Letters to the Editor
A Preliminary Report on Substance Use Patterns in an Adolescent Psychiatric Population
Dear Editor:
The prevalence of substance use among adolescents in Western countries is currently as high as 67.5%, with the age at first use being 12 to 14 years. The Ontario Student Drug Use Study (OSDUS), a 20-year prospective study, reported that 28.3% of high school students had used tobacco, 65.7% had used alcohol, and 29.2% had used cannabis. In addition, multisubstance use in this age group increased significantly (1). Despite several large-scale epidemiological studies, there remain unanswered questions pertaining to regional differences in the pattern of substance misuse among adolescents. Accurate information on the magnitude of this problem is crucial for allocation of limited resources.
In a pilot study, we gathered data on adolescents aged 12 to 18 years (minus 1 day) referred to inpatient and outpatient services at the Division of Child and Adolescent Psychiatry, Hotel Dieu Hospital, Kingston, Ontario. These patients had completed the substance use questionnaire (SUQ) appropriately and had given informed consent. We developed the SUQ based on the adult version. It includes questions about the patient’s sex and age, as well as about the frequency, quantity, and type of substance used (2,3). The SUQ also includes questions formulated from the DSM-IV criteria for substance abuse disorder and substance dependence disorder. To ensure that the patients understand the questionnaire, its language is consistent with Grade 8 reading level. The questionnaire was administered by the staff at the inpatient unit and (or) by the intake secretary in the outpatient service. A package including the informed consent form, the SUQ, and 2 envelopes was prepared for each patient. The patients were given information about the study and reassured of its anonymity. If, after reading the questionnaire, the patients decided to participate and were aged 16 years or over, they signed the consent form and completed the questionnaire. When patients were younger than age 16 years, their legal guardian was required to sign the consent form before they participated. Upon completion, patients placed the questionnaires in separate envelopes, sealed them, and returned them to the staff.
Preliminary data on 15 adolescent psychiatric outpatients and 34 inpatients show a preponderance of adolescent girls in both groups. This can be explained by the overall higher rates of psychiatric admissions and outpatient clinic attendance for female patients. Further, our data show strong evidence of an association between alcohol and cigarettes, cannabis and cigarettes, and especially, alcohol and cannabis. The association of alcohol and cannabis is statistically significant in both in- and outpatient groups. At the time of writing this letter, we have gathered further data on the above population and added pediatric outpatients as a comparison group. The final analysis on all 3 clinical sample populations is in process and will be reported in the near future.
References
1. Adlaf EM, Paglia A, Ivis FJ. Drug use among Ontario students, 1977–1999. Findings from the Ontario Student Drug Use Survey. Report from Centre for Addiction and Mental Health. Toronto: Univeristy of Toronto; 1999.
2. Addiction Research Foundation. Psychoactive Drug History Questionnaire. Questionnaire. Toronto: Centre for Addiction and Mental Health; 1997.
Located at Addiction Research Foundation, Toronto (ON).
3. Addiction Research Foundation. Adverse Consequences of Substance Use. Questionnaire.
Toronto: Centre for Addiction and Mental Health; 1997. Located at Addiction Research Foundation,
Toronto (ON).
John CC Chan, Hons BSc, MSc, MD, PGY4
Nasreen Roberts, MD, MRCPsych, FRCPC
Kevin Parker, PhD
Kingston, Ontario
|
