In recent years, we have learned more about children who bully others (bully perpetrators) and/or who are bullied (bully victims). Both are more likely to have problems with depression and self-esteem. Those who are bully-perpetrators also are more likely to demonstrate externalizing behaviors.
Substance use and abuse are considered externalizing behaviors. While there are some reports that have shown increased illegal drug use in those who were bully perpetrators during childhood and adolescence, these reports are old and do not include other forms of substance use, specifically alcohol and tobacco use.
Among this week’s early releases in Pediatrics is a meta-analysis by Dr. Charlotte Vrijen et al that looks longitudinally at those who were bully perpetrators, including those who were bully perpetrators-victims (i.e., those who both bullied others and were bullied by others) during childhood or adolescence and later risk of substance use (10.1542/peds.2020-034751).
After analyzing data from 28 papers, the authors found that:
- Those who were bully perpetrators during childhood or adolescence were more likely to use drugs, alcohol, and tobacco in adulthood. Depending on the substance, the odds of substance use was 40-70% higher than for controls.
- Those who were bully perpetrator-victims during childhood or adolescence were also 50% more likely to use tobacco in adulthood.
Timing was also an important factor. Depending on when one was a bully perpetrator or a bullying victim (childhood vs. adolescence), the risk was different, and the timing of when the substance use manifested was different as well.
Although one can only speculate at this time why those who are bully perpetrators or bully perpetrator-victims during childhood or adolescence might be at higher risk for later substance use, the implications of this relationship are important. We often take a hands-off approach, with the assumption that children will outgrow their bullying behavior, but this perhaps does a disservice to these children. Read the meta-analysis to learn more about this relationship; it may change your approach to patients who bully others or are bullied by others.