Health and Developmental Consequences of Youth Drug Abuse

Research Findings from February, 2001 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the developmental implications of drug use. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Correlates of Mental Health Service Utilization and Unmet Need Among a Sample of Male Adolescents

Researchers at CEDAR sought to identify the correlates of mental health services utilization and unmet need for these services among a sample of adolescent males. They hypothesized that their findings would replicate and extend those of the recent Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, which found that parental factors play a major role in their children's unmet mental health care needs. The CEDAR study involved an evaluation of mental health service utilization and unmet need during the prior 2 years, as reported by the subjects at a follow-up assessment at age 16. Four factors were found to predict increased mental health services utilization, including attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) among the adolescent males, the father's alcohol use disorder, and the mother's amphetamine use disorder. One factor was found to predict decreased utilization, the father's cannabis use disorder. Four factors significantly predicted unmet treatment need, including conduct disorder, the mother's amphetamine use disorder, a higher number of siblings, and a parental history of having had a childhood anxiety disorder. The results of this study suggest that parental psychopathology, parental substance abuse, the presence of conduct disorder, and an increased number of siblings act as barriers to adequate mental health treatment among adolescents. These findings confirm the crucial role that parental factors play in the treatment utilization and the unmet treatment need of their children, and also suggest that an increased number of siblings can also be associated with unmet treatment need. Cornelius, J.R., Pringle, J., Jernigan, J., Kirisci, L. and Clark, D.B. Correlates of Mental Health Service Utilization and Unmet Need Among a Sample of Male Adolescents. Addictive Behaviors, 26(1), pp. 11-19, 2001.

Predictors of Early High School Dropout

This study compared the adequacy of 5 theories to predict dropping out of high school before the 10th grade. These theories include full mediation by academic achievement and direct effects related to general deviance, deviant affiliation, family socialization, and structural strains. High drug use was one of the components of general deviance. Nested latent variable models were used to test these theories on prospective data from an ethnically diverse urban sample. Poor academic achievement mediated the effect of all independent factors on school dropout, although general deviance, bonding to antisocial peers, and socioeconomic status also retained direct effects on dropping out. Therefore, none of the theories tested was fully adequate to explain the data, although partial support was obtained for each theory. Implications for prevention of early high school dropout are discussed. Battin-Pearson, S., Newcomb, M.D., Abbott, R.D., Hill, K.G., Catalano, R.F., and Hawkins, J.D. Predictors of Early High School Dropout: A Test of Five Theories. Journal of Educational Psychology, 92(3), pp. 568-582, 2000.

Methamphetamine Use by High School Students

Researchers at the Tri-ethnic Center for Prevention Research at Colorado State University analyzed data on 9th through 12th graders' methamphetamine use reported in the American Drug and Alcohol Survey (n=629,722). From 1989 through 1992, methamphetamine use rates remained relatively stable. Since then, rates have increased, almost doubling, especially in Western states. There were no significant differences in methamphetamine use across year in school, but males were more likely to use than females though use among females has also increased. American Indians and Hispanics were more likely to use methamphetamine, followed (in order) by Asian Americans, White non-Hispanics, and African Americans. Compared to other heavily drug involved youth, methamphetamine users were more likely to use other drugs. The most commonly reported other drugs used by students who used methamphetamine were alcohol, marijuana, hallucinogens, uppers, and cocaine. Methamphetamine users were also more likely than other drug users to suffer drug use consequences such as traffic tickets, car accidents, being arrested, trouble at school, fighting, and other adverse consequences. Oetting, E.R., Deffenbacher, J.L., Taylor, M.J., Luther, N., Beauvais, F., and Edwards, R.W. Methamphetamine Use by High Schools Students: Recent Trends, Gender and Ethnicity Differences, and Use of Other Drugs. Journal of Child and Adolescent Substance Abuse, 10(1), pp. 33-50, 2000.

Aggression and Drug Use Related in Inner-City Youth

In a study of 517 inner-city eighth graders, investigators found that self-reported aggressive and unsafe behaviors were associated with initiation of drug use (use of tobacco, alcohol, and marijuana). Sex differences were found for aggressive behavior, victimization, and unsafe behavior. Epstein, J.A., Botvin, G.J., Diaz, T., Williams, C., and Griffin, K. Aggression, Victimization and Problem Behavior Among Inner-City Minority Adolescents. J. of Child and Adolescent Substance Abuse, 9(3), pp. 51-66, 2000.

Childhood Sexual Abuse Among Female Addicts and Subsequent Parenting

The relationship between childhood sexual abuse (CSA), family of origin and the status of 248 female narcotic addicts currently raising adolescent children was examined. Seventy-eight of these women reported a history of CSA. The CSA group and the non- CSA group were compared on variables related to parental substance abuse, parenting behavior, and other family dynamics (retrospectively for families of origin and contemporaneously for current families). Findings suggest that the abuse of alcohol by the mothers of some of the CSA subjects was a contributing factor in creating an environment or set of circumstances in which the abuse took place. The two groups also differed on variables such as involvement, attachment, responsibility, discipline, and punitive actions. CSA was also related to addiction careers, parental substance use, adult psychological symptoms, and home atmosphere. Blatchley, R.J., Hanlon, T.E., Nurco, D.N., and O'Grady, K. Childhood Sexual Abuse Among Female Addicts and Changes in Parenting Across Two Generations. Fishbein, D.H. (Ed), et al. The Science, Treatment and Prevention of Antisocial Behaviors: Application to the Criminal Justice System, Kingston, NJ, US: Civic Research Institute, pp. 27-25, 2000.

Cigarette Smoking and Anxiety Disorders

Cigarette smoking has been shown to be associated with some anxiety disorders, but the direction of the association between smoking and specific anxiety disorders has not been determined. This investigation assessed the longitudinal association between cigarette smoking and anxiety disorders among adolescents and young adults. A community-based sample of 688 youths (51% female) participating in this prospective longitudinal study were interviewed in the years 1985-1986, at a mean age of 16 years, and in the years 1991-1993, at a mean age of 22 years. Participant cigarette smoking and psychiatric disorders in adolescence and early adulthood were measured by age-appropriate versions of the Diagnostic Interview Schedule for Children. Results show that heavy cigarette smoking (>/=20 cigarettes/d) during adolescence was associated with higher risk of agoraphobia (10.3% vs. 1.8%; odds ratio [OR], 6.79; 95% confidence interval [CI], 1.53-30.17), generalized anxiety disorder (20.5% vs. 3.71%; OR, 5.53; 95% CI, 1.84-16.66), and panic disorder (7.7% vs. 0.6%; OR, 15.58; 95% CI, 2.31-105.14) during early adulthood after controlling for age, sex, difficult childhood temperament; alcohol and drug use, anxiety, and depressive disorders during adolescence; and parental smoking, educational level, and psychopathology. Anxiety disorders during adolescence were not significantly associated with chronic cigarette smoking during early adulthood. Fourteen percent and 15% of participants with and without anxiety during adolescence, respectively, smoked at least 20 cigarettes per day during early adulthood (OR, 0.88; 95% CI, 0.36-2.14). These results suggest that cigarette smoking may increase risk of certain anxiety disorders during late adolescence and early adulthood. Johnson, J.G., Cohen, P., Pine, D.S., Klein, D.F., Kasen, S. and Brook, J.S. Association between Cigarette Smoking and Anxiety Disorders during Adolescence and Early Adulthood. JAMA, 284(18), pp. 2348-2351, 2000.

Consequences of Adolescent Drug Use on Psychiatric Disorders in Early Adulthood

This article summarizes the existing literature on the relationship between adolescent drug use and abuse and the development of psychiatric disorders in adulthood. In recent years, there has been increased awareness of the co-occurrence of drug abuse and psychiatric disorders in adolescence and young adulthood. Few longitudinal studies, however, have examined specifically the impact of earlier drug use and abuse on later psychiatric disorders. The literature suggests three possible models to explain the relation between drug use and abuse and psychiatric disorders. According to the first model, adolescent psychiatric disorders precede drug use and abuse. A second model postulates that psychiatric disorders and drug use are correlated because they share one or more common etiological factor(s). The third model posits that drug use and abuse predict or precede certain psychiatric disorders. We present data from a recent longitudinal study to support this latter model. As drug use and abuse have been shown to increase the likelihood of psychiatric disorders, it is clear that medical attention needs to be given to adolescents who use drugs of abuse. It is expected that a decrease in adolescent drug abuse should lead to an accompanying reduction in later psychiatric disorders. Brook, J.S., Richter, L. and Rubenstone, E. Consequences of Adolescent Drug Use on Psychiatric Disorders in Early Adulthood. Ann Med., 32(6), pp. 401-407, 2000.