Understanding the Relationship Between Surviving School Shootings and Subsequent Substance Use

Gretchen Baas

Advisor: Beidi Dong, PhD, Department of Criminology, Law and Society

Committee Members: Christopher Koper, Sue-Ming Yang, Alaina Steck

Online Location, #Online
July 11, 2025, 09:00 AM to 11:00 AM

Abstract:

School shootings, like firearm violence more generally, have health consequences for both individuals directly exposed and community members; however, compared to other traumatic events, the health impacts of such tragedies remain significantly understudied. Cumulative and chronic traumatic experiences have undeniably been linked to substance use behaviors; however, singular, intense traumatic events, such as school shootings, have largely been ignored in the majority of such studies. Nonetheless, substances may be used as a way to manage both the psychological and physical injuries sustained from a school shooting, leaving victims of these incidents at higher risk for engaging in these behaviors. Youth engaging in these behaviors are at heightened risk for developing subsequent health problems that may impact them through adulthood. However, the development of trauma-based care and interventions to mitigate such adverse outcomes are limited due to the theoretical and methodological barriers to characterizing the relationship between school shootings and substance use. Understanding how school shootings impact surviving students’ health outcomes and risky behaviors is paramount to improving practical and policy strategies to help mitigate them. The overall objective of this inquiry is to provide new insight into the impacts of school shootings on the prevalence and severity of drug use, polysubstance drug use, and the environmental and social factors that moderate this relationship. This study investigated the impact of the Marjory Stoneman Douglas High School massacre on Broward County School District students’ substance use behaviors. For the purposes of the study, three comparison school districts were selected, at various geographical distances, and include Duval County, Orange County, and Palm Beach County. A difference-in-difference approach was used to uncover the impact of the school shooting on substance use behaviors.  Emphasis was placed on understanding the distance decay effect of school shootings on substance use behaviors. Students’ substance use behaviors was collected using the Youth Risk Behavior Survey, and community characteristics were obtained through Florida’s Department of Health and the United States Census Bureau.  Findings suggest that substance use prevalence, severity, and polysubstance use decreased following the school shooting, though the magnitude of reductions varied based on substance use type. Socioeconomic measures moderated the effect of the school shooting on subsequent substance use behaviors. No evidence of distance decay was found. The observed decreases in substance use may reflect heightened social support or enhanced community resources following collective trauma. The findings from this study contribute to our understanding of how singular, intense traumatic events during adolescents may impact substance use behaviors differently than chronic, cumulative trauma exposure.