CHAPTER 26
Substance Use and Abuse
In a society that permits adults to use selected psychoactive substances for
pleasure or the relief of stress, it is not surprising that most young people
choose to try psychoactive substances, and that many come to consume
them regularly, often with major public health consequences. Rates of
experimentation and regular use vary by age, gender, country and decade,
but it is possible to convey a sense of how common different patterns of
use are by using figures from a 2007 survey of British 11–15-year-olds:
Just over half had consumed at least one alcoholic drink at some point
in their lives: ranging from 20% of 11-year-olds to 81% of 15-year-olds.
Some 20% of boys and girls reported having drunk in the last week,
ranging from 3% of 11-year-olds to 41% of 15-year-olds. Among those
who had drunk in the last week, the average consumption was about 13
units (equivalent to nearly one and half bottles of wine or over six pints
of normal strength beer).
A third had tried smoking cigarettes at some point in their lives. Reg-
ularly smoking at least once a week ranged in prevalence from 1% of
11-year-olds to 15% of 15-year-olds. The average regular smoker was
consuming about six cigarettes per day. Girls were more likely than boys
to be regular smokers: 8% vs. 5%.
A quarter had tried drugs at least once. First drug use was most com-
monly sniffing volatile substances such as glue, solvents, aerosols or
gas (see Box 26.1). Beginning with volatile substances was particularly
characteristic of those experimenting early. By contrast, those who first
tried drugs at 14 or 15 were most likely to begin with cannabis.
Overall, 17% reported taking drugs in the previous year, with rates
rising from 6% of 11-year-olds to 31% of 15-year-olds. There were sim-
ilar rates in boys and girls. The most commonly used drug was cannabis,
taken by 9% in the previous year. Volatile substances came second, used
by 6% in the previous year. Sniffing amyl nitrate (‘poppers’) came third,
with these being used by 5%.
Drinking, smoking and taking drugs were correlated behaviours – any
one form of substance use was associated with higher rates of the other
forms of substance use (and also with higher rates of truancy and school
exclusion).Child and Adolescent Psychiatry, Third Edition. Robert Goodman and Stephen Scott.
©c2012 Robert Goodman and Stephen Scott. Published 2012 by John Wiley & Sons, Ltd.
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