White Coat

Read this if you're worried about teens and drugs

Two studies published earlier this month show teen drug use is on the decline, but vaping is on the rise. @NightshiftMD unpacks the latest trends.

If you ask parents what keeps them up at night, many would say it's substance use among teens. Now, there's a bit of good news. Two surveys published last week — one in Canada and the other in the U.S. — show a trend that is mostly downward.  

The good news is that drug, alcohol and tobacco use among teens is at the lowest level since the late 1970's. That's according to an Ontario-wide survey of 11,435 students in grades seven through 12. The survey of high school students has been running since 1977. Substance use peaked 20 years ago, and has gone down substantially since then. The proportion of teens who have tried alcohol has dropped from 66 per cent down to 43 per cent. Drinking and driving has dropped to from 14 per cent down to 4.2 per cent. Cannabis use has dropped from 28 per cent to 19 per cent.  And the proportion of teens who smoke cigarettes has dropped from 28.4 per cent to just seven per cent.

The researchers from the Centre for Addiction and Mental Health who analyzed the survey data say these long-term declines point to the combined efforts of parents, educators, public health and the government to address substance use and the problems it creates. In particular, they believe that public health messaging about the harms caused by substance use are getting through to adolescents. Some of that messaging isn't restricted to young people. Recent campaigns directed at the general public to discourage smoking in public places as well as drinking and driving have likely had an impact on teens as well.  

The researchers have also noticed that the onset of substance use is being delayed to later grades. If the incidences shifts from teens to young adults, then it wouldn't be as big a victory as if overall rates go down in all age groups.

We've heard a lot lately about the opioid crisis. The survey indicates a mixed picture regarding opioid use among teens. The good news is that the survey found that recreational or non-medical use of prescription opioids dropped from 20.6 per cent in the previous survey to 10.6 per cent currently. 

However, the non-medical use of over the counter cough and cold remedies in adolescent boys has gone up from 6.7 per cent in 2015 to 11.2 per cent today; there was no similar uptick in girls. The recreational use of drugs for ADHD like methylphenidate is up from one per cent in the previous survey to 2.3 per cent today. 

The most worrisome development is that nearly one per cent of teens surveyed said they had taken fentanyl, the opioid drug that has become synonymous with opioid related overdoses. The percentage is low. However, given how lethal fentanyl can be, it's a concern, especially if the trend continues upward.

Like Canada, fewer teens in the U.S. are misusing opioid pain relievers than in prior years. Overall recreational use of opioids in the U.S. has gone down from 9.5 per cent to 4.2 per cent. That's according to a survey by the National Institute on Drug Abuse.  The reason may be reduced availability of opioids. The current survey south of the border also found that 35.8 per cent of grade 12 students said opioids were easily available. That's down from 54 per cent in 2010. The use of illicit drugs such as heroin, crystal methamphetamine and cocaine have dropped and remained low in recent years among teens in the U.S.   

The U.S. survey indicates two worrisome trends. The first is that the use of marijuana among U.S. teens is going up. That likely has to do with the fact that 29 states and the District of Columbia have laws broadly legalizing marijuana in some form. Among U.S. teens, daily marijuana use has become as popular as cigarette smoking, if not more so.

The other trend in the U.S. is the growing popularity of vaping among teens. One in three 12th graders vaped at least once in the past year. A third said they vaped nicotine, while one in 10 vaped marijuana.  Concerns have been raised in the U.S. and in Canada that vaping nicotine could lead to cigarette smoking. The proposed legalization of marijuana in Canada in 2018 could affect use patterns among teens in this country too.

I'll be keeping an eye on both developments in 2018.

Have a safe and watchful holiday.

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