How Teen Drug Use Is Changing for Better and Worse

The new Monitoring the Future survey calls for optimism, but not complacence

Posted Jan 08, 2016

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Source: iStock Photo

Each year since 1975, a survey called Monitoring the Future (MTF) has peeked into the lives of U.S. youth to see what they really think about drugs and alcohol and, more crucially, what they’re doing with them.

This year, the view is encouraging.

According to the 2015 survey, which queried close to 45,000 students in eighth, 10th and12th grades, drug use is either down or stable virtually across the board, tobacco use is plummeting, and underage drinking continues its decline.

It’s a sign that education, prevention and intervention efforts are having an effect, and that teens may be getting the message that their developing brains make them uniquely vulnerable to the damaging effects of substances and to the risk of becoming addicted.

But for every bright spot in the survey — and there are many — there are troubling findings as well. Here are a few of the attention-getters on both sides of the equation.

Bucking the Opioid Trend

Among the most heartening numbers in the drug use statistics are those relating to teen use of opioids, meaning prescription drugs such as Vicodin and OxyContin and street drugs like heroin.

If you have somehow missed the news, the nation is in the midst of an opioid epidemic believed to have its roots in the rampant overprescribing of prescription painkillers that began in the 1990s. That, in turn, has triggered a surge in the use of its chemical cousin, heroin. Today, drug overdose death rates are at record highs, according to the latest figures from the Centers for Disease Control and Prevention, and the majority of those deaths — 6 out of 10 — involve opioids.

In short, things are so bad that every positive trend in opioid use is cause for celebration — and the MTF figures record such a trend, showing that previous small declines in teens abusing opioids are adding up. Past-year nonmedical use of Vicodin, for example, is at 2.5%, down from a high of 6.6% in 2003. And OxyContin use has fallen from its high of 3.9% in 2009 to 2.3%. Heroin use, always a smaller part of the teen picture, was at a high of 1.3% in 2000 and is now an encouraging 0.4%.

In a video highlighting some of the survey’s findings, Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), which funds MTF, noted that the teen use runs counter to other opioid statistics. “We are seeing significant increases across adults, but surprisingly, we are seeing decreases in teenagers,” she said. Youth, in short, appear to be bucking the national opioid use trends, and that bodes well for the future.

A Little Less Spice

Another bright spot in the MTF survey is the diminishing popularity of what is called synthetic marijuana but is in reality a mix of dried plant material and manmade chemicals. It’s also available as a type of liquid incense for use in devices such as e-cigarettes.

It’s easy to find at novelty and drug paraphernalia shops, through the Internet, and even at some gas stations under a variety of names, including Spice, K-2 and Black Mamba. Its makers sidestep the law by changing the chemical components as soon as one is made illegal and by marking packaging as “not for human consumption.” But this “potpourri,” as it is sometimes labeled, can be toxic, and reported effects include anxiety, vomiting, violent behavior and suicidal thoughts. It’s been linked to a surge of recent emergency room visits, and by halfway through 2015, it was blamed for the deaths of 15 people.

It is good news, then, to see past-year use of the drug drop almost by half, from 8% in 2012 to 4.2% in 2015. The numbers are even more dramatic among high school seniors, going from 11.4% in 2011 to 5.2% in 2015.

The irony of this drug is that it is sometimes sold as “natural” and, thus, a safer alternative than other drugs. In reality, it’s a chemical stew whose users can count on only one thing — that the results will be unpredictable.

The Not So Good

While the teen substance use picture is brightening overall, there remain dark clouds.

Youth cigarette use, for example, is at historic lows, but more teens are reaching for e-cigarettes. That’s a problem because these vaporizers aren’t being used just as a substitute for smoking; in some cases, they appear to be leading youth to cigarettes, according to a recent study from the research and policy group CASAColumbia. In addition, those who become addicted to nicotine, which is often an ingredient in e-cigarettes, become more susceptible to developing other addictions with drugs and alcohol, the study found.

Only about 20 percent of the teens that reported using e-cigarettes in the MTF survey said they inhaled nicotine; the flavorings appear to be the main attraction of the devices. But the reality is that e-cigarettes are currently unregulated, meaning there’s no telling what the ingredients really are, and some products marked nicotine-free may not be. Most disturbingly, many teens in the survey admitted being unsure what they were inhaling. It all points to a need for better education and regulation of this new and booming industry.

Other worries:

  • Marijuana — On the plus side, teen use of marijuana has inched down to 23.7% from 24.2% a year earlier. On the negative side, fewer students see the drug as risky — only 31.9% of high school seniors, as opposed to 36.1% the year before. The reality, however, is that for the developing brains of the young, there are clear dangers. Research has found, for example, that the addiction risk is higher for youth — about 17% of users as opposed to 9% for the general population — and that marijuana may have permanent effects on memory, learning and intelligence if used regularly by the young.
  • Opioids — Most teens who abuse prescription opioids get them (either openly or on the sly) from a relative or friend’s stash, but about a third have another source — their own prescription. It’s a reminder that teens should be monitored when taking pain pills and made aware of the very real risks of addiction.

A Long Road But the Right Direction

In short, even with the negatives, there remains plenty of cause for optimism. But this shouldn’t blind us to the whole picture. Even with the declines, more than one in four teens used an illicit drug in the past year and even more, about one in three, used alcohol, the MTF survey found.

That means much work remains before we can claim success in keeping kids from damaging substance use. Parents can help by paying attention to these areas:

Communication: Research shows that more than one in five parents of teens believe what they say has little influence on whether their child will use drugs or alcohol. Yet other studies find that teens who believe their parents would disapprove strongly of their using substances are less likely to do so. It may seem like what you say to your kid goes in one ear and out the other, but parents have more power than they realize.

Risks: Psychological problems in childhood can make teens much more likely to try substances in adolescence and to develop a problem with them. Anxiety, depression, ADHD, an impulsive personality, problems at school, and learning disabilities can also boost the risk. If your child is struggling, be sure they’re getting the help they need so that they’ll be less likely to turn to drugs and alcohol for the relief they can seem to offer.

Warning signs. Don’t become complacent and assume that because you are a loving and involved parent and your child is a good kid that he or she is somehow immune to the temptations and dangers of drug and alcohol use. It’s vital for all parents to recognize when their child is getting into trouble. Look for warning signs, such as:

  • Changes in appearance, hygiene, personality, mood, sleep, habits and friends
  • Secretiveness
  • A reluctance to make eye contact
  • Money problems
  • Deteriorating relationships with family and others
  • A loss of motivation
  • An academic downswing
  • Drug-related items such as pipes, eye drops and lighters
  • Disappearance of money, valuables, alcohol or prescription pills
  • Long absences
  • Physical symptoms such as vomiting, shakiness, nosebleeds, sweating and skin abrasions

Remember, troubling as it may be to realize your child needs help, the sooner he or she receives it, the greater the likelihood of recovery.

David Sack, MD, is board certified in psychiatry, addiction psychiatry and addiction medicine. He is Chief Medical Officer of Elements Behavioral Health, a network of mental health and addiction treatment centers that includes the Malibu Vista women’s mental health center and Lucida Treatment Center in Florida.