Intensifying Substance Use Trends among Youth: A Narrative Review of Recent Trends and Implications.

Purpose of review: Substance use among adolescents and young adults remains a critical public health concern, with patterns shifting dramatically in recent years. This narrative review examines trends in substance use behaviors during and following the COVID-19 pandemic.

Recent findings: Epidemiologic evidence shows declines in the proportion of youth who are using most substances but intensified consumption patterns with rising levels of disorder among adolescents who use substances. This picture may reflect the greater potency, availability and accessibility of substances, vulnerabilities related to poor mental health, minoritization, as well as social factors including pandemic stressors, commercial and regulatory forces - in short, features of the agent (substance), host (person), and environment (context), consistent with a public health formulation. Understanding trends in youth substance use and related problems, especially in the context of contributing factors, is critical for informing clinical care strategies and public health interventions to improve outcomes for youth across diverse populations.