Alcohol and Other Substance Abuse in Adolescence

Past month alcohol use, high school students 2003

0102030405060708090

100

Per

cent

Females Males

WhiteBlackHispanic

Drank Alcohol (more than few sips) < age 13 (2003)

0102030405060708090

100

Per

cent

Females Males

WhiteBlackHispanic

Heavy Drinking (5 or more drinks one occasion), Past Month, 2003

05

101520253035404550

%

Females Males

High School Students

WhiteBlackHispanic

Drinking and Driving (past 30 days), 2003

0

2

4

6

8

10

12

14

16

Females Males

High School Students

WhitesBlacksHispanic

Riding With Driver Who Had Been Drinking (past 30 days)

0

5

10

15

20

25

30

35

40

Females Males

WhitesBlacksHispanic

Blood Alcohol Levels-Males

Blood Alcohol Levels, Females

BAL In 1 Hour of Drinking

BAL in 2 Hours of Drinking

Marijuana Use, Past 30 Days

0

5

10

15

20

25

30

35

40

45

50

%

Females Males

WhiteBlackHispanic

Lifetime cocaine use, H.S. students, 2003

0

5

10

15

20

25

%

Females Males

WhiteBlackHispanic

Other substances, 2003 data, h.s. seniors: 7% had tried amphetamines12% had tried inhalants6% had used illegal steroids (5% females, 7% males)

Lifetime Use of Ecstasy Among High Schoolers (2003)

0

2

4

6

8

10

12

14

16%

Females Males

WhiteBlackHispanic

Marijuana Use Before Age 13 (2003)

0

5

10

15

20

25%

Females Males

WhiteBlackHispanic

8th Grader’s “Ever Used” Substance Use From Early 90’s to 2005

0

10

20

30

40

50

60

70

80

%

1991 1994 1996 1999 2002 2005

Any Drug Marij Hallucin Alcohol

H.S. Seniors’ Substance Use From Early 90’s to 2005

0102030405060708090

%

1991 1994 1996 1999 2002 2005

Any Drug Marij Hallucin Alcohol

Alcohol and Marijuana Use By Age

05

101520

2530354045

18 19-20

21-22

23-24

25-26

27-28

29-30

%

Binge DrinkingMarij Use 1-yr

Osgood et al., 1996: young adulthood has highest rate of substance use because it has highest unstructured socializing. By mid- to late-20’s, social role obligations (marriage and parenthood, work) increase. Rates drop for all groups by their 30’s, biggest drop for Caucasian males.

Progression of Substance Abuse

Other Illicit Drugs

Beer or Wine

Cigarettes Hard Liquor

Marijuana

Gatew

ay Drugs

Levels of Substance Use/Abuse

Experimental substance use: try a drug once or twice to see what it’s like (very common)

Social substance use: Use substances only during social activities (e.g., at parties)

Medicinal substance use: Use drugs to relieve unpleasant emotions (e.g., loneliness) (self-medicating)

Addictive substance use: Includes tolerance (need to use more of the drug to get high) and withdrawal symptoms (e.g. anxiety, tremors)

Is experimenting with drugs bad? (Shedler & Block, 1990) Teens who experiment with alcohol or

marijuana (i.e., < 1x/month), and those who abstain after reflective decision-making, have better current and previous mental health than those who abstain without reflection, frequent drug users, and those using drugs other than alcohol and marijuana.

Correlates of Adolescent Substance Abuse

Depression, Anxiety Risky Behaviors:

– Unprotected sex– Automobile crashes– Fatal drowning, fatal falls

Antisocial behaviors , anger, impulsivity Long-term health risks--heart, kidney, liver

disease Academic problems Peers who use drugs, accept drug use

Intergenerational Family Transmission of Alcoholism

Poor Parental Monitoring

Family Stress and Conflict

Disrupted Family Routines and Rituals (parental abuse)

Prevention of Alcohol and Substance Abuse in Adolescence Focus has been on three factors: Supply of drugs

– International drug seizures, border control– Police and sentencing crackdowns– Generally only modest effects

Individual characteristics of the potential drug user

Macro level: Community, social context, media

Programs Focusing on Individual Strengthen the “host” (e.g., build self

esteem)– Ineffective

Education about dangers of drugs and or Social Skills training– Example: DARE. – Largely ineffective– Knowledge doesn’t necessarily translate to

behavior change

Macro level programs

Community prevention efforts. Focus not only on students, but also train:– teachers– parents– peers (i.e., large community effort, multiple

high schools) Show more promising effects, but they

are expensive