Drug abuse effects on schoolchildren aged 10 to 18 in developed nations

Abstract While the prevalence of substance-abusing behaviors by young people has declined or leveled off in many developed nations including those in North American, Asia, Europe and Australia, the abuse of some illicit drugs such as cannabis and alcohol continues to increase, and some countries such as Australia are experiencing a veritable epidemic in methamphetamine use by young people today. To develop some fresh insights into this problem, the purpose of this research paper is to provide a systematic review of the peer-reviewed and scholarly literature concerning the adverse effects of drug abuse on schoolchildren aged 10 to 18 years in selected developed countries (i.e., the U.S., Canada, France, England, Germany, Italy, Russia, Australia, Japan, and China). A thematic analysis identified four prevailing themes that are assessed and analyzed, followed by a discussion concerning these issues as they apply to drug-abusing behaviors by young people in the age range of interest. Finally, a summary of the research and key findings together with implications for practice are presented in the study’s conclusion.

Impact of Drug Abuse on School Children Aged 10 to 18 in Developed Countries (U.S., Canada, France, England, Germany, Italy, Russia, Australia, Japan, and China)

Introduction Today, most young people in developed nations enjoy a lifestyle that would be the envy of their counterparts in many developing countries, including a comfortable place to live, longer life spans, better health care, and plenty of good things to eat. Notwithstanding these advantages, however, many young people in developed nations continue to engage in substance-abusing behaviors that endanger their health and lives. The purpose of this research paper is to provide a systematic, narrative critical review of the relevant literature concerning the impact of drug abuse on schoolchildren aged 10 to 18 years in selected developed countries (i.e., the U.S., Canada, France, England, Germany, Italy, Russia, Australia, Japan, and China). In this context, drug abuse is defined by the World Health Organization as “the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs” (Substance abuse 2019, p. 2). A statement of the aim of the literature review is followed by a description of the search strategy that was used to identify appropriate studies. In addition, a tabular results and data analysis section is followed by a summary of the research and implications for practice in the conclusion.

STATEMENT OF THE AIM FOR THE LITERATURE REVIEW The overarching aim of the literature review that follows below is to explicate the current impact of drug abuse on schoolchildren aged 10 to 18 years in the selected developed countries identified above. This aim is important because while there are regional and national differences in the trends concerning the type and amounts of illicit drugs used, there has been a general increase in cannabis use in developed nations over the past decade or so (Substance abuse, 2019). In addition, although the prevalence rate of abusing substances such as opioids, including prescription drugs, has leveled off in recent years, the rate is still inordinately and unacceptably high.
The one truly bright spot in this calculus has been the decline in the prevalence rate of amphetamine and cocaine usage that has been attributed to changing trends in many developed nations in North America and Europe (Substance abuse 2019). Likewise, substance abuse trends in the other selected developed nations selected for this analysis largely mirror these patterns, meaning that they all share a common concern over the adverse impact that these behaviors can have on young people today. Therefore, identifying the impact of drug abuse on young people in these developed nations can be generalized to other similarly situated countries that are also faced with this type of problem. These findings can be used to facilitate the development of more efficacious interventions that have a proven track record of success. The review of the literature for this purpose was achieved using the search strategy described below. METHODS: SEARCH STRATEGY The databases consulted for this study included EBSCOHost, Questia, Google Scholar, Proquest, and JSTOR. The search terms used for the search included “drug abuse” and “substance abuse” combined with terms such as “developed nations” and “first world” using Boolean operators. All told, a total of 13,456 articles were initially identified using these search strategies, and this total was narrowed to those set forth in Table 1 below based on their high degree of relevance and appropriateness for the above-stated aim of the literature review.

The respective inclusion and exclusion criteria for the studies selected for the review of the relevant literature are set forth in Table 1 below.
Table 1. Inclusion and exclusion criteria for studies selected for the literature review
Inclusion Criteria
Exclusion Criteria Published in the English language; Published between the year 2004 and 2019; Focused on the impact of drug abuse among adolescent school children in the developed world. Specifically mentioned at least one of the developed countries of the U.S., Canada, France, England, Germany, Italy, Russia, Australia, Japan, and China. Studies focused on drug abuse among adults Studies that examined drug treatments only with no discussion of the impact of abuse on children, Studies focused on drug abuse in the third world Studies published in languages other than English. Studies published prior to 2004.

RESULT AND DATA ANALYSIS The application of the inclusion and exclusion criteria set forth in Table 1 above produced the results set forth in Table 2 below.
Table 2: Summary of reviewed articles, the participants/setting and focus of the study
#
Authors of Articles
Participation /Settings
Purpose of the Study

1
Bergman et al. (2019)
318 seventh graders in Los Angeles, California
The purpose of this study was to test whether providing information to parents about their child’s academic performance and behavior in school will lead to lower rates of adolescent substance use.

2
Trudeau et al. (2017)
129 adolescent-aged participants (ages 13–23) living in California who received substance abuse treatment and participated in a randomized parallel-group study comparing two interventions.
The purpose of this study was to assess the efficacy of the online Navigating my Journey (NmJ) program, An Internet-based relapse prevention supplement to adolescent substance abuse treatment programming modality to reinforce treatment gains and enhance recovery.

3
Susukida et al. (July 1, 2016)
3,592 participants from 10 clinical trial networks in the United States
The purpose of this study was to compare the characteristics of individuals participating in randomized controlled trials of treatments of substance use disorder with individuals receiving treatment in usual care settings to provide a summary quantitative measure of differences between characteristics of these two groups of individuals using propensity score methods.

4
Eitle and Eitle (December 1, 2018)
A subsample of 623 American Indian adolescents using the National Longitudinal Study of Adolescent to Adult Health.
The purpose of this study was to examine the association between
body mass index and marijuana, other illicit drugs and heavy alcohol use, controlling for established predictors of youth substance use.

5
Vist (2016)
Population studies of Europe, Russia, and the United States concerning adolescent drug abuse prevalence levels
The purpose of this study was to identify protective factors against drug abuse by young people in the United States and Russia today.

6
Cordova et al. (2018)
30 adolescents from a youth-centered community health care clinic in Southeast Michigan
The purpose of this study was to assess the usability and acceptability of novel intervention for drug abuse among adolescents in primary care.

7
Ames et al. (May 1, 2017)
725 at-risk adolescents in 9th grade attending school in Los Angeles, California.
The purpose of this study was to test longitudinal additive and synergistic dual-process models in youth at documented risk for drug use.

8
Leblanc et al. (2015)
26 Franco-Ontarian young adolescents (aged 12-14 years) participated in Lions Quest, a program specially designed to prevent drug and alcohol use.
The purpose of this study was to develop a better understanding of the participating adolescents' conception of risk and protective factors in a linguistic minority context, with the eventual purpose to prevent or delay alcohol and drug use.

9
Trezza et al. (2014)
Quantitative meta-analysis of risk factors for drug abuse among young people in the United States
The purpose of this study was to provide an overview of the current understanding of the interaction between drugs of abuse and juvenile/adolescent social behavior to identify opportunities to improve existing treatment strategies.

10
Dixson et al. (April 2018)
267 adolescent females participating in a residential treatment program in NSW Australia
The purpose of this study was to investigate factors associated with methamphetamine use in adolescent females referred to as an Australian residential treatment service.

11
Goings et al. (2018)
9,339 bi/multiracial youth ages 12–17 living in the United States
The purpose of this study was to analyze and compare the prevalence of substance use among bi/multiracial youth with that of youth from other racial/ethnic groups to identify distinct profiles of bi/multiracial
youth by examining their respective substance use risk

12
Kislitsyna (2014)
A meta-analysis of health issues including drug abuse among young people in Russia, Germany, and England, among others.
The purpose of this study was to identify the causes of the dramatic surge in alcoholism and drug abuse among children aged 12 to 14 years in Russia.

13
Caspi et al. (2018)
Systematic literature review and content analysis of literature concerning the effects of gender and age on drug abuse among young people
The purpose of this study was to evaluate practice guidelines and the Sibling Substance Abuse Treatment Matrix in order to identify novel strategies for determining risk for drug-abusing behaviors by young people in developed nations to reduce their harmful effects on this population.

14
Russell et al. (2018)
70 adolescent Australian youths (mean age 16.6 years, 56% male, 58% White, 30% Aboriginal or Mètis)
The purpose of this study was to provide the preliminary results of a pilot implementation initiative at a youth care program that focuses on substance use disorder treatment.

15
Stepteau-Watson and Tolliver (September 1, 2018)
Content analysis of the Substance Abuse and Mental Health Services
Administration National Survey and other U.S. youth population survey data
The purpose of this study was to demonstrate how African-centered principles can be applied to substance abuse treatment interventions with African-American adolescents.

16
Singh et al. (October 2018)
Professional school social work experience, empirical observations, and analysis of current treatment strategies for drug-abusing youths in the U.S.
The purpose of this study was to emphasize the importance and principles of conducting adolescent screening, brief intervention, and referral to treatment for substance-abusing behaviors.

17
Border et al. (November 2018)
1,463 adolescents involved with the juvenile justice system or court?mandated substance abuse treatment programs in San Diego, California, and Denver, Colorado.
The purpose of this study was to examine common and independent contributions to mortality hazards in adolescents with conduct disorder and substance use disorder, their siblings and community controls. RESULTS Although there was no universal “one-size-fits-all” treatment strategy for drug-abusing young people, the results of the literature review did highlight the fact that a growing body of scholarship indicates that efficacious interventions are available, including some that are highly cost-effective. The key to success appears to relate to tailoring interventions to the unique needs of young people and their environment (Stepteau-Watson and Tolliver 2018), most especially taking into account any cross-cultural differences that may positively or negatively impact the effectiveness of interventions (Ferrari, Norman, Freedman et al. (2014). For example, in sharp contrast to the prevailing negative views about alcohol use and young people in the United States, families in many European countries such as Italy and Germany have a far more relaxed perspective and it is not unusual for even very young children to partake of a glass of wine or to have a sip of beer at the dinner table.
Yet another important point to emerge from the literature review was the fact that the developed countries of interest to this study are not all homogeneous in demographic composition, and some demographic groups, especially minorities, tend to experience far greater prevalence levels of drug abuse (Leblanc, Drolet, Ducharme, et al. 2015). For instance, according to Eitle and Eitle (2018, p.24), in the United States, “The prevalence rates for substance use among American Indians is either the highest or among the highest for any racial/ethnic group in America. American Indians had the highest prevalence of current and lifetime alcohol use disorders and the highest prevalence rate of past-year drug use disorder.”
Likewise, Goings, Salas-Wright, Howard, and Vaughn (2018) emphasize that youths that identify with having three or more racial/ethnic backgrounds are especially at risk of drug-abusing behaviors. In this regard, Goings and his colleagues (2018, p. 206) report that “With few exceptions, bi/multiracial youth in general report higher levels of tobacco, alcohol, marijuana, and other illicit drug use compared to other youth of color. Bi/multiracial youth also report higher levels of marijuana use compared to non-Hispanic white adolescents.” Given that these risk factors have been identified and in some cases exhaustively studied, it remains unclear why drug abuse interventions have not been more aggressively targeted at these populations in the past.
Taken together, it is clear that the public health issue of drug abuse among young people has been the focus of a growing body of research, and youths that are at elevated risk have been identified in a number of national settings (Kislitsyna, 2014). Nevertheless, it is equally clear that far more scholarship needs to be devoted to identifying what interventions work best in different venues and most especially why they work. Indeed, the sole universal factors that were identified in the studies and other literature reviewed was the importance of individualizing treatment protocols according to the unique needs of the young people involved and the need to actively involve parents and other family members in the process and these key results are examined and discussed further below. FINDINGS The primary findings that emerged from the systematic review and thematic analysis of the literature included four main themes as follows: (1) the importance of a parental role in efficacious intervention strategies for young people that are abusing drugs; (2) the respective protective and risk factors that are associated with school-aged children substance-abusing behaviors; (3) early interventions are critical for successful outcomes; and (4) drug abuse has an adverse effect on young people’s health and academic performance. Each of these four themes is examined and discussed further below.

THEME 1: THE IMPORTANCE OF A PARENTAL ROLE IN EFFICACIOUS INTERVENTION STRATEGIES Despite increasingly aggressive efforts to develop and administer efficacious intervention strategies for drug-abusing young people, one of the main factors that are frequently overlooked is the need for parental involvement (Vist 2016). The focus of the majority of the interventions that have been developed for treating young people’s drug abuse has largely been on (1) providing them with information concerning the dangers of drug abuse and (2) providing them with the tools and resources they need to cope with powerful peer pressure in healthy ways that avoid succumbing to these pressures while maintaining their youthful integrity in the eyes of their counterparts (Russell, Gillis, Law and Coulliard 2018).
While these types of interventions have shown modest effectiveness, they typically involve the use of significant amounts of resources and ongoing staff training which constrain their use and consistent implementation. Consequently, less expensive treatment strategies are urgently needed to help young people avoid drug abuse in the first place by understanding its harmful effects and how to respond to peer pressure as well as to help them recover from such drug use if it has already started (Bergman et al. 2019).
One strategy that has demonstrated potential value in this regard is encouraging parents to become actively involved in teaching their children’s education concerning the dangers of drug abuse as well as viable strategies for responding to pressure from peers to engage in such behaviors. For example, a study by Bergman et al. (2019) found that including parents in drug abuse prevention programs improved the effectiveness of these strategies in reducing illicit drug use, including alcohol and cannabis, two of the drugs that are most frequently abused by young people today. In this regard, Bergman et al. (2019, p. 1460) conclude that “On the basis of student surveys conducted at the end of seventh and eighth grade, self-reported lifetime use of marijuana was 10.5% in the control group and 5.6% in the intervention group. Combined, lifetime use of alcohol or marijuana was higher in the control group (18.2%) than in the intervention group.” THEME 2: PROTECTIVE AND RISK FACTORS ASSOCIATED WITH SCHOOL-AGED CHILDREN SUBSTANCE ABUSING BEHAVIORS One overarching risk factor for drug abuse among adolescents appears to relate to a combination of various environmental and genetic sources. For example, American Indian adolescents suffer the highest prevalence of drug abuse of any demographic group in North America (Eitle & Eitle 2018). Other risk factors that have been identified for exacerbating adolescent drug abuse include depression, poor coping skills, family conflict and having drug users in a young person’s peer network (Trudeau et al. 2017). In addition, students attending alternative school settings are also at higher risk of engaging in drug-abusing behaviors (Ames, Xie, Shono and Stacy 2017). Further, research has also shown that risk factors for drug abuse among adolescents include early social insults and antisocial personality traits (Trezza, Baarendse and Vanderschuren 2014).
Conversely, some of the protective factors against adolescent drug abuse that have been identified to date include social and problem-solving skills and a firm commitment to abstinence as well as social and problem-solving skills (Trudeau et al. 2017). In addition, another protective factor against adolescent drug abuse is having a strong family network, most especially one with involved parents (Eitle & Eitle 2018). Further, another protective factor for young people in the provision of the knowledge and tools they need to respond to peer pressure in healthy ways (Trudeau et al. 2017). THEME 3: EARLY INTERVENTIONS ARE CRITICAL FOR ACHIEVING SUCCESSFUL OUTCOMES Young people that are confronted with multiple risks of engaging in drug-abusing behaviors are far more likely to transition from mere experimentation to severe drug abuse by the time they reach adolescence (Cordova, Alers-Rojas, Lua, et al. 2018). Furthermore, the research to date confirms that many young people that are enrolled in secondary schools between the 8th and 12th grades are already involved with drug abuse and the majority of these young people regularly experiment with alcohol and other illicit drugs (Makhubele and Mdhluli 2018). Therefore, implementing interventions that are specifically targeted at this demographic group is essential to prevent young people from beginning drug-abusing behaviors as well as preventing those young people that are already experimenting from moving on to serious drug abuse.
In fact, the United Nations Office of Drugs and Crime (UNODC) stresses the need for early interventions, most especially when youth as young as 10 years (or even younger if appropriate) that are known to be at risk are involved. For example, the UNODC (Status and trend analysis of illicit drug markets, 2019, p. 2) emphasizes that:
Most drug use starts in adolescence and some 20 percent of them report past-month use of cannabis. In this context, it is important to note that what occurs during adolescence very much depends on what happened earlier on in an individual’s development, during childhood and early adolescence. For this reason, drug prevention efforts can and should be targeted at earlier ages than adolescence.
This theme also relates directly to the centrality of active parental involvement in the education of their children concerning legitimate strategies for responding to peer pressure as well as the dangers of drug abuse to their health and academic performance as discussed further below. THEME 4: DRUG ABUSE HAS A PROFOUNDLY ADVERSE EFFECT ON YOUNG PEOPLE’S MENTAL AND PHYSIOLOGICAL HEALTH AND ACADEMIC PERFORMANCE One of the consistent findings that emerged from the literature review was the adverse effect that drug abuse has on young people’s health and academic performance (Bergman et al., 2019). These are especially troubling findings since young people that do not abuse drugs can reasonably expect to see their 100th birthday. Moreover, competing in the 21st-century workplace requires far more knowledge and so-called “soft skills” compared to even the fairly recent past, and the rate of technological change demands individuals that possess the fine-tuned critical thinking skills that were consistently shown to be adversely affected by drug abuse. Moreover, the harmful effects of drug abuse on young people are cumulative and these effects can even begin with the very first use of illicit drugs. In this regard, Singh, McCann, Weber, et al. (2018, p. 38) report that “Adolescent substance use is particularly problematic because of the adverse health and education effects. The first encounter with a substance can impair decision making, causing injury, victimization, and even death.”
Indeed, adolescent drug abuse is routinely implicated in a wide array of health issues, including the onset of depression, anxiety and even suicidal ideations and actual suicides among young people in numerous national settings. For instance, according to Border, Curley, Brown, et al. (2018, p. 2107), “American youth who engage in risky behaviors, such as substance abuse and criminal activities, are two to nine times more likely to die prematurely than their general population counterparts.” Likewise, elevated health care problems, as well as suicide rates for drug-abusing young people, are also far higher in Russia and some European countries compared to the respective larger populations (Vist, 2016).
Unfortunately, even when presented with these alarming statistics, far too many young people ignore this eventuality since they may regard themselves as exceptions to the rule and invulnerable to harm. In sum, like the warnings posted prominently on tobacco products, young people aged 10 to 18 years may simply ignore the health risk and adverse impact on their academic performance in favor of drug-abusing behaviors, especially if they are exposed to these behaviors by their peers on a regular basis. DISCUSSION Despite the numerous cross-cultural differences that exist between the countries examined in this study, there were some common themes that emerged concerning the adverse effects of drug abuse on young people as well as what can be done to mitigate these behaviors. First and foremost, some young people enjoy numerous protective factors that help them avoid becoming involved with drug abusive behaviors in the first place. By sharp contrast, many other young people are at greater risk of drug abuse due to several environmental factors in their lives that tend to encourage drug abuse (Dixson, Woolfenden, Jayasinha, et al. 2018). When potential genetic predispositions to drug abusive behaviors are thrown into this mix, it is clear that developing truly effective interventions for drug-abusing young people represents a truly daunting enterprise (Caspi, Lardier, Barnos, et al. 2018).

LIMITATION OF THE REVIEW The overarching limitation of this review was the primary focus on school children in developed nations only. In addition, there remains a paucity of timely and relevant research concerning drug abuse among young people in specific European nations, this focus having been subsumed into a larger European Union context. Finally, given the comparatively high level of adolescent substance abuse in developing nations compared to the progress that has been achieved in developed nations, it is reasonable to posit that many of the efficacious interventions being implemented in third world nations are highly cost-effective and warrant further examination by clinicians in the developed countries of North America, Europe, Asia, and Australia.