Prescription Drug Misuse and Early Substance Use Initiation in American Indian Adolescents

Substance use is a well-documented problem within the American Indian population, and has been shown to be even greater for the adolescents who live on or near reservations. Alcohol, marijuana, and other drugs are used in higher quantities and frequencies compared to the general U.S. population. This increased risk is obfuscated by the number of simultaneous risk factors which may lead adolescents on the reservation to use various substances.

Prescription drug misuse has been a growing health issue in the United States over the last two decades. In 2004, there were roughly 2.4 million individuals, aged 12 years or older, reporting the initiation of prescription drug misuse within the past year. This trend has been seen in multiple age cohorts, with recent studies indicating the prevalence of prescription drug misuse with younger users. The reports from various studies have shown that prescription drug misuse is a growing issue within the American Indian community as well. Reports from tribal nations in Washington state demonstrated a theme of growing access and endorsement of prescription drug misuse, and also revealed how damaging prescription drug misuse has been in families and their communities.

Data was collected from 1988 adolescents who live on or near American Indian reservations from 2009 through 2013, representing multiple regions across the U.S. A majority of the participants, 66.8 %, were American Indian, with a mean age of 15.19. Participants who were below the age of 13 were removed to ensure participant’s had ample time to misuse prescription drugs, and to eliminate the youngest participants. A binary logistic regression was performed to determine the effect of age of onset of alcohol and marijuana consumption on the likelihood that participants will misuse prescription drugs. The model revealed that early initiation of alcohol was significantly related to the endorsement of prescription drug misuse, OR = 1.257, p < .001. The model also revealed that early initiation of marijuana was significantly related to the endorsement of prescription drug misuse, OR = 1.360, p < .001. The data shows that earlier initiation of both alcohol and marijuana significantly increases the probability of PDM being endorsed, with every year earlier the age of onset leading to an increase in the probability of endorsing prescription drug misuse.