Historically, it's not a bad time to be a teenager. Or the lungs.
Alcohol, tobacco, and drug use among high school students has been on the decline for a long time.
In 2023, 46 percent of older adults said they had consumed alcohol in the year before being interviewed. That rate has fallen sharply from 88 percent in 1979, when the behavior was at its peak, according to the annual Monitoring the Future survey, which closely monitors national surveys of youth drug use. Regarding smoking, similar decreasing trends were observed for 8th and 10th graders and these three age groups. By 2023, only 15% of older adults will say they have ever smoked, down from a peak of 76% in 1977.
Illicit drug use among teenagers has remained largely stable at low levels for the past 30 years, with a notable decline seen during the COVID-19 pandemic.
In 2023, 29% of high school seniors will report using marijuana in the previous year, down from 37% in 2017 and a peak of 51% in 1979.
This good news comes with some solemn warnings. For one, overdose deaths among teens are skyrocketing, with fentanyl-related youth deaths doubling from 2019 to 2020 and remaining at that level ever since.
Dr. Nora Volkow has dedicated her career to researching drug and alcohol use. She has served as director of the National Institute on Drug Abuse since 2003. She spoke to The New York Times to discuss changing patterns and the reasons behind changing drug use trends.
What is the big picture regarding teens and drug use?
People often don't realize that drug use rates among young people, especially teenagers, are at the lowest risk in decades. And it's also worth saying about legal alcohol and tobacco.
What do you credit for this change?
One big factor is education and prevention campaigns. Indeed, anti-smoking campaigns are some of the most effective campaigns we've ever seen.
Some of the policies implemented were not only to raise the legal age for alcohol and tobacco to 21, but also greatly contributed to the enforcement of those laws. This can stop the progression from more readily available drugs, such as tobacco or alcohol, to illicit drugs. And teenagers aren't exposed to advertising for legal drugs like they used to be. All of these policies and interventions have downstream effects on illicit drug use.
Does social media use among teenagers play a role?
absolutely. Social media has changed the opportunity to be in a physical space with other teenagers. That way, they are less likely to take drugs. And this became dramatically clear when schools were closed due to the coronavirus pandemic. We found that rates of use for many substances dropped significantly during the pandemic. Maybe it's because teens can't be together.
An interesting issue is that even though schools have reopened, the prevalence of substance use has not reached pre-pandemic levels. It's either stable or continues to fall. This is a significant downward revision and change, and some drug use trends continue to slowly decline.
Is it possible that the stimulation we get from using digital devices might satisfy some of the same neurochemical experiences or provide escapism as drugs do?
Yes, it's possible. There is variation in the types of reinforcers available to teenagers. It's not just social media, it's also video games, for example. Video games can be highly reinforcing and can create patterns of compulsive use. That is, you replace one reinforcer, one avoidance with another reinforcer. That may be another factor.
Is it too simplistic to view a decline in drug use as good news?
Objectively speaking, that's very good news. why? Because we know that the earlier you start using these drugs, the higher your risk of becoming addicted to them. Reduce the risk that these medications will interfere with your mental health, general health, ability to complete education, and future job opportunities. That's totally good news.
However, we do not want to be satisfied with the status quo.
The drug supply is more dangerous and leads to increased overdose deaths. I'm not exaggerating. This means that taking these drugs can lead to death.
What about electronic cigarettes? Although on the decline, usage is still significantly higher than cigarettes and in 2021. About a quarter of high school seniors said they had smoked nicotine in the previous year.. Why are teens resisting cigarettes and flocking to e-cigarettes?
Most of the toxicity associated with tobacco is thought to result from the burning of the leaves. Even though nicotine is the addictive element, burning tobacco has been linked to cancer and most other negative effects.
What we have come to understand is that nicotine e-cigarettes have their own harms, but this is not as well understood as with cigarettes. Another aspect of vaping that makes it so appealing to teenagers is that it is associated with all kinds of flavors (candy flavors). It wasn't until the FDA made these flavors illegal that vaping became less available.
My point is that there is no reason why teenagers should be exposed to nicotine. Because nicotine is highly addictive.
Is there anything else you would like to add?
We have a similar interest in cannabis and psychedelic drugs. And there's a lot of interest in the idea that psychedelic drugs may have therapeutic benefits. Preventing these new trends in drug use among teens requires a different strategy than we have used with alcohol and nicotine.
For example, we can say that consuming drugs such as alcohol or nicotine can lead to addiction. It is supported by extensive research. But warnings about addiction to drugs such as cannabis and hallucinogens may not be very effective.
Cannabis can also be addictive, but perhaps not as addictive as nicotine or alcohol, so more research is needed in this area, especially with newer high-potency products. Psychedelics usually do not lead to addiction, but they can cause adverse mental experiences that can put you at risk for psychosis.