A new survey of US teenagers finds that most have used alcohol and drugs by the time they reach adulthood.
The new research, published online in the Archives of General Psychiatry, found that almost 80% of teens had tried alcohol and more than 15% were abusing it by the time they turned 18. Some 16% were abusing drugs by age 18.
In comparison, 18% of adults meet standards for "lifetime abuse" of alcohol, and 11% meet the criteria for drug abuse, the study notes, suggesting an early start for at least some of those substance abusers.
"It's in adolescence that the onset of substance abuse disorders occurs for most individuals," said lead study author Dr Joel Swendsen, director of research at the National Centre of Scientific Research in Bordeaux, France. "That's where the roots take place."
Substances dangerous for young minds
"The reason we worry about it is that the earlier they use these substances the earlier they become addicted to it," said Susan Foster, vice president and director of policy research and analysis at the National Centre on Addiction and Substance Abuse at Columbia University in New York.
Foster, who was not involved in the new study, said starting to use potentially addictive substances is especially dangerous to younger people because their brains are still developing.
"There's really a type of rewiring that goes on with continued use that can result in an increased interest in using and an inability to stop using," she said.
The new study is based on interviews with 10,123 US teens that were surveyed between 2001 and 2004.
Teens use illicit drugs
Of the approximately 3,700 teens between the ages of 13 and 14, about 10% were drinking alcohol regularly - defined as twelve drinks within a year. That number jumped to about 50% in the approximately 2,300 17- to 18-year-olds.
Almost one in three of the regular users in the oldest age group met the criteria for lifetime alcohol abuse, the authors found. And the median age of onset for alcohol abuse, with or without "dependence," was 14.
As for drugs, about 60% of the teens said they had the opportunity to use illicit drugs, such as marijuana, cocaine, tranquilisers, stimulants and painkillers.
About one in ten of the 13- and 14-year-olds said they used at least one such drug, and that increased to about 40% in the oldest age group. Pot was the most common type of drug used, followed by prescription drugs.
Average age was 14
The median age of onset for drug abuse was 14 with dependence and 15 without dependence.
The researchers found differences between the kinds of youngsters who transitioned from general alcohol use to regular use, for example. Boys were more likely to transition between the usage groups, while blacks and other non-white ethnic groups were the least likely to do so.
"These findings may contradict common assumptions but are consistent with previous investigations in adult and adolescent samples," write the researchers.
Foster, whose organisation published a comprehensive report on substance abuse in US adolescents last year, also said these numbers are consistent with past research.
"We've had spikes and declines of abuse across the population," she said.
Dr Swendsen's team writes that strategies need to target adolescents to prevent drug and alcohol abuse, but need to take into account the different forces that influence it.
"We don't need to bombard them with information that's beyond their stage of development, but don't think a 13-year-old doesn't know what cannabis is," Dr Swendsen said.
Disease is complex
"Like any other disease it's very complex," Foster said. "There are a lot of... factors that come together."
She added that findings like those in the new study are especially helpful for parents and healthcare professionals who need to know how important their roles are in both preventing use and getting teens help.
"I think a lot of people don't understand yet the nature of the problem," Foster said.
(Andrew M. Seaman, Reuters Health, April 2012)
Street drugs and alcohol