Marijuana and hallucinogen use among young adults reached an all-time record last year after having leveled off during the first year of the coronavirus pandemic, according to federal survey data.
The findings, part of the government’s annual survey of drug use among young Americans, also found that nicotine vaping and excessive alcohol consumption continued to climb in 2021 after a brief pause. Another worrying trend among young people, ages 19 to 30: mounting consumption of alcoholic beverages suffused with THC, the psychoactive ingredient in cannabis.
But there were some bright spots in the survey. Cigarette smoking and opioid abuse among young adults dropped last year, a continuing trend that has heartened public health experts.
Taken in its entirety, the report provides a mixed picture of substance use in the United States that experts say reflects a number of disparate trends affecting young Americans: the devastating mental health effects of the pandemic; the increased availability of legal marijuana; and the emerging therapeutic embrace of psychedelics to treat depression, post-traumatic stress disorder and other psychological problems.
“Overall, the results are very concerning,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which publishes the annual Monitoring the Future survey. “What they tell us is that the problem of substance abuse among young people has gotten worse in this country, and that the pandemic, with all its mental stressors and turmoil, has likely contributed to the rise.”
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The online survey of people ages 19 to 60 was conducted from April to October 2021.
Substance use research experts said the mounting use of marijuana in young adults was especially notable. The survey found that 43 percent in the 19-30 age group had used cannabis 20 or more times over the previous month, up from 34 percent. In 2011, that figure was 29 percent. Daily marijuana consumption also jumped significantly, to 11 percent from 6 percent in 2011.
Increases in use also occurred among people ages 35 to 50, according to the survey.
Not surprisingly, the surge in marijuana use has been occurring in tandem with a rise in the number of states that have legalized recreational use — 19 in the past decade. (Another 13 states allow the medical use of cannabis.) Experts say the normalization of marijuana has helped persuade many young people that it is harmless.
A similar dynamic, experts say, is also at play with psychedelics. The use of hallucinogens had been stable for decades, but in 2021, 8 percent of young adults reported using psychedelics compared with 3 percent in 2011, a record high since the category was first surveyed in 1988.
Over the past few years, researchers say, increasing media coverage and social media chatter about the potential therapeutic value of ketamine, psilocybin mushrooms and ecstasy have helped chip away at long-held taboos that were fostered during the nation’s failed war on drugs.
“It’s about availability, but also about peer acceptability,” said Dr. Kevin M. Gray, a professor of psychiatry and behavioral sciences at the Medical University of South Carolina. “Generally speaking, young people don’t see these substances as dangerous, but the consequences of using them are still there.”
Although the risks associated with psychedelics tend to be short-lived — overdoses are rare and most compounds are not addictive — experts stress the importance of using them with professional guidance. Some states have decriminalized psilocybin, but it and other popular psychedelics remain prohibited under federal law, though the Food and Drug Administration is expected to grant approvals for some therapeutic uses in the coming years.
With marijuana use, the dangers include the risks of impaired driving, the potential for addiction and the effects on mental health such as heightened anxiety, depression and temporary psychosis.
Many of those risks have increased alongside the potency of THC levels in cannabis, and more so with vaping products, said Sion Kim Harris, co-director of the Center for Adolescent Substance Abuse Research at Boston Children’s Hospital. Some vaping concentrates contain THC levels of 90 percent or higher and the increased potency, she said, has contributed to a spike in cannabinoid hyperemesis syndrome, a condition that causes recurrent vomiting in heavy marijuana users.
Overall, Professor Harris said she was encouraged by some of the survey’s trends, including the continued declines in tobacco use, especially among teenagers. The drop in smoking, she noted, highlighted the benefits of sustained and consistent public health messaging about the perils of tobacco. But she said the rise in drug and alcohol use among college-age individuals was worrisome, especially given the potential to form lifelong habits during those pivotal years. “Stress is a real contributor to increased substance use and it’s really been a tough time for millennials and Gen Z,” she said.
Dr. Volkow, the N.I.D.A. director, agreed. Given the normalization of formerly illicit substances, she said public health experts needed to come up with more nuanced and thoughtful ways of communicating the potential dangers of recreational drugs that also have therapeutic benefits.
“As a society, we tend to be very categorical about these things,” she said. “We say drugs are so bad they will fry your brains like an egg and then we undermine the evidence that they can be harmful, depending on the dose and the person who takes them. By making everything black and white, we lose all credibility.”