A new study published by JAMA Pediatrics on March 29, 2021, has taken a hard look at substance use disorder “SUD” as it relates to the age of the user’s first drug or substance initiation.
The study suggests that the earlier the age of a user’s experience with a substance, such as: tobacco, alcohol, cannabis, cocaine, methamphetamine, and heroin, or prescription drugs (including opioids, stimulants, and tranquilizers) in adolescents aged 12 to 17 years and young adults aged 18 to 25 years, the more likely the early user will develop a SUD.
The study recommends that screening for substance misuse among adolescents should become a part of the US Preventive Services Task Force recommendations by requiring adolescent screening in a primary care setting, which is now limited to only adult testing.
The study indicated that alcohol, cannabis, and tobacco were the most used substances by those participating in the study. The prevalence of lifetime substance use among early use adolescents in 2018 was 26.3 percent. Young adult early users were found to have a 79.7 percent prevalence of lifetime substance abuse. Prevalence of lifetime misuse of prescription drugs in 2014 was 9.2 percent among adolescents and 26.3 percent among young adults.
Among the population with lifetime substance abuse, the adjusted prevalence of prescription opioid use disorder, prescription stimulant use disorder, and prescription tranquilizer use disorder were consistently higher for adolescents than for young adults.
However, the study acknowledged that the prevalence of SUDs differed by substance, age group, and time since initiation. For example, the adjusted prevalence of cannabis use disorder was higher among adolescents than among young adults within 12 months of initiation and at more than 36 months.
Prevalence of alcohol use disorder and nicotine dependence did not differ between the 2 groups within 12 months of initiation but was higher for young adults in subsequent periods.
It also admits that the prevalence of SUDs may have been underestimated because National Survey on Drug Use and Health “NSDUH” excludes incarcerated individuals and homeless individuals not living in shelters and is subject to recall or social biases. Nevertheless, the results identified adolescents as highly vulnerable to SUDs, supporting the need for research to evaluate the efficacy of early screening.
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