pediatrics
Drug and Substance Use in Adolescents
Specific Substances
The substances that are used most by adolescents are alcohol,nicotine(in tobacco or vaping products), and cannabis. Alcohol use is common and is the substance most often used by adolescents. The Monitoring the Future Survey on Drug Use reported that in 2021 by 12th grade, 54% of adolescents have tried alcohol, and nearly 26% are considered current drinkers (having consumed alcohol within the past month) ( Specific substances references ). Heavy alcohol use is also common, and adolescent drinkers may have significant Society and the media portray drinking as acceptable, fashionable, or even as a healthful mechanism for managing stress, sadness, or mental health problems. Despite these influences, parents can make a difference by conveying clear expectations to their adolescent regarding drinking, setting limits consistently, and monitoring. On the other hand, adolescents whose family members drink excessively may think this behavior is acceptable. Some adolescents who try alcohol go on to develop an Alcohol Use Disorder and Rehabilitation . Known risk factors for developing a disorder include starting drinking at a young age and genetics. Adolescents who have a family member with an alcohol use disorder should be made aware of their increased risk. The majority of adults who smoke cigarettes began smoking during adolescence. If adolescents do not try cigarettes before age 19, they are very unlikely to become smokers as adults. Children as young as age 10 may experiment with cigarettes ( Specific substances references ). Rates of combustible tobacco use among adolescents fell dramatically in the 1990s and 2000s and continue to decline. The Monitoring the Future Survey reported that in 2021, about 4.1% of 12th graders reported current cigarette use (smoked in the previous 30 days), down from 28.3% in 1991 and from 5.7% in 2019; only about 2% report smoking every day. The strongest risk factors for adolescent smoking are having parents who smoke (the single most predictive factor) or having peers and role models (eg, celebrities) who smoke. Other risk factors include Poor school performance High-risk behavior (eg, excessive dieting, particularly among girls; physical fighting and drunk driving, particularly among boys; use of alcohol or other substances) Poor problem-solving abilities Availability of cigarettes Poor self-esteem Adolescents may also use tobacco products in other forms. About 2% of high school students are current users of smokeless tobacco ( Specific substances references ); this rate has declined over the past 10 years. Smokeless tobacco can be chewed (chewing tobacco), placed between the lower lip and gum (dipping tobacco), or inhaled into the nose (snuff). Pipe smoking is relatively rare in the US. The percentage of people > age 12 who smoke cigars has declined. Parents can help prevent their adolescent from smoking and using smokeless tobacco products by being positive role models (that is, by not smoking or chewing), openly discussing the hazards of tobacco, and encouraging adolescents who already smoke or chew to quit, including supporting them in seeking medical assistance if necessary ( see Smoking Cessation ). and other substances), which is a decrease from 45.6% in 2019 ( Specific substances references ). Electronic cigarettes cause different adverse effects compared to Chronic effects of smoking . Other chemicals contained in vaping products can cause lung injury, which can be acute, fulminant, or chronic and, in its most severe form, lethal. In addition, these products can deliver very high concentrations of The Monitoring the Future Survey reported that in 2021 the prevalence of current Marijuana (Cannabis) use among high school seniors was 19.5%, which is a decrease from 22.3% in 2019. About 38.6% of high school seniors reported having used cannabis one or more times in their life ( The most significant increase in cannabis use is in THC vaping. The number of 12th graders who reported current THC vaping increased from 4.9% in 2017 to 14% in 2019 (see also Electronic cigarette products (vaping products) ). This percentage decreased to 12.4% in 2021 ( Use of substances other than alcohol,nicotine, and cannabis during adolescence is relatively rare. In the 2021 Monitoring the Future Survey, the following percentages of 12th grade students reported using illicit substances one or more times in their life ( Specific substances references ): Prescription drugs (without a prescription): 8.8% Volatile Solvents (eg, glue, aerosols): 5.0% Hallucinogens (eg, LSD, PCP, mescaline, mushrooms): 7.1% Cocaine: 2.5% Anabolic Steroids (oral or injectable): 0.8% Methylenedioxymethamphetamine (MDMA) (nonprescription): 0.6% Opioid Toxicity and Withdrawal : 0.4% Prescription drugs most frequently misused include Opioid Analgesics (eg, Nationwide, 1.6% of high school students had used a needle to inject any illegal drug ( Specific substances references ). 1.Johnston LD, Miech RA, O’Malley PM, et al: Monitoring the Future National Survey Results on Drug Use 1975-2021: 2021 Overview, Key Findings on Adolescent Drug Use. Ann Arbor, Institute for Social Research, University of Michigan, 2022. 2.Underwood JM, Brener N, Thornton J, et al: Youth Risk Behavior Surveillance—United States, 2019.MMWR Suppl69(1):1–83, 2020. doi: 10.15585/mmwr.su6901a1 