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Substance Abuse and Adolescence

Drugs use is very prevalent in our society as are substance use disorders (SUDS). There is much concern with how this substance use is effecting the teens and young adults of contemporary society (Single, Kandel & Faust, 1974; Branstrom, Sjostrom & Andeasson , 2007; Grady, Gersick, & Boratynski, 1985; Bogenschneider, Wu, Raffaelli & Tsay, 1998). The Substance Abuse and Mental Health Services Administration (SAMHSA) found that in 2009, 51.9% of teens over the age of 12 had used alcohol, this is comparable to past rates of alcohol use among similarly aged children (51.6% in 2008 and 51.1% in 2007. The same survey found that 23.7% of teens over the age of 12 had begun binge drinking, showing a similar slow rise since recent years (23.3 in both 2007 and 2008, up from 22.9 in 2002). When we control for age in this survey we see a rise in alcohol use that has a strong positive correlation with age. Though a decline for most age groups in the last decade. 3.5% 12-13 year-olds had used alcohol in 2009 dropping from 4.3% in 2002. In 14-15 year olds we see a drop from 16.6% in 2002 to 13.0% in 2009. Even in 16-17 there is a significant drop from 32.6% to 26.3% from 2002 to 2009, though there was a .1% rise from 2008-2009. 18-25 year olds had a rise from 60.5% to 61.8%. When we look at binge drinking under the same lens the story stays about the same. Binge drinking among 12-13 year-olds and 13-14 year olds has dropped from 1.8 to 1.6 percent and from 9.2% to 7.0% from 2002 to 2009 respectively. Binge drinking episodes dropped from 21.4% to 17.0% among 16-17 year olds. 18-25 year olds experienced a rise in binge drinking from 40.9% to 41.7% I from 2002 to 2009. The increase in drinking among this age group may be explained by the legal drinking age in the United States being 21 and right in the middle of this demographic. The

alcohol rates of use is not significantly different, but the rates of abuse (binge drinking are). 36.7% of males in this survey binge drink whereas only 16.1% of females report the same activity. When race is controlled for, whites have the highest rate of use 2009 (56.7%) People who identify as multiracial have the next highest rates of alcohol use and in 2009 with 47.6% followed by African Americans (42.8%) and Latinos and Hispanics (41.7%). Binge drinking in 2009 was highest among Latinos and Hispanics, Caucasians and then multiracial individuals (25%, 24.8%, 24.1% respectively) Alcohol is but one drug used by adolescents. SAMHSA found that 8.7% of children over the age of twelve had used other illicit drugs which is about a 1% rise since 2007. 6.6% of children over 12 used marijuana in 2009 which is again about a 1% rise since 2007. if we examine age we see similar trends to alcohol. 12-13 year-olds had a low rate of illicit drug use in 2009, 3.6% a .8%drop since 2002, but as the ages get older the rate of use increases. In 14-15 year olds the rate dropped from 11.2% in 2002 to 9.0% in 2009, this is a rise from 8.1% in 2008. 16 and 17 year-olds also experienced a drop in illicit drug use since the beginning of the decade. The percent of this age group using dropped from 19.8% in 2002 to 15.2% in 2008 but rose again to 16.7% in 2009. In 18-25 year olds the amount of illicit substance use rose from 20.2% un 2002 to 21.2% in 2009 , an interesting statistic considering the rate was 19.6% in 2008. fascinatingly American Indians and Alaskan Natives had the highest rate of illicit drug use, 18.3% in 2009 a sharp rise from 10.1% in 2002 and 9.5% in 2008. Thy were followed by people who identified as bi or multiracial then by African Americans with a rate of 9.6% in 2009, the race that had the next highest use of illicit drugs in 2009 were Caucasians with 8.8% and the Hispanics and Latinos with 7.9%. We will get into racial implications later in this paper, it is noteworthy, however, that Alaskan Natives have the highest use of illicit drugs because they

were the only people to not cultivate or have their own psychoactive drugs until they were brought alcohol by the Europeans (Weil, 1983; 2004). Age was not controlled for in racial or gender demographics. The National Institute for Drug abuse did a more age controlled and in depth study on the use psychoactive substances among high schoolers. This study compared data from 2007-2010 among 8th 10th and 12th graders, covering the ages of approximately 13,15 and 17. The survey controls for grade and substances used, it also controls for the amount of an individuals use by differentiating use in lifetime, in the past year and in the past month. The results are as follows: life time illicit drug use has risen from 19.0% in 2007 to 21.4% in 2010 among 8th graders, and individual use in the past year (from date of survey completion) rose 2.8% from 2007 to 2010. Lifetime use in the 10th grade level has risen from 35.6% to 37.0% from 2007 to 2010 and use in the month predating the administration of the survey rose 1.6%. from 2007 to 2010. Among high school seniors illicit drug use was the highest. This demographic rose from 46.8% having used in their lifetimes in 2007 to 48.2% in 2010. In the year anteceding the survey in 2010 38.3% of those surveyed had used some kind of illicit drug. A rise from 35.9% in 2007 to 38.3% in 2010. Across all grade levels, alcohol was the most widely used psychoactive drug. In 2010 35.8% of 8th graders surveyed had used alcohol at least once in their lives, 29.3% had used it in the last year, 13.8% had used it in the last month and 0.5% used it daily. These were all drops from the previous three years (38.9% use in lifetime, 31.8% use in past year, 15.9% use in past month in and 0.6% daily use in 2007). Between 2007 and 2010 use among 10th graders also dropped. Use during lifetime dropped 3.5% from 61.7% to 58.2%. Use in the past year was 56.3% in 2007 and 52.1% in 2010 and use in the past month dropped from 33.4% to 28.9%, daily use also dropped from 1.4% to 1.1%. Among high school seniors we begin to see less dramatic decreases in

usage over the four years controlled for and much higher rates f overall use. 71.0% of twelfth graders have used alcohol in their lives, 65.2% have used in the year preceding the survey and 41.2% have used in the month prior, 2.7% report daily use of alcohol. In 2007 these rates were 72.2%, 66.4%, 44.4% and 3.1% respectively. The high rate of alcohol use among 17 year old indicates that the rise in alcohol use described by the SAMHSA survey many not be due to the legal age of drinking an may be attributed to other confounding factors, we will examine these later. Cannabis and cigarettes have the next highest rates among adolescents in this study. Only among 8th graders is tobacco used more frequently than cannabis or hashish. when looking at usage during lifetime. 20%, a 2% drop since 2007, of 8th graders have smoked cigarettes in their lives and 17.3% have used marijuana. In the past year however 13.7% of this demographic had used cannabis and in the past month the rate was 8.0%, 1.2% reported being daily users. Cigarette usage in the past year was not reported but in the past month was 7.1% (stagnant from 2007 rates). Slightly less than 1% of eighth graders reported smoking half a pack or more of cigarettes a day. Among 10th graders use of cannabis during individuals lives was common of 33.4% of those surveyed This is a rise from 2007 where use was common in 31.0%. Use in the past year for the 2010 survey was 27.5%, it was 24.6% in 2007. Daily use among 10th graders was 3.3% in 2010 and 2.8% in 2007. Cigarette use among 10th graders was 33.0% reporting they had smoked during their lives. Of those 13.6% had smoked in the past month and 2.4% reported to smoke half a pack or more daily. Rates of cigarette use decreased over the years, but not significantly. NIDA found that among 12th graders the use of cannabis in all fields has risen from 2007 to 2010 with daily use going from 21.9% in 2007 to 2 23.8% in 2010. 48.2% of 12th graders have used marijuana in their lives and 28.3 have used in the past month. Cigarette use has

dropped in that same time frame percent of 12th graders smoking a pack or more a day dropped 1% in those four years. similar decreases were found in overall lifetime use as well as use in the past month. This study goes through a wide variety of commonly used psychoactive substances. After marijuana and cigarettes, smokeless tobacco had the highest rates of use among all three grade levels. 9.9% of 8th graders had used smokeless tobacco in 2010, the rate was 16.8% among 10th graders and 17.6% among students in grade 12. Here the consistency ends. Among 8th graders inhalants were the next most commonly abused drugs. The rate of 8th graders in the 2010 report using inhalants in the past year was 8.1%. This 2% higher than the same statistic for 10th graders and 4% higher than the use of inhalants in the past month by 12th graders. This was the only drug to show a negative relationship between use and age. Hallucinogen use dropped from 2010 but again rates of use rose as did age of the users. MDMA or ecstasy use has risen since 2007 and shows the same positive relationship with age as the rest of the drugs. The rates of use of cocaine, crack, tranquilizers, and steroids all follows these same patterns as MDMA. LSD was isolated from hallucinogens in this study to show that its use is increasing over the years detailed in NIDAs report. Heroin use has increased modestly among 12th graders from 2007 to 2010 but has stagnated among other grade levels. Meth use also stagnated among 8th graders and dropped among 10th and 12th graders. These surveys indicates which the levels of involvement wit drugs used and compares their rates of use and popularity among youth culture. The SAMHSA Survey allows us to look at drug use in relation to race, age and gender and also allows us to examine the rates of binge drinking in relation to age. NIDAs report allows us to see which drugs are gaining or losing popularity in youth culture. There is no question that drug abuse poses many risks to individuals

in our country and especially our youth who have less experience and education about them. Neither study talks about the dangers of using these drugs, or how they are being used among teens (with the exception of binge drinking as stated above). These are important factors when trying to determine the risk factors that contemporary youth face today when exposed to these illicit and licit drugs. Saying simply that drug use among teens is bad and a cause for concern is not valid without supporting research, these reports offer none of this, simply positing that this years Monitoring the Future survey raises concerns about increases in drug use among our Nations teens, particularly the youngest. (p.1). In order to assess the actual risks of these drug use among teenagers we must look to other research that aims to understand teen behavior and why they are drawn to such behaviors that have such negative labels among our society. Prominent drug expert and physiologist Andrew Weil posits that the need to experience states of altered conscious is an innate human desire and that highs come from within us like other moods and are simply brought out by the drugs (1983; 2004). This is a very interesting and revolutionary view of drugs that is contrary to those held by many government officials and agencies as well as many drug researchers. Weil provides the use of inhalants by young children as evidence of this. He also states that children achieve these altered states by whirling in circles to create dizziness, excessive tickling, hyperventilating as well as constricting each others airways to produce a loss of consciousness. We can see from the NIDA survey that solvent use is more prevalent among 8th graders than 12th graders. Beauvais and Oetting (1984) posit that inhalants are generally the first drugs to be used by children because they are so available in a household environment. They can come in the form of model glues, industrial cleaners and solvents, and aerosol from spray cans. In their study they found that the results suggest that there may be significant inhalant experimentation

by children younger than 12. (pp. 32). Weil states that these children undertake these activities with no prior learning from parents, who actively discourage all of these behaviors. Weil states that children must get pleasurable results because they repeat these behaviors in spite of parental objections. As children age they find more direct routes to altering consciousness, these being drugs, legal and illegal. The High is what is drives most users to drugs, Highs are characterized by euphoria, lightness, self transcendence, concentration and energy (Weil, 1983, pp. 15), It is hard to argue that this state is an undesirable one. Weil states that because drugs offer such reliable and often fast acting routes to this sought-after state of mind, as their availability increases there is more of a chance of them being used as ways to attain these pleasurable feelings. This is supported by Beauvais and Oetting as well as by the NIDA and SAMHSA surveys. As we look at the results for both studies we can see that it is common that as age increases so does the use of almost all drugs. This is because as individuals age they have more access to illicit drugs on the black market and licit ones from friends and family members. A five year old may be reduced to sniffing paint thinner found in his dads workshop, but the older and more independent a youth get the more access he or she has to the black market. In no way, however, is the paper trying to diminish the risks that drugs posit to our youth as well as in general. The use of many drugs can have hazardous health consequences. Interestingly some of the legal drugs are actually the most dangerous. We will start with alcohol. Alcohol is an ancient drug that has been around since fermented fruits. It is one of the most well researched because of its legality. According to a study done by Hastings (1990) alcohol is rated as more addictive than both heroin and cocaine. Weil as well as many other medical professionals posit that extended us of alcohol can cause irreversible organic damage to the human body especially in the liver. As we see from both NIDA and SAMHSA alcohol is the

most frequently used drug by persons of all ages. This is a cause for concern among many government and school officials as well as parents. Nicotine, which is the psychoactive chemical in tobacco is rated by Hastings as the most addictive substance over alcohol, crack and meth. Nicotine is also fatal in overdose though it takes a high concentration of nicotine to kill a person. There are illegal drugs that are much less harmful than both nicotine and alcohol as well. Weil (2004) purports that marijuana and LSD are the least toxic drugs known to modern medicine. (Pp. 40) he supports this by offering the therapeutic ratio, or in other words the dose of a drug that causes toxic symptoms versus the dose of a the drug that causes the desired effect, of marijuana and that of aspirin. The therapeutic ratio of aspirin is between 10 and 20 times the amount it would take to relieve a headache depending on characteristics of the individual. The therapeutic ratio for marijuana cannot be calculated; it seems to be in the order of thousands (pp. 40). The fact that aspirin is this dangerous in overdose and is readily available for purchase by anyone of any age, while marijuana is physiologically harmless as well as non-addictive shows that there are a lot of inconsistencies in drug laws today. In order to understand these drug laws and their effects on adolescents we must try to understand how they are made. Why is marijuana illegal when it has been shown to be harmless in a multitude of cases and cigarettes and alcohol are legal despite their well researched dangers? The topic of drug use is so steeped in politics and economics that it is hard to find unbiased research. Weil states that when examining research regarding drug use the authors and those who commissioned and funded the study must be examined and analyzed. Drug users have a motivation to justify their use and therefore have a stake in marginalizing the dangers of drug use while the government officials who are elected for anti-drug policies have a stake in overstating the dangers. The documentary Grass purports that marijuana was criminalized because of a

smear campaign run by a paper industry threatened by being replaced by hemp, a much easier and affordable way to make paper as well as a multitude of other products. If we look at the information released about marijuana in the early and mid 20th century we see that it is generally unbased and can be labeled propaganda, one remarkable example of this is the movie Reefer Madness released originally as Tell Your Kids in 1930. This film depicted unrealistic events that could happen to teens lured into trying marijuana. This film was also used by cannabis reform advocates in the 1970s. Pharmaceutical companies also have a stake in keeping some drugs illegal. Morphine is the psychoactive chemical in heroin. In Britain heroin is still used as an anesthetic and pain reliever for major surgery, In American Heroin is illegal for medical use and instead morphine is used. Marijuana has been shown to be an effective appetite stimulator as well as pain reliever and is often administered to cancer patients undergoing chemotherapy where it is legal to do so. These drugs do not suite the needs of pharmaceutical companies because they cannot patent them like they can other drugs. St. Johns wort had been shown to effectively treat depression significantly more than a placebo with much less side effects than SSRIs which are currently used. However, we never see commercials for st johns wort nor is it ever recommended by therapists or psychiatrists. Pharmaceutical companies cannot viably make money off these psychoactive and that is why they are not used commonly. Addiction is the biggest threat to teens, though marijuana is non addictive many researchers and officials alike argue that it leads to the use of harder more dangerous drugs. (Chambers, 1971). Researchers Single, Kandel, and Faust (1973) did a report on multiple drug use in high school students. In their findings they reported that because marijuana is by far the illicit drug most frequently used by students, it is the drug most frequently involved in patterns of drug use (pp. 348). They go on to say that if an adolescent has not used marijuana it is unlikely

that he or she has used any other illicit drugs. The authors also stress that comparative studies such as these do not prove that marijuana use leads to use of other drugs, that there are many factors that drive youth to drugs. They found that the use of any drug legal or illegal is positively correlated with the use of other drugs. This is especially true or alcohol, so it is interesting to note that there are no reports of alcohol being a gateway drug. The factors that effect teen drug use are many, and there is a lot of research detailing them. Adolescent substance abuse has been shown to increase when their guardians and role models are also substance abusers. This shows that environmental and genetic factors are also at hand. Another reason many teens use is because they form their identity around drug culture. Drug culture is a very broad topic and will not be completely covered by this paper, however we can apply contemporary deviance theory as well as symbolic interaction theory and psychotherapeutic concepts to drug adolescent drug use to explain its prevalence throughout the ages. Davis and Munoz (1968) purport that The act by a community of successfully labeling a particular practice deviant and/pr illegal almost invariably constrains the deviant to structure much of much his identity and activity in terms of such imputations of deviance and law breaking (p.157). This is very true of adolescents who according to Anna Freud (1953) purported that during adolescence there is a transition of cathexes from parents and ties to infancy to objects persons or things in the outside world. Many teens have this experience with drugs, which is supported more by the symbolic interaction theory, and that is relationships evolve because of meaningful experiences that individuals have with other people and things. It would be hard to argue that so purposefully breaking that law is not symbolic and that the deviant drug culture does not create these symbolic interactions between users often. Thus, many teens form identities around drug cultures and use alike. This is demonstrated in a study by Fletcher, Bonell and Rhodes who studied the counter-school cultures

formed by female students drug use in high schools. (2009) These researchers also found that many of these girls had histories of parents and family members with SUDs. It is clear that drug regulation in America is not working. Much of the research is how to eliminate it especially among adolescents. These students are taught abstinence is the only acceptable choice when it comes to drug use. This obviously is not working considering the we were facing the same problems in the seventies that we are in 2011. Social attitudes shape the way we think about drugs, this is demonstrated by the use of drugs in many other cultures without problems. What is lacking is adequate information about how to form good relationships with drugs. Many people get into bad relationship with drugs early because they are not aware of the dangers. For example, Weil states that heroin when administered orally is relatively nonaddictive but when administered intravenously is much more addictive. This is true of almost all drugs, the quicker they enter the blood stream the more addictive they are. Also much of the research done one teen users use samples referred by courts and juvenile detention centers, This is true of adults as well. This is an unsound methodology because these users have already gotten themselves into trouble with substances and therefore paint a picture that there is no such thing as responsible drug use. This is supported by Charles Winicks (1991) study of nonharmful drug use and its relation to social behavior and public policy. It is evident that more research needs to be conducted on users and policy needs to serve less interest groups and focus more on helping people learn how to use responsibly. As a society we must accept drug use a s truth and instead of waging war on it find out how to coexist with it in a responsible and safe manner.

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