Under Pressure: Young and Surrounded by Substances
Alcohol, drugs, edibles, vapes. The array of substances available to adolescents and young adults has grown exponentially over the years, in variety and strength, as has research suggesting that they may alter the developing brain. What will be the fallout?
Helena Shannon stopped drinking nearly five years ago, at age 23. She had no doubts about her decision: Drinking had become a problem. She drank to get drunk. But she did wonder how she would ever have a social life again. She was right out of college, in her first job, and knew no one who’d given up?alcohol?in their early twenties.
“I would come home on Friday nights after work and sit on my couch and cry,” says Shannon, now 28. She loved drinking and had always sought out friends who felt the same way. They weren’t hard to find. “One of the things that was coming up over and over and over again for me was, ‘I’m going to have no friends,’” she says.
But she persisted with her sobriety, and gradually she realized she was wrong about the friend thing. There were others like her. Shannon, who was living in Chicago at the time with the man who is now her husband, started a meet-up for young women who, like her, were trying to live sober. “There were so many other women out there looking for the same thing,” she said.
Stats and Facts About Substance Abuse in Today's Youth
Shannon can be forgiven for thinking she’d have a thin social life. It’s more the norm than the exception for teens and young adults to try a substance. In fact, experts recommend starting screening for substance use at age 9,?according to the Centers for Disease Control and Prevention (CDC).
As drugs and alcohol continue to appeal to young people for reasons like fitting in with their peers and attempting to?manage life stresses, the challenge for many now is to decide what place — and to what extent — these substances occupy a place in their lives.
Chemicals and Growing Brains: Imperfect Together
Beyond the risks of drinking and driving — and?overdose?— there’s the issue of dependency and, even more insidious, the impact on the developing brain.
According to the U.S. National Library of Medicine, the brain is not fully developed until our mid-twenties. Drug and alcohol use by teens and young adults can alter regular brain development, changing the way the brain circuits develop as well as the strength and weakness of synapses — the way in which neurons communicate with one another.
It’s not entirely clear yet how these changes manifest themselves. “I don’t think we have all the information on it, but what we do know is that it has an impact on learning because it has an impact on working memory and also on the prefrontal cortex [the part of the brain involved in planning and decision making],” says?Sara Gorman, PhD, the director of research and knowledge dissemination at The JED Foundation, a nonprofit devoted to emotional health and suicide prevention among teens and young adults
The National Institute on Drug Abuse notes?that early exposure to drugs could also predispose someone to drug use and addiction later on.
Drug and Alcohol Use Over the Years: A Rite-of-Passage Love Story
The use of illicit drugs has been cyclical, says?William Stoops, PhD, a professor of behavioral science, psychiatry, and psychology at the University of Kentucky in Lexington and a faculty member of the university’s Center for Drug and Alcohol Research, noting the heroin epidemic in the 1960s, a cocaine epidemic in the 1970s and 1980s, and the opioid epidemic beginning in the 1990s.
Among youths, substance use — especially illegal drug use — has largely declined over time, but still remains a persistent problem,?according to the National Institute on Drug Abuse (NIDA).
Now, according to the CDC, the most commonly used substances among youths include alcohol, marijuana, and cigarettes. About two-thirds of high school students say they’ve tried alcohol, nearly half say they’ve tried marijuana, and 4 in 10 say they’ve tried cigarettes. And according to NIDA, almost 28 percent of high school seniors say they’ve vaped, which is known to raise their risk of turning to regular tobacco cigarettes later on in life.
When it comes to college students,?marijuana?use,?vaping, and alcohol use remain common. Findings from a?survey conducted in 2019 by NIDA?showed the percentage of students ages 19 to 22 years who had vaped marijuana within the past 30 days rose from 5.2 percent in 2017 to 14 percent in 2019.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of why drinking is so common on college campuses is because students see it as a ritual or rite of passage. The NIAAA states that nearly 53 percent of full-time college students ages 18 to 22 had consumed alcohol within the past month as of January 2021.?Binge drinking?— when males consume five or more drinks and females consume four or more drinks in two hours — also remains a significant issue among college students, with 33 percent having engaged in binge-drinking within the same period of time.
What Effect Has the Pandemic Wrought?
And then there’s the?COVID-19 pandemic.
The last year-and-a-half has been full of stories of people turning to alcohol and drugs to ease the dislocation of the pandemic. The pandemic, of course, has not ended, and information is just starting to come out about alcohol and drug use among adolescents and young adults during the shutdowns.
“Although we don’t yet have complete data, there have been reports of increased overdoses, as well as increased substance misuse as a coping mechanism,” says psychiatrist?Patrice Harris, MD, medical editor in chief at large at Everyday Health, and a former president of the American Medical Association.
“For example, someone who previously had two glasses of wine in the evening may now have increased their intake to four glasses as a means to cope with stressors related to this pandemic,” Dr. Harris explains.
Recent studies have found young people showed less interest in alcohol and drugs, though with worrisome trends of increased daily marijuana use and vaping.?In a study funded by the National Institute of Drug Abuse,?published in the September 2021 issue of?Drug and Alcohol Dependence,?researchers from the University of Michigan questioned 12th-graders about their substance use from mid-July to mid-August 2020 and discovered that although teenagers thought marijuana and alcohol had become much less available, their use of both stayed steady.
In a?statement?about these results,?Nora Volkow, MD, the director of the National Institute on Drug Abuse,?called it striking that rates remained the same even as many teenagers remained at home with parents and other relatives.
Brandon G. Bergman, PhD, an assistant professor at Harvard Medical School and an associate director of the Recovery Research Institute at Massachusetts General Hospital in Boston, said that overall, data does suggest a decrease in alcohol use during the pandemic, at least between March 2020 and March 2021.
One reason might be that emerging adults, a term used for young people between adolescence and full-fledged adulthood, were socializing less and therefore drinking less, Dr. Bergman says.
But drug overdoses totaled more than 94,000 in the last year for all ages, up from more than 72,000 the previous year,?according to the National Center for Health Statistics. According to Dr. Stoops, the stress that has accompanied the pandemic may have affected alcohol and drug use during this time period.
As the pandemic wears on, 18- to 25-year-olds remain vulnerable to substance use. "That is the group that is more likely to engage in drug use relative to other age groups. They’re more likely to drink in risky fashion, they are more likely to use illicit drugs,” says Bergman.
The reason? People in this age group are often newly independent and under less supervision and, because of their age, ready to take risks, he says.
Not to mention, teenagers might be struggling with a lack of socializing that they need at that age, says Dr. Gorman.
“It’s like a developmental trigger that they really crave and need, that kind of peer-to-peer interaction, and they’re not getting it,” she says.
The last year-and-a-half has been difficult for the young patients of?Rachel Weller, PsyD, in New York City. The project manager of UPRISE, a program for 14- to 21-year-olds of the?Comprehensive Adolescent Rehabilitation and Education Service of Mount Sinai Health System, Dr. Weller says youths in this group have fallen into two camps: one whose substance use reduced during the pandemic — and they are probably in the minority — and substantially increased use in the other.
“The shift from in-person to remote services or remote groups was incredibly challenging,” she says.
Harris agrees, adding, “Certainly, this pandemic and the need to shelter in place early on disrupted access to services and supports for those seeking help as well as for those who already had a diagnosed substance use disorder. Fortunately, state and federal governments relaxed some regulations regarding telehealth, take-home medications, and harm reduction strategies to mitigate disruptions in treatment, care, and support.”
Leading by Public Example via Social Media
Meanwhile, people like Helena Shannon continue to chart new territory with navigating the availability and use of substances. And because they are young, that map is often writ large via social media, where anyone tech savvy, such as younger generations, can find it.
Zach Stevens, aka?@zach_clean on TikTok, began posting TikTok videos just as the world was going into coronavirus lockdown, and in them he addresses how hard it is to stay on-path.
For people figuring out how to navigate social media while getting or staying sober, @zach_clean has some words of wisdom based on his own experience. Read more about Zach's story at the link in our bio! ##蹿测辫シ ##foryoupage ##mentalhealth ##socialmedia ##cleanliving ##sober? original sound - EverydayHealth
“Lockdown is difficult for us all, and some of us I’m sure will feel pain right now, but it’s important that we remember we will feel happy again and this time will soon be over,” he says.
Stevens, who lives about 30 minutes from London, began smoking marijuana when he was 15 as a way to keep friends, and was heavily into cocaine by the time he was 21. Now 31, he has been alcohol- and drug-free for more than two years.
He wasn’t expecting much when he made his first video, but he ended up with more than 100,000 views, so he put up another, and another, and another.
Were it not for the pandemic, he’s not sure that he would have drawn such an audience. But people were home, online, isolated from friends — and sometimes in despair.
The coronavirus had at times ripped away the routines that allowed them to hide their addictions from themselves, and his messages seemed to break through.
“I think what people connect with is the brutal honesty of what I do, the vulnerability,” Stevens said. “I show people the good stuff, the happy things you get to achieve, but then I also show people how difficult it’s been, how much pain I can sometimes be in.”
Alicia Gilbert of Florida, the author of the blog Soberish, runs a Facebook group that has 4,000 members. She has been sober for about six years, but other members are newer to sobriety and have had some unique struggles during the pandemic, she says.
Isolation was especially difficult for those cooped up in tiny apartments, away from families and friends, and easy ways to exercise or otherwise distract themselves. Not everyone got through the pandemic still sober, she says.
The group has members in their early twenties, and for them to acknowledge that alcohol is a problem can be particularly difficult, she says. The culture is telling them to go out, party, get three hours of sleep and go to work smelling of Jack Daniels whiskey, says Gilbert, who is 40.
“There are different regions in the country where drinking alcohol and bingeing it is super normal,” she says. “And then there are other places where you’re seeing trends go in the opposite way where the younger groups — and this is the Gen Zers — are looking at drinking and being like, ’Why would I want to do something that makes me feel ridiculous and then I start vomiting?’”
The question is whether those from Generation Z, born after 1996, have substituted other drugs instead.
Will Sobriety Be the Next Trend?
It’s hard to say how the wide availability of drugs and alcohol to younger generations will play out. But it’s possible that the rise of substances to ubiquity will peak and turn in the other direction.
In Austin, Texas, the alcohol-free Sans Bar was closed for a year until reopening on Friday nights in March 2021. Chris Marshall, the bar’s founder and a former substance abuse counselor who stopped drinking when he was 23, said he opened Sans Bar in 2015 following the death of a client who relapsed after telling Marshall that having a social life was difficult without alcohol, and because there were no options nearby for people who wanted to be social and sober.
Sans Bar began as a series of pop-ups and then became a brick-and-mortar location. Marshall approached the college campuses in Austin to make sure students knew the bar was there, and recently welcomed a group — all under 25 — who tried his drinks with an eye to opening a sober bar in Houston.
The attitude toward alcohol is shifting, says Marshall, 38. Young adults are leading the way, more aware of the effect of alcohol on their lives and more mindful of what they put into their bodies. He wants to make sober bars commonplace.
“I’m totally stealing from the vegan playlist,” he says. “The vegan playbook is my bible, and I follow it to the letter. Thirty years ago the idea of veganism was this outlier: ‘Oh my gosh, who wouldn’t eat meat, that’s weird.’ And now I can go to any restaurant nearly and there’s a vegan option.”
Additional reporting by Christina Vogt.