Adolescents' substance use trajectories across the COVID-19 pandemic: implications of pandemic disruptions and other risk and protective factors.

This accelerated longitudinal study investigated how the COVID-19 pandemic, associated disruptions, and other risk/protective factors shaped youths' alcohol and cannabis use trajectories. Data were collected from 682 Midwestern U.S. families, each with two adolescent siblings (M = 14.44 years, SD = 1.54; 49.8% female) and one parent (M = 45.15 years, SD = 5.37; 85% mothers; 87% of participating parents identified as White, 9% as Black or African American, and 4% as another racial group; 5% were Latinx) across four waves preceding and coinciding with the pandemic (from March 2019 through May 2023). Across the full age span modeled (11.25 to 20.75 years), in addition to "non-users," two trajectory classes were identified for both alcohol and cannabis reflecting patterns of "later onset, infrequent use" and "earlier onset, more frequent use". Comparing equivalent aged youth, substance use frequency was higher during than before the pandemic in both trajectory classes and for both substances, with greater differences among earlier frequent users. Across pandemic-related experiences and risk/protective factors, substance use trajectory group membership was most consistently predicted by parent, sibling, and friend substance use, and also by family chaos and financial strain. Overall, the pandemic amplified trajectories of use among substance-using youth. As heavier substance use trajectories negatively impact role transitions, substance problems, and health, continued support across the transition to adulthood may help mitigate ongoing impacts of the pandemic.