Sex, age, and progression of drug use in adolescents admitted for substance use disorder treatment in the northeastern United States: comparison with a national survey.

Background: National adolescent drug use surveys are distributed in United States schools. Survey results determine trends in drug use and inform research and prevention efforts; however, students who have dropped out of school or were truant the day of the survey are excluded. Examining drug trends in a high-risk population (adolescents admitted for drug treatment) may better characterize drug users and their use patterns.

Methods: The current study examined questionnaires completed by 939 adolescents admitted for substance abuse treatment between 1995 and 2010.

Results: Age of first use (ranging from 13.2 years for alcohol to 15.1 years for cocaine) was significantly younger for cigarettes, alcohol, and cannabis than for "harder" drugs such as cocaine and heroin, and adolescents increased their use of almost every substance (except inhalants) with increasing age. This was not true of national data. Additionally, in the national data, less than 1.5% of participants reported using any of the harder drugs more than 5 times, but in the McLean data, even for harder drugs, >10% of adolescents used >50 times.

Conclusions: In the high-risk sample examined here, progression to harder drugs is accelerated and increases with age regardless of sex. These data underscore the importance of prevention and immediate treatment when adolescent substance use is identified.