III. ETIOLOGY – how/where did the problem begin? Is it different for adolescents vs. adults? Is it different by geographic location? Where are we now?
“In the United States, approximately three-fourths of all deaths among persons aged 10–24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1999 national Youth Risk Behavior Survey demonstrate that numerous high school students engage in behaviors that increase their likelihood of death from these four causes…[including alcohol and illicit drug use]” Morbidity & Mortality Weekly Report (MMWR),
Centers for Disease Control, Risk Youth Behavior Surveillance.
In 2009, 51.9% of Americans age 12 and older had used alcohol at least once in the 30 days prior to being surveyed; 23.7% had binged (5+ drinks within 2 hours); and 6.8% drank heavily (5+ drinks on 5+ occasions). In the 12-17 age range, 14.7% had consumed at least one drink in the 30 days prior to being surveyed; 8.8% had binged; and 2.1% drank heavily. (Source: National Survey on Drug Use and Health from NIDA)
-Monitoring the Future survey: annual survey of a nationwide sample of American eighth, tenth, and twelfth graders. Survey include data on substance abuse (441 Steinburg). This study has also been used to chart changes over time in adolescent substance use.
-Alcohol and nicotine are the most commonly used and abused substances.
Different “stages” of use
• Initiation/Experimentation
• Escalation—Regular Use
• Heavy or Problem Use
• Cessation/Relapse
WHERE ARE WE NOW?
(NIDA)
More than half of new illicit drug users begin with marijuana. Next most common is prescription pain relievers, followed by inhalants (which is most common among younger teens). (NIDA)
Alcohol
Drinking by underage persons (ages 12–20) has declined. Current alcohol use by this age group declined from 28.8 to 26.3 percent between 2002 and 2010, while binge drinking declined from 19.3 to 17.0 percent and the rate of heavy drinking went from 6.2 to 5.1 percent.
Binge and heavy drinking are more prevalent among men than among women. In 2010, 30.9 percent of men 12 and older and 15.7 percent of women reported binge drinking (five or more drinks on the same occasion) in the past month; and 10.1 percent of men and 3.4 percent of women reported heavy alcohol use (binge drinking on at least five separate days in the past month).
Driving under the influence of alcohol has also declined slightly. In 2010, an estimated 28.8 million people, or 11.4 percent of persons aged 12 or older, had driven under the influence of alcohol at least once in the past year, down from 14.2 percent in 2002.
ADOLESCENTS vs ADULTS
-Adolescents drink less frequently but in larger quantities.
-Compared with adults, teenagers minimized the perceived risk of experimental and occasional involvement in health-threatening activities
Declining: Amphetamines, ritalin, meth, crystal meth, steroids
Staying the same: Cocaine, crack, LSD, other hallucinogens, most prescription drugs (sedatives, oxycontin, vicodin), cough syrup
Rising: Ecstasy
Steady or small decline: Alcohol and cigarettes
Marijuana was on a steady decline since the late 1970s and rose sharply during the mid-1990s, and has mt decline to its form levels since.
Cigarette use by teenagers has declined significantly since 1997
Drug use is increasing among people in their fifties.
