“Kids who were in eighth grade at the start of the pandemic will be graduating from high school this year, and this unique cohort has ushered in the lowest rates of substance use we’ve seen in decades,” Miech noted.
For alcohol, use in the past 12 months among eighth graders was at 12.9 percent in 2024, similar to 2023 levels, which are all-time lows. For 10th graders, the rate dropped significantly from 30.6 percent in 2023 to 26.1 percent, and for 12th graders, from 45.7 percent to 41.7 percent—both record lows.
For nicotine vaping, rates fell for 10th graders (from 17.5 percent to 15.4 percent) and remained at low levels for eighth and 12th graders. For marijuana, use remained low for eighth and 10th graders and fell significantly for 12th graders (from 29 percent to 25.8 percent). All three grades are at lows not seen since 1990.
For abstainers from alcohol, marijuana, and nicotine in the prior 30 days, the rate among eighth graders hit 90 percent, up from 87 percent in 2017, when it was first measured. The rate was 80 percent among 10th graders, up from 69 percent in 2017, and 67 percent for 12th graders, up from 53 percent in 2017.
“This trend in the reduction of substance use among teenagers is unprecedented,” Nora Volkow, director of NIH’s National Institute on Drug Abuse (NIDA), said. “We must continue to investigate factors that have contributed to this lowered risk of substance use to tailor interventions to support the continuation of this trend.”
The Centers for Disease Control and Prevention on Thursday warned that a federal indictment of an allegedly fraudulent telehealth company may lead to a massive, nationwide disruption in access to ADHD medications—namely Adderall, but also other stimulants—and could possibly increase the risk of injuries and overdoses.
“A disruption involving this large telehealth company could impact as many as 30,000 to 50,000 patients ages 18 years and older across all 50 US states,” the CDC wrote in its health alert.
The CDC warning came on the heels of an announcement from the Justice Department Thursday that federal agents had arrested two people in connection with an alleged scheme to illegally distribute Adderall and other stimulants through a subscription-based online telehealth company called Done Global. The company’s CEO and founder, Ruthia He, was arrested in Los Angeles, and its clinical president, David Brody, was arrested in San Rafael, California.
“As alleged, these defendants exploited the COVID-19 pandemic to develop and carry out a $100 million scheme to defraud taxpayers and provide easy access to Adderall and other stimulants for no legitimate medical purpose,” Attorney General Merrick Garland said in a statement. “Those seeking to profit from addiction by illegally distributing controlled substances over the Internet should know that they cannot hide their crimes and that the Justice Department will hold them accountable.”
Deadly consequences
According to the Justice Department, Done Global generated $100 million in revenue by arranging for the prescription of over 40 million pills of Adderall and other stimulants, which are addictive medications used to treat ADHD (attention-deficit/hyperactivity disorder). Done Global allegedly eased access to the drugs by limiting the information available to prescribers, instructing prescribers to prescribe Adderall and other stimulants even if the patient didn’t qualify, and mandating that the prescribing appointments last no longer than 30 minutes. The company also discouraged prescriber follow-up appointments and added an “auto-refill” feature.
Prosecutors further allege that He and Brody continued with their scheme after becoming aware that patients had overdosed and died.
The CDC cautioned that the disruption from lost access to Done Global prescriptions comes amid a long-standing, nationwide shortage of Adderall and other stimulant medications. For patients with ADHD, the disruption could be harmful. “Untreated ADHD is associated with adverse outcomes, including social and emotional impairment, increased risk of drug or alcohol use disorder, unintentional injuries, such as motor vehicle crashes, and suicide,” the CDC warns. Further, a loss of access could drive some to seek illicit sources of the drugs, which could turn deadly.
“Patients whose care or access to prescription stimulant medications is disrupted, and who seek medication outside of the regulated healthcare system, might significantly increase their risk of overdose due to the prevalence of counterfeit pills in the illegal drug market that could contain unexpected substances, including fentanyl,” the CDC said. Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.
The Drug Enforcement Administration recently reported that seven out of every 10 pills seized from the illegal drug market contain a potentially lethal dose of illegally made fentanyl, the CDC noted.
This post was updated to clarify that the DEA’s data indicated that 70 percent of illicit pills seized contained “potentially” lethal doses, which was not included in the CDC’s warning.