Experimentation among most common reasons for substance use in adolescence

Takeaways:

Seeking a mellow or calm feeling, along with overall experimentation, were the most common motivations for substance use among adolescents being assessed for substance use disorder treatment, according to a CDC Morbidity and Mortality Weekly Report.
The cross-sectional study used self-reported, online assessments from individuals aged 13 to 18 years who were evaluated for substance use disorder treatment.
Marijuana use was reported in 84% of assessments, followed by alcohol in 49% of respondents, and nonprescription drug use in over 20% of assessments.
Feeling calm, relaxed, or mellow was the most common reason for substance use (73%), followed by having fun or experimenting (50%), using to fall asleep or sleep better (44%), and using to stop worrying or forget bad memories (44%).
Friends were the most common group with whom substances were used (81%), highlighting the potential for bystander intervention in case of an overdose, as approximately 70% of fatal adolescent overdoses occurred with a potential bystander present.

Seeking a mellow or calm feeling along with overall experimentation were the most common reasons for substance use among adolescents being assessed for substance use disorder treatment.

These findings were published by the Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report (MMWR), which states substance use, including alcohol and drug use, typically begins in adolescence.

These trends put youths at risk for substance use disorders (SUD) in adulthood or for fatal overdose risk, which if occurs, requires immediate medical attention.

A cross-sectional study was conducted to examine self-reported motivations for substance use among adolescents in efforts to develop and implement prevention strategies to help reduce the leading motivating factors for substance use.

Self-reported, online assessments from the National Addictions Vigilance Intervention and Prevention Program’s Comprehensive Health Assessment for Teens (CHAT) were used from individuals aged 13 to 18 years who were evaluated for SUD treatment.

The data set, consisting of assessments conducted from January 1, 2014 to September 28, 2022, was restricted to assessments reporting past-30-day use of marijuana, alcohol, or other drugs with at least 1 option selected for motivation or persons with whom substances were used, noted MMWR.

Assessment respondents were asked to report specific substances used in 6 categories:

Motivating factors were also asked for each of the 6 categories, and each motivation question had 15 response options. Respondents were asked to select all that applied.

Individuals were also asked to select the persons with whom they used substances, from 4 categories: alcohol, marijuana, hashish, or THC, drugs other than alcohol or marijuana and prescription drugs (prescription pain medications, prescription stimulants, and prescription sedatives or tranquilizers). Ten options were presented to describe these persons.

There were 9557 CHAT assessments conducted in the study period that indicated past-30-day use of marijuana, alcohol, or other drugs. Of these assessments, 9543 reported at least 1 motivation or person with whom substances were used.

In 84% of assessments, marijuana was used, followed by alcohol in 49% of respondents. On over 20% of assessments, nonprescription drug use was indicated (2032 assessments), with prescription pain medication reported as most common (13%), followed by prescription sedatives or tranquilizers (11%), and prescription stimulants (9%).

Feeling calm, relaxed, or mellow were the most common reasons reported for substance use (73%). Half of the participants reported that they used substances to have fun or experiment, 44% reported use to fall asleep or sleep better, and 44% reported use to stop worrying or to forget bad memories.

To make "something less boring" was reported as a substance use reason in 41% of participants, and 40% reported substance use to help with depression or anxiety.

According to results, friends were the most common group of whom substances were used with, as 81% reported this group. Twenty-five percent said they used substances with a boyfriend or girlfriend, 23% said with anyone who had drugs, and 17% reported they used substances with "someone else."

Over half of respondents reported using substances alone. Using alone and with friends were the most common, though prevalence changed by substance type.

The self-reports of using substances "to stop worrying about a problem or to forget about bad memories" and "to help with depression or anxiety," highlight the potential impact that mental health services could have on substance use.

Half of the adolescents in the study reported using substances alone. In addition, over half of individuals who reported prescription drug misuse reported using the drugs alone. This behavior presents a significant risk for fatal overdose.

Since adolescent substance use was most commonly reported with friends, there is an opportunity for bystander intervention in case of an overdose.

MMWR states approximately 70% of fatal adolescent overdoses occur with a potential bystander present, though no bystander response is documented in most cases.

"Overdose deaths can be prevented through education tailored to adolescents to improve recognition of signs of overdose and teach bystanders how to respond, including the administration of naloxone and increasing awareness of local Good Samaritan laws, which protect persons against liability when they provide emergency care to others," stated the study authors.

The study calls for harm reduction education that is specifically designed for adolescents to potentially discourage substance use in this age group while offering the possibility to teach how to recognize and respond to an overdose in others.

Connolly S, Govoni T, Jiang X, et al. Characteristics of alcohol, marijuana, and other drug use among persons aged 13–18 years being assessed for substance use disorder treatment — united states, 2014–2022. MMWR Morb Mortal Wkly Rep. 2024;73. doi:10.15585/mmwr.mm7305a1