Prenatal and postnatal cocaine exposure predict teen cocaine use

Abstract

Preclinical studies have identified alterations in cocaine and alcohol self-administration and behavioral responses to pharmacological challenges in adolescent offspring following prenatal exposure. To date, no published human studies have evaluated the relation between prenatal cocaine exposure and postnatal adolescent cocaine use. Human studies of prenatal cocaine-exposed children have also noted an increase in behaviors previously associated with substance use/abuse in teens and young adults, specifically childhood and teen externalizing behaviors, impulsivity, and attention problems. Despite these findings, human research has not addressed prior prenatal exposure as a potential predictor of teen drug use behavior. The purpose of this study was to evaluate the relations between prenatal cocaine exposure and teen cocaine use in a prospective longitudinal cohort (n=316) that permitted extensive control for child, parent and community risk factors. Logistic regression analyses and Structural Equation Modeling revealed that both prenatal exposure and postnatal parent/caregiver cocaine use were uniquely related to teen use of cocaine at age 14 years. Teen cocaine use was also directly predicted by teen community violence exposure and caregiver negativity, and was indirectly related to teen community drug exposure. These data provide further evidence of the importance of prenatal exposure, family and community factors in the intergenerational transmission of teen/young adult substance abuse/use.

Fig. 1

Model predicting teen cocaine use. Caregiver IQ and psychiatric symptoms were related to a caregiver covariate factor that included SES and caregiver education. Caregiver psychiatric problems also increased teen PTSD symptoms. Higher scores on the caregiver covariate factor were negatively related to caregiver current cocaine use. Maternal prenatal cocaine use was negatively related to consistent maternal custody (Always Mom’s custody). Maternal custody loss increased 7 year child community violence exposure (CVE). Further, both 7 and 14 year CVE were associated with increased teen PTSD symptoms. Teens with more community drug exposure were also exposed to more violence exposure. The only significant predictors of teen cocaine use were prenatal cocaine exposure and current caregiver cocaine use. Teens whose caregivers currently used cocaine were almost 6 times more likely to use cocaine; teens exposed to cocaine prenatally were more than twice as likely to use cocaine at the 14 year assessment.