Teens who've tried marijuana have used it in more than one form

Smoking tops adolescent pot preference but edibles and vaping entice, too

September 28, 2018

Science Daily/University of Southern California

Most teens who've tried marijuana have used the drug in more than one form, including cannabis products that are smoked, eaten or vaped, new USC research shows.

The study, published Friday in JAMA Network Open, raises concerns about adolescent health amid a booming cannabis market that touts sleekly packaged products claiming an array of health benefits.

"Cannabis use in adolescence increases risk for chronic use throughout adulthood, addiction and impaired cognitive development," said the study's senior author, Adam Leventhal, professor of preventive medicine and psychology and director of the USC Health, Emotion and Addiction Laboratory at the Keck School of Medicine of USC.

"In recent years, there's been a shift in teens' perception. Legalization and commercialization of cannabis are fostering the perception that this drug is not harmful," Leventhal said. "On my drive to work, I pass an advertising billboard for marijuana delivery right to your house. Marijuana has gone mainstream."

In a survey of 3,177 10th-graders from the Los Angeles area, Leventhal and his colleagues collected data via questionnaires at 10 Los Angeles area high schools from January to October 2015 -- three years before California's 2018 legalization of recreational marijuana.

Tenth-graders were asked, "Have you ever used the following substances in your life?" Combustible cannabis was worded as "smoking marijuana" (or weed, hash, reefer or bud); vaping was worded as liquid pot, dabbing or weed pen; edible marijuana included drinks infused with THC (the psychoactive compound in cannabis), brownies, butter and oil.

Of the 33.9 percent of students who reported ever using cannabis, smoking it was the most popular, followed by cannabis products that were edible or vaporized. Most 10th-graders (61.7 percent) who had ever used cannabis used multiple products to administer the drug.

Notably, 7.8 percent of cannabis "ever users" had never smoked pot, but instead ingested cannabis via edibles or vaping.

"A key question is whether a new pool of teens who've traditionally been at lower risk for smoking marijuana have been drawn to using the drug in these alternative non-smoked forms," said Leventhal, the study's corresponding author. In other words, cannabis products such as bubblegum-flavored vaping liquid may appeal to teen users who would otherwise be turned off by the smell or harsh sensation of marijuana smoke.

This study, supported by a grant from the National Institutes of Health (R01-DA033296), is part of an ongoing project looking at patterns of substance use and mental health over time.

Leventhal's previous survey studies have found digital media use is linked to behavioral and attention problems in kids, and that higher concentrations of nicotine in vaping liquid used by teens is associated with traditional cigarette use.

The study authors include Leventhal, Jessica L. Barrington-Trimis of USC's Department of Preventive Medicine; Erica N. Peters of the Battelle Public Health Center for Tobacco Research, Battelle Memorial Institute, Baltimore; Dayoung Bae of the Center for Family Research, University of Georgia, Athens; and Prantley P. Jarvis of NorthTide Group, LLC, Edgewood, Md.

https://www.sciencedaily.com/releases/2018/09/180928112949.htm

Teen use of any illicit drug other than marijuana at new low, same true for alcohol

December 13, 2016

Science Daily/University of Michigan

Teenagers' use of drugs, alcohol and tobacco declined significantly in 2016 at rates that are at their lowest since the 1990s, a new national study showed.

But University of Michigan researchers cautioned that while these developments are "trending in the right direction," marijuana use still remains high for 12th-graders.

The results derive from the annual Monitoring the Future study, now in its 42nd year. About 45,000 students in some 380 public and private secondary schools have been surveyed each year in this national study, designed and conducted by research scientists at U-M's Institute for Social Research and funded by the National Institute on Drug Abuse. Students in grades 8, 10 and 12 are surveyed.

Overall, the proportion of secondary school students in the country who used any illicit drug in the prior year fell significantly between 2015 and 2016. The decline in narcotic drugs is of particular importance, the researchers say. This year's improvements were particularly concentrated among 8th- and 10th-graders.

Considerably fewer teens reported using any illicit drug other than marijuana in the prior 12 months -- 5 percent, 10 percent and 14 percent in grades 8, 10 and 12, respectively -- than at any time since 1991. These rates reflect a decline of about one percentage point in each grade in 2016, but a much larger decline over the longer term.

In fact, the overall percentage of teens using any of the illicit drugs other than marijuana has been in a gradual, long-term decline since the last half of the 1990s, when their peak rates reached 13 percent, 18 percent and 21 percent, respectively.

Marijuana, the most widely used of the illicit drugs, dropped sharply in 2016 in use among 8th-graders to 9.4 percent, or about one in every 11 indicating any use in the prior 12 months. Use also declined among 10th-graders as well, though not by a statistically significant amount, to 24 percent or about one in every four 10th-graders.

The annual prevalence of marijuana use (referring to the percentage using any marijuana in the prior 12 months) has been declining gradually among 8th-graders since 2010, and more sharply among 10th-graders since 2013. Among 12th-graders, however, the prevalence of marijuana use is higher (36 percent) and has held steady since 2011. These periods of declining use (or in the case of 12th-graders, stabilization) followed several years of increasing use by each of these age groups.

Daily or near-daily use of marijuana -- defined as use on 20 or more occasions in the previous 30 days -- also declined this year among the younger teens (significantly so in 8th grade to 0.7 percent and to 2.5 percent among 10th-graders). However, there was no change among 12th-graders in daily use, which remains quite high at 6 percent or roughly one in every 17 12th-graders -- about where it has been since 2010.

Prescription amphetamines and other stimulants used without medical direction have constituted the second-most widely used class of illicit drugs used by teens. Their use has fallen considerably, however. In 2016, 3.5 percent, 6.1 percent and 6.7 percent of 8th-, 10th- and 12th-graders, respectively, say they have used any in the prior 12 months -- down from recent peak levels of 9 percent, 12 percent and 11 percent, respectively, reached during the last half of the 1990s.

Prescription narcotic drugs have presented a serious problem for the country in recent years, with increasing numbers of overdose deaths and emergencies resulting from their use. Fortunately, the use of these drugs outside of medical supervision has been in decline, at least among high school seniors -- the only ones for whom narcotics use is reported. In 2004, a high proportion of 12th-graders -- 9.5 percent, or nearly one in 10 -- indicated using a prescription narcotic in the prior 12 months, but today that percentage is down by half to 4.8 percent.

"That's still a lot of young people using these dangerous drugs without medical supervision, but the trending is in the right direction," said Lloyd Johnston, the study's principal investigator. "Fewer are risking overdosing as teenagers, and hopefully more will remain abstainers as they pass into their twenties, thereby reducing the number who become casualties in those high-risk years."

Users of narcotic drugs without medical supervision were asked where they get the drugs they use. About four in every 10 of the past-year users indicated that they got them "from a prescription I had."

"That suggests that physicians and dentists may want to consider reducing the number of doses they routinely prescribe when giving these drugs to their patients, and in particular to teenagers," Johnston said.

Heroin is another narcotic drug of obvious importance. There is no evidence in the study that the use of heroin has risen as the use of prescription narcotics has fallen -- at least not in this population of adolescents still in school, who represent over 90 percent of their respective age groups.

In fact, heroin use among secondary school students also has declined substantially since recent peak levels reached in the late 1990s. Among 8th-graders, the annual prevalence of heroin use declined from 1.6 percent in 1996 to 0.3 percent in 2016. And among 12th-graders, the decline was from 1.5 percent in 2000 to 0.3 percent in 2016.

"So, among secondary school students, at least, there is no evidence of heroin coming to substitute for prescription narcotic drugs -- a dynamic that apparently has occurred in other populations," Johnston said. "Certainly there will be individual cases where that happens, but overall the use of heroin and prescription narcotics both have declined appreciably and largely in parallel among secondary school students."

The ecstasy epidemic, which peaked at about 2001, was a substantial one for teens and young adults, Johnston said. Ecstasy is a form of MDMA (methylenedioxy-methamphetamine) as is the much newer form on the scene, "Molly."

"The use of MDMA has generally been declining among teens since about 2010 or 2011, and it continued to decrease significantly in 2016 in all three grades even with the inclusion of Molly in the question in more recent years," Johnston said.

MDMA's annual prevalence now stands at about 1 percent, 2 percent and 3 percent in grades 8, 10 and 12, respectively.

Synthetic marijuana (often sold over the counter as "K-2" or "Spice") continued its rapid decline in use among teens since its use was first measured in 2011. Among 12th-graders, for example, annual prevalence has fallen by more than two-thirds, from 11.4 percent in 2011 to 3.5 percent in 2016. Twelfth-graders have been showing an increased appreciation of the dangers associated with these drugs. It also seems likely that fewer students have access to these synthetic drugs, as many states and communities have outlawed their sale by retail outlets.

Bath salts constitute another class of synthetic drugs sold over the counter. Their annual prevalence has remained quite low -- at 1.3 percent or less in all grades -- since they were first included in the study in 2012. One of the very few statistically significant increases in use of a drug this year was for 8th-graders' use of bath salts (which are synthetic stimulants), but their annual prevalence is still only 0.9 percent with no evidence of a progressive increase.

A number of other illicit drugs have shown declining use, as well. Among them are cocaine, crack, sedatives and inhalants (the declining prevalence rates for these drugs may be seen in the tables and figures associated with this release.)

Alcohol

The use of alcohol by adolescents is even more prevalent than the use of marijuana, but it, too, is trending downward in 2016, continuing a longer-term decline. For all three grades, both annual and monthly prevalence of alcohol use are at historic lows over the life of the study. Both measures continued to decline in all three grades in 2016.

Of even greater importance, measures of heavy alcohol use are also down considerably, including self-reports of having been drunk in the previous 30 days and of binge drinking in the prior two weeks (defined as having five or more drinks in a row on at least one occasion).

Binge drinking has fallen by half or more at each grade level since peak rates were reached at the end of the 1990s. Today, the proportions who binge drink are 3 percent, 10 percent and 16 percent in grades 8, 10 and 12, respectively.

"Since 2005, 12th-graders have also been asked about what we call 'extreme binge drinking,' defined as having 10 or more drinks in a row or even 15 or more, on at least one occasion in the prior two weeks," Johnston said. "Fortunately, the prevalence of this particularly dangerous behavior has been declining as well."

In 2016, 4.4 percent of 12th-graders reported drinking at the level of 10 or more drinks in a row, down by about two-thirds from 13 percent in 2006.

Rates of daily drinking among teens has also fallen considerably over the same intervals. Flavored alcoholic beverages and alcoholic beverages containing caffeine have both declined appreciably in use since each was first measured -- again, particularly among the younger teens, where significant declines in annual prevalence continued into 2016.

Tobacco

Declines in cigarette smoking and certain other forms of tobacco use also occurred among teens in 2016, continuing an important and now long-term trend in the use of cigarettes.

https://www.sciencedaily.com/releases/2016/12/161213074519.htm

Drug use trends remain stable or decline among teens

2015 survey shows long term decline in illicit drug use, prescription opioid abuse, cigarette and alcohol use among the nation's youth

December 16, 2015

Science Daily/NIH/National Institute on Drug Abuse

The 2015 Monitoring the Future survey (MTF) shows decreasing use of a number of substances, including cigarettes, alcohol, prescription opioid pain relievers, and synthetic cannabinoids ("synthetic marijuana"). Other drug use remains stable, including marijuana, with continued high rates of daily use reported among 12th graders, and ongoing declines in perception of its harms.

The MTF survey measures drug use and attitudes among eighth, 10th, and 12th graders, and is funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. The survey has been conducted by researchers at the University of Michigan at Ann Arbor since 1975.

For the first time, daily marijuana use exceeds daily tobacco cigarette use among 12th graders. Daily marijuana use for this group remained relatively stable at 6 percent, compared to 5.5 percent reporting daily cigarette smoking (down from 6.7 percent in 2014).

"We are heartened to see that most illicit drug use is not increasing, non-medical use of prescription opioids is decreasing, and there is improvement in alcohol and cigarette use rates," said Nora D. Volkow, M.D., director of NIDA. "However, continued areas of concern are the high rate of daily marijuana smoking seen among high school students, because of marijuana's potential deleterious effects on the developing brains of teenagers, and the high rates of overall tobacco products and nicotine containing e-cigarettes usage."

"This year's Monitoring the Future data continue the promising trends from last year with declining rates of adolescent substance use, and support the value of evidence-based prevention, treatment, and recovery," said National Drug Control Policy Director Michael Botticelli. "Efforts to prevent drug use from ever starting are particularly important as we work to reduce the rising number of drug overdoses across the country. I encourage parents, teachers, coaches, and mentors to have a conversation with the young people in their lives about making the healthy decisions that will keep them on a path toward a successful future."

"We are very encouraged by the continued decline in underage drinking illustrated in these data," said George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism. "However, the percent of underage individuals drinking still remains unacceptably high. For example, approximately 40 percent of 12th graders have reported being drunk in the past year and binge drinking remains a significant problem."

Other highlights from the 2015 survey:

Drugs

·     Use of many illicit drugs has trended down. Among high school seniors, 23.6 percent report using an illicit drug in the past month, with 7.6 percent reporting they used an illicit drug other than marijuana.

·     Perception of marijuana use as risky continues to decline, with 31.9 percent of seniors saying regular use could be harmful, compared to 36.1 percent last year.

·     Past year use of synthetic cannabinoids ("synthetic marijuana") is at 5.2 percent for 12th graders, down significantly from 11.4 in 2011, the first year it was measured in the survey.

·     Past year use of heroin, typically very low among teens, is at an all-time low at 0.3 percent for eighth graders, and 0.5 for 10th and 12th graders.

·     Use of MDMA (also known as Ecstasy or Molly), inhalants, and LSD are generally stable or down. In 2015, 3.6 percent of seniors reported past year use of MDMA, compared to 5 percent in 2014.

·     Non-medical use of the prescription amphetamine Adderall, typically given for ADHD, remains high at 7.5 percent among 12th graders.

·     Use of prescription opioids continues its downward trend, with 4.4 percent of high school seniors reporting non-medical use of Vicodin (hydrocodone and acetaminophen), down from a peak of 10.5 percent in 2003.

·     Most teens abusing prescription opioids report getting them from friends or family members. However, one-third report getting them from their own prescriptions, underscoring the need to monitor teens taking opioids and evaluate prescribing practices.

Tobacco

·     Cigarette smoking rates have greatly declined among teens in recent years. For example, among 10th graders, there has been a 54.9 percent drop in daily smoking in just five years, reported at just 3 percent this year compared to 6.6 percent five years ago.

·     However, rates of use of other tobacco products, while not significantly changed from 2014, remain high with 12th graders, reporting rates of past year use of hookah and small cigars of 19.8 percent and 15.9 percent, respectively.

·     More than 75 percent of high school seniors view smoking a pack or more a day as harmful, compared to 51.3 percent in 1975, first year of the survey.

·     As e-cigarettes are currently unregulated, there is limited data on what chemicals teens are actually smoking. However, when asked what they inhaled the last time they used an e-cigarette, only about 20 percent said they were using nicotine. Most say they inhaled flavoring alone and many admitted they were unsure what they inhaled. In fact, about 13 percent of eighth graders who use e-cigarettes said they did not know what was in the device they used. Furthermore, some products labeled nicotine-free may actually contain nicotine.

·     Roughly twice as many boys as girls report using e-cigarettes (21.5 percent to 10.9 percent).

Alcohol

·     Alcohol use continues its gradual downward trend among teens, with significant changes seen in the past five years in nearly all measures.

·     Binge drinking (described as having five or more drinks in a row within the past two weeks) is 17.2 percent among seniors, down from 19.4 percent last year and down from peak rates in 1998 at 31.5 percent.

·     37.7 percent of 12th graders say they have been drunk in the past year, compared to 41.4 percent in 2014 and 53.2 percent in 2001, when rates were highest for that group.

·     High school seniors see a distinction in potential harmfulness between one or two drinks nearly every day (21.5 percent) versus four to five drinks nearly every day (59.1 percent).

Overall, 44,892 students from 382 public and private schools participated in this year's MTF survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th graders nationwide. Eighth and 10th graders were added to the survey in 1991. Survey participants generally report their drug use behaviors across three time periods: lifetime, past year, and past month. Questions are also asked about daily cigarette and marijuana use. NIDA has provided funding for the survey since its inception by a team of investigators at the University of Michigan at Ann Arbor, led by Drs. Lloyd Johnston and Richard Miech. MTF is funded under grant number DA001411. Additional information on the MTF Survey, as well as comments from Dr. Volkow, can be found at http://www.drugabuse.gov/drugpages/MTF.html.

https://www.sciencedaily.com/releases/2015/12/151216115801.htm