Saturday, August 31, 2013

New Report Sheds Light on Adolescent Substance Use

In a new report by the Center for Behavioral Health Statistics and Quality (CBHSQ), a public health data wing of SAMHSA, we are shown the rates of adolescent substance use through the lens of an "average day". While the overall use of substances declined from 2008 - the previous time this data was compiled -, rates for treatment-seeking have remained stable and the numbers are still quite shocking.

Among the highlights (emphasis mine):  
According to combined 2010 and 2011 NSDUH data, in the past year, nearly 7 million adolescents aged 12 to 17 drank alcohol, nearly 5 million used an illicit drug, and 3 million smoked cigarettes.

In addition, on an average day during the past year, adolescents aged 12 to 17 used the following substances:
• 881,684 smoked cigarettes;
• 646,702 used marijuana;
• 457,672 drank alcohol;
• 38,540 used inhalants;
• 21,775 used hallucinogens;
• 6,747 used cocaine; and
• 5,602 used heroin.

The combined 2010 and 2011 NSDUH data indicate that:
• adolescents who used alcohol in the past month drank an average of 4.3 drinks per day on the days they drank, and
• adolescents who smoked cigarettes in the past month smoked an average of 3.9 cigarettes per day on the days they smoked.
Number of Adolescents Aged 12 to 17 Who Used Cigarettes, Alcohol, or Illicit Drugs for the First Time on an Average Day: 2010 and 2011 NSDUHs:
This is a bar graph comparing number of adolescents aged 12 to 17 who used cigarettes, alcohol, or illicit drugs for the first time on an average day: 2010 and 2011 NSDUHs. Accessible table located below this figure.
Source: 2010 and 2011 SAMHSA National Surveys on Drug Use and Health (NSDUHs).

Treatment Data -
TEDS reported that there were 132,850 admissions for adolescents aged 12 to 17 to substance abuse treatment programs in 2010 (TEDS data come primarily from facilities that receive some public funding). TEDS indicates that, on a typical day in 2010, adolescent admissions to treatment reported the following primary substances of abuse:
This is a bar graph comparing number of adolescents aged 12 to 17 admitted to publicly funded substance abuse treatment facilities on a typical day, by primary substance of abuse: 2010 TEDS. Accessible table located below this figure.

The report also notes that in 2011 there were over 280,000 drug-related ED visits by adolescents, and on a typical day, alcohol - alone, or in combination with another drug - is most likely to be involved.

You can see the full report here.

Saturday, August 24, 2013

Street-Obtained Buprenorphine: Drug of Abuse, or Proof of Limited Access?

In a recent article from the journal Addictive Behaviors, researchers discovered that buprenorphine was rarely, if ever, used by IV drug users to get high. In fact, the vast majority of people who reported acquiring the medication from an illicit source did so with the expressed purpose of avoiding withdrawal symptoms. This seems to contradict the common misconception that heroin users "get high" on Suboxone, therefore we should promote abstinence-based treatment. To the contrary, studies like this one could be interpreted as evidence there is not enough access to these medications - if there were, people wouldn't be forced to seek the drugs from street dealers or friends.
Interested to hear your take on the subject.

Below is a table from study. You can read the abstract here:

Table 2. Knowledge and Use of Buprenorphine among 602 Injection Drug Users in Baltimore, Maryland.
N (%)
N (%)
N (%)
N (%)
N (%)
Ever heard of drug537 (89)355 (59)52 (9)68 (11)541 (90)
Seen sold on street430 (71)232 (39)13 (2)18 (3)446 (74)
Ever used246 (41)112 (19)12 (2)9 (1)273 (45)
Usual sourcea
124 (50)
32 (13)
55 (22)
71 (63)
8 (7)
18 (16)
9 (75)
1 (8)
1 (8)
6 (67)
2 (22)
152 (56)
35 (13)
64 (23)
Used last 3 months73 (12)50 (8)4 (1)1 (< 1)95 (16)
Used last 30 days47 (8)35 (6)3 (< 1)1 (< 1)69 (11)
year 1stused (median)20052006200620032005
Ever used to get high26 (4)10 (2)2 (< 1)1 (< 1)30 (5)
Usual sourcea
1 (4)
10 (38)
15 (58)
2 (20)
3 (30)
5 (50)
1 (50)
1 (50)
1 (100)
2 (7)
12 (40)
18 (60)
Used to get high in last 3 months14 (2)7 (1)1 (< 1)015 (2)
Used to get high in last 30 days5 (1)3 (< 1)1 (< 1)08 (1)
Used to get high more than once20 (3)8 (1)1 (< 1)1 (< 1)23 (4)
Totals may not add to 100 because of missing, don’t know, and refused responses; Individuals may be represented more than once in the “Any” column if they reported on more than one drug.
Proportion of the usual source of drug is among those who had reported ever using/ever using to get high
Genberg, B. et al. (2013). Prevalence and correlates of street-obtained buprenorphine use among current and former injectors in Baltimore, Maryland. Addictive Behaviors.

Monday, August 19, 2013

UMN Researchers: Brief Intervention Effective with Adolescent Substance Users

Some promising results out of the University of Minnesota’s Center for Adolescent Substance Abuse Research: brief interventions can help students aged 12-18 dramatically reduce their substance use – in as few as 2 sessions. The team, led by clinical psychologist Ken Winters, PhD, Tamara Fahnhorst, MPH, and Andria Botzet, M Ed., implemented a randomized controlled trial in an urban public school system, delivering one of two treatment conditions, plus a control. The first, student-only condition delivered two one-hour therapy sessions in a two-week period; the second added a session with the parent(s) of the student. The results are impressive: while 37% of the control group reported avoiding cannabis during the last three months at the 6-month follow-up, 63% of the parent-group and over 50% of the student-only group reported the same.

See a complete rundown at Drug and Alcohol Findings or check the Journal of Substance Abuse Treatment for the abstract.