Substance Use Among Teens Generally Holding Steady, Report Finds

Most types of substance use among teens held steady in 2022 after falling sharply in 2021, according to results released Thursday from a survey funded by the National Institute on Drug Abuse (NIDA).

Eleven percent of 8th graders, 21.5% of 10th graders, and 32.6% of 12th graders reported illicit drug use in the past year, NIDA’s Monitoring the Future survey showed. These proportions were similar to those from 2021, which represented a drop from the prior year. “Reported use for almost all substances decreased dramatically from 2020 to 2021 after the onset of the COVID-19 pandemic and related changes like school closures and social distancing,” the institute said in a press release.

“It is encouraging that we did not observe a significant increase in substance use in 2022, even as young people largely returned to in-person school, extracurricular activities, and other social engagements,” NIDA Director Nora Volkow, MD, noted.

The annual survey, conducted by researchers at the University of Michigan in Ann Arbor, looks at substance use behaviors and related attitudes among 8th, 10th, and 12th graders in the U.S. Students self-report their substance use behaviors over various time periods, such as the past 30 days, the past 12 months, and over their lifetime. The survey also documents students’ perceptions of harm, disapproval of use, and perceived availability of drugs. For the 2022 survey, investigators collected 31,438 surveys from students enrolled across 308 public and private schools.

Among high school seniors, the survey found that 31% used marijuana in the past 12 months. “These levels are significantly lower than they were during the pre-pandemic years of 2020 and 2019, when prevalence levels were 35% and 36%, respectively,” the investigators wrote. “The decline from 35% in 2020 to 31% in 2021 is the largest one-year decline among 12th grade students ever recorded in the 48 years of the survey for this measure.”

The percentage of 12th grade students who vaped nicotine within the last 12 months in 2022 was 27%, as it was in 2021. As with marijuana use, these numbers represent a significant drop from 2020 and 2019, when the prevalence level was 35% in both years. Also, as with marijuana, “the decline from 35% in 2020 to 27% in 2021 is the largest one-year decline recorded for 12th grade students since the survey began tracking nicotine vaping in 2017,” they noted.

Use of alcohol in this group took a different trajectory from marijuana and nicotine, with the percentage of 12th grade students who used alcohol within the last 12 months hitting 52%, a statistically significant increase from the 2021 level of 47%, the researchers found. “With this increase, prevalence in 2022 returned to pre-pandemic levels and does not significantly differ from the 55% level recorded in 2020 (or the 52% level of 2019).”

The researchers also looked at use of prescribed attention deficit-hyperactivity disorder (ADHD) medications and found that among 12th grade students, use rose significantly in 2022 — to 15% — from 11% in 2021. “It is possible that the need for treatment of ADHD increased during the pandemic due to adolescents experiencing more stress,” they said. “Another possibility is that sheltering at home during the pandemic may have made any attention issues of adolescents more salient to their parents, who then sought out medical care for their children.”

As for the steady state of marijuana and nicotine use, they posited two different possibilities. “First, it is possible that the factors that disrupted and lowered drug use during the pandemic in 2021 continued into 2022,” the investigators wrote. “These include disruptions in adolescents’ ability to use drugs outside of parental supervision, to obtain drugs, and to interact with friends who use drugs and may encourage drug use.”

“Second, an alternative scenario is that a one-year delay or halt in drug use during adolescence may lower adolescents’ drug use levels for the rest of their lives,” they continued. “This could occur if absence of drug use reduces involvement with peer groups that encourage the use of drugs, and/or these adolescents have been spared psychological or neurological changes that increased their susceptibility for future drug use. In future years we will be able to see which of these two scenarios plays out.”

Rahul Gupta, MD, MPH, director of the White House Office of National Drug Control Policy, praised the survey results. “I am encouraged by today’s data that show the vast majority of young people are continuing to avoid substance use,” he said in a statement Thursday. “At the same time, it is imperative that we continue to invest in evidence-based prevention strategies and raise awareness about the risks to youth of illicit drugs, including fake pills and marijuana, since we know perceived risk can play an important role in youth prevention.”