Why Do Delinquent Youth Quit Abusing Inhalants? A Latent Class Analysis of Desistance Motivations

Background: Substance users report various motivations to desist from drug use. Few studies of desistance motivations among adolescent inhalant users have been conducted, although inhalant use is prevalent in this population. Studies of desistance from inhalant use could increase our understanding of the natural history of inhalant use disorders and provide important information for use in prevention and treatment interventions targeting adolescent inhalant users. Using data from a NIDA-funded investigation of an under-researched population of incarcerated youth, we sought to 1) determine the prevalence and nature of diverse desistance motivations among adolescent inhalant users, and 2) identify adolescent inhalant user subtypes differing in their reasons for quitting inhalant use and associated characteristics.

Methods: Structured psychosocial assessments were completed with 279 Missouri adolescents in residential care who were lifetime inhalant users. Latent class analysis was used to identify subtypes of adolescent inhalant users differing in their desistance motivations. Empirically identified subtypes of adolescent inhalant desistors were compared across demographic and clinical characteristics.

Results: A model with 4 latent classes evidenced the best empirical and conceptual fit. Class 4 inhalant users evidenced high frequency inhalant use, significant psychiatric symptoms, were disproportionately female, poor, and non-white, and had the highest levels of agreement with all desistance motivations. Class 2 inhalant users evidenced the lowest frequency of inhalant use, psychiatric comorbidity, and the lowest levels of all desistance motivations. Classes 1 and 3 endorsed similar levels of desistance motivations, but Class 1 exhibited greater dysfunction with regard to frequency of inhalant use, suicidality, callous/unemotional personality traits, and antisocial attitudes.

Conclusions and Implications: This typology of inhalant user subtypes differing in their reasons for ceasing inhalant use and associated demographic and clinical profiles contributes to current understanding of natural recovery processes in adolescent inhalant users. Current findings suggest that prevention and treatment interventions should strive to increase youth's awareness of the harmful health consequences of inhalant use and to enhance their feeling and perception that “a change is needed,” and thereby encourage youth to cease their inhalant use earlier, before they suffer serious adverse medical or social consequences of such use.