Ecstasy use up sharply; use of many drugs steady, some declines

December 13, 2000

Use of the drug "ecstasy" (MDMA) by American adolescents continued to rise sharply this year, according to the latest results from the Monitoring the Future study, conducted at the University of Michigan Institute for Social Research (ISR). Reporting on the 26th national survey in the Monitoring the Future series, based on nationally representative surveys of some 45,000 students in grades 8, 10, and 12, ISR research scientists Lloyd D. Johnston, Jerald C. Bachman, and Patrick M. O'Malley also find that the use of several drugs has declined substantially in recent years. Inhalants, LSD, crystal methamphetamine ("ice"), and Rohypnol all are down from peak levels in the mid-90s. The proportion of students using each of these drugs sometime in the 12 months prior to the survey has declined by between a quarter and a third at all grade levels at which use was asked. In just the last year or two, crack cocaine and cocaine powder have also started to decline at all three grade-levels, though they have shown much smaller proportional declines so far.

During the past decade, the peak rates for using any illicit drug were reached among teens in 1996 or 1997, the U-M researchers report. Since then, this measure of overall use, which is largely driven by changes in the most widely used illicit drug, marijuana, has remained fairly level in the upper grades, but has shown a steady, gradual decline among eighth-graders.

According to Johnston, the study's principal investigator, this year the 12th- graders, who have generally tended to be the last to exhibit downturns in drug use, showed significant declines in their reported use of LSD, crack, and cocaine powder, all for the first time in recent years. This was also the first time in some years that the eighth-graders showed a significant decline in their use of heroin.

"One of the most encouraging findings from this year's survey," comments Johnston, "is the substantial and ongoing decline in teens' use of cigarettes and smokeless tobacco. The long-term implications of these changes for the health and longevity of this generation of American young people are enormous." [See accompanying news release on tobacco use for details.]

Despite progress on several fronts in recent years, the use of quite a few drugs remained essentially unchanged in the year 2000 at all three of the grade levels studied. These drugs include amphetamines, barbiturates, tranquilizers, hallucinogens other than LSD, opiates other than heroin, and alcohol.

Monitoring the Future, which is conducted at the U-M Institute for Social Research, has been supported since its inception 25 years ago through a series of investigator-initiated research grants made by the National Institute on Drug Abuse (NIDA), one of the National Institutes of Health in the U.S. Department of Health and Human Services. This year's survey results are based on nationally representative samples of 8th-, 10th-, and 12th-grade students attending public and private schools in the coterminous United States. In all, 45,200 students located in 435 schools completed the survey in the spring of 2000.

"Over the 25-year history of this study, the story has become more complicated by the continuing arrival of new substances onto the national scene," observes Johnston. "There are now many more drugs out there for kids to use and for us to try to track. Further, since the use of most drugs moves somewhat independently in response to factors specific to each---such as price, reputation, and perceived dangers---it is possible to have the use of various drugs simultaneously moving in quite different directions. That clearly is the case this year."

While the use of some drugs is falling, and the use of a number of others is holding steady, a few are showing increases. Increasing this year are the use of ecstasy (MDMA) by students at all grade levels; the use of heroin by 12th-graders; and the use of steroids by 10th-graders.

Ecstasy

In 1999, Johnston, O'Malley, and Bachman reported a sharp increase in ecstasy use among 10th- and 12th-graders---an increase that continued this year. But the growing popularity of this drug is now evident among eighth-graders, as well. The proportion of eighth-graders reporting any use of ecstasy in the prior 12 months rose from 1.7 percent in 1999 to 3.1 percent in 2000. Among 10th-graders, the use of ecstasy rose from 4.4 percent to 5.4 percent, and among 12th-graders from 5.6 percent to 8.2 percent. Ecstasy is thus used by more American teen-agers today than is cocaine.

Young adults in their early 20s also have been showing a sharp increase in ecstasy use, according to results from another part of the Monitoring the Future study. Each year a sample of participants from previous graduating high school classes is followed up by mail. These samples are representative of 19- through 32-year olds who are high school graduates, including college students. From 1994 through 1999, these follow-up surveys showed a sharp increase in ecstasy use in the 19- to 22-year-old age group, a slightly less sharp increase among 23- to 26-year-olds, but very little increase among those 27 or older. (Data from the 2000 follow-up survey are not yet available.)

"Thus the spread of ecstasy so far has been concentrated among those in their teens and early 20's---age groups most likely to be into the rave, club, and party scenes, where this so-called 'club drug' is frequently taken," says Johnston. Ecstasy use among American college students, who comprise a fair proportion of the 19-to 22-year-old follow-up respondents, rose from 0.5 percent in 1994 to 5.5 percent in 1999 in terms of past-year use, according to the study. (About 1,400 college students respond each year.)

Ecstasy, which is a street name for methylenedioxymethamphetamine or MDMA, is a synthetic compound with both stimulant and mildly hallucinogenic properties. Taken in pill form, it has effects that often last for three to six hours. When combined with extended physical exertion like dancing, its use can lead to hyperthermia (severe overheating) and severe dehydration. It can even lead to serious increases in blood pressure, as well as stroke and heart attack. According to the National Institute on Drug Abuse, repeated use may result in lasting neurological changes in the brain. An additional danger lies in the fact that dealers may substitute other, even more dangerous, compounds, sometimes with fatal results.

"Young people have not yet come to see 'ecstasy' as a very dangerous drug," according to Johnston, "and until they do, it seems unlikely that we will see the situation turn around." To date, there has been only a very modest change in that direction, with the proportion of 12th-graders seeing a great risk in trying ecstasy rising, from 34 percent in 1997 to 38 percent in 2000.

Johnston states, "Often it is one of the newer drugs on the scene that is rising in popularity, because its adverse effects have yet to become widely recognized. Other drugs that might have fit the same mold in earlier years, like Rohypnol and PCP, came and went much more quickly, because their dangers were more obvious and word about them spread relatively fast. Cocaine represents a more parallel case to ecstasy and maybe the parallel might be instructive to young people today.

"In the late 70s and early 80s young peoples' recognition of the risks of cocaine developed extremely slowly. Cocaine use was rising, and then remained at peak levels for about nine years, because the dangers of cocaine did not come to be fully appreciated by young people until about 1986. By then a lot of them had gotten into serious trouble with the drug. Maybe this generation of young people could learn from that earlier generation's mistake by learning not to trust all those reassuring things they hear about the newest drug on the block---in this case, ecstasy."

There has also been a dramatic increase in the perceived availability of ecstasy in recent years. While in 1989 only 22 percent of 12th-graders said they could get ecstasy fairly or very easily, if they wanted some, that proportion rose over the following decade to 40 percent by 1999, before again jumping sharply this year to 51 percent.

Because last year the increase in ecstasy use was largely concentrated in the Northeast, Johnston and his colleagues suggested that its use might well diffuse to other parts of the country this year. That seems to be exactly what has happened. In the Northeast there was little or no further increase this year in ecstasy use at any of the three grade levels, but some increase in all of the other three regions (North Central, South, and West) at all grade levels. There was a particularly large increase in ecstasy use this year among 12th-graders in the West, where 14 percent of the 12th-graders now report using ecstasy during the prior 12 months. That compares to 9 percent in the Northeast, and 6 percent in the South and North Central regions.

Heroin

While the use of heroin fell significantly among the 8th-graders this year, it simultaneously rose significantly among 12th-graders. Among eighth-graders, past-year use fell from 1.4 percent to 1.1 percent, reflecting a significant decline in their injecting heroin. Among the 12th-graders, past-year heroin use increased from 1.1 percent in 1999 to 1.5 percent in 2000. In this case, all of the change was due to more 12th-graders using by means other than injection

Steroids

The use of anabolic steroids rose sharply last year among both eighth- and 10th-graders. This year steroid use continued to rise among the 10th-graders, but held steady at grades 8 and 12. These drugs usually are not taken for their psychoactive effects but for their presumed influence on muscle development and healing. Their use is higher among boys than among girls; and in the year 2000, the proportion of boys using them in the prior 12 months was 2.2 percent at eighth-grade, 3.6 percent at 10th-grade, and 2.5 percent at 12th-grade.

Marijuana

Marijuana remains the most widely used of the illicit drugs, with 16 percent of the eighth-graders, 32 percent of the 10th-graders, and 37 percent of the 12th-graders indicating some use in the prior 12-month period. Only among the eighth-graders has there been a statistically significant decline in use between the peak year (1996 for that grade) and 2000, and even there it has been a modest decline. Past year prevalence for eighth-graders declined from 18.3 percent to 15.6 percent between 1996 and 2000. Use peaked at 10th- and 12th-grades a year later (1997), but there has been very little decline since then.

More recent classes of eighth-graders have begun to see marijuana as dangerous to the user, and to become more disapproving of its use, which probably helps to explain the recent decline in use. [Figure 2.] The study's investigators have previously demonstrated that both perceived risk and disapproval can be important determinants of use.

"The younger teens are less likely to have an established pattern of drug-using behavior than older ones, of course," notes Johnston, "which probably makes them the most responsive to new influences in society. They were the first to show many of the upturns in substance use of various sorts early in the 90s, and the first to show many of the downturns later in the 90s." In fact, in addition to marijuana, the more recent downturns started first, and have been the most sustained, among the eighth-graders for crack cocaine, cocaine powder, tranquilizers, Rohypnol, smokeless tobacco, and cigarettes.

Johnston adds, "The fact that these younger cohorts of teen-agers are starting to get the message about many of these drugs is certainly encouraging, but, unfortunately, they haven't yet gotten the message about all of them."

Alcohol

Alcohol use by teens has remained fairly stable in recent years. Nearly a quarter (22 percent) of the eighth-graders report having taken an alcoholic beverage in the last 30 days, and exactly half of the 12th-graders (50 percent) report having done so. One in every 12 eighth-graders (8.3 percent) reports being drunk at least once in the past 30 days, as do a third of the 12th-graders (32.3 percent). "These rates are high by most people's standards," comments Johnston, "but about where they have been over the past several years."

The annual surveys of high school seniors in the Monitoring the Future study were begun in 1975, and the annual surveys of eighth- and 10th grade students were added, starting in 1991. At each grade level students are drawn to be representative of all students in public and private schools in the coterminous United States. They complete self-administered, optically-scanned questionnaires given to them in their classrooms in the spring of the year by U-M personnel. In 2000 the sample sizes for eighth-, 10th-, and 12th-grades, respectively, were 17,311, 14,576, and 13,286. In all about 45,200 students in 435 schools participated in the study.

The results presented here will be published soon in monograph form by the National Institute on Drug Abuse as "Monitoring the Future national results on adolescent drug use: Overview of key findings, 2000," by Lloyd D. Johnston, Patrick M. O'Malley, and Jerald G. Bachman.
-end-
EDITORS: Results of this survey are scheduled to be released at a news conference in Washington, D.C., to be held at the Department of Health and Human Services' Hubert H. Humphrey Building. Participants will include Secretary of Health and Human Services Donna E. Shalala, Director of the Office of National Drug Control Policy Barry R. McCaffrey, Director of the National Institute on Drug Abuse Alan I. Leshner, and the principal investigator of the Monitoring the Future study, Lloyd D. Johnston. For further information on the study, contact Johnston at 734-763-5043.

University of Michigan

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