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Monitoring the Future (MTF) is designed to give such attention to substance use among the nation's youth and adults. It is an investigator-initiated study that originated with, and is conducted by, a team of research professors at the University of Michigan's Institute for Social Research. Since its onset in 1975, MTF has been funded continuously by the National Institute on Drug Abuse--one of the National Institutes of Health--under a series of peer reviewed, competitive research grants. The 2022 survey, reported here, is the 48th consecutive national survey of 12th grade students and the 32nd national survey of 8th and 10th grade students (who were added to the study in 1991). MTF contains ongoing national surveys of both adolescents and adults in the United States. It provides the nation with a vital window into the important but often hidden problem behaviors of use of illegal drugs, alcohol, tobacco, and psychotherapeutic drugs (used without a doctor's orders). For more than four decades, MTF has helped provide a clearer view of the changing topography of these problems among adolescents and adults, a better understanding of the dynamics of factors that drive some of these problems, and a better understanding of some of their consequences. It has also given policymakers, government agencies, and nongovernmental organizations (NGOs) in the field some practical approaches for intervening. Two of the major topics included in the present monograph are: (1) the prevalence and frequency of use of a great many substances, both licit and illicit, among U.S. secondary school students in 8th, 10th, and 12th grades; and (2) historical trends in use by students in those grades. Distinctions are made among important demographic subgroups in these populations based on gender, college plans, region of the country, population density, parent education, and race/ethnicity. MTF has demonstrated that key attitudes and beliefs about drug use are important determinants of usage trends, in particular the amount of risk to the user perceived to be associated with the various drugs and disapproval of using them; thus, those measures also are tracked over time, as are students' perceptions of certain relevant aspects of the social environment--in particular, perceived availability of each drug, peer norms about their use, use by friends, and exposure to use by others of the various drugs. Data on grade of first use, noncontinuation of use, trends in use in lower grades (based on retrospective reports), and intensity of use are also reported here. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2021. Volume I, Secondary School Students," see ED619855.]

Monitoring the Future (MTF) is an ongoing research program conducted at the University of Michigan's Institute for Social Research under a series of investigator-initiated, competing research grants from the National Institute on Drug Abuse beginning in 1975. The integrated MTF study includes annual surveys of nationally representative samples of 8th, 10th, and 12th grade students, as well as a subset of 12th grade students followed into adulthood from each graduating class. Repeating these annual cross-sectional surveys over time provides data to examine behavior change across history in consistent age segments of the adult population, as well as among key subgroups. The panel study now has over 110,000 individuals, with approximately 28,500 surveyed each year including young adults ages 19 to 30 and midlife adults ages 35 to 60. These data, gathered on national samples over such a large portion of the lifespan, are extremely rare and can provide needed insight into the epidemiology, etiology, and life course history of substance use and relevant behaviors, attitudes, and other factors. The current report is the latest in a series of publications dating back to 1986 and updated annually since then, all available at monitoringthefuture.org. [For the previous report, "Monitoring the Future Panel Study Annual Report: National Data on Substance Use among Adults Ages 19 to 60, 1976-2021," see ED623992.]

Despite the elevation of the opioid crisis in the U.S. to the level of a nationwide public health emergency in 2017, the number of opioid-involved overdose deaths has continued to rise. The impact of the opioid epidemic extends well beyond the tragedy of fatal overdose. Nonfatal overdose can result in brain injury and permanent disability, and research suggests that between 20 and 30 nonfatal overdoses occur for every overdose death. K-12 students affected by opioid abuse in the home face a number of challenges that can interfere with their educational engagement and success. Evidence indicates that children whose parents abuse opioids are at risk of experiencing trauma, school absences, behavioral issues, and even displacement from the home--all factors that can negatively affect educational and socioemotional outcomes. Similarly, research shows that college students who engage in drug use are more likely to experience gaps in enrollment, prolonged time to graduation, failure to graduate, and even lifelong struggles with addiction. Planning teams at K-12 schools and institutions of higher education (IHEs) can specifically address the risk of opioid-related emergencies, including overdose, in their emergency operations plans (EOPs) by including a Threat- and Hazard-Specific Annex for drug overdose. This fact sheet provides information and strategies for addressing opioid overdoses at K-12 schools and IHEs through EOPs and other preparedness activities.

Monitoring the Future (MTF) has become one of the nation's most relied upon scientific sources of valid information on trends in use of licit and illicit psychoactive drugs by U.S. adolescents, college students, young adults, and adults up to age 60. During the last four decades, the study has tracked and reported on the use of an ever-growing array of such substances in these populations of adolescents and adults. The annual MTF series of monographs is one of the primary mechanisms through which the new epidemiological findings are reported. Findings from the inception of the study in 1975 through 2022 are included--the results of 48 national in-school surveys and 46 national follow up surveys. MTF has conducted in-school surveys of nationally representative samples of: (1) 12th grade students each year since 1975; and (2) 8th and 10th grade students each year since 1991. In addition, beginning with the class of 1976, the study has conducted follow up surveys of representative subsamples of the respondents from each previously participating 12th grade class. These follow up surveys now continue well into adulthood, currently up to age 60. MTF is designed to detect age, period, and cohort effects in substance use and related attitudes. Age effects are similar changes at similar ages seen across multiple class cohorts; they are common during adolescence. Period effects are changes that are parallel over a number of years across multiple age groups (in this case, all three grades under study--8, 10, and 12). Cohort effects are substance use behaviors or attitudes that distinguish a class cohort from others that came before or after them and are maintained as the cohort ages. The survey results divide cleanly into the time periods before and after the onset of the COVID-19 pandemic. All surveys in 2020 were completed before March 15, when data collection was halted due to pandemic concerns. Consequently, results from 2020 and previous years are pre-pandemic, while results from 2021 and 2022 took place after the onset of the pandemic and the associated national response. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2021: Overview, Key Findings on Adolescent Drug Use," see ED618240.]

Monitoring the Future (MTF) is designed to give attention to substance use among the nation's youth and adults. It is an investigator-initiated study that originated with, and is conducted by, a team of research professors at the University of Michigan's Institute for Social Research. Since its onset in 1975, MTF has been funded continuously by the National Institute on Drug Abuse--one of the National Institutes of Health--under a series of peer reviewed, competitive research grants. The 2021 survey, reported here, is the 47th consecutive survey of 12th grade students and the 31st such survey of 8th and 10th graders (who were added to the study in 1991). MTF contains ongoing national surveys of both adolescents and adults in the United States. It provides the nation with a vital window into the important but often hidden problem behaviors of use of illegal drugs, alcohol, tobacco, and psychotherapeutic drugs (used without a doctor's orders). For more than four decades, MTF has helped provide a clearer view of the changing topography of these problems among adolescents and adults, a better understanding of the dynamics of factors that drive some of these problems, and a better understanding of some of their consequences. It has also given policymakers, government agencies, and nongovernmental organizations (NGOs) in the field some practical approaches for intervening. Two of the major topics included in the present volume are: (1) the "prevalence and frequency" of use of a great many substances, both licit and illicit, among U.S. secondary school students in 8th, 10th, and 12th grades; and (2) "historical trends" in use by students in those grades. Distinctions are made among important demographic subgroups in these populations based on gender, college plans, region of the country, population density, parent education, and race/ethnicity. MTF has demonstrated that key attitudes and beliefs about drug use are important determinants of usage trends, in particular the amount of risk to the user perceived to be associated with the various drugs and disapproval of using them; thus, those measures also are tracked over time, as are students' perceptions of certain relevant aspects of the social environment--in particular, perceived availability, peer norms, use by friends, and exposure to use by others of the various drugs. Data on grade of first use, discontinuation of use, trends in use in lower grades, and intensity of use are also reported here. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2020. Volume I, Secondary School Students," see ED615087.]

This volume presents new 2021 findings from the U.S. national Monitoring the Future follow-up (panel) study concerning substance use among the nation's college students and adults from ages 19 through 60. We report 2021 prevalence estimates on numerous illicit and licit substances, examine how substance use differs across this age span, and show how substance use and related behaviors and attitudes have changed over the past four decades. The panel study now has over 108,000 individuals, with approximately 28,500 surveyed each year including young adults ages 19 to 30 and adults ages 35 to 60. These data, gathered on national samples over such a large portion the lifespan, are extremely rare and can provide needed insight into the epidemiology, etiology, and life course history of substance use and relevant behaviors, attitudes, and other factors. The current report is the latest in a series of publications dating back to 1986. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2021: Volume 1, Secondary School Students," see ED619855. For "Monitoring the Future National Survey Results on Drug Use, 1975-2020. Volume II, College Students & Adults Ages 19-60," see ED615085.]

This occasional paper presents national demographic subgroup data for the 1975-2021 Monitoring the Future (MTF) national survey results on 8th, 10th, and 12th graders' use of drugs, alcohol, and tobacco. The study covers all major classes of illicit and licit psychoactive drugs for an array of population subgroups. The 2020 subgroup data presented here accompany the "Monitoring the Future National Survey Results on Drug Use: 1975-2021: Overview, Key Findings on Adolescent Drug Use" (see ED618240) and the "Monitoring the Future National Survey Results on Drug Use, 1975-2021, forthcoming: Volume I, Secondary School Students." The trends offered here in tabular and graphic forms cover demographic subgroups based on: (1) Gender; (2) College plans; (3) Region of the country; (4) Population density; (5) Education level of the parents (a proxy for socioeconomic level); and (6) Racial/ethnic identification. Detailed descriptions of the demographic categories are provided in the section starting on page 469 of this paper. The graphs and tables in this occasional paper present trend data for 8th-, 10th-, and 12th-grade respondents separately. Data for 12th grade begins with 1975, the first year in which a nationally representative sample of high school seniors was surveyed. Data for 8th and 10th grades begin with 1991, when the study's nationally representative annual surveys were expanded to include surveys of those lower grade levels.

Monitoring the Future (MTF) is a long term study of substance use and related factors among U.S. adolescents, college students, and adult high school graduates through age 60. It is conducted annually and supported by the National Institute on Drug Abuse. MTF findings identify emerging substance use problems, track substance use trends, are published with many scientific results, and help to inform policy and intervention strategies. The key findings regarding use of various substances by 8th, 10th, and 12th graders surveyed across the U.S. in 2021 are summarized below. But first a few words about the context. The preceding year, 2020, was an unusual year for the study in that data collection was halted earlier than usual, in March of that year, due to the emerging COVID-19 epidemic and the University of Michigan halting in-person research. This resulted in smaller samples being obtained that year, but based on careful analyses we believe that the smaller samples reflect drug use for all students that year with reasonable accuracy. The previous year, 2019, was unusual in a different way--it was the year that the study was transitioning from using paper and pencil questionnaires in schools to having students use electronic tablets. A random half of all respondents in 2019 used the older mode of administration, while the other half used tablets. How the authors e dealt with these two disruptions to the ongoing series is described in the section on Study Design and Methods. It should be noted that the 2020 data collection occurred early in 2020, covering the early months of the epidemic, but it did not cover most of the period of the epidemic that year, nor of its effects. However, the 2021 data collection occurred more than a year into the COVID epidemic and brought quite dramatic changes in adolescent drug use in the United States. A synopsis of the design and methods used in the study follows the introductory section. A separate section is then provided for each individual drug class, including figures that show trends in the overall proportions of students at each grade level (1) using the drug; (2) seeing a "great risk" associated with its use (perceived risk); (3) disapproving of its use (disapproval); and (4) saying that it would be "fairly easy" or "very easy" to get if they wanted to (perceived availability). For 12th graders, annual data are available since 1975--and for 8th and 10th graders since 1991, the first year they were included in the study. The tables at the end of this report provide the statistics underlying the figures; in addition, they present trend data on lifetime, annual, 30 day, and (for selected drugs) daily prevalence. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2020: Overview, Key Findings on Adolescent Drug Use," see ED611736.]

In Pennsylvania, subgrantee Philadelphia Works, Inc. partnered with JEVS Human Services to implement the National Health Emergency (NHE) demonstration grant. JEVS Human Services offers both employment and training services and behavioral health treatment and recovery services. By developing partnerships with behavioral health providers, the workforce system can reduce barriers to accessing employment and training services for people in recovery by providing these services on-site at locations where potential participants already gather and are comfortable. This strategy spotlight highlights an innovative effort, funded through an NHE Dislocated Worker Demonstration Grant to Address the Opioid Crisis to the state of Pennsylvania, to provide employment services in opioid treatment clinics. It is part of a study funded by the U.S. Department of Labor's Chief Evaluation Office, and conducted in collaboration with the Office of Policy Development and Research within the Employment and Training Administration (ETA). The study explores the implementation of the NHE Dislocated Worker Demonstration Grants to Address the Opioid crisis, which six states received in 2018. These grants, funded by ETA's Office of Workforce Investment (OWI), encouraged states to test innovative approaches to address the economic and workforce-related impacts of the opioid epidemic. [This is the first report in a four-part series.]

The present volume presents new 2020 findings from the U.S. national Monitoring the Future (MTF) follow-up study concerning substance use among the nation's college students and adults from ages 19 through 60. This volume reports 2020 prevalence estimates on numerous illicit and licit substances, examines how substance use differs across this age span, and shows how substance use and related behaviors and attitudes have changed over the past four decades. The 2020 panel data collections occurred during the start of the COVID-19 pandemic (from March 2020 through November 2020), and this volume constitutes one of the first considerations of possible pandemic effects on prevalence and trends of substance use among the MTF young and middle-aged adults. This volume reports the results of the repeated cross-sectional surveys of all high school graduating classes since 1976 as they are followed into their adult years. Segments of the general adult population represented in these follow-up surveys include: (1) U.S. college students; (2) same-aged youth who also are graduates from high school but not attending college full time, sometimes in the past called the "forgotten half,"; (3) all young adult high school graduates of modal ages 19 to 30, called the "young adult" sample; and (4) high school graduates at the specific later modal ages of 35, 40, 45, 50, 55, and 60. This volume emphasizes historical and developmental changes in substance use and related attitudes and beliefs occurring at these age strata. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2020. Volume I, Secondary School Students," see ED615087. For the report from the previous year, see ED608266.]

Monitoring the Future (MTF) is designed to give attention to substance use among the nation's youth and adults. Since its onset in 1975, MTF has been funded continuously by the National Institute on Drug Abuse -- one of the National Institutes of Health -- under a series of peer-reviewed, competitive research grants. The 2020 survey, reported here, is the 46th consecutive survey of 12th grade students and the 30th such survey of 8th and 10th graders. MTF contains ongoing national surveys of both adolescents and adults in the United States. It provides the nation with a vital window into the important but often hidden problem behaviors of use of illegal drugs, alcohol, tobacco, and psychotherapeutic drugs (not under a doctor's orders). For more than four decades, MTF has helped provide a clearer view of the changing topography of these problems among adolescents and adults, a better understanding of the dynamics of factors that drive some of these problems, and a better understanding of some of their consequences. It has also given policymakers, government agencies, and nongovernmental organizations (NGOs) in the field some practical approaches for intervening. Two of the major topics included in the present volume are: (1) the "prevalence and frequency" of use of a great many substances, both licit and illicit, among U.S. secondary school students in 8th, 10th, and 12th grades; and (2) "historical trends" in use by students in those grades. Distinctions are made among important demographic subgroups in these populations based on gender, college plans, region of the country, population density, parent education, and race/ethnicity. MTF has demonstrated that key attitudes and beliefs about drug use are important determinants of usage trends, in particular the amount of risk to the user perceived to be associated with the various drugs and disapproval of using them; thus, those measures also are tracked over time, as are students' perceptions of certain relevant aspects of the social environment -- in particular, perceived availability, peer norms, use by friends, and exposure to use by others of the various drugs. Data on grade of first use, discontinuation of use, trends in use in lower grades, and intensity of use are also reported here. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2020. Volume II, College Students & Adults Ages 19-60," see ED615085. For the report from the previous year, see ED608265.]

This occasional paper presents subgroup findings from the Monitoring the Future (MTF) study on levels of, and trends in, the use of a number of substances for nationally representative samples of high school graduates ages 19-30, "Monitoring the Future National Survey Results on Drug Use, 1975-2018. Volume II, College Students & Adults Ages 19-60" (see ED599071). The data have been gathered in a series of follow-up surveys of representative subsamples of high school seniors who were first surveyed in 12th grade as part of the MTF study. Data were first available for the 19-22 age group in 1980 and for the older age groups in subsequent years as the early cohorts progressed in age, as the tables and figures in this occasional paper indicate. The subgroup trends shown in the current occasional paper complement the last section of Chapter 5 (Trends in Drug Use in Early and Middle Adulthood) of that monograph by presenting the trend data for young adult subgroups in both graphic and tabular form. The results are described and discussed in Chapter 5, but the extensive set of tables and figures is provided here for the reader who wishes to view the figures and the underlying numerical values in tabular form. Three demographic dimensions are differentiated: gender, region of the country, and population density. Gender includes trends for males and females; region describes trends for each of the four major regions defined by the U.S. Census; and population density differentiates trends for five levels of community size. The Table of Contents and List of Figures in this occasional paper contain links to the content and figures. Following each figure is a table giving the numerical values associated with each trend line in that figure. [For the 1988-2019 Monitoring the Future Occasional Paper, see ED608244.]

The Pennsylvania Department of Labor and Industry (L&I) partnered with the Pennsylvania State College of Medicine (Penn State) to create a Project Extension for Community Healthcare Outcomes (ECHO) series for employers. The ECHO model, which originated in the medical field, provides virtual clinics led by expert specialist teams to discuss real-world health cases with community medical providers in underserved areas and work together to develop solutions. Employers seeking to have recovery-friendly workplaces might have questions about how to better support their employees who are recovering from a substance-use disorder. Small- and medium-sized employers, in particular, might not have sufficient capacity or expertise in human resources to address potential issues that can arise. This strategy spotlight highlights an innovative effort, funded through a National Health Emergency (NHE) Dislocated Worker Demonstration Grant to Address the Opioid Crisis, to provide Pennsylvania employers with free expert advice on how to address potential issues and support their employees in recovery. [This is the fourth report of a four-part series. For the third report, "Registered Apprenticeships for Community Health Workers and Dually Certified Peer Recovery Specialist-Community Health Workers," see ED617974.]

Community health workers (CHWs) and peer recovery specialists (PRSs) can play an important role in meeting the health care needs of people with opioid use disorder. Registered apprenticeship programs, an "earn while you learn" approach, can help build a certified workforce of CHWs and PRSs by providing classroom and on-the-job training. Apprenticeship RI, an initiative of Building Futures, develops registered apprenticeships in partnership with the Rhode Island Department of Labor. With funds from the National Health Emergency (NHE) demonstration grant, Building Futures, the subgrantee, worked with two partners to develop registered apprenticeship programs for two occupations that could help address the opioid crisis: CHWs and dually certified PRS-CHWs. This strategy spotlight highlights an innovative effort, funded through an NHE Dislocated Worker Demonstration Grant to Address the Opioid Crisis to the state of Rhode Island, to develop registered apprenticeships for CHWs and dually certified PRS-CHWs. [This is the third report of a four-part series. For the second report, "Adapting Work Readiness Training for People in Recovery," see ED617846.]

The present volume presents new 2019 findings from the U.S. national Monitoring the Future (MTF) follow-up study concerning substance use among the nation's college students and adults from ages 19 through 60. This report includes 2019 prevalence estimates on numerous illicit and licit substances, examines how substance use differs across this age span, and shows how substance use and related behaviors and attitudes have changed over the past four decades. MTF, now in its 46th year, is a research program conducted at the University of Michigan's Institute for Social Research under a series of investigator-initiated, competing research grants from the National Institute on Drug Abuse -- one of the National Institutes of Health. The integrated MTF study comprises several ongoing series of annual surveys of nationally representative samples of 8th and 10th grade students (begun in 1991), 12th grade students (begun in 1975), and high school graduates followed into adulthood (begun in 1976). Note that the data reported in this volume were collected before the COVID-19 pandemic. The authors report the results of the repeated cross-sectional surveys of all high school graduating classes since 1976 and follow them into their adult years. Segments of the general adult population represented in these follow-up surveys include: (1) U.S. college students; (2) same-aged youth who also are graduates from high school but not attending college full time, sometimes in the past called the "forgotten half"; (3) all young adult high school graduates of modal ages 19 to 30 (or 19-28 for trend estimates), to whom we refer as the "young adult" sample; and (4) high school graduates at the specific later modal ages of 35, 40, 45, 50, 55, and 60. This volume emphasizes historical and developmental changes in substance use and related attitudes and beliefs occurring at these age strata. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2019. Volume I, Secondary School Students," see ED608265. For the report from the previous year, see ED599071.]

Substance use is a leading cause of preventable morbidity and mortality; it is in large part why, among 17 high-income nations, people in the U.S. have the highest probability of dying by age 50. Substance use is also an important contributor to many social ills including child and spousal abuse, violence more generally, theft, suicide, and more; and it typically is initiated during adolescence. It warrants our sustained attention. Monitoring the Future (MTF) is designed to give such attention to substance use among the nation's youth and adults. It is an investigator-initiated study that originated with, and is conducted by, a team of research professors at the University of Michigan's Institute for Social Research. Since its onset in 1975, MTF has been funded continuously by the National Institute on Drug Abuse -- one of the National Institutes of Health -- under a series of peer-reviewed, competitive research grants. The 2019 survey, reported here, is the 45th consecutive survey of 12th grade students and the 29th such survey of 8th and 10th graders. Two of the major topics included in the present volume are: (1) the prevalence and frequency of use of a great many substances, both licit and illicit, among U.S. secondary school students in 8th , 10th, and 12th grades; and (2) historical trends in use by students in those grades. Distinctions are made among important demographic subgroups in these populations based on gender, college plans, region of the country, population density, parent education, and race/ethnicity. MTF has demonstrated that key attitudes and beliefs about drug use are important determinants of usage trends, in particular the amount of risk to the user perceived to be associated with the various drugs and disapproval of using them; thus, those measures also are tracked over time, as are students' perceptions of certain relevant aspects of the social environment--in particular, perceived availability, peer norms, use by friends, and exposure to use by others of the various drugs. Data on grade of first use, discontinuation of use, trends in use in lower grades, and intensity of use are also reported here. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2019. Volume II, College Students & Adults Ages 19-60," see ED608266. For the report from the previous year, see ED599067.]

Substance use is a frequently cited health risk behavior in the youth gang literature, yet little is known about how substance use patterns vary among gang-involved youth or the social ecological factors that contribute to potential variation. Developing relevant and effective service approaches will require an understanding of this variation and the malleable factors that are likely to promote or inhibit particular patterns of use. Using latent class analysis, we identified four substance use classes within a school-based sample of gang-involved youth (n = 2,770): Non-Users (38%), Past Users (15%), Casual Users (27%), and Frequent Multi-Users (21%). These classes were distinguished by substance type, frequency of use, and source of access. Demographic and substance use-specific ecological factors across the family, peer, school, and neighborhood contexts were found to significantly differentiate these classes. Specifically, acceptance of use by parents, friends, and neighbors, along with a lack of family rules and high accessibility in the neighborhood, significantly differentiated use patterns. Findings highlight the need for service approaches that are responsive to the unique needs of individuals and their environments. Implications for practice are discussed, including the potential utility of applying a harm reduction service framework to address youth gang substance use. [This paper was published in "Children and Youth Services Review" v119 2020.]

This occasional paper presents subgroup findings from the Monitoring the Future (MTF) study on levels of, and trends in, the use of a number of substances for nationally representative samples of high school graduates ages 19-30, "Monitoring the Future National Survey Results on Drug Use, 1975-2018. Volume II, College Students & Adults Ages 19-60" (see ED599071). The data have been gathered in a series of follow-up surveys of representative subsamples of high school seniors who were first surveyed in 12th grade as part of the MTF study. The subgroup trends shown in this occasional paper complement the last section of Chapter 5 (Trends in Drug Use in Early and Middle Adulthood) of that monograph by presenting the trend data for young adult subgroups in both graphic and tabular form. The results are described and discussed in Chapter 5, but the extensive set of tables and figures is provided in this occasional paper for the reader who wishes to view the figures and the underlying numerical values. Three demographic dimensions are differentiated: gender, region of the country, and population density. Gender includes trends for males and females; region describes trends for each of the four major regions defined by the U.S. Census; and population density differentiates trends for five levels of community size. The Table of Contents and List of Figures in this occasional paper contain links to the content and figures. Following each figure is a table giving the numerical values associated with each trend line in that figure.

Monitoring the Future (MTF) is a long-term study of substance use and related factors among U.S. adolescents, college students, and adult high school graduates through age 60. It is conducted annually and supported by the National Institute on Drug Abuse. MTF findings identify emerging substance use problems, track substance use trends, and inform national policy and intervention strategies. The key findings regarding use of various substances by 8th, 10th, and 12th graders surveyed across the coterminous U.S. in 2019 are summarized. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2018: Overview, Key Findings on Adolescent Drug Use," see ED594190.]

This volume presents new 2018 findings from the U.S. national Monitoring the Future (MTF) follow-up study concerning substance use among the nation's college students and adults from ages 19 through 60. The authors report 2018 prevalence estimates on numerous illicit and licit substances, examine how substance use differs across this age span, and show how substance use and related behaviors and attitudes have changed over the past four decades. MTF, now in its 45th year, is a research program conducted at the University of Michigan's Institute for Social Research under a series of investigator-initiated, competing research grants from the National Institute on Drug Abuse--one of the National Institutes of Health. The integrated MTF study comprises several ongoing series of annual surveys of nationally representative samples of 8th and 10th grade students (begun in 1991), 12th grade students (begun in 1975), and high school graduates followed into adulthood (begun in 1976). The authors report the results of the repeated cross-sectional surveys of all high school graduating classes since 1976 as they follow them into their adult years. Segments of the general adult population represented in these follow-up surveys include: (1) U.S. college students; (2) their age-peers who are not attending college, sometimes called the "forgotten half"; (3) all young adult high school graduates of modal ages 19 to 30 (or 19-28 for trend estimates), to whom the authors refer to as the "young adult" sample; and (4) high school graduates at the specific later modal ages of 35, 40, 45, 50, and 55. This volume emphasizes historical and developmental changes in substance use and related attitudes and beliefs occurring at these age strata.

Substance use is a leading cause of preventable morbidity and mortality; it is in large part why, among 17 high-income nations, people in the U.S. have the highest probability of dying by age 50. Substance use is also an important contributor to many social ills including child and spousal abuse, violence more generally, theft, suicide, and more; and it typically is initiated during adolescence. It warrants our sustained attention. Monitoring the Future (MTF) is designed to give such attention to substance use among the nation's youth and adults. It is an investigator-initiated study that originated with, and is conducted by, a team of research professors at the University of Michigan's Institute for Social Research. Since its onset in 1975, MTF has been funded continuously by the National Institute on Drug Abuse--one of the National Institutes of Health--under a series of peer-reviewed, competitive research grants. The MTF annual monograph series has been a primary vehicle for disseminating MTF's epidemiological findings. The current monograph presents the results of the 44th survey of drug use and related attitudes and beliefs among U.S. high school seniors and 28th such survey of 8th and 10th grade students.

A joint effort by the National Center for Education Statistics and the Bureau of Justice Statistics, this annual report examines crime occurring in schools and colleges. This report presents data on crime at school from the perspectives of students, teachers, principals, and the general population from an array of sources--the National Crime Victimization Survey, the School Crime Supplement to the National Crime Victimization Survey, the Youth Risk Behavior Survey, the School Survey on Crime and Safety, the Schools and Staffing Survey, EDFacts, and the Campus Safety and Security Survey. The report covers topics such as victimization, bullying, school conditions, fights, weapons, the presence of security staff at school, availability and student use of drugs and alcohol, student perceptions of personal safety at school, and criminal incidents at postsecondary institutions. [For the 2017 report, see ED581798.]

This occasional paper presents subgroup findings from the Monitoring the Future (MTF) study on levels of, and trends in, the use of a number of substances for nationally representative samples of high school graduates ages 19-30, "Monitoring the Future National Survey Results on Drug Use, 1975-2018. Volume II, College Students & Adults Ages 19-60" (see ED599071). The data have been gathered in a series of follow-up surveys of representative subsamples of high school seniors who were first surveyed in 12th grade as part of the MTF study. Therefore, the universe being described omits people who did not complete high school--between 8 and 15% of each age group, with the most recent class cohorts closer to the bottom of that range. Surveys of the graduating cohorts of high school seniors started in 1976 and have continued with each graduating class since. Data were first available for the 19-22 age group in 1980 and for the older age groups in subsequent years, as the tables and figures in this occasional paper indicate. The general epidemiological findings from these samples are discussed in "Volume II" of the annual monograph series. The subgroup trends shown in this occasional paper complement the last section of Chapter 5 (Trends in Drug Use in Early and Middle Adulthood) of that monograph by presenting the trend data for young adult subgroups in both graphic and tabular form. The results are described and discussed in Chapter 5, but the extensive set of tables and figures is provided in this paper for the reader who wishes to view the figures and the underlying numerical values. Three demographic dimensions are differentiated: gender, region of the country, and population density. Gender includes trends for males and females; region describes trends for each of the four major regions defined by the U.S. Census; and population density differentiates trends for five levels of community size. The Table of Contents and List of Figures in this occasional paper contain links to the content and figures. Following each figure is a table giving the numerical values associated with each trend line in that figure.

Monitoring the Future (MTF) is a long-term study of substance use and related factors among U.S. adolescents, college students, and adult high school graduates through age 60. It is conducted annually and supported by the National Institute on Drug Abuse. MTF findings identify emerging substance use problems, track substance use trends, and inform national policy and intervention strategies. MTF is designed to detect age, period, and cohort effects in substance use and related attitudes. Age effects are similar changes with age seen across multiple class cohorts; they are common during adolescence. Period effects are changes that are parallel over a number of years across multiple age groups (in this case, all three grades under study--8, 10, and 12). Cohort effects are consistent differences among birth cohorts (or in this case, class cohorts) that are then maintained as the cohorts age. The key findings regarding use of various substances by 8th, 10th, and 12th graders surveyed across the coterminous U.S. in 2018 are presented in this report. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2017: Overview, Key Findings on Adolescent Drug Use," see ED589762.]

Nearly all states and the District of Columbia have policies requiring schools to address prevention of alcohol or drug use and abuse in high school health education curricula, according to National Association of State Boards of Education's (NASBE's) State Health Policy Database. But with the added concerns about the pandemic's impact on youth mental and physical health, some states have reexamined their approaches to substance abuse education and prevention. In particular, they have sought to address opioid, tobacco, and e-cigarette use among youth. This policy update examines what individual states are doing.

It is the position of the National Association of School Nurses (NASN) that the safe and effective management of opioid-related overdoses in schools must be incorporated into the school emergency preparedness and response plans. The registered professional school nurse provides leadership in all phases of emergency preparedness and response. When emergencies happen, including drug-related emergencies, proper management of these incidents at school is vital to positive outcomes. The school nurse is essential to the school team responsible for developing and implementing emergency response procedures. School nurses in this role should facilitate access to naloxone for quick response in the management of opioid-related overdoses in the school setting. Through community outreach with prescription opioid abuse, misuse and overdose awareness programs, school nurses can provide valuable education and be a useful resource for K-12 students and their families. Furthermore, school nurses can assist families in recognizing the signs and symptoms of substance abuse, support and guide them in locating resources for care, counseling, and even refer students for appropriate treatment of opioid use disorder (OUD). [This position statement was initially adopted in June 2015. It was revised in June 2020.]

This occasional paper presents subgroup findings from the Monitoring the Future (MTF) study on levels of, and trends in, the use of a number of substances for nationally representative samples of high school graduates ages 19-30. The data have been gathered in a series of follow-up surveys of representative subsamples of high school seniors who were first surveyed in 12th grade as part of the MTF study. Therefore, the universe being described omits people who did not complete high school--between 8 and 15% of each age group, with the most recent class cohorts closer to the bottom of that range. Surveys of the graduating cohorts of high school seniors started in 1976 and have continued with each graduating class since. Data were first available for the 19-22 age group in 1980 and for the older age groups in subsequent years, as the tables and figures in this occasional paper indicate. Three demographic dimensions are differentiated: gender, region of the country, and population density. Gender includes trends for males and females; region describes trends for each of the four major regions defined by the U.S. Census; and population density differentiates trends for five levels of community size.

Monitoring the Future (MTF), now in its 42nd year, is a research program conducted at the University of Michigan's Institute for Social Research under a series of investigator-initiated, competing research grants from the National Institute on Drug Abuse--one of the National Institutes of Health. The study comprises several ongoing series of annual surveys of nationally representative samples of 8th- and 10th-grade students (begun in 1991), 12th-grade students (begun in 1975), and high school graduates followed into adulthood (begun in 1976). The current monograph reports the results of the repeated cross-sectional surveys of all high school graduating classes since 1976 as they are followed into their adult years (as discussed in Chapter 4, these cross sections come from longitudinal data). Segments of the general adult population represented in these follow-up surveys include: (1) U.S. college students; (2) their age-peers who are not attending college, sometimes called the "forgotten half"; (3) all young adult high school graduates of modal ages 19 to 30 (or 19-28 for trend estimates), who are referred to as the "young adult" sample; and (4) high school graduates at the specific later modal ages of 35, 40, 45, 50, and 55. In this volume, historical and developmental changes in substance use and related attitudes and beliefs occurring at these age strata receive particular emphasis. The follow-up surveys have been conducted by mail on representative subsamples of the previous participants from each high school senior class. This volume presents data from the 1977 through 2016 follow-up surveys of the graduating high school classes of 1976 through 2015, as these respondents have progressed into adulthood. The oldest MTF respondents, from the class of 1976, were the first to be surveyed through age 55 in 2013-37 years after their graduation. Other monographs in this series include the Overview of Key Findings, 2 which presents early results from the secondary school surveys; Volume I, 3 which provides an in-depth look at the secondary school survey results; and the HIV/AIDS monograph, 4 drawn from the follow-up surveys of 21- to 40-year-olds, which focuses on risk and protective behaviors related to the transmission of HIV/AIDS. To enable the present volume to stand alone, three chapters from Volume I have been repeated. Chapter 2 provide a summary of key findings from five of the populations under study (8th graders, 10th graders, 12th graders, college students, and young adults). Chapter 3 outlines the study's design and procedures. Chapter 10 (which is Chapter 11 in Volume I) provides a summary of recent publications from the MTF study. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2015. Volume I, Secondary School Students" see ED578604.]

Monitoring the Future (MTF) is designed to give sustained attention to substance use among the nation's youth and adults. It is an investigator-initiated study that originated with and is conducted by a team of research professors at the University of Michigan's Institute for Social Research. Since its onset in 1975, MTF has been continuously funded by the National Institute on Drug Abuse--one of the National Institutes of Health--under a series of peer-reviewed, competitive research grants. MTF contains ongoing national surveys of both adolescents and adults in the United States. It provides the nation with a vital window into the important but often hidden problem behaviors of illegal drug use, alcohol abuse, tobacco use, anabolic steroid abuse, and psychotherapeutic drug abuse. MTF has helped provide a clearer view of the changing topography of these problems among adolescents and adults, a better understanding of the dynamics of factors that drive some of these problems, and a better understanding of some of their consequences. It has also given policymakers, government agencies, and nongovernmental organizations (NGOs) in the field some practical approaches for intervening. This annual monograph series has been a primary vehicle for disseminating MTF's epidemiological findings. This monograph presents the results of the 42nd survey of drug use and related attitudes and beliefs among American high school seniors and 26th such survey of 8th and 10th grade students. Two of the major topics included in the present volume are (1) the "prevalence and frequency" of use of a great many substances, both licit and illicit, among American secondary school students in 8th, 10th, and 12th grades and (2) "historical trends" in use by students in those grades. Distinctions are made among important demographic subgroups in these populations based on gender, college plans, region of the country, population density, parent education, and race/ethnicity. MTF has demonstrated that key attitudes and beliefs about drug use are important determinants of usage trends, in particular the amount of risk to the user perceived to be associated with the various drugs and disapproval of using them; thus, those measures also are tracked over time, as are students' perceptions of certain relevant aspects of the social environment--in particular, perceived availability, peer norms, use by friends, and exposure to use by others of the various drugs. Data on grade of first use, discontinuation of use, trends in use in lower grades, and intensity of use are also reported. This report focuses attention on drug use at the higher frequency levels rather than simply report proportions that have ever used various drugs. This is done to help differentiate levels of seriousness, or extent, of drug involvement. Appendices are included. [For "Monitoring the Future National Survey Results on Drug Use, 1975-2016. Volume II, College Students & Adults Ages 19-55," see ED578605.]