The current study illustrates that discrimination, COVID-related racial bias, and other stressors impacted AAs during the COVID-19 pandemic. Most participants used alcohol to cope with COVID-19 stressors, followed by tobacco, then cannabis. Whereas stressors related to discrimination based on race/ethnicity and racial bias were associated with some of the outcomes of AOD use to cope with COVID-19 stressors in the discrete and partially adjusted models, only perceived racial bias was associated with cannabis use to cope. Furthermore, the total sum of non-discrimination COVID-19 related stressors was associated with all three AOD outcomes. These findings suggest that stress related to discrimination based on race/ethnicity is associated, to an extent, with use of AOD to cope during the pandemic.

Many AAs in the study reported experiencing racial/ethnic discrimination and bias. This finding is consistent with the experiences of AAs in the U.S. during the pandemic where individuals reported incidents of verbal harassment and physical attacks [1, 38]. For AAs, these stressors are compounding. AAs may also be experiencing economic stress, such as threat to employment security and business [39]. Within the framework of syndemic theory [21], the continued presence of COVID-19 alongside stressors magnified by the pandemic can have health implications such as the use of AOD as a form of coping mechanism within the AA population.

Akin to the general population [9], 16% of the AAs in this study reported using AOD to cope with stress related to the pandemic. While national data show that AAs have lower prevalence of AOD compared to other racial groups [40, 41], previous studies found that there are differences in AOD use by Asian ethnic groups [7, 42]. For instance, national data found that younger AAs compared to older AAs and U.S. born Filipino, Indian Americans, and Koreans were at high-risk for binge drinking and alcohol use disorder compared to other U.S. born Asian ethnic groups [43].

Experiences of discrimination related to race/ethnicity were associated with AOD to cope with COVID-19 stressors to a certain degree but other stressors during the pandemic may be driving the use of AOD to cope with COVID-19 stressors in the AA population. Whereas the stress engendered by discrimination based on race/ethnicity and racial bias have a certain effect on use of AOD to cope, only experience of racial bias related to the COVID-19 pandemic remained consistently associated with marijuana/CBD use when other non-discrimination COVID stressors were considered. Alternatively, the number of non-discrimination COVID-related stressors was consistently associated with all AOD substances. AAs who experience racial bias as one of the stressors during the pandemic might have a preference to use marijuana/CBD when compared to alcohol or tobacco as a coping mechanism. Although studies found evidence on the use of marijuana to cope with anxiety [44], research exploring stressors because of racial bias is understudied and future studies warrant how stress specific to racism is associated with using marijuana/CBD to cope. Other stressors not related to discrimination are influencing participants to use AOD underscoring that AOD remain to be a mechanism of managing stress. While almost a quarter of AAs reported discrimination-related stress and racial bias, perhaps these may not be the primary stressors that are encouraging them to use AOD. For instance, familism is an important cultural trait in AA communities [45], providing financial support for one’s family and keeping family safe from the virus can be stress inducing.

These findings are balanced by a few limitations. First, only alcohol, tobacco, and cannabis use were examined. We did not ask about other substances, such as opioids, which is currently a national crisis [46]. Furthermore, we were unable to fully examine polysubstance use due to low sample sizes. In our weighted sample, only 4.1% of participants used more than 2 substances.

Second, we only examined the perceived mechanism underlying substance use behavior in coping with COVID-19 stressors rather than general substance use behavior. It is possible that some individuals may use AOD habitually or recreationally and not as a coping mechanism to deal with COVID-19 related stress. National studies have found that alcohol use increased by 5% among adults ages 21 to 24 years old while cannabis use has increased by 1.2% among adults 25 years and older between 2018 and 2020 [10]. While these trends may be reflective of potential use to cope with COVID-19 stress, it was unclear if these trends are confounded by increase recreational use due to destigmatizing of cannabis.

Third, we were unable to fully disaggregate the type of cannabis use to cope with COVID-19 stressors. Different cannabis types (e.g., CBD, marijuana) have different safety and psychoactive profiles that may perpetuate single versus chronic use. Future studies should consider disentangling cannabis as well as other substances to examine the specific type used.

Fourth, our measures of discrimination did not ask about the timing or frequency of discrimination that AAs may have faced. Instead, it asked if racial/ethnic discrimination was a major source of stress from the pandemic. We also asked if facing discrimination impacted participants’ families. Thus, participants may have vicariously experienced discrimination despite never experiencing any interpersonal incidents. Studies have noted how greater reports of vicarious racism and vigilance among Black and AA people were associated with greater depression, anxiety [22] and worse sleep [47].

Finally, although this study was a national survey of AAs, it should be acknowledged that we were not able to account for the full breadth of AA ethnic groups. While examining differences in AOD use by Asian ethnic group was not the main focus of this study, we do provide some preliminary comparisons to the mean level of substance use. In addition, there may be other factors at the state and local level that could affect the association between discrimination and substance use. For example, living in a state or community with fewer Asian individuals may expose Asian people to more severe experiences of discrimination.