Substance Use Profiles of Urban American Indian Adolescents: A Latent Class Analysis

A growing majority of American Indian adolescents now live in cities and are at high risk of early and problematic substance use and its negative health effects. Objective: This study used latent class analysis to empirically derive heterogeneous patterns of substance use among urban American Indian adolescents, examined demographic correlates of the resulting latent classes, and tested for differences among the latent classes in other risk behavior and prosocial outcomes. Method: The study employed a representative sample of 8th, 10th, and 12th grade American Indian adolescents (n = 2,407) in public or charter schools inmetropolitan areas of Arizona in 2012. Latent class analysis examined eight types of last 30 day substance use. Results: Four latent classes emerged: a large group of "nonusers" (69%); a substantial minority using alcohol, tobacco, and/or marijuana [ATM] (17%); a smaller group of polysubstance users consuming, alcohol, tobacco, marijuana, other illicit drugs, and prescription or OTC drugs in combination (6%); and a "not alcohol" group reporting combinations of tobacco, marijuana, and prescription drug use, but rarely alcohol use (4%). The latent classes varied by age and grade level, but not by other demographic characteristics, and aligned in highly consistent patterns on other nonsubstance use outcomes. Polysubstance users reported the most problematic and nonusers the least problematic outcomes, with ATM and "not alcohol" users in the middle. Conclusions: Urban AI adolescent substance use occurs in three somewhat distinctive patterns of combinations of recent alcohol and drug consumption, covarying in systematic ways with other problematic risk behaviors and attitudes.