Adolescents aged 12 to 17 years who use alcohol, cannabis, tobacco, and/or illegal drugs are more likely to develop life-long substance use disorder (SUD) than those who start at a later age, researchers reported in a letter to JAMA Pediatrics.

The researchers examined data for individuals aged 12 to 25 years from the 2015 to 2018 National Surveys on Drug Use and Health (NSDUH) of the Substance Abuse and Mental Health Services Administration. The data included initiation dates, use in the past 12 months, lifetime use, and diagnosed SUD.

Lifetime substance use among adolescents in 2018 was, on average, 26.3% for alcohol, 15.4% for cannabis, and 13.4% for tobacco. For those aged 18 years and older, the prevalence was 79.7% for alcohol, 51.5% for cannabis, and 55.0% for tobacco.

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The prevalence of cannabis use disorder was higher among adolescents (aged 12-17 years) than young adults within 12 months of first use. The prevalence of lifetime use of illicit drug use within 12 months of first use was 30.9% for heroin use disorder and 24.8% for methamphetamine use disorder.

A limitation of this study was that the NSDUH data excludes incarcerated and unhoused individuals, which means prevalence could be underestimated.

“Nevertheless,” the researchers concluded, “our results identified adolescents as highly vulnerable to SUDs, supporting the need for research to evaluate the efficacy of screening for substance use and SUDs in primary care settings and the timely treatment thereof.”

Disclosures: Dr Compton reports stock ownership in General Electric, 3M, and Pfizer Inc. No other disclosures were reported.


Volkow ND, Han B, Einstein EB, Compton WM. Prevalence of substance use disorders by time since first substance use among young people in the US. JAMA Pediatr. Published online March 29, 2021. doi:10.1001/jamapediatrics.2020.6981

This article originally appeared on Psychiatry Advisor