Results from 2010 Dayton Area Drug Survey suggest long-running decline in substance abuse among teens is reversing

Results from the 2010 Dayton Area Drug Survey (DADS) suggest the long-running trend of declining drug use by teens may be ending. For example, the percentage of 12th grade students reporting ever having been drunk increased from 54.3 percent in 2008 to 55.2 percent in 2010, with similar sized increases occurring for 7th and 9th graders as well. For the first time in many years, the percentage of teens reporting experience with cigarettes and smokeless tobacco increased. Marijuana initiation also increased over 2008 levels. And while the increases were generally small, they may be a harbinger of an upward swing in youthful drug use. The 2010 results were presaged by the mixed news from the 2008 DADS where it appeared the decline in the initiation of use had stalled with high school seniors. Notably, there are epidemiological indicators from several recent national surveys that also suggest the decline has leveled out and may be tilting upwards, at least for some drugs. Consequently, what is happening here in the Dayton area may be part of a national trend.

DADS is a biennial, cross-sectional study that provides estimates of teen drug use in the Miami Valley. First administered in 1990, DADS is a collaborative effort between the Center for Interventions, Treatment, and Addictions Research at Wright State University's Boonshoft School of Medicine and area school districts, who participate in the survey at no charge. Districts choose which grades between 7 and 12 they want to survey. Students respond anonymously and on a voluntary basis, following a protocol approved by the Wright State University Institutional Review Board. In the spring 2010, 16,307 students from 15 Miami Valley area school districts provided usable data. The majority of the sample was white (about 82 percent), suburban and nearly evenly split between boys and girls.

Alcohol remains the most widely used drug. Among 12th graders (n = 3049), 71.8 percent reported drinking alcohol at least once in their lifetimes. Among the 55.2 percent who reported drinking to drunkenness at least once, 44.7 percent said they had done so 10 or more times. In the two weeks before the survey, 26.7 percent of the respondents reported having had five or more drinks in a row on at least one occasion. Among 9th graders (n = 3753), 45.4 percent reported lifetime experience with alcohol, 25.7 percent reported having been drunk at least once, and 19.7 percent of these reported doing so 10 or more times. Having five or more drinks in a row in the two weeks before the survey was reported by 9.1 percent. The corresponding percentages for 7th graders (n=2949) are 22.3 percent, 7.0 percent, 8.2 percent, and 2.4 percent, respectively. (Data for 8th (n = 2133), 10th (n = 2257), and 11th (n = 2166) graders are not reported in this summary but fit well within the data reported by 7th, 9th, and 12th graders.)

DADS data on alcohol use reflect the scope of the substance abuse problem among young people in grades 7-12. As we have repeatedly noted in previous reports, alcoholic beverages are widely advertised and used in our society. Consequently, attitudes toward the use of alcohol are more tolerant than they are toward the use of other drugs. Research on alcohol and brain development in adolescents suggests that alcohol use, heavy use in particular, is fraught with long term, adverse consequences. Research also suggests that young people who get involved with alcohol while they are young teens have a much higher likelihood of becoming alcoholics than those who postpone drinking until they are older. A multi-faceted, preventive approach, such as the one that has been effective with tobacco, has not been applied to alcohol, particularly in regard to advertising. Imposing restrictions on alcohol advertising as part of a comprehensive effort to change teens' attitudes toward alcohol as well as their drinking practices should be seriously considered.

DADS data show 41.6 percent of high school seniors reported any cigarette use, up from 39.8 percent in 2008. Similar increases also occurred among 9th and 7th grade students. This is another signal that the decline seems to have stalled. It is noteworthy that Ohio now ranks 45th among states in funding tobacco prevention efforts, down from 2007 when it ranked 13th.

Teenagers' use alcohol and tobacco is significant for at least two reasons. First, it is well-known that the abuse of these drugs alone can result in a variety of untoward health and social consequences, some of which can last a lifetime. Secondly, tobacco and alcohol are "gateway drugs," drugs whose use often presages the abuse of other drugs. Consequently, people concerned about preventing teen drug abuse need to pay careful attention to teens' involvement with alcohol and tobacco.

The percentage of 12th grade students who reported having used marijuana (or hashish) at least once increased significantly, from 39.4 percent in 2008 to 44.1 in 2010. The percentage of teens reporting daily marijuana use, defined in DADS as having used the drug 20 or more times in the 30 days before the study, also increased, from 4.7 percent in 2008 to 6.3 percent in 2010. Lifetime marijuana use was reported by 22.0 percent of 9th graders, with 2.3 percent reporting daily use. Nearly 5 percent of 7th graders reported having used marijuana at least once.

Among 12th graders, increases occurred in the lifetime use of non-prescribed prescription drugs including depressants, such as the benzodiazepines, opioids like hydrocodone and oxycodone, amphetamine and methylphenidate as well as non-prescription drugs like cocaine HCl, hallucinogens, and inhalants. The use of dextromethorphan, a common ingredient in over-the-counter cough and cold preparations, increased from 3.8 percent in 2008 to 6.2 percent in 2010. The reported use of crack cocaine and steroids decreased as did the use of over-the-counter diet and stay-awake pills. The percentages of 12th graders reporting the lifetime use of ecstasy and methamphetamine were unchanged from 2008.

If there is any good news in the 2010 DADS findings, it is that the percentage of young people who use drugs other than alcohol, tobacco, and marijuana heavily is very small, much less than 1 percent of the sample in any given grade.

High school seniors were queried about drug use and motor vehicle behavior. When asked if they had ridden in a motor vehicle when they believed the driver was under the influence of alcohol or other non-medical drugs (other than caffeine or tobacco), 45.7 percent said they had, essentially the same as in 2008. Among these, 60.6 percent reported that they had done so more than once or twice. When asked if they had driven a motor vehicle while under the influence, 27.8 percent reported they had. Among these, 57.1 percent reported they had done so more than once or twice.

By the time 12th graders in the 2010 DADS sample neared the end of their high school careers, 49.2 percent reported having used an illicit drug at least once in their lifetimes, while 29.3 percent reported having used an illicit drug other than marijuana at least once. In contrast, 21.8 percent of high school seniors reported they had never having used alcohol, tobacco, or any illicit drugs. Essentially equal proportions of girls and boys were abstemious.

The 2010 DADS incorporated CRAFFT, a 6-item screening test for clinically-defined problematic drug use, developed by John Knight and his colleagues at Harvard Medical School. Data from 12th grade students responding to CRAFFT suggests that 17.5 percent of them have had or currently have substance use practices indicative of drug dependence.

DADS covered non-drug issues, too. Results show:

  • 26.1 percent of 7th graders, 21.8 percent of 9th graders, and 13 percent of 12th graders felt bullied by other teens in the 30 days before the survey;
  • 13.4 percent of 7th graders, 11 percent of 9th graders, and 7.8 percent of 12th graders got into a physical fight with someone in the 30 days before the survey;
  • 3.5 percent of 7th graders, 6.3 percent of 9th graders, and 12.4 percent of 12th graders missed school without the permission of a parent or guardian in the 30 days before the survey;
  • 54.5 percent of 12th graders were employed outside of the home or school; and
  • About 84 percent of 7th graders, 86 percent of 9th graders and 89 percent of 12th graders considered themselves to be happy or very happy with their lives, while the remainder considered themselves to be unhappy or very unhappy.

It is important to note that DADS was administered in late winter/early spring of 2010, so the percentages may have changed by the actual end of the school year in June. It is also important to note that the schools and classes participating in DADS are not randomly selected, nor could they have been given what DADS is - a community service designed to give school districts what they want, a series of snapshots over time to help them understand the drug use practices of the young people who attend their schools. Therefore, the results of DADS are limited to those districts which actually participated in the study. Another limitation of DADS is that it does not assess some of the more esoteric drug use practices such as those involving synthetic compounds that mimic cannabinoids or naturally occurring plants like salvia and jimsonweed, to name but a few.

Overall, DADS results suggest the need for ongoing, intensive drug abuse prevention programs in the schools that extend beyond the 9th grade, when such efforts currently often end. The rationale for such an extension is based on the fact that school is the place where large numbers young people congregate and the strong evidence that initiation of drug use continues throughout adolescence. For example, DADS data suggest that the percentage of teenagers who will get drunk for the first time will double between the 9th and 12th grades. Marijuana use will also come close to doubling. Implementing and sustaining evidence-based, public health-oriented school and community prevention programs can help reduce the rate of erosion of abstinence as well as decrease drug-related problems among teens.