Substance use among adolescents, which declined precipitously amid the social distancing and isolation brought about by the COVID-19 pandemic, continues to remain remarkably low years after the pandemic’s restrictions have waned.
A newly released report funded by the National Institutes of Health (NIH) and undertaken by researchers at the University of Michigan, Ann Arbor, shows adolescent substance use has held steady at lower levels for the past four years in a row—an accomplishment NIH officials call unprecedented.1
What’s more, this trend is taking place across almost all measured substance categories including, alcohol, nicotine, and cannabis. It’s a development researchers say requires further investigation to determine what’s driving such success.
But these same experts already have a few theories about why adolescents continue to avoid substance use in such large numbers.
NIH Report Findings on Adolescent Substance Use
Since 1975, the NIH has been providing research grants for an annual Monitoring the Future Survey, which is given to students in eighth, 10th, and 12th grades who self-report their substance use behaviors. And for the past 15 years running, this survey has shown that substance use across these age groups has been trending downward, Nora D. Volkow, MD, director of NIH’s National Institute on Drug Abuse (NIDA), tells Parents.
But in an unexpected development, that downward trajectory accelerated dramatically between 2020 and 2021, which were of course, the first years of the COVID-19 pandemic.
“The trend was that substance use was going downward slowly and then COVID comes along and there’s a sharp decline in drug use,” Dr. Volkow explains. “So, it was not just a continuation of the trending down, but an acceleration of that trending down. And it’s likely that a key contributor was that kids were no longer in the physical presence of other kids.”
In other words, the peer pressure that is fundamental to drug experimentation and ongoing drug use among adolescents, was no longer present, explains Dr. Volkow. Kids being required to distance from each other, including no longer hanging out at school, at parties, or even at football games, meant substance use became less prevalent almost overnight.
Fast forward to 2022 and 2023, when daily life increasingly returns to normal and surprisingly, reduced substance use continues to hold steady, which is not what researchers were expecting. And the latest survey data, from 2024, shows once again that those lowered levels of substance use are remaining firmly in place, as opposed to reversing course and heading back upward.
“It is unprecedented how low the levels of drug use are in teenagers right now in the United States,” says Dr. Volkow. “It’s the lowest that we’ve ever recorded since the inception of Monitoring the Future in 1975. It is unprecedented how less and less teenagers are using drugs and that pertains to legal and illegal drugs.”
Usage levels by drug category
The 2024 report is broken down by drug category, which includes: alcohol, nicotine, vaping, cannabis, Delta 8 THC, illicit drugs other than marijuana, and narcotics other than heroin (such as Vicodin, OxyContin, and Percocet).
This year’s data reveals that across nearly all of those categories, substance use held steady at lower levels for the preceding 12 months. But in some instances, usage declined even further.
Alcohol consumption among 10th graders who were surveyed, for instance, dropped even more between 2023 and 2024 from 30.6% to 26.1%. Similarly, among 12th graders alcohol use also decreased from 45.7% to 41.7%.
Nicotine vaping among 10th graders also trended further downward between 2023 and 2024, dropping from 17.6% to 15.4%. Another notable decline was found in the category of illicit drug use beyond marijuana. In this case, usage declined among eighth graders, from 4.6% in 2023 to 3.4% in 2024.
Why Is Adolescent Substance Use Declining?
Dr. Volkow has several ideas about what may be influencing such dramatic behavioral changes, including that the pandemic may have actually had some positive impacts for adolescents.
The data shows that the highest rate of drug use is typically among 12th graders, who are 17 or 18 years old. This group of kids was 13 to 14 years old when the pandemic struck. And that’s exactly the age at which kids are at the highest risk for drug experimentation, says Dr. Volkow. But the social distancing required by the pandemic meant that kids in this age range were largely shielded from such risk.
“During those crucial years of high risk, they didn’t get exposed to drugs and therefore they learned to navigate social interactions without the need to show other kids that they are cool by taking drugs and instead they adopted alternative behaviors,” says Dr. Volkow, adding that this is why some of the largest decreases in substance use in the 2024 survey are found among the 12th grade survey respondents.
But it’s not just the oldest survey respondents who are reporting low substance use. The survey’s younger participants, who were not entering a high risk age range during the pandemic, also report abstaining from substance use in significant numbers. That brings Dr. Volkow to a few additional theories about the motivations for such behavior.
Around 2013, adolescents began increasingly relying on social media for interactions with peers, she says. In particular, there was an uptick in cell phone use among teenagers at that time and as a result, social media blossomed. That in turn, has caused a shift in the behavior of teens.
“Instead of face-to-face interactions, many interactions are through cell phones and are virtual, which basically protected them from being in circumstances where they would be exposed to drugs,” Dr. Volkow explains. “This may have been a situation where social media had a positive effect, where it protected kids from exposure to drugs.”
This reality has triggered other changes in the everyday life of teenagers, as well. With so many of their interactions taking place on social media, teens are also increasingly seeking and obtaining social reinforcement through social media. Meaning they no longer need to prove their cool-factor through substance use.
“Now, instead of looking to be accepted because you’re willing to take risks and drink [alcohol], you’re actually getting reinforcement from likes on social media accounts,” she explains.
Video gaming is another powerful factor that has emerged as well. Instead of getting together in a parking lot to consume drugs, for instance, kids these days are more likely to be online playing video games.
“This is speculative on my part and hypothesis testing,” concludes Dr. Volkow. “But these are factors that changed concurrently with reductions in drug use among teenagers.”
What Other Experts Have To Say
Dr. Volkow is not alone in her theories regarding what’s driving reduced substance use among adolescents and teens. Other experts share similar ideas about both the impacts of the COVID pandemic, social media, and the ongoing changes in social behaviors.
“The COVID-19 pandemic disrupted social interactions, reducing opportunities for teens to experiment with substances,” shares Pamela Tambini, MD, a double board-certified physician in internal medicine and addiction medicine, who is medical director at Engage Wellness.
Dr. Tambini also thinks social media may have had a positive role, but believes that role may have been in spreading awareness about the dangers of certain drugs. The opioid crisis has also played a role in the behavior of the current generation.
In particular, Dr. Tambini believes there’s a growing awareness around fentanyl and counterfeit pills that has made many teens more cautious. “They’ve seen the devastating consequences of even a single use of laced substances, which has likely made experimentation far less appealing,” says Dr. Tambini.
Christopher Wall, MD, chief medical Officer and psychiatrist for PrairieCare, a Minnesota-based treatment network that provides mental health and substance use services for teens and young adults, concurs with both Dr. Tambini and Dr. Volkow.
“Social media adds another layer, as many athletes and celebrities use their platforms to promote sobriety, mental health, and physical wellness. The ability to closely follow social influencers can provide more relatable role models for teens,” says Dr. Wall.
And there’s one more potential factor driving the behavioral shift now being witnessed: An increased focus on wellness overall among adolescents.4
“There’s a cultural shift happening with this generation,” says Dr. Tambini. “Today’s teens are often described as more health-conscious and risk-averse than previous generations. Many find healthier coping methods, such as exercise, mindfulness, and creative outlets.”
Originally published in Parents.