By contributor
updated 6/29/2011 8:42:55 AM ET 2011-06-29T12:42:55

Nearly half of all U.S. high school students currently smoke, drink or use other drugs, and a third of users meets the medical criteria for addiction, according to a report out Wednesday.

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Adolescent substance use is “the number one public health problem any way you look at it,” says Susan Foster, the report’s lead researcher. Foster serves as vice president and director of policy research and analysis at The National Center on Addiction and Substance Abuse, or CASA, at Columbia University. “This is an epidemic.”

Although teen use of cigarettes, marijuana and prescription drugs has declined in recent years, Foster says, “the improvements seem to have stalled,” and the use of smokeless tobacco has been rising since 2003.

The more than 400-page CASA report, which Foster calls the most comprehensive look at teen substance use to date, is based partly on nationally representative online surveys of 1,000 high school students, 1,000 parents of high school students and 500 school personnel, including teachers, principals, counselors and coaches.

The findings include:

  • Three-fourths of high school students have smoked cigarettes, drunk alcohol or used another drug.
  • Alcohol is the most preferred addictive substance among high school students, followed by cigarettes, marijuana and controlled prescription drugs, such as narcotic painkillers.
  • Two-thirds of high school students have used more than one addictive substance.
  • A quarter of teens who responded to the CASA survey said they consider marijuana to be harmless, and about one in six view it as medicine.

The younger people are when they start using addictive substances, the greater the likelihood they’ll become addicted, according to the CASA report. People who use addictive substances before age 18 are six times more likely to develop a substance use disorder than those who didn’t start using until they were 21 or older.

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In a statement accompanying the report, former Rep. Jim Ramstad, R-Minn., chair of the CASA national advisory commission on substance use among high school-age Americans, explains why: “The teen brain is primed to take risks including experimenting with these substances and, because it is still developing, it is more vulnerable to their harmful effects.”

Some teens are especially vulnerable, Foster says. Their parents may abuse drugs or alcohol, they may have other mental health problems or they may be victims of neglect or other trauma.

The report emphasizes that “teen substance use is a preventable public health problem and addiction is a treatable disease.” However, although 1.6 million U.S. high school students meet the clinical criteria for an alcohol or drug use disorder —  defined by the National Institute on Drug Abuse as “characterized by compulsive drug-seeking and use despite harmful consequences” — only about 100,000 have received treatment in the past year.

Because of a widespread misunderstanding about the impact of teen substance use, the report says, parents are left in the dark about how to keep their children safe, health care professionals are insufficiently trained in diagnosing and treating disorders and insurers are reluctant to pay for treatment.

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