Patterns of simultaneous and nonsimultaneous use of cannabis and alcohol among American Indian adolescents

AbstractBackground American Indian (AI) adolescents report earlier initiation and higher rates of cannabis and alcohol use compared to their non-AI peers. Simultaneous cannabis and alcohol (SCA) use is increasingly common. A primary goal of our research was to identify profiles of cannabis and alcohol use, including SCA use, among AI adolescents using latent class analysis (LCA).Method Data from 1,673 7th–12th grade students attending 45 reservation-area schools throughout the United States who reported using alcohol and/or cannabis in the past year were used to identify the latent classes. Multinomial logistic regression analysis determined associations of sex, grade, and multiethnicity to class membership.Results A four-class solution was found: (1) SCA-Heavier Use (16.1%); (2) SCA-Lighter Use (25.2%); (3) Primarily Cannabis Use (33.3%); and (4) Primarily Alcohol Use (25.4%). Multinomial regression showed higher grade, identifying as multiethnic, and being female were associated with higher likelihood of membership in the SCA class.Conclusion AI adolescents were more likely to be classified in the Primarily Cannabis Use class as compared to all other classes. Characterizing profiles of use may help identify those engaging in risky or co-use and help researchers and clinicians better understand how AI adolescents engage with alcohol and marijuana.Keywords: American Indianadolescentslatent class analysissimultaneous usecannabisalcohol Ethics StatementAll procedures were approved by the university Institutional Review Board and by appropriate tribal research review boards, school boards, and school staff.Disclosure statementNo potential conflict of interest was reported by the authors.Notes1 Simultaneous Cannabis and Alcohol use (SCA) is also commonly referred to as simultaneous alcohol and marijuana use (SAM). However, given the negative connotations that have been historically associated with the term marijuana, we have opted to use SCA throughout this manuscript.2 Monitoring the future is a long-term epidemiological study of substance use that surveys U.S. 8th, 10th, and 12th grade adolescents.Additional informationFundingThis research was supported by grant # R01DA003371 from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH).