Women under the Influence reveals critical and relatively unknown facts about women and substance abuse, including differences between the sexes in their reasons for using drugs, how they exhibit abuse, how drugs of abuse are metabolized, and the effects and consequences of abuse. This book takes the first comprehensive look at substance abuse &endash; tobacco, alcohol, illicit and prescription drugs &endash; and the American woman

New publication: How to Raise a Drug Free Kid

Tobacco: The Smoking Gun (Report)
The CASA white paper cites more than a dozen scientific studies that may explain the factors that contribute to the relationship between smoking tobacco and drinking alcohol. Some of the factors include:
- Nicotine exposure at any early age may cause neurological changes which an increase teen vulnerability
- Animal studies have show a "distinct temporal link between nicotine exposure and alcohol consumption" a progression from cigarette use to alcohol use
- Nicotine increases dopamine levels in the brain which increases a propensity for alcohol and the amount of alcohol consumed
- Smoking nicotine increases nicotine receptors, also known as upregulation, especially in adolescents. Also the research cited dozens of studies, with both animals and humans, that demonstrate that nicotine use causes complex changes in the brain that make adolescents more vulnerable to marijuana, cocaine and cocaine.

Comparing adolescents aged 12-17 who don't smoke, to teens who do the CASA study found:
--five times more likely to drink
--13 times more likely to use marijuana

Comparing those who started to smoke before age 12 to nonsmokers the study found:
--more than three times more likely to binge drink
--nearly 15 times more likely to smoke marijuana
--nearly seven times more likely to sue heroin and cocaine

Smoking and mental health disorders
The CASA study found that among teens who smoke cigarettes:
--twice as likely to suffer depression in the past years
--more likely to experience hopelessness, depression and worthlessness
--more likely to report panic attack and general anxiety disorders
--more likely to report post-traumatic stress disorder

Signals of Teen Substance Abuse Risk
The more sexually active friends a teen has and the more time a teen spends with a boyfriend or girlfriend, the greater the risk that teen will smoke, drink, get drunk or use illicit drugs, according to the NATIONAL SURVEY OF AMERICAN ATTITUDES ON SUBSTANCE ABUSE IX: TEEN DATING PRACTICES AND SEXUAL ACTIVITY.

The CASA survey found:

Compared to teens with no sexually active friends, teens who report half or more of their friends are sexually active are more than six and one-half times likelier to drink; 31 times likelier to get drunk; 22.5 times likelier to have tried marijuana; and more than five and one-half times likelier to smoke.

Teens who spend 25 or more hours a week with a boyfriend/girlfriend are two and one-half times likelier to drink; five times likelier to get drunk; 4.5 times likelier to have tried marijuana; and more than 2.5 time likelier to smoke than teens who spend less than 10 hours a week with a boyfriend/girlfriend.

Girls with boyfriends two or more years older are more than twice as likely to drink; almost six times likelier to get drunk; six time likelier to have tried marijuana; and four and one-half times likelier to smoke than girls whose boyfriends are less than two years older or who do not have a boyfriend.

Sexual activities linked to substance abuse:

Teens, half or more of whose friends regularly view and download Internet pornography, are more than three times likelier to smoke, drink or use illegal drugs, compared to teens who have no friends who engage in such behavior.

Forty-four percent of high school students thing that boys at their school often and sometimes 'push girls to drink alcohol or take drugs in order to get the girls to have sex or do other sexual things."

Top Risk Factors in Teen Substance Abuse

The risk that teens will smoke, drink, get drunk and use illegal drugs increases sharply if they are highly stressed, frequently bored or have substantial amounts of spending money, according to The National Survey of American Attitudes on Substance Abuse VIII: Teens and Parents, an annual back-to-school survey conducted by The National Center on Addiction and Substance Abuse (CASA) at Columbia University,

Among CASA's survey findings:

High stress teens are twice as likely as low stress teens to smoke, drink, get drunk and use illegal drugs.

Often bored teens are 50 percent likelier than not often bored teens to smoke, drink, get drunk and use illegal drugs.

Teens with $25 or more a week in spending money are nearly twice as likely as teens with less to smoke, drink and use illegal drugs, and more than twice as likely to get drunk.

Teens exhibiting two or three of these characteristics are at more than three times the risk of substance abuse as those exhibiting none of these characteristics. More than half the nation's 12-to-17 year olds (52 percent) are at greater risk of substance abuse because of high stress, frequent boredom, too much spending money, or some combination of these characteristics.

"High stress, frequent boredom and too much spending money are a catastrophic combination for many American teens," said CASA Chairman and President and former U. S. Secretary of Health, Education and Welfare Joseph A. Califano, Jr. "But it is a catastrophe that can be avoided through parental engagement. Parents must be sensitive to the stress in their children's lives, understand why they are bored and limit their spending money." Other findings of this year's survey:

More than 5 million 12-to-17 year olds (20 percent) can buy marijuana in an hour or less; another 5 million (19 percent) can buy marijuana within a day.

The proportion of teens that consider beer easier to buy than cigarettes or marijuana is up 80 percent from 2000 (18 percent vs. 10 percent).

For the first time in the survey's eight-year history, teens are as concerned about social and academic pressures as they are about drugs.

Teens at schools with more than 1,200 students are twice as likely as teens at schools with less than 800 students to be at high risk of substance abuse (25 percent vs. 12 percent).

"The commercial value of underage and pathological drinking to the Alcohol Industry, The National Center of Addiction and Substance Abuse at Columbia University May (2006).

Duran, Lauren R.; Gavilanes, Nancy; "The commercial value of underage drinking and adult abusive and dependent drinking to the alcohol industry", ARCHIVES OF PEDIATRICS AND ADOLESCENT MEDICINE (May, 2006). Underage drinkers and adult pathological drinkers (those that meed the clinical DSM-IV criteria for alcohol abuse or addiction) consume between 37.5 percent and 48.8 percent of the value of all alcohol in the United States. $22.5 billion in consumer spending on alcohol came from underage drinking and $25.8 billion came from adult pathological drinking. Other findings include: Alcohol abuse and addiction cost the nation an estimated $220 billion in 2006 - more than cancer ($196 billion and obesity ($133 billion). Each day more than 13,000 children and teens take tier first drink. The 25.9 percent of underage drinkers who are alcoholics and alcohol abusers consume 47.3 percent of alcohol drunk by underage drinkers. The 9.6 percent of adult pathological drinkers consume 25 percent of alcohol drunk by adult drinkers. Children and teens that begin drinking before age 15 are four time likelier to become alcohol dependent that those who do no drink before age 21.

The National Center of Addition and Substance Abuse at Columbia University (CASA) released a three year study, SHOVELING UP: THE IMPACT OF SUBSTANCE ABUSE ON STATE BUDGETS, revealing that in 1998 states spent conservatively $81.3 billion dollars on substance abuse and addiction--13.1 percent of the $620 billion in total sate spending. Of each dollar, 96 cents went to shovel up the wreckage of substance abuse and addiction, only four cents to prevent and treat it.

CASA conducted an elaborate survey of the states, examined programs designed to prevent and treat substance abuse or deal with its consequences and interviewed scores of state budget and program officials. Forty-five states, the District of Columbia and Puerto Rico responded to the survey. CASA estimated spending for the five states that did not respond, Indiana, Maine, New Hampshire, North Carolina and Texas.

And the update--"Shoveling up II: The Impact of Substance Abuse on Federal, State and Local Budgets". National Center on Addiction and Substance Abuse at Columbia University (New York, New York). May 2009.

Key 2005 findings of the report are:
For every dollar federal and state governments spent to prevent and treat substance abuse and addictions, they spend $59.83 in public programs shoveling up its wreckage.

If substance abuse and addiction were its own state budge category, it would rank second just behind spending on elementary and secondary education.

If substance abuse and addiction were its own budget category at the federal level, it would rank sixth behind social security, national defense, income security, Medicare and other health programs including the federal share of Medicaid.

Federal and state governments spend more that 60 times as much to clean up the devastation substance abuse and addiction visits on children as they do on prevention and treatment for them--notes from Joseph A. Califano. Check out the entire article at:


CASA Publications Address:

Publications examples:

Crossing the Bridge: An Evaluation of the Drug Treatment

Alternative-to-Prison (DTAP) Program 03/11/03

The Economic Value of Underage and Adult Excessive Drinking to the Alcohol Industry 02/27/03

The Formative Years: Pathways to Substance Abuse Among Girls and

Young Women Ages 8-22 02/24/03

2002 CASA National Survey of American Attitudes on Substance

Abuse VII: Teens, Parents and Siblings 08/20/02

Teen Tipplers: America's Underage Drinking Epidemic 02/26/02

Substance Use and Risky Sexual Behavior Fact Sheets 02/07/02

"Malignant neglect: substance abuse and American's schools," CASA,

  • "Each year, there are 13.2 million incidents where a 12- to 17-year old tries tobacco, alcohol, marijuana and Ecstasy or some other illicit drug. Many Americans tend to look at experimentation with cigarettes, alcohol and illegal drugs as a benign rite of passage, "something kids will get over." To the contrary, the CASA report finds that a high proportion of students who experiment with these drugs continue using them throughout their years in high school."

"The CASA report found that two of the most important factors leading to student substance abuse were the availability of drugs and perception of risk in using them."

The Formative Years: Pathways to substance Abuse Among Young Girls and Young Women Ages 8-22, National Center on Addiction and Substance Abuse at Columbia University, New York, New York, February, 2003.

THE FORMATIVE YEARS explores the pathways girls travel toward substance abuse--via family circumstances, personality traits, childhood experiences, biology, the influences of friends and peers, the communities where they live and the advertising and media messages that bombard them. The report describes the effects on substance use of key transitions in a girl's life, such as moving from middle to high school and high school to college, and physiological and emotional transitions experienced during puberty and throughout adolescence. Most importantly, it reveal vital opportunities for prevention and intervention during those key transitions.

  • Girls who abuse substances are likelier to be depressed and suicidal--increasing the risk for substance abuse.
  • Girls are likelier than toys to diet and have eating disorders. Such girls are at increased risk for substance abuse.
  • Girls are likelier than boys to have been physically or sexually abused. Such girls are at increased risk for substance abuse.
  • Among teens who move frequently from one home or neighborhood to another, girls are at greater risk than boys of smoking, drinking and using drugs.
  • Girls typically experience puberty at an earlier age than boys. Girls who experience early puberty are at increased risk of using substances earlier, more often and in larger amounts than their later-maturing peers.
  • Substance use can sink into abuse more quickly for girls and young women than for boys and young men, even using the same amount or less of a particular substance.
  • Girls and women are likelier than males to experience adverse health consequences from smoking, drinking or using drugs.
  • Substance use increases the likelihood that girls will engage in risky sex or be victims of sexual assault.
  • Teen age girls are likelier than women of any other age to smoke, binge drink and use illicit drugs during pregnancy.
  • Girls differ from boys in their ease of obtaining tobacco, alcohol and drugs and in the offers they receive to use these substances. 

To download the entire document go to:

"Wasting the best and brightest: substance abuse at colleges and universities". This study found that forty-nine percent (3.8 million) of full time college students binge drink and/or abuse prescription and illegal drugs, according to Wasting the Best and the Brightest: Substance Abuse at America's Colleges and Universities, a new report by The National Center on Addiction and Substance Abuse at Columbia University.

The study also finds that 1.8 million full-time college students (22.9 percent) meet the medical criteria for substance abuse and dependence, two and one half times the 8.5 percent of the general population who meet these same criteria.

The comprehensive 231-page report, the result of more than four years of research, surveys, interviews and focus groups is the most extensive examination ever undertaken of the substance abuse situation on the nation's college campuses.

updated 12/13/16