A Qualitative Study of the Context of Child and Adolescent Substance Use Initiation and Patterns of Use in the First Year for Early and Later Initiators

Abstract

Individuals who initiate substance use before high school are at higher risk of negative outcomes. Eighty-six young adults between the ages of 18 and 28 participated in semi-structured qualitative interviews focused on the circumstances surrounding participants’ first use of substances and their pattern of use in the year following initiation in order to investigate similarities and differences between early versus later initiators. Initiation and use among early initiators were more likely to be encouraged by poor parental monitoring or active facilitation of use by parents. Early initiators were more likely to report risky patterns of use such as daily use and using alone. The data suggest that interventions targeting this population should focus on improving parental monitoring and decreasing positive parental attitudes toward adolescent substance use and efforts to increase identification and intervention by middle school staff to reach youth from high-risk families.

A systematic review of research on adolescent solitary alcohol and marijuana use in the United States

“…A consistent finding in reviewed studies is that adolescents who use alcohol or marijuana more frequently are more likely to have engaged in solitary use [7,8,27,31,40]. Some researchers have used this fact, and the fact that solitary use of these substances is associated with early initiation of use [7,20] and substance-related consequences [27,36] to view solitary use as a dimension of problem substance use. Studies led by Tucker and Creswell have gone beyond conceptualizing solitary substance use as an indicator of problem use, and explored the possibility that solitary versus social use has unique risk factors and consequences.…”

“…Finally, of note, Kingston et al conducted semistructured retrospective interviews with a sample of young adults, asking about their adolescent psychoactive substance use. Reporting in the aggregate for the use of 'alcohol, tobacco, marijuana or another drug', these authors found through qualitative analyses that early initiators of drug use were more likely to engage in solitary use [20]. [41], which included items concerning social context of use that were asked of high school seniors.…”

Drug abuse among street children

“…Similarly the findings revealed that children obtain drugs through various means including peers offering them, buying them jointly, adults abusers offerings them, picking remains in streets and ghettoes, stealing, as gifts for services to sellers, buying them individually, payment for services and including romantic ones, etc. This is supported the by drugs initiators often obtained substances from friends but more frequently they stole them from parents or guardians, Kingston, S. et al, (2017). A majority of the adolescents purchase substances from their self-earning, Sarangi, L. et al, (2008).…”

“…et al, (2014). One participant initiated substance use with his mother's supply and escalated immediately to daily use by continuing to steal his mother's alcohol and prescription drugs, Kingston, S. et al, (2017). The most common place for initiation of substance abuse was recreational avenues for males and homes for females, Sarangi, L. et al, (2008).…”

Editorial Perspective: Based on current evidence, should mental health clinicians assess children for substance use initiation and substance use disorders?

“…Childhood initiation of substance use is consequential. It is associated with future hazardous drinking (Liang & Chikritzhs, ), polysubstance use and comorbid mental disorders (SAMHSA, ), co‐occurring psychiatric illness including mood dysregulation disorder, and especially disruptive disorders including ADHD, Oppositional Defiant Disorder and Conduct Disorder (Deas & Thomas, n.d.; Temcheff, Déry, St‐Pierre, Laventure, & Lemelin, ), childhood assaultive behavior (Mathias et al., ), chaotic and abusive family environments and parental substance use disorders (Dube et al., ; Kingston, Rose, Cohen‐Serrins, & Knight, ), and adolescent suicide attempts (Cho, Hallfors, & Iritani, ). Because of the relationship of childhood substance initiation and co‐occurring and future morbidity and mortality, screening for childhood substance use would identify children who are likely to have multiple service needs including social services, mental health treatment, and treatment directed at specifically at substance use.…”