The positive trends in drug use among adolescents appear to be continuing – overall, according to the 2017 Monitoring the Future survey.

“This year, we have very good news, because ... the pattern of drug use among teenagers in the United States is continuing to go down, and it’s most notable in the case of opioid drugs,” Nora D. Volkow, MD, director of the National Institute on Drug Abuse said in a video interview posted by NIDA. “We are observing some of the lowest rates of opioid use that we have been monitoring through the survey.”

The national survey results of 8th, 10th, and 12th graders, released Dec. 14, found that lifetime, past-year, and past-month misuse of prescription pain medications are at lows that NIDA called historic. Among high school seniors, the survey showed, Vicodin use was at its lowest point since 2002 at 2% – a decrease from its high of 10.5% in 2003. Similarly, the reported use of OxyContin among high school seniors dropped from 5.5% in 2005 to 2.7% this year.

Misuse of “narcotics other than heroin” decreased as well. In 2004, 9.5% of high school seniors reported past-year use of these drugs. In the 2017 survey, 4.2% of 12th graders reported misuse. According to the survey, more than half of high school seniors said those drugs were easily accessible in 2010. As of 2017, 35.8% of 12th graders said they could acquire such narcotics.

“We’re also seeing continuing decreases in cigarette smoking that are at the lowest levels that we’ve ever seen,” Dr. Volkow said in the interview. Daily cigarette use was 0.6% among 8th graders, 2.2% among 10th graders, and 4.2% among 12th graders in 2017. Those numbers were down from 10.4% and 18.3% among 8th and 10th graders in 1996, and a peak of 24.6 % of 12th graders in 1997.

Twelfth graders also reported lower past-year use of hookah: Use of that substance declined to 10% this year from 13% a year earlier.

As the use of traditional and smokeless tobacco has decreased, however, overall vaping levels held steady in 2017. For the first time, Monitoring the Future reported national, standard estimates of four categories of vaping: nicotine, marijuana, flavoring-only, and any vaping. The reported past-year rates of use under the “any vaping” category in the 2017 survey was 13.3% for 8th graders, 23.9% for 10th graders, and 27.8% for 12th graders. Vaping for flavoring only was the most popular option, and the highest rates were reported by 12th graders – who reported past-month use of 9.7%.

Dr. Volkow said a key concern is that it is unclear that adolescents know what substance they are vaping. Furthermore, adolescents who start vaping any substance are more likely to start to vape nicotine than are those who do not vape. “And we know that when an individual is exposed to nicotine and then gets exposed to another drug, that drug will be more rewarding,” Dr. Volkow said in a teleconference announcing the results.

Richard A. Miech, PhD, MPH, principal investigator of the survey, echoed Dr. Volkow’s concerns.

“These findings emphasize that vaping has progressed well beyond a cigarette alternative,” Dr. Miech said in a statement. “Vaping has become a new delivery device for a number of substances, and this number will likely increase in the years to come.”

Meanwhile, the past-year use of marijuana among adolescents climbed significantly by 1.3% in 2017, to 24% for all three grades levels combined.

“Historically marijuana use has gone up as adolescents see less risk of harm in using it,” Dr. Miech, of the University of Michigan, Ann Arbor, said in another statement. “We’ve found that the risk adolescents see in marijuana use has been steadily going down for years to the point that it is now at the lowest level we’ve seen in 4 decades.”

Reported overall illicit use of substances such as cocaine, anabolic steroids, and “synthetic marijuana” was relatively low.

“We should take encouragement from this year’s MTF results,” Dr. Volkow wrote on her blog. “Most substance use by middle and high school students is the lowest it has ever been, which suggests that prevention interventions and policies continue to have the desired effect. ...“There is also need to expand on prevention strategies to further reduce drug use – such as use of marijuana.”

The Monitoring the Future survey has been conducted since 1975. The 2017 survey, taken at the beginning of the year, is based on reports from almost 45,000 students in about 380 public and private secondary schools across the country. The survey is designed and conducted by research scientists at the University of Michigan, and is funded by NIDA.

ilacy@frontlinemedcom.com

SOURCE: Miech RA et al. 2017 Monitoring the Future

Adolescents’ use of opioids, cigarettes is down; pot use is up