Early drinkers do not necessarily mature out of a problematic lifestyle as young adults. Interventions for these high-risk youth should start early and address their other public health problems, particularly their tendency to smoke and use other illicit drugs.

Over the past several years, there has been growing interest in identifying distinct developmental trajectories of substance use. Using data from the RAND Adolescent/Young Adult Panel Study (N = 6,527), we synthesize our prior findings on patterns of smoking, binge drinking, and marijuana use from early adolescence (age 13) to emerging adulthood (age 23). We also present new data on how these trajectory classes compare on key psychosocial and behavioral outcomes during emerging adulthood. For each type of substance use, we found two periods of vulnerability: early adolescence and the transition to emerging adulthood. As expected, early users were at relatively high risk for poor outcomes at age 23 compared to consistent low-level users and abstainers, even if they reduced their use during adolescence. However, youths who were not early users, but steadily increased their use over time, also tended to be at relatively high risk. Results suggest that multiple prevention approaches might be needed to successfully reach at-risk youths.

School-based drug prevention programs can prevent occasional and more serious drug use, help low- to high-risk adolescents, and be effective in diverse school environments.

Results from a longitudinal experiment to curb drug use during junior high indicate that education programs based on a social-influence model can prevent or reduce young adolescents' use of cigarettes and marijuana. This multi-site experiment involved the entire seventh-grade cohort of 30 junior high schools drawn from eight urban, suburban, and rural communities in California and Oregon. Implemented between 1984 and 1986, the curriculum's impact was assessed at 3-, 12-, and 15-month follow-ups. The program, which had positive results for both low- and high-risk students, was equally successful in schools with high and low minority enrollment. However, the program did not help previously confirmed smokers and its effects on adolescent drinking were short-lived.

Latent growth mixture modeling was used to identify developmental trajectories (described in terms of demographics, exposure and resistance to a pro-drug environment, and deviant behavior) of binge drinking among 5,694 individuals who completed 6 surveys from ages 13 to 23 years: nonbingers (32%); moderate stables (37%), who had consistently low levels of bingeing; steady increasers (16%), who increased from the lowest to highest level of bingeing; adolescent bingers (9%), whose early rise in bingeing was followed by a decrease to a moderate level; and early highs (6%), who decreased from the highest level of bingeing to a moderate level. Results show considerable diversity in binge drinking patterns and the correlates of bingeing across trajectory classes.