What Challenges Are Boys Facing, and What Opportunities Exist To Address Those Challenges? Fact Sheet: Substance Abuse*

David was looking forward to some Friday night fun.  A starter on his high school basketball team, he had practiced hard every evening that week for the big game against a crosstown rival and still had to make time to study for his first period geometry test.  After dinner with his family, he headed over to a party at the house of a schoolmate whose parents were out of town.  When he got there, the alcohol was already flowing.  And then someone offered David some pot.  He had to make a decision.

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(*)  This fact sheet is based on a comprehensive review of the scientific literature, including computer searches of major bibliographic databases (e.g., PsycINFO, MEDLINE/PubMed, EBSCOhost), looking for epidemiological studies that evaluated what factors make boys more or less prone to certain outcomes. The literature search was limited to scholarly journal articles and government documents published in 2000 and later unless an article was a seminal piece in the field or contributed to tracking trends over time. The statistics provided are from the most recent year for which data were available. Where possible, data related specifically to boys are included, but when these data were not available, data on youth, ages 10 to 18, are provided.

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Some Facts about Boys and Substance Abuse

Alcohol Use

• In middle school, adolescents of both genders begin drinking around the same age, but by high school, boys drink more frequently and more heavily and have more drinking problems than girls do.¹
• In 2006, boys were typically more likely than girls to drink large quantities of alcohol in a single sitting, and these gender differences become considerably larger at the upper grade levels.²
• In 2006, 47% of twelfth grade boys, 34% of tenth grade boys, and 16% of eighth grade boys reported drinking alcohol in the past 30 days.³

Tobacco and Inhalant Use

• In 2005, three out of five high school boys had tried cigarette smoking, and more than two out of five high school boys had used inhalants, such as glue, aerosols, nail polish remover, and other household substances.⁴
• In 2006, 22% of twelfth grade boys, 13% of tenth grade boys, and 8% of eighth grade boys reported smoking at least one cigarette in the past 30 days.⁵
• Daily cigarette use fell by more than half among eighth and tenth grade students between 1996 and 2006. In 2006, 4% of eighth graders and 8% of tenth graders reported smoking daily, compared with 10% and 18%, respectively, in 1996.⁶
• Among high school students, lifetime inhalant use decreased from 20% in 1995 to 12% in 2003 and then remained steady at 12% from 2003 to 2005.⁷
• While older boys tend to smoke, drink, and use drugs more than younger boys do, eighth graders are more likely than older boys to use inhalants.⁸

Marijuana and Illicit Drugs

• According to a 2006 survey, the percentage of twelfth graders who had used marijuana in the past year was higher among boys than girls (33% versus 30%, respectively), as was the percentage using marijuana daily (6% for boys versus 3% for girls). This gender difference also holds true among eighth and tenth graders.⁹
• The gender disparity among twelfth graders in the use of marijuana and alcohol has been decreasing as overall rates of use have gone down. The narrowing gender gap is a result of greater declines in use for boys compared to girls.¹⁰
• In 2006, 38% of twelfth graders, 29% of tenth graders, and 15% of eighth grade boys and girls had taken illegal drugs in the past year.¹¹

Any Illicit Drug Use in the Last 30 Days (%)

Prescription Drugs

• Among boys and girls ages 12 to 17, prescription drugs have become the second most abused drug behind marijuana.¹²
• Of boys and girls ages 12 to 17, 3% reported current abuse of prescription drugs in 2005.¹³
• Girls use prescription drugs more than boys do. In 2007, nearly 1 in 10 teen girls reported using a prescription drug to get high at least once in the past year, compared to 1 in 13 teen boys. But boys use street drugs more than girls do.¹⁴

Substance Use as a Risk Factor for Problem Behaviors and Negative Outcomes

• Studies have linked adolescents’ abuse of alcohol, drugs, and tobacco to many other problem behaviors and outcomes, including low academic performance, suicide, automobile accidents, and juvenile delinquency.^{15, 16, 17, 18}
• Adolescent boys who use drugs and alcohol are more likely than their peers to act out in school and get into fights.¹⁹

Adolescents Seeking and Receiving Treatment for Substance Abuse

• In 2005, almost 8% of all treatment admissions for substance abuse were boys and girls between the ages of 12 and 17.²⁰
• In 2006, about one-third of all substance abuse treatment facilities in the United States offered programs for adolescents.²¹
• A 2002 study found that with treatment, boys experience significant reduction in substance use rates relative to comparison youth in the short run; the benefits of treatment for girls emerged later and endured longer.²²

Trends in Substance Use Among Youth

• The proportion of eighth graders reporting use of an illicit drug at least once in the past 12 months dropped by nearly half from 24% in 1996 to 13% by 2007.²³
• The percentage of twelfth grade students who report being substance free (no cigarettes, no alcohol, and no illicit drugs) in the last 30 days increased from 26% in 1976 to a high of 48% in 2006.²⁴
• Boys’ smoking and drinking rates have declined since the mid- to late-1990s.²⁵

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(1)  Faden, V. B., & Goldman, M. (2004/2005). Introduction: Alcohol and development in youth — A multidisciplinary overview. Alcohol Research and Health, 28, 107-108.

(2)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). Monitoring the Future national survey results on drug use, 1975–2006: Volume I, Secondary school students (NIH Publication No. 07-6205). Bethesda, MD: National Institute on Drug Abuse. Retrieved March 7, 2008, from http://www.monitoringthefuture.org/pubs/monographs/vol1_2006.pdf  [PDF format]

(3)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

(4)  Centers for Disease Control and Prevention. (2006). Youth Risk Behavior Surveillance — United States, 2005.

Surveillance Summaries, June 9, 2006. MMWR 2006; 55(No. SS-5).

(5)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

(6)  Child Trends. (n.d.). Daily cigarette use. In Child Trends Data Bank. Retrieved March 14, 2008, fromhttp://www.childtrendsdatabank.org/indicators/3Smoking.cfm

(7)  Centers for Disease Control and Prevention. (2006). Youth Risk Behavior Surveillance — United States, 2005. Surveillance Summaries, June 9, 2006. MMWR 2006; 55(No. SS-5).

(8)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

(9)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

(10)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

(11)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

(12)  Office of National Drug Control Policy: Executive Office of the President. (2007). Teens and prescription drugs: An analysis of recent trends on the emerging drug threat. Washington, DC.

(13)  Substance Abuse and Mental Health Services Administration. (2006). The 2005 National Survey on Drug Use and Health. Rockville, MD. http://www.oas.samhsa.gov/NSDUH/2k5NSDUH/2k5results.htm

(14)  Office of National Drug Control Policy. (2007). Women and prescription drugs. Washington, DC: Author. Retrieved May 28, 2008, fromhttp://www.whitehousedrugpolicy.gov/drugfact/factsht/women_presc_drgs.html

(15)  Substance Abuse and Mental Health Services Administration. (2006). Academic performance and substance use among students aged 12 to 17: 2002, 2003, and 2004 [Electronic version]. The NSDUH Report, 18. Retrieved May 27, 2008, fromhttp://www.oas.samhsa.gov/2k6/academics/academics.htm

(16)  Cho, H., Hallfors, D. D., & Iritani, B. J. (2007). Early initiation of substance use and subsequent risk factors related to suicide among urban high school students. Addictive Behaviors, 32, 1628-1639.

(17)  Zador, P. L., Krawchuk, S. A., & Voas, R. B. (2000). Alcohol-related relative risk of driver fatalities and driver involvement in fatal crashes in relation to driver age and gender: an update using 1996 data. Journal of Studies of Alcohol, 61, 387-395.

(18)  Doherty, E. E., Green, K. M., & Ensminger, M. E. (2008). Investigating the long-term influence of adolescent delinquency on drug use initiation. Drug and Alcohol Dependence, 93, 72-84.

(19)  Springer, F. J., Sambrano, S., Sale, E., Kasim,R., Hermann, J. (2002). Making prevention effective for adolescent boys and girls: Gender differences in substance use and prevention. In The National Cross-site Evaluation of High-risk Youth Programs (Monograph Series No. 4). Rockville, MD: Substance Abuse and Mental Health Services Administration.

(20)  Substance Abuse and Mental Health Services Administration. (2008). Substance abuse treatment admissions by primary substance of abuse. Treatment Episode Data Set (TEDS). Retrieved May 28, 2008 from, http://wwwdasis.samhsa.gov/webt/quicklink/US05.htm

(21)  Substance Abuse and Mental Health Services Administration. (2006). National survey of substance abuse treatment services (N-SSATS). Retrieved May 28, 2008, from http://wwwdasis.samhsa.gov/webt/state_data/US06.pdf [in PDF format, 4 pages]

(22)  Springer, J. F., Sambrano, S., Sale, E., Kasim, R., & Hermann, J. (2002).

(23)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2008). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2007 (NIH Publication No. 08-6418). Bethesda, MD: National Institute on Drug Abuse.

(24)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

(25)  Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007).

What Factors Increase or Decrease the Risk of Substance Abuse?

While the proportion of boys using alcohol, tobacco, and other drugs has risen and fallen over time, researchers have learned valuable lessons about risk factors — those traits and life experiences that can jeopardize a person’s healthy development — and protective factors — the characteristics and life experiences that can increase a person’s likelihood of positive outcomes.

Risk and protective factors for boys and girls are influenced by individual characteristics, families, peers, school environments, and communities.

Individual risk factors for substance abuse include:

• Aggressive or antisocial behavior and conduct disorders, such as having difficulty following rules and behaving in socially unacceptable ways^26,27
• Resistance to authority or rebelliousness²⁸
• Doing poorly in school^29,30

The following family, school, and community factors contribute to risks for substance abuse among boys:

• Having parents who use drugs and have a positive attitude towards drug use^31,32
• Hanging out with friends who use alcohol or other drugs^33,34
• Having low educational aspirations or dropping out of school^35,36
• Easy availability of drugs in the community³⁷
• Poor enforcement of laws and regulations regarding drugs^38,39,40

Protective factors that help boys avoid substance abuse:

• Having high expectations and being optimistic about the future^41,42
• Consistent parental monitoring, discipline, and warmth^43,44
• Involvement with positive peer group activities and good relationships with peers^45,46,47
• Positive experiences and achievements at school^48,49
• Presence and involvement of caring and supportive adults^50,51,52
• Religious or spiritual connectedness⁵³

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(26)  Sullivan, T. N., Farrell, A. D., & Kliewer, W. (2006). Peer victimization in early adolescence: Association between physical and relational victimization and drug use, aggression, and delinquent behaviors among urban middle school students. Development and Psychopathology, 18, 119-137.

(27)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64-105.

(28)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(29)  Williams, J. H., Davis, L. E., Johnson, S. D., Williams, T. R., Saunders, J. A., & Nebbitt, V. E. (2007). Substance use and academic performance among African American high school students. Social Work Research, 31, 151-161.

(30)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(31)  Ryan, L. G., Miller-Loessi, K., & Nieri, T. (2007). Relationships with adults as predictors of substance use, gang involvement, and threats to safety among disadvantaged urban high-school adolescents. Journal of Community Psychology, 35, 1053-1071.

(32)  Williams, J. H., Davis, L. E., Johnson, S. D., Williams, T. R., Saunders, J. A., & Nebbitt, V. E. (2007).

(33)  Williams, J. H., Van Dorn, R. A., Ayers, C. D., Bright, C. L., Abbott, R. D., & Hawkins, J. D. (2007). Understanding race and gender differences in delinquent acts and alcohol and marijuana use: A developmental analysis of initiation. Social Work Research, 31, 71-81.

(34)  Faden, V. B., & Goldman, M. (2004/2005). Environmental and contextual considerations. Alcohol Research & Health, 28, 155-162.

(35)  Crum, R. M., Storr, C. L., & Anthony, J. C. (2005). Are educational aspirations associated with the risk of alcohol use and alcohol use-related problems among adolescents? Substance Use and Misuse, 40, 151-169.

(36)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(37)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(38)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(39)  Van Horn, M. L., Hawkins, J. D., Arthur, M. W., & Catalano, R. F. (2007). Assessing community effects on adolescent substance use and delinquency. Journal of Community Psychology, 35, 925-946.

(40)  Faden, V. B., & Goldman, M. (2004/2005).

(41)  Crum, R. M., Storr, C. L., & Anthony, J. (2005).

(42)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(43)  Ryan, L. G., Miller-Loessi, L., & Nieri, T. (2007).

(44)  Faden, V. B., & Goldman, M. (2004/2005).

(45)  Faden, V. B., & Goldman, M. (2004/2005).

(46)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(47)  Sussman, S., Dent, C. W., & Stacy, A. W. (1990). Peer group association and adolescent tobacco use. Journal of Abnormal Psychology, 99, 349-352.

(48)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(49)  Catalano, R. F., Haggerty, K. P., Oesterle, S., Fleming, C. B., & Hawkins, J. D. (2004). The importance of bonding to school for healthy development: Findings from the social development research group. Journal of School Health, 74, 252-261.

(50)  Ryan, L. G., Miller-Loessi, L., & Nieri, T. (2007).

(51)  Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992).

(52)  Faden, V. B., & Goldman, M. (2004/2005).

(53)  Bartkowski, J. P., & Xu, X. (2007). Religiosity and teen drug use reconsidered; A social capital perspective. American Journal of Preventive Medicine, 32 (Suppl 6), S182-S194.

Conclusion

Given the serious consequences of substance abuse among young people, researchers have made considerable efforts to understand what factors make young people more or less likely to use drugs and alcohol.

Though there are some alarming statistics about alcohol and drug use among young people, there is also some good news. Currently, research indicates that boys like David — who have a caring adult in their lives, do well in school, and participate in afterschool activities — are unlikely to use alcohol, tobacco, and other drugs. Other protective factors include a sense of belonging at school and at home, a religious or spiritual connectedness, and being optimistic about the future. Researchers have also found that facing certain challenges — such as doing poorly in school or being exposed to family conflict — increase the likelihood that boys will abuse substances.

Research into what works to build boys’ strengths and reduce the challenges they face is still growing. Although the results are promising, there is a need to build on prior research to continue to pinpoint what strengths make some boys more likely to succeed and what risks or challenges increase the likelihood that they will struggle.