Regular marijuana use by teens continues to be a concern

NIDA’s 2012 Monitoring the Future survey shows rates stable or down for most drugs

marijuanaContinued high use of marijuana by the nation’s eighth, 10th and 12th graders combined with a drop in perceptions of its potential harms was revealed in this year’s Monitoring the Future survey, an annual survey of eighth, 10th, and 12th-graders conducted by researchers at the University of Michigan. The survey was carried out in classrooms around the country earlier this year, under a grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

The 2012 survey shows that 6.5 percent of high school seniors smoke marijuana daily, up from 5.1 percent five years ago. Nearly 23 percent say they smoked it in the month prior to the survey, and just over 36 percent say they smoked within the previous year. For 10th graders, 3.5 percent said they use marijuana daily, with 17 percent reporting past month use and 28 percent reporting use in the past year. The use escalates after eighth grade, when only 1.1 percent reported daily use, and 6.5 percent reported past month use. More than 11 percent of eighth graders said they used marijuana in the past year.

The Monitoring the Future survey also showed that teens’ perception of marijuana’s harmfulness is down, which can signal future increases in use. Only 41.7 percent of eighth graders see occasional use of marijuana as harmful; 66.9 percent see regular use as harmful. Both rates are at the lowest since the survey began tracking risk perception for this age group in 1991. As teens get older, their perception of risk diminishes. Only 20.6 percent of 12th graders see occasional use as harmful (the lowest since 1983), and 44.1 percent see regular use as harmful, the lowest since 1979.

A 38-year NIH-funded study, published this year in the Proceedings of the National Academy of Sciences, showed that people who used cannabis heavily in their teens and continued through adulthood showed a significant drop in IQ between the ages of 13 and 38—an average of eight points for those who met criteria for cannabis dependence. Those who used marijuana heavily before age 18 (when the brain is still developing) showed impaired mental abilities even after they quit taking the drug. These findings are consistent with other studies showing a link between prolonged marijuana use and cognitive or neural impairment.

“We are increasingly concerned that regular or daily use of marijuana is robbing many young people of their potential to achieve and excel in school or other aspects of life,” said NIDA Director Nora D. Volkow, M.D. “THC, a key ingredient in marijuana, alters the ability of the hippocampus, a brain area related to learning and memory, to communicate effectively with other brain regions. In addition, we know from recent research that marijuana use that begins during adolescence can lower IQ and impair other measures of mental function into adulthood.”

Research clearly demonstrates that marijuana has the potential to cause problems in daily life or make a person’s existing problems worse. In one study, heavy marijuana abusers reported that the drug impaired several important measures of well-being and life achievement, including physical and mental health, cognitive abilities, social life, and career status.

“We should also point out that marijuana use that begins in adolescence increases the risk they will become addicted to the drug,” said Volkow. “The risk of addiction goes from about 1 in 11 overall to about 1 in 6 for those who start using in their teens, and even higher among daily smokers.”

Use of other illicit drugs among teens continued a steady modest decline. For example, past year illicit drug use (excluding marijuana) was at its lowest level for all three grades at 5.5 percent for eighth graders, 10.8 percent for 10th graders, and 17 percent for 12th graders. Among the most promising trends, the past year use of Ecstasy among seniors was at 3.8 percent, down from 5.3 percent last year.

“Each new generation of young people deserves the chance to achieve its full potential, unencumbered by the obstacles placed in the way by drug use,” said Gil Kerlikowske, director of National Drug Control Policy. “These long-term declines in youth drug use in America are proof that positive social change is possible. But now more than ever we need parents and other adult influencers to step up and have direct conversations with young people about the importance of making healthy decisions. Their futures depend on it.”

The survey also looks at abuse of drugs that are easily available to teens because they are generally legal, sometimes for adults only (tobacco and alcohol), for other purposes (over-the-counter or prescribed medications; inhalants), or because they are new drugs that have not yet been banned. Most of the top drugs or drug classes abused by 12th graders are legally accessible, and therefore easily available to teens.

For the first time, the survey this year measured teen use of the much publicized emerging family of drugs known as “bath salts,” containing an amphetamine-like stimulant that is often sold in drug paraphernalia stores. The data showed a relative low use among 12th graders at 1.3 percent. In addition, the survey measured use of the hallucinogenic herb Salvia, finding that past year use dropped among 10th and 12th graders, down to 4.4 percent for 12th graders from last year’s 5.9 percent.

Abuse of synthetic marijuana (also known as K-2 or Spice) stayed stable in 2012 at just over 11 percent for past year use among 12th graders. While many of the ingredients in Spice have been banned by the U.S. Drug Enforcement Administration, manufacturers attempt to evade these legal restrictions by substituting different chemicals in their mixtures. Another drug type – inhalants – continues a downward trend. As one of the drugs most commonly used by younger students, the survey showed a past year use rate of 6.2 percent among eighth graders, a significant drop in the last five years when the 2007 survey showed a rate of 8.3 percent.

The data shows a mixed report regarding prescription drug abuse. Twelfth graders reported non-medical use of the opioid painkiller Vicodin at a past year rate of 7.5 percent. Since the survey started measuring its use in 2002, rates hovered near 10 percent until 2010, when the survey started reporting a modest decline. However, past year abuse of the stimulant Adderall, often prescribed to treat ADHD, has increased over the past few years to 7.6 percent among high school seniors, up from 5.4 percent in 2009. Accompanying this increased use is a decrease in the perceived harm associated with using the drug, which dropped nearly 6 percent in the past year—only 35 percent of 12th graders believe that using Adderall occasionally is risky. The survey continues to show that most teens who abused prescription medications were getting them from family members and friends.

The survey also measured abuse of over-the-counter cough and cold medicines containing dextromethorphan─5.6 percent of high school seniors abused them in the past year, a rate that has held relatively steady over the past five years.

The 2012 results also showed a continued steady decline in alcohol use, with reported use at its lowest since the survey began measuring rates. More than 29 percent of eighth graders said they have used alcohol in their lifetime, down from 33.1 percent last year, and significantly lower that peak rate of 55.8 percent in 1994. For 10th graders, 54 percent of teens reported lifetime use of alcohol, down from its peak of 72 percent in 1997. Binge drinking rates (five or more drinks in a row in the previous two weeks) have been slowly declining for eighth graders, at 5.1 percent, down from 6.4 percent in 2011, and 13.3 percent at their peak in 1996.

Cigarette smoking continues at its lowest levels among eighth, 10th and 12th graders, with dramatic long-term improvement. Significant declines were seen in lifetime use among eighth graders, down to 15.5 percent from last year’s 18.4 percent, compared to nearly 50 percent at its peak in 1996. Significant declines were also seen in 10th grade lifetime use of cigarettes, down to 27.7 percent from 30.4 percent in 2011. Peak rates for 10th graders were seen in 1996 at 61.2 percent. For some indicators, including past month use in all three grades, cigarette smoking remains lower than marijuana use, a phenomenon that began a few years ago.

The survey also measures several other kinds of tobacco delivery products. For example, past year use of small cigars was reported at nearly 20 percent for 12th graders, with an 18.3 percent rate for hookah water pipes.

“We are very encouraged by the marked declines in tobacco use among youth. However, the documented use of non-cigarette tobacco products continues to be a concern,” said Howard K. Koh, M.D., M.P.H., assistant secretary for health for the U.S. Department of Health and Human Services. “Preventing addiction includes helping kids be tobacco free so they can enjoy a fighting chance for health.”

Overall, 45,449 students from 395 public and private schools participated in this year’s Monitoring the Future survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th-graders nationwide. Eighth and 10th graders were added to the survey in 1991. Survey participants generally report their drug use behaviors across three time periods: lifetime, past year, and past month. Questions are also asked about daily cigarette and marijuana use. NIDA has provided funding for the survey since its inception by a team of investigators at the University of Michigan at Ann Arbor, led by Dr. Lloyd Johnston. Additional information on the MTF Survey, as well as comments from Dr. Volkow, can be found at www.drugabuse.gov/drugpages/MTF.html.
MTF is one of three major surveys sponsored by the U.S Department of Health and Human Services that provide data on substance use among youth. The others are the National Survey on Drug Use and Health and the Youth Risk Behavior Survey. The MTF website is: http://monitoringthefuture.org. Follow Monitoring the Future 2012 news on Twitter at @NIDANews, or join the conversation by using: #MTF2012. Additional survey results can be found at www.hhs.gov/news or www.whitehouse.gov/ondcp. Information on all of the surveyed drugs can be found on NIDA’s Web site: www.drugabuse.gov.

The National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration, is the primary source of statistical information on substance use in the U.S. population 12 years of age and older. More information is available at: www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm.

The Youth Risk Behavior Survey, part of HHS’ Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System, is a school-based survey that collects data from students in grades 9-12. The survey includes questions on a wide variety of health-related risk behaviors, including substance abuse. More information is available at www.cdc.gov/HealthyYouth/yrbs/index.htm.

In Favor of the Pacifier

Pacifier PrinciplesIn Favor of the Pacifier

Most parents wonder whether or not they should use a pacifier with their baby. Some object because they are breastfeeding, while others have images of five year old kids that are addicted to their pacifier burned in their minds, believing that it is too habit forming and hard to break. Some believe that if a baby has a pacifier, she won’t learn how to suck her own thumb (which many, like I, want). Some are afraid that a pacifier will mean braces will be needed, and others simply fear a baby will not be able to self-soothe without it.

But, pacifiers have been around since babies have been, so there must be good reason for them! Archaeologists have found prehistoric pacifiers, Ancient Egyptian drawings of babies with pacifiers and different forms of pacifiers have been used throughout the centuries. If you follow basic pacifying principles and use them properly, they will prove to be valuable on many levels for baby and you.

Newborns Need to Suckle

A newborn has very little control over her body, but she does have control over her mouth.  She has an actual need to suckle separate from feeding, which satisfies the oral stimulation she needs. A newborn may have the need to suckle for several hours throughout the day! Remember, though, that vigorous sucking does make your newborn tired. This is the type of sucking that should be happening during feeding, while pacifiers should be suckled (a very clear difference in the type of suck). If your baby is sucking aggressively, she is probably hungry. Don’t let a newborn suck vigorously at a pacifier when it close to feeding time. You don’t want her to waste her energy on the pacifier and not have enough to get in a full feed.

Reducing the Chance of SIDS

Several studies have shown a major decrease of SIDS deaths among babies who use a pacifier. The American Academy of Pediatrics goes as far as recommending pacifier use! In a report published in 2005, they concluded:

“Published case-control studies demonstrate a significant reduced risk of SIDS with pacifier use, particularly when placed for sleep. Encouraging pacifier use is likely to be beneficial on a population-wide basis: 1 SIDS death could be prevented for every 2733 (95% CI: 2416–3334) infants who use a pacifier when placed for sleep (number needed to treat), based on the US SIDS rate and the last-sleep multivariate SOR resulting from this analysis. Therefore, we recommend that pacifiers be offered to infants as a potential method to reduce the risk of SIDS. The pacifier should be offered to the infant when being placed for all sleep episodes, including daytime naps and nighttime sleeps. This is a US Preventive Services Task Force level B strength of recommendation based on the consistency of findings and the likelihood that the beneficial effects will outweigh any potential negative effects. In consideration of potential adverse effects, we recommend pacifier use for infants up to 1 year of age, which includes the peak ages for SIDS risk and the period in which the infant’s need for sucking is highest. For breastfed infants, pacifiers should be introduced after breastfeeding has been well established.”

For Breastfed Babies

Opinions are all over the place on what parents should do about pacifiers for the breastfed baby. Some resources suggest waiting 3-4 weeks, others recommend waiting up to 6 weeks, while some say it’s ok to start with them right away. There is no right or wrong time to introduce a pacifier to breastfed babies. Ultimately, you have to do what is right for you and your baby. The main concerns with pacifiers and breastfeeding are nipple confusion and mom’s milk supply getting established, so keep these things in mind:

  • If your baby is having a hard time figuring out how to breastfeed, latch on or suck, you should probably hold off on the pacifier.
  • If your baby is not being super fussy and is not needing to suck all the time for comfort, you don’t need to give her a pacifier right away.
  • Don’t ever substitute a pacify for feeding your baby or to hold her off. Newborns need to eat very frequently and should not be encouraged to wait longer between feeds until she is much older. Your newborn baby needs to be eating 8-12 times a day.
  • If your baby is having problems gaining weight, she should be at the breast as often as possible and a pacifier should not be used until weight gain is adequate.
  • If mom is having problems with her milk supply, a pacifier should not be used until the supply is established. The more a baby sucks at the breast, the more of a demand for milk there is.
  • If your baby is spending an hour or more at the breast for a feeding, she is probably spending some time just suckling. A pacifier may help satisfy her desire to suck between feeds. Just be sure that you know your baby is not hungry.
  • Studies show that babies that have a pacifier wean earlier than those that do not. This is probably because as a baby gets older and is established on solid food, his desire to suck keeps him on the breast. Babies who use pacifiers are getting that need to suck met with the pacifier instead of the breast, so they may decide to give up breastfeeding sooner than if they did not take a pacifier. To avoid this, limit pacifier use for babies older than three months.

How Long to Use a Pacifier?

The AAP recommends pacifier use up to one year. The most important time is during those first three months when a baby’s need to suckle is the strongest and he is unable to control his limbs and find his thumb to suck on. The pacifier will help calm him before sleep and soothe him when he is upset. Many children (including some toddlers) use a pacifier as a transitional object, something that relieves stress and helps your child adjust to new or challenging situations. Once you are past the first few months, limit pacifier use so it does not become a habit that is difficult to break and causes developmental delays. If your child is learning to speak or is having speech delays, the pacifier can be a problem.

It is best to set an absolute timeline for your baby’s pacifier use, so you have a plan on when you will get rid of it as soon as you get started. This way time won’t get away from you and you won’t have a five year old walking around with a pacifier in his mouth all day long. The longest your baby should probably go using a pacifier is 18 months, although this is a personal decision. Whatever time you decide to get rid of the pacifier is best, stick with it and don’t let your child change your mind!

Pacifier Principles

  1. Don’t use a pacifier to replace feeding a hungry baby. If your baby is hungry it is important to feed him. If you need to keep baby quiet while you prepare to feed him or if you are trying to hold him off for a few minutes using a pacifier is ok. Just be sure that you are keeping track of your baby’s feeding schedule and you are determining why he is crying before offering the pacifier.
  2. Don’t use a pacifier at all times of the day, as your baby gets older. When your baby is a newborn and for the first three months your baby will want and need to suck more than any other time. But, as your baby enters his fourth month consider reducing use to sleeping times only. A child does not need a pacifier when he is happy and playing.
  3. If your newborn doesn’t take to a pacifier right away, keep trying. This doesn’t mean that he won’t like a pacifier or doesn’t have a need for one. Some babies just take a while to get used to one. Also, sometimes when a baby is figuring out how to suck a pacifier it pops right back out. This is not always intentional and could be result of the way you are offering it. As you put the pacifier in your baby’s mouth, try lightly stroking just to the side of his mouth and gently hold the pacifier in his mouth for a moment as he starts sucking.
  4. Find a pacifier that your baby likes. There are many different types of pacifiers available and babies do not find them one in the same. Try to find one that matches your nipple (or the nipple on the bottle you use) the closest. IF your baby doesn’t seem to be taking to one, try another kind until you find one he likes.

To read all about Tracy Hogg’s Sleep Methods and to hear many case studies, check out her incredible books: Secrets of the Baby Whisperer and The Baby Whisperer Solves All Your Problems.

Recommended Reading

To read more about pacifier use or problems, we recommend Tracy Hogg’s books, Secrets of the Baby Whisperer and The Baby Whisperer Solves All Your Problems