Prevalence of Substance Abuse

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Abstract
Quantifying the number of young people who are high risk because of substance abuse is complicated by the ambiguity of existing definitions and the absence of ideal data. Among other definitional problems, the term substance abuse covers a multitude of “sins”—smoking, drinking, use of marijuana, and use of a whole range of drugs from over-the-counter diet pills to illicit heroin and cocaine. In recent years, chewing smokeless tobacco and wine coolers have been added to the menu. To add to the confusion, the substance abuse field has not produced an adequate response to the question: Who is at risk of long-term consequences? In the teen pregnancy field, the problem is generally defined using the outcome to be prevented, early childbearing (see Chapter 5). Teen fertility is quantifiable, measured from official statistics (Vital Statistics), and the characteristics of those at risk can be determined by studying the outcome date. In the delinquency field, there are official arrest figures. In the education field, school records and selfreports can be used to define low achievers and dropouts. In the substance abuse field, research suggests that there are important differences between occasional users and those who ever tried these substances (but are not abstainers), and the subset who become heavy users. It is the subset of heavy users who should be the prime targets of interventions, and yet it appears that most prevention is aimed at the larger group. The task of defining risk groups for substance-abuse prevention programs would be facilitated if one could turn to a data set that had all the requisite parts: a large random sample of 10- to 17-year-olds, followed longitudinally, and rich in detail about precursors and the social environment. From such a resource, we could better understand the antecedents of drug and alcohol use, current use patterns by different subgroups of the population, and the consequences that followed from that use. A number of researchers have produced important work on what they describe as the etiology or the causes of substance abuse, others have focused on the consequences, and many surveys have been conducted to track prevalence patterns.

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