New data show relatively low use of illicit substances, yet overdose death rates among adolescents have risen in recent years

The percentage of teenagers reporting they used any illicit substances in 2023 held steady below the pre-pandemic levels reported in 2020, according to the latest results from the Monitoring the Future survey.

Reported use for almost all substances decreased dramatically between 2020 and 2021, after the onset of the COVID-19 pandemic and related changes like school closures and social distancing. In 2022, most reported substance use among adolescents held steady at these lowered levels, and these latest data show that this trend has continued this year. In 2023, 10.9% of eighth graders, 19.8% of 10th graders, and 31.2% of 12th graders reported any illicit drug use in the past year.

The Monitoring the Future survey is conducted by researchers at the University of Michigan and funded by the National Institute on Drug Abuse, part of the National Institutes of Health.

“We’ve been watching closely to see if the big declines in teen substance use after the pandemic would persist, or if substance use levels would bounce back when students returned to school. We’re glad to see that the declines have persisted,” said Richard Miech, team lead of the Monitoring the Future study at U-M’s Institute for Social Research. “These results support a growing body of evidence showing that a one-year delay in drug use during adolescence can lower future trajectories of drug use for years to come.”

The Monitoring the Future survey is given annually to students in eighth, 10th and 12th grades who self-report their substance use behaviors over various time periods, such as past 30 days, past 12 months and lifetime. The survey also documents students’ perceptions of harm, disapproval of use and perceived availability of drugs. Results are released the same year the data are collected. From February through June 2023, the Monitoring the Future investigators collected 22,318 surveys from students enrolled across 235 public and private schools in the United States.

When breaking down the data by specific drugs, the survey found that teens most commonly reported use of alcohol, nicotine vaping and cannabis in the past year, and levels generally declined from or held steady with the lowered use reported in 2022. Compared to levels reported in 2022, data reported in 2023 show:

• Alcohol use remained stable for eighth and 10th graders, with 15.1% and 30.6% reporting use in the past year respectively, and declined for 12th graders, with 45.7% reporting use in the past year (compared to 51.9% in the previous year).
• Nicotine vaping remained stable for eighth graders, with 11.4% reporting vaping nicotine in the past year. It declined in the older grades, from 20.5% to 17.6% in 10th grade and from 27.3% to 23.2% in 12th grade.
• Cannabis use remained stable for all three grades surveyed, with 8.3% of eighth graders, 17.8% of 10th graders and 29% of 12th graders reporting cannabis use in the past year. Of note, 6.5% of eighth graders, 13.1% of 10th graders and 19.6% of 12th graders reported vaping cannabis within the past year, reflecting a stable trend among all three grades.
• Delta-8 THC (a psychoactive substance found in the cannabis sativa plant, of which marijuana and hemp are two varieties) use was measured for the first time in 2023, with 11.4% of 12th graders reporting use in the past year. Beginning in 2024, eighth and 10th graders will also be asked about delta-8 use.
• Any illicit drug use other than marijuana also remained stable for all three grades surveyed, with 4.6% of eighth graders, 5.1% of 10th graders, and 7.4% of 12th graders reporting any illicit drug use other than marijuana in the past year. These data build on long-term trends documenting low and fairly steady use of illicit substances reported among teenagers—including past-year use of cocaine and heroin, and misuse of prescription drugs, generally.
• Use of narcotics other than heroin (including Vicodin, OxyContin, Percocet, etc.) decreased among 12th graders, with 1% reporting use within the past year (matching the all-time low reported in 2021 and down from a high of 9.5% in 2004).
• Abstaining, or not using, marijuana, alcohol and nicotine increased for 12th graders, with 62.6% reporting abstaining from any use of these substances over the past month. This percentage remained stable for eighth and 10th graders, with 87% and 76.9% reporting abstaining from any use of marijuana, alcohol and nicotine over the past month.

“For 49 consecutive years, the Monitoring the Future survey has closely monitored shifts in substance use trends among young people, helping to identify and track emerging trends with public health relevance,” Miech said. “This year’s addition of a measure to assess use of delta-8 is one example of this, and we were surprised to see use levels this high among 12th graders. Moving forward, as policies and access to this drug change, it will be important to continue to monitor use of this drug among teens.”

Though the sample size of 22,318 respondents in 2023 was lower than the sample size of a typical pre-pandemic year’s data collection, the results were gathered from a nationally representative sample and the data were statistically weighted to provide national numbers.

This year, 13% of students who took the survey identified as Black or African American, 1% as American Indian or Alaska Native, 3% as Asian, 25% as Hispanic, 1% as Middle Eastern, 41% as white and 16% as more than one of the preceding categories. The survey also asks respondents to identify as male, female, other or prefer not to answer. For the 2023 survey, 48% of students identified as male, 47% identified as female, 1% identified as other and 4% selected the “prefer not to answer” option.

The Monitoring the Future investigators note that schools opt-in to participate in the survey, and some schools that had historically participated opted-out in the years following the onset of the COVID-19 pandemic. All participating students took the survey via the web—either on tablets or on a computer—with 98% of respondents taking the survey in-person in school in 2023. Therefore, students with less engagement in school—a known risk factor for drug use—may have been less likely to participate in the survey.