Adolescent Substance Use Following a Deadly U.S. Tornado Outbreak: A Population-Based Study of 2,000 Families

Abstract

Objective Despite conceptual links between disaster exposure and substance use, few studies have examined prevalence and risk factors for adolescent substance use and abuse in large, population-based samples affected by a recent natural disaster. We addressed this gap using a novel address-based sampling methodology to interview adolescents and parents who were affected by the fourth deadliest tornado outbreak in U.S. history. Method Post-disaster interviews were conducted with 2,000 adolescent-parent dyads living within a 5-mile radius of the Spring 2011 U.S. tornadoes. In addition to descriptive analyses to estimate prevalence, hierarchical linear and logistic regression analyses were used to examine a range of protective and risk factors for substance use and abuse. Results Approximately 3% reported substance abuse since the tornado. Greater number of prior traumatic events and older age emerged as consistent risk factors across tobacco and alcohol use and substance abuse since the tornado. Tornado incident characteristics, namely greater loss of services and resources after the tornado and PTSD since the tornado, were associated with greater alcohol consumption. Service loss increased risk for binge drinking, whereas, for substance abuse, PTSD increased risk and parent presence during the tornado decreased risk. Greater family tornado exposure was associated with a greater number of cigarettes smoked in female but not male teen participants. Conclusions Both trauma and non-trauma-related factors are relevant to post-disaster substance abuse among adolescents. Future research should examine the role of broader ecological systems in heightening or curtailing substance use risk for adolescents following disaster exposure.

Alcohol Use and Mental Health among Older American Adults during the Early Months of the COVID-19 Pandemic

“…We add to previous literature on mental health and alcohol use, finding that both increases and decreases in usual alcohol were common, and were often experienced alongside mental health symptomatology among middle-aged and older US adults during the early COVID-19 pandemic, a period of collective adversity. Evidence suggests that increases in alcohol consumption are concomitant with adverse mental health outcomes following large-scale traumatic exposures, such as a natural disaster, widespread economic assault, or acts of terrorism [ 37 , 38 , 39 , 40 , 41 , 43 , 44 , 52 , 53 , 54 ]. Taken together, these findings generally support the tension reduction hypothesis, indicating that alcohol consumption may be used to cope with negative emotions triggered by stress [ 20 , 22 , 23 , 42 ].…”

“…While previous studies have produced mixed results supporting the tension reduction hypothesis, consistent evidence identifies a strong and bidirectional relationship between alcohol use and depression [ 22 , 23 , 31 , 32 , 33 , 34 , 35 , 36 ]. Further, previous studies suggest that exposure to stress or stressful stimuli are important motivators for increased alcohol intake [ 23 , 34 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. However, it is not known how alcohol consumption may have changed among middle-to-older aged US adults during the COVID-19 pandemic.…”

Effects of extreme weather events on child mood and behavior

“…In addition to psychosocial and environmental factors, some demographic variables have been implicated when considering key influencers of post‐disaster mental health in children, although the results are somewhat mixed. For example, older age and being female have been associated with PTS, depressive symptoms, and negative externalizing behaviors in separate studies during which EWE survivors were evaluated; females carried greater risk in these investigations 7,12,13,20,46,51 . However, in a study of young Californians affected by wildfires, 41 being female was significantly associated with PTG and neither age or sex were related to PTS symptoms in a study of young people impacted by flooding in Nashville, Tennessee 52 …”

“…Finally, as previously discussed, the presence of a parent/caregiver during an EWE appears to confer protection. It is, therefore, intuitive that the absence of a parent may place a child at an elevated risk of a complicated or incomplete mental health recovery process 20,24 . Other factors that have been implicated as potential risk factors for negative mental health outcomes include pre‐disaster levels of negative life events and negative friendship interactions, 52 having experienced interpersonal violence, 30 lower household income, 46 parental injury, 20 and exposure to community violence 58 …”

Substance Use in the Life Cycle of a Disaster: A Research Agenda and Methodological Considerations

“…This sharp albeit abbreviated increase represents the period of greatest risk for postdisaster substance use and there is strong evidence of this acute postevent increase in alcohol use in the study of a wide variety of disasters. Short-term elevated alcohol use has been observed following the 2011 earthquakes in Japan (Kanehara et al, 2016) and New Zealand (Williamson, 2014), in the aftermath of hurricanes Katrina and Rita in New Orleans (Cerda et al, 2011), Sandy in New York (Lowe et al, 2017), the 2004 Southeast Asia tsunami (Nordløkken et al, 2013; Vetter et al, 2008), and after other types of disasters as well (Danielson et al, 2017; Stewart et al, 2004).…”