have difficulty regulating their emotions and controlling their impulsive behavior have higher risks for becoming bullies as well substance misuses.[1] 

Some teens who are prone to bullying behavior may transition to substance misuse because their social circles include peers who do the same things. 

In looking at the connection between bullies and substance use in adulthood, researchers suggest that people who engage in bullying behavior have some degree of shame and unhealthy coping strategies for dealing with some trauma of their own.[5] Furthermore, a person who was already engaging in bullying behavior during childhood was more likely to use alcohol and tobacco in adulthood. 

There are specific differences between genders when it comes to bullying and substance use during adolescence. For males, daily alcohol consumption and smoking were more common among male children who engaged in bullying. Use of cannabis and hard drugs was more common in female bullies. Therapists caution that the link is more correlative than causal. People who bully others, who then feel ashamed of what they’ve done, may turn to substances to self-medicate their guilt and anxiety.

The Link Between Victims of Bullying & Substance Misuse

Past research found that bully-victims have a higher risk of engaging in smoking, drinking, and cannabis use. A possible explanation for this is that adolescents who show violent and aggressive tendencies may spend more time with other adolescents who engage in substance use. Similarly, people who had experienced bullying were more at risk for smoking and alcohol use. The research on victim patterns of substance misuse suggests that victims who engage in smoking do so “to reduce the anxiety produced by the constant aggression.” Those who do engage in drug use do so to increase their social image among their peers, perhaps to rebuild their confidence or to mitigate the humiliation of the bullying. 

An article published in Pediatrics reported on the results of a longitudinal study that followed almost 4,300 fifth graders. By 10th grade, 24% of the students had started drinking, 15% had started smoking cannabis, and 12% were using cigarettes.[7] 

Students who experienced bullying by 5th grade were more likely to be depressed by 7th grade. This, in turn, was associated with a greater chance of the students using drugs or alcohol in their later adolescent years. 

The researchers asked the students if they had consumed any alcohol, cannabis or tobacco in the prior 30 days and how often the students had been bullied by their classmates in the previous year. The “bullying” here included physical aggression as well as emotional abuse, such as spreading rumors or calling names. About 10% of students in 5th grade reported being victims of bullying. Students who had chronic illnesses, who were members of racial and sexual minorities, and who were boys were more frequently targeted than students who were not. By the time they reached 7th grade, 2% of students reported experiencing symptoms of depression, like a lack of interest in friends and social activities and having no energy.  At the conclusion of the study, students who were bullied and had experienced symptoms of depression were more likely to engage in substance misuse. The researchers emphasize that the study was not designed to discover “proof” that bullying directly causes substance misuse, but does suggest a correlation. 

The Link Between Bystanders & Substance Misuse

Frontiers in Psychology also discovered “a higher risk [among bystanders] for alcohol and tobacco use [as well as] a higher risk for cannabis”. They theorized that people who see bullying in progress, but who are not aggressors, are akin to victims in that they may also be scared and traumatized by the act of bullying (a phenomenon known as psychological co-victimization). They may then turn to substances as a coping mechanism. 

Additionally, bystanders may fear being victimized themselves. They may also fear retaliation or targeting by the aggressor. 

Prevention Strategies

Researchers writing in the Pediatrics journal in 2021 noted that if bullies are encouraged by their peers, early intervention by parents, teachers and school staff, or other people in a leadership capacity might be able to similarly deter the development of future substance misuse.[6] 

The Pediatrics study was hailed by other researchers for spotlighting the similarities between the factors that might predispose children toward bullying, and the factors that might predispose them for drug and alcohol misuse in their later  years.

Being able to identify bullies can help teachers, parents and caregivers to mitigate the risks for substance misuse issues later in life. Such interventions might be helping them develop positive coping strategies for their emotional dysregulation and their impulsivity — skills that can be easily adapted to controlling the temptation to misuse drugs or alcohol.

Substance Misuse More Likely With Bullying & Depression

When a teenager is bullied, the experience either leads to depression and anxiety or exacerbates pre-existing mental health conditions. Regardless, a teen who is bullied is more likely to withdraw from their social activities and other things in which they find interest.[8] In that depression and isolation, many turn to substance misuse to cloak their pain.

While bullying might be inevitable, it should not be normalized. Interventions should be based on helping these teens have positive and healthy ways of dealing with conflict before it escalates to bullying, whether this is through artistic expression, religious and spiritual reflection, or simply having another group of friends who can offer support and encouragement. Getting help should be more normative than being bullied. 

The fact that bullying is associated with everything from low self-esteem to depression and violence suggests that people who bully are carrying a lot of trauma and pain. While this should not excuse or condone their behavior, it should be taken into consideration when determining the best way to prevent future bullying.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

Medically Reviewed By

Reviewed By

Is Suboxone treatment a fit for you?

Contact us directly to speak with a specialist.


  1. Child Bullies at Higher Odds for Substance Abuse as Adults: Study. U.S. News & World Report. https://www.usnews.com/news/health-news/articles/2021-02-17/child-bullies-at-higher-odds-for-substance-abuse-as-adults-study. February 2021. Accessed March 2022.
  2. The Mediating Role of Bullying and Victimisation on the Relationship Between Problematic Internet Use and Substance Abuse Among Adolescents in the UK: The Parent–Child Relationship as a Moderator. Frontiers in Psychiatry. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.493385/full. October 2021. Accessed March 2022.
  3. Secret Service Study: Most School Shooters Were Badly Bullied, Showed Warning Signs. The Colorado Sun. https://coloradosun.com/2019/11/07/school-shootings-columbine-high-gun-violence-sandy-hook/. November 2019. Accessed March 2022.
  4. Substance Use among Adolescents Involved in Bullying: A Cross-Sectional Multilevel Study. Frontiers in Psychology. https://pubmed.ncbi.nlm.nih.gov/28701974/. June 2017. Accessed March 2022.
  5. Bullying Behavior and Substance Abuse Among Underage Psychiatric Inpatient Adolescents. European Psychiatry. https://www.cambridge.org/core/journals/european-psychiatry/article/abs/bullying-behaviour-and-substance-abuse-among-underage-psychiatric-inpatient-adolescents/A6B614B1583D0907BD57C49252987FC5. April 2020. Accessed March 2022.
  6. Childhood and Adolescent Bullying Perpetration and Later Substance Use: A Meta-Analysis. Pediatrics. https://pubmed.ncbi.nlm.nih.gov/33597287/. March 2021. Accessed March 2022.
  7. Peer Victimization, Depressive Symptoms, and Substance Use: A Longitudinal Analysis. Pediatrics. https://pubmed.ncbi.nlm.nih.gov/28562268/. June 2017. Accessed March 2022.
  8. Bullied Teens More Likely to Smoke, Drink and Use Drugs. Reuters. https://www.reuters.com/article/us-health-bullying-depression/bullied-teens-more-likely-to-smoke-drink-and-use-drugs-idUSKBN1852IY. May 2017. Accessed March 2022.
  9. Adverse Childhood Experiences and School-Based Victimization and Perpetration. Journal ofInterpersonalViolence. https://pubmed.ncbi.nlm.nih.gov/29294639/. February 2020. Accessed March 2022.

Imagine what’s possible on the other side of opioid use disorder.

Our science-backed approach boasts 95% of patients reporting no withdrawal symptoms at 7 days. We can help you achieve easier days and a happier future.

Get Startedor book an enrollment call