Identifying adolescents at risk for hard drug use: Racial/ethnic variations

Purpose: To examine early risk factors for initiation of hard drug use by 1 0th grade in a sample of adolescents drawn from diverse high schools and co mmunities, compares the results across different racial/ethnic groups, and to evaluate the predictive performance of a user-friendly risk scale agains t the more complex logistic model. Methods: Using longitudinal data from 4347 adolescents from California and Oregon, we developed and cross-validated logistic and additive prediction m odels for non-Hispanic white students (the largest group) and assessed how well each model worked for black, Hispanic, and Asian adolescents. We also developed a best logistic model for each group, Predictor variables were me asured at Grade 7; the hard drug use outcome was measured at Grade 10. Results: Major risk factors for initiation of hard drug use included early marijuana and cigarette use, deviant behavior, poor parent-child communicat ion, being offered drugs, and. prodrug attitudes and intentions. White adol escents had the most risk factors, followed, by Hispanics, Asians, and Blac ks. Specific risk factors played more important roles for some groups than others. Early marijuana use provided the strongest warning signal for all g roups except Blacks, while exposure to drug offers increased the risk for a ll but Hispanic youth. Poor communication with parents was particularly imp ortant for Hispanic and Asian adolescents, whereas doing poorly in school w as a key predictor only for Asians. social influences to use drugs and inte ntions to use them were the only predictors for Blacks. Although family dis ruption and limited parental education were associated with an increase in risk for white adolescents, the latter had the opposite effect for Hispanic s and Blacks. The simple additive model worked almost as well as the most c omplicated logistic model in predicting hard drug use for each group except Blacks. Conclusions: These results suggest that curbing early initiation of marijua na and cigarettes and reducing prodrug influences and attitudes may dampen initiation of other substances for most youth. They also suggest that drug prevention programs need to be sensitive to differences across racial/ethni c groups and that using social background characteristics as indicators of risk can be very misleading. Carefully constructed risk scales based on sim ple additive models could help guide program development and provide clinic ians with useful information about a troubled adolescent's likely trajector y. (C) Society for Adolescent Medicine 1999.