Subtypes of Adolescent Substance Use and Their Schooling Experience

Purpose: Substance use behaviors are among the most potent predictors for morbidity and mortality in today's adolescents. Furthermore, a growing body of evidence suggests that school-based factors such as academic achievement and school bonding are associated with reduced risk for smoking, binge drinking, and marijuana use. However, most of these studies have failed to consider the different patterns of polydrug use that exist among adolescents (e.g. alcohol users vs. alcohol and illicit drug users), and how academic achievement and school bonding relate to these different patterns. Hence, this study seeks to identify subtypes of adolescent substance use behaviors involving binge drinking, cigarette smoking, marijuana, and other illicit drug use. In addition, this study seeks to understand the relationship of the subtypes with school bonding and academic achievement.

Method: A latent class analysis (LCA) was used to identify subtypes of substance use behaviors from three national samples (2004, 2005, 2006) of 12th grade adolescents in the United States (n=7,572) from the Monitoring the Future project. Data was collected at approximately 130 public and private high schools using self-administered anonymous surveys. The data was pooled across years to ensure adequate sample size for the analysis of this study. Subsequently, multinominal logistic regression was used to understand the relationship between the subtypes, school bonding and academic achievement.

Results: From the LCA, four subtypes of adolescent substance use behaviors were identified: a subtype of minimal substance use behaviors; a subtype of predominant binge drinking behaviors; a subtype of predominant drug use behaviors; and a subtype of multiple and frequent substance use behaviors. The odds for adolescents with higher school bonding to engage in predominant binge drinking behaviors are 0.38 (95% CI, 0.25, 0.59); 0.07 (95% CI, 0.04, 0.12) for predominant drug use; and 0.03 (95% CI, 0.02, 0.04) for multiple and frequent substance use. The odds for adolescents with better academic achievement to engage in predominant binge drinking behaviors are 0.93 (95% CI, 0.88, 0.98); and 0.91 (95% CI, 0.85, 0.99) for predominant drug use. Academic grades are not statistically associated with the multiple and frequent substance use subtype.

Conclusions and Implications: Findings from this study have shown that school bonding and academic achievement have differing outcomes across the subtypes of substance use behaviors. The findings suggest that different intervention approaches are needed in response to the nature of substance use behaviors. As such, in intervening with adolescents engaged in substance use behaviors, social workers should first assess patterns of polydrug use before planning for the appropriate school-based interventions. Furthermore, in planning for interventions, this study also highlights the limited effectiveness of academic achievement as a protective factor to adolescents who are engaged in substance use behaviors that are of a lesser intensity. On the other hand, school bonding was consistently associated with lower odds of engaging in substance use behaviors across all subtypes. Hence, this study offers empirical evidence for social workers to consider when planning for interventions with adolescents who engage in substance use behaviors.