Brennan, Margaret M, Corrigan, Ciara, Mongan, Deirdre, Doyle, Anne ORCID: https://orcid.org/0000-0002-2776-3476, Galvin, Brian
ORCID: https://orcid.org/0000-0002-5639-1819, Nixon, Elizabeth, Zgaga, Lina, Smyth, Bobby P
ORCID: https://orcid.org/0000-0003-3797-5541, Ivers, Jo-Hanna and McCarthy, Noel
(2024)
Predictors and outcomes of adolescent alcohol and drug use: a scoping review.
Dublin:
Health Research Board and Trinity College Dublin.
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Background Adolescence and young adulthood, typically defined as 10-24 years, are pivotal life stages marked by educational advancement, entry into the workforce or further training and formation of lasting relationships. Globally, adolescence is also the peak period during which individuals first engage in alcohol and/or drug consumption. Initiation of substance use during this critical period can disrupt significant life transitions and has been linked to detrimental short- and long-term health as well as social consequences. In 2019, there were 3.2 million young people with substance use disorders in Europe. Substance use during adolescence may co-occur and complicate the trajectory of common mental health disorders that also frequently manifest during this time. This scoping review aims to summarize existing longitudinal research on factors and outcomes related to youth drug and alcohol use. Our objectives were twofold: first, to gain insight and identify research gaps from existing evidence and secondly, to evaluate methodologies commonly used in longitudinal datasets. This work will provide the foundational background for a planned series of longitudinal analyses of the Growing Up in Ireland cohort study.
Methods This is a scoping review that focuses on longitudinal studies and reviews, conducted in accordance with the PRISMA extension for scoping reviews. A systematic literature search was conducted on PubMed. Further studies were identified through handsearching key reference lists and Google Scholar searches. Studies were eligible for inclusion if they were prospective cohort studies and scoping or systematic reviews, and reported factors predicting, or outcomes associated with youth substance use. Data was extracted into a spreadsheet. Narrative synthesis was completed grouped by outcome reported.
Results One hundred and twenty-three studies were included in our scoping review, twelve of which were review articles and one hundred and eleven cohort studies based on six-six unique cohorts of young people. Publication dates span 1996 to 2023 but 50% of cohort studies were published in the last seven years. Over 60% of cohort studies originated from North America, 29% from Europe, 7% Australia/New Zealand and 2% from both South America and Asia. Adolescent substance use (ASU) is defined in many different ways ranging from patterns that may represent sporadic or experimental (“ever use”) to hazardous patterns of use such as binge drinking or substance use disorders. Factors that are consistently associated with increased risk of ASU include being male, increasing age, externalizing disorders such as conduct disorder, adverse childhood experiences, and peer or parental substance use. Few studies reported wider community or environmental factors but neighborhood availability of drugs was associated with ASU. Regarding outcomes, early initiation and higher frequency of ASU was predictive of later-life substance use patterns. ASU has also been linked with increased risk of education derailment, contact with the justice system and mental health disorders. From a methodological standpoint, most studies (n=78) employed some variation of multivariable regression models to investigate associations. Others used path analysis or structural equation modelling (n=14). Twenty-three studies used latent class methodologies to describe patterns or trajectories of ASU.
Conclusions The body of longitudinal evidence on ASU is rapidly expanding. However, a number of important research gaps remain, including the influence of social and environmental factors, intermediary mechanisms through which early life exposures influence ASU, factors associated with initiation of illicit drugs other than cannabis, and the relationship between ASU and critical transitions from adolescence to adulthood. Our research group will address these gaps using rich longitudinal data from the Growing Up in Ireland cohort to advance understanding of ASU and generate contemporary evidence that can be used to inform interventions and day-to-day practice.
A Substance use and dependence > Personal history of substance use (pathway) > Initiation
B Substances > Cannabis / Marijuana
B Substances > Alcohol
B Substances > Tobacco (cigarette smoking)
B Substances > Tobacco (cigarette smoking) > Nicotine product (e-cigarette / vaping / heated)
B Substances > Cocaine
F Concepts in psychology > Psychological stress / emotional trauma / adversity > Adverse childhood experiences (ACE)
G Health and disease > State of health > Mental health
J Health care, prevention, harm reduction and treatment > Risk and protective factors
L Social psychology and related concepts > Interpersonal interaction and group dynamics > Peer relations / social networks > Level of substance use among peers
T Demographic characteristics > Adolescent / youth (teenager / young person)
T Demographic characteristics > Gender / sex differences
T Demographic characteristics > Child of person who uses substances
VA Geographic area > International
VA Geographic area > Europe > Ireland
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