The workings of the adolescent mind can be mysterious, confounding, and unpredictable. For the lead investigators of “Monitoring the Future,” the nation’s longest-running and most comprehensive study of American youth, the adolescent mind is an endless source of fascination and data.
Headquartered since 1974 in U-M’s Institute for Social Research (ISR), “Monitoring the Future” has set the gold standard of investigator-initiated research. It is funded by the National Institute on Drug Abuse, one of the National Institutes of Health. Each year since 1975 U-M researchers have surveyed nationally representative samples of 40,000-50,000 students in 400 secondary schools. Respondents are culled from the 8th, 10th, and 12th grades.
Policymakers have come to rely on data regarding teens’ use and abuse of substances, from tobacco and marijuana to inhalants and prescription drugs. In addition to queries about substance use, researchers also focus on adolescents’ attitudes regarding race relations, gender roles, education, violence, and more.
One of the most striking statistics from 2014 is the fact that e-cigarettes, currently unregulated, have surpassed tobacco cigarettes in use among teens. At the same time, teens’ use of alcohol, tobacco, and most illicit drugs is stabilized or declining.
Living in the real world
“The subtitle of ISR is ‘social science in the public interest,’ and I was attracted to the idea of making a difference in the world,” says study co-founder Lloyd Johnston, the Angus Campbell Collegiate Research Professor and distinguished senior research scientist. “The study fills a need in society to know how things are changing, how fast they are changing, and, especially, whether new drugs are coming onto the scene.”
Johnston has been the principal investigator on the study since its inception. He and the study’s co-founder, Jerald Bachman, demonstrated early on that an increase in the perceived risk of a drug would cause its use to fall — and vice versa. The study also served as an early warning signal for a spike in teen smoking in the early ’90s.
Now in its 40th year, “Monitoring the Future” is the largest RO1 grant funded by any NIH institute. Every five years the team is reviewed by peers in the NIH system to secure a new round of funding.
In the following Q&A, Johnston reflects on the past four decades and lessons learned from our nation’s youth.
You have been with the study since its inception. What keeps you interested in this work?
Lloyd Johnston: As a social psychologist, I could have explored many subject areas. As it happened, I ended up in the substance abuse area. It has turned out to be a really fascinating and rewarding endeavor because there has been so much change over historical time, and for that matter, across ages, and even across cohorts. I did not pick a quiet area for investigation.
What have you learned about the human condition over all these years?
LJ: People always want to say each generation is different. But we’ve found in the data they are more similar than different. There’s a constancy in American adolescents that is surprising, in a way. Kids want to try new things; they are very experimental. I think it’s a failure of our secondary school biology courses that kids don’t really understand and appreciate just how delicate the brain and nervous system are.
Talk a bit about the changes you’ve seen since starting this study in the ’70s.
LJ: We’ve seen a growing smorgasbord of drugs come to the table, while very few have left. There will always be new drugs to tempt adolescents. And each new drug has its own “honeymoon period” of unrealistic testimony from early users, which can create an epidemic very quickly. We feel a responsibility to tamp that down as much as we can. So if there’s a new substance on the scene – ecstasy, GHB – it’s very important to get the research established to determine the dangers.
We also track “perceived risk.” To what degree do young people see the use of a substance as dangerous? The longer it takes for them to learn about the dangers and consequences of a substance, the longer an epidemic will go, and the more serious the problem will become. In the case of cocaine, the honeymoon period lasted nearly a decade.
The importance of perceived risk has been a major finding that came out of the study. It has implications for prevention and government policy. It gives people something to work with. A decline in perceived risk tends to precede a change in behavior by a year. Once perceived risk goes down, disapproval goes down a year later, and use goes up.
What accounts for a change in the perceived risk of a drug that’s already been established as dangerous?
LJ: I attribute much of that to generational replacement and “generational forgetting.” As new kids come into adolescence, what has been learned in an earlier period is lost. Today’s adolescents were not around when cocaine and crack were all over the news, so they don’t know why they shouldn’t experiment with them. I always call attention to a substance where use has yet to rise, but perceived risk is going down. This sets the stage for a “relapse” in use. Right now, for example, that’s true for inhalants.
Talk a bit about the study’s impact on cigarette smoking among adolescents.
LJ: One of the most vivid and important things we’ve done is to document in the early ’90s that cigarette smoking was rising extremely rapidly among teens. In a few years it went up by 50 percent. No one else was documenting that, and we received a lot of national media coverage.
That helped give rise to a much bigger policy response from the President, the Congress, and the FDA. People were becoming aware of and concerned about the problem of teenage smoking. In 1998 the historic settlement occurred between the four largest tobacco manufacturers and the attorneys general of 46 states. [The settlement called for, among other things, creation and funding of the National Public Education Foundation — now called the Legacy Foundation — dedicated to reducing youth smoking and preventing diseases associated with smoking.]
In the years since the settlement we’ve tracked a very significant decline in cigarette smoking among teens. Many fewer are starting to smoke; many fewer are actively smoking. The impact on the longevity and health of this generation is going to be dramatic. I take particular pride in that aspect of the study.
Right now, ironically, we’re looking at a rise in e-cigarette use. Typically, the e-cigarette vapor contains nicotine, but other ingredients in the vapor are not known. And they’re not regulated. Since nobody knows exactly what the contents are, it’s going to take some time to determine the impact of e-cigarettes on health. The big concern is that kids will get hooked on nicotine, and might end up smoking cigarettes. I would find it a great tragedy if the use of e-cigarettes reversed all the progress we’ve seen on cigarette smoking.
Do you ever draw parallels between current events and drug use? For example, would war, an economic crisis, etc., portend a potential spike in substance abuse?
LJ: The Vietnam War was a major historical stimulus with great impact on the nation’s drug-using habits. It really changed the nature of the drug problem among our adolescents. It made drug use more acceptable, even positive, and more widespread. This was a period of great stress and alienation in society. I think of it as an historical accident that drug use became a symbol of rebellion in that period, and we have not seen anything that bad in the years since.
In the early ’90s the country really took its eye off the drug problem, in part due to the first Gulf War, which used up all the oxygen in terms of media coverage. Congress cut back funding. Parents were reassured and didn’t talk to their kids about drugs as much. Media coverage of the issue disappeared for some years. And, sure enough, there was a “relapse phase,” because the forces of containment had subsided. Drug use among teens increased. As a result our study and others got more attention for our results and the country began to attend to the issue again.
The media plays a big role in disseminating your annual results.
LJ: We see two kinds of results when we release the data. If it’s particularly bad news it’s on the front page of The New York Times. If it’s particularly good news it’s probably not even covered in The New York Times. And you can generalize from that to most of the other media.
How has it been for you interacting with government leaders over the years?
LJ: It’s varied over time. There have been a number of administrations, from quite conservative to quite liberal. As a scientist I feel it’s my job to bring reality to the public with no spin. At the same time, I try not to go out of my way to embarrass the sitting administration. But one year President Clinton took a hit from our data. I tuned into C-Span one evening and saw a senator holding up a chart from our study to demonstrate how terrible things had gotten under the Clinton administration. It was quite a shock to see our results used in that way.
Looking back over the decades, what are some key trends that stand out?
LJ: In the ’70s, daily marijuana use was going through the roof among kids and there was a lot of attention on that. Then in the ’80s drug use in general went down considerably for reasons I don’t think anyone can fully explain. Kids did come to perceive marijuana as much more dangerous than they used to, and I think that had a lot to do with the larger decline in using drugs. Our finding that one in nine high school seniors was a daily pot smoker in 1981 stimulated a lot of concern and attention to the problem.
At the same time, cocaine was not seen as dangerous or addictive. Reality corrected those perceptions, especially when Len Bias [second overall pick in the 1986 NBA draft] overdosed two days after being signed to the Boston Celtics. Soon after, we saw a 75 percent decline in kids using cocaine.
But we’ve also seen the opposite effect. We saw that with Mark McGwire, the great homerun hitter in the ’90s, who was using a precursor to steroids, androstenedione. He had these huge forearms and could hit the ball out of the park repeatedly. Suddenly steroid use among young males from 8th-10th grade jumped by about 50 percent. At that time they could get certain steroids over the counter.
That’s sort of like the ‘heroin chic’ when the spotlight was on Seattle in the ’90s.
LJ: We tracked a doubling of heroin use among adolescents at that time. Low numbers, but still a doubling. World production of heroin was so great that prices went down and purity went up. Once the purity went up you could take it in ways other than injecting it, like smoking or snorting it, which removed the aversion to using a needle. Roughly half the young heroin users in that phase were using it by noninjection means. Once people started dying and heroin lost its chic, use went down and stayed down among adolescents, which is good news.
So now we are up to the new millennium. What trends did you see at the turn of the century?
LJ: Use of most of the illicit drugs leveled off and began to decline by the late ’90s, but the misuse of prescription drugs by adolescents continued to rise into the early 2000s. Much of the advertising, particularly of sleep-inducing drugs, probably played a role in making them seem safe and normative. Ironically, they may be a little safer than illicit drugs because they’re made in a pharmaceutical lab and not some dirty lab in the back of a house. But they still are dangerous.
The most troubling trend was a rise in the use of opiates. They’re so addictive and have such high potential for overdose deaths, which did increase considerably. The use of prescription opiates has leveled off and there’s been a gradual decrease in recent years in the proportion of kids who are misusing those substances. I think perceived risk played a part there, as well.
What do you see on the horizon for marijuana in light of medical uses and legalization in some states?
LJ: Marijuana use had been going up for several years and is stabilized right now. Medical use and legalization likely changed some kids’ perceptions of how dangerous it is. We know that perceived risk for marijuana has been falling quite sharply. We probably over-prosecute people for marijuana, but it’s not harmless either. Evidence is now accumulating that for people under the age of 25, marijuana may not kill you, but it may make you dumber because of its effects on the developing brain. We haven’t seen the last of the marijuana issue by any means.
Your study is unique in that you continue to follow a set of adults first surveyed in the ’70s. How does behavior change with age?
LJ: The study is actually funded by two grants: One covers data collection in the schools. The other covers follow-up into adulthood. We now have people, at age 55, who we first surveyed as high school seniors. It’s a very rare dataset of people in the normal population passing through much of the lifespan. We’ve found active use of illicit drugs goes down very substantially as people age, and that is reassuring in some sense, but a surprisingly high number of today’s adults have had experience with illegal drug use.
What current trends do you see that may impact future surveys and areas of inquiry?
LJ: Today’s adolescents live quite different lives than the adolescents we studied in the ’70s, primarily because of the evolution of the cell phone and all the things you can do with it. Peer communication is very highly evolved and I suspect it has the potential to spread new habits, both constructive and not constructive. So we have been looking at that. We also are now dealing — in another study that parallels this one — with childhood obesity.
“Monitoring the Future” has been funded under a series of competing, investigator-initiated research grants from the National Institute on Drug Abuse, one of the National Institutes of Health. The lead investigators, in addition to Lloyd Johnston, are Patrick O’Malley, Jerald Bachman, John Schulenberg, and most recently Richard Miech — all research professors at the University of Michigan’s Institute for Social Research.