The recreational use of various intoxicants is prevalent in young adults.  Early adult life is often characterized by experimentation and exploration, with sensation-seeking behavior often being fulfilled through consumption of alcohol and other substances.  Harmful drinking is a widespread concern among the young adult demographic in the United States, rendering a litany of consequences related for risky drinkers.  Additionally, cannabis consumption continues to increase across all demographics in the U.S. due in part to decriminalization and legalization measures implemented across nearly half of the states.  While the research regarding the health effects of cannabis is not nearly as robust as that of alcohol, early studies have identified cannabis use to potentially precipitate and/or exacerbate different forms of mental illness like schizophrenia and depression in predisposed individuals.  While the existence of alcohol use disorders is considered common knowledge, use disorders of cannabis have also been found to be prevalent despite public perception.  This study aims to delineate potential changes in alcohol and cannabis use patterns among young adults from 2002 to 2018. 

The study utilizes data from a nationwide, longitudinal series of surveys created and administered by the National Survey of Drug Use and Health from 2002 to 2018.  Response data for 182,722 survey participants aged 18-22 was pulled and quantified, serving as the study’s sample (N=182,722, 51.1% male).  The sample was grouped according to college attendance status, and the following measures taken from the NSDUH surveys were assessed: past-year alcohol use, past-year cannabis use, past year illicit substance use, past-year prescription drug use, alcohol use disorder symptoms (using DSM-IV criteria), cannabis use disorder symptoms (using DSM-IV criteria), general mental health history, and demographics.  The data was analyzed using binary and multinomial regression analysis. 

Results of the data analysis indicated an increase in past-year alcohol abstinence (with a corresponding decrease in disordered use) in young adults from 2002 to 2018, but also a decrease in past-year cannabis abstinence in the demographic.  These findings were consistent for both college-attending and non-college-attending individuals.  Additionally, non-disordered cannabis use increased across both aforementioned cohorts, while disordered use prevalence did not change.  Co-use of alcohol and cannabis also increased, and illicit drug use and prescription drug use was found to be rather common (>75%) in disordered alcohol-cannabis users.   

Takeaway: alcohol use among young adults may show signs of population-wide improvements, while cannabis consumption continues to steadily increase across the demographic.  Research concerning cannabis use will remain in high demand as public health officials consider the substance’s various impacts.  Prescription drug abuse among young adults must also be more thoroughly investigated in order to develop necessary prevention and intervention protocols.

McCabe SE, Arterberry BJ, Dickinson K, et al. Assessment of Changes in Alcohol and Marijuana Abstinence, Co-Use, and Use Disorders Among US Young Adults From 2002 to 2018. JAMA Pediatrics. 2021;175(1):64-72. doi:10.1001/jamapediatrics.2020.3352