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Substance use by young people is on the rise, and initiation of use is occurring at ever-younger ages. Patterns of substance use over the past 20 years have been documented by two surveys--the National Household Survey on Drug Abuse conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Monitoring the Future Study conducted by the National Institute on Drug Abuse (NIDA). Data released in 1996 indicated that in the early to mid-1990s, the percentage of 8th graders who reported using illicit drugs (i.e., drugs illegal for Americans of all ages) in the past year almost doubled, from 11.3 percent in 1991 to 21.4 percent in 1995 (NIDA, 1996a). Drug use by high school students also has risen steadily since 1992. The survey also indicates that 33 percent of 10th graders and 39 percent of 12th graders reported the use of an illicit drug within the preceding 12 months (NIDA, 1996a). These estimates are probably low because the statistics are gathered in schools and do not include the high-risk group of dropouts. Most of the recent increase is attributed to marijuana use, which rose significantly during this period.
An estimated 15 percent of 8th graders, 24 percent of 10th graders, and 30 percent of 12th graders reported having had five or more drinks within the preceding 2 weeks (Johnston et al., 1995). Slightly more than half of high school students (grades 9 through 12) reported having had at least one drink of alcohol during the 30 days preceding a 1995 Centers for Disease Control and Prevention (CDC) survey (CDC, 1996). It is further estimated that 9 percent of adolescent girls and up to 20 percent of adolescent boys meet adult diagnostic criteria for an alcohol use disorder (Cohen et al., 1993). Furthermore, the proportion of daily smokers among American high school seniors remains disturbingly high at about 20 percent.
The surveys have found that the perceived risk of harm from drug involvement has been declining while the availability of drugs has been rising (NIDA, 1996a; SAMHSA, 1998a). Particularly in the case of marijuana, sharp declines in harm perception have been observed among 8th, 10th, and 12th graders (see Figure 1-1). This shift has occurred at the same time that marijuana use has spread (NIDA, 1996a). Since 1991, the percentage of students who thought that regular marijuana use carries a "great risk" of harm has dropped from 79 percent to 61 percent among 12th graders, from 82 percent to 68 percent among 10th graders, and from 84 percent to 73 percent among 8th graders (NIDA, 1996a). During the same period, reported use of marijuana within the preceding year rose for all these grades by an average of 11 percent (NIDA, 1996a).
Household products are abused as well as illegal drugs: The percentage of youths 12 to 17 years old who tried inhalants rose from 1.1 percent in 1991 to 2.2 in 1994 (NIDA, 1996a). "Heroin chic" as exemplified by rock stars and fashion models has boosted the popularity of that drug among young people. Panel members reported that in some areas, the adolescent use of heroin mixed with water and then inhaled has increased. Clearly, drug use trends among young people are a major national concern. Within the context of national surveys of frequency of use, the prevalence of those meeting criteria for a diagnosis is becoming clearer. A 1996 statewide Minnesota survey provided the first systematic look at the rate of substance use disorders in a large student population: 11 percent of 9th grade students and 23 percent of 12th grade students met formal diagnostic criteria as established in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) for drug abuse or drug dependence disorder (Harrison and Fulkerson, 1996).
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