The natural history of drug use from adolescence to the mid-thirties in a general population sample
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OBJECTIVES: This study sought to describe patterns of initiation, persistence, and cessation in drug use in individuals from their late 20s to their mid-30s, within a broad perspective that spans 19 years from adolescence to adulthood. METHODS: A fourth wave of personal interviews was conducted at ages 34-35 with a cohort of men and women (n = 1160) representative of adolescents formerly enrolled in New York State public secondary high schools. A school survey was administered at ages 15-16, and personal interviews with participants and school absentees were conducted at ages 24-25 and 28-29. Retrospective continuous histories of 12 drug classes were obtained at each follow-up. RESULTS: There was no initiation into alcohol and cigarettes and hardly any initiation into illicit drugs after age 29, the age at which most use ceased. The largest proportion of new users was observed for prescribed psychoactives. Periods of highest use since adolescence based on relative and absolute criteria were delineated. Among daily users, the proportions of heavy users declined for alcohol and marijuana but not for cigarettes. CONCLUSIONS: Cigarettes are the most persistent of any drug used. Drug-focused interventions must target adolescents and young adults.
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Initiation of substance use typically occurs during mid-to-late adolescence (~14-18 years), with frequency increasing during adolescence into early adulthood and peaking in the 20s.
“Initiation of substance use (i.e., first use of alcohol, marijuana, or other drugs) typically occurs during mid-to-late adolescence (~14–18 years), with frequency of use increasing during adolescence into early adulthood, and peaking during their 20’s”
From Impact of Sleep and Circadian Rhythms on Addiction Vulnerability in Adolescents (2018) · cites this paper as [3]
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- Authors
- Chen, K., & Kandel, D. B.
- Affiliations
- Columbia University (US)
- New York State Psychiatric Institute (US)
- ORCID
- Kandel, D B
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 1995-01
- Volume
- 85
- Issue
- 1
- Pages
- 41-47
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- OpenAlex
- W2035631704
- Cited by
- 857
- References
- 16
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 21 · 2021: 14 · 2020: 19 · 2019: 27 · 2018: 22 · 2017: 25 · 2016: 34 · 2015: 31 · 2014: 36 · 2013: 51 · 2012: 42
- FWCI
- 18.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (2r01da003196-05, 5r01da004866-07)
- National Institute of Mental Health (MH30906)
- National Institute on Drug Abuse (DA03196, DA00081, DA04866)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Demography › Youth, Drugs, and Violence
- Keywords
- drug use patterns, substance use initiation, substance use cessation, alcohol consumption, cigarette smoking, cannabis use, illicit drug use, heavy drug use, adolescence to adulthood, young adults, school-based cohort
- MeSH terms
- Adolescent, Adult, Age Factors, Alcohol Drinking, Cocaine, Female, Follow-Up Studies, Humans, Male, Marijuana Smoking, Smoking, Illicit Drugs, Cohort Studies, Prevalence, Substance-Related Disorders
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