More than one-third of adolescents aged 12-17 have used alcohol or drugs in the past year, with adolescents of Native American, white, Hispanic, and multiple race/ethnic backgrounds most at risk for substance use and substance-related disorders, according to a study released Nov. 7.
The study, published in the Archives of General Psychiatry, found that nearly 8% of adolescents meet the criteria for a substance-related disorder. Native American teenagers had the highest prevalence of substance use – more than 47% – and the highest level of drug or alcohol disorders (Arch. Gen. Psychiatry 2011;68:1176-85).
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A study has found that nearly 8% of U.S. adolescents meet the criteria for a substance-related disorder, while Native American teens had the highest prevalence of substance use – more than 47% – and the highest level of drug or alcohol disorders.
"Adolescence marks the period of life with the highest risk for initiating substance abuse," wrote Li-Tzy Wu, Sc.D., and colleagues. "Thus, adolescents constitute a high-risk group requiring research to guide prevention efforts and health policy making."
Dr. Wu of Duke University Medical Center in Durham, N.C., and colleagues examined the number of substance-related disorders among 72,561 adolescents of white, Hispanic, African American, Native American, Asian or Pacific Islander, and multiple race/ethnic backgrounds. They noted that "young racial/ethnic groups are the fastest growing population in the United States."
The study, which used data from the 2005-2008 National Survey on Drug Use and Health (NSDUH), found that 37% of adolescents aged 12-17 reported using drugs or alcohol in the past year. About one-third of all adolescents reported using alcohol, 19% said they used any illicit or nonmedical drugs, and 15% said they had used both alcohol and drugs.
Those using drugs most frequently reported using marijuana; approximately 13% of all adolescents said they’d used marijuana in the past year, and adolescents reported using marijuana more frequently throughout the year than alcohol or other drugs. In fact, "marijuana use has been increasing after a few years of decline," the researchers wrote. Analgesic opioids were the second most frequently abused illegal drugs in all racial/ethnic groups, although Native American adolescents and adolescents of multiple race/ethnicity were slightly more likely to use opioids than were other ethnic groups.
Dr. Wu and colleagues noted that analgesics have replaced inhalants as the second-most commonly used drug, behind marijuana. Users of marijuana, heroin, cocaine, or sedatives also showed an elevated rate of abuse or dependence on those drugs, the study found.
Native Americans were most likely to have a substance abuse–related disorder; 15% of those adolescents met the criteria. About 9% of white adolescents and adolescents of multiple race/ethnicity had a substance-related disorder, while about 8% of Hispanics, 5% of African Americans, and less than 4% of Asians or Pacific Islanders met the criteria for such a disorder.
The study’s results support rising concerns about adolescent marijuana use, according to the authors. More than 25% of marijuana users in the study exhibited a marijuana use disorder, with the high rate possibly related to frequency of use; marijuana users on average spent the most days using the drug, compared with other substance users.
"Research is needed to closely monitor marijuana use and associated disorders among adolescents and identify prevention programs that truly work," the authors concluded.
In addition, the study authors recommended educational or prevention programs that incorporate effective messages about the health risk for nonmedical use of prescription drugs, and said screening for nonmedical drug use of analgesic opioids should be considered for high-risk adolescents.
One of the limitations of the study is that it relied on self-reports. In addition, the findings do not apply to adolescents who are homeless or institutionalized, because that population was not included in the NSDUH.
"Substance use is widespread among adolescents of Native American, white, Hispanic, and multiple race/ethnicity," the authors concluded. "Taken together, these findings call for efforts to identify and expand prevention measures that are culturally effective and address the quality and acceptability of treatment for adolescents with substance use problems."
Dr. Wu reported no relevant financial disclosures. One of the authors, Dr. George E. Woody, is a member of the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS) system postmarketing study scientific advisory group, whose job is to assess abuse of prescription medications. Denver Health administers RADARS, and pharmaceutical companies support its work.
The study was supported by several grants from the National Institutes of Health.