Polysubstance Use Among Adolescents in a Low Income, Rural Community: Latent Classes for Middle- and High-School...

Area of Science:

• Public Health
• Adolescent Psychology
• Rural Health

Background:

• Nationwide epidemic of prescription opioid misuse impacts rural communities.
• Rural adolescent substance users face significant risk for future addiction.

Purpose of the Study:

• Identify subtypes of polysubstance users among rural adolescents using Latent Class Analysis.
• Examine predictive validity of identified substance use classes based on youth and family characteristics.

Main Methods:

• Latent Class Analysis (LCA) applied to a sample of 7,074 rural adolescents (middle and high school).
• Cumulative ordinal logistic regression used to assess predictive validity of substance use classes.

Main Results:

• A 4-class solution emerged for both age groups: Substance Nonusers, Primarily Alcohol Users, Initiators-Low Frequency Users, and Initiators-Moderate-to-High Lifetime Frequency Users.
• Prescription drug and inhalant use was noted, particularly among younger adolescents in higher frequency use classes.
• Substance use classes were associated with race/ethnicity and socioeconomic factors (free/reduced lunch for high schoolers).

Conclusions:

• Younger rural adolescents, while having lower overall use rates, show concerning trends in prescription drug and inhalant initiation.
• Findings support universal and targeted substance use prevention programs for at-risk youth.
• Enhanced substance abuse treatment options are crucial for rural communities.