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Substance use during adolescence can be a crucial indicator of behavioral health issues in adulthood. Data shows more than two million adolescents aged 12 to 17 report using drugs within the last month.
A new CDC study found that the most commonly reported reason for teens to use a substance is to relieve stress – and that half of teens report using substances alone, increasing the risk of fatal overdose.
Research shows that most adults with a substance use disorder (SUD) begin using substances during adolescence and that the severity of a SUD in adolescence can increase rates of substance misuse in adulthood.
The CDC study relied on data from CHAT, a self-reported, online assessment for adolescents between the ages of 13 and 18 who are currently being evaluated for SUD treatment. Data from Jan. 1, 2014, to Sep. 28, 2022 that indicated the use of substances within the past 30 days were analyzed in the CDC study, totaling 15,963 assessments.
Adolescent substance use is often spurred by a desire “to feel mellow, calm, or relaxed,” according to data from the National Addictions Vigilance Intervention and Prevention Program’s Comprehensive Health Assessment for Teens (CHAT).
Adolescents also reported using substances to sleep better or fall asleep, to stay awake, or to feel less shy or more social.
Marijuana was the most commonly reported substance, with 84% of youth reporting using the drug within the past 30 days. Alcohol was reported in 49% of assessments, followed by nonprescription drug use, including methamphetamine, cough syrup and hallucinogens. Prescription drug misuse was reported on 19% of assessments.
The study also found that half of adolescents reported using substances while alone. Using substances while alone increases the risk of fatal overdose. Using substances while alone increases the risk of fatal overdose.
Drug-related teen overdose deaths skyrocketed between 2019 and 2020. Fentanyl-involved deaths primarily drove the increase.
More than half of adolescents who reported misusing prescription drugs said they used the drugs while alone, which the study’s authors said was of “particular concern.”
“Prescription drug misuse while alone presents a significant risk for fatal overdose, especially given the proliferation of counterfeit pills resembling prescription drugs and containing illegal drugs (e.g., illegally manufactured fentanyl),” the study’s authors wrote.
Novel opioids like nitazenes, which are 10 times as potent as fentanyl, are increasingly being found cut into other drugs.
While half of adolescents said they use substances while alone, they reported that they most commonly used substances with friends, which the study’s authors said presents the opportunity for overdose intervention.
Several factors limited the study. The sampled adolescents were only those evaluated for SUD treatment, which is not generalizable to all adolescents in the U.S. Additionally, data was self-reported and subject to biases and memory lapses.
The study’s findings point to two main interventions.
To prevent fatal overdoses, which are more likely when substances are used alone, the study’s authors recommend harm reduction education specifically tailored to adolescents, focusing on the dangers of using substances while alone. Education should also include messaging on how to recognize and respond to overdoses in others, such as administering the opioid overdose reversal drug naloxone.
Secondly, addressing stress and mental health concerns among adolescents could prevent adolescents from reaching for substances to cope.
“These interventions could be implemented on a broad or local scale to improve adolescent well-being and reduce harms related to substance use,” the study’s authors wrote.