Young People and Drugs

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Page last updated June 10, 2020 by Doug McVay, Editor/Senior Policy Analyst.

41. Vulnerability of Teens to Effects of Drugs

"The teen brain is a work in progress, making it more vulnerable than the mature brain to the physical effects of drugs. The potential for developing substance abuse and dependence is substantially greater when an individual’s first exposure to alcohol, nicotine and illicit drugs occurs during adolescence than in adulthood."

Steinberg, L., Distinguished University Professor and Laura H. Carnell Professor of Psychology, Department of Psychology, Temple University and author of You and Your Adolescent: The Essential guide for ages 10 to 25 (personal communication, June 9, 2011), as quoted in "Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 13.
http://www.casacolumbia.org...

42. Proportion of Students Using Any Drug Changes Slowly

"Overall, these data reveal that, while use of individual drugs (other than marijuana) may fluctuate widely, the proportion using any of them is much more stable. In other words, the proportion of students prone to using such drugs and willing to cross the normative barriers to such use changes more gradually. The usage rate for each individual drug, on the other hand, reflects many more rapidly changing determinants specific to that drug: how widely its psychoactive potential is recognized, how favorable the reports of its supposed benefits are, how risky its use is seen to be, how acceptable it is in the peer group, how accessible it is, and so on."

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan, p. 10.
http://www.monitoringthefuture...

43. Likelihood That Young People with Diagnosed Mental Health Conditions Will be Put on Long Term Opioid Therapy

"In this nationwide study of commercially insured adolescents, LTOT [Long Term Opioid Therapy] was relatively uncommon. The estimated incidence of LTOT receipt was 3.0 per 1000 adolescents within 3 years of filling an initial opioid prescription. Although adolescents with a wide range of preexisting mental health conditions and treatments were modestly more likely than adolescents without those conditions or treatments to receive an initial opioid, the former had substantially higher rates of subsequent transitioning to LTOT. Associations were strongest for OUD [Opioid Use Disorder], OUD medications, nonbenzodiazepine hypnotics, and other SUDs. The associations were stronger sooner after first opioid receipt for OUD, as well as for anxiety and sleep disorders and their treatments, suggesting that adolescents with these conditions and treatments were more likely to quickly transition into LTOT."

Quinn PD, Hur K, Chang Z, et al. Association of Mental Health Conditions and Treatments With Long-term Opioid Analgesic Receipt Among Adolescents. JAMA Pediatr. 2018;172(5):423–430. doi:10.1001/jamapediatrics.2017.5641
https://jamanetwork.com/journa...
https://www.ncbi.nlm.nih.gov/p...

44. Ease of Obtaining Drugs

"This year we asked teens, 'Which is easiest to get: cigarettes, marijuana, beer or prescription drugs?' (prior to 2010, we asked, 'Which is easiest to buy?') Cigarettes remain at the top of the list, with 27 percent of teens saying cigarettes are easier to get than other drugs. Beer closely followed cigarettes as the easiest drug for teens to get. Marijuana is third, with 19 percent of teens reporting that it is easiest to get this year, compared to 22 percent last year. Compared to 2011, slightly more teens this year say prescription drugs are easier to get than other drugs (13 percent in 2012 vs. 10 percent in 2011)."

QEV Analytics, LTD., "National Survey of American Attitudes on Substance Abuse XVII: Teens," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2012), p. 21.
http://www.casacolumbia.org/ad...

45. Mortality Among High School Students in the US

"In 2016 in the United States, 74% of all deaths among persons aged 10–24 years resulted from four causes: motor vehicle crashes (22%), other unintentional injuries (20%), suicide (17%), and homicide (15%) (1). Among persons aged 15–19 years, 209,809 births (2); 488,700 cases of chlamydia, gonorrhea, and syphilis (3); and 1,652 diagnoses of human immunodeficiency virus (HIV) (4) were reported. Among persons aged ≥25 years, 54% of all deaths in the United States resulted from cardiovascular disease (31%) and cancer (23%) (1). These leading causes of mortality, morbidity, and social problems (e.g., academic failure, poverty, and crime) among youth and adults in the United States are associated with six categories of priority health-related behaviors: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that related to unintended pregnancy and sexually transmitted infections (STIs), including HIV infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. These behaviors, as well as obesity, overweight, and asthma, frequently are related, are established during childhood and adolescence, and extend into adulthood.

"Significant health disparities exist among demographic subgroups of youth defined by sex, race/ethnicity, and grade in school, and especially between sexual minority and nonsexual minority youth (5–7). More specifically, violence, human immunodeficiency virus (HIV) infection, STIs, and pregnancy occur more frequently among sexual minority youth than nonsexual minority youth. In addition, some sexual minority youth struggle with stigma, discrimination, family disapproval, and social rejection. However, although differences based on sex, race/ethnicity, and grade in school have been well documented, not enough is known about health-related behaviors that contribute to negative health outcomes among sexual minority youth (5,7)."

Laura Kann, PhD; Tim McManus, MS; William A. Harris, MM; et al. "Youth Risk Behavior Surveillance — United States, 2017," Morbidity and Mortality Weekly Report Surveillance Summaries (Atlanta, GA: Centers for Disease Control, June 15, 2018), Vol. 67, No. 8.
https://www.ncbi.nlm.nih.gov/p...
https://www.cdc.gov/...

46. Likelihood That Young People with Diagnosed Mental Health Conditions Will be Put on Long Term Opioid Therapy

"Of the 1,000,453 opioid recipients (81.7%) with at least 6 months of follow-up, 51.1% were female, and the median age was 17 years (interquartile range, 16-18 years). Among these adolescents, the estimated cumulative incidence of LTOT [Long Term Opioid Therapy] after first opioid receipt was 1.1 (95% CI, 1.1-1.2) per 1000 recipients within 1 year, 3.0 (95% CI, 2.8-3.1) per 1000 recipients within 3 years, 8.2 (95% CI, 7.8-8.6) per 1000 recipients within 6 years, and 16.1 (95% CI, 14.2-18.0) per 1000 recipients within 10 years. The prevalence of mental health conditions and treatments in this sample is shown in eTable 3 in the Supplement.

"All mental health conditions and treatments were associated with higher rates of transitioning from a first opioid prescription to long-term therapy. Table 2 provides the estimated incidence of LTOT among those with and without mental health conditions and treatments.Adjusted relative increases in the rate of LTOT ranged from a factor of 1.73 for ADHD [Attention-Deficit/Hyperactivity Disorder] (hazard ratio [HR], 1.73; 95% CI, 1.54-1.95) to approximately 4-fold for benzodiazepines (HR, 3.88; 95%CI, 3.39-4.45) and nonopioid SUDs [Substance Use Disorders] (HR, 4.02;95%CI, 3.48-4.65) to 6-fold for non benzodiazepine hypnotics (HR, 6.15; 95%CI, 5.01-7.55) and to nearly 9-fold for OUD [Opioid Use Disorder] (HR, 8.90; 95%CI, 5.85-13.54). In addition, relative to no condition, the number of condition types was also associated with higher LTOT rates (1 condition: HR, 2.21; 95% CI, 2.01-2.43; 2 or more conditions: HR, 4.01; 95% CI, 3.62-4.46).

"Given the strong associations for OUD, we explored other mental health factors and opioid receipt among those with preexisting OUD. These adolescents were more likely than
adolescents without OUD to have other mental health conditions and treatments (eTable 4 in the Supplement). For example, 76.1% of adolescents with OUD had other SUDs, 61.0% had depressive disorders, and 52.6% had received an SSRI [Selective Serotonin Reuptake Inhibitor]. During follow-up, those with preexisting OUD received opioid drugs similar to those received by adolescents without OUD, although the former were more likely to receive certain opioids (eg, oxycodone and tramadol; eTable 5 in the Supplement). Of those with preexisting OUD, 15.5% filled a prescription for OUD medication treatment during follow-up."

Quinn PD, Hur K, Chang Z, et al. Association of Mental Health Conditions and Treatments With Long-term Opioid Analgesic Receipt Among Adolescents. JAMA Pediatr. 2018;172(5):423–430. doi:10.1001/jamapediatrics.2017.5641
https://jamanetwork.com/journa...
https://www.ncbi.nlm.nih.gov/p...

47. Importance of Family Dinners in Substance Use Prevention

"Compared to teens who have five to seven family dinners per week, those who have fewer than three family dinners per week are twice as likely to say they expect to try drugs (including marijuana and prescription drugs without a prescription to get high) in the future (17 percent vs. 8 percent)."

"The Importance of Family Dinners VIII: A CASAColumbia White Paper," The National Center on Addiction and Substance Abuse (New York, NY: September 2012), p. 7.
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48. Top Concerns Among Adolescents

"Every year teens tell us that tobacco, alcohol and other drugs are the biggest problem facing teens their age. This year, 26 percent of teens surveyed say that alcohol, drugs and tobacco are the most important issue teens face, followed by social pressures [18%] and academic pressures [11%]."

QEV Analytics, Ltd., "National Survey of American Attitudes on Substance Abuse XVII: Teens" (New York, NY: National Center on Addiction and Substance Abuse, August 2012), p. 25.
http://www.casacolumbia.org/ad...

49. Parental Incarceration and Adverse Childhood Experiences (ACEs)

"Children exposed to parental incarceration were more likely to have other ACEs than children not exposed to parental incarceration. For example, only 14.3% of children exposed to parental incarceration had no other ACEs, compared to 72.2% of children not exposed to parental incarceration. Further, among children exposed to parental incarceration, about 28.9% experienced one other ACE (compared to 19.4% of children not exposed to parental incarceration), 21.2% experienced two other ACEs (compared to 5.5%), 16.4% experienced three other ACEs (compared to 1.8%), and 19.3% experienced four or more other ACEs (compared to 1.2%).

"Table 2 presents descriptive statistics of ACEs for two groups of children: those who experienced parental incarceration and those who did not experience parental incarceration. Children exposed to parental incarceration had more ACEs than those not exposed to parental incarceration (2.06 compared to 0.41, p < 0.001). Children exposed to parental incarceration were also more likely to report any ACE (85.7% compared to 27.8%, p < 0.001). Children exposed to parental incarceration were nine times more likely to experience household member abuse (31.9% compared to 3.4%, p < 0.001) and violence exposure (20.3% compared to 2.3%, p < 0.001). They were eight times more likely to experience household member substance problems (45.5% compared to 5.8%, p < 0.001); five times more likely to experience parental death (11.8% compared to 2.5%, p < 0.001); and four times more likely to experience household member mental illness (24.1% compared to 6.4%, p < 0.001) and parental divorce or separation (72.7% compared to 20.5%, p < 0.001)."

Kristin Turney, Adverse childhood experiences among children of incarcerated parents, Children and Youth Services Review, Volume 89, 2018, Pages 218-225, ISSN 0190-7409, https://doi.org/10.1016/j.chil....
http://www.sciencedirect.com/s...

50. Illicit Use of Prescription Drugs

"Abuse of prescription medicine [by teens] remains high, but there are signs that it may be plateauing. Close to one in five teens (17 percent) say they have used a prescription medicine at least once in their lifetime to get high or change their mood. This is slightly, although not significantly, down from 22 percent in 2010 and from 20 percent in 2009. Use of prescription pain medicines, specifically Vicodin or OxyContin, is trending downward. One out of ten teens reports using pain medication to get high in the past year and six percent say they used in the past 30 days – down significantly from 2009 levels."

"The Partnership Attitude Tracking Study: 2011 Parents and Teens Full Report," MetLife Foundation and The Partnership at Drugfree.org (New York, NY: May 2, 2012), p. 13.
http://www.drugfree.org/wp-con...

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