Teen Drinking, Drug Use Down; e-Cigarette Use a Concern

Megan Brooks

December 16, 2014

Use of tobacco cigarettes, alcohol, and illicit drugs and abuse of prescription pain relievers among US teenagers has declined since 2013, and rates of marijuana use have held steady, according to the 2014 Monitoring the Future (MTF) survey, released today by the National Institute on Drug Abuse (NIDA).

Dr Nora Volkow

"With the rates of many drugs decreasing and the rates of marijuana use appearing to level off, it is possible that prevention efforts are having an effect," NIDA Director Nora D. Volkow, MD, said in a statement.

"It is now more important than ever for the public health community to continue to educate teens, parents, teachers, community leaders, the media, and healthcare providers about the specific harms of drug use among teens, whose brains are still developing," she added.

However, rates of e-cigarette use among teens, measured for the first time in the MTF survey, are "very high," Dr Volkow noted during a press briefing. She called the e-cigarette data "worrying."

The MTF survey measures drug use and attitudes among 8th, 10th, and 12th graders. The survey is funded by NIDA and is conducted by researchers at the University of Michigan at Ann Arbor. Overall, 41,551 students from 377 public and private schools participated in this year's survey.

Good News

In 2014, past-month use of smoked marijuana remained steady among 8th graders, at 6.5%; 10th graders, at 16.6%; and 12th graders, at 21.2%.

Nearly 6% of 12th graders said they use marijuana daily. Marijuana "edibles" are popular in states with medical marijuana laws. In these states, 40% of 12th graders who reported past-year marijuana use said they had consumed marijuana food products, vs 26% in nonmedical marijuana states.

Most high school seniors say marijuana is easy to get and think occasional marijuana smoking is not harmful.

Prescription and over-the-counter drug abuse continued positive downward trends; 6.1% of seniors reported past-year use of narcotics other than heroin (which includes all opioid pain relievers), down from 7.1% a year earlier and markedly lower than the 2004 peak of 9.5%.

During the past 5 years, there have been "pretty dramatic" reductions in the two most frequently abused drugs, acetaminophen/hydrocodone (multiple brands) and oxycodone (multiple brands), Dr Volkow said.

Fewer teens are abusing cough/cold medicines containing dextromethorphan, with only 2% of 8th graders using them for nonmedical reasons, down from 3.8% 5 years ago.

Past-year use of 3,4-methylenedioxy-N-methylamphetamine (MDMA, also known as Ecstasy or Molly) and inhalants, as well as synthetic marijuana (K2/Spice), Bath Salts, and the hallucinogen salvia also declined.

This year's MTF data show "promising signs on the declining rates of adolescent substance use and reinforce the need to continue efforts on prevention, treatment, and recovery," National Drug Control Policy Acting Director Michael Botticelli said in a statement.

Bad News

During the past 5 years, across all school grades, daily cigarette smoking has fallen markedly (nearly 50%), the researchers said.

"The one fly in the ointment has to do with e-cigarettes," lead researcher Lloyd D. Johnston, PhD, of the Institute for Social Research, University of Michigan, Ann Arbor, said during the briefing.

The survey found that 8.7% of 8th graders, 16.2% of 10th graders, and 17.1% of 12th graders reported using e-cigarettes in the prior month.

"This is the first national study to show that, among teens, e-cigarettes now have higher use than regular tobacco cigarettes. e-Cigarettes have become the nicotine delivery device of choice among today's teens," said Richard Miech, PhD, of the Institute of Social Research, University of Michigan, Ann Arbor.

"[W]e are concerned about the levels of e-cigarette use among teens that we are seeing. It would be a tragedy if this product undid some of the great progress made to date in reducing cigarette smoking by teens," Dr Johnston added.

Alcohol use declined in all grades. In 2014, 9.0% of 8th graders, 23.5% of 10th graders, and 37.4% of 12th graders reported drinking alcohol in the past month, compared with 10.2%, 25.7%, and 39.2%, respectively, in 2013.

This represents a significant drop during the past 5 years, with rates at 14.9%, 30.4%, and 43.5% in 2009. Alcohol use among teenagers, "while still at substantial levels, is at historical lows in the history of this study," Dr Johnston said.

There was also a significant drop in binge drinking (five or more drinks in a row in the last 2 weeks) in 2014 among high school seniors, which is now under 20%, compared with the 1998 peak of 31.5%.

"We are encouraged to see a continued decrease in binge drinking among young people. Still, nearly one in five high school seniors report binge drinking within the past 2 weeks, which is unacceptably high and underscores the need for underage drinking research to remain a priority," said George F. Koob, PhD, director of the National Institute on Alcohol Abuse and Alcoholism.

The complete report is available online at MTF's Web site.

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