Recanting Use of Harmful Legal Products: Longitudinal Changes in Self-Reported Substance Use Among Adolescents in Frontier Alaska Communities

Aims.Research has demonstrated significant recanting of inhalant use by adolescents and has concluded that such recanting occurs primarily because of denial of use by older adolescents and, to a lesser extent, because older youth correct previous erroneous reports (Martino, et al., 2009). We extended this research by examining other harmful legal products (HLPs) that could be ingested or inhaled to get high in a sample of young adolescents living in frontier Alaska. We investigated age-related changes in reports of lifetime HLPs use and compared these patterns with those for alcohol, tobacco, and marijuana.

Procedures. We investigated self-reported lifetime use of (a) harmful legal products (HLPs), (b) alcohol, (c) tobacco, and (d) marijuana in a sample of adolescents (N = 1,774) from 18 diverse communities in frontier and rural Alaska, including 10 predominately Alaska Native communities. We examined data for three age cohorts (5^th, 6^th, 7^th grade at Wave 1) obtained using in-school surveys administered on two occasions two years apart. Open-ended questions asked students to describe any HLPs they had used.

Analyses.We used multi-level logistic regression to analyze the quantitative data. Cross-level interactions between survey wave and grade cohort were included to investigate differential changes in reported substance use by age group. Covariates included community-level (e.g., % Alaska Native, population, % in poverty) and individual-level (e.g., gender, Alaska Native, White) factors.

Results. Lifetime prevalence of reported HLPs use decreased substantially over time. A significant cohort x time interaction (OR = 2.26) indicated that this reduction was greater in the younger age cohorts. Specifically, HLPs use decreased from 25% to 8% in the youngest cohort, from 14% to 7% in the middle cohort, and remained at 15% in the oldest cohort. In contrast, lifetime alcohol, tobacco, and marijuana use consistently increased over time and showed similar increases across age cohorts. Responses to open-ended questions about HLPs indicated that many younger students reported use of products (e.g., cough syrup, Tylenol^®) given by a parent or use of products that are not abusable to get high (e.g., amoxicillin).

Conclusion.There was substantial recanting of HLPS use, particularly among younger students. Recanting did not occur for alcohol, tobacco, or marijuana. In contrast to previous research, our qualitative data suggest that recanting may largely result from younger students erroneously reporting HLPs abuse and later correcting their reports.

Reference

Martino, S.C., McCaffrey, D.F., Klein, D.J., & Ellickson, P.L. (2009). Recanting of life-time inhalant use: How big a problem and what to make of it. Addiction, 104, 1373-1381.