Cover art by Isabella Marsh
Substance usage in the Tamalpais Union High School District
By Cian Kelly and Wes Fitzpatrick
To view the interactive infographic, click here.
Miracle drug turned modern eating disorder
By Maddie Petersmeyer and Amrit Aujla
What started solely as a medication for diabetics has quickly transformed into Hollywood’s latest weight-loss shortcut. Ozempic has helped many people live healthier lives with its appetite suppression; however, in recent years, the accessibility of the drug has been abused to create superficial skinniness. According to Pew Research, in 2021, about 8.2 million prescriptions for Ozempic were written in the U.S., quadrupling the number just two years earlier. But what prompted this extreme uprise? While many of these prescriptions have been used to treat diabetes, this increase can largely be attributed to celebrity promotion of Glucagon-like peptide-1, better known as GLP-1’s. One of the first mainstream celebrities to advertise the use of GLP-1’s for non-diabetic use was Oprah Winfrey. After a 2023 interview with People Magazine, Winfrey’s endorsement of the drug caused an 18 percent spike in prescriptions. More recently, Serena Williams' ad campaign with the telehealth company Ro caused a 27 percent increase in GLP-1 use. Williams’ ad campaign stirred conversation because of her career as a professional tennis player. Many were shocked by this promotion as she was already fit, and the public assumed it was unnecessary. Both Winfrey’s and Williams’ promotions were portrayed healthily; however, that hasn’t been the case for other well-known influencers and celebrities. Reality TV personality Layla Taylor of the Secret Lives of Mormon Wives came forward to the public and admitted her extreme addiction to the drug. “I can’t even count on both hands how many people I know abuse GLP-1s, like myself, and it’s a real problem,” Taylor said in an interview with Yahoo News. Because of the popularity of the television series amongst teenagers, its portrayal of unhealthy drug abuse and eating habits was especially alarming, given the strong influence the show has on its viewers. When young adults and teenagers look at celebrity bodies and see emaciation, they don’t think about the unhealthy habits that led to that appearance. Emaciated looks have become a big trend in Hollywood. People on social media are quick to call out celebrities on red carpets who appear significantly skinnier than they were on previous sightings. Figures such as Ariana Grande and Emma Stone, especially, have become a topic of conversation on social media after people noticed that their collarbones and sternums were clearly visible. For many fans, this raises questions of how their favorite celebrities were able to lose so much weight in a short amount of time. A body image survey conducted by TODAY found that 80 percent of teenage girls compare themselves to the images they see of celebrities, and half of which said that it made them feel dissatisfied with their appearance. When these celebrities don’t disclose their use of GLP-1’s for extreme weight loss, they set unrealistic beauty standards that their fans internalize. According to the National Eating Disorder Collaboration, rates of disordered eating among individuals seeking treatment from GLP-1’s is high and the decreased hunger associated with the drug increases the risk of developing an eating disorder among those vulnerable. Similarly, research by the National Eating Disorder Association found that misuse or abuse of the drug can worsen the cognitive and behavioral symptoms of eating disorders, such as body image concerns, weight obsessions, skipping meals or over-exercising. The idea that addiction to GLP-1 use is a gateway to eating disorders is also shared by Dr. Samantha DeCaro, the head of clinical outreach at The Renfrew Center. DeCaro told NPR, “GLP-1s are legitimate evidence-based treatments for obesity, but they also sit inside our culture, which has intense weight pressure, weight stigma and eating disorder risk.” In order to prevent this cycle of unrealistic expectations, it is necessary that celebrities disclose GLP-1 use and stop promoting these drugs to predominantly young audiences. Teens and young adults will continue to pay the price until public figures stop contributing to a culture built on eating disorders.
Illustration by Lucy Jeffers
Best alternatives to help quit nicotine
To view the interactive infographic, click here.
Illustration by Lucy Jeffers
Teens need to know about nicotine product design
By Kate Morgan
Vaping has changed the way a lot of teens see nicotine. Instead of something dangerous, it now seems modern and not a risk. A big reason for this is how vape companies design and market their products. The bright colors, small devices and sweet flavors like fruit or candy make vaping feel harmless, almost like it’s just another trend. But in reality, it’s still addictive and risky. In the early 2000s, e-cigarettes were introduced, first developed by a Chinese pharmacist named Hon Lik in 2003 as an alternative to smoking. But major tobacco companies quickly got involved and turned vaping into a huge industry. Instead of the harsh image of cigarettes, companies like JUUL redesigned nicotine. JUUL’s early marketing used young models and social media campaigns that made vaping look trendy, especially to teens. This was the first major turning point in the way that nicotine was viewed. This shift is especially concerning because it directly impacts high school students, who are more vulnerable to peer influence and targeted advertising. When something harmful is made to look normal or even appealing, it becomes much easier for teens to overlook the risk and start using it without fully understanding the consequences. This rebranding is very intentional. Instead of the smell and look of cigarettes, vapes are sleek, small, and brightly colored. According to Truth Initiative, 85% of e-cigarette devices use flavors. These design attributions make them feel more like an accessory rather than a dangerous product. According to the Centers for Disease Control, over 2.1 million middle and high school students in the U.S. used e-cigarettes in 2023, which shows how effective this shift has been. The appeal isn’t just the device; it’s also the flavors. A study by Adam M Leventhal, et. al. found that flavored e-cigarettes are one of the main reasons young people start vaping. The flavors make nicotine easier to use and less harsh, which can lead to addiction without people realizing it. Overall, nicotine has been completely rebranded for a new generation. What used to be seen as harmful is now marketed as modern and safe, but the reality hasn’t changed. At schools like Redwood, where events like Amnesty day and guest speakers address substance use, it’s made clear that vaping is a real and present issue among students. The fact that vaping is often seen as “cool” or normal shows these market strategies working. That’s what makes this issue so serious, students are not just making the independent choice to use nicotine products, they are being influenced by an industry that designed addiction to look appealing. Because of this, it’s important for teens to recognize these tactics and actively protect themselves from it.
Wired and wanting more
By Brooke Hansen
In the glass-front refrigerator of a gas station, rows of brightly colored cans advertise “energy,” “focus” and “performance.” For many teens, grabbing one before school or practice has become routine—a quick solution for exhaustion and packed schedules. However, what starts as an occasional boost can quickly turn into something harder to control. For some teens, that first energy drink comes from a practical need rather than habit. Junior Reed Oberbauer describes that his usage of energy drinks began out of necessity to ensure he stayed awake. “I had to wake up early to go to a robotics meet, and when I would do that, I would get an energy drink to actually wake myself up,” Oberbauer said. Even though the reason for energy drink consumption was different for sophomore Ariana Nikfar, the result was similar in its effects. “My doctor told me that energy drinks and coffee are a stimulant, and an alternative to taking medication for my ADHD,” Nikfar said. Now, she drinks them regularly—about three to four times a week. What began as a temporary solution has evolved into something the show now relies on more consistently. Growing reliance: Though energy drinks have become a common source of caffeine for teens, medical professionals warn that regular use can quickly exceed recommended limits. Pediatrician Erin Heath said moderate caffeine intake for adolescents, about 2.5 milligrams per kilogram of body weight, is generally considered safe, but many energy drinks push teens beyond that range. “For most teens, that’s roughly 100-175 milligrams per day,” Heath said. “Some recommendations suggest staying closer to 100 milligrams.” Higher intake levels, especially above 400 milligrams per day, are associated with increased risk of negative physical and psychological effects. Since caffeine is a stimulant, repeated use can lead to dependence, where the body begins to rely on it to feel alert or “normal.” According to Johns Hopkins Medicine, these drinks often contain high levels of caffeine and are not recommended for adolescent consumption. What’s more, Columbia University Irving Medical Center notes that adolescents are particularly sensitive to caffeine, increasing the likelihood of these effects.
How teens become dependent: Beyond caffeine intake itself, energy drinks are designed to appeal directly to younger consumers. By making these drinks more attractive and accessible, companies increase the chances that teens will consume them frequently and potentially become dependent on them over time “For Monsters specifically, they’re really colorful. They have cool designs on them, so it probably targets it more towards teenagers,” Oberbauer said. Nikfar echoed this idea, pointing to both marketing and flavor as a common reason for why the drinks are so beloved by teens. “I think the colors and flavors kind of make it easier to sell to teenagers,” Nikfar said. “Kids are more drawn to pretty things and cooler flavors.” With taste also playing a major role in keeping teens coming back, Nikfar is not the only one who considers the flavors an attraction. “I just like how they taste. If I have the choice between that or a soda, I’ll usually choose an energy drink,” Oberbauer said. Nikfar, in a similar sense, compared energy drinks to coffee, and viewed them as more appealing alternatives. “When I’m drinking an Alani, it’s fruity like a soda. Coffee just doesn’t taste good,” Nikfar said. Caffeine consumption has increased exponentially according to PubMed Central, raising concerns about overuse and dependency. Over time, this overconsumption can create a cycle. Fatigue leads to caffeine use, which can interfere with sleep, leading to more fatigue and more caffeine. Effect on the body: While the immediate boost may feel helpful, the long-term effects can be harder to ignore, especially when it comes to sleep. Heath identified sleep disruption as one of the most consistent concerns linked to caffeine use in adolescents. “Caffeine can delay when teens fall asleep, reduce total sleep time and affect sleep quality,” Heath said. Studies have shown that teens with higher caffeine intake are significantly more likely to get less than six hours of sleep per night. Nikfar mentions how this is a recurring notion in her routine: she tends to stay up later if she drinks an energy drink and she often has to use melatonin in order to fall asleep. Caffeine can also affect the cardiovascular system and mental health. Some common risks that Heath noted include an increased heart rate, anxiety, irritability and, in some cases, heart rhythm issues. Nikfar, however, describes herself feeling more at ease and more energetic once she’s had an energy drink. “I’m in a better mood, and I have a lot more energy. It’s easier to go about my day in classes, I feel more focused and normal,” Nikfar said. But that short-term improvement can come with long-term trade-offs that don’t leave an individual feeling as positive. Dependency past the can: For some teens, energy drinks shift from an occasional habit to something harder to stop, even if they don’t always recognize it as dependence. Nikfar said she doesn’t feel fully dependent, but her routine suggests a level of reliance. “I feel like I could not drink it if I wanted to, but I usually do,” Nikfar said. She also pointed to the factors driving that routine stemmed from lack of sleep, school schedule and athletics. Oberbauer described changes he has noticed over time in the way the drinks affect him. “The only one that was really powerful was the first time,” Oberbauer said. “Since then, it has a boost of energy, then dies off.” Heath explained that this pattern reflects tolerance, where the body adapts to caffeine and requires more to achieve the same effect. She also noted that regular use can lead to withdrawal symptoms, including headaches, fatigue and irritability, reinforcing continued consumption.
Cycle: Despite growing awareness, energy drinks remain widely available and socially accepted. For teens balancing school, sports and social pressures, the appeal of a quick energy fix is hard to ignore. Even when teens are aware of the potential downsides, that doesn’t always change consumption. In fact, Oberbauer mentions how he knows that too many energy drinks would have many negative effects on his body. But, like many teens, he still drinks them due to their flavor and convenience. What starts as a solution to feeling tired may ultimately contribute to the very exhaustion it aims to fix, creating a cycle that’s increasingly difficult to break.
Facts about energy drink addiction
To view the interactive infographic, click here.
Supplemental perfection
By Oren Weingarten and Tate Ralston
Teen culture has been taken over by the stigmatization of perfection. Teens have become fueled by the urge to buy whatever product they can get their hands on in order to seemingly improve their quality of life, whether physically or mentally. Supplements have been the catalyst. This boom in usage of supplements and medications among teens has left people deciding between digital influence and clinical concern. On one side, influencers, friends and peers rave about their life-changing experiences with muscle gain from creatine, or exponential protein intake from protein powder; while on the other side, the hesitant doctors, parents and guardians are wrestling with the idea of their children shoveling down possibly unsafe supplements just to improve their image. Yet, both sides are looking right past each other. As supplements and body-focused health products become increasingly normalized among teens, they reveal a broader trend: dependency that is rooted less in the substances themselves and more in the pressure to constantly improve and optimize the body. Most of these products are legal, accessible, and in some cases supported by research. As a result, their increased usage is shifting the question from if they work, to what behaviors will result around them. Dr. Perelmuter, an anesthesiologist at the California Pacific Medical Center in San Francisco, gave insight into the addictive qualities and nuanced perspectives of these supplements, particularly creatine. Creatine is a natural compound produced by the body from amino acids, credited to providing a quick energy source and an increase in muscle strength. While the substances themselves are not considered chemically addictive, Perelmuter noted that continued use can still result in dependence. “[Creatine] could be behaviorally addicting. I feel that if you depend on anything too much in large quantities, it can become addictive. It is a fine line, unfortunately,” Perelmuter said. Most of the time, behavioral addiction shows up less and less in the product itself and more in the routine around it. The tracking, consistency and feeling that progress depends on supplement use all fuel this dependency, regardless of the ingredients on the label. For many teens, these habits seem to exist because of the media. Being continually reinforced by content, fitness routines and transformation videos, improvement is framed as something that should always be happening. In this environment, supplement use changes from optional to expected. Perelmuter also noted the appeal of rapid results. “Everyone is looking for an easy fix, and the more you look around, the more supplements you see. Most of them don’t really carry their weight. They may only make you feel good by looking good,” said Perelmuter. While supplements like creatine and protein powder are linked to exercise and brain health, a similar pattern emerges in another area: weight loss. Medications like Ozempic are becoming increasingly popular amongst teens. A study conducted by The University of Michigan Medical School discovered a 594 percent increase in monthly usage of Ozempic and similar products amongst teens from 2020 to 2023, suggesting pressure to follow others. An anonymous student, whom we will refer to as Jackie, expressed their journey with medicated weight loss and looked back on why this is what they chose to do. “I never thought that I was going to take it, but now I feel like it really helped me embrace who I am,” Jackie said. This feeling seems to be a trend among recipients of the medication. But the bottom line is pure enjoyment. “I don't think of it as addicting, I just love the way that it makes me look, so it keeps me using it,” Jackie said. This shows the body's compulsion and that the way it naturally exists never seems to be enough. This is the territory of behavioral addiction. Teens know they could quit, but their skewed perception from the media of what is desirable and obtainable from these supplements, can make it almost impossible. Behavioral addiction often goes unnoticed, as its benefits can blend with other aspects of adolescents' lives. It’s important to do your own research, and look into what makes sense for you personally. Distinguishing between improvement and obsession can be difficult, so use your resources, be mindful and be sure to question pressures.
How substances can lead to identity adoption
GLP-1s found to be useful in combating addiction, National Library of Medicine study finds
By Josephine Perlov
The emergence of glucagon-like peptide-1s, or GLP-1s, has largely been associated with type two diabetes treatment and weight loss, but new studies suggest GLP-1s could also be used to treat addiction. GLP-1s are synthetic peptides that mimic glucagon, which in turn slows digestion. In addition, the drugs can also trigger a feeling of fullness and target rewarding stimuli. Scientists from the National Library of Medicine have found that GLP-1s target reward and dopamine pathways in the brain responsible for gratification following habitual behaviors. According to Gabriel Amorim Moreira Alves et al., this leads to “reduced reward sensitivity, craving, and substance-seeking behaviors” (PubMed review, 2025). This means that things that may have otherwise been compulsory, like hitting a vape or checking your phone, become less attractive and therefore less addictive. The study also states that GLP-1s affect regions of the brain involved in habit formation, indicating they may not only slow the progression of addictive behaviors but potentially reduce their development. “Early research in both animals and humans suggests that these treatments may help reduce alcohol and other substance use,” researcher Lorenzo Leggio said. This is especially impactful as exposure to addiction early on can lead to long-term dependence and worsened brain development. Although the data is preliminary, the possibility of implementing GLP-1s in addiction treatment is encouraging and suggests promising directions for future research. Scientists remain hopeful that the technology can be used in tandem with existing behavioral therapies. Many habits are formed in youth, with some estimates suggesting up to 50 percent, according to the Australian Institute of Professional Counsellors. The teenage years are especially formative, as the brain undergoes significant development in systems related to reward and decision-making. The foundation of healthy habits related to screen use, alcohol and drug exposure during this period may significantly influence long-term outcomes.
Illustration by Paloma Nacamuli
TUPE speaks on substance addiction
By Beatrice Nass and Madeleine Wagner
To watch the video, click here.
Know your rights: A guide for minors
Melatonin abuse
The more exposure you get, the harder it is to quit: peer pressure and reliance
Esperanza Cubillos
If people know that most substance use is bad for them, then why would they try it? One of the key catalysts for this is social influence. Whether it’s your parents’ glass of wine at every dinner, or smoke lifting out of the bathroom stall at school, students everywhere are being exposed to the culture of substance use. Research shows that someone feeling pressure to conform doesn't have to have a friend dare them to try drugs or alcohol; they just have to believe that everyone else around them is already doing it. For example, almost all kids in elementary school are taught from a young age that cigarette use is bad for their health, and 88 percent of kids ages 8-11 reported that they would not smoke when they are older. However, according to a CDC survey, “In 2024, 1 of every 8 middle school students (12.9%) and nearly 1 of every 4 high school students (23.6%) said that they [have] had tried a tobacco product, [such as cigarettes or e-cigarettes,].” Most kids before the age of 18 try smoking because it seems cool, fun or like you’re living on the edge. Some kids become interested in these products because of the advertisements they see that market nicotine products like some sort of candy. Mari Silva, a junior in the Tobacco Use Prevention Education (TUPE) program at Redwood, aims to inform youth from all around the San Francisco Bay Area about the effects of drugs and alcohol on adolescent minds and bodies. “You know IceBreakers? Zyns [are] the same size circle, one obviously [contains] nicotine, is harmful, and 21+, and the other is just regular mints that you can get at Target. A lot of the time around Marin, if you go to gas stations or wherever they sell Zyn products, [these stores] place ice breakers very close to them so it almost looks like the Zyn pouches are candy,” Silva Said. Marketing is fundamentally linked to peer pressure when businesses capitalize on the human instinct to conform. Social media can also be linked to peer pressure. For instance, seeing an idol or friend using substances drives consumer instinct to purchase a product by 30 percent. In the case of substance use, this number is alarmingly high. “[Noah Kahan] is a very popular singer who did a promotion for Zyns. He and other creators who have this big influence on youth [are used by brands] to push these products,” Silva Said. Peer pressure peaks from ages 14 through 18 in all people, making high school students the most susceptible to risk-taking behaviors and conformity to peer pressure from the media, people at school, family and close friends. Additionally, inner temptations cause experimentation such as a deep-rooted desire to feel a sense of belonging, a way to relieve boredom or push away one’s struggles, insecurities about body image, fear of judgement, loneliness and more. Especially in Marin County, peer pressure can be poisonous if you can’t control yourself. The Marin Healthy Youth Partnerships calls it the “2X problem” since kids in Marin use substances almost twice as much as average kids in California. For teens, the most common forms of substance use in this community are through nicotine vapes, cannabis, zyns, alcohol and prescription drugs. Shockingly, in 2019, 47 percent of teens in Marin had admitted to vaping at least once, and 67 percent had tried alcohol by their senior year. “In our anonymous Q&As, we have had students saying that they have a friend who pressures them to use, and they don’t want to lose the friendship. The best advice that we try to give them is that if you say no, most people will respect that, and if there’s someone who really wants you to use, it just reflects that they’re addicted and have a problem themselves,” said Silva. Additionally, with Marin being one of the top ten wealthiest counties in all of the United States, wealthy households are often readily available with alcohol for children to access. Katrina Southard is one of the lead Wellness specialists at Archie Williams High School in Marin. In an interview by The Pitch, Archie’s journalism program, Southard spoke on this same issue. “Statistically, Marin County has a fairly high rate of alcohol use and binge drinking among adults. That use behavior could trickle down, and students might start drinking a little earlier than they would if they were living somewhere where the alcohol use rate was not as high,” Southard said. Furthermore, this culture of affluence is often associated with busy parents and isolated teens, creating more room for risks and less parental guidance. The problem is that if you conform to peer pressure, it’s not like your bad decision just goes away when the party is over. The second you’ve opened the door to substance use, dependency creeps in. For example, nicotine, the main addictive drug in tobacco, makes quitting very hard for someone who smokes, even if they have only done it once. “For vapes and nicotine substances in general, it takes only around 2 to 3 times to turn into a dependency, [since] nicotine is the second most addictive substance [in the world] after heroin,” said Silva. Many teens who have already tried nicotine once don’t back away from the chance for a second try because they think they can quit later on, ignoring the fact that the more exposure you get, the harder it is to quit. Additionally, according to performcare.org, “Only 5 percent of high-school-age smokers believe they'll still be smoking five years after graduation, but they don't understand how difficult quitting can be. Research shows that after eight years, 75 percent of those smokers will still be using some form of tobacco.” According to the Center for Disease Control and Prevention (CDC), “Over time, nicotine changes how your brain works and makes it seem like you need [it] just to feel okay. When you stop smoking, your brain gets irritable. As a result, you might get anxious, upset, have a hard time concentrating or sleeping [and] have strong urges to smoke.” Some teens develop this sort of “I can quit at any time” mindset, which isn’t just underestimating the power of addiction, but most importantly, ignoring the irreversible health consequences that come from substance use. Although peer pressure can feel strong, it is important that you don’t feel a need to conform to it. Whether it’s verbal pressure, social norms, social media, friends, family and more, at the end of the day, your health matters most. Most teens never planned to use substances when they were young, because they grew up knowing how harmful they are. The truth is, not everyone is using substances, and the idea that they are or that peer pressure is all bad is a myth. In reality, everyone would be perfectly fine if these substances never existed; however, since they do, it’s important to understand the risk of addiction and how it can slowly shape your identity in ways you never intended.
Peptides
From a Redwood TUPE member: The dangers of nicotine pouches
Starbucks new Caffeine Refreshers
By Charlie Anderson and Olen Johnson
Learn more about the effects of caffeine in a drink review here.