Investigating Substance Use as a Coping Strategy Among Adolescent Psychiatric Inpatients: A Comparative Analysis Before and During the COVID-19 Pandemic
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: The COVID-19 pandemic was accompanied by significant changes in daily life, which impacted mental health and substance use behavior. Among adolescents, studies of COVID-related changes in rates of substance use yielded mixed findings. While studies of large U.S. samples found no significant increases in adolescent substance use during COVID-19, studies of youth with psychiatric symptoms suggest that some adolescents used substances to cope with negative affect during COVID-19. The current study compared rates of past-year substance use among adolescent psychiatric inpatients before and during COVID-19. Motives for coping with changes due to COVID-19 were assessed and evaluated in relation to correlates associated with psychiatric acuity (e.g., suicidal thoughts), and rate of past-year substance use. Methods: This cross-sectional chart review study analyzed hospital intake data of psychiatrically hospitalized adolescents before and during COVID-19. Count models assessed if the number of past-year days of alcohol and cannabis use was higher among adolescents (n=491, 11-18 years, 61% female) hospitalized between 3/14/20 to 4/5/21 (“COVID-19”) versus 8/30/2019 to 3/13/20 (“pre-COVID). For a subsample of inpatients admitted during COVID-19 (n=124; 75% female), we evaluated psychiatric correlates of endorsing alcohol, cannabis, or e-cigarettes to cope with COVID-19 changes/rules. Finally, we tested if past-year days of alcohol or cannabis use were greater for adolescents reporting they used that substance to cope with COVID-19.Results: Adolescents admitted during COVID-19 reported significantly more past-year alcohol and cannabis use days than adolescents admitted pre-COVID. Adolescents endorsed using alcohol (19%), cannabis (33%), and e-cigarettes/vaping (25%) to cope with COVID-19. E-cigarette/vaping to cope during COVID-19 was significantly related to lifetime suicide attempt. Endorsing alcohol or cannabis to cope with COVID-19 was associated with a significantly greater number of past-year use days for each respective substance. Conclusion: Adolescents admitted to a psychiatric inpatient unit during COVID-19 had a higher rate of substance use than adolescents admitted pre-COVID. Using substances to cope was linked to psychiatric correlates (suicide attempt, impairment). Substance use patterns among psychiatrically vulnerable adolescents may be distinct from adolescents whose substance use is linked to other, non-coping motivations, and have important implications from preventing compounding negative outcomes among these youth.
Authors: Sarah A. Thomas, Elizabeth C. Thompson, Jessica R. Peters, Lauren Micalizzi, Samuel N. Meisel, Micaela Maron, Sarah K. Ryan, Jennifer C. Wolff
Language: English
Topic: COVID-19 and Mental Health
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Awards: Anger Rumination in the Development of Psychopathology, Experimentally Testing the Effect of Parent-Adolescent Conflict on HIV Risk, A Treatment Engagement Protocol to Improve Follow-Up Care for Psychiatrically Hospitalized Adolescents at Clinical High Risk for Psychosis, Cognitive flexibility and reward motivation in adolescent cannabis use: An investigation of neurobehavioral mechanisms and intrinsic resting state connectivity., Assessing Parenting at the Momentary Level to Understand Parenting Behaviors that Contribute to Improved Treatment Outcomes for Youth with Co-Occurring Disorders, Prenatal Tobacco Exposure: Self-Regulatory Pathways to Externalizing Behaviors, Advance Clinical and Translational Research (Advance-CTR), COBRE Center for Sleep and Circadian Rhythms in Child and Adolescent Mental Health
OpenAlex ID: W4400313542