Adolescent CAM Survey Looks To Clarify Possible Herbal/Illicit Drug Use Link

An upcoming survey on adolescents' use of complementary and alternative medicine could help clarify previous research indicating teens who took herbal/ natural products were more likely to use illicit drugs.

The quantitative survey will aim to characterize adolescents' patterns of CAM use and the factors influencing their decisions. The project, to be administered by researchers at the University of Rochester within the year, will complement a series of qualitative interviews and focus groups conducted roughly seven months ago.

The two-tiered study will seek to: "determine the prevalence of [CAM] use among adolescents; describe the range of therapies adolescents use, and where they are procured; describe [factors] associated with communications between adolescents and their providers about [CAM]; and describe adolescents' exposure to information about CAM from sources such as parents, providers, and the media, and how this impacts CAM use," the grant application states.

Sponsored by the National Institutes of Health's National Center for Complementary & Alternative Medicine, the study is being overseen by University of Rochester's Jonathan Klein, MD.

The survey portion of the research initially was designed to look at 1,200 adolescents in Monroe County, N.Y., but has since been expanded to encompass a larger, nationally representative sample.

Among the factors that prompted the researchers to broaden the survey's scope were recent findings associating adolescent use of herbal and/or natural products with cigarette, alcohol and illicit drug use.

Susan Yussman, MD, University of Rochester, et al. found that of the 2,000 randomly selected Monroe County adolescents surveyed, the 28.6% who reported use of herbal/natural supplements at some point in their lives were 3.5 times more likely to have reported alcohol consumption and 2.2 times more likely to have smoked cigarettes.

Yussman presented the data at the Society for Adolescent Medicine's annual meeting in Boston March 6-10.

The survey also found students who reported herbal/ natural product use were 14.5 times more likely to report use of anabolic steroids and 8.8 times more likely to report heroin use, while use of methamphetamines was 6.8 times higher, cocaine use was six times greater and marijuana use was 2.2 times higher.

The frequency of herbal product use differed measurably among various ethnic groups as well. Hispanic teens were most likely to use supplements (33%), with Caucasians ranking a close second (30.9%) and Asians, Native Americans and Pacific Islanders, collectively ranking third (28.8%). The rate of herbal use among African-Americans was the lowest, at 12.1%.

Other findings showed ninth graders were less likely to take supplements than 12th graders, with 24.4% and nearly 30% of the two age groups reporting CAM use, respectively.

Yussman emphasized no conclusions can be drawn from the figures, noting the statistics were obtained by adding a single question to the Monroe County, New York Youth Risk Behavior Survey.

The question, which asked adolescents if they had used "herbal or other natural products to feel better, or perform better in sports or school," was general and limited, Yussman noted.

She pointed out the data do not reveal whether students who reported illicit drug use are continuing to take them, or what types of herbal/natural products they use.

The upcoming survey will attempt to fill in the gaps left open from the prior effort. The researchers noted their findings likely will show a disparity in drug use levels based on the type of supplement taken.

For example, they speculated that adolescents using ginkgo biloba and echinacea would have lower illicit drug use rates than those using DHEA.

However, in the absence of such data, Yussman et al. conclude that "herbal product use is common, and is strongly associated with illicit drug use among high school students. Health care providers should inquire about adolescents' herbal product use, and disclosure should prompt an in-depth substance abuse history."