Alcohol and drug involvement after adolescent treatment and functioning during emerging adulthood

Abstract

This study identified patterns of alcohol and other drug (AOD) involvement during the decade following adolescent AOD treatment and developmental outcomes in emerging adulthood. AOD and psychosocial variables were assessed at eight time points from adolescence into adulthood (n=153; 41.2% women) in an inpatient treatment sample of alcohol and other drug dependent teens. Latent class growth analysis identified six trajectories based on alcohol and substance use frequency which were consistent with developmental transitions and validated by measures of dependency symptoms. While few differences were evident at intake, the educational, occupational and interpersonal attainments were differentially associated with the alcohol/drug trajectories as youth transitioned into adulthood. High rates of high school graduation (71.1%), professional occupations (45.2%), marriage/cohabitation (48.5%), and financial responsibility for children (F[5,27]=2.75, p=.02) were evident for those with the least alcohol and drug involvement. More severe drug use trajectories were associated with higher rates of dependence, incarceration and more treatment at the final period of assessment. Outcomes of the trajectory of frequent alcohol involvement were distinct from combined alcohol and drug use. These findings highlight the long-term diversity of substance use outcomes following adolescent treatment and suggest that identification of these patterns of use following treatment can help clarify the developmental impact of youth alcohol and drug use on outcomes in young adulthood.

Figure 1

Composite use of alcohol, marijuana and other drugs across a decade after adolescent treatment. Units are in days per month for each type of substance (e.g., days beer + days wine+ days hard liquor, 8 types of drugs), leading to frequencies greater than 30, as more than one type of alcohol or drug could be consumed in a given day.

Figure 2

Proportion of each class using alcohol, marijuana and other drugs at each follow up time point. Vertical bases represent the mean 95% confidence interval for each class.

Figure 3

Mean number of DSM-IV alcohol and drug use dependence symptoms endorsed by participants assigned to each trajectory class. For drug dependence symptoms, if participants were polysubstance users, they were credited for a particular symptom only one time, even if they experienced the same symptom for multiple substances.