Substance use declined in youth despite COVID-19 stressors


A study examining the COVID-19 pandemic finds that substance use declined substantially across nearly all categories in 2018-2019 vs 2020 among youth and young adults.

A recent analysis from a nationally representative sample of youth and adults evaluated whether substance use prevalence in the early part of the COVID-19 pandemic in 2020 differed from the prepandemic periods of 2018-2019 and 2016 to 2018 in the US.

The study found that substance use substantially decreased across nearly all categories in 2018-2019 compared with 2020, among youth and young adults. Reductions in youth, but not adults during this period of social isolation could partially reflect youth-specific sensitivity to peer influences on substance use.

Despite significant stressors during 2020, substance use declined in youth, the findings suggested. However, differences in data collection methods may have contributed to observed changes, so the findings should be interpreted with caution, investigators stated. In the older adult population, no consistent changes were observed.

Substance Use During the Pandemic Across Age Groups

The study population representative of the US civilian noninstitutionalized population. Wilson Compton, MD, National Institute on Drug Abuse, National Institutes of Health, and investigators, evaluated the 30 previous days of self-reported use of tobacco, alcohol, binge drinking, cannabis, and any other illegal or misused prescription drugs.

After comparing 2018-2019 with 2020 among youth, investigators observed the prevalence of all substances used declined. Results showed cannabis use decreased in those aged 16-17 years from 14.9% to 7.6%, while tobacco use declined from 37.8% to 22.8% among young adults.

In adults between the ages of 21-24 years, tobacco use declined from 39% to 30.9%, while alcohol use increased from 60.2% to 65.2%. Again, when looking at those aged 25 years or older, showed a decrease in tobacco use from 39% to 30.9%, while cannabis use increased from 11.3% to 12.4%. Other substance use declined from 5.8% to 3.7% in this adult population.

The Cross-Sectional Study

The study included a sample of 19,631 individuals, comprising 7129 youth between the ages of 13-17 years, 3628 young adults aged 18-20 years, and 8874 adults over the age of 21. Household residents aged 13 years or older were interviewed in person from 2016-2019, and by telephone in 2020.

Investigators noted some limitations. The data collection method changed in 2020 due to the pandemic, which may have affected the final results. The investigation was also limited to self-reported data, which may be subject to bias. In addition, the study didn’t include an evaluation on whether changes in substance use were related to the pandemic, and the study didn’t assess changes in substance use after mid-March 2020.

Despite these limitations, the study provided valuable insights into substance use during the COVID-19 pandemic, investigators acknowledged. Substance use has been a significant public health concern in the US, and the pandemic has raised concerns that substance use may increase as a result of stress, anxiety, and social isolation.

In conclusion:

The demonstrated data may have implications for public health policy and intervention, according to the study. The reduction in substance use in youth during the pandemic could suggest that interventions aimed at reducing peer influences on substance use, such as social norms campaigns, might be effective.

Further research is needed to comprehensively understand the factors driving the changes in substance use during this period, and to develop targeted interventions to reduce substance use in all age groups. Overall, the results highlighted the importance of continued monitoring of substance use trends in the US to inform public health policy and intervention.

This article was initially published by our sister publication HCP Live.


Compton WM, Flannagan KSJ, Silveira ML, et al. Tobacco, Alcohol, Cannabis, and Other Drug Use in the US Before and During the Early Phase of the COVID-19 Pandemic. JAMA Netw Open. 2023;6(1):e2254566. doi:10.1001/jamanetworkopen.2022.54566

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