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A new analysis of national survey data reveals that alcohol and marijuana use among U.S. teenagers has declined significantly since the early 1990s. However, these declines are far less pronounced among adolescents who have recently considered or attempted suicide.
Researchers from Duke University School of Medicine examined responses from over 254,000 high school students (grades 9–12) collected between 1991 and 2023. The study focused on trends in alcohol and cannabis use among teens with and without a recent history of suicidal thoughts or behaviors (STBs).
Key findings:
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Alcohol use dropped sharply among teens with no history of suicidal thoughts or attempts, with a biennial percent change (BPC) of -5.41 since 2009.
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Among those who had considered suicide or made an attempt, declines in alcohol use were more modest (BPC of -3.51 and -2.82, respectively).
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Binge drinking also fell more steeply among teens without STBs compared to those with such histories.
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Cannabis use decreased significantly only among adolescents without STBs; for those with suicidal thoughts or attempts, rates remained largely unchanged since the 1990s.
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Among girls with recent suicidal thoughts or attempts, the decline in alcohol use was slower, and cannabis use rates have plateaued since the 1990s.
The authors emphasize the importance of continued screening for substance misuse among adolescents presenting with suicidal thoughts or behaviors, and the need for targeted interventions to address these co-occurring issues1.
Study limitations include possible underestimation of substance use rates due to school-based survey methods (as STBs and substance use are linked to absenteeism), inconsistent survey timing during the COVID-19 pandemic, and lack of data on factors such as gender identity or poverty.
“These findings suggest the need for continued screening and assessment of substance misuse among adolescents presenting with STBs, as well as the importance of developing targeted treatments to address these co-occurring concerns,” the authors wrote.
Disclaimer:
This article is based on a study summary published by Medscape and does not constitute medical advice. The findings are subject to limitations as described by the study authors. If you or someone you know is struggling with suicidal thoughts or substance use, seek help from a qualified healthcare professional or contact a crisis support service.
