Many Questions Remain About Youth Substance Use Trends

December 15, 2020

The following is from the web blog of Dr. Nora Volkow, Executive Director of NIDA.

The results of the 2020 Monitoring the Future (MTF) survey of drug use and attitudes in middle and high school students were released today, with the encouraging news that the alarming rises in teen vaping both of nicotine and marijuana seen in prior years had leveled off, although use remained high. But as with so many other efforts in 2020, the MTF survey was impacted by the COVID-19 pandemic. And we are left at the end of this tumultuous year with many questions about how circumstances have affected youth, their substance use, and their mental health more generally.

The MTF survey is ordinarily conducted from February until May, with the results released later the same year. This year, schools closed in mid-March before the majority of the students could be surveyed, leaving the University of Michigan researchers who conduct the survey with a smaller-than-usual sample—11,821 students in 112 schools. Although only a quarter the size of the usual sample, it remained nationally representative and contained much valuable data.

Generally, the 2020 MTF showed continued low levels of most forms of substance use among teens, including very low levels of opioid use despite the devastating effects opioids have had on all older age groups including young adults. However, there are other indications that the evolving addiction and overdose crisis is directly affecting youth. For example, a study by CDC researchers just published in the Journal of Pediatrics shows increases in suspected nonfatal overdoses involving stimulants (a category that includes prescription stimulants, cocaine, and methamphetamine) in children and teens between 2016 and 2019. MTF shows decreases in use of prescription stimulants in 10th and 12th graders but a trend toward increased use among 8th graders. It will be important to closely monitor adolescent stimulant use in future MTF surveys.

The MTF data collected at the beginning of this year reflect a certain point of relative normality before the COVID-19 pandemic threw all our lives into upheaval, including the lives of teens. As we seek to understand adolescent substance use in this new reality, we look to research to answer many important questions on how the stresses of the pandemic may have affected substance use by teens. For example, it is important to investigate the consequences of social distancing and virtual classes on adolescent drug experimentation and use, since those are strongly influenced by peer pressure and group dynamics. NIDA has issued supplemental funds to existing grantees to help study the impact of the pandemic on adolescents’ risk of substance use; their access to prevention and treatment services; and the pandemic’s effects on families. Future research, including the results of next year’s MTF survey, can help us understand how school closures and lockdowns affected adolescent substance use.  

Although research has suggested that the pandemic’s stresses have increased many forms of substance use in adults, it remains to be seen whether reduced ability to interact with peers or other sources of drugs may be a mitigating factor in youth. There is already evidence that reduced commercial availability of vape products during the pandemic may be affecting teen vaping. Researchers at Stanford and University of California San Francisco captured self-reported vaping habits of 2,167 teen and young-adult e-cigarette users in May, two months after the national emergency was declared and after MTF stopped gathering data for the 2020 survey. Over half of the respondents reported changing their use of vaping products, with 68 percent of those reporting that they had reduced their use or quit. Inability to purchase the products was one reason cited.

2020 has posed many urgent questions for science. Finding out the different ways the pandemic and other stresses of the year have affected young people is a high priority. Adolescence is an important period of social and emotional development, and the pandemic has disrupted many of the processes that impact that development. NIDA research has pivoted to ensure we address this unique time in history as we pursue scientific solutions to the impacts of drug use and addiction across the lifespan.

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