Alcohol and Other Substance Abuse in Adolescence

Past month alcohol use, high school students 2003

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

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

Drinking and Driving (past 30 days), 2003

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

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

Lifetime cocaine use, H.S. students, 2003 Other substances, 2003 data, h.s. seniors: 7% had tried amphetamines 12% had tried inhalants 6% had used illegal steroids (5% females, 7% males)

Lifetime Use of Ecstasy Among High Schoolers (2003)

Marijuana Use Before Age 13 (2003)

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

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

Alcohol and Marijuana Use By Age 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 CigarettesHard Liquor Marijuana Gateway Drugs

Levels of Substance Use/Abuse n Experimental substance use: try a drug once or twice to see what it’s like (very common) n Social substance use: Use substances only during social activities (e.g., at parties) n Medicinal substance use: Use drugs to relieve unpleasant emotions (e.g., loneliness) (self- medicating) n 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) n 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 n Depression, Anxiety n Risky Behaviors: –Unprotected sex –Automobile crashes –Fatal drowning, fatal falls n Antisocial behaviors, anger, impulsivity n Long-term health risks--heart, kidney, liver disease n Academic problems n 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 n Focus has been on three factors: n Supply of drugs –International drug seizures, border control –Police and sentencing crackdowns –Generally only modest effects n Individual characteristics of the potential drug user n Macro level: Community, social context, media

Programs Focusing on Individual n Strengthen the “host” (e.g., build self esteem) –Ineffective n 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 n Community prevention efforts. Focus not only on students, but also train: –teachers –parents –peers (i.e., large community effort, multiple high schools) n Show more promising effects, but they are expensive