A Biopsychosocial Perspective
Robert J. McCaffrey
Catherine A. Forneris
University at Albany
State University of New York
Epidemiological data suggests a declining trend in psychoactive substance use beginning during the late 1970s and continuing through the early 1980s. In spite of this, psychoactive substance use among adolescents has continued to pose a significant social problem. In 1990, the National Institute on Drug Abuse (NIDA) reported that 19% of high school seniors surveyed responded that they smoked cigarettes daily, 4% drank alcohol daily, and 3% smoked marijuana daily ( Hoover, 1991). More than 50% of high school seniors admitted trying an illicit drug. At some time in their life, greater than 90% reported having had some experience with alcohol, 44% with marijuana, and 10% with cocaine. When asked about substance use within the past month, 60% of responding seniors admitted to using alcohol, and 33% reported having five or more consecutive drinks in the past 2 weeks.
Although illicit drug use appears to be on the decline, the prevalence of alcohol use appears to have remained relatively stable. Perhaps even more alarming is the trend toward earlier initiation of drug and alcohol use. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reported that the mean age of initial use to be 14 years ( Hoover, 1991). There is also a concomitant trend for adolescents to use more than one substance at a time, that is, polysubstance abuse (PSA). A survey of Maryland adolescent users revealed that the typical adolescent used 3.4 drugs simultaneously (Maryland Department of Health and Mental Hygiene-Drug Abuse Administration, 1985).
A key factor in the deterioration of adolescent health is drug and alcohol use. Hoover ( 1991) reported that it is a major contributor to disability and death for individuals in the 15- to 25-year-old age group. Almost one half