Marijuana was the most widely used drug, with 13 percent of teens using it, followed by narcotic painkillers (7 percent).
"Analgesic opioids have replaced inhalants as the second most commonly used drug, and analgesic opioid use disorders comprise the second most prevalent illicit drug use disorder," Wu said.
In addition, almost one-fourth of adolescent alcohol or drug users met established criteria for an alcohol or drug use disorder, and users of marijuana, heroin, cocaine or sedatives showed an elevated rate of abuse or dependence on these drugs.
The highest rates of both alcohol and drug use were among Native Americans (20.5 percent), mixed race/ethnic teens (18.1 percent) and white teens (16.2 percent).
The highest rates of alcohol and drug addiction were among Native Americans (31.5 percent) mixed race/ethnic teens (25.2 percent), whites (22.9 percent) and Hispanics (21 percent).
Addiction expert Dr. J.C. Garbutt, a professor of psychiatry at the University of North Carolina at Chapel Hill, said that "these data support the growing concern over the misuse of prescription opioids, with opioids now representing the second most commonly used substance among adolescents after marijuana."
Opioids are of particular concern because they can be lethal, and many young people are unaware of the danger of opioids, he said, with opioid-related overdose deaths increasing rapidly in young people.
"The ethnic distribution points to the significant problem of substance use in Native Americans, and highlights the need to better address this issue in this population," Garbutt added.
"The diversity of substance use patterns across ethnic groups shows that cultural factors are important in promoting and protecting from using substances. Prevention and treatment programs that make use of culturally related
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