Using substances at school may be cry for help

When teens are caught drinking or using marijuana at school, a trip to the dean's office may not suffice. These students also should be screened for exposure to trauma, mental health problems and other serious health risks, according to a study to be presented Saturday, May 3, at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Researchers found that using substances at school was associated with increased odds of serious problems such as depression, intimate partner violence and attempting suicide.

"At-school substance use is not just an isolated event requiring simple disciplinary action but an important signal identifying teens in need of urgent psychosocial assessment and support," said lead author Rebecca N. Dudovitz, MD, MS, FAAP, assistant professor of pediatrics at Mattel Children's Hospital UCLA and the UCLA Children's Discovery & Innovation Institute.

Dr. Dudovitz and her colleagues analyzed data from the 2011 Youth Risk Behavior Survey, a nationally representative survey of more than 15,000 U.S. high school students. The Centers for Disease Control and Prevention conducts the survey every two years to monitor conditions and behaviors that impact adolescent health.

Researchers looked at whether at-school alcohol and marijuana use by high school students was associated with nine other serious health risks, including driving while intoxicated or riding in a car with a driver who was intoxicated; fighting; carrying a weapon at school; drinking alcohol or using drugs the last time they had sex; experiencing intimate partner violence; being forced to have intercourse; having symptoms of depression; thinking about suicide; and attempting suicide.

Results showed that 9 percent of all students reported using alcohol or marijuana at school. For both boys and girls, using alcohol or marijuana on campus was associated with dramatically higher odds of exhibiting all nine serious health risks than using substances only out-of-school.

For example, students who reported using either alcohol or marijuana on school campus had a 64 percent chance of having been in a car with an intoxicated driver, a 46 percent chance they had symptoms of depression, a 25 percent chance they had experienced intimate partner violence and a 25 percent chance they had attempted suicide.

"These represent a considerable history of and ongoing risk for immediate harm that might not otherwise come to the attention of a parent or school official," Dr. Dudovitz said.

"When a student is found using substances at school, we should think of it as a sign that a child needs help," she said. "Given the strong association of at-school substance use with some very serious and dangerous health risks, like having experienced sexual trauma and attempting suicide, we should not dismiss at-school substance use as just another school infraction. Instead, it may be a truly urgent call for caring adults to get involved and help that student access appropriate services."