Substance Use Disorder Carries Over into Adulthood

What’s New in Psychology?

Substance Use Disorder Carries Over into Adulthood  

Jim Windell

           Drug overdose deaths are the leading cause of injury-related death in the U.S. In 2021, there were more than 100 000 deaths related drug overdoses.

           Although most of these overdose deaths were adults, but many were teens. Overall, more than one in three people in this country will develop a substance use disorder (SUD) in their lifetime. However, the prevalence of SUD is highest during young adulthood.

           These statistics underscore the urgency of developing more effective efforts to identify those individuals who are at the greatest risk for falling victim to overdose and SUD. Despite the fact that we know a lot about the long-term trajectories of alcohol and cannabis use from adolescence into young adulthood, we know little about the long-term sequelae of SUD symptoms from adolescence through adulthood.

           Therefore, the primary objective of a new study was to examine the association between SUD symptoms during adolescence and the presence of later prescription drug use, prescription drug misuse (PDM), and SUD symptoms in adulthood at ages 35 and beyond. This new study was published recently in JAMA Network Open.

           For the research, 11 cohorts of 12th graders were followed from age 18 to age 50 in the Monitoring the Future study, one of the nation's most relied upon sources of information on emerging trends in illicit drug, alcohol and tobacco use among American adolescents, college students and young and middle-aged adults.  

           The findings from the University of Michigan School of Nursing researchers are not encouraging. It was found that the majority of 18-year-olds with severe substance use disorder symptoms who were followed in a longitudinal study over 32 years still had multiple substance use disorder symptoms as adults. Additionally, researchers discovered that an estimated 12% of 18-year-olds had severe SUD symptoms. Also, adolescents with severe SUD symptoms were significantly more likely to report prescription drug misuse in adulthood. The relationship between severe SUD symptoms and later SUD symptoms also held for adolescents with severe alcohol, cannabis and other drug use disorder symptoms. Finally, most adults in the study prescribed opioids, benzodiazepines or other sedatives/tranquilizers had multiple SUD symptoms during adolescence. 

           According to lead author Sean Esteban McCabe, professor at the U-M School of Nursing and director of the Center for the Study of Drugs, Alcohol, Smoking, and Health, “This is a major wake-up call. The majority of middle-age adults being prescribed these medications had multiple substance use disorder symptoms at age 18, raising serious concerns about the safety of prescribing controlled substances to these individuals.”

           McCabe went on to say that some of the disorders and conditions that are treated with these same medications are also associated with an increased risk for SUD, such as anxiety disorders, sleep disorders and pain. “We must rethink how we screen and prescribe to individuals who have multiple substance use disorder symptoms in their past, because they might need additional help to take their medication safely. For example, some people in long-term recovery from substance use disorders use 'gatekeepers' to help dispense and dispose of medications, and lockboxes to reduce access to only the gatekeepers.”

            Most of the people in the study did not seek treatment, and the findings suggest the need to find ways of offering treatment over long periods of time even if the person is not ready for help, according to McCabe. Better screening, prevention and education through adulthood would also help, McCabe added.  

           “Screening that accounts for polysubstance use and substance use disorder symptom severity during adolescence can identify individuals at the greatest risk for prescription drug misuse and substance use disorder in adulthood,” McCabe said.

           To read the original article, find it with this reference:

Sean Esteban McCabe, John E. Schulenberg, Ty S. Schepis, Vita V. McCabe,  & Philip T. Veliz. (2022). Longitudinal Analysis of Substance Use Disorder Symptom Severity at Age 18 Years and Substance Use Disorder in Adulthood. JAMA Netw Open, 5(4):e225324. doi:10.1001/jamanetworkopen.2022.5324



Share this post:

Comments on "Substance Use Disorder Carries Over into Adulthood "

Comments 0-5 of 0

Please login to comment