Trajectories of Substance Use Among Young American Indian Adolescents: Patterns and Predictors

Abstract

Substance use often begins earlier among American Indians compared to the rest of the United States, a troubling reality that puts Native youth at risk for escalating and problematic use. We need to understand more fully patterns of emergent substance use among young American Indian adolescents, risk factors associated with escalating use trajectories, and protective factors that can be parlayed into robust prevention strategies. We used growth mixture modeling with longitudinal data from middle-school students on a Northern Plains reservation (Wave 1 N=381, M age at baseline = 12.77, 45.6% female) to identify subgroups exhibiting different trajectories of cigarette, alcohol, and marijuana use. We explored how both risk (e.g., exposure to stressful events, deviant peers) and protective (e.g., positive parent-child relationships, cultural identity) factors were related to these trajectories. For all substances, most youth showed trajectories characterized by low rates of substance use (nonuser classes), but many also showed patterns characterized by high and/or escalating use. Across substances, exposure to stress, early puberty, and deviant peer relationships were associated with the more problematic patterns, while strong relationships with parents and prosocial peers were associated with nonuser classes. Our measures of emergent cultural identity were generally unrelated to substance use trajectory classes among these young adolescents. The findings point to the importance of early substance use prevention programs for American Indian youth that attenuate the impact of exposure to stressful events, redirect peer relationships, and foster positive parent influences. They also point to the need to explore more fully how cultural influences can be captured.

Psychometric Examination of the Center for Epidemiologic Studies Depression Scale with Older American Indians: The Native Elder Care Study

“…To our knowledge, there are only a handful of studies that have examined mental health among AI/AN adolescents (Beals et al, 1997; Manson, Ackerson, Dick, Baron, & Fleming, 1990; Whitesell et al, 2014). Regarding epidemiology, the research has predominantly focused on older adolescents.…”

“…It has been found that AI/AN adolescents show elevated rates of drug use in comparison to their non-AI/AN peers (Beauvais, 1996). Whitesell and colleagues (2014) examined predictors of escalating substance use among AI/AN youth and found that exposure to stress, early puberty, and deviant peer relationships were associated with increased substance use. In another sample of AI/AN youth, 70% identified at least one parent or grandparent who met lifetime criteria for an alcohol use disorder (Walker et al, 1996), which may also explain why AI/AN youth are at greater risk for substance use disorders.…”

Coaches’ Health Promotion Activity and Substance Use in Youth Sports

“…Substances that are legally available for adults, such as alcohol, tobacco and other nicotine products can be infiltrated into adolescence subculture [7]. The use of substances is appealing during adolescence as it may help define maturity and passage into adulthood [8]. It has been well documented that substances are problematic when they are addictive or lead to intoxication [9] and the effects from substances weaken sports performance [10].…”

A cross-sectional examination of medicinal substance abuse and use of nonmedicinal substances among Canadian youth: findings from the 2012-2013 Youth Smoking Survey

“…[1][2][3][4][5][6] Controlled substances are drugs that have been identified by the Canadian federal government as having an elevated potential for abuse or addiction, and are listed in schedules I to V of Canada's 1996 Controlled Drugs and Substances Act. 7 Abuse of controlled medication refers to the consumption of substances intended for medical treatment for the purpose of producing euphoric feelings of well-being (a "high"), whereas misuse refers to a deviation from prescribed instructions, such as taking an additional sleeping pill when the first did not have the desired effect.…”