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| '''Inhalants''' || 4.5% || 5.3% || 10% || <1% | | '''Inhalants''' || 4.5% || 5.3% || 10% || <1% | ||
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| − | | '''Stimulants''' || 2.2% || 2.4% || 17% || | + | | '''Stimulants''' || 2.2% || 2.4% || 17% || 0.6% |
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| − | | '''Cocaine ''' || 1.8% || '''3.7%''' || 23% || | + | | '''Cocaine ''' || 1.8% || '''3.7%''' || 23% || 0.4% |
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* A quarter of adolescents who use marijuana go on to develop marijuana use disorder; this fraction is higher than for adolescents using alcohol and similar to rates of cocaine and heroin users developing cocaine/heroin use disorder. | * A quarter of adolescents who use marijuana go on to develop marijuana use disorder; this fraction is higher than for adolescents using alcohol and similar to rates of cocaine and heroin users developing cocaine/heroin use disorder. | ||
| − | === | + | ==High-Yield Facts== |
| − | + | ||
| − | + | ||
| + | ===Black belt facts=== | ||
| + | *DSM-IV does not recognize '''cannabis withdrawal''' as a distinct diagnosis, despite extensive data that such syndrome exists (3) | ||
| + | |||
| + | ==Further Reading== | ||
| + | |||
| + | (1) Lewis's Child and Adolescent Psychiatry. 2008 <br> | ||
| + | (2) Wu et.al. Racial/Ethnic Variations in Substance-Related Disorders Among Adolescents in the United States. Arch Gen Psychiatry. 2011;68(11):1176-1185 <br> | ||
| + | (3) Budney AJ, Hughes JR, Moore BA, Vandrey R: Review of the validity and significance of cannabis withdrawal syndrome. Am J Psychiatry 161:1967–77, 2004. | ||
[[Category:Substance Use Disorders]] | [[Category:Substance Use Disorders]] | ||
{{stub}} | {{stub}} | ||
Revision as of 20:51, 28 November 2011
Introduction
Substance use disorders (SUDs) include two major categories: substance abuse (SA) and substance dependence (SD). In addition, there are intoxication and withdrawal states related to specific substances.
Generally, the term illicit substances does not include alcohol, and tobacco, but does include prescription medications used inappropriately. Alcohol, tobacco, and caffeine are "licit" substances in this sense.
While increased tolerance and s/sx of withdrawal are frequently used to screen for SD, they are neither necessary nor sufficient (need 3 of 7 criteria) to make the diagnosis.
Epidemiology
Prevalence of substance use and substance-related disorder increase from early to late adolescence. Approximately one in four older adolescents meets criteria for abuse for at least one substance, and one in five meets criteria for SD. (1)
This table was adopted from a large survey of drug use in adolescents (12-17) in the last year, n=72561 (2):
| Substance | Population prevalence | Prevalence in Native Americans | Population fraction developing use disorder | Use disorder Prevalence |
| Alcohol | 35% | 37% | 16% | 5.4% |
| Any drug use* | 19% | 31% | 23.8% | 4.6% |
| Marijuana | 14% | 23.5% | 26% | 3.4% |
| Opioid analgesics | 7.5% | 9.7% | 15% | 1.2% |
| Inhalants | 4.5% | 5.3% | 10% | <1% |
| Stimulants | 2.2% | 2.4% | 17% | 0.6% |
| Cocaine | 1.8% | 3.7% | 23% | 0.4% |
* excludes alcohol and nicotine.
Few points are notable:
- Native-American adolescents have startling rates of drug use (not necessarily alcohol); overall, Native-Americans have highest prevalence of substance-related use (47.5%).
- Opioid analgesics have replaced inhalants as the second most used drug.
- A quarter of adolescents who use marijuana go on to develop marijuana use disorder; this fraction is higher than for adolescents using alcohol and similar to rates of cocaine and heroin users developing cocaine/heroin use disorder.
High-Yield Facts
Black belt facts
- DSM-IV does not recognize cannabis withdrawal as a distinct diagnosis, despite extensive data that such syndrome exists (3)
Further Reading
(1) Lewis's Child and Adolescent Psychiatry. 2008
(2) Wu et.al. Racial/Ethnic Variations in Substance-Related Disorders Among Adolescents in the United States. Arch Gen Psychiatry. 2011;68(11):1176-1185
(3) Budney AJ, Hughes JR, Moore BA, Vandrey R: Review of the validity and significance of cannabis withdrawal syndrome. Am J Psychiatry 161:1967–77, 2004.