The Mitigating Effects of Protective Parenting on Level of Adolescent Substance Use Risk.

Background: Protective parenting clearly reduces the risk of substance use among young people, but its relationship with cumulative risk for substance use, or the number of risk factors a young person experiences, has not been examined. Objectives: The analysis explores how protective parenting is associated with cumulative risk for adolescent substance use. Methods: A nationally representative online survey of adolescents ages 12-17 (N = 965; 50.8% male; 49.2% female) explored the role of a number of protective parenting variables in predicting substance use risk among adolescents. Parenting behaviors, such as providing warmth, trust, and emotional support; spending time together; communicating about substance use; and monitoring were considered protective. Risk factors included having close friends who use substances, witnessing use, low perceptions of harm, unreliable sources of information about substances, perceived access, and lying to parents. Results: 21.7% of respondents reported 0-1 risk factors, 27.6% reported 2-3 risk factors, and 50.7% reported 4 or more risk factors. Controlling for demographics, a protective parenting composite measure of trust, warmth, and emotional support was associated with decreased risk of reporting 4 or more risk factors (0.45 RRR, p<.05) and spending time together was associated with decreased risk of reporting 2-3 and 4 or more risk factors compared to 0-1 risk factors (0.42 RRR, p<.05; 0.43 RRR, p<.05). Conclusion: These findings highlight the importance of protective parenting in mitigating the cumulative risk for youth substance use. Involving parents in prevention efforts should be a routine component of prevention practice, especially for youth at higher risk.

The co-occurrence of nicotine and other substance use and addiction among youth and adults in the United States: implications for research, practice, and policy.

BACKGROUND: The increasing popularity of non-cigarette nicotine products, especially among youth, highlights the need for greater attention to their potential risks, including nicotine addiction and other substance use and addiction. OBJECTIVES: To examine the extent to which nicotine product use co-occurs with other substance use and addiction among youth and adults, describe the demographic groups and types of nicotine products associated with an increased risk of such co-occurrence, and discuss implications for research, prevention, clinical practice, and policy. METHODS: Analyzing 2014 data from two nationally representative US surveys, the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) study, we examined the co-occurrence between nicotine product use and alcohol and other drug use and addiction. RESULTS: Individuals of all ages who reported using nicotine products of any kind were significantly more likely than nonusers to report alcohol, marijuana, other drug, and poly-substance use and to meet diagnostic criteria for a substance-use disorder. Users of multiple nicotine products generally were the most likely to engage in alcohol and other drug use and to be addicted to these other substances. CONCLUSIONS: The substantial co-occurrence of all forms of nicotine use and other substance use and addiction underscores the need to control the growing use of non-cigarette nicotine products among youth and to incorporate all forms of nicotine product use into substance use and addiction research, prevention, clinical practice, and policy efforts.

Assessing the risk of marijuana use disorder among adolescents and adults who use marijuana.

BACKGROUND: The changing political and social climate surrounding marijuana use, coupled with the fact that available estimates of marijuana use disorder prevalence are outdated and do not adequately represent adolescents, underscore the need for up-to-date and comprehensive prevalence estimates of marijuana use disorder. OBJECTIVES: To provide recent national estimates of marijuana use disorder as a function of usage patterns, age, and other sociodemographic, substance use, and mental health variables. METHODS: Analyses of data from the 2014 National Survey on Drug Use and Health examined the prevalence of marijuana use disorder among respondents (N = 55,271) with various sociodemographic, substance use, and mental health characteristics. Logistic and multinomial regression analyses examined the correlates of marijuana use disorder as a function of these variables, with a special focus on age. RESULTS: In 2014, 3.49% of lifetime, 11.62% of past-year, and 15.32% of past-30-day marijuana users met DSM-IV criteria for a marijuana use disorder; rates among youth generally were at least double those of adults across reported time frame and intensity of use. Regression analyses indicated that young age, black race/ethnicity, greater intensity of use, current tobacco/nicotine use, and alcohol and other drug use disorders were associated with increased odds of a marijuana use disorder. CONCLUSIONS: A significant proportion of marijuana users, especially youth, are at risk for having a marijuana use disorder, even at relatively low levels of use.

Underage drinking: prevalence and correlates of risky drinking measures among youth aged 12-20.

BACKGROUND: Underage drinking and its effects have been researched extensively. However, no study to date has examined how the levels of drinking that have been defined as risky for adults might relate to youth who have a heightened physiological vulnerability to alcohol. OBJECTIVES: To examine a range of drinking measures that go beyond common measures of youth alcohol use to gain a more detailed understanding of the nature of underage drinking and its associated correlates and outcomes. METHODS: Analyzing data from a 2013 nationally representative US survey, we examined a variety of measures of alcohol use among 24,445 youth (weighted N = 381,155,562), the demographic groups most likely to have reported drinking in these ways, and associations between these measures of drinking and a number of adverse outcomes. RESULTS: On all measures of potentially risky drinking, including meeting diagnostic criteria for an alcohol use disorder, underage drinkers exceeded the rates found for adults. Independent of sex, race, and age, youth who reported drinking in ways that exceeded guidelines set for adults had increased odds of meeting diagnostic criteria for an alcohol, tobacco, or other drug use disorder, and of reporting a number of health problems. CONCLUSIONS: The high rates at which youth report engaging in a range of risky drinking behaviors suggest a need for a more nuanced approach to substance use and mental health screening and interventions in clinical practice. The findings also underscore the need to address apparent misconceptions about what constitutes unhealthy or unsafe alcohol use among youth.