Martin C S, Kaczynski N A, Maisto S A, Tarter R E
Pittsburgh Adolescent Alcohol Research Center, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pennsylvania, USA.
Alcohol Clin Exp Res. 1996 Sep;20(6):1099-1108. doi: 10.1111/j.1530-0277.1996.tb01953.x.
Alcohol and other substance use disorders are highly comorbid, but little is known about patterns of polydrug use in adolescents with different levels of alcohol involvement. This research examined patterns and correlates of polydrug use in 176 adolescent drinkers with DSM-IV alcohol dependence (n = 61), alcohol abuse (n = 57), and no alcohol diagnosis (n = 58). Alcohol and other Substance Use Disorders were assessed using a modified version of the Structured Clinical Interview for the DSM. Lifetime histories of alcohol use and other drug use were assessed using a structured interview. Subjects also completed a questionnaire measure of the frequency of use of specific alcohol-drug combinations. The total number of illicit drugs ever used was greater in the alcohol dependence (mean = 3.8, SD = 2.1) and abuse groups (mean = 3.0, SD = 2.1), compared with the no-alcohol diagnosis group (mean = 1.9, SD = 1.3). Consistent with previous findings, there was a consistent pattern in the age of onset of psychoactive substance use: alcohol, followed by marijuana, followed by other drugs. The recent use of alcohol and other drugs in combination was reported by a greater percentage of subjects in the alcohol dependence (69%) and abuse groups (72%), compared with drinkers without an alcohol diagnosis (45%). The most common alcohol-drug combination was alcohol with marijuana (58% of the total sample), followed by alcohol-hallucinogens (16%). The frequency and extent of polydrug use was associated with being older and having higher levels of behavioral undercontrol and negative emotionality. Adolescent polydrug use, particularly the use of alcohol and other drugs in combination, is an important area for research, treatment, and prevention.
酒精使用障碍和其他物质使用障碍高度共病，但对于不同酒精使用程度的青少年中多药滥用模式却知之甚少。本研究调查了176名青少年饮酒者的多药滥用模式及其相关因素，这些青少年中，有61人符合《精神疾病诊断与统计手册》第四版（DSM-IV）的酒精依赖诊断标准，57人符合酒精滥用诊断标准，58人无酒精相关诊断。使用《精神疾病诊断与统计手册》结构化临床访谈的修订版对酒精使用障碍和其他物质使用障碍进行评估。通过结构化访谈评估终生饮酒史和其他药物使用史。受试者还完成了一份关于特定酒精-药物组合使用频率的问卷调查。与无酒精诊断组（均值 = 1.9，标准差 = 1.3）相比，酒精依赖组（均值 = 3.8，标准差 = 2.1）和酒精滥用组（均值 = 3.0, 标准差 = 2.1）使用过的非法药物总数更多。与之前研究结果一致，精神活性物质使用的起始年龄呈现出一种固定模式：先使用酒精，其次是大麻，然后是其他药物。与无酒精诊断的饮酒者（45%）相比，酒精依赖组（69%）和酒精滥用组（72%）中有更高比例的受试者报告近期同时使用酒精和其他药物。最常见的酒精-药物组合是酒精与大麻（占总样本的58%），其次是酒精与致幻剂（16%））多药滥用的频率和程度与年龄较大、行为控制能力较差以及消极情绪水平较高有关联。青少年多药滥用，尤其是酒精与其他药物同时使用，是研究、治疗和预防工作的一个重要领域。
