Adolescents' drug use patterns and associations with psychological factors for alcohol prevention

Despite its negative effects, alcohol remains the most used substance among adolescents and is often consumed with other drugs. Since polydrug use can undermine prevention efforts, this study aimed to analyze drug use patterns and their association with alcohol-related psychological risk factors in adolescents. A cross-sectional study was conducted, involving 2010 high school students aged 15–18 (55.5 % female). Participants were assessed for drug use, motivation to reduce drinking, self-efficacy, perceived risk, and drinking attitudes. A Multiple-Group Latent Class Analysis was used to identify drug use patterns across sexes, and ANCOVA for group comparisons. Five patterns were identified: ‘Low-Likelihood Use’ (26.7 %), ‘Sporadic Alcohol Use’ (37.7 %), ‘Binge Drinking and Sporadic Tobacco Use’ (17.5 %), ‘High-Risk Drinking, Tobacco and Sporadic Cannabis Use’ (14.8 %), and ‘High-Risk Polydrug Use’ (3.3 %). The patterns were invariant across sexes. Yet, female adolescents were more likely to engage in ‘Binge Drinking and Sporadic Tobacco Use’, while male in ‘Low-Likelihood Use’. Participants in the three polydrug patterns showed lower self-efficacy and motivation, and greater ambivalence in drinking attitudes than those with low-likelihood or sporadic use. No differences were observed for perceived risk. Tailored interventions addressing these psychological factors are recommended to enhance prevention programs, considering characteristics of both low-alcohol and polydrug patterns.