A longitudinal study funded by the National Institute for Drug Abuse (NIDA) and just recently published in the Journal of American Medicine (JAMA Network Open) concludes the majority (60%) of adolescents with symptoms of heavy substance use had 2 or more symptoms of substance use disorder (SUD) in adulthood.[1]
Up front, this research is rather exceptional, in that it truly qualifies as a “long-term study,” in that it’s well beyond the typical 5-10 years associated with the phrase. The authors of this study tracked 5,300 high school seniors starting in 1976, assessing their substance use at the outset and then randomly every other year until age 30, and then every five years until age 50.
The bottom line? The often-heard adage, “Oh, his/her teenaged experimentation with drugs and alcohol will pass with age” is actually—in 6 out of 10 cases—plain wrong.
According to Sean Esteban McCabe, director of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan and lead author of the study, “There has been some work suggesting most people age out of substance-related problems, but these studies have not adequately accounted for the severity of the substance-related problems. We found that most U.S. adolescents with severe substance use disorder symptoms persisted with multiple symptoms in middle adulthood.”[2]
At the start of the study, participants were classified according to varying levels of drug abuse, based on criteria used in the Diagnostic and Statistical Manual of Mental Disorders (DSM):
- 2-3 symptoms – a “mild” substance abuse disorder
- 4-5 symptoms – higher substance use disorder (SUD) symptoms
- 6 or more symptoms – a “severe” drug issue (heavy substance use)[3]
Approximately 12% of 18-year-olds surveyed for this study reported severe drug use issues or heavy substance use. Further, more than 40% stated they had at least a mild drug problem. By the end of the study, six out of ten teenagers who’d presented a severe drug problem declared at least mild drug misuse as adults, “often involving different drugs, or a combination of several.”[4]
It’s important to note even those adolescents presenting with mild drug problems seemed to face a high risk for ongoing substance use struggles as adults: more than half reported mild or worse substance abuse issues as they aged.
“(There are) very serious concerns about the safety of prescribing controlled substances to these individuals,” said McCabe, given that some young people clearly develop “unhealthy relationships with substances that persist over time,” adding this study’s conclusions illumine the fact there were over 100,000 drug overdose deaths in the United States in 2021.[5]
Telling teens, he said, they will inevitably “mature out of their substance use disorders … is like advising a jar of pickles that they can become cucumbers some day.”[6]
Upon publication of this research, NIDA’s director, Dr. Nora Volkow, pointed to the importance of paying greater attention to youthful drug issues, so as to decrease the risk for lifelong problems.
“Screening for drug use early in an individual’s life is an important part of evidence-based interventions to help identify substance use disorder risk, and possibly prevent these disorders and associated negative outcomes, such as drug overdoses in adulthood.”[7]
She concluded, “Health care systems, communities, schools and financial systems that support them must be ready to incorporate screening not only to identify drug use but also its severity.”[8]
[1] McCabe, S.E., et al. “Longitudinal Analysis of Substance Use Disorder Symptom Severity at Age 18 Years and Substance Use Disorder in Adulthood.” JAMA Network Open. April 1, 2022.
[2] Mozes, A. “Teens Who Misuse Drugs Rarely Shake the Issue as Adults: Study.” U.S. News & World Report. April 4, 2022.
[3] McCabe, S.E., et al. “Longitudinal Analysis of Substance Use Disorder Symptom Severity at Age 18 Years and Substance Use Disorder in Adulthood.” JAMA Network Open. April 1, 2022.
[4] Ibid.
[5] Mozes, A. “Teens Who Misuse Drugs Rarely Shake the Issue as Adults: Study.” U.S. News & World Report. April 4, 2022.
[6] Ibid.
[7] Ibid.
[8] Ibid.
