Changes in Young Adult Substance use during COVID-19 as a Function of ACEs, Depression, Prior Substance use and Resilience

Abstract

Background: Given the potential for increased substance use during COVID-19, we examined (1) young adults’ changes in cigarette, e-cigarette, marijuana, and alcohol use from pre- to during COVID-19; and (2) related risk/protective factors. These findings could inform intervention efforts aimed at curbing increases in substance use during periods of societal stress. Methods: We analyzed Wave 3 (W3; September–December 2019) and Wave 4 (W4; March–May 2020) from the Vape shop Advertising, Place characteristics and Effects Surveillance (VAPES), a 2-year, five-wave longitudinal study of young adults across six metropolitan areas. We examined risk/protective factors (i.e. adverse childhood experiences [ACEs], depressive symptoms, resilience) in relation to changes in past 30-day substance use frequency. Results: In this sample (N = 1084, Mage=24.76, SD = 4.70; 51.8% female; 73.6% White; 12.5% Hispanic), W3/W4 past 30-day use prevalence was: 29.1% cigarettes (19.4% increased/26.4% decreased), 36.5% e-cigarettes (23.2% increased/28.6% decreased), 49.4% marijuana (27.2% increased/21.2% decreased), and 84.8% alcohol (32.9% increased/20.7% decreased). Multivariate regressions indicated that, greater increases were predicted by: for e-cigarettes, greater ACEs; and for alcohol, greater depression. Among those with low resilience, predictors included: for e-cigarettes, greater depression; and for marijuana, greater ACEs. Conclusions: Interventions to reduce substance use during societal stressors should target both risk and protective factors, particularly resilience.

Substance Use Among Youth During the COVID-19 Pandemic: a Systematic Review

“…A total of 32 studies included measures on alcohol use; 27 of those also included measures on one or more other types of substance use [ 22 , 23 ••, 24 – 31 , 32 •, 33 , 34 ••, 35 – 48 ], with five focusing exclusively on alcohol use as the outcome [ 49 – 53 ]. Fourteen studies employed a cross-sectional design [ 22 , 25 , 26 , 33 , 37 – 41 , 44 – 46 , 48 , 49 ] and 18 used longitudinal designs [ 23 ••, 24 , 27 – 31 , 32 •, 34 ••, 35 , 36 , 42 , 43 , 47 , 50 – 53 ]. Twenty-four studies used a non-random selection of participants, including convenience, purposive, or volunteer samples [ 22 , 24 – 26 , 28 , 29 , 31 , 35 – 46 , 49 – 53 ].…”

“…Five studies reported increase in alcohol use [ 22 , 26 , 30 , 36 , 45 ], 12 studies reported decrease in alcohol use [ 23 ••, 32 •, 34 ••, 35 , 38 , 39 , 47 , 48 , 50 – 53 ], and four studies reported no change [ 24 , 28 , 31 , 43 ], as noted above, mainly because of cross-sectional design where alcohol was employed as a covariate or group divider. Eleven studies reported neither an increase nor a decrease in alcohol use [ 25 , 27 , 29 , 33 , 37 , 40 – 42 , 44 , 46 , 49 ].…”

“…A total of 20 studies included measures on use of cannabis, including marijuana, hashish, and edibles. Seventeen of these also included measures into one or more other type of substance use [ 24 – 28 , 31 , 32 •, 33 , 34 ••, 35 , 36 , 39 , 42 , 44 , 46 , 47 , 54 ], three of which focused exclusively on cannabis use as the outcome [ 55 •, 56 , 57 ]. Nine studies employed a cross-sectional design [ 25 , 26 , 33 , 39 , 44 , 46 , 54 , 56 , 57 ] and 11 used a longitudinal design [ 24 , 27 , 28 , 31 , 32 •, 34 ••, 35 , 36 , 42 , 47 , 55 •].…”

“…Seventeen of these also included measures into one or more other type of substance use [ 24 – 28 , 31 , 32 •, 33 , 34 ••, 35 , 36 , 39 , 42 , 44 , 46 , 47 , 54 ], three of which focused exclusively on cannabis use as the outcome [ 55 •, 56 , 57 ]. Nine studies employed a cross-sectional design [ 25 , 26 , 33 , 39 , 44 , 46 , 54 , 56 , 57 ] and 11 used a longitudinal design [ 24 , 27 , 28 , 31 , 32 •, 34 ••, 35 , 36 , 42 , 47 , 55 •]. Fifteen studies used a non-random selection of participants, including convenience, purposive, or volunteer samples [ 24 – 26 , 28 , 31 , 35 , 36 , 39 , 42 , 44 , 46 , 54 , 55 •, 56 , 57 ].…”

“…Nine studies employed a cross-sectional design [ 25 , 26 , 33 , 39 , 44 , 46 , 54 , 56 , 57 ] and 11 used a longitudinal design [ 24 , 27 , 28 , 31 , 32 •, 34 ••, 35 , 36 , 42 , 47 , 55 •]. Fifteen studies used a non-random selection of participants, including convenience, purposive, or volunteer samples [ 24 – 26 , 28 , 31 , 35 , 36 , 39 , 42 , 44 , 46 , 54 , 55 •, 56 , 57 ].…”