Alcohol and Other Drug Use Initiation in American Indian Adolescents
Generally, risk of alcohol and tobacco use begins during adolescence,
and users of these substances are more likely to progress (up
until young adulthood) to marijuana and then other illicit
drugs. To examine these risks among American Indian adolescents,
investigators studied semiannual survey data collected over
3 years from 14–20 year olds at 7 predominantly American
Indian high schools.
- Of 568 adolescents
who were abstinent at the start of the study, 42% initiated use
with alcohol, marijuana, and/or inhalants, while 7% initiated
use with other illicit drugs (e.g., cocaine). Initiation of substance
use peaked at approximately age 18, and alcohol was the most
common first substance used. - Of 1244
adolescents who used alcohol, marijuana, and/or inhalants at
the start of the study, 24% progressed to other illicit drug
use. - Adolescents
who had initiated substance use with marijuana or inhalants (versus
alcohol) were significantly more likely to progress to other
illicit drug use. - Risk of initiation
and progression significantly differed by tribal group and season.
Comments:
All American Indian
adolescents, like other adolescents, will not necessarily follow the
specified patterns of substance use initiation and progression. The
findings of this study, however, do suggest that almost half of American
Indian adolescents initiate substance use with alcohol, marijuana,
and/or inhalants, and a quarter of users progress to other illicit
drugs. This study did not address the role of tobacco in substance
use progression (i.e., because it could not distinguish between ceremonial
and non-ceremonial use). But, its results do imply that efforts to
prevent initiation and progression may need to be tailored to the specific
issues facing individual communities.
Richard
Saitz, MD, MPH
Reference:
Novins DK, Barón
AE. American Indian substance use: the hazards for substance use initiation
and progression for adolescents aged 14 to 20 years. J Am Acad Child
Adolesc Psychiatry. 2004;43(3):316–324.
(view
abstract)