Transcript Methamphetamine Use Among Adolescents & Young Adults

Methamphetamine Use Among
Adolescents & Young Adults
Rachel Gonzales, Pre-Doctoral Fellow
UCLA Integrated Substance Abuse Programs
NPI - Semel Institute for Neuroscience
Presentation Objectives
• Examine MA use trends among youth specific
to the West
• Highlight unique gender differences
• Examine plausible risk factors associated with
use
• Future directions for research
What do we know about the problem?
• Most widely used sources:
–National Survey on Drug Use and
Health (NSDUH)
–Monitoring the Future Study (MTF)
–Youth Risk Behavior Survey (YRBS)
Percent of Respondents
Past Month Drug Use Rates
50
45
40
35
30
25
20
15
10
5
0
8th grade
10th grade
12th grade
Alcohol
Cigarettes
Any Illicit
Drug
Marijuana
Meth
Source: NIDA, Monitoring the Future, Nat’l Results on Adolescent Drug Use, 2004.
Inhalants
Measurement Challenges
• While beneficial, national surveys tend to
underrepresent youth at risk for drug use:
Dropouts and delinquent youth
Homeless and runaways
Foster care youth
Other Sources
• Adolescent Treatment Programs
• Juvenile Justice System
• Emergency Room Data
– Reveal that MA use is a problem by young people.
Primary Drug Problem Among Adolescent &
Young Adult Treatment Admissions: 2004
17 years and under
2%
25%
Alcohol
Methamphetamine
Cocaine
Marijuana
Other
Heroin
18-25 years old
9%
14%
4%
26%
12%
59%
36%
2%
11%
Source: LA County ADPA, July 2003-April 2004
Juvenile Justice Data
• Since 2000, a significant proportion of juveniles aged
12 to 18 in CA have tested positive for dangerous
drugs (including MA, PCP, and LSD) upon arrest.
• In the second half of 2002, 22% of male arrestees
aged 18 to 21 in Los Angeles County tested positive
for MA.
Source: Arrestee Drug Abuse Monitoring (ADAM) System
Extent of Adolescent Drug Use Mentioned
in DAWN ED System, LA-Long Beach, 2002
12-17 year olds*
18-25 year olds*
Inhalants
72.5%
10.0%
Marijuana
12%
11.8%
Meth
8.1%
32.6%
Alcohol
4.7%
17.6%
PCP
4.4%
30.4%
Cocaine
1.9%
15.1%
0%
10.0%
Heroin
*Percent of all mentions for each substance
Gender Differences
MA use has become increasingly
problematic among adolescent
and young adult females
FEMALES
Percent of Female Respondents
Adolescent (<18) Treatment Admissions
by Gender July 2003-April 2004
70
60
50
40
30
41.3
30.9
21.7
20
10
0
Source: LA
county ADP
Percent of Male Respondents
Alcohol
MALES
3.8
2.3
Cocaine
Marijuana
Meth
66.4
70
60
50
40
30
22.1
20
10
0
2.2
7.7
1.6
Other
Treatment Studies
• Research on drug treatment outcome
studies among adolescents is limited.
• Very few published studies specific to
MA and youth.
• Recent articles on MA and youth in
Taiwan growing.
Matrix Treatment Study N=305
adolescents 13 to 18 years old
90
81.3
80
70
63.6
60
50
45.5
Males
Females
40
30.8
30
20
14.3
12.1
10
8.8
12.1
0
Meth
N=90
THC
Alcohol
N=215
Poly
Source: Rawson et al., 2005
Matrix Treatment Study found:
• Older teens (ages 17-18) more likely to use
than younger youth.
• Greater psychological & legal dysfunction than
non-MA users.
• More alcohol and drug use during treatment
than non-MA users.
• Greater drop out rates than non-MA users.
• No injectors (14% smoke, 12% smoke/snort,
4% snort)
Source: Rawson et al., 2005
Phoenix House Treatment Found:
• MA accounted for 42.3% of teen treatment admissions
in 2005.
• 16% increase in MA admissions between 2002 and
2005 (172 to 210).
• More youth females are presenting for treatment with
MA problem than males.
Year
2002
2003
2004
Boys
25%
23%
27%
Girls
43%
51%
53%
Source: CBS2 News Story, 2006
2005 Tarzana Treatment Centers Admissions by
Drug of Choice, Gender, and Age
70%
Female age 12-17 (n=293)
60%
50%
40%
30%
20%
10%
m
ph
eth
a
M
P rimary Drug
th
er
O
et
am
in
es
ua
na
M
ar
ij
in
er
o
H
ra
ck
Co
ca
in
e/
C
lco
h
ol
0%
A
Percent Admissions
Male age 12-17 (n=546)
MA Admission Trends:
LA County 2000-05
100%
90%
93%
93%
88%
79%
80%
74%
No Meth Use
Meth Use
70%
60%
N=5,527
50%
40%
26%
30%
21%
20%
10%
7%
7%
12%
0%
00 01
01 02
02 03
03 04
04 05
Source: LA County ADP, 2006
Gender Differences: LA County
90%
90%
80%
70%
67%
No Meth Use
Meth Use
60%
N=5,527
50%
40%
33%
30%
20%
10%
10%
0%
Female (N=1,637)
Male (N=3,890)
Source: LA County ADP, 2006
MA Use by Ethnicity: LA County
30%
25%
26%
23%
20%
17%
16%
15%
10%
10%
Meth Use
5%
2%
N=943
W
hi
te
(n
=1
B
07
la
ck
8)
(n
A
=5
si
63
an
)
N
(n
at
=
iv
eA 195
)
La m (
n=
tin
29
o
(n
)
=
O
33
th
80
er
)
(n
=2
75
)
0%
Source: LA County ADP, 2006
3 year CASA study on adolescents 8 to
22 years old found:
• Females became dependent upon MA
faster.
• Females suffered more adverse effects
sooner than males.
Source: National Center on Addiction and Substance Abuse at Columbia University, 2003
Risk Factors for MA Use
Largely understudied area
Anecdotal Reports
• Clinicians indicate low self-esteem, depressive
symptoms, & eating disorder make girls
especially vulnerable to use and continued
misuse of MA
• Deviant behavioral problems in males – ASPD,
ADHD make males vulnerable to MA use (Yen
& Chung, 2006)
CASA Study: Female Risk Factors
Sexual
Abuse
Physical
Abuse
MA
Abuse
Tension
Low Self
Esteem
Depression
Weight
Concerns
Source: National Center on Addiction and Substance Abuse at Columbia University, 2003
Risk Factors among adolescents in
Matrix Treatment
65
60
50
48
40
40
% 30
18
20
10
0
Depression
Suicidality
Males
Females
(Matrix Sample); p<.001
Other Factors to Consider
• Readily available to youth
• Simple, home-made manufacturing
• Cheap
• Easy access to primary chemicals at local
merchants
Adolescent Story
• One teen resident at Phoenix House who
shared his story of MA addiction said:
“When I first tried crystal meth, I
automatically fell in love. I had finally
found the drug that I was looking for.
The stuff was pretty cheap and it was
very easy for me to get.”
Source: CBS2 News Story, 2006
Clinical Characteristics
• Cognitive dysfunction
• Rapid mood swings
• Hyperactivity & Impulsivity
• Lesion-marked skin
• Depression
• Paranoia & Psychoses (auditory hallucinations)
Risky Behaviors
• Agitation & Aggressive Behaviors
• Partner Violence
• Multiple sex partners & unprotected sex
• Suicide
Relapse Antecedents for MA Use
• Social pressure & Social In-adaptation
• Lack of emotional stability
• Low educational level
• Psychiatric Disorder Status
Yen & Chang, 2005 (Taiwanese sample, N=60)
Summary: Key Points
• Researchers need to be aware of other
critical data sources to understand the
scope of MA use among youth
• It remains unclear which risk factors are
occurring for MA use and between the sexes
Future Research
• More studies to look at specific risk factors
for MA use & relapse
• Other study populations should include:
– Homeless/runaway youth
– Juvenile justice system youth
– Child welfare system (foster care) youth
• Issues of HIV Risk Behaviors and Violence
• Developmental processes
Acknowledgments
Richard Rawson
Beth Rutkowski
CA Department Alcohol & Drugs
LA County Department Alcohol & Drugs
Jim Peck
Questions?
For copies of slides or a reference list,
please contact me at:
[email protected]
(310) 445-0874 ext. 346