America's Youth: A Population at Risk

There are a number of excellent sources of data about trends in adolescent drug use. These include the University of Michigan's Monitoring the Future Study (MTFS), the National Household Survey on Drug Abuse and other surveys by the Department of Health and Human Services, the Partnership for a Drug-Free America's Attitude Tracking Study (PATS), and surveys of parents, youth, teachers, and principals conducted by the National Center on Addiction and Substance Abuse (CASA). While the exact sampling procedures, methodologies, and measures vary among these studies, their findings are similar. After a substantial decline through the 1980s, drug use among teenagers and pre-teens has been on the rise since 1991 (see Figure 1 below).* Although the most recent data indicate that this upswing may be leveling, adolescent drug use rates currently stand at or near historically high levels (MTFS, 1997). During this period, there has also been a dramatic decline in anti-drug attitudes and beliefs, particularly among 11-12 year-olds. Moreover, younger children now have access to drugs more easily than before, and more of them say they know people who use illegal drugs.

No One is Immune

Prevalence data indicate that adolescent drug use is a problem that cuts across all geographic, socio-economic, racial, and ethnic boundaries in American society (MTFS, 1997). After analyzing the socio-psychological correlates of drug use in the United States, the National Survey of American Attitudes on Substance Abuse II (1996) concluded that "Every child in America is at risk of using drugs, regardless of race, ethnicity or economic status."

The overall rate of illicit drug use shows little regional variation, except that marijuana use has traditionally been 3 to 4 percentage points lower in the South. The South does not, however, have lower rates of use of other illicit drugs. There is also some indication that children start using marijuana earlier in the West, but use among high school seniors is equally high in the West and in the Northeast (MTFS, 1997). It is also believed that drug use "fashions" often originate in the urban areas and then radiate out to suburbs and rural areas; however, there is no real difference in overall use rates among urban, suburban, and rural youth. Thus, although there are some differences in when and which drugs are used, the overall picture is equally grim in all parts of the United States.

Socio-economic status, as measured by parents' educational level, does influence the age at which drug use is initiated, but does not have an effect on the overall levels of use. For younger children, parental education has a protective influence on drug use, and drug use rates among 8th graders are higher among those students whose parents have less education. By the 10th grade, however, many of these differences have disappeared, and by the 12th grade the relationship has actually reversed for drugs such as marijuana, inhalants, hallucinogens, and LSD (MTFS, 1997). The trends in drug use for children of different socio-economic levels have shown virtually identical upswings since 1991.

Overall rates of drug use are roughly equal among white and Hispanic adolescents, and slightly lower among black adolescents. The specific drugs used vary somewhat by ethnicity: White adolescents are more likely to use marijuana, hallucinogens, amphetamines and barbiturates, and opiates other than heroin, while Hispanic adolescents have the highest use rates for crack and heroin. Hispanic children also have higher rates of use in the 8th grade, but white children catch up by the 10th grade. Thus, despite stereotypes and media portrayals, illicit drug use is not just a problem for black inner city youth; it concerns all American youth.

From 1992 to 1996, the use of illicit drugs showed parallel increases for 8th, 10th, and 12th graders. In percentage terms, the increase is far more dramatic for the youngest age group. Illicit drug use among 8th graders more than doubled between 1991 (11.3 percent) and 1996 (23.6 percent), and then leveled off in 1997 (22.1 percent).¹ More important, this upswing in drug use was actually first observed among the 8th graders in 1991, and then appeared a year later in the 10th and 12th graders (MTFS, 1997).

Marijuana and Inhalant Use Account for Much of the Increase

By far, the most widely used of the illegal psychoactive drugs is marijuana. It accounts for three-quarters of the total teen drug use (National Household Survey on Drug Abuse, 1996). Close to a fifth of 8th graders and over a third of 12th graders report they have used marijuana in the past year; and almost a quarter of 8th graders and half of 12th graders report that they have tried the drug at least once in their lives (MTFS, 1997).

The use of marijuana has been increasing at a much faster rate than the use of other drugs, particularly among the youngest teens, and directly accounts for much of the rise in overall drug use statistics. Marijuana use among 8th grade students nearly tripled from 6.2 percent in 1991 to 18.3 percent in 1996, and leveled off at 17.7 percent in 1997 (MTFS, 1997).

Inhalants are another important class of drugs, second only to marijuana in their lifetime use prevalence rates among adolescents. Inhalants are easily available, inexpensive, and often not classified as illicit drugs in the minds of children and their parents. Inhalant use is most prevalent among younger children (8th graders or younger); in 1997, 21 percent of 8th graders, 18 percent of 10th graders, and 16 percent of 12th graders said they had bagged, huffed, or sniffed a chemical at least once in their lives. Inhalants are dangerous; even a single episode of inhalant use can cause brain damage and death.

The Consequences of Drug Use

The direct physical consequences of using "hard" drugs such as cocaine and heroin are generally well known, at least among the adult population, as a result of the considerable coverage they have received in the popular media. The public is less aware of the dangers of using marijuana and inhalants.

Marijuana.

One danger of adolescents' using marijuana is that it places them at higher risk for using more dangerous drugs. However, marijuana use itself has serious immediate and long-term adverse consequences.

The immediate effects of marijuana use include sleepiness, difficulty in keeping track of time, and most important, reduced ability to perform tasks requiring concentration or complex psycho-motor skills. These neuro-psychological symptoms can severely impair a child's performance of activities such as studying, memorizing, driving, and sports. Marijuana use also reduces motivation and activity level, thereby interfering with the development of physical and psychological skills important for later life (NIDA, 1997).

Furthermore, the environment in which today's adolescents are using drugs is perilous, and adolescents today deal with life risks and choices that youth and teenagers did not have to cope with in previous decades. Thus, having impaired judgment and awareness is simply more risky now than it used to be.

While all of the long-term effects of marijuana use are not completely understood, there is evidence that marijuana can cause serious health problems.** Marijuana smoke contains more than 400 carcinogenic compounds, and a person who smokes five joints per week may be taking in as many cancer-causing chemicals as someone who smokes a full pack of cigarettes every day (NIDA, 1997). Ironically, many people mistakenly believe that cigarette smoking is more harmful than using marijuana because marijuana users typically smoke less than cigarette smokers. In fact, regular marijuana smokers have the same kinds of respiratory problems as cigarette smokers -- daily cough and phlegm and more frequent chest colds.

THC (the active ingredient in marijuana) also affects hormonal systems and can impair sexual and reproductive functions (NIDA, 1997). In males it may delay the onset of puberty and lower the sperm count. In women, it can disrupt the menstrual cycle and inhibit ovulation. Long-term use of marijuana may compromise the immune system (NIDA, 1997). Some people also build tolerance for the drug and may develop a chemical dependency.

Long-term use of marijuana may also cause chronic psychological problems. Some frequent users of marijuana develop "amotivational syndrome" characterized by chronic fatigue, a lack of motivation, and not caring what happens to them.

Inhalants.

The list of physical consequences of inhalant use is as diverse as the list of inhalants themselves. Of the thousand or so chemicals that adolescents have been known to sniff to get high, nearly all can cause brain damage, suffocation, visual hallucinations, and sudden death, even the first time they are used. Short-term effects of inhalants include heart palpitations, delirium, breathing difficulty, dizziness, and headaches. Prolonged use can result in irreversible damage to the nervous system, headaches, muscle weakness, nausea, nosebleeds, decreased sense of smell, irregular heart rhythms, abnormal kidney function, liver damage, incontinence, violent behavior, and dangerous chemical imbalances in the body (NCADI, 1997).

Societal costs of adolescent drug use.

Adolescent substance use takes its toll on the Nation in direct and indirect ways, some of which are quantifiable while others are not. Most often, marijuana use is part of a constellation of deviant behaviors including use of other substances (alcohol, tobacco, over-the-counter medications, inhalants, and other illicit drugs), truancy, academic failure, violence, theft, and risky sexual behavior (Ary et al., in press; Berger & Levin, 1993; Donovan, Jessor, & Costa, 1988; Farrell, Danish, & Howard, 1992; Osgood, Johnston, O'Malley, & Bachman, 1988). Most of the leading causes of death for this age group -- motor vehicle crashes, homicide, injury, and suicide -- are more likely to occur when one is under the influence of psychoactive substances (Cohen, Kibel, & Stewart, 1997).

Drug use by adolescents accelerates their transition into adulthood, but does not give them the opportunity to acquire the necessary skills and abilities for a successful transition (Newcomb, 1994). At the very least, the time adolescents spend under the influence of drugs is wasted time -- a sort of hiatus in normal development. At worst, drug use can lead to diminished economic opportunity, incarceration, addiction, and even death. The full societal cost of these outcomes is staggering.

* The escalation in drug use among youth thus comes at a time when adult drug use is in decline.

** The long-term effects of marijuana are still being investigated. The marijuana that is available today is much stronger than what was commonly available in the sixties and seventies, and thus is more likely to have long-term consequences.