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Patterns of Substance Use Among U.S. Teens

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According to several national studies, most U.S. adolescents will engage in some form of substance use by the time they graduate from high school. However, more research is needed to identify patterns of substance use and abuse. 

Scientists in the Health Behavior Branch (HBB) of the NICHD Division of Intramural Population Health Research used the NEXT study, a nationally representative sample of more than 2,500 U.S. adolescents in the 10th grade to assess patterns of substance use.  About 29% of these adolescents reported using any illicit drugs in the past year. Within the past year, 26% used marijuana, 9% misused prescription medication, and 8% used other illicit drugs (e.g., ecstasy, amphetamine, cocaine, anabolic steroids, or glue/solvents). During the past month, 35% reported alcohol use, 27% binge drank, and 19% smoked cigarettes. 

Four groups of teens were identified from the data (PMID: 23465320). 

  • Nearly 60% of teens were classified in the “nonuser” group. These teens had very low probabilities of any substance use. 
  • About 23% of teens were considered predominantly alcohol users. These teens had high probability of drinking and moderately high probability of binge drinking, moderate probabilities of using marijuana and smoking cigarettes, and low probabilities of misusing medication and using other illicit drugs. 
  • About 10% of teens were considered predominantly marijuana users. These teens had high probabilities of using marijuana, low probabilities of using other substances, and had virtually no use of alcohol or binge drinking. 
  • The final group, comprising about 7% of teens, were classified as “polysubstance users.” Teens in this group had high probabilities for using each of the substances. The polysubstance group was the only group with high probability for misuse of prescription medication. Moreover, the polysubstance teens were much more likely to experience mental health issues. Teens in the polysubstance group reported higher levels of depressive symptoms and more headaches, stomachaches, and backaches, which often underlie depression. 
Last Reviewed: 05/01/2014
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