Substance Use Among Adolescents Remains Low in 2022

Measuring substance abuse in adolescents

The Monitoring the Future survey is conducted annually by researchers at the University of Michigan and quizzes students in eighth, 10th, and 12th grades about their substance use over various time periods, including the past 30 days, the past 12 months, and over their lifetimes. 

Between February and June 2022, 31,438 surveys were completed by students at 308 public and private schools across the United States. The survey is nationally representative and statistically weighted.

Related: Alcohol, drugs & young people

Rates of nicotine vaping, cannabis use, and illicit drug use largely stable

The results revealed that the decline in substance use seen during the pandemic held up even as students returned to in-person schooling, extracurricular activities, and socializing.^[1]

Rates of nicotine vaping among teenagers were stable, with 12% of eighth graders, 20.5% of sophomores, and 27.3% of seniors reporting vaping nicotine in the past year.

Cannabis (marijuana) use was similarly stable in all three grades. 8.3% of eighth graders, 19.5% of 10th graders, and 30.7% of 12th graders reported using cannabis in the past 12 months. 

Vaping continued to be a popular method of consuming cannabis among adolescent users and was reported by 6% of eighth graders, 15% of 10th graders, and 20.6% of 12th graders. The rates of cannabis vaping were stable among eighth and 12th graders and slightly elevated among 10th graders compared to 2021 but still significantly below pre-pandemic levels.

Alcohol use remained near its 2021 low for younger students: 15.2% of eighth graders and 31.3% of 10th graders. However, it rebounded to pre-pandemic levels among seniors, with 51.9% reporting drinking alcohol in the past year.

Meanwhile, the long-running trend of low but steady rates of use of other illicit drugs by adolescents continued in 2022. 4.9% of eighth graders, 5.7% of 10th graders, and 8.0% of 12th graders reported the use of drugs other than cannabis, including cocaine, heroin, and amphetamines, or non-medical use of prescription drugs in the past year.

“We were curious to see whether the significant decreases in substance use we observed last year would continue into the future, and we now see that there may indeed be a longer lasting impact for some substances,” said Richard A. Miech, Ph.D., team lead of the Monitoring the Future study at the University of Michigan. 

“The fact that cannabis use and nicotine vaping did not appear to return to pre-pandemic levels in 2022 is a fascinating data point. Moving forward, it will be important to continue to monitor these trends to understand the impact on future drug use behavior and outcomes,” he added.

Rise in narcotic use among 12th graders

The survey's findings weren’t all so cheering. The use of prescription narcotics such as Vicodin, OxyContin, and Percocet climbed modestly among 12th graders between 2021 to 2022, to 1.7%. However, that level was consistent with that observed before the pandemic: 2.7% in 2019 and 2.1% in 2019.

The survey also questioned students about their perceptions of the harm of occasionally taking prescription narcotics for non-medical reasons. The proportion of students who reported seeing a “great risk” from narcotics use ranged from 22.9% among eighth graders to 52.9% among 12th graders.

Similarly, 28.1% of eighth graders said occasionally taking AHDH medication Adderall, a popular study aid, was a “great risk,” an opinion shared by 39.6% of high school seniors.

But climbing rates of overdose deaths among adolescents, attributed to the presence of the powerful opioid fentanyl in counterfeit pills, suggest that students may be underestimating the risk of taking these medications without a prescription.

Substance use is down but overdoses are up

Despite a long-term trend of declining or stable substance use among young people, overdose deaths among Americans ages 14 to 18 have risen dramatically in recent years. In 2010, overdose deaths among adolescents stood at 2.40 per 100, 000 population, a rate that held steady until 2019 (2.36 deaths per 100,000 population).^[2]

But in 2020, overdose deaths in this population climbed to 4.57 per 100,000 people, a 94% increase year-on-year. Deaths rose still higher in 2021, to 5.49 per 100,000 people, an annual increase of 20%. 

The sharp rise in overdose deaths among adolescents, which is paralleled by a high but less sharp spike in overall overdose deaths, has been attributed to the presence of the synthetic opioid fentanyl in counterfeit pills, commonly made to resemble prescription drugs such as opioids, ADHD medications, and benzodiazepines.

“The proliferation of fentanyl in the drug supply is of enormous concern. Though the data indicate that drug use is not becoming more common among young people than it has been in the past, the tragic increase in overdose deaths among this population suggest that drug use is becoming more dangerous than ever before,” said Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA), which funded the survey.

“It is absolutely crucial to educate young people that pills purchased via social media, given to someone by a friend, or obtained from an unknown source may contain deadly fentanyl,” she said.