Stages in adolescent involvement in drug use

TLDR

Longitudinal surveys of New York high‑school students reveal a four‑stage progression of drug use—beginning with legal substances such as beer, wine, cigarettes, or hard liquor, followed by marijuana, and culminating in other illicit drugs—where legal drugs serve as necessary intermediates. Progression rates show that 27 % of students who smoke and drink move to marijuana within 5–6 months, versus only 2 % of those who never used legal substances, and that 26 % of marijuana users advance to LSD, amphetamines, or heroin compared with 1 % of non‑marijuana users and 4 % of legal‑drug users; this pattern persists across all four high‑school years and the year after graduation, with a reverse sequence for regression.

Abstract

Two longitudinal surveys based on random samples of high school students in New York State indicate four stages in the sequence of involvement with drugs: beer or wine, or both; cigarettes or hard liquor; marihuana; and other illicit drugs. The legal drugs are necessary intermediates between nonuse and marihuana. Whereas 27 percent of high school students who smoke and drink progress to marihuana within a 5- to 6-month follow-up period, only 2 percent of those who have not used any legal substance do so. Marihuana, in turn, is a crucial step on the way to other illicit drugs. While 26 percent of marihuana users progress to LSD, amphetamines, or heroin, only 1 percent of nondrug marihuana users and 4 percent of legal drug users do so. This sequence is found in each of the 4 years in high school and in the year after graduation. The reverse sequence holds for regression in drug use.