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Substance use is a leading cause of preventable morbidity and mortality, and it is in large part why people in the U.S. have the highest probability among 17 high-income nations of dying by age 50.1 Substance use is also an important contributor to many social ills including child and spouse 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 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. The 2014 survey, reported here, is the 40th consecutive survey of 12th-grade students and the 24th such survey of 8th and 10th graders.

MTF contains ongoing series of national surveys of both American adolescents and adults. It provides the nation with a vital window into the important but largely hidden problem behaviors of illegal drug use, alcohol abuse, tobacco use, anabolic steroid abuse, and psychotherapeutic drug abuse. For 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.

A widespread epidemic of illicit drug use emerged in the 1960s among American youth, and since then dramatic changes have occurred in the use of nearly all types of illicit drugs, as well as alcohol and tobacco. Of particular importance, as discussed in detail below, are the many new illicit drugs that have emerged, along with new forms of alcoholic beverages and tobacco products. Among the more recently abused substances are new classes of drugs, including over-the-counter medications, synthetic marijuana, synthetic stimulants, such as “bath salts,” drugs taken for strength enhancement, new tobacco- and nicotine-based products, and a number of so-called club drugs. E-cigarettes, a recent arrival on the scene of adolescent drug use, have been added to MTF coverage this year. Unfortunately, while many new substances have been added to the list over the years, very few have been removed because they have remained in active use. Throughout these many changes, substance use among the nation’s youth has remained a major concern for parents, teachers, youth workers, health professionals, law enforcement, and policymakers, largely because substance abuse is one of the largest and yet most preventable causes of morbidity and mortality during and after adolescence.