Substance use increased among some populations during Covi-19. Among youth, though, it did not. In fact, data suggests lowered use of some substances, even in the face of an increase in some mental health issues. This is a potential silver lining, as using drugs at younger ages increases the chance of becoming a chronic user.
Adolescents are peer conscious, and substance use is influenced by peer interaction. Less time spent face-to-face with peers is among the conditions mitigating drug use during the pandemic. Instead, youth spent more time at home with their parents.
Child health advocates are considering how to maintain gains as youth return to more normal activity with greater face-to-face peer contact and (in some cases) greater stress. A number of governmental organizations collect data about youth substance.
The following is a look at some of the early data and where it points.
The 2020 Monitoring the Future Survey took a look at substance use among eighth, tenth, and twelfth graders around the nation (https://www.drugabuse.gov/about-nida/noras-blog/2020/12/2020-closes-many-questions-remain-about-youth-substance-use-trends). Alcohol and marijuana use were similar in 2019 and 2020. Vaping, which had been rising at a precipitous level, plateaued.
The Colorado Healthy Kids Survey is normally conducted every other year, but the researchers felt it was important to capture pandemic data. They carried out an extra study, although smaller than usual, in the fall of 2020. The Colorado study included grades nine through twelve; study participants reported what, if any, substances they had used in the prior 30 days. The number using alcohol dropped from 29% to 21% while the number using marijuana from 19% to 13%. Vaping saw the greatest drop (29% to 16%). Cigarette use dropped from 8% to 5%. The study also found a small decline in illicit use of prescription drugs, though, given the small numbers, it did not have clear statistical significance. There was some difference in population in the 2020 study; most 2020 participants were rural.
The University of California used a cohort model to study ninth and tenth graders’ substance use at two intervals six months apart (https://jamanetwork.com/journals/jamapediatrics/fullarticle/2779444). By comparing the changes over time of two different cohorts, they could study whether there were significant change after stay at home orders. There were not. The researcher found that overall use of most substances was about the same pre-pandemic and pandemic. The researcher noted a decrease in vaping over time in both groups.
Linda Richter, PhD writing for The Journal of Adolescent Health, had noted as early as August 2020 that the effects on adolescent substance use might not all be bad (https://www.jahonline.org/article/S1054-139X(20)30412-2/fulltext). She cited multiple risk factors that might be altered under pandemic conditions. While some students might experience an increased urge to self-medicate or use substances for coping, there were multiple other risk factors that might be decreased. Among the factors contributing to reduced drug use were a decrease in sleep deprivation, an increase in family time relative to peer time, and reduced ability to shop for drugs without parental knowledge. She noted reduction in school stress as another possibility.
How did these predictions play out? Clearly, youth did not experience the same mood-related rises in substance behavior that adults did – even though, for many students, Covid-19 schooling led to increased academic stress. As the pandemic wore on, with schools upping their virtual schooling demands, many families reported high stress levels, though a minority found that virtual school suited their rhythms and led to a decrease in anxiety. Thus, the effects could have been opposite for different groups.
It is important to consider subgroups who may have increased their substance usage. Richter stated that it was important to take a nuanced look at alterations in substance use to guide future action. Ashley Brooks-Russell, an associate professor who worked on the Colorado survey, stated that despite the overall encouraging data, there might have been a subset of students who increased their substance use as a result of stress.
The University of California study noted differences in individual substance use in the context of overall similar numbers. A research team representing Brazilian departments of psychiatry about neuroscience theorized about a subset of students who might be expected to be better protected from alcohol use in a structured environment (https://www.frontiersin.org/articles/10.3389/fpsyt.2020.581113/full).
Monitoring the Future researchers have highlighted how Covid-19 data can guide future efforts. The fact that youth used substances as much as they did despite having to put more effort into getting them is telling. It’s important to educate and craft effective messages not just reduce access.
Regarding vaping, there is reason to believe that gains reflect more than just the response to Covid-19. That, too, will be a consideration for future study. Two Public Health experts recently provided recommendations for capitalizing on the favorable vaping statistics (https://thehill.com/opinion/healthcare/559950-lets-make-sure-teens-dont-start-vaping-again?rl=1).
The Society for Adolescent Health and Medicine has resources for adolescent substance abuse (https://www.adolescenthealth.org/Resources/Clinical-Care-Resources/Substance-Use/Substance-Use-Resources-For-Adolesc.aspx).