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November 20, 2017

Teen use of illicit drugs besides marijuana at new low; same for alcohol

December 13, 2016

Teen use of illicit drugs besides marijuana at new low; same for alcohol

Teenagers' use of drugs, alcohol and tobacco declined significantly in 2016 at rates that are at their lowest since the 1990s, a new national study showed.

But University of Michigan researchers cautioned that while these developments are "trending in the right direction," marijuana use remains high for 12th-graders.

The results derive from the annual Monitoring the Future study, now in its 42nd year. About 45,000 students in some 380 public and private secondary schools have been surveyed each year in this national study, designed and conducted by research scientists at the Institute for Social Research and funded by the National Institute on Drug Abuse. Students in grades eight, 10 and 12 are surveyed.

Overall, the proportion of secondary school students in the country who used any illicit drug in the prior year fell significantly between 2015 and '16. The decline in narcotic drugs is of particular importance, the researchers say. This year's improvements were particularly concentrated among eighth- and 10th-graders.

Considerably fewer teens reported using any illicit drug other than marijuana in the prior 12 months — 5 percent, 10 percent and 14 percent in grades eight, 10 and 12, respectively — than at any time since 1991. These rates reflect a decline of about one percentage point in each grade in 2016, but a much larger decline over the longer term.

In fact, the overall percentage of teens using any of the illicit drugs other than marijuana has been in a gradual, long-term decline since the last half of the 1990s, when their peak rates reached 13 percent, 18 percent and 21 percent, respectively.

Marijuana, the most widely used of the illicit drugs, dropped sharply in 2016 in use among eighth-graders to 9.4 percent, or about one in every 11 indicating any use in the prior 12 months. Use also declined among 10th-graders as well, though not by a statistically significant amount, to 24 percent or about one in every four 10th-graders.

The annual prevalence of marijuana use (referring to the percentage using any marijuana in the prior 12 months) has been declining gradually among eighth-graders since 2010, and more sharply among 10th-graders since 2013.

Among 12th-graders, however, the prevalence of marijuana use is higher (36 percent) and has held steady since 2011. These periods of declining use (or in the case of 12th-graders, stabilization) followed several years of increasing use by each of these age groups.

Daily or near-daily use of marijuana — defined as use on 20 or more occasions in the previous 30 days — also declined this year among the younger teens (significantly so in eighth grade to 0.7 percent and to 2.5 percent among 10th-graders). However, there was no change among 12th-graders in daily use, which remains quite high at 6 percent or roughly one in every 17 12th-graders — about where it has been since 2010.

Prescription amphetamines and other stimulants used without medical direction have constituted the second-most widely used class of illicit drugs used by teens. Their use has fallen considerably, however.

In 2016, 3.5 percent, 6.1 percent and 6.7 percent of eighth-, 10th- and 12th-graders, respectively, say they have used any such stimulants in the prior 12 months — down from recent peak levels of 9 percent, 12 percent and 11 percent, respectively, reached during the last half of the 1990s.

Prescription narcotic drugs have presented a serious problem for the country in recent years, with increasing numbers of overdose deaths and emergencies resulting from their use. Fortunately, the use of these drugs outside of medical supervision has been in decline, at least among high school seniors — the only ones for whom narcotics use is reported.

In 2004, a high proportion of 12th-graders — 9.5 percent, or nearly one in 10 — indicated using a prescription narcotic in the prior 12 months, but today that percentage is down by half to 4.8 percent.

"That's still a lot of young people using these dangerous drugs without medical supervision, but the trending is in the right direction," said Lloyd Johnston, the study's principal investigator. "Fewer are risking overdosing as teenagers, and hopefully more will remain abstainers as they pass into their 20s, thereby reducing the number who become casualties in those high-risk years." 

Users of narcotic drugs without medical supervision were asked where they get the drugs they use. About four in every 10 of the past-year users indicated that they got them "from a prescription I had."

"That suggests that physicians and dentists may want to consider reducing the number of doses they routinely prescribe when giving these drugs to their patients, and in particular to teenagers," Johnston said.

Heroin is another narcotic drug of obvious importance. There is no evidence in the study that the use of heroin has risen as the use of prescription narcotics has fallen — at least not in this population of adolescents still in school, who represent over 90 percent of their respective age groups.

In fact, heroin use among secondary school students also has declined substantially since recent peak levels reached in the late 1990s. Among eighth-graders, the annual prevalence of heroin use declined from 1.6 percent in 1996 to 0.3 percent in 2016. And among 12th-graders, the decline was from 1.5 percent in 2000 to 0.3 percent in 2016.

"So, among secondary school students, at least, there is no evidence of heroin coming to substitute for prescription narcotic drugs — a dynamic that apparently has occurred in other populations," Johnston said. "Certainly there will be individual cases where that happens, but overall the use of heroin and prescription narcotics both have declined appreciably and largely in parallel among secondary school students."

The ecstasy epidemic, which peaked at about 2001, was a substantial one for teens and young adults, Johnston said. Ecstasy is a form of MDMA (methylenedioxy-methamphetamine) as is the much newer form on the scene, "Molly." 

"The use of MDMA has generally been declining among teens since about 2010 or 2011, and it continued to decrease significantly in 2016 in all three grades even with the inclusion of Molly in the question in more recent years," Johnston said.

MDMA's annual prevalence now stands at about 1 percent, 2 percent and 3 percent in grades eight, 10 and 12, respectively.

Synthetic marijuana (often sold over the counter as "K-2" or "Spice") continued its rapid decline in use among teens since its use was first measured in 2011. Among 12th-graders, for example, annual prevalence has fallen by more than two-thirds, from 11.4 percent in 2011 to 3.5 percent in 2016. Twelfth-graders have been showing an increased appreciation of the dangers associated with these drugs. It also seems likely that fewer students have access to these synthetic drugs, as many states and communities have outlawed their sale by retail outlets.

Bath salts constitute another class of synthetic drugs sold over the counter.  Their annual prevalence has remained quite low — at 1.3 percent or less in all grades — since they were first included in the study in 2012. One of the few statistically significant increases in use of a drug this year was for eighth-graders' use of bath salts (which are synthetic stimulants), but their annual prevalence is still only 0.9 percent with no evidence of a progressive increase.  

A number of other illicit drugs have shown declining use, as well. Among them are cocaine, crack, sedatives and inhalants.

Alcohol

The use of alcohol by adolescents is even more prevalent than the use of marijuana, but it, too, is trending downward in 2016, continuing a longer-term decline. For all three grades, both annual and monthly prevalence of alcohol use are at historic lows over the life of the study. Both measures continued to decline in all three grades in 2016.

Of even greater importance, measures of heavy alcohol use are also down considerably, including self-reports of having been drunk in the previous 30 days and of binge drinking in the prior two weeks — as defined by having five or more drinks in a row on at least one occasion.

Binge drinking has fallen by half or more at each grade level since peak rates were reached at the end of the 1990s. Today, the proportions who binge drink are 3 percent, 10 percent and 16 percent in grades eight, 10 and 12, respectively.

"Since 2005, 12th-graders have also been asked about what we call 'extreme binge drinking,' defined as having 10 or more drinks in a row or even 15 or more, on at least one occasion in the prior two weeks," Johnston said. "Fortunately, the prevalence of this particularly dangerous behavior has been declining as well."

In 2016, 4.4 percent of 12th-graders reported drinking at the level of 10 or more drinks in a row, down by about two-thirds from 13 percent in 2006.

Rates of daily drinking among teens has also fallen considerably over the same intervals. Flavored alcoholic beverages and alcoholic beverages containing caffeine have both declined appreciably in use since each was first measured — again, particularly among the younger teens, where significant declines in annual prevalence continued into 2016.