Margot Sanger-Katz and Aaron E Carroll
Teenage dramas have typically presented a soapy view of high school, with more sex, drugs and wild behavior than in real life. But HBO’s new series “Euphoria” portrays a youth bacchanal that’s a stretch even for Hollywood. The show suggests that our modern society, with its smartphone dating apps, internet pornography and designer drugs, has made teenage life more extreme and dangerous than ever before.
Actually, nearly the opposite is true.
You wouldn’t know it from “Euphoria,” but today’s teenagers drink less than their parents’ generation did. They smoke less, and they use fewer hard drugs. They get in fewer car accidents and fewer physical fights. They are less likely to drop out of high school, less likely to have sex, and less likely to become pregnant. They commit fewer crimes.
They even wear bike helmets.
Across a wide range of classically risky teenage behaviors, today’s teenagers are getting tamer and more responsible, making better decisions and eschewing the dangerous choices that, for many adults today, defined youth.
“There is a whole bunch of good news out there,” said Bill Albert, the chief innovation officer at Power to Decide, a group that used to be called the Campaign to Prevent Teen and Unplanned Pregnancy, before teenage pregnancy rates fell by half. “I think it is fair to call this the cautious generation.”
Teenagers today do face some heightened risks, some of which “Euphoria” tackles. Suicide among teenagers is rising, and the incidence of certain mental health diagnoses also may be growing more common. Teenage nicotine vaping has taken off so fast that it has alarmed public health officials. And, as certain types of drugs are becoming more dangerous, overdose deaths are rising, even though fewer youths use drugs.
But overall, adolescence is safer than it has ever been.
Most Teenagers Aren’t Having Sex
The show’s depiction of sexual activity among teenagers may be where it strays furthest from the facts. In the first episode, the character Jules encourages her virginal friend Cat to have sex, saying, “This isn’t the ’80s.” Many, many characters are shown having sex and talking about it, as if it were something all teenagers do. But the rates of sex — and particularly risky sex — among teenagers are lower now than they were then. Most teenagers the age of the main characters report, on surveys, that they are virgins.
The percentage of high school juniors who have ever had sexual intercourse has declined to 42 per cent from 62 per cent since 1991, according to a national survey of teenagers conducted by the Centers for Disease Control and Prevention. And the number having sex with multiple partners has fallen: Fewer than 11 per cent of high school juniors have had four or more partners, down from 22 per cent in 1991. More teenagers who are having sex are using contraception. And the rates of teenage birth have fallen by more than half.
One thing that certainly is true is that teenagers today have more access to porn than ever before. They are also more likely to sext, and share nude photos online (“Unless you’re Amish, nudes are the currency of love,” says the main character, Rue, played by Zendaya, who has a tendency to exaggerate). It’s possible that teenagers will be less shocked than many television reviewers have been at a locker room scene in Episode 2 featuring many, many penises. But wider access to pornography doesn’t mean adolescents are more promiscuous. Young people who have grown up with this technology and access are having less sex than those who lacked it.
Drug Use Is Declining
The series depicts extensive drug use among teenagers, including cocaine, opioids and synthetic hallucinogens. But the use of nearly every type of drug, including alcohol and tobacco, has been falling among teenagers for decades, according to a long-standing survey conducted by researchers at the University of Michigan.
In Episode 1, Rue and Jules use a hallucinogen. Only 0.5 per cent of 10th-graders now report having used a hallucinogen in the past month. That’s about a third of the rate in the late 1990s. In 2018, only 19 per cent of 10th-graders reported having consumed an alcoholic beverage in the prior 30 days, down from more than 40 per cent in the 1990s.
Cigarette use has fallen even more precipitously. In 2018, only 4 per cent of 10th-graders had smoked in the past 30 days, down from highs of 30 per cent.
The one major exception to the trend is marijuana use. Teenagers seem to smoke pot at around the same rate that they did a generation ago, with just more than one in four 10th-graders reporting any use in the past year.
There has been an increase in the use of electronic cigarettes, which deliver the drug nicotine. Though vaping has fewer long-term health risks than smoked tobacco, federal officials have characterized the recent increases as a new epidemic. About 16 per cent of 10th-graders and 21 per cent of 12th-graders reported use in the past month in 2018.
The declines in drug use among teenagers have several health benefits. Young people, whose brains keep developing till their mid-20s, may be at higher risk of addiction when they begin consuming substances. And, as the opioid supply in many parts of the country has become more dangerous and less predictable, anyone taking such drugs is at an increased risk of a fatal overdose.
There are a number of theories that may explain the declines in drug use. Some experts point to a benevolent effect of peer pressure. As fewer teenagers use substances, doing so becomes more stigmatized and less cool. The parties with rampant drug and alcohol use depicted in “Euphoria” clearly differ from the social experiences of many American teenagers today.
But Suicide Is a Growing Worry
The first episode contains a few quick depictions of suicide (and plenty of self-destructive behavior). This is one area that has actually been worsening for adolescents.
From 2000 through 2007, the rates of teenage suicide were somewhat flat, according to CDC data. From 2008 through 2014, the annual rate of suicide began increasing. Beginning in 2014, through 2017, the most recent year with complete data, the rate rose even more, to a 10 per cent increase per year.
Among girls 15 to 19, changes have been even more significant. The overall rate in 2017 was about twice that in 2000. The suicide rate among adolescents is currently at its highest level in 20 years based on available CDC data. It’s the second-leading cause of death in this age group. Yet teenage suicide remains far from common: Fewer than 2,500 teenagers died this way in 2017.
It’s worth noting that almost half of these deaths are via firearms, and many could probably be prevented.
There is some evidence that mental health problems, like depression and anxiety, are becoming more common among teenagers. Recent data are not available, but a study published last year found that the lifetime prevalence of anxiety or depression in children between the ages of 6 and 17 increased to 8.4 per cent in 2011–12 from 5.4 per cent in 2003. (Rue is put on more medications at a very young age than almost any pediatrician would support.)
Researchers say there is no one simple explanation for the decline in reckless behavior among teenagers. Besides positive peer pressure, some possible causes they cite include the rise of more intensive parenting; internet distractions that keep teenagers at home rather than out and about; expanded health coverage and improvements in mental health care; and the elimination of brain-damaging lead from gasoline in the 1970s.
There is such a tendency to catastrophize teenage behavior that many parents and television writers have missed this revolution in the nature of adolescence.
“In the long term, the trends are quite clear,” said David Finkelhor, a sociology professor and director of the Crimes Against Children Research Center at the University of New Hampshire. “But even in the short term, we’re undergoing a period of dramatic improvements that have not been widely acknowledged or underlined, and it’s too bad.”