Overall rates of drug use among American adolescents held stable six months into COVID-19 pandemic, however shifting trends indicated an uptick in nicotine and prescription drug misuse while alcohol use fell.

Federally-backed research published in the Journal of Adolescent Health drew from surveys of over 7,800 kids aged 10-14 enrolled in the Adolescent Brain Cognitive Development study (ABCD), said to be the largest-ever long-term U.S. study of brain development and pediatric health.

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Results also suggested young teens who experienced severe stress, anxiety or depression, or familial economic hardship were at highest risk of using substances.

"The past year has been difficult, and adolescents have experienced a year of turmoil and stress in precarious space between childhood and adulthood," Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, said in a news release. "Recognizing how the stress of the past year translates into substance use has profound implications into adulthood, because drinking and drug use at these ages are associated with a substantially higher risk of long-term alcohol and drug use disorders and related harms."

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Researchers conducted the study through three surveys administered in May, June and August 2020. Findings among a subset of over 1,000 participants revealed declining alcohol use, from 1.9% to 0.7% among surveys taken 30 days prior to the pandemic to the first survey collected during the pandemic. Nicotine and prescription drug misuse climbed, with researchers reporting an increase from 0% in the month pre-pandemic to 1.5% and 0.7% in the first survey during the pandemic, respectively.

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The study didn’t explain the underlying causes behind the shifting trends and the release noted further studies are needed.

"These data suggest substance use during the pandemic was concentrated among youth from the most vulnerable families, underscoring the need to provide support to those young people and their families," William E. Pelham, Ph.D., study lead of the University of California, San Diego, said in a statement in part. "But we should also look forward, beyond the 2020 data, to understand how alcohol and drug use will continue to evolve as people return to school and work."