Most substance use down in 2021 among high schoolers

Key takeaways:

• Substance use among high schoolers dropped from 2009 to 2021.
• Lifetime inhalant use increased from 2019 to 2021.
• About 34% of high schoolers currently using a substance reported co-use with another substance.

The prevalence of substance use among high school students was lower in 2021 compared with that in 2009 and 2019, although lifetime inhalant use was up from 2019, findings in the Morbidity and Mortality Weekly Report Supplement showed.

Brooke E. Hoots, PhD, of the CDC’s National Center for Injury Prevention and Control Division of Overdose Prevention, and colleagues analyzed data from the biennial Youth Risk Behavior Survey (YRBS) to estimate the prevalence of current — meaning within the past 30 days — and lifetime substance use among high school students.

The YRBS identified current alcohol use, marijuana use, binge drinking and prescription opioid misuse, as well as lifetime use of alcohol, marijuana, synthetic marijuana, inhalants, ecstasy, cocaine, methamphetamine, heroin and injection drugs and prescription opioid misuse.

Overall, 29% of students reported current alcohol or marijuana use or prescription opioid misuse, and 34% of those reporting any current substance use reported using two or more substances.

Compared with 2009 or the year first recorded, all substance use in high schoolers was significantly lower in 2021. For example, current alcohol use decreased from 41.8% to 22.7%, current marijuana use decreased from 20.8% to 15.8%, lifetime alcohol use decreased from 68.4% to 47.4%, lifetime marijuana use decreased from 36.8% to 27.8% and lifetime cocaine use decreased from 6.4% to 2.5%.

Similarly, current alcohol and marijuana use and binge drinking, as well as lifetime alcohol, marijuana and cocaine use and prescription opioid misuse decreased from 2019 to 2021. However, there were no differences in current prescription opioid misuse and lifetime ecstasy, methamphetamine, heroin, injection drug and synthetic marijuana use between those years. Notably, use of inhalants rose from 6.4% to 8.1% from 2019 to 2021, the researchers wrote.

“Youth substance use has declined over the past decade, including during the COVID-19 pandemic; however, substance use remains common among U.S. high school students, and continued monitoring is important in the context of the changing marketplaces for alcohol beverage products and other drugs,” Hoots and colleagues wrote. “Scaling-up tailored, evidence-based policies, programs and practices to reduce factors that contribute to risk for adolescent substance use and promote factors that protect against risk might help build on recent declines.”