{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T23:31:42Z","timestamp":1769643102907,"version":"3.49.0"},"reference-count":45,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T00:00:00Z","timestamp":1720915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Mississippi youth are demographically unique compared to those of the nation. The aim of the study was to examine the drug use among adolescents in Mississippi compared to that in the US, which included determining prevalence and trends in drug use as well as drugs on school property and estimating the differences in drug use prevalence by gender and by race. National and Mississippi Youth Risk Behavior Surveillance System (YRBSS) data from 2001 to 2021 were obtained for analysis. Summary statistics, prevalence ratio, and survey Chi-squared tests of independence statistics were generated for the comparison for all students, and by gender and race separately. Trend analysis was conducted using logistic regression combined with joinpoint regression. The six survey questions being studied were the following: have you ever used marijuana, an inhalant, heroin, methamphetamines, or injected drugs, and were you offered, sold, or given an illegal drug on school property during the last 12 months. Survey packages in R were used to account for the complex sampling design of YRBSS data. On the national level, all six drug-related risk behaviors being studied showed a significant decrease from 2001 to 2021. In Mississippi, however, only \u201cever used marijuana\u201d showed a decrease trend, while three remain unchanged, and two increased. The 2021 YRBSS data show that Mississippi adolescents exhibited a significantly higher prevalence of drug use, and are more likely to be offered, sold or given an illegal drug on school property. This research showed detailed findings on drug use-related issues in Mississippi, which is alarming. This poses an important challenge for public health in Mississippi and sounds an urgent call for drug use intervention among Mississippi adolescents. More concerted actions at the community, school and government level are needed for reducing youth drug use and controlling the drug traffic on school property.<\/jats:p>","DOI":"10.3390\/ijerph21070919","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T18:17:32Z","timestamp":1721067452000},"page":"919","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Prevalence of and Trend in Drug Use among Adolescents in Mississippi and the United States: Youth Risk Behavior Surveillance System (YRBSS) 2001\u20132021"],"prefix":"10.3390","volume":"21","author":[{"given":"Zhen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Jackson State University, Jackson, MS 39213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-7322","authenticated-orcid":false,"given":"Amal K.","family":"Mitra","sequence":"additional","affiliation":[{"name":"Department of Public Health, Julia Jones Matthews School of Population and Public Health, Texas Tech University Health Sciences Center, Abilene, TX 79601, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"School of Social Work, College of Health Sciences, Jackson State University, Jackson, MS 39213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,14]]},"reference":[{"key":"ref_1","unstructured":"Center for Disease Control and Prevention (2020). Youth Risk Behavior Surveillance\u2014United States, 2019. Morb. Mortal. Wkly. Rep. Suppliment, 69, 1\u201383. Available online: https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/pdf\/2019\/su6901-H.pdf."},{"key":"ref_2","unstructured":"National Institute on Drug Abuse (NIDA) (2024, July 04). Reported Drug Use among Adolescents Continued to Hold below Pre-Pandemic Levels in 2023. 13 December 2023, Available online: https:\/\/nida.nih.gov\/news-events\/news-releases\/2023\/12\/reported-drug-use-among-adolescents-continued-to-hold-below-pre-pandemic-levels-in-2023."},{"key":"ref_3","unstructured":"Center for Disease Control and Prevention (2024, May 20). Youth Risk Behavior Survey Data Summary & Trends Report, 2009\u20132019, Available online: https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/pdf\/YRBSDataSummaryTrendsReport2019-508.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hofer, M.K., Robillard, C.L., Legg, N.K., and Turner, B.J. (2024). Influence of perceived peer behavior on engagement in self-damaging behaviors during the transition to university. J. Res. Adolesc.","DOI":"10.1111\/jora.12933"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"115053","DOI":"10.1016\/j.psychres.2023.115053","article-title":"First epidisode psychosis with and without the use of cannabis and sysnthetic cannabinoids: Psychopathology, global functioning and suicidal ideation","volume":"320","author":"Ricci","year":"2023","journal-title":"Psychiatry Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.biopsych.2015.08.001","article-title":"Association between cannabis and psychosis: Epidemiologic evidence","volume":"79","author":"Gage","year":"2015","journal-title":"Biol. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Singh, D., Azuan, M.A., and Narayanan, S. (2024). High-risk sexual behavior among Malaysian adolescents who use drugs: A mixed-methods study of a sample in rehabilitation. J. Subst. Use, 1\u20136.","DOI":"10.1080\/14659891.2024.2329885"},{"key":"ref_8","unstructured":"Center for Disease Control and Prevention (2024, May 15). Substance Use and Sexual Risk Behaviors among Youth, Available online: https:\/\/www.cdc.gov\/healthyyouth\/substance-use\/pdf\/dash-substance-use-fact-sheet.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"209350","DOI":"10.1016\/j.josat.2024.209350","article-title":"Patterns of mean age at drug use initiation by race and ethnicity, 2004\u20132019","volume":"161","author":"Alcover","year":"2024","journal-title":"J. Subst. Use Addict. Treat."},{"key":"ref_10","first-page":"38","article-title":"Prescription opioid misuse and use of alcohol and other substances among high school students\u2014Youth Risk Behavior Survey, United States, 2019","volume":"69","author":"Jones","year":"2020","journal-title":"Morb. Mortal. Wkly. Rep. Suppliments"},{"key":"ref_11","first-page":"e23712","article-title":"A retrospective study of the incidence of bacterial sexually transmitted infection (Chlamydia and Gonorrhea) in the Mississippi Delta before and during the COVID-19 pandemic","volume":"14","author":"Ozua","year":"2022","journal-title":"Cureus"},{"key":"ref_12","unstructured":"Centers for Disease Control and Prevention, and National Center for Health Statistics (2024, May 12). Teen Birth Rate by State, Available online: https:\/\/www.cdc.gov\/nchs\/pressroom\/sosmap\/teen-births\/teenbirths.htm."},{"key":"ref_13","unstructured":"Center for Disease Control and Prevention (2023). Overview and Methods for the Youth Risk Behavior Surveillance System\u2014United States, 2021. Morb. Mortal. Wkly. Rep. Suppliments , 72, 1\u201312. Available online: https:\/\/www.cdc.gov\/mmwr\/volumes\/72\/su\/su7201a1.htm."},{"key":"ref_14","unstructured":"Center for Disease Control and Prevention (2024, February 20). 2021 YRBS Data User\u2019s Guide. April 2023, Available online: https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/pdf\/2021\/2021_YRBS_Data_Users_Guide_508.pdf."},{"key":"ref_15","unstructured":"Center for Disease Control and Prevention (2024, February 20). 2021 YRBS National, State, and District Combined Datasets User\u2019s Guide. July 2023, Available online: https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/pdf\/2021\/2021-YRBS-SADC-Documentation508.pdf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/josh.13311","article-title":"Trend in sexual risk behavior responses among high school students between Mississippi and the United States: 2001 to 2019 YRBSS","volume":"93","author":"Risley","year":"2023","journal-title":"J. Sch. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s10654-016-0149-3","article-title":"Statistical tests, P values, confidence intervals, and power: A guide to misinterpretations","volume":"31","author":"Greenland","year":"2016","journal-title":"Eur. J. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1093\/aje\/kwh007","article-title":"Re: \u201cepidemiology of salmonellosis in California, 1990-1999: Morbidity, mortality, and hospitalization costs\u201d","volume":"159","author":"Mulla","year":"2004","journal-title":"Am. J. Epidemiol."},{"key":"ref_19","unstructured":"Center for Disease Control and Prevention (2024, March 01). Conducting Trend Analysis of YRBS Data. April 2023, Available online: https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/pdf\/2021\/2021_yrbs_conducting_trend_analyses_508.pdf."},{"key":"ref_20","unstructured":"(2024, March 01). National Cancer Institute, Available online: https:\/\/surveillance.cancer.gov\/help\/joinpoint\/setting-parameters\/method-and-parameters-tab\/apc-aapc-tau-confidence-intervals."},{"key":"ref_21","first-page":"e2113513","article-title":"Temporal trends in suicidal ideation and attempts among US adolescents by sex and race\/ethnicity, 1991\u20132019","volume":"4","author":"Xiao","year":"2021","journal-title":"JAMA"},{"key":"ref_22","unstructured":"Center for Disease Control and Prevention (2024, January 24). Software for Analysis of YRBS Data. August 2020, Available online: https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/pdf\/2019\/2019_yrbs_analysis_software.pdf."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1056\/NEJMra1402309","article-title":"Adverse health effects of marijuana use","volume":"370","author":"Volkow","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_24","unstructured":"Centers for Disease Control and Prevention (2024, May 15). Mental Health and Substance Use, Available online: https:\/\/www.cdc.gov\/mentalhealth\/index.htm."},{"key":"ref_25","unstructured":"National Institute on Drug Abuse (NIDA) (2024, May 15). Health Consequences of Drug Misuse, Available online: https:\/\/nida.nih.gov\/publications\/research-reports\/marijuana\/health-effects."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Johnston, L.D., Miech, R.A., O\u2019Malley, P.M., Bachman, J.G., Schulenberg, J.E., and Patrick, M.E. (2020). Monitoring the Future National Survey Results on Drug Use 1975\u20132019: Overview, Key Findings on Adolescent Drug Use, Institute for Social Research, The University of Michigan.","DOI":"10.3998\/2027.42\/162579"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/archgenpsychiatry.2011.1503","article-title":"Use and abuse of alcohol and illicit drugs in US adolescents: Results of the National Comorbidity Survey\u2013Adolescent Supplement","volume":"69","author":"Swendsen","year":"2012","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Whyte, A.J., Torregrossa, M.M., Barker, J.M., and Gourley, S.L. (2018). Editorial: Long-Term consequences of adolescent drug use: Evidence from pre-clinical and clinical models. Front. Behav. Neurosci., 12.","DOI":"10.3389\/fnbeh.2018.00083"},{"key":"ref_29","unstructured":"U.S. Census Bureau (2024, May 05). Poverty Rankings 2022. U.S. Census Bureau, Available online: https:\/\/data.census.gov\/."},{"key":"ref_30","unstructured":"(2024, May 05). US News & World Report. US News Best States 2024. US News & World Report. Available online: https:\/\/www.usnews.com\/news\/best-states\/mississippi."},{"key":"ref_31","unstructured":"Mississippi State Department of Health (2024, May 06). Health Equity, Available online: https:\/\/msdh.ms.gov\/msdhsite\/_static\/44,0,236.html."},{"key":"ref_32","unstructured":"Substance Abuse and Mental Health Services Administration (2024, May 06). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health, Available online: https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt42731\/2022-nsduh-nnr.pdf."},{"key":"ref_33","unstructured":"Kammer, F. (2019). The Privilege of Plenty: Educational Inequity in Mississippi, Jesuit Social Research Institute, Loyola University. Available online: https:\/\/jsri.loyno.edu."},{"key":"ref_34","first-page":"507","article-title":"School, parent, and student perspectives of school drug education","volume":"23","author":"Bond","year":"2018","journal-title":"Health Educ. Res."},{"key":"ref_35","unstructured":"Mental Health America (2024, May 08). Access to Care Data. Available online: https:\/\/mhanational.org\/issues\/2022\/mental-health-america-access-care-data."},{"key":"ref_36","unstructured":"HRSA (2024, May 08). Overview of the State-Mississippi-2021. U.S. Department of Health and Human Services, Available online: https:\/\/www.hrsa.gov."},{"key":"ref_37","first-page":"176","article-title":"Barriers to mental health care access in rural America","volume":"35","author":"Anderson","year":"2020","journal-title":"J. Rural. Health"},{"key":"ref_38","unstructured":"National Institute on Drug Abuse (2024, May 09). Monitoring the Future National Survey Results on Drug Use 1975\u20132020: Overview, Key Findings on Adolescent Drug Use, Available online: https:\/\/nida.nih.gov\/research-topics\/trends-statistics\/monitoring-future."},{"key":"ref_39","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA) (2024, May 13). Substance Use and Mental Health Issues among U.S.-Born and Immigrant Hispanics, Available online: https:\/\/www.samhsa.gov\/data\/release\/2020-national-survey-drug-use-and-health-nsduh-releases."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1111\/j.1530-0277.2009.00945.x","article-title":"The impact of underage drinking laws on alcohol-related fatal crashes of young drivers","volume":"33","author":"Fell","year":"2009","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Kaufman, P., Alt, M.A., and Chapman, C.D. (2024, May 09). Dropout Rates in the United States: 2001. 2004, National Center for Education Statistics, Available online: https:\/\/nces.ed.gov\/pubs2005\/2005046.pdf.","DOI":"10.1037\/e672832007-008"},{"key":"ref_42","unstructured":"Mississippi Institutions of Higher Learning (2024, May 07). Mississippi High School Outcomes. Available online: http:\/\/mississippi.edu\/urc\/downloads\/articles\/MSHighSchoolOutcomes-June2007.pdf."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"107818","DOI":"10.1016\/j.addbeh.2023.107818","article-title":"Cigarette and e-cigarette use trajectories and prospective prescription psychotherapeutic drug misuse among adolescents and young adults","volume":"147","author":"Moriah","year":"2023","journal-title":"Addict. Behav."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e192574","DOI":"10.1001\/jamapediatrics.2019.2574","article-title":"Association between electronic cigarette use and marijuana use among adolescents and young adults: A systematic review and meta-analysis","volume":"173","author":"Chadi","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Porter, J.J., Hudgins, J.D., Monuteaux, M.C., and Bourgeois, F.T. (2019). Prescription opioid use and misuse among adolescents and young adults in the United States: A national survey. PLOS Med., 16, Available online: https:\/\/journals.plos.org\/plosmedicine\/article?id=10.1371\/journal.pmed.1002922.","DOI":"10.1371\/journal.pmed.1002922"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/7\/919\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:16:48Z","timestamp":1760109408000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/7\/919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,14]]},"references-count":45,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["ijerph21070919"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21070919","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,14]]}}}