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Health

Adult drug use rose during pandemic, but dropped dramatically in youth, study says

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CNN
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Use of marijuana and other substances dropped in teenagers during the first year of the pandemic, according to a new study.

But adults’ use of cannabis, illegal drugs and alcohol, including binge drinking, either stayed the same or increased compared to the two years before Covid-19.

“Substance use decreased between 2019 and 2020 among those aged 13 to 20 years,” wrote first author Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse.

However, “consistent declines were not seen in older persons other than tobacco use reductions, and cannabis use increased among adults ages 25 years and older,” he and his coauthors wrote.

The study analyzed data from the Population Assessment of Tobacco and Health Study, which follows tobacco and other substance use over time among 49,000 US youths and adults.

“A particular strength of this study was the longitudinal design,” said Joseph Palamar, an associate professor of population health at NYU Grossman School of Medicine, who was not involved in the study.

“This design allows us to look at changes among the same people over time as opposed to other national studies which compare different groups of people across time,” he said.

Substance abuse dropped in teenagers between ages 13 and 17, according to the study published Tuesday in the journal JAMA Network Open.

Cannabis use among teenagers ages 13 and 15 dropped by 3.4 percentage points in 2020 compared to 2018 and 2019, while tobacco use declined by about 4 points, the study found. The use of other illegal or misused prescription drugs also fell 2.5 percentage points in this age group.

Use of marijuana in teens ages 16 and 17 dropped 7.3 percentage points in 2020 compared to 2018 and 2019. Tobacco use fell by over 10 points and misuse of drugs sank by nearly 3 percentage points. Binge drinking dipped by 1.6 percentage points across the age group.

“I think availability plays a big part,” Palamar said. “If high schoolers are separated from their friends for a long time and stuck inside, they’ll likely have decreased access to drugs.

“Even if a teen successfully obtained weed, this doesn’t mean he or she had somewhere away from parents to smoke it if the whole family was on lockdown,” he added.

The use of alcohol increased by over five percentage points (from 60.2% to 65.2%) among adults ages 21 to 24 years old in 2020 compared to the previous two years. Binge drinking, however, fell by 2.2 points.

Tobacco use fell by about 8 percentage points, but use of marijuana and other illegal or prescription drugs did not change significantly in this age group, according to the study.

Use of marijuana increased slightly in adults 25 and up, by 1.2 percentage points. Declines in other substance abuse in this age group were not significant, the study authors said.

Tobacco use fell for all adults, the study found. The number of young adults ages 18 to 20 smoking tobacco dropped by just over 15 percentage points in 2020 compared to 2018 and 2019. Smoking also declined by about 8 points in adults ages 21 and up over the same period.

However, a drop in drug use during the early days of Covid did not mean the reduction continued as the pandemic wore on, said Palamar, who has been studying drug availability during that period.

“Decreases in use during the early months of Covid are meaningful, but we need to keep in mind that use of some drugs rebounded,” Palamar said. “For example, we found that seizures of marijuana and methamphetamine decreased after the start of Covid, and then rebounded to a much higher rate later in the year.”

A separate survey of people ages 19 to 30 found they were using marijuana and hallucinogens at high rates in 2021. The Monitoring the Future Study, published in 2022, found 11% of people in this age group used marijuana on a daily basis in 2021, while 43% said they had used it in the past year.

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Surgeon General says 13 is ‘too early’ to join social media

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CNN
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US Surgeon General Vivek Murthy says he believes 13 is too young for children to be on social media platforms, because although sites allow children of that age to join, kids are still “developing their identity.”

Meta, Twitter, and a host of other social media giants currently allow 13-year-olds to join their platforms.

“I, personally, based on the data I’ve seen, believe that 13 is too early … It’s a time where it’s really important for us to be thoughtful about what’s going into how they think about their own self-worth and their relationships and the skewed and often distorted environment of social media often does a disservice to many of those children,” Murthy said on “CNN Newsroom.”

The number of teenagers on social media has sparked alarm among medical professionals, who point to a growing body of research about the harm such platforms can cause adolescents.

Murthy acknowledged the difficulties of keeping children off these platforms given their popularity, but suggested parents can find success by presenting a united front.

“If parents can band together and say you know, as a group, we’re not going to allow our kids to use social media until 16 or 17 or 18 or whatever age they choose, that’s a much more effective strategy in making sure your kids don’t get exposed to harm early,” he told CNN.

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New research suggests habitually checking social media can alter the brain chemistry of adolescents.

According to a study published this month in JAMA Pediatrics, students who checked social media more regularly displayed greater neural sensitivity in certain parts of their brains, making their brains more sensitive to social consequences over time.

Psychiatrists like Dr. Adriana Stacey have pointed to this phenomenon for years. Stacey, who works primarily with teenagers and college students, previously told CNN using social media releases a “dopamine dump” in the brain.

“When we do things that are addictive like use cocaine or use smartphones, our brains release a lot of dopamine at once. It tells our brains to keep using that,” she said. “For teenagers in particular, this part of their brain is actually hyperactive compared to adults. They can’t get motivated to do anything else.”

Recent studies demonstrate other ways excessive screen time can impact brain development. In young children, for example, excessive screen time was significantly associated with poorer emerging literacy skills and ability to use expressive language.

Democratic Sen. Chris Murphy, who recently published an op-ed in the Bulwark about loneliness and mental health, echoed the surgeon general’s concerns about social media. “We have lost something as a society, as so much of our life has turned into screen-to-screen communication, it just doesn’t give you the same sense of value and the same sense of satisfaction as talking to somebody or seeing someone,” Murphy told CNN in an interview alongside Murthy.

For both Murphy and Murthy, the issue of social media addiction is personal. Both men are fathers – Murphy to teenagers and Murthy to young children. “It’s not coincidental that Dr. Murthy and I are probably talking more about this issue of loneliness more than others in public life,” Murphy told CNN. “I look at this through the prism of my 14-year-old and my 11-year-old.”

As a country, Murphy explained, the U.S. is not powerless in the face of Big Tech. Lawmakers could make different decisions about limiting young kids from social media and incentivizing companies to make algorithms less addictive.

The surgeon general similarly addressed addictive algorithms, explaining pitting adolescents against Big Tech is “just not a fair fight.” He told CNN, “You have some of the best designers and product developers in the world who have designed these products to make sure people are maximizing the amount of time they spend on these platforms. And if we tell a child, use the force of your willpower to control how much time you’re spending, you’re pitting a child against the world’s greatest product designers.”

Despite the hurdles facing parents and kids, Murphy struck a note of optimism about the future of social media.

“None of this is out of our control. When we had dangerous vehicles on the road, we passed laws to make those vehicles less dangerous,” he told CNN. “We should make decisions to make [social media] a healthier experience that would make kids feel better about themselves and less alone.”

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Health

Updated childhood obesity treatment guidelines include medications, surgery for some young people

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CNN
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Updated American Academy of Pediatrics guidelines for treatment of obesity urge prompt use of behavior therapy and lifestyle changes, and say surgery and medications should be used for some young people.

The guidelines, published Monday in the journal Pediatrics, are the first comprehensive update to the academy’s obesity treatment guidelines in 15 years. They provide guidance for treatment of children as young as 2 and through the teen years.

The guidelines acknowledge that obesity is complex, and tied to access to nutritious foods and health care, among other factors.

Treatment for younger children should focus on behavior and lifestyle treatment for the entire family, including nutrition support and increased physical activity. For children 12 and older, use of weight loss medications is appropriate, in addition to health behavior therapy and lifestyle treatment, AAP says. Teens 13 and older with severe obesity should be evaluated for surgery, according to the guidelines.

“There is no evidence that ‘watchful waiting’ or delayed treatment is appropriate for children with obesity,” Dr. Sandra Hassink, an author of the guideline and vice chair of AAP’s Clinical Practice Guideline Subcommittee on Obesity, said in a statement. “The goal is to help patients make changes in lifestyle, behaviors or environment in a way that is sustainable and involves families in decision-making at every step of the way.”

For children and teens, overweight is defined as a body mass index at or above the 85th percentile and below the 95th percentile; obesity is defined as a BMI at or above the 95th percentile.

Myles Faith, a psychologist at the State University of New York at Buffalo who studies childhood eating behaviors and obesity, praised the new report both for acknowledging that the causes of childhood obesity are complex and that its treatments must be a team effort.

“It’s not one cause for all kids,” he says. “There’s not been this kind of report to say that there are more options and that we shouldn’t automatically discount the possibility of medication, that we shouldn’t discount the role of surgery. For some families, it might be something to consider,” said Faith, who was not involved in the creation of the guidelines.

The new guidelines do not discuss obesity prevention; it will be addressed in another AAP policy statement to come, it says.

“These are the most comprehensive, patient-centered guidelines we have had that address overweight and obesity within childhood,” Dr. Rebecca Carter, pediatrician at the University of Maryland Children’s Hospital and assistant professor at the University of Maryland School of Medicine, said in an email Monday.

“New to these recommendations are several new medication management strategies that have proven very successful in the treatment of obesity as a chronic disease for adults, and are now being recommended for use in children and adolescents,” Carter said. “This is a major step in allowing overweight and obesity to be considered as the chronic diseases that they are.”

She added that the recommendations also are a “major step forward” in helping both parents and medical teams “take ownership” over a child’s long-term health risks related to overweight and obesity.

“They give a variety of tools to help families feel empowered that there are ways to treat these medical conditions, and that there are nuanced causes for these conditions that go beyond easy solutions and certainly take our focus away from outdated or unhealthy dieting strategies,” Carter said.

The new guidelines are designed for health care providers, but Carter said parents should talk with their children’s doctor if there are concerns about weight, and discuss strategies to optimize health and monitor changes.

“It is also appropriate to do this in a child-focused manner, taking care not to stigmatize them or make them feel bad about their body, while empowering the child to feel they have the tools needed to keep their body healthy over time.”

The new guidelines are a “much-needed advancement” to align holistic care with current science, Dr. Jennifer Woo Baidal, assistant professor of pediatrics and director of the Pediatric Obesity Initiative at Columbia University in New York City, said in a separate email Monday.

“Uptake of the new guidelines will help reverse the epidemic of childhood obesity,” she said. “More work at policy levels will be needed to mitigate policies and practices that propagate racial, ethnic, and socioeconomic disparities in obesity starting in early life. Although the guidelines support advocacy efforts of pediatricians, we as a society need to voice our support for healthful environments for the nation’s children.”

AAP says more than 14.4 million children and teens live with obesity. Children with overweight or obesity are at higher risk for asthma, sleep apnea, bone and joint problems, type 2 diabetes and heart disease, according to the US Centers for Disease Control and Prevention.

Separate research, published last month in the American Diabetes Association journal Diabetes Care, suggests that the number of young people under age 20 with type 2 diabetes in the United States may increase nearly 675% by 2060 if current trends continue.

Last month, the CDC released updated growth charts that can be used to track children and teens with severe obesity.

Growth charts are standardized tools used by health care providers to track growth from infancy through adolescence. But as obesity and severe obesity became more prevalent in the last 40 years – more than 4.5 million children and teens had severe obesity in 2017-2018, the agency says – the charts hadn’t kept up.

The growth chart in use since 2000 is based on data from 1963 to 1980 and did not extend beyond the 97th percentile, the agency said. The newly extended percentiles incorporate more recent data and provide a way to monitor and visualize very high body mass index values.

The existing growth charts for children and adolescents without obesity will not change, the CDC said, while the extended growth chart will be useful for health care providers treating patients with severe childhood obesity.

“Prior to today’s release, the growth charts did not extend high enough to plot BMI for the increasing number of children with severe obesity. The new growth charts coupled with high-quality treatment can help optimize care for children with severe obesity,” Dr. Karen Hacker, director CDC’s National Center for Chronic Disease Prevention and Health Promotion, said in a statement. “Providers can work with families on a comprehensive care plan to address childhood obesity.

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A newly unsealed affidavit details the clues that led investigators to the suspect in Delphi teen girl killings

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CNN
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A .40 caliber unspent round that was found near the bodies of two teen Indiana girls was tied to suspect Richard Allen, who was arrested last month in connection with the killings, according to a probable cause affidavit.

The affidavit, unsealed by a judge on Tuesday, helps shed light on how investigators narrowed in on Allen and arrested him more than five years since the February 2017 slayings of Abigail Williams, 13, and Liberty German, 14. Allen is charged with two counts of murder and has pleaded not guilty.

The two girls went for a hike along Delphi Historic Trails in February of that year but never showed up at a previously arranged time to meet Libby’s dad, police previously said. Their bodies were found the next day in a wooded area near the trail, about a half mile from the Monon High Bridge where they’d been dropped off, according to authorities.

A grainy video of a man walking and a garbled voice recording were among the scant clues authorities publicized over the years.

Investigators believe the evidence they gathered shows that Allen is the man seen on a video from Liberty’s phone who forced the girls down a hill and that he led them to the location they were killed, according to the affidavit.

Among that evidence are interviews with witnesses who were at the area the teens set out to hike in during a day off from school on February 13, 2017, as well as the video from Libby’s phone. The video shows a man in a dark jacket and jeans walking behind the girls and then telling them, “Guys, down the hill,” according to the affidavit.

The two girls were dropped off in the area just before 1:50 p.m. that day, the affidavit says. The video shows they encountered the man at the Monon High Bridge at 2:13 p.m.

A witness told investigators she had seen a man heading away from that bridge later “wearing a blue colored jacket and blue jeans and was muddy and bloody,” and appeared to have gotten in a fight, the affidavit says. The man was traveling on a road adjacent to the crime scene, and investigators were able to determine that took place shortly before 4 p.m.

Another witness told investigators she noticed an oddly parked vehicle at an old Child Protective Services building. A tip that came in to investigators had also referenced a vehicle parked at that building that “appeared as though it was backed in as to conceal the license plate.” Investigators believe the description of that vehicle matched one of two vehicles that Allen owned in 2017, the affidavit says.

When Allen spoke with an officer in 2017, he admitted he was on the trail for roughly two hours, the affidavit says. In a subsequent interview in October 2022, Allen told authorities he had gone out there to “watch fish,” that he was wearing jeans and a black or blue jacket and also said he owns firearms which were at his home, according to the affidavit.

“On October 13th, 2022, Investigators executed a search warrant of Richard Allen ‘s residence,” the affidavit says. “Among other items, officers located jackets, boots, knives and firearms, including a Sig Sauer, Model P226, .40 caliber pistol with serial number U 625 627.”

According to the document, investigators found a .40 caliber unspent round less than two feet away from one of the bodies, and between the two victims.

Lab results confirmed the unspent round had been cycled through Allen’s Sig Sauer, the affidavit says. When Allen was questioned about that result, he denied knowing their victims or having any involvement in their killings, according to the affidavit.

The affidavit does not make any reference to any other participants in the girls’ killings, despite Carroll County Prosecutor Nick McLeland recently saying in court that he had “good reason to believe that Richard Allen is not the only actor in this heinous crime.”

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