A longitudinal study of change in substance use from before to during the COVID-19 pandemic in young adults

Sylvestre, Marie‐Pierre; Dinkou, Gillis D Tchouangue; Naja, Mounia; Riglea, Teodora; Pelekanakis, Annie; Bélanger, Mathieu; Maximova, Katerina; Mowat, David L.; Paradis, Gilles; O’Loughlin, Jennifer

doi:10.1016/j.lana.2021.100168

Cited by 29 publications

(26 citation statements)

References 30 publications

(56 reference statements)

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“…While screen-positives increased over the academic year before and during the pandemic, there appeared to be a greater increase in female students studying under pandemic conditions, particularly for symptoms of anxiety. Conversely, reported levels of problematic substance use (alcohol binging and/or regular recreational drug use) were lower during the pandemic, consistent with reductions in alcohol consumption reported among young adults in Canada, 21 , 22 associated with decreases in social gatherings and COVID-related restrictions. 21 Students indicated that the pandemic had negatively impacted their lives and university studies and shared concerns around reduced social and school connectedness, the quality of their learning experience and specifically remote learning, as well as concerns about future academic and career prospects.…”

Section: Discussionsupporting

confidence: 61%

The Impact of the COVID-19 Pandemic on the Mental Health of First-Year Undergraduate Students Studying at a Major Canadian University: A Successive Cohort Study

et al. 2022

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Objective To examine the impact of the COVID-19 pandemic on first year undergraduate student mental health. Methods As part of the Queen’s University U-Flourish Student Well-Being and Academic Success study, three successive cohorts of students entering undergraduate studies in 2018 (pre-pandemic), 2019 (transitional), and 2020 (during pandemic) completed electronic surveys at entry and completion of first year. Validated self-report measures were used to assess mental health status including symptom levels of anxiety, depression, and insomnia, self-harm and frequency of substance use. Propensity matching and multivariable log-binomial regression were used in comparisons of mental health indicators across the cohorts. Results Clinically significant symptoms of depression, anxiety, insomnia, and self-harm were reported more frequently in the 2020–2021 cohort, coincident with remote learning and pandemic restrictions. In female students, screen positive rates for anxiety and depression, and suicidal ideation increased from about one-third to just under one-half in association with the pandemic (χ2, p < .01), while increases in mental health concerns were less pronounced among males. Among females, increases in clinically significant symptoms over first year appeared greatest during the pandemic year, while striking decreases in alcohol consumption in both females and males were reported in that same year. Studying under pandemic conditions had a negative impact on student well-being, social relationships and school connectedness, quality of learning experience, leisure activities, and optimism about future prospects. Conclusions Mental health concerns including anxiety, depression and sleep problems increased in first year students during the pandemic, especially among females, while alcohol use declined. These findings highlight the negative mental health impact associated with studying under pandemic restrictions involving remote learning and social distancing.

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Section: Discussionsupporting

confidence: 61%

The Impact of the COVID-19 Pandemic on the Mental Health of First-Year Undergraduate Students Studying at a Major Canadian University: A Successive Cohort Study

et al. 2022

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“…Poisson regression allowed us to estimate prevalence of more common binary outcomes rather than odds (30)(31)(32), and we utilized GEE with robust standard error estimation to adjust for the within-patient correlation of repeated measures [there were 405,547 (45%) patients in both cohorts] while accounting for lack of independence in replications of patients induced by weighting (33). Secondly, we estimated the change in prevalence of unhealthy alcohol use from pre-to post-COVID onset (i.e., prevalence ratio) by refitting the weighted Poisson GEE model, adjusting for sex, age group (18-20 vs. [21][22][23][24][25][26][27][28][29][30][31][32][33][34], race/ethnicity, type of insurance, NDI quartile, number of medical conditions, any mental health condition, and any drug use disorder. A very small proportion of patients had unknown NDI (0.2%), which we imputed as the cohort's mean and assigned to the third quartile.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, young adults may have been very severely affected by the pandemic due to factors such as less job security, housing stability, and higher debt compared to other age groups. Previous studies have reported higher distress and mental health issues caused by the pandemic and its containment measures in younger adults (19)(20)(21). Therefore, the aim of this study was to examine impacts of the COVID-19 pandemic on alcohol use problems among a diverse, large sample of young adults (18-34 years) who utilized primary care.…”

Section: Introductionmentioning

confidence: 99%

Alcohol Use Among Young Adults in Northern California During the COVID-19 Pandemic—An Electronic Health Records-Based Study

et al. 2022

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BackgroundIndividuals globally were affected by the COVID-19 pandemic in myriad of ways, including social isolation and economic hardship, resulting in negative impacts on mental health and substance use. Young adults have been subjected to extraordinary challenges such as job loss, virtual school, or childcare issues, but have received limited attention from research so far.MethodsUsing electronic health record data from a large integrated healthcare system in Northern California, this longitudinal observational study examined changes in the prevalence of unhealthy alcohol use (identified via systematic alcohol screening in adult primary care) from pre- (3/1/2019–12/31/2019) to post-COVID onset (3/1/2020–12/31/2020) among young adults (18–34 years). Among the 663,111 and 627,095 young adults who utilized primary care in the pre- and post-COVID onset periods, 342,889 (51.9%) and 186,711 (29.8%) received alcohol screening, respectively. We fit generalized estimating equation Poisson models to estimate the change in prevalence of unhealthy alcohol use from pre- to post-COVID onset among those who were screened, while using inverse probability weighting to account for potential selection bias of receiving alcohol screening. Heterogeneity in the change of prevalence by patient characteristics was also examined.ResultsOverall, the unadjusted prevalence of unhealthy alcohol use slightly decreased from 9.2% pre-COVID to 9.0% post-COVID onset. After adjusting for patient covariates, the prevalence of unhealthy alcohol use decreased by about 2% [adjusted prevalence ratio (aPR) = 0.98, 95% CI = 0.96, 1.00]. The prevalence of unhealthy alcohol use increased among women by 8% (aPR = 1.08, 95% CI = 1.06, 1.11), patients 18–20 years by 7% (aPR = 1.07, 95% CI = 1.00, 1.15), and Latino/Hispanic patients by 7% (aPR = 1.07, 95% CI = 1.03, 1.11). While the prevalence of unhealthy alcohol use decreased among men by 12% (aPR = 0.88, 95% CI = 0.86, 0.90), patients 21–34 years by 2% (aPR = 0.98, 95% CI = 0.96, 0.99), White patients by 3% (95% CI = 0.95, 1.00), and patients living in neighborhoods with the lowest deprivation indices by 9% (aPR = 0.91, 95% CI = 0.88, 0.94), their unadjusted prevalence remained higher than their counterparts post-COVID onset. There was no variation in the change of prevalence by comorbid mental health conditions or drug use disorders.ConclusionsWhile changes in unhealthy alcohol use prevalence among young adults were small, findings raise concerns over increased drinking among women, those younger than the U.S. legal drinking age, and Latino/Hispanic patients.

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“…AYAs are known to be at a risk of new psychiatric diagnoses ( 20 – 22 ), experimentation with substances and high-risk behaviors ( 23 – 25 ), sexually transmitted infections ( 26 , 27 ), sedentary lifestyles ( 28 ), and poor eating habits ( 29 ). In the pandemic context, loneliness and low education among youths are associated with increased use or initiation of cannabis, e-cigarettes, and binge drinking ( 30 ) and opioid and stimulant-associated mortality ( 31 , 32 ). AYAs living with CP are at especially high risk of suicidality ( 33 ).…”

Section: Introductionmentioning

confidence: 99%

Transitional Pain Care in Quebec: Did We Forget Our Youths? A Brief Research Report

et al. 2022

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Adolescents and young adults (AYAs) represent a unique population with distinct psycho-social risks and care needs. About 10% of AYAs live with chronic pain (CP) and transition to adult pain care between 16 and 25 years of age. These transitions in care happen simultaneously with other bio-psycho-social changes and require flexible multi-disciplinary support models. As it stands, transitional pain care appears suboptimal, fragmented, and opportunistic in Quebec (Canada). The objective of this Brief Report is, therefore, to present our study findings and propose a multi-disciplinary transitional framework vision applicable to AYAs living with CP. Data were collected using a sequential-consensual qualitative design with a longitudinal participatory component. The consecutive stages of this work included an exploratory stage, semi-structured interviews with primary care providers, and inter-disciplinary deliberative stakeholder consultation groups. The deductive inductive thematic approach and the three-level Health Care Transition Research Consortium's theoretical framework were used to analyze the data. A representative group of stakeholders discussed findings from the first two steps, made fifteen actionable recommendations and formulated their vision of a transitional pain care model that can be further adapted in other settings. The study results present important insights into various psycho-social factors associated with transitional pain care for AYAs.

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A longitudinal study of change in substance use from before to during the COVID-19 pandemic in young adults

Cited by 29 publications

References 30 publications

The Impact of the COVID-19 Pandemic on the Mental Health of First-Year Undergraduate Students Studying at a Major Canadian University: A Successive Cohort Study

The Impact of the COVID-19 Pandemic on the Mental Health of First-Year Undergraduate Students Studying at a Major Canadian University: A Successive Cohort Study

Alcohol Use Among Young Adults in Northern California During the COVID-19 Pandemic—An Electronic Health Records-Based Study

Transitional Pain Care in Quebec: Did We Forget Our Youths? A Brief Research Report

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