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How Adolescents Used Drugs During the COVID-19 Pandemic

Alcohol use declined, but use of nicotine and misuse of prescription drugs rose


  • Scott LaFee

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  • Scott LaFee

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The advent of the COVID-19 pandemic, which began in earnest in the United States in early 2020, affected different demographic groups in different ways. According to a new study, among adolescents ages 10 to 14 in the U.S., the overall rate of drug use remained relatively stable in the first six months of the COVID-19 pandemic. However, one change was a decreased use of alcohol, but an increased use of nicotine and misuse of prescription drugs.

The findings, publishing in the August 24, 2021 issue of the Journal of Adolescent Health, are derived from the ongoing Adolescent Brain Cognitive Development (ABCD) study, the largest long-term study of brain development and child health ever conducted in the United States.

“The COVID-19 pandemic has produced sustained disruptions to several domains of adolescents’ lives, including alcohol and drug use,” said first author William Pelham III, PhD, a postdoctoral scholar in the Center for Human Development at UC San Diego. “Thus, surveillance of adolescent substance use is an important public health priority.”

The ABCD study, which began in 2015 with central components and leadership from UC San Diego, is following almost 12,000 children for at least 10 years, starting at ages 9 to 10. Researchers will track the children’s biological and behavioral development through adolescence into young adulthood.

In the current paper, researchers monitored 7,842 adolescents and their families at 21 sites across the United States for six months following the first issuing of stay-at-home orders. In multiple surveys, the participants were asked to describe their substance use, including alcohol, tobacco and un-prescribed drugs.

Surveys also assessed youth’s intensity of worry about COVID-19 and measured related stressors, such as educational disruptions, loss of jobs or hardships within their families.

Survey responses were adjusted so that ABCD participants reflected the demographics of same-age youth across the United States. Substance use among surveyed adolescents was stable during the first six months of the pandemic: 8 percent reported using a substance in the past 30 days; 3.4 percent reported using alcohol; 3.6 percent reported using nicotine.

Compared to pre-pandemic behavior, use of alcohol declined, but use of nicotine or misuse of prescription drugs increased, perhaps, suggested researchers, because the latter are easier to hide when families were locked down together.

In families that experienced loss of income or material hardship during the pandemic, substance use among youth was higher. Heightened stress, depression and anxiety were all robustly associated with youth substance abuse.

“Taken together, these findings underscore the disproportionate burden of the pandemic on youth and families with pre-existing disadvantages,” said Pelham. “Providing material support to distressed families and linking emotionally distressed youth to support may serve as important risk-mitigation strategies, both today and during similar events in the future.”

“Continued surveillance of adolescents’ alcohol and drug use as many adolescents return to their pre-pandemic routines will comprise an important public health priority and goal of the ABCD Study.”

Co-authors of this study include: Susan F. Tapert, Marybel R. Gonzalez, Connor J. McCabe, Wesley K. Thompson, Natasha Wade and Sandra A. Brown, UC San Diego; Krista M. Lisdahl, University of Wisconsin at Milwaukee; Elisabet R. Alzueta and Fiona C. Baker, SRI International; Forence J. Breslin, Laureate Institute for Brain Research; Anthony Steven Dick, Florida International University; Gayathri J. Dowling and Elizabeth A. Hoffman, National Institute on Drug Abuse; Mathieu Guillaume, Bruce D. McCandliss and Amandine M. Van Rinsveld, Stanford University; Andrew T. Marshall and Elizabeth R. Sowell, University of Southern California; Chandni S. Sheth, University of Utah.

Funding for this research came, in part, from the National Institute on Drug Abuse, part of the National Institutes of Health, (grants U01DA041048, U01DA050989, U01DA051016, U01DA041022, U01DA051018, U01DA051037, U01DA050987, U01DA041174, U01DA041106,U01DA041117, U01DA041028, U01DA041134, U01DA050988, U01DA051039,U01DA041156, U01DA041025, U01DA041120, U01DA051038, U01DA041148,U01DA041093, U01DA041089, U24DA041123 and U24DA041147) and federal partners, the National Science Foundation (NSF 2028680) and Children and Screens: Institute of Digital Media and Child Development Inc.

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