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Trends in Youth Substance Use · Talking FACS

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Welcome to Talking Facts.
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What you need to know about family food finance and fitness.
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This nationally recognized award winning podcast is hosted by the University of Kentucky Family and Consumer Sciences Extension Program.
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Hello and welcome to Talking Fact.
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What you need to know about family food finance and fitness.
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I am your host,
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Mindy mckelley Extension Specialist for instructional support with Family and Consumer Sciences Extension.
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We are halved in the Martin Gatton College of Agriculture,
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Food and Environment.
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My guest today is Doctor Alex Elswick,
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who is our extension specialist for substance use prevention and recovery.
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Welcome,
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Alex.
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Good morning,
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Mindy.
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I am so excited that we're going to talk about a couple of things today.
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First,
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we're going to talk about exciting event that's going to happen in August right here in Lexington.
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And then also we are going to talk about the trends that we're seeing in substance use.
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And so I know that this is a discussion that's going to be so important for our listeners.
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Let's kick off with,
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first of all,
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tell us about the summit.
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I wanna hear what's going on next month.
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Yes.
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The summit is uh really exciting.
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It's gonna be August 2nd and third at the Hyatt Regency downtown Lexington.
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It's actually titled a summit on substance use recovery and diverse populations.
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You know,
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I've been to so many different addiction conferences and they're all wonderful.
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But,
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but oftentimes we hear many of the same things at the same conferences.
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So the idea here was really to try to do something different.
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And so we've brought together these experts from all over the country who really focus on unique aspects of substance use or with unique populations.
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So we have folks talking about trauma,
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folks talking about addiction among older adults.
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Folks talking about um gender responsiveness in treatment and programming and so all kinds of cool stuff.
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We're really excited.
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It's gonna be a great day.
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And then on the second day on August the third,
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my friend Jody Jagger is coming to do an over response training to teach folks how to respond to an overdose and they can walk away with some naloxone if they like.
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So that is exciting because we don't often think about something that's important as naloxone in our own fingertips.
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So that's really exciting that,
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that,
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that they're going to be able to take that home with them.
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Of course,
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we are talking about the summit for substance use recovery and diverse populations because we need to talk about trends in substance use,
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especially for our youth,
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we're seeing trends that might be something that,
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that parents and other caregivers and educators might not be aware of.
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So,
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let's talk about what we're seeing among our Kentucky 10th graders.
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That's ok.
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So this is my favorite place to start.
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And I know that you were gonna ask me this question,
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but I'm gonna flip it back on you because it's my favorite way to start prevention programming.
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So,
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what percentage of our Kentucky 10th graders would you guess used cannabis in the past 30 days?
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I'm gonna be safe and say 50.
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Ok.
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And that as a safe guess.
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And so I've done this in so many different contexts with adults,
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with kids all across the board,
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I get lots of different numbers.
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But here's what's surprising the,
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according to the KIP survey data,
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which is our best Kentucky level data,
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8% of Kentucky 10th graders used cannabis in the past 30 days.
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808.
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It's awesome.
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It's shocking.
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It's wonderful.
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But here's why that's important.
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So two reasons,
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one,
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we know all about peer pressure.
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So we know if kids think that everybody else is doing something,
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then they're gonna be more likely to do it as well.
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So when I go to schools and I ask kids,
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what percentage of your peers do you think are using cannabis regularly?
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They'll say 90% they'll say 95%.
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And they're not saying it to be,
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to,
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to,
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to be funny,
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they really believe that.
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And so if you think about the impact of kids believing that 90% of their peers are,
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are smoking pot all the time,
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then they're definitely gonna feel like a,
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a weirdo frankly,
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you know,
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uh an outlier for choosing not to.
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Whereas if you knew that 92% of your peers are also choosing not to engage in that behavior.
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It gives you a lot more confidence to say,
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I don't think I want to do that.
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So,
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um I,
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I like it for that reason.
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I also like it to say to adults because it's a shockingly low number.
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And sometimes we get a little hysterical about substance use with youth and we get a little bit of fear mongering going on.
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And um the truth is we're doing a pretty good job and I think it's a good place to start the discussion.
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I love that you started that way because I think it is so important.
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Let's clarify for our listeners that the KIP survey is the Kentucky incentives for prevention survey.
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Ok.
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So if we're seeing the this low trend,
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which is fabulous in cannabis use,
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what are we seeing in other drugs that we might not think about?
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Or parents might think about as drugs because there's something that's in their homes.
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So I think what's surprising to educators extension staff,
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people who might be working with youth is that across the board with the sort of the rate of substance use among youth is surprisingly low.
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It's also decreasing.
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If you look at the trend over the last 20 years,
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it's really decreasing across every measure of every drug with the exception of tobacco.
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And so this is kind of a Bugaboo because our reduction in smoking for adults and youth has been like the single biggest public health success story in the United States.
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It's like our biggest win,
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you know,
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down to,
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to really small percentage.
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But then about 10 years ago,
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with the advent of all the vapes and the electronic kind of nicotine delivery devices that trend has,
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has dramatically reversed.
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And so in my mind,
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looking at at prevention and,
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and the the trends across the board,
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even though substance use seems to be declining,
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that big increase in uptake of nicotine for young people,
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I think is a big risk factor for other addictions in the future.
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And do you think that it's because they don't see vaping as detrimental to their health as smoking?
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Yes,
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I think that's part of it.
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There is research that would support exactly that thing,
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you know,
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part of it is we long ago the FDA banned flavored tobacco.
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Uh so like strawberry flavored tobacco or whatever and,
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and the reason they banned it is because they said this is way too appealing to kids,
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right?
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We haven't been able to do the same thing with vaporizers.
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So you have,
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you know,
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cotton candy or bubble gum flavored,
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whatever.
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I mean,
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frankly it tastes good.
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So,
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you know,
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they're not having to suffer through a cigarette which might have had to in the 19 sixties or whatever,
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it makes it more appealing and,
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um,
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also easier to hide it.
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You don't get a smell on your hands or in your clothes.
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So I think it's,
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it's a genuinely concerning trick.
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What about alcohol?
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What are we seeing with alcohol use?
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Yeah.
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To our surprise,
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alcohol use has generally been declining kind of across the board when we look at at not just rates of drinking but rates of at risk or risky drinking.
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So binge drinking,
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for instance,
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that in particular has decreased and I don't know exactly what to attribute that to,
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but it's a good thing.
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Yeah,
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that is,
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that is a good thing.
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Ok,
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so we said that the rate of cannabis use by 10th graders was 8%.
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But what are the trends that we're seeing in use?
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Yeah,
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that this one is also surprising to me because we talk so much about cannabis.
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We talk about it in politics because you know,
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is it gonna be legalized for recreational use or medicinal use?
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And we talk about it in it's in movies and TV.
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And it lives so much in our popular imagination.
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I would have guessed that a lot more kids are smoking pot than they are.
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And so surprising to me that even as social attitudes towards cannabis become more and more lax youth,
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cannabis use is not increasing.
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And so I think that's,
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that's promising for people who,
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as we talk more about decriminalizing or legalizing and,
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and people have concerns about how will that impact youth so far?
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What we're seeing is no impact.
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Ok,
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so now let's talk about opioids.
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Those are those painkillers or,
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or other drugs that we might have in our medicine cabinet and kids are finding him.
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So tell me,
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tell me what are the trends?
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There was a huge spike at the beginning of the opioid epidemic where it,
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it had a lot to do with the amount of opioid pills,
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just the amount of physical pills that were being diverted all over the place.
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In simple terms,
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there were just so many pills per capita that kids were more likely to,
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to access them like you said,
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through the medicine cabinet or at grandma's house or whatever it was.
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So there was a sharp spike 15 years ago.
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But again,
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in particular,
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we've done a good job doubling down on reducing opioid misuse among young people.
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So that's,
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it's a negligible number at this point and almost zero.
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So you give me hope for the future because everything that you've told me we're seeing declining view and that is exciting.
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So I would say definitely,
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yes.
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And let's just feel good about all those positives,
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but it's bad news still to come here.
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Ok.
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Ok.
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So yes,
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that is true.
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And the fact that anybody is using substances that that's still a problem.
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So we need to work on it,
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right.
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Ok.
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So what is the impact of COVID-19 on youth substance use?
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Another one?
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That's really surprising.
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I think a lot of people who work in this space and the so called experts or the people like me who really think they,
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they know that we all expected that COVID-19 was gonna have a really dramatically negative impact on youth substance use because it was gonna drive isolation and drive all these risk factors that make it more likely that kids use drugs.
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And it turns out kind of the opposite was true.
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Turns out there was actually a reduction in youth substance use through the pandemic and the,
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the,
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you know,
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scientists have offered different explanations.
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The one that I think makes the most sense is that you saw a really sharp increase in parental monitoring during the pandemic.
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All of a sudden kids are right under your nose.
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And so it's a lot harder to go out and smoke pot or whatever it is binge drink when you know,
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mom is in the other room.
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So I think that alone might,
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might explain a lot of it and they might have been isolated,
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but they were isolated from those triggers.
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Right.
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Well,
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right,
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and isolated from peers who might,
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you know,
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encourage them to make a bad decision or whatever.
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I mean,
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I think it's a fair point.
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Yeah.
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Yeah.
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Ok.
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So that,
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that gives me hope because that's not the same trend that we saw in adults.
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Is that correct?
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That's exactly right.
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Ok.
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And then you by gender,
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are we,
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are we seeing differences between male and female?
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Are we seeing differences?
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I'm sure in age groups.
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But you know that those demographic little numbers seem to,
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to have curious questions for me.
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They do.
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And another surprising finding and this is where I think we've heard a lot of positive stuff so far.
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This is where um this,
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this is a little more pessimistic.
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So pretty much across the board of all the indicators that we collect.
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The KIP survey,
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females fare worse than males,
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fe adolescent females far,
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far worse than males.
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And that includes the use of almost every substance.
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There is an exception in there.
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I can't remember which it is,
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it might be,
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it might be tobacco,
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but pretty much across the board,
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females are more likely to use substances.
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And then what's even more concerning than that is KIP collects some data that's more focused on mental health.
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So they ask questions about um self-harm suicidality and psychological distress.
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And so females are more likely to engage in self harm,
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more likely to attempt suicide.
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And 25% more than twice the number of males of adolescent males,
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25% of our high school females are experiencing serious psychological distress.
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Yes.
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And I thought about that and I thought,
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you know,
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it's one thing for a kid to endorse on a survey.
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Yeah,
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I'm experiencing distress but even the way that that's written serious psychological distress,
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that's a quarter of our students,
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that's one out of every four kids you interact with is,
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is hanging on by a thread.
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You know.
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And so while I do find that,
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that all these substance use numbers are pretty encouraging,
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I would have to think that those mental health numbers represent huge risk for substance use as,
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as adults for problematic substance use as adults.
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And I just had a conversation with our friend,
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Doctor David Wen Horn and we were talking about social media use and it is a much higher and maybe we could even say social media overuse,
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but it is much higher in,
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in young adolescent females as well.
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So I think that that that probably has an impact on that mental health and I think it's impacting a lot of things anyway,
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let let's just say that.
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Yeah.
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And you know,
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social media,
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screen time,
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all that stuff,
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technology.
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It it's,
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it's rewarding the same part of the brain that's rewarded when you use a drug.
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So there really is something about that.
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That makes sense.
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Yeah.
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So are we seeing a difference in use of,
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of different races?
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Yes,
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there's been a uh an increase in adolescent overdose,
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particularly among black and brown communities over the last really over the last five years.
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Really?
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Since the opioid epidemic shifted from prescription pain pills into heroin and fentaNYL.
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Since that time,
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we've really seen black and brown communities much more affected.
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But what's also surprising related to that is that across all indicators of substance use.
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Apart from that overdose indicator,
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white students are more likely to use substances.
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They're more likely to binge drink,
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they're more likely to smoke pot,
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they're more likely to use tobacco,
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they're more likely to use opioids.
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And that also surprises folks sometimes who would assume,
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you know,
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black and brown communities might face more risk factors.
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But the the reality,
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what we're seeing in the data seems to be there's more availability of substances in predominantly white schools and for white students.
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So yeah.
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So,
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you know,
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on the whole kind of mixed findings,
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I mean,
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I think there's some bright spots but there there's still plenty of work to be done.
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I know that our goal is to work you out of a job,
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but I hope that that's something that we can achieve in our lifetime.
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That would be a good problem to have,
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wouldn't it?
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Yes.
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Yeah,
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I'm sure we can find you something else today.
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That's right.
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I'll come work for you.
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There we go.
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That,
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that would be great.
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Well,
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Alex,
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I know that all of these findings are important and help to frame the reason why we are having the summit on substance use recovery and diverse populations.
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So,
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do you want to just give one more final plug for for that event.
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Yeah,
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one more final push.
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So August 2nd and third at the Downtown Hyatt,
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um registration is still open.
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You can come for,
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for one day or both days.
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I'd encourage you to come to both days.
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It's gonna be um a lot of new interesting material.
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I genuinely think everyone's gonna walk away with a more nuanced understanding of,
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of drug use and drug use disorders and I will link registration information in the show notes so you can just click right from there and register if you are interested.
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Make it easy.
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Thanks so much for taking the time to share with me this morning.
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I know that this is such an important topic that we have to keep on the forefront of Kentuckians minds,
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right?
15:54
That's right.
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Thanks Mindy.
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