Risks of heavy high school drug use rarely remain in past

According to a new study, people who abused drugs in their teenage years were more likely to do the same later in life.

Dave Yasvinski 4 minute read April 4, 2022
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Researchers found that severity of substance abuse disorder symptoms in high school predicted higher rates of prescription drug abuse in adulthood. GETTY

A new study has found that the majority of adults who suffered from multiple symptoms of substance abuse disorder in adolescence still exhibit two or more of these symptoms later in life.

The study, published in JAMA Network Open, found that, as adults, these people were more likely to use and misuse prescription drugs and to self-medicate using opioids, sedatives or tranquilizers. The research, which was funded by the National Institute on Drug Abuse (NIDA), runs counter to the notion that symptomatic substance abuse declines as teenagers enter adulthood — particularity among heavy users with multiple symptoms of the disorder.

“Screening adolescents for drug use is extremely important for early intervention and prevention of the development of substance use disorder,” said Nora Volkow, director of NIDA. “This is critical especially as the transition from adolescence to adulthood, when brain development is still in progress, appears to be a period of high risk for drug use initiation.”

Such screening has historically been hindered by knowledge gaps, the researchers said, including a tendency to treat substance abuse disorder as one broad category without accounting for severity.

Researchers relied on data from Monitoring the Future, an NIDA-funded study that surveyed panels of Grade 12 students on their drug attitudes and behaviours since 1976. The team examined a subgroup of this study that included 5,317 students who were asked about their drug use at three time periods: over their lifetime, over the past year and over the past month. After first being evaluated between 1976 and 1978, these individuals completed additional surveys at two-year, then five-year intervals until they turned 50. Of this group, 51 per cent were female and 78 per cent were white.

Researchers were interested in the relationship between the severity of this group’s substance use disorder at age 18 and how this affected their drug use decades later. Severity of the disorder in adolescence was measured by the number of symptoms these people reported experiencing on their initial surveys. Questions were based on the criteria the Diagnostic and Statistical Manual of Mental Disorders uses for alcohol, cannabis and “other drug” use disorders.

Subjects were divided by five levels of severity: exhibiting no symptoms, one symptom, two to three symptoms, four to five symptoms and six or more symptoms. Examples of symptoms of abuse included substance use that resulted in a failure to meet major obligations and repeating use even when it was dangerous to one’s health.

The initial surveys revealed that about 12 per cent of adolescents experienced severe substance use disorder in high school. More than 60 per cent of this group still exhibited two or more symptoms of the disorder as adults, with the association holding for alcohol, cannabis and other drug use disorders.

Of the roughly 21 per cent of people who indicated mild substance abuse disorder (two or more symptoms) in adolescence, 54 per cent maintained two or more of these symptoms into adulthood. Researchers found that severity of symptoms in high school predicted higher rates of prescription drug abuse in adulthood.

When all substances were factored in, more than 40 per cent of the subject pool reported two or more symptoms of substance abuse disorder in adolescence. The fact that more than half of those who were prescribed opioids, tranquilizers or sedatives in adulthood also reported at least two symptoms of substance abuse disorder as teenagers is proof the problem is not being left in the past, researchers said.

“Teens with substance use disorder will not necessarily mature out of their disorders and it may be harmful to tell those with severe symptoms that they will,” said Sean Esteban McCabe, senior author of the study and director of the Center for the Study of Drugs, Alcohol, Smoking and Health at University of Michigan. “Our study shows us that severity matters when it comes to predicting risk decades later and it’s crucial to educate and ensure that our messaging to teens with the most severe forms of substance use disorder is one that’s realistic. We want to minimize shame and sense of failure for these individuals.”

According to the team, more research is required to better understand the underlying mechanisms that cause the symptoms of substance abuse disorder to begin and carry over into adulthood and to improve the effectiveness of prevention and treatment.

Dave Yasvinski is a writer with Healthing.ca

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