Alcohol, Prescription Drug Misuse, Sexual Violence and Dating Violence Among High School Youth

Introduction: Sexual violence, teen dating violence, and substance use are significant public health concerns among adolescents in the United States. Some literature conceptualizes substance use as a risk factor for sexual and teen dating violence, but existing studies often fail to consider how different substance use co-occurs within individuals to predict sexual violence or teen dating violence. More information on the influence of prescription drug misuse, in particular, is warranted since it is on the rise among American adults and a cause for concern for adolescents. This study extends previous work by treating substance use as a potential risk factor for both sexual violence and teen dating violence victimization and perpetration, and examining how latent classes of baseline alcohol use and prescription drug misuse differ with respect to victimization and perpetration at baseline and again one year later.

Methods: Students from six Midwestern high schools (n=1,875; grades 9 -11) completed surveys across two consecutive Spring semesters. Latent class analysis was used to identify classes of individuals according to four substance use variables (lifetime alcohol use, current alcohol use, current binge drinking, and lifetime non-medical misuse of prescription drugs). A latent class regression and a manual three-step auxiliary approach were used to assess concurrent and distal relationships between identified classes and sexual violence and teen dating violence victimization and perpetration.

Results: Three classes of substance use were identified: low/no use (41% of sample), alcohol only use (45%), and alcohol and prescription drug misuse (14%). Youth in the alcohol and prescription drug misuse class experienced greater sexual violence and teen dating violence victimization and perpetration than the alcohol only class at baseline, as well as one year later with the exception of sexual and physical teen dating violence perpetration. Youth in the low/no use class were less likely to experience sexual and teen dating violence victimization and perpetration than youth in the alcohol only class at baseline with the exception of relational teen dating violence perpetration, as well as one year later with the exception of sexual violence perpetration.

Conclusions: The combined use of alcohol and prescription drugs emerged as a significant risk factor for later sexual and teen dating violence among adolescents, even when compared to those who only used alcohol. Findings suggest that future research might continue to assess the nature of these associations. Furthermore, findings suggest that sexual and teen dating violence prevention efforts might be more effective if they begin in middle school and address both alcohol and prescription drug misuse, particularly their use together.