Last year, a nationwide 12-year trend survey on substance use among high school students revealed a decline in the use of all substances surveyed (alcohol, marijuana, illicit drugs, prescription opioids). Now, researchers from Rice University’s Baker Institute for Public Policy have taken a deep dive into the findings from the survey for students specifically in the Houston (Texas) Independent School District (HISD). In a recently published brief, they note an increase in opioid use, methamphetamine use and inhalants among HISD students.
The Youth Risk Behavior Survey (YRBS) is a federally supported representative survey that provides school administrators, teachers, and parents with information about student behavior across a range of topics, including substance use, school environment, sexual behavior, unintentional injuries and dietary behaviors. It is an anonymous survey including those actively attending public schools across the nation.
Nationwide, the YRBS survey saw 10- and 12-year declines in the teen use of alcohol, cigarettes, marijuana, opioids, inhalants, cocaine, methamphetamine and ecstasy. However, not all the trends were reflected at a more local level. Some areas, like Houston for example, saw increases in specific substance use.
Opioids
In 2017, YRBS reported prescription painkiller misuse among high school students in the U.S. at an average of 14%. As of 2023, the national average declined to 11.6%.
However, Houston has experienced the opposite trends. In 2017, HISD students reported lower rates of prescription painkiller misuse than the U.S. average at 12.9%. But by 2023, that rate increased to 18.8%. Additionally, the percentage of students who have ever tried heroin in HISD was approximately 4x higher in 2023 than the U.S. average—6.6% compared to 1.6%.
The authors—Katharine Neill Harris, Christopher Kulesza, Katarina Reyes and Sandra McKay, all from the Baker Institute for Public Policy—found this particularly concerning given the proliferation of fentanyl in the illicit drug supply in recent years.
“Students who may believe they are using heroin or prescription opioids are at high risk for exposure to fentanyl. While adolescents have lower overdose rates than adults, youth have been more acutely affected by the presence of fentanyl, possibly because they are more likely to rely on social media sources for procuring drugs,” write the authors.
For example, from 2018 to 2022, as fentanyl became dominant in the illicit opioid supply, drug-related deaths among 15- to 19-year-olds in Harris County, which includes Houston and HISD, increased by 544% compared to a 65% increase among adults aged 20 and older.
Meth and more
From 2013 to 2019, HISD experienced declines in the percentage of students reporting lifetime use of illicit substances, including cocaine, methamphetamine and ecstasy. However, use rates for several substances increased from 2019 to 2023.
For example, inhalant use—defined as having “sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high”—increased from 7.6% in 2019 to 11.4% in 2023. In Houston, this is double the rate of inhalant use compared with the nationwide U.S. sample.
Reported cocaine use, which includes powder and crack cocaine, also increased among HISD students in recent years—though it is still lower than in 2013. In 2023, 6.6% of HISD students said they had tried cocaine at least once—more than twice the national average. Methamphetamine use among HISD students increased from 4.8% in 2021 to 6.9% in 2023. For comparison, less than 2% of U.S. high school students reported lifetime methamphetamine use in 2023. In Houston, overdoses involving cocaine and methamphetamine increased for the period 2010–2024.
While the authors note that factors out of the school district’s control contribute to substance use—including Houston’s position as a major drug trafficking hub—school must be safeguarded as it is typically one of the most stable parts of youth life.
“It imperative that the district work with community partners to ensure student mental health and substance use needs are met. Much of this work is already underway, and the district’s efforts in this challenging domain should not be overlooked,” the authors conclude. “At the same time, the extreme lethality of today’s illicit drugs heightens the urgency of coordinated efforts to make sure that life-saving measures, such as naloxone access, are available to everyone in the Houston community.”