WASHINGTON - Teenagers who drink or use drugs are much more likely than others to be sexually active, starting sexual intercourse as early as middle school and with a greater likelihood of multiple partners, a research group reports.
With condom use among teens being erratic at best, there is a fear that the combination of substance abuse and sex could increase the 12 million new annual cases of sexually transmitted disease.
''In America, drinking and drug abuse are bundled with high-risk sex,'' said Susan Foster, who directed the report ''Dangerous Liaisons: Substance Abuse and Sex'' for the Center on Addiction and Substance Abuse at Columbia University. ''Yet despite the high coincidence of substance abuse and sexual activity, remarkably few public or private prevention, treatment and counseling programs deal with this connection.''
In its report, gleaned from a variety of data on 34,000 teenagers in grades 7-12, the research center admits it's not sure what comes first - the drinking and drug-taking or the promiscuity. In its analysis, the group factored out other reasons - such as socioeconomic status or race - that are associated with either drinking or having sex but not necessarily both and could have made the connection look weaker or stronger than it actually is.
But the report suggests there could be some lessons from adults: adult heavy drinkers - defined as about seven drinks a day over two weeks - are five times more likely than those who don't drink at all to have at least 10 sexual partners a year.
Ben Smilowitz, a University of Connecticut freshman who often finds little social life on campus beyond drinking parties, said his peers are not only turning to drink because of stress, they also are imitating adults.
''People see drinking as way of relaxing because that's what adults do,'' the 18-year-old said. ''You go to a football game or hockey and see adults getting trashed.''
He says more kids are drinking and therefore engaging in riskier behavior all around.
The report said drug-using teens are five times as likely to have sex than nonusers, and three times as likely to have it with four or more partners, according to the two-year analysis of data.
A generation ago, the report said, fewer teens were having sex. In 1970, 5 percent of 15-year-old girls had sex; in 1972, 20 percent of 15-year-old boys said they had sex. In 1997, 45 percent of boys and 38 percent of girls said they have had intercourse in their teen years.
Joseph A. Califano Jr., the research center's chairman, and a former secretary of health, education and welfare under President Carter, says the report shows parents must realize that today's teens more than ever are forced to make decisions about drinking, illegal drugs and sex as early as middle school.
Califano said school counselors, parents, clergy and other adults to address whichever teen activity -- sex or substance use -- that first comes to their attention.
''Adults should be prepared to work with the teen on both matters,'' he said.
The group urges middle and high schools to create comprehensive education programs that address the link between substance abuse and sex.
But students have a different view.
''When society tells kids don't have sex, don't drink, don't use drugs, it's just creating forbidden fruit,'' Smilowitz said. ''Society needs to reexamine its way of dealing with kids.''
The report was funded by the Henry J. Kaiser Family Foundation and the Carnegie Corporation of New York. Besides data from the teens, the report also relied on articles, expert interviews and examination of dozens of prevention and treatment programs for substance abuse, sex and sexual violence.