Substance use in adolescence and emerging adulthood : trends, developments and transitions

Abstract

Substance use trajectories most often commence during the adolescent years (Sampson & Laub, 2016; White et al., 2005), may escalate in emerging adulthood (Andrews and Westling, 2016; Arnett, 2016) and most often are terminated on entry into adulthood (Prins, 2008). Some individuals move on to use drugs problematically. A wealth of evidence supports the significance of age in relation to risky behaviours, including substance use (Sampson & Laub, 2016). Extensive research indicates that substance use at a young age, particularly during early adolescence, has more serious consequences than it would otherwise have if substance use started later on in adulthood (Griffin et al., 2000). Understanding the prevalence of youth substance use is therefore an important consideration for policy and service development. Researching trends in adolescent substance use, sheds light on the effectiveness of prevention efforts and alerts prevention science to new emerging risk behaviours. The Save a Life Foundation in collaboration with the Faculty for Social Wellbeing therefore embarked on this research project documenting the state of play of knowledge into youth substance use in the Maltese context. This project brings together the vast array of statistical data available on the subject and compiles this into a meaningful review that is theoretically based and located within a sociological understanding of Maltese society in the early 21st century. This project was guided by the following objectives: • to compile into one comprehensive document the developing trends of youth substance use on the Maltese Islands in the last two decades; • to locate these within a theoretical understanding of youth and youth transitions on the Maltese Islands; • to explore the perspectives of experts in the youth and addiction sectors on substance use among youth in Malta; and • to make recommendations for research, policy and service development. Chapter 1 introduces the subject matter, presents a rationale for the study and identifies the research questions and methodological approach. The study uses a mixed methods approach drawing on both primary and secondary data. Chapter 2 presents a descriptive literature review on the topic of youth and youth substance use located within a theoretical understanding of youth and youth transitions on the Maltese Islands. With a focus on 13–30 year olds, as defined by the Maltese national youth policy, this chapter presents a brief history of the development of the understanding of adolescence. The sociohistorical transformations and the rapid changing times impact the experiences of adolescents, offering young people both new opportunities and risks (Beck, 1992). Arnett (2004) in fact, argued that the experiences of young people in technologically advanced societies changed dramatically and coined the term ‘emerging adulthood’ as a new universal life stage where young people are no longer adolescents but are not yet adults. The chapter provides a review of theories of adolescent development and concludes with Bronfenbrenner’s ecological theory (Bronfenbrenner & Morris, 1998) framing the transitions young people go through in their life course. The chapter proceeds towards a review of different aspects of development in adolescence and emerging adulthood and the situation of young people in late modernity and in the local context. The recent decades are marked by major changes which brought about progress and innovation, as well as changes for young people. The chapter concludes with a review of the risk and resiliency factors surrounding substance use in adolescence and summarises some of the main findings from international data since local studies on risk and resiliency factors for substance use among young people are limited. Drawing on the seminal work of Bronfenbrenner, (1977; 1979), for the purposes of this review, risk and resiliency factors are discussed in relation to five domains in the young person’s life: (i) individual, (ii) family, (iii) peer, (iv) school/employment and (v) the wider community, and the interrelations among these dimensions. Chapter 3 presents an analysis of the primary and secondary data collected. This chapter discusses trends in youth substance use and looks into specific categories of substances from alcohol, through tobacco, cannabis, the non-medical use of prescription drugs (NMUPD) and other drugs. We present findings related to the onset of use of these substances, their prevalence, availability, and factors surrounding young people’s use of these substances. Treatment data are also presented. Finally, the perspectives of 11 youth and addiction experts are analysed and discussed in view of the observations drawn from the secondary data. Chapter 4 presents the main findings and a number of recommendations for policy, further research and prevention as outlined below. The review of the literature and the findings from both the primary and secondary data collected for the purposes of this study lead to a number of conclusions: • While according to Maltese national youth policy young people are persons between the ages of 13 and 30, it is important to acknowledge the different developmental challenges and needs of adolescents and emerging adults (young people in their 20’s). • Young people’s experiences are best understood in an ecological model that considers the impact of a number of systems including the family, the peer group, the school/workplace and the wider community; the interaction between these systems; as well as the broader cultural and historical context the young person is situated in. • Maltese society has experienced a period of rapid social change that impacts considerably the life-world of young people in the 21st century. • Simple answers to the question “what causes drug abuse?” cannot easily be found. • A number of ‘risk’ and ‘protective’ factors are identified in the literature. These present themselves differentially across the development of the substance use trajectory and in relation to five domains in the young person’s life: individual; family; peer group; school/ employment; and, wider community. • Onset of substance use occurs during adolescence and peaks in early emerging adulthood.