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Presenter: Mildred M. Maldonado-Molina, Ph.D., University of Florida
Discussant/Mentor: William Vega, M.D., UMDNJ-RWJMS

Patterns of Substance Use Onset Among Hispanic Adolescents

Authors: Maldonado-Molina, Collins, Lanza, Ramirez, Canino

Background:
The present study examined patterns of progression in substance use among youth 11-17 years of age from a longitudinal study of Puerto Rican islanders. Progression of substance use over time was conceptualized as advancement through a sequence of qualitatively distinct stages of drug  involvement. A lower rate of substance use disorders among Puerto Rican adolescents and adults living on the island has been reported when compared with the rates in mainland populations (Canino et al., 2004). A higher prevalence of last year alcohol use in Puerto Rico, however, has also been reported when compared with the rates in the United States; and Puerto Rican young adults who used alcohol have reported more symptoms of dependence without meeting criteria for the diagnosis (Warner, Canino, and Colón, 2001).

Method:
This study uses data from Canino et al. (2004), the first longitudinal psychiatric epidemiology study of Puerto Rican youth living on the island. A total of 911 adolescents were selected from an island-wide probability household sample of children (age from 4 to 17) living in Puerto Rico. Latent Transition Analysis was used to estimate the probability of membership in each stage of substance use and incidence of transitions between different substance use stages across two consecutive times.

Results:
Six stages were sufficient to describe patterns of substance use, including: (1) no use, (2) alcohol only, (3) alcohol and cigarettes, (4) alcohol and drunkenness, (5) alcohol, cigarettes, and drunkenness, and (6) alcohol, cigarettes, drunkenness, and other illicit drugs.

Conclusions:
Results highlight the role of alcohol and drunkenness in the progression to advanced substance use among youth.  Implications of these findings and their relation to patterns of substance use involvement among Puerto Rican youth are discussed. Prevention programs and policies should
actively target the role of alcohol in the progression of substance use involvement.