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Sixty percent of 12th graders do not view regular marijuana use as harmful

NIH’s 2013 Monitoring the Future Survey shows high rates of marijuana use; decreases in abuse of pain relievers and synthetic drugs

The percentage of high-schoolers who see great risk from being regular marijuana users has dropped dramatically in the past 10 years, according to this year’s Monitoring the Future (MTF) survey, which measures drug use and attitudes among the nation’s eighth-, 10th-, and 12th-graders. The change in attitudes is reflected in continued high rates of marijuana use in all three grades and could predict higher use in future years, based upon past MTF data (PDF - 204KB) showing an association between softening attitudes and increased use of marijuana.

The survey reports that 39.5 percent of 12th graders view regular marijuana use as harmful, down from last year’s rate of 44.1 percent, and considerably lower than rates from the last two decades.

The rates of marijuana use have also shown significant changes in the past two decades, with 6.5 percent of seniors smoking marijuana daily compared to 6 percent in 2003 and 2.4 percent in 1993.

“This is not just an issue of increased daily use,” said NIDA Director Nora D. Volkow, M.D. “It is important to remember that over the past two decades, levels of THC — the main psychoactive ingredient in marijuana — have gone up a great deal, from 3.75 percent in 1995 to an average of 15 percent in today’s marijuana cigarettes. Daily use today can have stronger effects on a developing teen brain than it did 10 or 20 years ago.”

Nearly 23 percent of seniors say they smoked marijuana in the month prior to the survey, and just over 36 percent say they smoked it during the past yearFor 10th graders, 4 percent say they use marijuana daily, with 18 percent reporting past month use and 29.8 percent reporting use in the previous year. More than 12 percent of eighth graders say they used marijuana in the past year.

“We should be extremely concerned that 12 percent of 13- to 14-year-olds are using marijuana,” Volkow added. “The children whose experimentation leads to regular use are setting themselves up for declines in IQ and diminished ability for success in life.”

“These increases in marijuana use over the past few years are a serious setback in our nation’s efforts to raise a healthy generation of young people,” said Gil Kerlikowske, director of National Drug Control Policy. “Teens deserve to grow up in an environment where they are prepared to meet the challenges of the 21st century, and drug use never factors into that equation. Today’s news demands that all of us recommit to bolstering the vital role prevention and involved parenting play in keeping young people safe, strong, and ready to succeed.”

There is mixed news regarding abuse of prescription medications. The survey shows continued abuse of Adderall, commonly used to treat attention deficit hyperactivity disorder, or ADHD, with 7.4 percent of seniors reporting taking it for non-medical reasons in the past year. However, only 2.3 percent of seniors report abuse of Ritalin, another ADHD medication. Abuse of the pain reliever Vicodin has shown a marked decrease in the last 10 years, now measured at 5.3 percent for high school seniors, compared to 10.5 percent in 2003. In addition, 5 percent of seniors report abuse of cough products containing dextromethorphan, down from 6.9 percent in 2006, the first year it was measured by the survey.

Graph showing perceived harm from marijuana
Percentage who think regular marijuana use is harmful
There are some other bright spots in this year’s survey. Past year use of K2 or Spice, sometimes called synthetic marijuana, dropped to 7.9 percent among high school seniors from 11.3 percent last year. While many of the ingredients in synthetic cannabinoids have been banned by the U.S. Drug Enforcement Administration, Spice manufacturers have attempted to substitute other chemicals in their mixtures, and many young people continue to experience toxic reactions to these substances.

The use of substances commonly known as bath salts is at or under 1 percent in all three grades. Bath salts refers to an emerging family of drugs containing one or more synthetic chemicals related to cathinone, an amphetamine-like stimulant found naturally in the khat plant. Use of the hallucinogenic herb salvia is declining, with 3.4 percent of 12th-graders reporting past year use, compared to 5.9 percent in 2011 and 4.4 percent last year.

The past year use of inhalants in all three grades has declined. Among eighth-graders, the 2013 rate is at 5.2 percent, compared to 8.7 percent 10 years ago and 11.0 percent 20 years ago. Inhalants are among the abused substances that have higher rates of use by the younger students in the survey. Four percent of seniors report use of Ecstasy (MDMA) in the previous year, still considerably lower than 2001, when use peaked at 9.2 percent.

For cocaine and heroin, while there was no significant change from the 2012 rates, there continues to be a gradual decline in use, with both drugs at historic lows in all three grades. The 2013 rate for high school seniors for past year cocaine use is 2.6 percent, compared to a peak of 6.2 percent in 1999. Similarly, the reported use of heroin by 12th-graders is 0.6 percent this year, compared to a peak of 1.5 percent in 2000.

Cigarettesmoking continues to decline as well. For the first time, the percentage of students in all three grades combined who say they smoked in the past month is below 10 percent (9.6 percent) compared to 16.7 percent 10 years ago and 24.7 percent in 1993. Daily smoking of cigarettes is now at 8.5 percent for 12th-graders, 4.4 percent for 10th-graders, and 1.8 percent for eighth-graders. However, 21.4 percent of seniors report smoking tobacco with a hookah in the past year, more than 3 percent above the rate teens reported in 2012 (18.3 percent).

“While cigarette use among youth continues to decline, such progress is threatened by use of other tobacco products such as hookahs,” said Howard K. Koh, M.D., M.P.H., assistant secretary for health for the U.S. Department of Health and Human Services. “We must remain vigilant in protecting kids against both old and new agents that promote addiction.”

Theuse of alcohol by teens continues its steady decline. For 12th-graders, alcohol use peaked in 1997, with more than half (52.7 percent) reporting drinking alcohol in the past month. Only 39.2 percent of seniors reported past month use this year. An indicator of binge drinking (defined in the survey as five or more drinks in a row at least once in the past two weeks) stayed the same as last year for eighth-graders (5.1 percent) but dropped considerably for 10th-graders (to 13.7 percent from 15.6 percent in 2012.) The 2013 binge drinking rate for 12th-graders is 22.1 percent.

In 2012, the survey added questions about where students get marijuana. Looking at the last two years combined, 34 percent of marijuana-using 12th-graders living in states with medical marijuana laws say that one of the ways they obtain the drug is through someone else’s medical marijuana prescription. In addition, more than 6 percent say they get it with their own prescription. The team of investigators who conduct the survey will continue to explore the link between state laws and marijuana’s accessibility to teens.

Overall, 41,675 students from 389 public and private schools participated in this year's Monitoring the Future survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th–graders nationwide. Eighth- and 10th-graders were added to the survey in 1991. Survey participants generally report their drug use behaviors across three time periods: lifetime, past year, and past month. Questions are also asked about daily cigarette and marijuana use. NIDA has provided funding for the survey since its inception by a team of investigators at the University of Michigan at Ann Arbor, led by Dr. Lloyd Johnston. MTF is funded under grant number DA001411. Additional information on the MTF Survey, as well as comments from Dr. Volkow, can be found at

MTF is one of three major surveys sponsored by the U.S Department of Health and Human Services that provide data on substance use among youth. The others are the National Survey on Drug Use and Health and the Youth Risk Behavior Survey. The MTF website is: External Web Site Policy. Follow Monitoring the Future 2013 news on Twitter at @NIDANews, or join the conversation by using: #MTF2013. Additional survey results can be found at External Web Site Policy or External Web Site Policy. Information on all of the surveyed drugs can be found on NIDA's website:

The National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration, is the primary source of statistical information on substance use in the U.S. population 12 years of age and older. More information is available at: External Web Site Policy.

The Youth Risk Behavior Survey, part of HHS' Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System, is a school–based survey that collects data from students in grades nine–12. The survey includes questions on a wide variety of health–related risk behaviors, including substance abuse. More information is available at External Web Site Policy.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at, which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA’s DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax or email requests to 240-645-0227 or Online ordering is available at NIDA’s media guide can be found at, and its new easy-to-read website can be found at

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

Daniel Brody, DMD, receives NATIONAL RECOGNITION

Valley Health – Fort Gay Family Dentist Receives Indispensable Man Award from NNOHA


Fort Gay, W.Va. – Valley Health is pleased to announce that one of its practitioners, Daniel Brody, DMD, received the Indispensable Man Award from the National Network for Oral Health Access (NNOHA) Board of Directors at the 2013 National Primary Oral Health Conference, recently held in Denver, Colo.

The conference, which had more than 600 attendees, was sponsored by NNOHA, a national organization whose mission it is to improve the oral health of underserved populations and contribute to overall health through leadership, advocacy and support to oral health providers in safety-net systems.

Dr. Brody was honored for the “talent, dedication, wisdom, guidance, and friendship we cannot imagine doing without, and without which we cannot imagine the successes we have achieved,” said NNOHA President, Wayne W. Cottam, DMD, MS, Associate Dean for Community Partnerships for the Arizona School of Dentistry and Oral Health at Still University of Health Sciences.
Dr. Brody has been a member of NNOHA for 18 years and has served on the organization’s Board of Directors and Executive Committee. He is also slated to chair the 2014 National Primary Oral Health Conference.
Dr. Brody is an actively-practicing family dentist, who has been instrumental in developing the Oral Health Program at Valley Health during his 29-year tenure, through which he has served in many capacities. He provides comprehensive family dentistry services to both children and adults at Valley Health - Fort Gay.

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Valley Health Systems, Inc. has been a leader in quality healthcare since 1975. Providing primary and preventative care to southern West Virginia and southeastern Ohio through the more than 30 health centers and public health programs it operates across the region, Valley Health’s medical experts provide care in family medicine, internal medicine, pediatrics, women’s health, behavioral health and dentistry. Valley Health also operates a full-service pharmacy and specializes in programs including Women, Infants and Children (WIC) nutrition services, school-based health centers and programs for the homeless. Valley Health serves nearly 70,000 patients each year while maintaining its mission of providing quality health care to all individuals with an emphasis on reaching those who are underserved. 

Kentucky Health News

Events, trends, issues, ideas and journalism about health care and health in Kentucky


Night lingers in Appalachia, but there are rays of sunlight

In 1963, Harry Caudill of Letcher County published Night Comes to the Cumberlands: A Biography of a Depressed Area, a book that brought national attention to poverty in Appalachia and spurred the War on Poverty. Fifty years later, as part of a year-long series, the Lexington Herald Leader is examining the challenges that Kentucky Appalachians still face on their path to progress, and the story of heartbreak and hope includes the region's contentious battle with drug abuse.

From 2000 to 2010, the number of drug-overdose deaths in Kentucky rose a staggering 296 percent, highlighting the state's drug abuse epidemic that now kills more than 1,000 Kentuckians a year. But communities have started to rise up and fight back against this lethal weapon, and for the first time in 10 years, deaths from prescription-drug abuse in Kentucky declined last year.

Still, the state's highest rates of overdose deaths are consistently found in Eastern Kentucky, where chronic poverty and economic hardships remain and numerous factors make it one of the worst areas in the nation for prescription drug abuse, experts say. Poverty is at the top of the list, reports Estep.

Social rank is also a key predictor of drug abuse, which consider how people see their place in the world and their ability to improve their lot, and many people in Eastern Kentucky rank low because of chronic poverty, Robert Walker, a researcher at the Center for Drug and Alcohol Research at the University of Kentucky, told Estep: "It's the belief that I can't do anything to fix this or make my life any better. That is a profound risk condition for drug abuse."

Another factor was the region's chronic health problems, reports Estep. It is well documented that Appalachians suffer from disproportionately poor health and have increased risks of adverse health outcomes, compared to the rest of the nation and the rest of the state; many people addressed these problems with drugs, which unintentionally led to drug addiction.

Public assistance also played a role in the developing drug abuse problem. "Medicaid recipients can get prescription drugs at little cost, and some people then resell them for cash," Estep writes. For example, in Clay County, which has the third highest rate of drug overdoses per 100,000 people, 42 percent of residents were eligible for Medicaid in fiscal 2012, compared with 18.8 percent statewide.

Eastern Kentucky's ongoing battle against pills started well before a decade ago as the area suffered economic devastation of the Great Depression and doctors handed out pills to mask pain for injured coal miners and the sick poor, Caudill wrote, adding that the drudgery of coal-camp life also drove the use of pills.

Fifty years later, Estep writes, "Rising drug abuse added misery to the economic malaise, and corruption among public officials inflamed the drug problem. Drug dealers helped power brokers buy votes, then benefited as some local police and other officials turned a blind eye to their illicit sales."

A story of heartbreak and hope in Manchester

Malanda AdamsMalanda AdamsThe story of one recovering addict, Melanda Adams, embodies these forces. Her home Clay County was at the center of the prescription-drug explosion, and her father, the county school superintendent, was convicted in a vote-buying scheme that he said he joined to help oust officials who were protecting drug dealers.

Social use of alcohol and drugs led Adams to start abusing drugs, but by the time she was 23, she was snorting as much as $800 worth of OxyContin pills and methamphetamine a day, she told Estep, adding that people start abusing drugs for a variety of reasons, and the shame of their addiction then becomes part of the reason to keep abusing them. "Your soul is tormented, really," she said.

Her craving for drugs led Adams to steal the ingredients that a drug dealer had provided her boyfriend to make a batch of meth, for which she suffered an almost fatal beating that still didn't curb her addiction. After stints in jail and in rehab, police found her agitated and bleeding in her home. She remained in jail for three months, where she suffered from the sharp pain of detoxification and withdrawal. Then she started on the road to recovery, reports Estep.

Fueling problems of addiction faced by thousands, Eastern Kentucky counties used corrupt relationships with local police and political officials in their illegal businesses, which included selling drugs.

Jurors convicted Adams' father, school Supt. Douglas Adams of vote fraud in a number of elections. As part of his defense, Adams said his motivation for getting involved in the most notorious election at issue in the trial, the 2002 primary for county clerk, was that the incumbent, Jennings B. White, had been protecting drug dealers, reports Estep. Adams said he was fighting against White to save his daughter and others who had fallen victim to drugs.

In the late 1990's, Congress designated Eastern Kentucky as a High Intensity Drug Trafficking Area, which led to efforts that helped dry up the county's drug rings. The FBI led investigations, "leveraging charges against drug dealers to pursue investigations of local officials," reports Estep. In the end, more than a dozen public officials or election offers in Clay County had been convicted. This shook up the local political structure, which was necessary for the community to take a stand against drugs, Estep reports.

Now, as a result of greater community awareness, activism against drugs, and targeted law enforcement, drug overdose deaths in Clay County have fallen from 43 in 2011 to 27 in 2012. Coroner Danny Finley also credits this reduction to better practices by many doctors, and new state laws that have cracked down on pain clinics and over-prescribing doctors, reports Estep.

While the fight against drugs is never over, Melanda Adams is proof that there's hope in Manchester and hope for Clay County. "She has clear eyes, a big laugh and a feisty 6-year-old daughter," reports Estep. She runs her own convenience store and says its important for drug addicts who feel trapped to know that they are more than just addicts. "There is a chance," she told Estep. "Give 'em that hope."

Posted by Molly Burchett

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