The uncomfortable truths behind the latest numbers on teen drug use

Up, as in smoke.
Up, as in smoke.
Image: Reuters/Jose Luis Gonzalez
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The National Institute on Drug Abuse has released its annual findings about US teenagers and substance abuse. The big news is that opioid misuse by teens is at historic lows (clearly a good thing). The late-to-the-party news is that young people really like vaping.

This year’s survey also saw the lowest percentage of teen cigarette smokers in 43 years. Unfortunately, they are still smoking a lot of pot.

Nora Volkow, director of NIDA—which is part of the National Institutes of Health—says officials are concerned about vaping because some teens who use electronic cigarettes are also first-time nicotine users. That could lead to tobacco smoking later in life. “It is critical that we intervene with evidence-based efforts to prevent youth from using these products,” she told reporters Dec. 14.

That nicotine set off alarm bells for the NIDA is emblematic of the agency’s approach to messaging around teen drug use overall. It is highlighting findings that were relevant in mid-century America while sidestepping some of the more disquieting facts in the 2017 report. To be sure, studies have shown that addiction to cigarettes correlates highly to other addictions later in life. But teenagers in 2017 are more likely to be reaching for the phones in their pockets, than a package of smokes.

The NIDA plans to start inquiring about how social media might interplay with drug use this year. They are speculating that because kids are spending less face-to-face time with one another, they may be under less peer pressure. “As more kids have less interactions because of social media they may be using less drugs,” Volkow said.  (One hopes that the NIDA folks will begin by reading the literature on cyber bullying.)

Here is a look at the 2017 findings:

An uptick in marijuana use

As teens continue to light up, it is possible that some are skipping nicotine in favor of marijuana. The numbers show that pot smoking is going up. (Marijuana use in adults is up significantly as well.)

What is causing this? Richard Miech, a senior investigator on the Monitoring the Future survey— which is funded by the NIDA and conducted by the University of Michigan—told Quartz that he could not make a direct connection between the legalization of pot in many US states and the growth in teen use. He said, however, that teens get signals even if they live in states where smoking is not legal. More and more kids are able to see people getting high, and the results should raise eyebrows. “It seems like we’re primed to see more marijuana use in the future,” he says.

The popularity of vaping is increasing

Nearly 1 in 3 students in 12th grade report using of some kind of vaping device over the course of one year, and that has the NIDA and Meich concerned.

Despite the fact that e-cigarettes have been on the market since 2006, the researchers are just beginning to ask in-depth questions about them. Last year, teenagers were asked about “any vaping.” This year, they are asking specifically what they were vaping: nicotine, marijuana, or just flavoring.

Miech says more questions weren’t asked sooner because vaping is a fast-moving field, the prevalence was very low, and e-cigarettes originally were sold as a way to wean-off cigarettes, so it wasn’t immediately obvious that teens would be smoking anything other than nicotine.

Among the questions kids were asked in 2015 was whether one of the important reasons they were vaping was to help them quit smoking—9.6% said yes, compared to 53.6% who said they vaped to experiment or just to see what it was like.

Similarly, the study asks about cigars or cigarillos, but researchers again assume that they are being used for the nicotine itself and not as marijuana-delivery vehicles–as blunts, packed with weed.

The good news on heroin

The survey does get into specifics as to how kids are taking heroin, either with or without a needle. The hopeful takeaway here, is that while the US heroin crisis is ravaging adult addicts, the vast majority of teenagers say they are not using.

Unfortunately, if you look at the chart of 12th graders above, the percentage of teens using the hallucinogen LSD is now higher among 16-year-olds than those using the amphetamine ecstasy, also known as molly or, more formally, MDMA (methylenedioxymethamphetamine.)

The world of “study drugs”

In terms of “study drugs”—prescription pills for ADHD misused to boost concentration —the data show that as kid age Adderall becomes the drug of choice over Ritalin. 

The numbers on synthetic weed

On the positive side, use of the worrisome and deadly synthetic marijuana K2, or spice, is on the wane.

Inhalant use is increasing

One uptick, however, that concerns Meich is the rise in the use of inhalants among 8th graders even as the numbers drop for those in older grades. Inhalants are more popular with the younger set because they tend to experiment with products that are easier to obtain, like nitrous-oxide canisters for whipped-cream dispensers available at grocery stores.

Overall, the survey itself is limited by what can reasonably be answered by young people who step out of health or gym class for 45 minutes in the middle of a school day.  To narrow down which drugs are surveyed, a team of investigators meets annually to review findings from the field, changes in prevalence and recommendations from colleagues. That process, according to Miech, is more art than science.

There is no way to know, for instance, when a drug is new to the scene if it’s a passing fad or the start of a trend. For instance, hookah smoking peaked in 2014 around 20%, and it’s now down to roughly 10%, according to Lloyd Johnston, one of the investigators who designed the original Monitoring the Future study.

Miech’s job is to stay ahead of teenagers. Unfortunately, that’s an impossible task—all the data really show is what has happened in the past.