Substance use decreased among youth, young adults during COVID-19 pandemic

Despite “significant stressors” that emerged from the COVID-19 pandemic, substance use decreased among adolescents and young adults in 2020 compared with pre-pandemic years, according to researchers.

“Many assume that substance use increased across the board during the pandemic, but several reports confirm reduced drug use for youth and widely varying drug use trends for adults,” Wilson M. Compton, MD, MPE, the deputy director of the National Institute on Drug Abuse (NIDA), told Healio. “Results from the NIDA-supported Monitoring the Future (MTF) survey for example found that the percentage of 8th-, 10th- and 12th-graders reporting drug use decreased significantly as the pandemic endured, consistent with our findings here showing marked reduction in substance use among youth aged 13 to 20 years in 2020.”

The “massive shifts to social functioning” early in the pandemic led to abrupt discontinuations of data collection on national substance use, Compton and colleagues wrote in JAMA Network Open.

Due to the ensuing data gaps on “these markedly constrained surveillance activities,” the researchers conducted a cross-sectional study with 2016 to 2020 data from the Population Assessment of Tobacco and Health, which administered telephone surveys during the pandemic.

The 2020 sample consisted of 7,129 youths aged 13 to 17 years, 3,628 young adults aged 18 to 20 years, and 8,874 adults aged 21 years and older.

Compton and colleagues found that among youths aged 13 to 15 years and 16 to 17 years, the prevalence of any 30-day tobacco use increased between 2016 to 2019, while other substance and alcohol use did not increase or decrease. However, from 2018 and 2019 to 2020, the prevalence of past 30-day tobacco use declined from 6.9% to 2.6% among youth aged 13 to 15 years, and 19.5% to 9.2% among youth aged 16 to 17 years.

The prevalence of all substance use declined among youth, with cannabis use declining from 14.9% in 2018 and 2019 to 7.6% in 2020 (absolute difference; –7.3 percentage points; 95% CI, –8.8 to –5.8).

Among young adults, the prevalence of all substance use other than alcohol decreased from 2018 and 2019 to 2020. For example, the researchers noted a drop in the prevalence of tobacco use among young adults, from 37.8% to 22.8% (absolute difference, –15.1 percentage points; 95% CI, –16.8 to –13.3).

Among adults aged 21 to 24 years, tobacco use declined from 39% to 30.9% (absolute difference, –8.2 percentage points; 95% CI, –10.6 to –5.7), while alcohol use rose from 60.2% to 65.2% (absolute difference, 5 percentage points; 95% CI, 95% CI, 2.3-7.7).

“For adults 25 years or older, we found that drug use patterns were mixed — with past-month cannabis use increasing and tobacco use declining, for instance — which is also consistent with trends reported by the MTF survey for adults 35 to 50 years old in 2020 and 2021,” Compton said. “However, because of differences in data collection methods and sample size, comparisons between our study and other surveys on drug use should be made with caution.”

The researchers posed several possibilities for decreases in substance use, which included reduced peer interaction, increased parental supervision, young adults moving from college to home settings and fears of tobacco exacerbating COVID-19 pulmonary infections.

Compton also said that drug use likely increased in some populations while decreasing in others “based on the mix of risk and protective factors for different people posed by COVID-19.”

“Studies on differential rates of drug use for various age groups and populations during the pandemic are instrumental to our understanding of how healthcare crises, social disruptions, social determinants of health, and other factors may drive or hinder substance use for different people,” he said.

References:

• Adult substance use prevalence and trends. https://monitoringthefuture.org/wp-content/uploads/2022/08/mtfpanelchap3_2022.pdf. Accessed Feb. 14, 2023.
• College students & adults ages 19–60. https://monitoringthefuture.org/wp-content/uploads/2022/08/mtf-vol2_2020.pdf. Accessed Feb. 14, 2023.
• Compton W, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2022.54566.
• Layman H, et al. Curr Psychiatry Rep. 2022;doi:10.1007/s11920-022-01338-z.
• Percentage of adolescents reporting drug use decreased significantly in 2021 as the COVID-19 pandemic endured. https://nida.nih.gov/news-events/news-releases/2021/12/percentage-of-adolescents-reporting-drug-use-decreased-significantly-in-2021-as-the-covid-19-pandemic-endured. Published Dec. 15, 2021. Accessed Feb. 14, 2023.