Revised December 2014
This year’s Monitoring the Future Survey of drug use and attitudes among American 8th, 10th, and 12th graders continues to show encouraging news, with decreasing use of alcohol, cigarettes, and misuse of prescription pain relievers; stable rates of marijuana use among teens; decreasing use of inhalants and synthetic drugs, including K2/Spice and Bath Salts; and a general decline over the last two decades in the use of illicit drugs. However, the survey highlighted growing concerns over the high rate of electronic cigarette use and softening of attitudes around some types of drug use, particularly decreases in perceived harm and disapproval of marijuana use.
The Good News
- Abuse of prescription and over-the counter drugs continued to decline in among the nation’s youth. Past year use of the opioid pain reliever Vicodin showed a significant 5 year drop, with 4.8 percent of 12th graders using Vicodin for non-medical reasons, compared to 9.7 percent in 2009. Past year use of narcotics other than heroin (which includes all opioid pain relievers) among high school seniors showed a significant drop to 6.1 percent from 7.1 percent a year ago and from 9.5 percent at the peak in 2004. Past year non-medical use of the stimulants Adderall and Ritalin (often prescribed for ADHD) remained relatively steady, at 6.8 percent and 1.8 percent respectively for high school seniors. The survey continues to show that most teens get these medicines from friends or relatives and to a lesser degree, from their own prescription from a previous medical issue. There was also a significant drop in the past year use of cough/cold medicines containing dextromethorphan (DXM) among 8th graders, with only 2 percent using them for non-medical reasons, down from 2.9 percent last year and 3.8 percent five years ago.
- Likewise, 5-year trends continue to show significant decreases in alcohol use among all grades. 9.0, 23.5 and 37.4 percent of 8th, 10th and 12th graders respectively reported past month use of alcohol, compared to 14.9 percent, 30.4 percent and 43.5 percent in 2009. There was also a significant drop in binge drinking in 2014 among high school seniors, which is now under 20 percent after peaking in 1998 at 31.5 percent. The binge drinking rate represents the percentage of students who reported consuming 5 or more drinks in a row sometime in the last two weeks.
- Cigarette smoking has decreased markedly over the past 5 years (almost 50%) across all grades and is currently at its lowest rate in the survey’s history. Daily cigarette smoking decreased to 1.4 percent among 8th graders compared to 2.7 percent five years ago; to 3.2 percent among 10th graders, compared to 4.4 percent last year, and 6.3 percent five years ago; and to 6.7 percent among high school seniors, down from 8.5 percent last year, 11.2 percent in 2009, and nearly 25 percent at the peak in 1997.
- Marijuana use did not increase despite softening of perceived risks. Past month use of marijuana remained steady among 8th graders at 6.5 percent, 10th graders at 16.6 percent and 12th graders at 21.2 percent. Close to 6 percent of 12th graders report daily use of marijuana. 81 percent of high school seniors say it is easy to get marijuana. Among 8th graders, there was a drop in perceived availability, with 36.9 percent saying it is easy to get marijuana, compared to last year’s 39.1 percent.
- The survey also revealed that marijuana is frequently consumed as an edible, which is more prevalent among states with medical marijuana; specifically of the12th graders who consumed marijuana in the past year 40% of them reported having consumed it in an edible form in the medical marijuana states versus 26% in non-medical marijuana states. In 2014 there was no significant difference in the rates of marijuana use among high school seniors in medical marijuana states compared to non-medical marijuana states (34.5 and 30.1 respectively); this is in contrast to 2013 when 40.4 percent of high school seniors in medical marijuana states reported smoking marijuana in the past year compared to 29.7 percent in non-medical marijuana states.
- Use of illicit drugs has generally declined over the past two decades. Past year use of illicit drugs for all grades combined now sits at 27.2 percent, down from its peak in 1997 at 34.1 percent. Past year use of MDMA (also known as ecstasy or “Molly”) saw a significant decline among 10th graders to 2.3 percent, from 3.6 percent in 2013, now just about one third of the 2001 peak level of 6.2 percent. Past year use of heroin remained very low despite increased use among adults over 26 years of age in 2013.
- There has been a considerable decline in past year use of K2/Spice (sometimes called “synthetic marijuana”) in the two years the survey has been tracking its use. 5.8 percent of 12th graders reported its use this year, compared to 7.9 percent last year and 11.3 percent in 2012. This was associated with an increase in the perceived risk of taking synthetic marijuana once or twice among 12th graders. Use of the hallucinogen salvia also dropped significantly among 12th graders in the past year to 1.8 percent, from 3.4 percent in 2013.
- Past year use of the amphetamine-like stimulants known as bath salts (added to the survey in 2012) remained low, and dropped considerably among 8th graders, to 0.5 percent compared to 1 percent last year.
- Use of inhalants is at its lowest levels in the history of the survey, among 10th and 12th graders. Rates of inhalant use are traditionally highest among 8th graders (unlike most other drugs. Past year use among this age group is at 5.3 percent, down from 8.1 percent five years ago and 12.8 percent at its peak rate in 1995.
- The survey also shows a decline in the perceived availability of most substance over the past few years including alcohol, cigarettes, marijuana, powder cocaine, crystal methamphetamine, and prescription painkillers.
Areas of Concern
- Measured for the first time in the MTF survey this year, the use of electronic cigarettes (e-cigarettes) is high among teens with 8.7 percent of 8th graders, 16.2 percent of 10th graders, and 17.1 percent of 12th graders using e-cigarettes in the past month. Only 14.2 percent of 12th graders view regular e-cigarette use as harmful. The nicotine in e-cigarettes is vaporized and inhaled (not smoked), however, the health impact of e-cigarette use is not yet clear, nor is it known if use of e-cigarettes increases the likelihood of transitioning to conventional cigarettes or other tobacco products. While many of these student e-cigarette users have a history of cigarette and/or smokeless tobacco exposure, approximately 2.9% of 8th graders, 4.5% of 10th graders and 3.8% of 12th graders report past month use of e-cigarettes while denying ever using tobacco cigarettes or smokeless tobacco.
- While marijuana use has remained relatively stable over the past few years there continues to be a changing of attitudes about the perceived risk of harm associated with marijuana use. The majority of high school seniors do not think regular marijuana smoking is harmful, with only 36.1% saying that regular use puts the user at great risk compared to 52.4 percent five years ago. However, 56.7% of seniors say they disapprove of occasional marijuana smoking, and 73.4 percent say they disapprove of regular marijuana smoking, down from 65.6 percent and 80.3 percent respectively in 2009. Eighty-one percent of seniors say it is easy to get marijuana.
- Marijuana use continues to exceed cigarette use in all three grade levels. In 2014, 21.2% of high school seniors used marijuana in the past 30 days compared with 13.6% who smoked cigarettes.
- Past-year hookah use continued to increase among 12th graders to 22.9%—the highest rate since 2010, when the survey started capturing this type of tobacco use.
- Changing attitudes toward substance abuse often precede changes in reported use. The perceived risk of harm of regularly smoking marijuana and taking prescription stimulants including amphetamines has continued to decline among 12th graders. This is evidenced by a 5 year decline in the perceived harm of regularly smoking marijuana from 52.4 percent in 2009 to 36.1 percent in 2014 and a decline in the perceived harm of regularly taking prescription amphetamines from 69.0 percent in 2009 to 55.1 percent in 2013. This could indicate that use of these drugs could begin to rise again in future years.
 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS, Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services, Administration, 2014.