Sex and Drugs Decline Among Teens, but Depression and Suicidal Thoughts Grow

Condom use is declining among sexually active teens, a federal survey found.CreditFrederic J. Brown/Agence France-Presse — Getty Images

One in seven high school students reported misusing prescription opioids, one of several disturbing results in a nationwide survey of teenagers that revealed a growing sense of fear and despair among youth in the United States.

The numbers of teenagers reporting “feelings of sadness or hopelessness,” suicidal thoughts, and days absent from school out of fear of violence or bullying have all risen since 2007. The increases were particularly pointed among lesbian, gay and bisexual high school students.

Nationally, 1 in 5 students reported being bullied at school; 1 in 10 female students and 1 in 28 male students reported having been physically forced to have sex.

“An adolescent’s world can be bleak,” said Dr. Jonathan Mermin, an official with the Centers for Disease Control and Prevention, which conducted the survey and analyzed the data. “But having a high proportion of students report they had persistent feelings of hopelessness and 17 percent considering suicide is deeply disturbing.”

In 2017, 31 percent of students surveyed said they had such feelings, while 28 percent said so in 2007. In 2017, nearly 14 percent of students had actually made a suicide plan, up from 11 percent in 2007.

The Youth Risk Behavior Survey is given every two years to nearly 15,000 students in high schools in 39 states, and poses questions about a wide array of attitudes and activities.

The report did offer some encouraging trends, suggesting that the overall picture for adolescents is a nuanced one. Compared to a decade ago, fewer students reported having had sex, drinking alcohol or using drugs like cocaine, heroin or marijuana.

Because this was the first time that the question about prescription opioids had been given, the researchers who compiled the report could not say whether the 1 in 7 (or 14 percent) figure represented an increase or decrease.

David C. Harvey, a social worker who is executive director of the National Coalition of STD Directors, said that even without a means of comparison, the numbers offered an important look at the lesser-known impact of opioids on adolescents. He said they strongly suggest that opioid use may be contributing to a rise in sexually transmitted diseases among young people.

Mr. Harvey noted that the report also shows that condom use is declining among teenagers. Fifty-four percent of teens who were sexually active reported using condoms the last time they had sex, compared to 62 percent in 2007. Combining that decline with prescription drug abuse, he said, is “a recipe for disaster,” referring to transmissions of HIV and hepatitis as well as other STDs, such as syphilis.

Dr. Mermin, director of the C.D.C.’s National Center for HIV/AIDS, viral hepatitis, STD and TB prevention, echoed his concern, and said, “These numbers call on all of us to respond quickly and effectively.”

Although health disparities still remain among races, some sexual risk behaviors are decreasing across the board. The percentage of white students who’d ever had sex, for example, decreased to 39 percent in 2017 from 44 percent in 2007. Among black students, the rate plummeted to 46 percent from 66 percent in 2007 and, among Hispanic students, decreased to 41 percent from 52 percent.

Overall, the percentage of students who had ever had sex decreased to 39 percent in 2017 from 48 percent in 2007.

The percentage of students who had experienced sexual dating violence declined to 7 percent in 2017 from 10 percent in 2013.

Experts said that the decade-long decline in risky sexual behavior and drug and alcohol use underscored the ability of adolescents to make wise choices, which made Dr. Mermin hopeful.

“There’s strong data to show that family support and attention by your parents to what you’re doing can make a difference in an adolescent’s life,” he said. “Communities can support access to mental health and substance use services. Schools can offer coping skills and bystander intervention training.”

Risky behaviors were disproportionately higher among gay and bisexual teenagers.

Their sense of emotional and physical safety is becoming only more threatened. In the 2015 survey, three times as many lesbian, gay and bisexual teenagers reported having been physically forced to have sexual intercourse as their heterosexual peers. This year, four times as many indicated that they had been raped. They were more likely in 2017 than in 2015 to report having stayed out of school because of worries about their own safety.

Geography also had an effect on results. In New York, for example, 31 percent of students reported ever having had intercourse. By contrast, in Delaware, 45 percent said they had, as did 39 percent in South Carolina.

Experts remain puzzled about why condom use is dropping. “Condom use is decreasing as hormonal birth control increases,” Dr. Mermin said. “Some students do not appreciate the additional benefit of condoms.”

And he made a connection between the declining rates and decreases in health education. “We monitor school health policies and there has been a decrease in requirements for HIV, STD and infectious disease prevention education over time,” Dr. Mermin said. “So maybe youth are more complacent about their risk for HIV and STDs.”