Table 1.
School, substance, mental, and health problems by SUD severity among youth aged 12–18 years in school.
| SUD severity-based on DSM-V | OR or Cohen’s d | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Self-reported problems | Total | None (0–1 Sx) | Mild (2–3 Sx) | Moderate (4–5 Sx) | Severe (6–11 Sx) | Stat. | None vs. total | Mild vs. total | Moderate vs. total | Severe vs. total |
| Estimated population (in 1000s) | 28,511 | 24,648 | 1314 | 1150 | 1399 | |||||
| Row % | 100% | 86.5% | 4.6% | 4.0% | 4.9% | |||||
| A. Any school problema | 62.9% | 60.2% | 79.8% | 78.8% | 85.9% | OR | 0.89 | 2.33 | 2.19 | 3.58 |
| Past month school absence | 40.0% | 37.9% | 51.8% | 50.6% | 59.0% | OR | 0.92 | 1.62 | 1.54 | 2.16 |
| Serious fight at school | 20.4% | 19.1% | 27.8% | 29.1% | 34.4% | OR | 0.92 | 1.50 | 1.60 | 2.04 |
| Teacher says seldom or never doing well | 19.1% | 16.7% | 31.5% | 35.8% | 42.1% | OR | 0.85 | 1.95 | 2.36 | 3.08 |
| Hated school | 17.8% | 15.8% | 28.9% | 29.0% | 39.4% | OR | 0.87 | 1.87 | 1.88 | 3.00 |
| Average grade of D or lower | 5.0% | 3.9% | 10.0% | 12.6% | 16.8% | OR | 0.77 | 2.09 | 2.72 | 3.82 |
| Mean number of 5 school problems | 0.96 | 0.88 | 1.34 | 1.45 | 1.66 | d | −0.08 | 0.40 | 0.50 | 0.72 |
| B. Any SUDb | 13.6% | 0.0% | 100.0% | 100.0% | 100.0% | – | – | – | – | – |
| Alcohol use disorder | 5.8% | 0.0% | 52.2% | 22.6% | 48.8% | OR | 0.00 | 17.84 | 4.77 | 15.56 |
| Marijuana use disorder | 5.4% | 0.0% | 36.0% | 25.0% | 55.6% | OR | 0.00 | 9.86 | 5.83 | 21.89 |
| Opiate use disorder | 1.1% | 0.0% | 4.5% | 2.7% | 16.8% | OR | 0.00 | 4.11 | 2.40 | 17.50 |
| Stimulants use disorder | 0.4% | 0.0% | 0.0% | 0.7% | 7.0% | OR | 0.00 | 0.00 | 2.01 | 20.33 |
| Cocaine use disorder | 0.2% | 0.0% | 0.5% | 0.4% | 3.2% | OR | 0.00 | 2.75 | 2.00 | 17.25 |
| Other drug use disorder | 0.8% | 0.0% | 0.2% | 5.2% | 12.0% | OR | 0.00 | 0.20 | 6.83 | 16.93 |
| Mean number of 6 substance problems | 0.14 | 0.0% | 0.93 | 0.56 | 1.42 | d | −0.29 | 1.68 | 0.90 | 2.73 |
| Any SUD treatment | 0.6% | 0.1% | 1.2% | 1.6% | 8.1% | OR | 0.20 | 1.91 | 2.63 | 14.28 |
| C. Any mental health problem | 10.9% | 9.1% | 17.4% | 20.7% | 27.2% | OR | 0.82 | 1.73 | 2.14 | 3.06 |
| Major depressive episodec | 8.3% | 6.9% | 14.7% | 17.0% | 20.5% | OR | 0.82 | 1.89 | 2.25 | 2.84 |
| ;Depression diagnosisd | 3.0% | 3.0% | 5.0% | 5.0% | 13.0% | OR | 1.00 | 1.70 | 1.70 | 4.83 |
| Anxiety diagnosisd | 3.0% | 2.0% | 2.0% | 5.0% | 11.0% | OR | 0.66 | 0.66 | 1.70 | 4.00 |
| Mean number of 3 mental health problems | 0.14 | 0.11 | 0.21 | 0.26 | 0.43 | d | −0.06 | 0.16 | 0.26 | 0.65 |
| Any mental health treatment | 4.7% | 3.7% | 8.8% | 8.9% | 14.8% | OR | 0.78 | 1.95 | 1.99 | 3.53 |
| D. Any physical health problemsd | 15.3% | 14.7% | 16.8% | 16.9% | 22.9% | OR | 0.96 | 1.12 | 1.13 | 1.64 |
| Asthma | 10.0% | 9.8% | 9.8% | 12.4% | 11.3% | OR | 0.98 | 0.98 | 1.27 | 1.14 |
| Bronchitis | 2.6% | 2.5% | 4.2% | 1.8% | 3.4% | OR | 0.96 | 1.61 | 0.67 | 1.32 |
| High blood pressure | 1.1% | 1.0% | 1.5% | 1.4% | 1.8% | OR | 0.94 | 1.35 | 1.26 | 1.60 |
| Pneumonia | 0.8% | 0.7% | 1.5% | 0.9% | 1.4% | OR | 0.90 | 1.88 | 1.18 | 1.77 |
| Pregnancy (females only) | 0.7% | 0.6% | 0.6% | 0.2% | 1.5% | OR | 0.86 | 0.86 | 0.28 | 2.16 |
| Sinusitis | 0.6% | 0.6% | 0.2% | 0.9% | 0.7% | OR | 1.02 | 0.30 | 1.57 | 1.13 |
| Sexually transmitted disease | 0.5% | 0.3% | 1.2% | 1.5% | 3.4% | OR | 0.50 | 2.46 | 2.93 | 7.05 |
| Diabetes | 0.5% | 0.4% | 0.5% | 0.7% | 1.5% | OR | 0.87 | 1.00 | 1.46 | 3.16 |
| HIV/AIDS | 0.01% | 0.00% | 0.00% | 0.00% | 0.1% | OR | 0.00 | 0.00 | 0.00 | 12.01 |
| Other health problemse | 1.1% | 1.0% | 1.3% | 1.5% | 3.0% | OR | 0.88 | 1.18 | 1.32 | 2.65 |
| Mean number of 10 physical health problems | 0.17 | 0.16 | 0.20 | 0.20 | 0.26 | d | −0.02 | 0.06 | 0.07 | 0.22 |
| Any physical health treatment | 31.5% | 30.0% | 38.6% | 42.0% | 42.7% | OR | 0.93 | 1.37 | 1.57 | 1.62 |
| Mean number of 24 problems across areas | 1.32 | 1.09 | 2.45 | 2.34 | 3.53 | d | −0.16 | 0.75 | 0.68 | 1.48 |
| E. Vocational/legal costs to societyf | ||||||||||
| Days of missed school costs | $196 | $172 | $298 | $315 | $426 | d | −0.06 | 0.24 | 0.28 | 0.55 |
| Days of missed work costs | $177 | $140 | $440 | $294 | $484 | d | −0.03 | 0.20 | 0.09 | 0.24 |
| Arrest costs | $103 | $47 | $315 | $370 | $711 | d | −0.09 | 0.33 | 0.41 | 0.94 |
| Total of 3 Vocational/legal costs | $474 | $358 | $1043 | $969 | $1580 | d | −0.07 | 0.36 | 0.31 | 0.70 |
| F. Health care utilization costse | ||||||||||
| SUD outpatient cost | $2 | $0 | $4 | $8 | $22 | d | −0.04 | 0.09 | 0.15 | 0.49 |
| SUD residential cost | $6 | $2 | $5 | $2 | $85 | d | −0.04 | 0.01 | −0.03 | 0.65 |
| Mental health outpatient cost | $6 | $4 | $10 | $12 | $26 | d | −0.03 | 0.17 | 0.09 | 0.24 |
| Mental health hospital cost | $5 | $3 | 5 | $0 | $33 | d | −0.01 | 0.00 | −0.04 | 0.23 |
| Physical health hospital cost | $401 | $325 | $496 | $801 | $1319 | d | −0.03 | 0.07 | 0.09 | 0.33 |
| Physical health emergency room cost | $4191 | $3968 | $5076 | $5783 | $5951 | d | −0.03 | 0.16 | 0.25 | 0.23 |
| Total of these 6 health care costs per person | $4445 | $4141 | $5504 | $6367 | $7229 | d | −0.04 | 0.19 | 0.27 | 0.31 |
| Total of 9 costs above per person | $4918 | $4498 | $6547 | $7338 | $8798 | d | −0.04 | 0.14 | 0.21 | 0.34 |
Source: Based on data from SAMHSA (2012).
Not asked of 18-year-olds.
Based on DSM-V (2013), 2 or more of 11 symptom-based criteria.
Based on symptom count.
Respondent reported being told of diagnosis in the past year by a doctor or other medical professional.
Other health problems including hepatitis, tuberculosis, cirrhosis of the liver, heart disease, lung cancer, pancreatitis, sleep apnea, stroke, tinnitus, and ulcers.
Monetary conversion factors for physical health, mental health, and substance abuse treatment services came from the AHRQ (2009), American Medical Association (2010), French et al. (2008), and McCollister et al. (2013), adjusted using the consumer price index to 2012 dollars for unit costs of $19.58 per day missed school; $116.63 per day missed work; $2237.92 per arrest (past year arrest limited to 3+); $33.18 per day in SUD outpatient; $124.14 per night in SUD residential; $81.44 per day in mental health outpatient; $479.44 per night in a mental health hospital; $2248.46 per night in a physical health hospital; and $6611.08 per visit to an emergency room.