COVID-19 and Youth Substance Use: We Need More than Good Intentions

Abstract

An "epidemic hidden in a pandemic". 1(np) That is what Andrea Raby, D.O. of Bayless Integrated Healthcare, calls the threat to our youth who are now at increased risk of substance use disorder and overdose in the wake of the COVID-19 pandemic. "This is always a vulnerable time during this period in their growth, in their development, in their growth of their identity, and often times what helps our adolescent population is structure and predictability and of course with COVID, this renders everything the opposite". 1(np) Transitioning to remote or hybrid classes, social lives put on pause, canceled athletics, and extracurricular activities leave some teens looking for ways to numb the pain. Dr. Raby is not alone in her concerns. Many experts believe the pandemic could lead to a nationwide spike in substance use disorders as people struggle with the anxieties and uncertainties borne of the pandemic. As much as we would like to believe that our young people are somehow protected from these temptations, in truth, no group is more vulnerable. Left unchecked, addiction and substance use among young people can accelerate poor health outcomes and lead to even worse behaviors as adults. Youth who are desperately in need of care may not get the services they need if no one identifies the problem early. We know little about the emerging threats of COVID-19 on our youth. As I write this in late September 2020, we are experiencing the phenomenon of "COVID fatigue" and with it, some people are demonstrating a more cavalier approach to wearing masks and social distancing. A new school year is being defined by remote learning and hybrid classes, businesses are feeling the financial pains of prolonged restrictions, and we are facing the advent of the annual "flu season". Much of the insight we do have about this issue is based on observations of previous disasters. A Dutch study tells us that, in the long run, the negative behavioral and emotional problems for adolescents decrease with time, but the effects regarding alcohol use remain. 2 In the aftermath of Hurricane Katrina, "survivors were smoking cigarettes, consuming alcohol, and experiencing alcohol consumption-related problems at a substantially higher rate". 3(p.1) A Canadian study on adolescent substance use pre-and post-COVID-19 found that, "For most substances, the percentage of users decreased; however, the frequency of both alcohol and cannabis use increased. Although the greatest percentage of adolescents was engaging in solitary substance use (49.3%), many were still using substances with peers via technology (31.6%) and, shockingly, even face to face (23.6%)". 4(p.1) To be sure, this is just one study that focused on a relatively small

Impact of the COVID-19 pandemic on substance use among adults without children, parents, and adolescents

“…Demarest (2020) suggested the pandemic might increase depression among adolescents, leading to increased substance use, constituting an “epidemic hidden in a pandemic”. Ingoglia (2020) suggested disruption in daily routines for adolescents (through canceled in-person classes, athletics, and extracurricular activities) might make them particularly vulnerable. He concluded, “We know little about the emerging threats of COVID-19 on our youth” (p. 1).…”

Advancing Mental Health and Psychological Support for Health Care Workers Using Digital Technologies and Platforms

“…Common behavioral problems include performance avoidance, decreased work enthusiasm and physical activity, increased dependence on families, and disorderly lifestyle and self-management. Health care workers may also experience unhealthy lifestyle activities, such as smoking, drinking, staying up late, and overeating; or blind behaviors, such as panic buying and stockpiling of disinfection supplies, food, drugs, etc [ 19 ].…”

Randomized controlled trial to test the efficacy of a brief, communication-based, substance use preventive intervention for parents of adolescents: Protocol for the SUPPER Project (Substance Use Prevention Promoted by Eating family meals Regularly)

“…Adolescent substance use is a national problem and while decreasing with some substances, continues to persist and escalate in others [ 5 , 6 ]. The COVID-19 pandemic has added further urgency to addressing this issue as adolescents may turn to substances to cope or self-medicate during this difficult time [ 10 – 12 ]. Currently there is lack of family-based, universal substance use prevention programming to reduce and/or delay substance use initiation among youth that reduce participant burden, are easily disseminated, and sustainable.…”

“…Given the stress and increased mental health problems among youth [ 10 ], the COVID-19 pandemic has raised some concerns regarding adolescent substance use, although evidence is limited [ 11 , 12 ]. One study of Canadian adolescents reported the proportion of adolescents who reported one or more substance-using days within a period of three weeks pre-COVID compared to 3 weeks during COVID increased significantly from 0.76 to 0.96 (p = 0.02) and from 0.94 to 1.10 (p = 0.01) for alcohol and marijuana, respectively [ 13 ].…”