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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Friday 30th December 2011 

I’ve complained before about the difficulty of getting an overall picture of the use of psychoactive substances because of the tendency to separate the legal ones, alcohol and tobacco, from the illicit drugs though it should be said that, increasingly, reports on illicit drugs include the so-called ‘legal highs’.

A couple of weeks ago, I came across a report that does look at all substances together regardless of status but I hadn’t got around to looking at it until I saw a very interesting discussion about it that I’ll return to later.

The report is called ‘Monitoring the Future’ (MTF) and is, annually, prepared by the Survey Research Center in the Institute for Social Research at the University of Michigan on behalf of the National Institute on Drug Abuse, a federal agency. It has its own website and describes the MTF as ‘an ongoing study of the behaviors, attitudes, and values of American secondary school students, college students, and young adults. Each year, a total of approximately 50,000 8th, 10th and 12th grade students are surveyed.’

The headline for this year’s survey is that cannabis use is increasing but alcohol use is at its lowest level measured since the survey began in 1975. Because the survey is conducted on behalf of the government, the official line is that the increase in cannabis use is a worry but, as the commentary I referred to, above, suggests it may be that young people are choosing cannabis over alcohol as they come to understand the true potential for harms.

I won’t even try and paraphrase Kristen Gwynne’s piece. I recommend you read it as it talks about a subject close to my heart; the need to tell young people the truth about substances if we want to have any hope of minimising their use of these substances and the harm that results.

The one thing that stands out from a report where prevalence is looked at for illegal drugs and alcohol is how much greater the use of alcohol is for all age groups of young people. Just to give one example, 38.3% of 12th graders in the survey reported using an illegal substance in the previous year. 34.8% said they had used cannabis and 17.3% said they had used a substance other than marijuana. But, 65.2% said they had drunk alcohol at least once in the previous year.

The comparable figures for last 30 days prevalence are 23.8% all substances, 21.4% cannabis, 8.6% substances other than cannabis and 41.2% alcohol.

Drawing any conclusions at the higher end of consumption is more difficult. The survey looks at daily use for cannabis and alcohol but, here, the figures are so small that a few either way makes a substantial difference to the total and, in any event, problem drinkers tend to include those who drink large amounts but not, necessarily, every day. With 12th graders, again, 6.1% said they used cannabis daily but only 2.7% said the same thing for alcohol.

The survey has another measure for large-scale drinking; consumption of five or more drinks in a single day within the past two weeks. That measure, typical of the sort of drinker who binges at the weekend, showed 23.2% of 12th graders drink in this way. Not directly comparable with daily marijuana use but showing that many more young people are drinking at levels that could be problematic than are using cannabis.

But the most interesting figures, for me, came when I looked at the figures for reported prevalence of getting drunk and calculated the percentage of drinkers who are getting drunk. It’s important to stress that someone reporting drinking in the past month and being drunk over the same period should not be viewed as getting drunk every time they use alcohol. Someone could drink, say, fifteen times a month and get drunk only once and they would still appear in both categories for past 30 day prevalence.

What interested me about these two sets of numbers was to see if there was any trend in the rate of drunkenness for the difference prevalence periods.

% of Drinkers who also report getting drunk Ever Annual Monthly Daily
8th Grade 45.5% 39.2% 36.2% 40.0%
10th Grade 63.4% 57.4% 50.9% 27.3%
12th Grade 76.2% 67.5% 65.0% 59.3%
Total 64.8% 58.1% 55.2% 48.6%

I’m not sure what I was expecting to find and I’m cautious about reading too much into the ‘Ever’ and ‘Daily’ prevalence results, the first because it will include those who tried drink one, got drunk and decided alcohol was not for them and the second because only 320 of the 46,500 students in the survey said they got drunk daily (242 of them 12th graders) so the figures can easily be distorted by the small sample.

But the ‘Annual’ and ‘Monthly’ prevalence results are quite similar and seem to suggest there is a similar tendency to get drunk when drinking whether one drinks every month or less.

Kristen Gwynne suggests ‘Give young people accurate information, and they will use it to make better decisions that result in less harm to themselves’ to explain the growth in cannabis use versus a fall in alcohol use. Given the high proportion of drinkers who get drunk (on some but not necessarily all of their drinking occasions it must be remembered) I’m not sure that ‘better decisions’ are being made in all cases.