Patterns of Substance Abuse Among School-Age Children: Clinical Paper


Substance use is prevalent among school-age children, with up to 70% having experimented with substances, and the rates of abuse have been steady at approximately 6% from 1996 – 1999. There are numerous situations that influence the likelihood of a child using a substance, ranging from school to home to peers, with each offering both risk and protective factors. Drug abuse education programs vary widely, and their implementation can take many forms, with interactive, multimodal approaches working the best.


General Prevalence

Substance abuse is prevalent in today’s school-age children. Historically, the rates of use rose from the mid to late 1970’s, leveled out in the 1980’s and began rising again in the 1990’s (Johnson, O’Malley, and Bachman, 1995). Overall, the numbers of students meeting the criteria for having a substance abuse disorder (SUD) remained fairly steady between 1996 and 1999 with youth in both years meeting the DSM-III-R criteria for a substance abuse disorder at a rate of 6.2% in a general community sample (Kandel, Johnson, & Bird, 1999; Rohde, Lewinsohn, & Seely, 1996).

The rates, however, rise sharply when specific populations are considered. With environmental factors, children involved in the juvenile justice system had a lifetime prevalence rate of a SUD of 62.1% and those involved with child welfare a lifetime prevalence of 19.2%. When looking at mental/emotional factors, children had a lifetime prevalence rate of 40.8% of a SUD if they were being seen for mental health issues, and a lifetime prevalence rate of 23.6% if they were classified as having a serious emotional disturbance (Aarons, Brown, Hough, Garland & Wood, 2001).

The most troubling figure, however, is the trend in which teens are asked if they would ever try illegal drugs. This number has been decreasing, with 86% saying they would never try illegal drugs in 1995, 51% in 1996, and 46% in 1997 (Bruner & Fishman, 1998).

Drug-Specific Prevalence

The most abused substance is alcohol in adolescents, followed by cigarettes and marijuana (Johnson, O’Malley and Bachman, 1994). Crome (1997) found that at least 30% of secondary school students drink alcohol regularly, with 10% drinking more than moderately. 10 – 20% of the students smoke cigarettes regularly, 70% have tried at least one illicit drug, with 2.5% using an illicit drug at least weekly. When only a single month is looked at, 33% of 12th graders and 9% of 8th graders reported being drunk at least one time in the past month in the study conducted by Johnston, O’Malley, & Bachman (1999). They also found that 23% of high-school seniors and 10% of 8th graders reported using marijuana in the last month. This is an increase of 9% and 7% over the last 8 years. Cigarette usage in the last month also increased, to 35% of seniors and 18% of 8th graders. This is an increase of 7 and 4% respectively over the last 8 years.

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Derek Wood is a Nationally Board Certified Psychiatric/Mental Health Nurse, and holds a Master's degree in Psychology. His experience in the online arena of mental health can be traced back to 1997, when he was a host for Online Psych on AOL. He joined Get Mental Help, Inc. as Clinical Content Director for Mental Health Matters. Derek, with his wife Lisa, developed the original version of psychTracker (then called A Mood Journal), after his diagnosis with Schizo-Affective Bipolar, when they could not find a system available that was robust enough to help him effectively manage his symptoms and accurately interpret his charting. Derek has worked in the field of mental health since 2001, as a Unit Manager of an adult long-term treatment facility, a charge nurse in an adolescent short-term inpatient facility and long-term residential facility, and as a School Psychologist. He has also written several articles which are being used as CEU for nurses and educators.

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