In a recent study posted to the medRxiv* preprint server, researchers demonstrated changes in alcohol and cannabis use among young adults in Canada and the United States (US) during pre-coronavirus disease 2019 (COVID-19) times, COVID-19-induced lockdown, and when social restrictions eased later.
With the emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, the world will likely continue to go back and forth between various extents of social restrictions, if not a complete lockdown. Thus, it is imperative to evaluate the long-term impacts of a pandemic on substance use and mental health.
In the present retrospective study, researchers invited 552 young adults from Canada and the US to complete online questionnaires for three-time points: Pre-COVID-19, Lockdown, and Eased Restrictions, and assessed the impact of sociodemographic factors, such as age, gender, employment status, education level, and perceived social support on substance use.
The final study population comprised 463 participants, from which the team collected data between August and November 2020. The time point 1 from January to early March 2020 was the pre-COVID era. Likewise, point 2 from mid-March to the end of May 2020 was the COVID-19 lockdown time, and point 3 between June to July 2020 was the Eased Restrictions.
The researchers used a validated multi-dimensional scale of perceived social support (MSPSS) to measure social support across all three study time points. The MSPSS had 13 questions rated on a seven-point Likert scale, with one indicating 'very strongly disagree' to seven indicating 'very strongly agree'. They summed all items to assign a composite Social Support score to every study participant.
Likewise, the researchers used a validated Timeline Followback Alcohol and Marijuana Use Calendar (TLFB) to measure alcohol and cannabis use among the study participants. The number of drinks (alcohol) and ingestions (cannabis) indicated the quantity of alcohol and cannabis consumed. Respondents typically self-reported the number of days and the number of alcoholic drinks consumed in a typical week for each time point. Similarly, they reported the number of days and the number of times they ingested cannabis during a typical week within each time point.
The team ran an Analysis of Variances (ANOVAs)to determine the impact of time points on perceived social support and levels of substance use. Subsequently, they used four linear mixed-effects models to predict each substance use measure from social support for three study time points (fixed effects), and participants (random effects).
The MSPSS scores ranged between 12 and 84, i.e., from low to high social support. Regarding overall trends in substance use, the number of days alcohol consumed first decreased from Pre-COVID to Lockdown time (M= 2.01 vs. 1.34 vs. 2.36) before increasing again during Eased Restrictions. Likewise, the quantity of alcohol consumed followed the same pattern during these three-time points, with M=7.25 vs. 3.37 vs. 5.75.
Conversely, the number of days for which Cannabis was consumed increased from Pre-COVID to Lockdown (M= 1.64 vs. 2.36 vs. 1.66) before decreasing during Eased Restrictions. Likewise, the quantity of cannabis ingested followed the same pattern during these three-time points, with M=3.96 vs. 6.56 vs. 4.19.
The current study showed the impact of social support and changes to social environments during the COVID-19-induced lockdown. Compared to pre-COVID-19 times, during the lockdown, while alcohol use decreased, cannabis use increased. Perhaps during the COVID-19 lockdown, the young adults substituted alcohol with cannabis, reflecting that motives to use these two substances vary. In other words, drinking alcohol is socially motivated, whereas cannabis use is typically motivated by a desire to reduce stress and anxiety.
The COVID-19 lockdown gave fewer opportunities for social interactions but enhanced boredom and pandemic-related stress. The authors noted a rebound in alcohol use and cannabis use to pre-COVID-19 levels among young adults during Eased Restrictions. These findings further evidenced that drinking in young adults is socially motivated; furthermore, individuals with higher social support used cannabis to cope with stress and boredom during prolonged social isolation during the COVID-19 lockdown.
Future studies using cross-sectional and prospective cohort designs alone could satisfactorily answer the concerns raised in the current review. First, these studies should investigate alcohol and cannabis use in different living situations. Second, it is crucial to clarify the degree to which social motivations dictate alcohol use among young adults with higher versus lower social support. Similarly, studies should investigate if stress reduction is the real motivation for youth to indulge in cannabis use.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.