Patterns of Polysubstance Use Among Non-Hispanic White and American Indian/Alaska Native Adolescents: An Exploratory Analysis

INTRODUCTION: The prevalence of polysubstance use is well described, but less is known about correlates and patterns of polysubstance use. Previous research characterized latent subgroups of substance users by the type substance used. Racial disparities in the prevalence of polysubstance use exist, particularly for American Indian/Alaska Native (AI/AN) populations. The objective of our study was to describe differences in patterns of polysubstance use between non-Hispanic white and AI/AN adolescents. METHODS: We obtained data from the 2013 Youth Risk Behavior Survey (YRBS). We analyzed substance use patterns (cigarettes, alcohol, marijuana, cocaine, inhalants, heroin, methamphetamines, ecstasy, steroids, and injected drugs) separately among 375 AI/AN and 15,633 non-Hispanic white adolescents. We calculated pairwise correlations. Exploratory factor analysis identified latent factors of polysubstance use patterns. RESULTS: The use of all substances by AI/AN adolescents was the same or higher than use by non-Hispanic white adolescents, particularly for cocaine, heroin, and steroids. We found strong correlations between use of heroin and injected drugs and between use of cocaine and ecstasy among both populations. We found a latent factor for cigarettes, alcohol, and marijuana and another factor for broad polysubstance use among both populations. We found a factor for steroids and injected drugs among AI/AN adolescents, a factor for cocaine and ecstasy among non-Hispanic white adolescents, and a unique factor for methamphetamines. CONCLUSION: Differences in substance use patterns exist between AI/AN and non-Hispanic white adolescents, particularly for illegal drug use. If validated in future research, information on these differences could be used to inform tailored intervention programs aimed at preventing substance use.