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Investigating Substance Use as a Coping Strategy Among Adolescent Psychiatric Inpatients: A Comparative Analysis Before and During the COVID-19 Pandemic

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Abstract

The COVID-19 pandemic resulted in significant changes in daily life, potentially impacting mental health and substance use behavior. Research on COVID-related changes in adolescent substance use have yielded mixed findings. The current cross-sectional chart review study compared rates of past-year substance use before and during COVID-19 among adolescent psychiatric inpatients, and investigated how motives for coping with COVID-19 changes were related to psychiatric acuity, and past-year substance use. 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 during COVID-19 (3/14/20 to 4/5/21) versus adolescents hospitalized before COVID-19 (8/30/2019 to 3/13/20). For a subsample of COVID-19 inpatients (n = 124; 75% female), we evaluated psychiatric correlates of endorsing substances to cope with COVID-19 changes/rules. Results indicated adolescents admitted during COVID-19 reported significantly more past-year alcohol and cannabis use days than adolescents admitted before COVID-19. Adolescents endorsed using alcohol (19%), cannabis (33%), and e-cigarettes/vaping (25%) to cope with COVID-19. E-cigarette/vaping to cope with 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. Adolescent psychiatric inpatients admitted during COVID-19 reported more substance use days than adolescents admitted before COVID-19. Using substances to cope was linked to psychiatric correlates (e.g., suicidality). Assessing the presence and function of substance use in this population may be important to identify, treat, and prevent compounding negative outcomes during times of community stress.

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Data Availability

Data from the current study are not available because of the sensitive nature of the content and because neither parental or adolescent consent was obtained to release the data.

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Acknowledgements

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Funding

Funding included K23DA050911 (Thomas), K23 MH119211 (Thompson), K01DA048135 (Micalizzi), K99AA030030 (Meisel), K23MH112889 (Peters), and the COBRE Center for Sleep and Circadian Rhythms in Child and Adolescent Mental Health P20GM139743. National Institutes of Health (NIH) had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Bradley Hasbro Children’s Research Center, 25 Hoppin St, Box #36, Providence, RI, 02903, USA

    Sarah A. Thomas

  2. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA

    Sarah A. Thomas, Elizabeth C. Thompson, Jessica R. Peters & Jennifer C. Wolff

  3. Child and Adolescent Psychiatry, Rhode Island Hospital, Providence, Rhode Island, 02903, USA

    Elizabeth C. Thompson & Jennifer C. Wolff

  4. Bradley Hospital, Riverside, RI, 02915, USA

    Elizabeth C. Thompson, Samuel N. Meisel, Micaela Maron, Sarah K. Ryan & Jennifer C. Wolff

  5. Center for Alcohol & Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI, 02903, USA

    Lauren Micalizzi & Samuel N. Meisel

  6. Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G, Providence, RI, S121-502912, USA

    Lauren Micalizzi

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Contributions

ST designed the study, analyzed and interpreted the data, and contributed to writing and editing the manuscript. ET contributed to study design and was a major contributor in writing the manuscript. JP contributed to data analysis, interpretation, and manuscript editing. LM and SM were major contributors in writing the manuscript. MM organized and pre-processed the data prior to analyses and contributed to manuscript writing. SR prepared and edited tables, references, and contributed to manuscript editing. JW contributed to study design, data collection, and manuscript writing/editing. All authors read and approved the final manuscript.

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Correspondence to Sarah A. Thomas.

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The study was conducted as a retrospective chart review, for which informed consent/assent was waived, that was approved by the hospital’s institutional review board (IRB # 879582).

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Thomas, S.A., Thompson, E.C., Peters, J.R. et al. Investigating Substance Use as a Coping Strategy Among Adolescent Psychiatric Inpatients: A Comparative Analysis Before and During the COVID-19 Pandemic. Child Psychiatry Hum Dev (2024). https://doi.org/10.1007/s10578-024-01731-0

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