Cannabis, prescription drug abuse in younger years, accelerates the onset of substance use disorders

April 01, 2021

2 min read

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Disclosure:
A study author reports on shareholdings in General Electric Co., 3M Co., and Pfizer Inc.

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Younger age at first cannabis use or prescription drug abuse was associated with faster development of substance use disorders, according to study results in a research letter published in JAMA Pediatrics.

“We have long known that the younger people are when they first start using drugs, the more likely they are to develop a substance use disorder.” Nora Volkow, MD, The director of the National Institute for Drug Abuse at the NIH told Healio Psychiatry. “In this study, we wanted to expand this research by examining how the prevalence of specific substance use disorders changed over time in adolescents aged 12-17 and young adults aged 18-25 in the United States since first substance use or abuse changes. In addition, after checking for possible confounding factors, we wanted to investigate whether the prevalence of certain substance use disorders in the past year differs depending on the substance, age group and time since the beginning. “

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Nora Volkow

Volkow and colleagues received data from participants in the National Surveys on Drug Use and Health (NSDUH) of the Agency for Substance Abuse and Mental Health from 2015 to 2018. They did not contain any data on prescription drugs between 2005 and 2014 because not all initiation data were collected between 2015 and 2018 were. The NSDUH contained nationally representative data on substance use according to lifetime use, use in the past year and initiation date as well as substance use disorders among non-institutionalized civil populations.

The results showed that alcohol, cannabis, and tobacco were the most commonly used substances. The prevalence of lifelong substance use among adolescents in 2018 was 26.3% (95% CI, 25.4-27.2) for alcohol, 15.4% (95% CI, 14.7-16.1) for cannabis and 13 , 4% (95% CI, 12.7-14.1) for alcohol tobacco. The prevalence of lifelong substance use among young adults in 2018 was 79.7% (95% CI, 78.9-80.5) for alcohol, 51.5% (95% CI, 50.4-52.6) for cannabis and 55% (95% CI, 53.9-56.1). for tobacco.

The prevalence of substance use disorders has varied depending on the substance, age group, and time since inception. Adolescents had an adjusted prevalence of cannabis use disorder of 10.7% (95% CI, 9.3-12.3), while young adults had an adjusted prevalence of 6.4% (95% CI, 5.2 -7.9). After 36 months, this prevalence was 20.1% (95% CI, 18-22.3) in adolescents and 10.9% (95% CI, 10.3-11.4) in young adults.

The two groups had the same prevalence of alcohol use disorder and nicotine dependence within 12 months of initiation; However, young adults had a higher prevalence at later time points.

In 2018, young adults had a lifelong prevalence of 11.4% (95% CI, 10.7-12.1) for cocaine, 2.5% (95% CI, 2.2-2.8) for methamphetamine and 1.3% (95% CI, 1.1-1.5). for heroin. The researchers have not reported any estimates for these drugs for adolescents due to limited sample sizes. In 2014, adolescents had a lifelong prescription drug abuse prevalence of 9.2% (95% CI, 8.7-9.7) compared to 26.3% (95% CI, 25.4-27.2 ) in young adults.

Adolescents had consistently higher adjusted prevalence of prescription opioid disorder, prescription stimulant disorder, and prescription sedative disorder than young adults among those with lifelong abuse.

“The consistently higher prevalence of cannabis use disorders and prescription drug use disorders in adolescents than in young adults underscores the susceptibility of adolescents to substance use disorders and suggests reconsidering the screening for substance use among adolescents in primary care,” said Volkow. “These results provide further evidence that primary care providers should screen their adolescent and young adult patients for substance use and use disorders. In addition, these results highlight the importance of drug use prevention measures that aim to delay exposure to substances until the brain is better developed and less prone to developing a substance disorder. “

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