Compared with Europe, American teens have high rates of illicit drug use

American youths in 10th grade have a high illicit drug use compared to their European counterparts, but have among the lowest rates of drinking and smoking, according to a new study.

A 2015 survey of 15- and 16-year-olds in 35 European countries provides some perspective on the substance using habits of American adolescents.

The results of the European School Survey Project on Alcohol and Other Drugs (ESPAD), which were released this week, show country-by-country results for the use of various licit and illicit drugs. In all but a few of the 35 countries included, the findings are based on national samples of the same age group.

In the U.S., data from the Monitoring the Future study's national survey of 10th-graders—upon which much of the design of the European study is based—provide results for comparison. MTF is conducted by scientists at the University of Michigan's Institute for Social Research and is sponsored by the National Institute on Drug Abuse.

Among the key findings for illicit drug use are the following:

• Europe has shown recent trends in the use of several important substances similar to those seen in the U.S., including a rise in marijuana use and declines in the use of cigarettes and alcohol by teens. This is the sixth survey in the ESPAD series, conducted at four-year intervals since 1995, and the 41st survey in the annual MTF series.
• On average, only 18 percent of the European students had used an illicit drug in their lifetime, compared to 35 percent of U.S. students the same age. Only the Czech Republic ranked higher than the U.S. at 37 percent.
• The U.S. was tied with France for second highest in lifetime cannabis use at 31 percent. In the European countries, the average was about half of that (16 percent), and the highest rate again was in the Czech Republic at 37 percent. There were large variations in the rates for individual countries, ranging down to 4 percent in Moldova.
• Cannabis use in the prior 30 days was highest in the U.S. (15 percent) and France (17 percent)—more than twice the average across all 35 European countries of 7 percent.
• Lifetime use of amphetamines was by far the highest among the U.S. teens at 10 percent. The average for the 35 ESPAD countries was only 2 percent.
• The U.S., Ireland and Georgia had the highest rates of ecstasy use (which has been in decline in the U.S.) at 4 percent lifetime prevalence.
• The U.S. and Poland had the highest rates of lifetime hallucinogen use at 5 percent, compared to an average of 2 percent across the European countries.
• Lifetime cocaine use by U.S. teens was above average at 3 percent versus 2 percent on average in Europe, but there were somewhat higher rates in Bulgaria (5 percent), France (4 percent) and Poland (4 percent).
• Lifetime heroin use in the U.S. sample was at the average for the European countries at 1 percent lifetime prevalence, but several countries had higher rates of 2 percent to 3 percent.
• While U.S. teens stand out for having high levels of use of controlled substances, their use of cigarettes and alcohol is equally noteworthy for being low in comparison to most of the countries of Europe.
• Daily cigarette smoking in the prior 30 days by U.S. teens is tied with Iceland at next to lowest (3 percent). Only Norway is lower at 2 percent, while the average for the 35 ESPAD countries was 12 percent (with national estimates ranging widely from 2 percent to 25 percent).
• The percentage of U.S. 15- and 16-year-old students who drank any alcohol in the 30 days prior to the survey was 22 percent—less than half the average proportion in the European countries (48 percent). Only Iceland had a lower prevalence of use (9 percent) and the U.S. was tied with Norway for second lowest.
• The percentage of students who said they had five or more drinks on one or more occasions in the prior 30 days was 35 percent, on average, in Europe. The U.S. sample had 11 percent indicating such binge drinking in the prior two weeks, second lowest only to Iceland at 8 percent. "While the U.S. number would be a bit higher if it referred to the prior 30 days rather than the prior two weeks, it likely would not change its overall ranking," according to MTF principal investigator Lloyd Johnston.

Overall, Johnston said that the considerable differences in terms of substance use between U.S. teens and those in Europe are not entirely new.

"The popular illicit drug use epidemic first emerged in the U.S. in the 1960s and eventually spread to be a pandemic affecting countries around the world," he said. "But it has not blossomed in Europe to the extent it did in this country.

"On the other hand, smoking and drinking are long established behaviors in many countries of Europe, and we can see in these coordinated surveys of adolescents that smoking and drinking—while declining some—are still more entrenched there than in the U.S., where we have seen substantial declines among youth in recent years."

Marijuana was seen as available to a greater proportion of students in the U.S. than in any of the European countries. Two thirds of U.S. 10th-graders said it would be fairly easy or very easy to get, compared with an average of only 30 percent among those the same age in Europe.

On the other hand, alcohol and cigarettes were seen as readily available to slightly more of the U.S. students 15 and 16 years old, than to their counterparts in Europe, despite the fact that use of both cigarettes and alcohol is relatively low among the U.S. teens compared to teens in Europe.

More than 96,000 students were surveyed in the 35 European countries that were included in the ESPAD study—24 of which are member states of the European Union. Among the few European countries not included in the 2015 ESPAD survey were Great Britain, Germany and Russia. The 35-country study was coordinated by the European Monitoring Centre for Drugs and Drug Addiction.