Substance Use and Substance Use Disorders in a Community Sample of Adolescents and Young Adults: Incidence, Age Effects and Patterns of Use

Abstract

Objective: We present the prevalence and incidence rates of alcohol, nicotine, and illicit substance use, abuse, and dependence in a sample of German adolescents and young adults. Patterns of onset, cohort trends, and use of various substance classes are also analyzed. Method: A prospective longitudinal epidemiological study with a representative sample of adolescents and young adults (n = 3,021; baseline age range = 14–24 years) was conducted in Munich, Germany. Participants were assessed between 1995 and 1999 with the Munich-Composite International Diagnostic Interview. Results: Cumulative lifetime incidence (up to age 28) of any substance abuse or dependence was 43.8%, and 12-month prevalence of any substance abuse or dependence was 24.4%. The lifetime incidence of nicotine dependence was most frequent (24.8%), followed by alcohol abuse (19.3%) and alcohol dependence (9.2%); 61.7% endorsed the regular use of a substance for at least one circumscribed period during their lifetime. Age-specific incidence rates and age at onset of substance use disorders differed by age cohorts. Furthermore, nicotine dependence was significantly associated with illicit substance use disorders (HR = 2.6, 95% CI 1.7–4.0). An interactive relationship between age, age at onset of nicotine dependence, and subsequent onset of illicit substance use disorders was found. Conclusions: Since the baseline investigation in 1995, high incidence rates of substance use disorders and substance use have been observed in this young German sample. Especially younger cohorts report significantly earlier ages at onset of abuse and dependence. There also seems to be a trend towards a secondary age at onset peak of nicotine dependence after the onset of illicit drug use disorders. Further investigations are needed to study these patterns in younger samples. However, results emphasize the need for a combined prevention of illicit drugs and nicotine dependence.

High prevalence rates of tobacco, alcohol and drug use in adolescents and young adults in France: Results from the GAZEL Youth study

“…We found that younger youths started using tobacco, cannabis and other illicit drugs at an earlier age than older youths, which is consistent with studies conducted in the Netherlands, Germany and the United States (Johnson et al, 2006;Monshouwer et al, 2005;Perkonigg et al, 2006). As other researchers,…”

“…In recent years, rates of adolescent substance use appear to have increased across industrialized countries (Bachman et al, 1998;. Moreover, there is evidence that youths start using psychoactive substances at earlier ages than in the past (Monshouwer et al, 2005;Perkonigg et al, 2006). This is of concern because adolescents who regularly use psychoactive substances are at high risk of substance-related abuse or dependence, as well as employment problems and delinquency later in life (Ellickson et al, 2003;Perkonigg et al, 1999;Riala et al, 2004).…”

“…As levels of substance use in the population change over time, only studies that compare youths of different ages at a single point in time can assess age-and cohort-related trends. To date, research has mostly focused on substance use among adolescents, and there is still need for additional data pertaining to young adults (Perkonigg et al, 2006).…”

Water-Pipe Smoking Among North American Youths

“…Although findings were similar to prevalences reported among young adults in Canada, 33 Europe, 30 Australia, 34 and the United States, [35][36][37][38] there was a high level of psychoactive substance use among NDIT Study participants irrespective of water-pipe use.…”

Unemployment and Substance Use in Young Adults: Does Educational Attainment Modify the Association?

“…Across industrialized countries, tobacco, alcohol and cannabis use levels in young adults are high [1,2,3]. This may in part be because the period between 18 and 30 years of age is characterized by role exploration, high accessibility of psychoactive substances and high tolerance of addictive behaviors [4,5].…”