We are all concerned about the issue of substance abuse by our youths. By substance abuse, we are referring to drugs, alcohol, and cigarettes. According to the 2003 National Survey on Drug Use and Health (NSDUH):
- 11.6% of the U.S. population between 12 and 17 has engaged in illicit drug use
- 29.0% of the age group 12 to 20 drank alcohol in the month prior to the survey, and 19.2% were binge drinkers. A binge drinker is a person who had five or more drinks on a single occasion at least once in the past 30 days
- For the age group between 12 and 17, 12.2% smoke (11.9% of the boys smoke and 12.5% of the girls smoke).
The above survey shows that the size of the problem is large. For example:
- 11.6% of the age group between 12 and 17 means that 2.9 million youths in this age bracket have engaged in illicit drug use
- 29.0% of the age group 12 to 20 means that 10.9 million youths in this age bracket drank alcohol in the month prior to the survey
- 7,000 young people under 16 have their first drink of alcohol every day
- 12.2% of the age group between 12 and 17 means that 3.1 million youths in this age bracket smoke.
Furthermore, the consequences of the problems are also very large. These include problems with academics, health (including mental health), crimes, fights, accidents, alienation from peers and family members, employment, etc. For example, let’s illustrate for the alcohol problem:
- The Center for Disease Control (CDC) reported that 4,554 people under age 21 died from excessive drinking in 2001
- The U.S. National Highway Traffic Safety Administration (NHTSA) reported that 3,571 young drivers ages 16 to 20 died in motor vehicle crashes in 2003, and 1,131 (more than 31%) of these had been drinking
- Youths who start drinking before age 15 are five times more likely to develop alcohol dependence abuses later in life than those who begin drinking at or after 21
- Young people under the age of 21 commit 45% of rapes, 44% of robberies, and 37% of other assaults, and it is estimated that 50% of violent crime is alcohol-related
- Recent medical studies have found that heavy exposure of the adolescent brain to alcohol may interfere with brain activity and brain development, causing loss of memory and other skills.
The youth substance abuse problems clearly have a toll on the American society, in terms of direct and indirect cost, quality of life, and community safety. These problems continue year after year, and in general the seriousness of the problem is not decreasing, and is often increasing.
How do we solve the above problems? Many methods have been proposed. For example, for the alcohol problem, the Underage Drinking Enforcement Training Center (UDETC) has proposed the following methods:
- Increase alcohol prices
- Restrict (i.e., reduce) the density of alcohol outlets
- Enforce minimum purchase age laws
- Control alcohol advertising and promotion
- Encourage public support for alcohol policy change
For the illicit drug use problem, analogous methods have been proposed. These are all useful methods in attacking the problem. However, I believe that there is one important factor that is not addressed by these methods. Children and young people observe and copy the behavior of adults, especially their adult family members. It is not what the adults say that is important, but what is most important is what the adults do. As long as there are serious substance abuse problems among the adult population, it will be extremely difficult, and possibly impossible, to solve the youth substance abuse problems.
Let’s take a look at the corresponding statistics associated with the adult population in the U.S. (Some of the statistics mentioned below were deduced by me based on the statistics provided by the NSDUH and data from the U.S. Census Bureau.)
- 7.9% for age 18 and above has engaged in illicit drug use, as compared to the previously mentioned 11.6% for age 12 to 17
- 54% for age 21 and above drank alcohol in the past month, as compared to the previously mentioned 29% for age 12 to 20. 23% for age 21 and above are binge drinkers, as compared to the previously mentioned 19.2% for age 12 to 20
- 31.9% for age 18 and above smoke, as compared to the previously mentioned 12.2% for age 12 to 17
Thus we see that the percentages of drinkers and smokers for the adult population are significantly higher than the corresponding percentages of drinkers and smokers for the youth population (for this discussion, adults mean 21 and above for alcohol, and 18 and above for smoking, since 21 and 18 are respectively the legal drinking and smoking age in the U.S.). The percentage of illicit drug users for the adult population (for this discussion, meaning 18 and above) is still a substantial number, although smaller than the corresponding percentage for the youth population.
I believe that it is extremely difficult, if not impossible, to ask our youths to refrain from substance abuse when they see that their adult friends and family members are engaged in substance abuse. We cannot ask and expect our youths not to do something when they see that their adult friends and family members are doing those same things. Therefore, in order to reduce significantly the substance abuse problems among our youths, we must at the same time address reducing significantly the substance abuse problems among the adults. We must address the total problem across all age brackets. In other words, we must have our own adult “house” in order, to be successful in getting the youth “house” in order.
 The legal drinking age in the U.S. is 21.
 The statistics below come from the following two documents: (1) “Underage Drinking in the United States: A Status Report, 2004” by The Center on Alcohol Marketing and Youth of Georgetown University, and (2) “Alcohol & Public Health” by the Center for Disease Control (CDC) of the U.S. Department of Health and Human Services.
 See, e.g., the presentation “Epidemiology and Directions for Preventing Drug Use Among Adolescents,” by Dr. Amy Khan, who specializes in Additive Medicine and Preventive Medicine, and is the National Medical Director for Wellness TotalCare at Concentra, one of the largest providers of health care services in the nation.