Novins Douglas K, Barón Anna E
National Center for American Indian and Alaska Native Mental Health Research, University of Colorado Health Sciences Center, Aurora, CO 80045, USA.
J Am Acad Child Adolesc Psychiatry. 2004 Mar;43(3):316-24. doi: 10.1097/00004583-200403000-00013.
To describe the risks and risk factors for substance use initiation and progression among a large sample of American Indian (AI) adolescents.
Data came from surveys completed by 2,356 AI adolescents aged 14 to 20 years who participated in two or more consecutive waves of a longitudinal study between 1993 and 1996 (response rate 74%). Discrete-time survival analysis was used to describe the risks and risk factors for substance use initiation and progression.
The risk for initiating use of any substance accelerated in early adolescence and peaked at age 18. The risk for progression from use of alcohol, marijuana, and/or inhalants to the use of other illicit drugs (e.g., cocaine) increased over the first 4.5 years after initiating substance use, then diminished in subsequent years. The risk of substance use initiation and progression varied across the four participating communities and by season of the year. Compared to adolescents who initiated substance use with alcohol only, adolescents who initiated substance use with marijuana or inhalants were more likely to progress to use other illicit drugs.
Prevention programs for AI communities should be designed to address these community, age, and seasonal variations in the risks for substance use initiation and progression.
描述大量美国印第安（AI）青少年开始使用毒品及毒品使用升级的风险和风险因素。
数据来自于1993年至1996年间参加了两期或更多期纵向研究的2356名14至20岁AI青少年所完成的调查问卷（应答率74%）。采用离散时间生存分析来描述开始使用毒品及毒品使用升级的风险和风险因素。
开始使用任何毒品的风险在青春期早期加速上升，并在18岁时达到峰值。从使用酒精、大麻和/或吸入剂升级到使用其他非法药物（如可卡因）的风险在开始使用毒品后的头4.5年里有所增加，随后几年则有所下降。开始使用毒品及毒品使用升级的风险在四个参与社区以及一年中的不同季节有所不同。与仅以酒精开始使用毒品的青少年相比，以大麻或吸入剂开始使用毒品的青少年更有可能升级到使用其他非法药物。
针对AI社区的预防项目应设计用于应对这些社区、年龄和季节在开始使用毒品及毒品使用升级风险方面的差异。
