Adolescent Substance Abuse

Adolescent substance use and abuse includes a wide range of substances, including alcohol, marijuana, nicotine, cocaine, heroin, inhalants, phencyclidine (PCP), lysergic acid diethylamide (LSD), dextromorphan, anabolic steroids and various club drugs, 3,4-methylenedioxymethamphetamine (MDMA or Ecstasy), flunitrazepam (Rohypnol), γ-hydroxybutyrate (GHB), and ketamine (Ketalar). It is estimated that approximately 20 percent of eighth graders in the United States have tried illicit drugs and about 30 percent of tenth through twelfth graders have used an illicit substance. Alcohol remains the most common substance used and abused by adolescents. Binge drinking occurs in about 6 percent of adolescents, and teens with alcohol use disorders are at greater risk of problems with other substances as well.

Many risk and protective factors influence the age of onset and severity of substance use among adolescents. Psychosocial risk factors mediating the development of substance use disorders include parent modeling of substance use, family conflict, lack of parental supervision, peer relationships, and individual stressful life events. Protective factors that mitigate substance use among adolescents include variables such as a stable family life, strong parent-child bond, consistent parental supervision investment in academic achievement, and a peer group that models prosocial family and school behaviors. Interventions that diminish risk factors are likely to mitigate substance use.

Approximately one of five adolescents has used marijuana or hashish. Approximately one-third of adolescents have used cigarettes by age 17 years. Studies of alcohol use among adolescents in the United States have shown that by 13 years of age, one-third of boys and almost one-fourth of girls have tried alcohol. By 18 years of age, 92 percent of young men and 73 percent of young women reported trying alcohol, and 4 percent reported using alcohol daily. Of high school seniors, 41 percent reported using marijuana; 2 percent reported using the drug daily.

Students should study the questions and answers below for a useful review of these abuses.

Questions

Directions

Each of the questions or incomplete statements below is followed by five responses or completions. Select the one that is best in each case.

51.1 It is estimated that what percent of eighth graders have tried illicit drugs?

A. 10 percent

B. 20 percent

C. 30 percent

D. 40 percent

E. 50 percent

View Answer

51.1 The answer is B

It is estimated that approximately 20 percent of eighth graders in the United States have tried illicit drugs, and about 30 percent of tenth through twelfth graders have used an illicit substance. Alcohol remains the most common substance used and abused by adolescents. Binge drinking occurs in about 6 percent of adolescents, and teens with alcohol use disorders are at greater risk of problems with other substances as well.

51.2 Which of the following statements about adolescent substance abuse is true?

A. Substance use among adolescents does not differ between males and females.

B. White and Hispanic students are less likely than African American students to report lifetime alcohol use and heavy episodic use.

C. White and Hispanic students are less likely than African-American students to report both lifetime and current marijuana use.

D. “Experimenters” who are more likely to progress to substance use disorders are youth with multiple risk factors.

E. None of the above

View Answer

51.2 The answer is D

“Experimenters” who are more likely to progress to substance use disorders are youth with multiple risk factors. The literature on the development of substance use and substance use disorders in adolescents has identified an assortment of individual, peer, family, and community risk factors. Within a developmental context, genetic predispositions to affective, cognitive, and behavioral dysregulation are exacerbated by family and peer factors in addition to the normative developmental issues of puberty, leading to substance use and pathological use. Both temperament and social interactions (i.e., family, peer relations) have a critical role in outcomes of adolescent substance use disorder. A number of family factors have been implicated as increasing the risk of substance use disorder in children and adolescents. Family environment and the extent to which youth feel supported and connected to their families of origin can have protective influences on treatment outcomes for teens. Some of the most widely recognized familial risk factors include the nature of bonding, parental supervision, discipline style, and adherence to religious practices. Affiliation with socially deviant peers has been shown in many studies to promote substance use. Affiliation with older peers may be especially hazardous because of premature exposure to risky situations, including drugs, sex, automobile travel, and otherwise problematic social settings without adult supervision. Although general indices of peer support suggest a detrimental effect on teen substance use, having nonusing social supports in youth social networks has been shown to be predictive of abstinence posttreatment.

51.3 Which of these psychiatric disorders is most commonly associated with substance abuse in adolescents?

A. Conduct disorder

B. Attention-deficit/hyperactivity disorder

C. Schizophrenia

D. Generalized anxiety disorder

E. None of the above

View Answer

51.3 The answer is A

A number of psychiatric disorders are commonly comorbid with adolescent substance abuse, including conduct disorder, oppositional-defiant disorder, attention-deficit/hyperactivity disorder (ADHD), dysthymia, major depressive disorder, bipolar disorder, posttraumatic stress disorder, social phobia, bulimia nervosa, and schizophrenia. Of these, conduct disorder is most commonly associated with substance use disorders in adolescents, with studies suggesting rates of conduct disorder ranging from 50 to 80 percent among adolescents with substance abuse or dependence. Although ADHD is commonly observed in adolescents who abuse drugs or alcohol, the observed association is likely attributable to the high comorbidity between conduct disorder and ADHD.

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