1.2 Adolescent substance use

Youth & Drugs and Mental Health: A Resource For Professionals

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• 1.2 Adolescent substance use
• 1.2.1 Ontario data on students’ substance use

1.2 Adolescent substance use

Many young people experiment with alcohol and other drugs, much like they test out other “adult” behaviours. Often, this is a way for them to express independence and autonomy. But not all substance “use” leads to “abuse.” In fact, most young people who use substances “do not progress to problem use or dependency” (CAMH, 2002a).

At the same time, given the fact that young people have not reached full maturity, physically, psychologically or socially, substance use may interrupt those crucial developmental processes. If a young person’s use of alcohol or drugs hampers his or her ability to master key developmental tasks, he or she may experience difficulties in reaching full potential.

All young people will not develop dependence on the drugs they use. Those who do become dependent can develop either psychological or physical dependence. Psychological dependence means they are emotionally or psychologically driven to continue taking drugs to maintain their sense of well-being. Physical dependence refers to the adjustment of bodily tissues in response to the continued presence of a drug, such that withdrawal symptoms develop when use of the drug is discontinued.

Our concern is not so much with what might be called “abuse,” but primarily with the “continuum of use.” In young people, the significance of a minimal-use pattern cannot be foretold. It may pass uneventfully or turn into a destructive lifestyle. From this standpoint, we must be concerned about all adolescent drug use.

Resilience (also referred to as resiliency) is a concept that incorporates two components:

• • exposure to significant stressors or risks
  • demonstration of competence and successful adaptation. (Braverman, 2001)

Mental health is a continuum that ranges from optimum mental health at one end to severe and persistent mental health disorders at the other end, with emotional problems lying somewhere in the middle (Adlaf et al., 2002).

Mental health problems are diminished cognitive, social or emotional abilities but not to the extent that the criteria for mental disorders are met.

Mental disorders (often used interchangeably with mental illness) are diagnosable illnesses characterized by alterations in thinking, mood or behaviour (or some combination thereof) associated with distress that significantly interferes with an individual’s cognitive, emotional or social abilities.

1.2.1 Ontario da ta on students’ substance use

The Ontario Student Drug Use Survey (OSDUS) data confirm that substance use among young people is very common. Across the province, two-thirds of all students in grades 7 to 13 reported having used alcohol during the year prior to the survey (Adlaf & Paglia, 2001). One-third of students in grades 7 to 13 reported having used an illicit drug at least once during the year prior to the survey (Adlaf & Paglia, 2001). There are key differences in drug use patterns and trends across the province. For more specific information about the experiences of young people in different regions, consult the OSDUS reports.

Some public health flags from the OSDUS

• One quarter of students smoke cigarettes.
• Heavy drinking (i.e., binge drinking, getting drunk) remains at an elevated level among all students, compared to a decade ago.
• Over the past decade, there has been a steady increase in illicit drug use among students, even when cannabis is excluded.
• One in seven students drink and drive and one in five report driving after cannabis use.
• About one-third of all students report being a passenger with a driver who had been drinking.
• Fewer students today disapprove of drug use compared to students a decade ago.
• The reported availability of drugs (except for LSD) is increasing.
• Use of ecstasy has increased substantially (from less than one per cent in 1991 to about six per cent in 2001).
• A substantially larger percentage of students today use hallucinogens such as mescaline and psilocybin compared to 1979.
• Daily cannabis use has increased significantly over the past decade.
• Over the past decade, cocaine use has been steadily increasing among all students and among several demographic subgroups. One example is the dramatic rise in cocaine use since 1993 among 11th-grade students.
• Over the past decade, there has been a steady increase in stimulant use (e.g., diet pills) among female students.

Substance use patterns and prevalence vary among specific groups of young people:

• Although young women and young men have a relatively similar prevalence of substance use, there are some differences. For example, in 2001, young women reported higher rates of non-medical (not medically prescribed) stimulant use compared to young men. Young men reported higher rates of heavy drinking, use of cannabis, glue, methamphetamine, lsd and hallucinogens (Adlaf & Paglia, 2001).
• Aboriginal youth are at a two-to-six times higher risk for every alcohol-related problem compared to other young people.
• Aboriginal youth use solvents more frequently than other young people. One in five Aboriginal youth report having used solvents. One-third of those who have used solvents are under the age of 15 and more than half began using solvents before the age of 11.
• First Nations and Métis youth are more likely to use illicit drugs than other young people.
• Aboriginal youth are likely to begin using substances such as tobacco, solvents, alcohol and cannabis at a much earlier age than other young people (Canadian Centre on Substance Abuse [CCSA] and CAMH, 1999).
• The majority of young people entering the youth justice system have significant substance use problems (Trupin & Boesky, 2001).

Homeless and street-involved youth report much higher levels of substance use than other young people. One-quarter to one-half report frequent heavy drinking. 66 to 88 per cent report using cannabis and 18 to 64 per cent report using cocaine. Many street-involved youth report having used injection drugs (11 per cent in a national study;48 per cent of males and 32 per cent of females in a Vancouver sample; and 36 per cent in a Montreal sample). More than half (58 per cent) of a sample of street youth in Montreal had shared needles (Health Canada, 2001).

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