Social contextual risk factors for stimulant use among adolescent American Indians

Abstract

Objective Stimulants are the most common and efficacious treatment for Attention-Deficit Hyperactivity Disorder (ADHD). We examined the relationship between stimulant misuse and social factors that could be malleable to prevention among American Indian (AI) adolescents. Method Participants were AI students (N=3,498) sampled from 33 schools in 11 states. Participants completed the American Drug and Alcohol Survey. A multilevel analytic approach was used to evaluate the effects of participant-level (level 1) variables (i.e., gender, grade, peer, school, family, stimulant prescribed by doctor) on lifetime and current simulant use to ‘get high’. Results Nearly 7% of our sample had been prescribed stimulants and nearly 6% of the sample reported using stimulants to get high. Age [OR=1.22; 95% CI = 1.09, 1.36, p<.001], perception of peer substance use [OR=1.19; 95% CI = 1.14, 1.23, p <.001], parental monitoring [OR=.96; 95% CI = 0.92, 1.99, p=.04], and stimulants prescribed by a doctor [OR=8.79, 95% CI = 5.86, 13.18, p<.001] were associated with ever using stimulants to get high. Perception of peer substance use, [b = 0.09, SE = .02, p <.001, 95%CI [0.05, 0.13], and having stimulants prescribed by a doctor, [b = 0.58, SE = .21, p=.006, 95%CI [0.17, 0.99], were associated with frequency of past month use to get high. There was also a significant quadratic effect for parental monitoring, suggesting that low and high levels were associated with increased stimulant use. Conclusions Our results suggest a need for prevention efforts to be directed to AI youth who are prescribed stimulants.

Systematic Review: Nonmedical Use of Prescription Stimulants: Risk Factors, Outcomes, and Risk Reduction Strategies

“…Individual study details are available in Table S1, available online. 9,11,15,[18][19][20][21][22]27,31,32,[42][43][44]50,52,54,55,58,61,63,[72][73][74][75][76][77]80,82,84,93,[95][96][97][98][99][100]103,105,109,118 NMU ¼ nonmedical use.…”

Illicit Stimulant Use Development in Adolescence and Early Adulthood Among Juvenile Offenders: Risk Factors Predicting Heterogeneity

“…Parental monitoring. Past research has indicated that weak monitoring of adolescents' behavior by parents is related to increased risk of stimulant use (Spillane et al, 2017), necessitating the inclusion of this variable in analyses. Parental monitoring was measured using a series of four ordinal items assessing the degree to which participants report that their parents monitor their behavior, with higher scores indicating greater monitoring (e.g., How often do you have a set time to be home on weekend nights?).…”

“…Social control mechanisms posited by Hirschi (1969) have been identified as risk factors for stimulant use. Weakened social control in the forms of low religiosity, weak parental monitoring, and low commitment to school have all been identified as risk factors for stimulant use (Herman-Stahl, Krebs, Kroutil, & Heller, 2007; McCabe, Knight, Teter, & Wechsler, 2005; Spillane, Weyandt, Oster, & Treloar, 2017). Social control theory (Hirschi, 1969) would predict that this is due to the weakened bond that an individual has to conventional society, freeing them to engage in deviant behavior.…”

“…Agnew (1992) posits in general strain theory that exposure to strain leads to the arousal of negative affective states like depression, which then leads to a need to cope with these emotions—with substance use being a major means of doing so. A final psychosocial risk factor which has been identified as a predictor of stimulant use is peer influence (Brecht, O’Brien, Von Mayrhauser, & Anglin, 2004; Sattah et al, 2002; Spillane et al, 2017). Peer influences conducive to stimulant use have been demonstrated to predict increased risk of the behavior.…”

Regional and gender differences in tobacco use among American Indian youth

“…Other studies on tobacco use among AI adolescents have tended to focus on isolated regions or tribes, though there is reason to believe that rates may differ by region based on previous substance use research examining stimulant (Spillane, Weyandt, Oster, & Treloar, 2017) and alcohol use (Whitbeck et al, 2014). Spear and colleagues (2005) examined lifetime and past month cigarette use among 7 th grades from the Northern Plains and found higher rates of smoking among American Indians, compared to White students (Spear, Longshore, McCaffrey, & Ellickson, 2005).…”