Repeated surveys of more than 7,800 people ages 10 to 14 conducted between September 2019 and August 2020 showed that the overall rate of drug use among these young adolescents remained relatively stable before and during the first six months of the COVID-19 pandemic. However, researchers detected shifts in the drugs used, with alcohol use declining and use of nicotine products and misuse of prescription medications increasing. Adolescents who experienced pandemic-related severe stress, depression, or anxiety, or whose families experienced material hardship during the pandemic, were most likely to use substances.
The study, which published today in the Journal of Adolescent Health, was funded by the National Institute on Drug Abuse (NIDA) and nine other institutes, centers, and offices that are part of the National Institutes of Health. The analysis used data from the ongoing Adolescent Brain Cognitive DevelopmentSM (ABCD) Study, the largest long-term study of brain development and child health ever conducted in the United States.
“The past year has been difficult, and adolescents have experienced a year of turmoil and stress in precarious space between childhood and adulthood. Recognizing how the stress of the past year translates into substance use has profound implications into adulthood, because drinking and drug use at these ages are associated with a substantially higher risk of long-term alcohol and drug use disorders and related harms,” said NIDA Director Nora D. Volkow, M.D. “Because the ABCD Study had already been following this diverse, young population, researchers were able to make direct comparisons between trends in substance use before and during the pandemic, emphasizing the value of investing in long-term, collaborative research projects.”
Several studies previously determined that older adolescents’ substance use held steady or even declined during the pandemic. However, most of these analyses were done earlier in the pandemic, and no data existed on the pandemic’s influence on younger adolescents, particularly after an extended period of COVID-19–related disruptions of daily lives.
To fill this gap, the research team conducted three surveys in the six months following the initiation of stay-at-home orders—in May, June, and August 2020—with more than 7,800 ABCD Study participants ages 10 to 14 and their families participating in at least one survey. They assessed the adolescents’ use of alcohol, nicotine products, cannabis, and other drugs, misuse of prescription drugs, as well as numerous general and pandemic-related factors that could influence substance use.
The study found that overall substance use in this age group remained relatively stable across the three surveys and occurred infrequently. Across all three surveys, 8% of the adolescents reported any substance use in the past 30 days. Alcohol and nicotine use were most common (3.4% and 3.6% of the adolescents, respectively), whereas rates of misuse of prescription drugs and use of cannabis, inhalants, or other drugs were low (1.1% of adolescents or less). Most youth reported using only one substance and only on one to two days per month.
The researchers also found that youth stress, anxiety, and depressive symptoms were all positively associated with the use of any substance, and that several pandemic-related factors increased adolescents’ likelihood of substance use. For example, youth who reported feeling “extreme” stress from the uncertainty associated with the pandemic were 2.4 times more likely to use any substance than youth who reported “very slight” stress.
For a subset of 1,079 participants, researchers were able to link assessments taken after the onset of the COVID-19 pandemic to assessments that had been completed during the months immediately before the pandemic. Importantly, for this subsample of youth, the overall rate of drug use did not increase significantly after the beginning of the pandemic compared to before the pandemic.
However, shifts occurred in the types of substances used. Alcohol use decreased, shifting from 1.9% of youth reporting alcohol use in the past 30 days in the surveys taken before the pandemic, to only 0.7% in the first survey during the pandemic. Conversely, nicotine use and prescription drug misuse increased, with 0% of youth reporting use of nicotine or misuse of prescription drugs in the past 30 days in the surveys taken before the pandemic, compared to 1.5% and 0.7% respectively in the first survey during the pandemic.
“These data suggest substance use during the pandemic was concentrated among youth from the most vulnerable families, underscoring the need to provide support to those young people and their families,” said William E. Pelham, Ph.D., of the University of California, San Diego, who led the study. “But we should also look forward, beyond the 2020 data, to understand how alcohol and drug use will continue to evolve as people return to school and work. By continuing to follow these young people for five or six more years through the ABCD Study, we can help determine the pandemic’s full impact on America’s youth and care for their health and wellbeing.”
The authors note that the study does not directly test or explain why the changes in the drugs used occurred, and additional analyses are needed to determine the mechanisms underlying these trends. Earlier findings from a different study reported steady rates of substance use in older adolescents. Continued research to understand substance use trends during and following the outset of the COVID-19 pandemic are needed for all age groups and across demographics.
Reference: WE Pelham III, SF Tapert, MR Gonzalez, et al. Early adolescent substance use before and during the COVID-19 pandemic: A longitudinal survey in the ABCD Study cohort. Journal of Adolescent Health. DOI: 10.1016/j.jadohealth.2021.06.015 (2021).
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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.
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JOURNAL
Journal of Adolescent Health
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
Not applicable
ARTICLE TITLE
Early adolescent substance use before and during the COVID-19 pandemic: A longitudinal survey in the ABCD Study cohort
ARTICLE PUBLICATION DATE
24-Aug-2021
How adolescents used drugs during the COVID-19 pandemic
Alcohol use declined, (LESS SOCIALIZING) but use of nicotine and misuse of prescription drugs rose
Peer-Reviewed PublicationUNIVERSITY OF CALIFORNIA - SAN DIEGO
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 United State, 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.”
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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.
JOURNAL
Journal of Adolescent Health
