Novins D K, Beals J, Mitchell C M
National Center for American Indian and Alaska Native Mental Health Research, University of Colorado Health Sciences Center, Denver 80220, USA.
J Am Acad Child Adolesc Psychiatry. 2001 Oct;40(10):1168-74. doi: 10.1097/00004583-200110000-00010.
To determine whether the predominant pattern of the sequence of use of different classes of substances among a large sample of American Indian (AI) adolescents is consistent with Stage Theory [i.e., (1) alcohol, (2) marijuana, (3) other illicit drugs, and (4) cocaine].
Data came from surveys completed by 1,562 AI high school students in 1993. Pairwise comparisons of age of first use for alcohol, marijuana, inhalants, cocaine, and other illicit drugs were examined, as were the prevalence rates of specific sequences of substance use.
Thirty-five percent of the AI youths who had used both alcohol and marijuana reported using alcohol first. Seventy-five percent of youths who had used three or more substances reported a sequence of first use that was inconsistent with Stage Theory. However, a general pattern of using alcohol, marijuana, and/or inhalants prior to the use of cocaine and other illicit drugs was observed. Sequences of first use varied by gender, age of first substance use, community, and number of classes of substances used.
To enhance the validity of Stage Theory for AI adolescents, the authors recommend its revision to include alcohol, marijuana, and inhalants as initiating substances.
确定在大量美国印第安（AI）青少年样本中，不同类别物质使用顺序的主要模式是否与阶段理论一致[即（1）酒精，（2）大麻，（3）其他非法药物，以及（4）可卡因]。
数据来自1993年1562名AI高中生完成的调查。对酒精、大麻、吸入剂、可卡因和其他非法药物首次使用年龄的成对比较进行了检查，物质使用特定顺序的患病率也进行了检查。
在既使用过酒精又使用过大麻的AI青少年中，35%报告先使用酒精。在使用过三种或更多物质的青少年中，75%报告的首次使用顺序与阶段理论不一致。然而，观察到在使用可卡因和其他非法药物之前先使用酒精、大麻和/或吸入剂的一般模式。首次使用顺序因性别、首次使用物质的年龄、社区以及使用的物质类别数量而异。
为提高阶段理论对AI青少年的有效性，作者建议对其进行修订，将酒精、大麻和吸入剂纳入起始物质。
