Research & Resources

Adolescence is a critical phase of development and is frequently a period of initiating and engaging in risky behaviors, including alcohol and other substance use. To examine substance use patterns and understand how substance use among high school students changed before and during the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) analyzed data from the nationally representative Youth Risk Behavior Survey. This report presents estimated prevalence among high school students of current (i.e., previous 30-day) alcohol use, marijuana use, binge drinking, and prescription opioid misuse, as well as lifetime alcohol, marijuana, synthetic marijuana, inhalant, ecstasy, cocaine, methamphetamine, heroin, and injection drug use and prescription opioid misuse. The survey demonstrated that substance use prevalence declined from 2009 to 2021. From 2019 to 2021, the prevalence of current alcohol use, marijuana use, and binge drinking; lifetime use of alcohol, marijuana, and cocaine; and lifetime prescription opioid misuse decreased, while lifetime inhalant use increased. In 2021, substance use varied by sex, race and ethnicity, and sexual identity. Nearly one-third of students (29%) reported current alcohol or marijuana use or prescription opioid misuse. Among those reporting any current substance use, approximately 34% used two or more substances. Widespread implementation of tailored, evidence-based policies, programs, and practices likely to reduce risk factors for adolescent substance use and promote protective factors might further decrease substance use among U.S. high school students. Such programs are urgently needed in the context of the changing marketplace for alcohol beverage products and other drugs (e.g., release of high-alcohol beverage products and increased availability of counterfeit pills containing fentanyl).

This paper, “Alcohol and other substance use before and during the COVID-19 pandemic among high school students—Youth Risk Behavior Survey, United States, 2021,” was funded by the Centers for Disease Control and Prevention (CDC) and published in the journal Morbidity and Mortality Weekly Report (MMWR) Supplements.