Patterns of Simultaneous and non-Simultaneous Use of Cannabis and Alcohol Among American Indian Adolescents

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).

Data from 1,673 7^th - 12^th grade students attending 45 reservation-area schools throughout the U.S. 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.

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.

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.