Department of Pediatrics/Children's Discovery and Innovations Institute, University of California Los Angeles, Los Angeles, Calif.
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif.
Acad Pediatr. 2015 Jan-Feb;15(1):41-6. doi: 10.1016/j.acap.2014.06.022.
At-school substance use is associated with increased rates of violence and delinquency. However, whether at-school substance use is a useful marker for other serious health risks and whether this association varies by gender or substance is still unclear.
We analyzed data from the national 2011 Youth Risk Behaviors Survey of 15,698 ninth to 12th grade students. We used multivariate regressions controlling for age and race and evaluated whether at-school marijuana and alcohol users were more likely than out-of-school users to exhibit 9 serious health risks (exposure to intoxicated driving, fighting, carrying a weapon at school, substance use with intercourse, experiencing intimate partner violence, being forced to have intercourse, experiencing depression, suicidal ideation, and attempting suicide). We included interaction terms to determine whether this association varied by gender or substance.
At-school alcohol and marijuana use were both associated with increased odds of all 9 serious health risks. The association between at-school substance use and fighting and being forced to have sex was greater for boys than for girls. Associations did not vary significantly by substance. Specificity of at-school substance use for serious health risks ranged from 0.93 to 0.96, and positive predictive values ranged from 0.23 to 0.69, well above the ranges for out-of-school use and nonuse.
Students found using alcohol or marijuana at school should be immediately and carefully screened for other serious health risks that pose significant present dangers; this might represent a critical opportunity to identify troubled youth.
在校内使用药物与暴力和犯罪率的上升有关。然而，在校内使用药物是否是其他严重健康风险的有用指标，以及这种关联是否因性别或药物种类而异，目前仍不清楚。
我们分析了来自 2011 年全国青少年风险行为调查的 15698 名 9 至 12 年级学生的数据。我们使用多元回归控制年龄和种族，并评估校内大麻和酒精使用者与校外使用者相比，更有可能表现出 9 种严重健康风险（接触醉酒驾驶、打架、在学校携带武器、药物使用伴性交、经历亲密伴侣暴力、被迫发生性关系、抑郁、自杀意念和自杀企图）。我们包括交互项来确定这种关联是否因性别或药物种类而异。
校内酒精和大麻的使用都与所有 9 种严重健康风险的发生几率增加有关。校内药物使用与打架和被迫发生性关系的关联在男孩中比女孩中更为明显。关联在药物种类之间没有显著差异。校内药物使用对严重健康风险的特异性范围为 0.93 至 0.96，阳性预测值范围为 0.23 至 0.69，远高于校外使用和未使用的范围。
在学校发现使用酒精或大麻的学生应立即接受仔细的筛查，以了解他们是否存在其他严重的健康风险，这些风险会带来重大的当前危险；这可能是识别问题青年的一个关键机会。
