Most illicit drug use by teenagers holding steady; possible turnaround seen with alcohol
The use of most illicit drugs among the nation's teenagers either is holding steady from last year or showing some modest declines, according to findings in the 2012 Monitoring the Future study conducted at the Institute for Social Research.
In particular, marijuana use has stopped trending upward and synthetic marijuana did not show a rise this year, although it remains at high levels and is not declining despite DEA attempts to ban many of the most common ingredients of synthetic marijuana.
Another exception to this generally positive story is the appearance of a turnaround in alcohol use among the older teens after rates declined to historic lows in 2011.
The findings regarding marijuana use, along with data indicating that use of synthetic marijuana held level among 12th-graders in 2012, are among the more important findings of this year's survey, which are based on national samples of 45,000 to 50,000 students in eighth, 10th and 12th grades surveyed every year since 1991.
"Whether this is more than a pause in the ongoing increase that we have seen in teen marijuana use in recent years is unclear at this point," said Lloyd Johnston, the study's principal investigator.
"One important variable that has been a lead indicator of use — namely the amount of risk teenagers perceived to be associated with marijuana use — continued its sharp decline in 2012 among teens, which would suggest further increases in use in the future."
After four straight years of increasing use among teens, annual marijuana use showed no further increase in any of the three grades surveyed in 2012. The 2012 annual prevalence rates (i.e., percent using the drug in the prior 12 months) were 11 percent, 28 percent, and 36 percent for eighth, 10th, and 12th graders, respectively.
Among the eighth graders there was a modest decline across the past two years —from 13.7 percent in 2010 to 11.4 percent in 2012 — that reached statistical significance.
Daily use of marijuana, which had also been rising in all three grades in recent years, remained essentially flat between 2011 and 2012 at relatively high levels. The recent increases have been substantial — up by a quarter to one third compared with their recent low points reached between 2006 and 2008 for the three grades. Today one in every 15 high school seniors (6.5 percent) is a daily or near-daily marijuana user. The comparable rates in eighth and 10th graders are 1.1 percent and 3.5 percent.
Synthetic marijuana — sold by such names as K-2 or Spice — has been of increasing concern both because of its adverse effects and its high rates of use, first documented by this study last year. Use held level among 12th graders this year at 11.3 percent annual prevalence.
"The fact that use of this dangerous drug has leveled is encouraging, but the fact that its prevalence rate has remained this high despite federal and state efforts to reduce its use is troublesome," said Johnston, the Angus Campbell Collegiate Research Professor, distinguished senior research scientist at ISR, and research professor at the Survey Research Center.
Synthetic marijuana use was measured for the first time this year in eighth and 10th grades — their annual prevalence rates were 4.4 percent and 8.8 percent, respectively. Aside from alcohol and tobacco, this is the second most widely used drug among 10th and 12th graders after marijuana, and the third-most widely used among eighth graders after marijuana and inhalants.
Synthetic marijuana is made by spraying synthetically produced cannabinoids (chemical elements found in cannabis) on herbs or other plant materials. It usually is sold over the counter or on the Internet. In 2011, the Drug Enforcement Administration banned a number of specific chemicals commonly used to make it, but chemical variations continue to appear.
The Monitoring the Future study is conducted at the Institute for Social Research and funded since its inception under a series of research grants from the National Institute on Drug Abuse, one of the National Institutes of Health. Surveys of nationally representative samples of American high school seniors were begun in 1975, and surveys of eighth and 10th graders were added to the design in 1991.
Use of alcohol declined on all measures in 2011, bringing rates down to historic lows during the life of the study. For eighth-graders, these significant declines continued into 2012 for 30-day prevalence of drinking and two-week prevalence of having five or more drinks in a row (binge drinking).
For 10th- and 12th-graders, however, the declines in alcohol use halted in 2012. In fact there is some evidence to suggest a turnaround. In particular, binge drinking among 12th-graders increased significantly in 2012 by 2.0 percentage points to 24 percent. In other words, about a quarter of the seniors reported that they engaged in binge drinking in just the two weeks prior to taking the survey.
"This possible turnaround in alcohol consumption among the older teens is somewhat unexpected, and certainly not a welcome development," Johnston said.
There was no decline in perceived risk or disapproval of binge drinking, or any increase in perceived availability of alcohol that might have helped to explain the change in use. Availability of alcohol to eighth-graders did continue its sharp decline this year.
"Despite the modest increases in alcohol use this year among the older teens, it still is important to put them into perspective," Johnston said. "The percent of eighth-, 10th-, and 12th-graders who report binge drinking in the prior two weeks is 5 percent, 16 percent, and 24 percent in 2012. However, these rates reflect proportional declines of 62 percent, 36 percent, and 25 percent, respectively, since the peak years of use in the mid-1990s."
Other findings from the 2012 survey include:
So-called because they are often marketed as "bath salts," really are products containing designer drugs — synthetic cathinones, which are stimulants that have effects something like amphetamines. Questions on the use of these powerful and dangerous drugs were included in the survey for the first time in 2012.
A relatively small proportion of teens indicate having used bath salts in the prior 12 months. The annual prevalence rates were 0.8 percent, 0.6 percent, and 1.3 percent for grades eight, 10, and 12, respectively.
Like synthetic marijuana, these drugs are frequently sold over the counter in gas stations and head shops under a number of different names. They are reported to have a number of serious side effects, including paranoia, suicidal thoughts, violent behavior, hallucinations and increased heart rate.
Calls to poison control centers about bath salts increased dramatically after 2010. Reportedly, there were 3,500 calls in the last six months of 2011, but that number fell to 1,700 in the first six months of 2012 and has been falling further since.
Any illicit drug
The index of any illicit drug use tends to be driven by marijuana, which is by far the most prevalent of the many illicitly used drugs. Like marijuana, it showed no significant changes in 2012 for annual prevalence.
In 2012, the percentages of students indicating any use of an illicit drug in the prior 12 months were 13 percent, 30 percent, and 40 percent in grades eight, 10, and 12, respectively. The percentages indicating any use in their lifetime were 19 percent, 37 percent, and 49 percent. In other words, about half of America's high school seniors have tried an illicit drug by the time they graduate and four-fifths of them used it in just the past year.
Any illicit drug other than marijuana
When marijuana is removed from the list of illicit drugs, far fewer students report use of any of the other drugs included in the index. These include hallucinogens, cocaine, crack, and heroin, as well as use of any of the psychotherapeutic drugs — amphetamines, sedatives, tranquilizers, or narcotics — taken without medical supervision.
In 2012, 6 percent, 11 percent, and 17 percent of the students in the three grades, respectively, reported using any of these other drugs. Those percentages have continued to drop gradually since around 1996 or '97, but the declines in annual prevalence between 2011 and 2012 were not statistically significant.
Most of the individual illicit drugs showed no significant change in use between 2011 and 2012. Only ecstasy, salvia, and use of heroin without a needle showed statistically significant declines this year.
The annual prevalence of Ecstasy declined significantly this year in all three grades. Over the past dozen years, the use of Ecstasy has changed quite a bit, with rates being high in the early 2000s, decreasing through the mid-2000s, and then increasing since then.
The 2012 annual prevalence rates are 1.1 percent, 3.0 percent, and 3.8 percent in grades eight, 10, and 12 — less than half the peak rates observed in 2001.
Salvia divinorum is an herb in the mint family that can induce relatively short-acting hallucinogenic effects when smoked or eaten. Salvia, first measured in 2009, had significant declines among 10th- and 12th-graders this year, and a non-significant decline in eighth grade. The annual prevalence rates in 2012 for salvia are 1.4 percent, 2.5 percent, and 4.4 percent in grades 8, 10, and 12.
Use of heroin without a needle declined significantly in eighth and 12th grades and remained unchanged (but at lower than recent peak levels) in 10th grade. Annual prevalence rates are very low at 0.3 percent in grade eight and 0.4 percent in grades 10 and 12. Use of heroin with a needle declined (not significantly) to 0.4 percent annual prevalence in all three grades. Both forms of heroin use are substantially below their recent peak levels, which generally occurred in the mid- to late-1990s.
The use of narcotic drugs other than heroin — mostly prescription analgesics — has increased sharply in recent years, as have emergency room admissions involving these drugs, making this class of drugs of particular concern.
Use in 12th grade — the only grade for which use of this drug is reported — showed some decline (but not a significant one) in 2012, as was true for the two major components of that class — Vicodin and OxyContin. For the three grades combined, however, both Vicodin and OxyContin declined significantly in 2012, a function of the greater precision gained with the larger combined sample.
LSD use remained at very low levels, which have held for a decade. Annual prevalence declined slightly, but nonsignificantly, in all three grades in 2012. Use of hallucinogens other than LSD declined in all three grades, significantly so in eighth grade.
Inhalant use continued its long-term gradual decline in all grades, but only the 30-day prevalence decline among eighth-graders was statistically significant. Younger students are most likely to be using inhalants: The annual prevalence of use is 6 percent, 4 percent, and 3 percent in grades eight, 10, and 12, respectively — a reversal of the situation for virtually all other drugs.
One drug class that showed some sign of increasing use this year was Adderall, but only among 12th-graders and not significantly. While the use of Adderall outside of medical supervision still may be rising at grade 12, use is down from peak levels in grades eight and 10 where it held steady this year.
In 2012, there was some decline in all measures of tranquilizer use at all three grade levels, though none of them reached statistical significance. Nevertheless, all three grades reached their lowest level of annual prevalence in some years in 2012. Perceived availability of tranquilizers continues a gradual decline that has been very substantial over the life of the study.
Sedative use, reported only for 12th-graders, grew steadily from 1992 through 2005, reaching a peak level of 7.2 percent. From 2005 through 2011, there was a steady decline that halted in 2012. Annual prevalence in 2012 among 12th-graders is 4.5 percent, down some 37 percent from the recent peak in 2005. As with tranquilizers, perceived availability of sedatives has shown an appreciable and continuing long-term decline.
Use of any prescription drug without medical supervision — The proportion of 12th-graders indicating that they have used any prescription drug outside of medical supervision has remained relatively stable since 2008. In 2012, 21.2 percent indicated use without a doctor's orders of at least one prescription drug in their lifetime, while 14.8 percent indicated such use in the past year. In 2008, these rates were 21.5 percent and 15.4 percent, respectively.
The sources of such prescription drugs remain primarily informal networks of friends and, to a lesser extent, relatives. In the years 2009–12, among past-year users of amphetamines the most prevalent sources were "given by a friend" (55 percent), "bought from a friend" (44 percent), and "bought from a drug dealer or stranger" (20 percent). Among past-year users of tranquilizers, the same three sources topped the list at 56 percent, 42 percent, and 25 percent, respectively. Among past-year users of narcotics other than heroin, these three sources were endorsed by 52 percent, 34 percent, and 17 percent, respectively — however, the response "from a prescription I had" ranked second at 36 percent.
Other drugs holding steady
The use of a number of other drugs held steady this year. These include cocaine powder, crack, methamphetamine, crystal methamphetamine, Rohypnol, GHB, Ketamine, steroids, and over-the-counter cough and cold medicines taken to get high.
One important question for the future will be whether the continuing decline in the risk teens associate with marijuana use will lead to increases in their use in the future, as generally has occurred in previous historical periods. Another is what will be the impact on teen attitudes and beliefs nationally of legalizing the use of marijuana in states like Colorado and Washington.
"The nation's teenage drug problems are far from disappearing," Johnston said. "We continue to see a number of new drugs coming onto the scene, like synthetic marijuana and 'bath salts.' Synthetic drugs like these are particularly dangerous, because they have unknown, untested, and ever-changing ingredients that can be unusually powerful, leading to severe consequences. Users really don't know what they are getting and, as the thousands of calls to the nation's poison-control centers relating to these drugs indicate, they may be in for a very unpleasant surprise."
Lead investigators for Monitoring the Future, in addition to Johnston, are Patrick O'Malley, Jerald Bachman and John Schulenberg — all research professors at ISR.