A survey of Colorado high school students found they were less likely to report drug use and suicidal thoughts during the pandemic than a year earlier.
The teens surveyed in fall 2020 were less likely to say they’d recently used alcohol, marijuana, tobacco or e-cigarettes than those who had participated in 2019. Fewer reported recently using prescription drugs without a doctor’s order, though the decline was small enough that it could have been a random fluctuation.
The survey’s mental health questions also suggested some students benefited from the changes of the last year, or at least coped with them. The percentage of teens reporting they had felt sad or hopeless for at least two weeks was roughly stable, and the percentage who reported thoughts of suicide or suicide attempts was down.
Black teens were an exception, reporting higher rates of suicidal thoughts or attempts, but the survey included so few that it’s uncertain if the change was real or a statistical fluke. Suicide deaths among adults in Colorado did rise for people of color last year and fell for white people.
It’s possible the survey wasn’t big enough to find subgroups of teens who increased their substance use because of stress, or who already had depression or anxiety and saw their symptoms worsen during the pandemic, said Ashley Brooks-Russell, an assistant professor at the Colorado School of Public Health who was part of the survey team.
Still, after predictions of a tsunami of youth mental health problems and suicide, it was a relief to see most teens who participated in the survey reported they were coping well, and some seemed to be less stressed when they were away from school, she said.
“There may have been silver linings,” she said.
Brooks-Russell cautioned that the survey doesn’t represent all teens in Colorado. About 4,800 high school students in 26 schools participated. All but three of the participating schools are in rural areas, so it’s possible teens in urban and suburban areas had different experiences.
Normally, the state asks a broader swath of the teen population to take the Healthy Kids Colorado survey every two years, with the next one scheduled for this fall. The pandemic created such unusual conditions that it was important to get some data, even though the group was smaller, Brooks-Russell said.
“It kind of caught us by surprise that it was going to go on for so long,” she said.
It’s unusual to see notable reductions in the use of multiple substances, which may reflect that teens were spending more time at home, Brooks-Russell said.
“I would suspect this is not a trend that’s going to last, that it’s going to go back up,” she said.
The results contrast with the nationwide Monitoring the Future survey of 12th-grade students, which found they used marijuana and reported binge drinking at about the same rates during the pandemic as they had before, despite reporting it was harder to get marijuana or alcohol.
E-cigarette use went down, though, which could reflect changes in perceptions that started before the pandemic.
Vaping started to plateau in 2019 and early 2020, after reports of then-unexplained lung injuries, said Dr. Richard Miech, a research professor at the University of Michigan’s Institute for Social Research who worked on the nationwide survey. Most cases were eventually linked to an additive in marijuana vaping products.
Some of the differences between the Colorado and nationwide results could be due to the different student mix. The Colorado survey involved kids in grades nine through 12, while the national survey only queried high school seniors. It also had a small sample, with about 500 students participating.
“Twelfth graders have a little more autonomy, and those who are using drugs are a little more experienced,” increasing the odds they can successfully find substances when access is less convenient, Miech said.
Miech said he had expected to see far lower rates of substance use after students went to remote learning, because of reduced peer pressure and opportunities to buy or share drugs. It could be that students who used those substances worked harder to get them, or that supply wasn’t actually very restricted — about three in five said they could get marijuana and alcohol at least “fairly easily.”
The results raise questions about whether the effort to make it harder to get drugs would be better spent trying to change attitudes, Miech said. Cigarette use was high until the late 1990s, when a massive settlement from the tobacco industry funded campaigns to make smoking a disgusting habit, rather than a desirable one. Something similar may have started to happen, as more students have reported they thought vaping was risky since 2019.
“You look at the lockdown, which was one of the most dramatic things in a century… and that didn’t change kids’ alcohol and marijuana use,” he said. “If it was just availability, we would have alcohol go down, and also marijuana.”
Dr. Nora Volkow, director of the National Institute on Drug Abuse, said small surveys may not have identified disparities, like that students whose parents are essential workers were at a greater risk for drug use and poor academic performance last year, because no one was home with them and their teachers couldn’t effectively monitor their behavior.
Students from low-income families were already at greater risk, because of the many stressors they face, and the pandemic may have compounded that, she said.
While studies aren’t finding overall increased drug use now, students may be at risk in the future, because of increased stress, anxiety and depression, Volkow said. States can decrease the odds of future harm to youth by increasing the price of substances like alcohol through taxes; ensuring legal alcohol and marijuana sellers follow the laws banning sales to minors; teaching parents how to talk to their kids about drugs; and helping students develop skills that reduce impulsive behavior, she said.
“Recognizing that we have lived one of the most stressful experiences in the past three decades… we need to be proactive,” she said.
Percentage of students in 26 Colorado schools who reported using substances in the last 30 days
Alcohol
- 2019: 29%
- 2020: 21%
E-cigarettes
- 2019: 29%
- 2020: 16%
Marijuana
- 2019: 19%
- 2020: 13%
Cigarettes
- 2019: 8%
- 2020: 5%
Source: Healthy Kids Colorado fall 2020 survey. The survey group was smaller than usual, so the results may not apply to all students.
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