Latent Classes of Polysubstance Use Among Adolescents in the United States: Intersections of Sexual Identity with Sex, Age, and Race/Ethnicity

Abstract

Purpose: We aimed to estimate latent classes of concurrent polysubstance use and test for sexual orientation differences in latent class memberships with representative data from adolescents living in 19 U.S. states. We also tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships. Methods: We analyzed data from 119,437 adolescents from 19 states who participated in the 2015 Youth Risk Behavior Survey. Latent class analysis characterized polysubstance use patterns based on self-reported frequency of lifetime and past-month use of alcohol (including heavy episodic drinking), tobacco (cigarettes, cigars, and smokeless tobacco), and marijuana. Multinomial logistic regression models tested differences in latent class memberships by sexual identity. Interaction terms tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships. Results: A six-class model of polysubstance use fit the data best and included nonusers (61.5%), experimental users (12.2%), marijuana-alcohol users (14.8%), tobacco-alcohol users (3.8%), medium-frequency three-substance users (3.6%), and high-frequency three-substance users (4.1%). Gay/lesbian-and bisexual-identified adolescents had significantly higher odds than heterosexual-identified adolescents of being in all of the user classes compared with the nonuser class. These sexual identity differences in latent polysubstance use class memberships were generally larger for females than for males, varied occasionally by race/ethnicity, and were sometimes larger for younger ages. Conclusion: Compared with their heterosexual peers, gay/lesbian and bisexual adolescents-especially females-are at heightened risk of engaging in multiple types of polysubstance use. Designing, implementing, and evaluating interventions will likely reduce these sexual orientation disparities.

Same-day use of cigarettes, alcohol, and cannabis among sexual minority and heterosexual young adult smokers.

“…We found that compared to their heterosexual counterparts, SM young adult smokers had significantly increased odds of engaging in same-day use of both cigarettes and cannabis as well as same-day use of all three substances. This finding is consistent with the extant literature showing greater odds of multiple substance use among SM adolescents and young adults than their heterosexual counterparts; however, those studies focused on any co-use occurring within a large timeframe of 30 days or 1 year (Coulter et al, 2019;Dermody, 2018;Dermody et al, 2016;Kecojevic et al, 2017). Furthermore, SM participants in our study reported fewer days with single substance use and more days with multiple substance use than their heterosexual peers.…”

The roles of child maltreatment and fathers in the development of substance use in an at-risk sample of youth: A longitudinal study

“…These findings are consistent with prior work that found higher risks and levels of polysubstance use among White adolescents and adolescents whose parents of other family members have substance use problems (Gilbert et al, 2020;Russell et al, 2015;Tomczyk et al, 2016). For example, a recent study found that White youth were more likely than Black youth to be tobaccoalcohol users, medium-frequency three-substance users, and high-frequency three-substance users compared with nonusers (Coulter et al, 2019). In contrast to these risk factors, we found that high quality mother-child relationships predicted a lower initial number of substances used.…”

Substance use classes and symptoms of anxiety and depression among Canadian secondary school students

“…6 Our study findings differed from that review in two main ways. First, we identified only one multi-use group, while other studies have identified a moderate and a high multi-use group; 14,24,[59][60][61][62] although many of these surveys included additional illicit substances (i.e. ecstasy, amphetamines, cocaine 14,24,59 ), which were not examined in this study.…”