Youth Drug Use Trends Provide Insights for Prevention Efforts, but State Data Collection Faces Barriers

By: Adam White, Graduate Assistant

The collection of meaningful and accurate data on substance use trends among adolescents is critical to the efforts of policymakers and community leaders in order to strengthen prevention programming. In its March 16 meeting, the Ohio Joint Study Committee on Drug Use Prevention Education reviewed adolescent substance use trends at the national level before discussing how this data is collected in Ohio.

.@adamwhite720 takes a closer look at drug use trends in young people & the barriers #Ohio has collecting this data Click To Tweet

The committee first heard from Dr. Richard Meich, who is the principal investigator of the Monitoring the Future  study at the University of Michigan. Monitoring the Future is an ongoing study of the behaviors, attitudes and values of 8th, 10th and 12th graders across the country that has recently published an extensive report detailing trends in drug use among these age groups. This nationally representative sample of more than 40,000 youth indicates that use of alcohol, tobacco and illicit drugs other than marijuana have all steadily decreased among adolescents since the late 1990s. Marijuana use, meanwhile, has remained steady over the past two decades.

Marijuana use, meanwhile, has remained steady over the past two decades.

Dr. Meich noted that the prevailing theory about youth substance use, particularly in regards to marijuana, is that there is an inverse relationship between the perceived risk associated with a drug and the use of that drug. This relationship proved true in the 1970s and 80s, with marijuana use rising as the percentage of youth reporting they perceive “great risk” in using the drug was falling. This trend continued up until 1979, when the perceived risk of marijuana among youth increased sharply over the following decade, corresponding with an equally sharp decline in the drug’s usage.

But this pattern has not held true in the 21st century. With the continued push toward legalization of medical and recreational marijuana over the past decade, the perceived risk that youth associate with the drug has fallen to the lowest levels ever recorded since the study began in 1975. In 2017, less than 30 percent of 12th graders reported seeing “great risk” in using marijuana regularly. Based on the inverse risk-use relationship of decades past, one would expect youth marijuana use to have reached all-time highs in recent years. In reality, marijuana use among 12th graders has remained virtually constant since 1995, and has declined among 10th and 8th graders.

The perceived risk that youth associate with [marijuana] has fallen to the lowest levels ever recorded since the study began in 1975.

Interestingly, the Monitoring the Future data shows that marijuana use is actually increasing among adolescents who are also users of tobacco and alcohol. But, since overall tobacco and alcohol use have both seen steady declines among youth in recent decades, no increase in marijuana use is observed in the youth population as a whole. Dr. Meich proposes that these trends provide a strong indication that the effects of tobacco cessation efforts have extended beyond just cigarettes and other tobacco products, to discourage the use of other drugs among adolescents.

Where the successes of tobacco cessation efforts become complicated is with the rise in e-cigarette use, or “vaping” among young people. According to Dr. Meich, the practice of vaping is too new to draw conclusions about its health consequences, but his data shows conclusive evidence that youth who have never smoked are five times more likely to begin smoking cigarettes if they used vaping products within the previous year. Teen vaping use has increased substantially in recent years, more than tripling between 2013 and 2014 alone.

Although Monitoring the Future samples students from all 50 states, the data is only generalizable to the U.S. as a whole, meaning the samples from Ohio cannot be used to draw conclusions about drug use trends at the state level. Ohio’s primary tool for gathering state level data on adolescent drug use is the Center for Disease Control’s (CDC) Youth Risk Behavior Survey (YRBS), which is conducted every other year by the Ohio Department of Health (ODH). However, ODH was unable to release YRBS data in both 2015 and 2017 due to poor response rates from schools in certain parts of the state. ODH’s Sara Haig explained to the committee that the timing of the survey, the sensitive subject matter and survey fatigue are all reasons that school district administrators may decline to participate. Due to the CDC’s rigid survey administration protocol, ODH has little flexibility to adjust the timing or content of the survey to improve response rates. Currently the most recent year for which Ohio YRBS data is available is 2013 and there is no certainty whether new data will be published after the survey is conducted again in 2019. This absence of reliable and timely data on adolescent drug use, may make it difficult to evaluate school-based prevention programs.

In discussion of whether the committee should be taking an active role in improving YRBS participation, committee members suggested that greater coordination across school districts, county and state agencies is needed to reduce the fatigue that is created by surveys being administered at multiple levels.

As the committee works toward releasing a companion piece to the recommendations it issued last year, it will be convening small working groups in the coming months with the goal of producing prevention materials for schools to use in the coming school year.