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The use of both depressants and stimulants can also lead to substance use disorders, influenced by genetic predisposition, environmental factors, and comorbid mental health conditions

The number of substances used/misused by age of initiation of substance use and never use Past-year prevalence of using 4 substances was 16.9% (95% CI = 16.317.5%) among adults who initiated using any substance before age 18, compared with 2.3% (95% CI = 1.92.8%) among those who initiated it at ages 2129 (Table 2)

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