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Reported drug use among adolescents continued to hold below pre-pandemic levels in 2023

New data show relatively low use of illicit substances, yet overdose death rates among teens have risen in recent years

Reports and Proceedings

NIH/NATIONAL INSTITUTE ON DRUG ABUSE

The percentage of adolescents reporting they used any illicit substances in 2023 continued to hold steady below the pre-pandemic levels reported in 2020, with 10.9% of eighth graders, 19.8% of 10th graders, and 31.2% of 12th graders reporting any illicit drug use in the past year, according to the latest results from the Monitoring the Future survey. Reported use for almost all substances decreased dramatically between 2020 and 2021, after the onset of the COVID-19 pandemic and related changes like school closures and social distancing. In 2022, most reported substance use among adolescents held steady at these lowered levels, and these latest data show that this trend has continued into 2023.

The Monitoring the Future survey is conducted by researchers at the University of Michigan, Ann Arbor, and funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. 

The 2023 data continue to document stable or declining trends in the use of illicit drugs among young people over many years. However, importantly, other research has reported a dramatic rise in overdose deaths among teens between 2010 to 2021, which remained elevated well into 2022 according to a NIDA analysis of CDC and Census data. This increase is largely attributed to illicit fentanyl, a potent synthetic drug, contaminating the supply of counterfeit pills made to resemble prescription medications. Taken together, these data suggest that while drug use is not becoming more common among young people, it is becoming more dangerous.

“Research has shown that delaying the start of substance use among young people, even by one year, can decrease substance use for the rest of their lives. We may be seeing this play out in real time,” said Nora Volkow, M.D., NIDA director. “This trend is reassuring. Though, it remains crucial to continue to educate young people about the risks and harms of substance use in an open and honest way, emphasizing that illicit pills and other substances may contain deadly fentanyl.”

The Monitoring the Future survey is given annually to students in eighth, 10th, and 12th grades who self-report their substance use behaviors over various time periods, such as past 30 days, past 12 months, and lifetime. The survey also documents students’ perceptions of harm, disapproval of use, and perceived availability of drugs. The survey results are released the same year the data are collected. From February through June 2023, the Monitoring the Future investigators collected 22,318 surveys from students enrolled across 235 public and private schools in the United States.

When breaking down the data by specific drugs, the survey found that adolescents most commonly reported use of alcohol, nicotine vaping, and cannabis in the past year, and levels generally declined from or held steady with the lowered use reported in 2022. Compared to levels reported in 2022, data reported in 2023 show: 

• Alcohol use remained stable for eighth and 10th graders, with 15.1% and 30.6% reporting use in the past year respectively, and declined for 12th graders, with 45.7% reporting use in the past year (compared to 51.9% in the previous year).
• Nicotine vaping remained stable for eighth graders, with 11.4% reporting vaping nicotine in the past year. It declined in the older grades, from 20.5% to 17.6% in 10th grade and from 27.3% to 23.2% in 12th grade. 
• Cannabis use remained stable for all three grades surveyed, with 8.3% of eighth graders, 17.8% of 10th graders, and 29.0% of 12th graders reporting cannabis use in the past year. Of note, 6.5% of eighth graders, 13.1% of 10th graders, and 19.6% of 12th graders reported vaping cannabis within the past year, reflecting a stable trend among all three grades.
• Delta-8-THC (a psychoactive substance found in the Cannabis sativa plant, of which marijuana and hemp are two varieties) use was measured for the first time in 2023, with 11.4% of 12th graders reporting use in the past year. Beginning in 2024, eighth and 10th graders will also be asked about Delta-8 use.
• Any illicit drug use other than marijuana also remained stable for all three grades surveyed, with 4.6% of eighth graders, 5.1% of 10th graders, and 7.4% of 12th graders reporting any illicit drug use other than marijuana in the past year. These data build on long-term trends documenting low and fairly steady use of illicit substances reported among teenagers – including past-year use of cocaine, heroin, and misuse of prescription drugs, generally.
• Use of narcotics other than heroin (including Vicodin, OxyContin, Percocet, etc.) decreased among 12th graders, with 1.0% reporting use within the past year (matching the all-time low reported in 2021 and down from a high of 9.5% in 2004).
• Abstaining, or not using, marijuana, alcohol, and nicotine increased for 12th graders, with 62.6% reporting abstaining from any use of these substances over the past month. This percentage remained stable for eighth and 10th graders, with 87.0% and 76.9% reporting abstaining from any use of marijuana, alcohol, and nicotine over the past month.

“For 49 consecutive years, the Monitoring the Future survey has closely monitored shifts in substance use trends among young people, helping to identify and track emerging trends with public health relevance,” said Richard A. Miech, Ph.D., team lead of the Monitoring the Future study at the University of Michigan. “This year’s addition of a measure to assess use of delta-8 is one example of this, and we were surprised to see use levels this high among 12th graders. Moving forward, as policies and access to this drug change, it will be important to continue to monitor use of this drug among teens.”

Though the sample size of 22,318 respondents in 2023 was lower than the sample size of a typical pre-pandemic year’s data collection, the results were gathered from a nationally representative sample, and the data were statistically weighted to provide national numbers. This year, 13% of students who took the survey identified as Black or African American, 1% as American Indian or Alaska Native, 3% as Asian, 25% as Hispanic, 1% as Middle Eastern, 41% as white, and 16% as more than one of the preceding categories. The survey also asks respondents to identify as male, female, other, or prefer not to answer. For the 2023 survey, 48% of students identified as male, 47% identified as female, 1% identified as other, and 4% selected the “prefer not to answer” option. 

The Monitoring the Future investigators note that schools opt-in to participate in the survey, and some schools that had historically participated opted-out in the years following the onset of the COVID-19 pandemic. All participating students took the survey via the web – either on tablets or on a computer – with 98% of respondents taking the survey in-person in school in 2023. Therefore, students with less engagement in school – a known risk factor for drug use – may have been less likely to participate in the survey.

The 2023 Monitoring the Future data tables highlighting the survey results are available online from the University of Michigan. 

For more information on substance and mental health treatment programs in your area, call the free and confidential National Helpline 1-800-662-HELP (4357) or visit www.FindTreatment.gov. 

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About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

About substance use disorders: Substance use disorders are chronic, treatable conditions from which people can recover. In 2022, nearly 49 million people in the United States had at least one substance use disorder. Substance use disorders are defined in part by continued use of substances despite negative consequences. They are also relapsing conditions, in which periods of abstinence (not using substances) can be followed by a return to use. Stigma can make individuals with substance use disorders less likely to seek treatment. Using preferred language can help accurately report on substance use and addiction. View NIDA’s online guide.

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