Marijuana Use Spikes Among Teens but Cigarette Smoking and Drinking Decline

by Stephen Spotswood

February 17, 2012

WASHINGTON — A new survey of teen drug use shows that, while alcohol use continues its long-term decline, marijuana use has surprisingly spiked, suggesting a changing attitude among teens about the dangers of its regular use. The survey, officials said, can act as a road map for prevention efforts.

At the same time, government leaders are focusing on the recovery side of the equation and attempting to redefine mental disorders and substance-use disorders in hopes of creating a more modern, applicable groundwork for recovery efforts.

Use of synthetic marijuana,shown in the photo, is increasing among high-schoolers in the United States. – Courtesy of Drug Enforcement Administration

According to National Institute of Drug Abuse (NIDA) Director Nora Volkow, MD, the results of the 2011 Monitoring the Future Survey is a good news-bad news scenario.

The good news is that trends of substance-use decline that NIDA has seen in past years are continuing. Cigarette smoking among teens is declining — which Volkow says she believes will have considerable positive downstream health consequences.

“Good news also comes on the alcohol indicators, which also show they are at the low end since 1996,” Volkow said at a press conference announcing the survey’s findings.

Daily alcohol drinking is 46% lower than in 1996, while binge drinking, which Volkow called “also very problematic,” is down 30%.

“These exemplify the concept that prevention interventions work and can have a big impact,” she said.

The bad news comes in the area of marijuana use. During the past five years, marijuana use has increased, especially among 10th- and 12th-graders.

“We have the highest rates on everyday marijuana smoking among 12th-graders since 1981,” Volkow said. “6.6% of 12th-graders are smoking marijuana daily, regularly. And considering the adverse effects of marijuana on memory and learning, that of course can predict where the consequences are going in terms of educational achievement.”

One new factor found in the survey results is the emergence of synthetic marijuana — something which came to light in Europe in 2008 but only recently seen in the United States. Synthetic marijuana is cannabis mixed with other plants, which users believe give them more of an herbal high than a chemical one.

“Well, they are not herbal high; they’re chemical highs,” Volkow said. “They are cannabinoids. And the survey, for the first time, evaluated it, and to my surprise, it’s extremely high. Among 12th-graders, past-year use of these synthetic cannabinoids is 11.3%.”

According to HHS’ Assistant Secretary for Health Howard Koh, MD, federal and state governments are working quickly to criminalize synthetic forms of marijuana.

“A few months ago, the Drug Enforcement Agency used its emergency-scheduling authority to ban the sale of the chemicals used to manufacture [two forms of synthetic marijuana called] K2 and Spice,” Koh said. “We have convened several working groups at the federal level, working with our colleagues on Capitol Hill to also — we could not be more proud that the House of Representatives, I believe last week — pass legislation to ban this. It will now be in front of the Senate. And I think there is strong support to get these things off the market. And many states — I believe 38 states — have taken action already, because the states can move quickly on these kinds of issues.”

Part of this increase in marijuana use is a change in perception, Volkow noted. Fewer children view smoking marijuana regularly as having any harmful effects. Experience conducting the survey has taught researchers that perception of risk predicts whether children will eventually use the drug.

“So, whether we do an intervention to change that or we can predict that, use of marijuana is going to increase,” Volkow said.

Marijuana Use Spikes Among Teens but Cigarette Smoking and Drinking Decline Cont.

Redefining Recovery

Previous definitions of recovery dealt strictly with abstinence from drugs or the absence of mental-health symptoms. Treatment methods have evolved drastically during the past decade, however. Today, recovery efforts are far more holistic and focus as much on reengaging patients with their families and the community around them as they do on symptoms and drug use.

The Substance Abuse and Mental Health Administration (SAMHSA) has released a new working definition of recovery that it says reflects these changes: a process of change through which individuals improve their health and wellness, live a self-directed life and strive to reach their full potential.

“Over the years, it has become increasingly apparent that a practical, comprehensive, working definition of recovery would enable policymakers, providers and others to better design, deliver and measure integrated and holistic services to those in need,” said SAMHSA Administrator Pamela Hyde. 

SAMHSA began the redefinition effort in August 2010 when it convened a meeting of behavioral-health leaders. During the meeting, they helped develop a draft definition and a set of principles of recovery. During the next year, SAMHSA continued to work with healthcare experts, reviewing drafts and refining its list of principles.

A SAMHSA blog post in August that included the working definition, as it then stood, garnered 259 comments. SAMHSA’s online feedback forums on the subject had more than 1,000 participants and 1,200 comments — many of which have been incorporated into the current working definition.

SAMHSA and its collaborators defined four major dimensions which support recovery: health, home, purpose and community. The guiding principles, such as “recovery is culturally-based and influenced” and “recovery is supported by peers and allies” support that four-dimensional outlook on recovery.

Guiding Principles of Recovery

-Recovery emerges from hope: The belief that recovery is real provides the essential and
motivating message of a better future — that people can and do overcome the internal
and external challenges, barriers and obstacles confronting them.

-Recovery is person-driven: Self-determination and self-direction are the foundations for
recovery as individuals define their own life goals and design their unique paths.

Recovery occurs via many pathways: Individuals are unique, with distinct needs,
strengths, preferences, goals, culture and backgrounds, including trauma experiences that
affect and determine their pathways to recovery. Abstinence is the safest approach for
those with substance-use disorders.

-Recovery is holistic: Recovery encompasses an individual’s whole life, including mind,
body, spirit, and community. The array of services and supports available should be
integrated and coordinated.

Recovery is supported by peers and allies: Mutual support and mutual aid groups,
including the sharing of experiential knowledge and skills, as well as social learning, play
an invaluable role in recovery.

-Recovery is supported through relationship and social networks: An important factor
in the recovery process is the presence and involvement of people who believe in the
person’s ability to recover, who offer hope, support and encouragement, and who suggest
strategies and resources for change.

-Recovery is culturally-based and influenced: Culture and cultural background in
all of its diverse representations, including values, traditions and beliefs, are keys in
determining a person’s journey and unique pathway to recovery.

Recovery is supported by addressing trauma: Services and supports should be trauma-
informed to foster safety (physical and emotional) and trust, as well as promote choice,
empowerment and collaboration.

-Recovery involves individual, family and community strengths and responsibility:
Individuals, families, and communities have strengths and resources that serve as a
foundation for recovery.

-Recovery is based on respect: Community, systems and societal acceptance and
appreciation for people affected by mental-health and substance-use problems —
including protecting their rights and eliminating discrimination — are crucial in
achieving recovery.

National Institute of Drug Abuse – Monitoring the Future

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