Substance use among teens dropped significantly in 2021, survey finds

By Deidre McPhillips, CNN

Substance use among teens — including alcohol, marijuana, vaping and illicit drugs — dropped significantly in 2021, according to the National Institute on Drug Abuse’s latest Monitoring the Future survey, published Wednesday.

The researchers found the largest single-year decline in illicit drug use since the survey began in 1975, with drops of about 5% from 2020 among eighth- and 12th-graders and nearly 12% among 10th-graders.

While vaping remains the most common method of nicotine consumption among adolescents, the share of students who report vaping nicotine within the past year dropped significantly, from 17% of eighth-graders in 2020 to 12% in 2021, from 31% to 20% among 10th-graders, and from 35% to 27% among 12th-graders.

“These data are unprecedented and highlight one unexpected potential consequence of the COVID-19 pandemic, which caused seismic shifts in the day-to-day lives of adolescents,” said Dr. Nora Volkow, director of the institute.

“Moving forward, it will be crucial to identify the pivotal elements of this past year that contributed to decreased drug use — whether related to drug availability, family involvement, differences in peer pressure, or other factors — and harness them to inform future prevention efforts.”

A follow-up survey of 12th-graders found that marijuana use and binge drinking did not change significantly in the first six months of the Covid-19 pandemic, despite a record decline in perceived availability of the substances in 2021.

“These results challenge the idea that reducing adolescent use of drugs can be achieved solely by limiting their supply,” the researchers wrote.

But overall alcohol use among adolescents declined compared with 2020: from 55% to 47% among 12th-graders, from 41% to 29% among 10th-graders and from 21% to 17% among eighth-graders, according to the survey.

The 2021 survey also asked students about their mental health during the pandemic. Students across all age groups reported increases in negative feelings, including boredom, anxiety, depression, loneliness and worry.

This decline in mental health would typically increase risk of substance use, but the pandemic shifted social interactions in a way that probably limited the effects, Volkow told CNN.

“We are uncertain what will happen once isolation is removed and social life returns, whether that state of depression and loneliness disappears or lingers,” she said. “It is important that we go out with our eyes wide open. If we are not proactive in doing prevention, I suspect numbers in drug taking among adolescents will go back to what they were before the emergency declaration of the pandemic. They could even get worse because of the deterioration of mental health that puts them at risk.”

And these record declines in drug use among teens come just a month after the US Centers for Disease Control and Prevention reported a record number of overdose deaths.

Volkow says that she’s been closely watching trends in the use of opioids among adolescents. Less than 1% of adolescents reported taking OxyContin in 2021, from about 5% of 12th-graders a decade ago. Heroin use is also the lowest it’s ever been, along with methamphetamines, according to the new survey.

And even a year of reduced exposure is a positive thing, she said.

“Delaying drug taking by teenagers significantly improves the likelihood that they will not be exposed and decreases their risk of becoming addicted. There is potential long-term benefit.”

The study’s lead investigator, Dr. Richard Miech, said “we knew that this year’s data would illuminate how the COVID-19 pandemic may have impacted substance use among young people, and in the coming years, we will find out whether those impacts are long-lasting as we continue tracking the drug use patterns of these unique cohorts of adolescents.”

The Monitoring the Future survey is conducted annually among students in eighth, 10th and 12th grades. Between February and June 2021, more than 32,000 surveys were collected by researchers at the University of Michigan.

Fewer students participated this year than in prior years, and 60% conducted the survey while at home for virtual schooling. The researchers note that this shift in location is a limitation of the survey, as different privacy levels may lead some students to not feel as comfortable responding as truthfully as they would otherwise.

Evidence-based prevention strategies emphasize the importance of open dialogue, Volkow told CNN.

“It is important that parents initiate those conversations during childhood — or with teens, better late than never — not with a critical attitude but in terms of an objective of understanding.”

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