Session: Initiation of Substance Use and Abuse Among American Indian Youth (Society for Prevention Research 22nd Annual Meeting)

Given the high rates of substance use that have been reported for American Indian (AI) youth, and in particular, reservation-based AI youth, it is essential that researchers monitor and understand substance use among this group to better inform prevention and treatment efforts that will aid in reducing the resulting health, social and economic costs.  This session will explore initiation and progression of substance use and abuse among AI adolescents, using three sources of data from regions having significant reservation/reserve populations. 

Reducing disparities in substance use disorders is likely to hinge at least in part on delaying initiation of use.  Understanding patterns of initiation and identifying factors associated with elevated risk for both early initiation and rapid progression are critical to developing successful interventions.  Study#1 opens the session with an analysis of differences in initiation rates for marijuana and intoxication between AI and white youth attending the same schools on or near reservations located in the Northern Plains, the Upper Great Lakes, and the Southwest. The estimated hazard models show that there are large differences in initiation rates for AI and white youth even when comparing youth who attend the same schools, especially for marijuana. During this presentation, we will explore these patterns and potential predictors of the differences.  Study #2 uses 4 waves of longitudinal data from middle school students on a Northern Plains reservation to examine initiation of cigarette, alcohol, and marijuana use from age 9 to age 13 and among those who had initiated use of one substance, age-related risk of progression to a second substance.  In addition, hazard ratios are modeled as a function of risk and protective factors.  Patterns of risk and protection for both initiation and progression will be discussed in terms of implications for efforts to delay onset of substance use and prevent the emergence of substance use disorder among AI youth. 

Study #3 explores the progression of onset of substance use disorders (SUD) and asks whether addictions proceed in a developmental sequence from dependence on licit substances to more illicit drugs.  Using 8 waves of data from a panel study of Indigenous adolescents living in the U.S. and Canada who share the same culture, findings provide evidence of temporal gateways from nicotine dependence to alcohol dependence, and in turn, marijuana dependence.   The implications for prevention will be discussed during this presentation.