Early Adolescent Substance Use Before and During the COVID-19 Pandemic: A Longitudinal Survey in the ABCD Study Cohort.

paper Cited Public

Authors: Pelham, William E; Tapert, Susan F; Gonzalez, Marybel Robledo; McCabe, Connor J; Lisdahl, Krista M; Alzueta, Elisabet; Baker, Fiona C; Breslin, Florence J; Dick, Anthony Steven; Dowling, Gayathri J; Guillaume, Mathieu; Hoffman, Elizabeth A; Marshall, Andrew T; McCandliss, Bruce D; Sheth, Chandni S; Sowell, Elizabeth R; Thompson, Wesley K; Van Rinsveld, Amandine M; Wade, Natasha E; Brown, Sandra A
Year: 2021
Journal: The Journal of adolescent health : official publication of the Society for Adolescent Medicine
PMID: 34452728
DOI: 10.1016/j.jadohealth.2021.06.015
PMCID: PMC8768966

Figure 1

Changes in rate of youth substance use from before to during the pandemic. Note. Based on subsample of youth (n = 1079). “Before pandemic” measurement from September 2019-January 2020. “During pandemic” measurement from COVID surveys, May-June 2020. Asterisks next to labels for alcohol, nicotine, and prescription drugs indicate that the changes from before pandemic to during pandemic were statistically significant (p < .05) for these substances. Use of “any substance” was collapsed across use of alcohol, nicotine, cannabis, prescription drugs, and inhalants. Analysis could not be conducted for vaping nicotine because prepandemic assessments did not measure smoking and vaping separately.

Figure 2

Associations between correlates measured before and during pandemic and youth use of any substance during pandemic. Note. Dots indicate estimated odds ratios, and horizontal bands indicate 95% confidence intervals (confidence intervals that exclude the value 1 indicate that the association was statistically significant, p < .05). Odds ratios were estimated in logistic regressions that covaried youth age and survey wave (Table S4). Odds ratios greater than one indicate positive associations; odds ratios lower than one indicate negative associations. Nondichotomous variables were rescaled to standard deviation units. For racial/ethnic identity, White youth served as reference level, and “other racial/ethnic identity” category included youth of Native Hawaiian, Pacific Islander, Alaskan Native, American Indian, and multiple races [23]. For schooling status/format, not completing any schooling served as reference level.

Figure 3

Statistically significant correlates of youth substance use during the pandemic. Note. Each panel depicts rate of youth substance use as a function of a different correlate. Association between correlate and youth use of any substance in past 30 days was statistically significant (p < .05) in all instances.

Figure 4

Associations with youth substance use during the pandemic that varied significantly by youth age. Note. Each panel depicts rate of youth substance use as a function of a different correlate. Interaction between each correlate and youth age in predicting youth use of any substance was statistically significant (p < .05) in all instances. Associations between prepandemic externalizing problems, parent alcohol use, youth perceived stress, and youth depressive symptoms were stronger among older youth. The interaction of parent frequency of alcohol use with youth age was no longer statistically significant after applying the false discovery rate (FDR) adjustment (p = .18).

#	Section	Preview
20	Results — Analysis 2: changes in substance use compared to before the pandemic	Using the pretest/posttest design, Figure 1 shows the change in rates of substance use from before…
21	Results — Analysis 2: changes in substance use compared to before the pandemic	The age-period design yielded convergent results (Figure S4). More 11-year-olds reported past-30-day…
22	Results — Analysis 3: correlates of substance use during the pandemic	Figure 2 shows the estimated associations. Table S4 reports the corresponding regressions.
23	Results — Analysis 3: correlates of substance use during the pandemic — Demographics and pre-existing psychopathology	Youth sex (p = 0.78) and race/ethnicity (ps = 0.11-0.55) were not associated with use of any…
24	Results — Analysis 3: correlates of substance use during the pandemic — Direct impacts of COVID-19	Youth were more likely to report use of any substance when endorsing greater levels of…
25	Results — Analysis 3: correlates of substance use during the pandemic — Direct impacts of COVID-19	(p = .13) was significantly associated with youth use of any substance. However, there was a…
26	Results — Analysis 3: correlates of substance use during the pandemic — Youth's stress and emotionality	Youth stress, anxiety, and depressive symptoms during the pandemic were all positively associated…
27	Results — Analysis 3: correlates of substance use during the pandemic — Parent's substance use	Youth were more likely to use any substance when parents drank alcohol more frequently (p = .02; RR…
28	Discussion	In a nationwide, sociodemographically diverse, prospective longitudinal sample of U.S. youth in…
29	Discussion	Our findings complement those of existing studies [12,13] by describing changes among a younger,…
30	Discussion	Our finding of increased nicotine use was in contrast to previous studies reporting reductions among…
31	Discussion	Youth had higher rates of substance use when in school (vs. out of school), whether that schooling…
32	Discussion	Youth in families who experienced loss of income or material hardship during the pandemic were more…
33	Discussion	We found that stress, depression, and anxiety were robustly associated with youth substance use,…
34	Discussion	Youths' worry about the virus itself (i.e., infection) was not associated with youth substance use,…
35	Discussion	This study had limitations. First, we compared substance use before versus during the pandemic…
36	Discussion	Strengths of this study include the nationwide sample and prospective longitudinal design. Rates of…

Name	Type
11-year-olds local	cohort
11-year-olds 2018/2019 (pre-pandemic) local	cohort
11-year-olds 2020 (pandemic) local	cohort
12-year-olds local	cohort
12-year-olds 2019 (pre-pandemic) local	cohort
12-year-olds 2020 (pandemic) local	cohort
ABCD 3.0 data release local	cohort
ABCD COVID-19 Survey First Data Release local	cohort
ABCD study	cohort
active e-cigarette users local	cohort
adolescents	cohort
alcohol	phenotype
Alcohol Use	phenotype
Alcohol use days per month local	phenotype
American Community Survey	cohort
anxiety	phenotype
any substance local	drug
Any substance local	drug
any substance use	phenotype
brain development	phenotype
Cannabis product local	drug
cannabis use	phenotype
Cannabis use times per day local	phenotype
chew local	drug
Chew local	drug
cigarettes	phenotype
Cigar/hookah/pipe local	drug
Community-based cohort local	cohort
concentrates local	drug
COVID-19 local	drug
COVID-19 pandemic local	phenotype
COVID-19-related uncertainty local	phenotype
depression	phenotype
depressive symptoms	phenotype
drug	drug
drug dependence	phenotype
drugs	drug
e-cigarette local	drug
economic support local	drug
Edible products local	drug
educational attainment	phenotype
electronic nicotine delivery system local	drug
Electronic nicotine delivery system local	drug
emotional support local	drug
externalizing disorders	phenotype
Extreme stress about uncertainty local	phenotype
families	cohort
General anxiety local	phenotype
hookah local	drug
Hookah local	drug
Household income loss due to COVID-19 local	phenotype
inhalants	drug
inhalant use local	phenotype
internalizing disorders	phenotype
Loss of Income local	phenotype
Material hardship local	phenotype
Material Hardship local	phenotype
medication	drug
misuse of prescription drugs local	phenotype
nationwide sample local	cohort
nicotine	drug
nicotine use	phenotype
Nicotine use times per day local	phenotype
Number of drinks local	drug
Older teens local	cohort
online schooling local	cohort
other drugs	drug
parental alcohol use	phenotype
parental education	phenotype
Parental education level local	phenotype
Parental Unmarried Status local	phenotype
Parent cannabis use local	phenotype
Parent drug use local	drug
Parent drunkenness frequency local	drug
Parent nicotine use local	phenotype
parents	cohort
Parents being married local	phenotype
Parent tobacco use local	drug
past-30-day alcohol use	phenotype
past-30-day nicotine use	phenotype
perceived stress	phenotype
pipe	drug
Potential for harm local	phenotype
Pre-existing Externalizing/Internalizing Psychopathology local	phenotype
Prescription drugs (misuse) local	drug
Prescription drugs (non‑prescribed) local	drug
schooling local	phenotype
school-related contact with peers local	phenotype
School-related peer contact local	phenotype
site	cohort
smokeless tobacco	phenotype
Smokeless tobacco/chew/snus local	drug
smoking flower local	drug
Smoking flower local	drug
smoking oils local	drug
Smoking oils or concentrates local	drug
snus	drug
Social distancing local	phenotype
stress	phenotype
substance	phenotype
substances	phenotype
substance use	phenotype
Survey wave local	cohort
tobacco cigar local	drug
Tobacco cigar local	drug
tobacco cigarette local	drug
unmarried parents local	phenotype
U.S. children aged 9/10 years local	cohort
U.S. youth cohort local	cohort
vaping local	drug
vaping flower local	drug
Vaping flower local	drug
Vaping nicotine local	drug
Vaping of nicotine local	phenotype
Vaping oils or concentrates local	drug
Worry about COVID-19 local	phenotype
Worry about infection local	phenotype
Younger subsamples local	cohort
Youth age local	phenotype
Youth alcohol use local	phenotype
Youth any substance use local	phenotype
Youth externalizing problems local	phenotype
Youth internalizing problems local	phenotype
Youth race/ethnicity local	phenotype
Youth sex local	phenotype
youth substance use	phenotype

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