Teenage drug, alcohol and nicotine use declined dramatically from 2020 to 2021, according to the U.S. National Institute on Drug Abuse’s (NIDA) annual Monitoring the Future (MTF) survey. Overall, the drop-off in illicit drug use was the most significant NIDA has seen in a single year since it began MTF in 1975.
“It is really in all categories that we are seeing that, in terms of drops from one year to the other,” says NIDA Director Dr. Nora Volkow.
Many forms of drug, alcohol and tobacco use have been declining among U.S. teenagers for years, and the pandemic seems to have accelerated those trends. That may be surprising, given worrying upticks observed among adults. More than 100,000 people in the U.S. (most of them adults) died of drug overdoses from May 2020 to April 2021, and studies have also shown that adult alcohol use is up.
Plus, like adults, teenagers’ mental health has suffered during the pandemic. In 2021, MTF respondents reported moderate increases in anxiety, depression, boredom, loneliness, worry and difficulty sleeping—all of which would seem to predict a jump in substance use.
And yet, the opposite has been true for young people. Volkow thinks that’s in large part because pandemic restrictions (and time spent at home with parents) eliminated some opportunities for social drinking or drug use. Indeed, MTF data show that there were larger drop-offs in past-month or past-year use of substances, rather than daily use. That suggests a significant decrease in casual drug use in 2021, Volkow says.
Even with the declines, alcohol remains the most commonly used illegal substance among U.S. teenagers. About 47% of 12th graders and 29% of 10th graders said they consumed alcohol in the past year, compared to 55% and 41% in 2020.
Teen vaping is also down from its peak a couple years ago, as U.S. Centers for Disease Control and Prevention data have also shown. In the MTF survey, about 27% of 12th graders and 20% of 10th graders said they’d vaped nicotine in the past year, compared to almost 35% and 31% in 2020.
Similar numbers of students said they’d used marijuana in some form in the past year. But few reported using illicit drugs other than marijuana—just 7% of seniors and 5% of sophomores, down from about 11% and 9% in 2020.
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Traditional cigarette use also remains rare among teenagers, with just 4% of seniors and 2% of sophomores saying they’d smoked in the past 30 days.
While those figures are encouraging, the researchers did warn that pandemic-era data collection comes with drawbacks. NIDA, along with researchers from the University of Michigan, conducts MTF each year, surveying thousands of eighth, 10th and 12th graders across the country. For the 2021 version, the roughly 32,000 respondents filled out the survey online—some at school and some at home.
That may have skewed the results somewhat, since teenagers may feel uncomfortable honestly reporting their substance use when their parents are nearby, the researchers warn. Students who are not engaged with schoolwork—which is considered a risk factor for drug use—may also have been less likely to take the survey if they were learning remotely, and thus may have been underrepresented in the group.
It’s also possible, Volkow says, that some of this progress may be erased in future years, as pandemic restrictions ease and life inches closer to normal. “I am concerned that, if we are not proactive in trying to do prevention, we will get back to the numbers that we had before,” Volkow says. “We can [maintain this year’s] numbers if we are able to provide strong education and training for teenagers, and provide them with alternative behaviors.”
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