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CME

High IQ Influences Later Drug Use Habits of Children

  • Authors: News Author: Deborah Brauser
    CME Author: Désirée Lie, MD, MSEd
  • CME Released: 11/22/2011
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 11/22/2012
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Target Audience and Goal Statement

This article is intended for primary care clinicians, psychiatrists, and other specialists who care for children and adolescents.

The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  1. Describe the association between childhood IQ and illegal drug use in adolescence and adulthood.
  2. Compare the prevalence and risk for illegal drug use between men and women in relationship to childhood IQ.


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Author(s)

  • Deborah Brauser

    is a freelance writer for Medscape.

    Disclosures

    Deborah Brauser has disclosed no relevant financial relationships.

Editor(s)

  • Brande Nicole Martin

    CME Clinical Editor, Medscape, LLC

    Disclosures

    Disclosure: Brande Nicole Martin has disclosed no relevant financial relationships.

CME Author(s)

  • Désirée Lie, MD, MSEd

    Clinical Professor; Director of Research and Faculty Development, Department of Family Medicine, University of California, Irvine at Orange

    Disclosures

    Disclosure: Désirée Lie, MD, MSEd, has disclosed the following relevant financial relationship:
    Served as a nonproduct speaker for: "Topics in Health" for Merck Speaker Services

CME Reviewer(s)

  • Sarah Fleischman

    CME Program Manager, Medscape, LLC

    Disclosures

    Disclosure: Sarah Fleischman has disclosed no relevant financial relationships.


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CME

High IQ Influences Later Drug Use Habits of Children

Authors: News Author: Deborah Brauser CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CME Released: 11/22/2011

Valid for credit through: 11/22/2012

processing....

Clinical Context

According to the current study by White and Batty, children and adolescents who score high on IQ tests have lower rates of mortality in adulthood, and high childhood IQ predicts higher health literacy in later life, but it is not clear if childhood IQ correlates with adult use of illegal drugs.

This population-based cohort study of children born in the United Kingdom in 1970 examines the association between childhood IQ at age 5 years and age 10 years and use of illegal drugs at age 16 years and at age 30 years.

Study Synopsis and Perspective

Highly intelligent children may be at increased risk for using illicit drugs as adolescents and adults, new research suggests.

In a population-based cohort study that included almost 8000 participants, investigators found that high IQ scores at the age of 5 years were significantly associated with cannabis use at the age of 16 years, and with cannabis and cocaine use in women and amphetamine and ecstasy use in men at the age of 30 years.

Moreover, these associations held up even after adjusting for psychological distress during adolescence and life-course socioeconomic position.

"The takeaway message for MDs is that we should not assume that a high IQ will only be associated with healthy behaviors," lead author James White, PhD, research associate at the Center for the Development and Evaluation of Complex Public Health Interventions at Cardiff University, United Kingdom, told Medscape Medical News.

"For the most part, a high IQ is a very good thing, and has been associated in the past with a healthier lifestyle and robust indicators of cardiovascular risk, such as blood pressure and lipid levels. However, our study and others indicate it can also be associated with drug and alcohol misuse," said Dr. White.

The study was published online November 14 in the Journal of Epidemiology and Community Health.

Fulfilling a Need for Novelty?

The investigators note that because individuals with high IQs have been shown to score highly on tests of stimulation seeking and openness to experiences, it may be that alcohol and illegal drugs fulfill their desire for novelty and stimulation. Drug use may also be seen as a way of staving off boredom and/or a way to cope with stigmatization from peers.

"There is a clear need for future epidemiological and experimental studies to explore these and other pathways," the authors write.

"Most previous research has shown high childhood IQ is associated with a healthy lifestyle. For example, high IQ in childhood has been associated with a healthier diet, being more physically active, and being less likely to smoke as an adult," said Dr. White.

However, because 2 recent studies ( Am J Public Health. 2008;98:2237-2243, Soc Sci Med. 2007;64:2285-2296) suggested that high IQ is associated with an increased risk for excessive alcohol use and alcohol dependency in adulthood, the investigators wanted to explore possible associations with illegal drug use.

"If we know what is associated with drug use, we have more information to guide future research, which will hopefully be helpful in reducing dependency on drugs," added Dr. White.

30-Year Follow-up

The investigators evaluated data on 7904 participants with IQ scores assessed at the age of 5 years and 7946 patients with IQ scores assessed at the age of 10 years from the 1970 British Cohort Study, which measured lifetime drug use and socioeconomic factors up to the age of 30 years.

All participants were enrolled in the study at birth. At the 5-year follow-up, the Human Figure Drawing Test, a Copying Design Test, the English Picture Vocabulary Test, and the Profile Test were administered in-home to assess cognitive function.

At the 10-year follow-up, a modified version of the British Ability Scales was used to evaluate IQ. At the 16-year follow-up, self-reports were collected on level of psychological distress (according to the 12-item General Health Questionnaire) and lifetime use of illegal drugs, such as cannabis, cocaine, uppers and downers, lysergic acid diethylamide, and heroin.

At the final 30-year follow-up, participants were asked about use in the previous year of the already named drugs plus amphetamines, ecstasy, amyl nitrate, temazepam, ketamine, crack, and methadone.

The participants were also asked about polydrug use, which was defined as using 3 or more illicit drugs, and about highest educational achievement, monthly gross salary, and occupational social class.

Increased Cannabis, Cocaine Use

Results showed that higher IQ scores at the age of 5 years were associated with an increased use of cannabis at the age of 16 years for both sexes, and with increased cannabis and cocaine use at the age of 30 years.

When looking at the specific sexes, investigators found that high IQ scores for girls at the age of 5 years were positively associated with use of cannabis (odds ratio [OR], 2.25) and cocaine (OR, 2.35) at the age of 30 years. For boys, it was associated with subsequent amphetamine (OR, 1.46), ecstasy (OR, 1.65), and polydrug use (OR, 1.57).

High IQ scores at the age of 10 years for all participants were positively associated with cannabis use at the age of 16 years, and with cannabis, cocaine, ecstasy, amphetamine, and polydrug use at the age of 30 years.

"In the analyses of drug use at 30 years, associations with IQ at both 5 and 10 years were stronger among women than among men," report the researchers.

They note that further studies are needed examining the associations between childhood IQ and adult drug use "in different geographical and historical contexts."

"We need to know more about the exact level of harm associated with infrequent drug use, and we need more detailed research on the long-term harms of illegal drug use in the wider population, rather than just in those dependent on drugs," added Dr. White.

The study was supported by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Assembly government (under the auspices of the UK Clinical Research Collaboration), and the Wellcome Trust. The study authors have disclosed no relevant financial relationships.

J Epidemiol Community Health. Published online November 14, 2011. Abstract

Study Highlights

  • The 1970 British Cohort Study is an ongoing longitudinal study of children born between April 5 and April 11, 1970, in England, Scotland, and Wales. They were observed at ages 5, 10, 16, and 26 years, and at ages 29 to 30 years.
  • All assessments during childhood took place in the homes.
  • At 5 years, the Human Figure Drawing Test, the Copying Designs test, the English Picture Vocabulary Test, and the Profile Test were used to assess cognitive function.
  • General cognitive ability was assessed with use of the sum of each of the 4 tests, and the g score derived was converted to the widely used IQ distribution.
  • IQ was assessed at age 10 years via the modified version of the British Ability Scales with 4 subscales: word definition, word similarities, recall of digits, and matrices.
  • At age 16 years, study participants were assessed for their level of psychological distress and use of illegal drugs (including street names): cannabis, cocaine, uppers, downers, lysergic acid diethylamide (LSD), heroin, and a fictitious drug.
  • The General Health Questionnaire was used to assess psychological distress.
  • At age 30 years, similar questions were used to assess the use of illegal drugs during the prior year: cannabis, cocaine, amphetamines, ecstasy, LSD, amyl nitrate, magic mushrooms, temazepam, ketamine, crack, heroin, methadone, and a fabricated drug (semeron).
  • Polydrug use was defined as the use of 3 or more drugs.
  • At age 30 years, social class, educational achievement, and monthly income were also elicited.
  • Overall mean IQ score was higher in children whose parents were in higher social classes with a profession, had achieved higher education, and had higher gross income.
  • Of the 3818 male and 4128 female participants, 7.0% and 6.3%, respectively, had used cannabis at age 16 years, and adolescents who reported cannabis use had a higher mean IQ than those who did not.
  • Cocaine use was reported by 0.7% of boys and 0.6% of girls at age 16 years.
  • At age 30 years, 35.4% of men and 15.9% of women reported cannabis use within 12 months, and 8.6% of men and 3.6% of women reported cocaine use within 12 months.
  • A similar pattern was seen for amphetamines (8.1% vs 2.6%), ecstasy (6.8% vs 2.3%), and polydrug use (5.2% vs 2.0%). Men were using twice as commonly as women.
  • IQ score at age 5 years was significantly associated with increased use of cannabis, but not cocaine, at age 16 years and increased use of cannabis and cocaine at age 30 years.
  • IQ score at age 5 years was associated with amphetamine, ecstasy, and polydrug use at age 30 years among men but not women.
  • The largest ORs were seen for comparison of the top vs the lowest tertile of IQ scores.
  • The ORs for IQ scores at age 5 years for women (age 30 years) were 2.25 for cannabis and 2.35 for cocaine use.
  • For men (age 30 years), the ORs were 1.46 for amphetamines, 1.65 for ecstasy, and 1.57 for polydrug use.
  • Associations were stronger for women vs men and were independent of psychological distress in adolescence and socioeconomic position.
  • The authors concluded that higher IQ in childhood was associated with a higher risk for illegal drug use and that the association was stronger in women than in men.

Clinical Implications

  • Higher IQ score at ages 5 and 10 years is associated with a higher risk for illegal drug use at ages 16 and 30 years.
  • The association of IQ with illegal drug use is stronger for women vs men, although the prevalence of illegal drug use is higher in men vs women.

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