Abstract

Individuals who initiate substance use before high school are at higher risk of negative outcomes. Eighty-six young adults between the ages of 18 and 28 participated in semi-structured qualitative interviews focused on the circumstances surrounding participants’ first use of substances and their pattern of use in the year following initiation in order to investigate similarities and differences between early versus later initiators. Initiation and use among early initiators were more likely to be encouraged by poor parental monitoring or active facilitation of use by parents. Early initiators were more likely to report risky patterns of use such as daily use and using alone. The data suggest that interventions targeting this population should focus on improving parental monitoring and decreasing positive parental attitudes toward adolescent substance use and efforts to increase identification and intervention by middle school staff to reach youth from high-risk families.

Highlights

  • Individuals who begin using psychoactive substances at an early age, typically defined as prior to age 13 or 14 [1,2] are at greater risk of negative psychosocial, educational and mental health outcomes than individuals who initiate substance use at a later age

  • Despite a relatively robust literature on the negative outcomes related to early substance use initiation and the risk factors associated with early initiation there is a paucity of research on whether the context of initiation and the early trajectory of use differs between early versus later initiators

  • Tobacco and marijuana use has been associated with an increased risk of substance misuse and negative outcomes associated with intoxication

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Summary

Introduction

Individuals who begin using psychoactive substances at an early age, typically defined as prior to age 13 or 14 [1,2] are at greater risk of negative psychosocial, educational and mental health outcomes than individuals who initiate substance use at a later age. These early initiators typically begin their substance use with alcohol, tobacco and marijuana and experience more pronounced individual and family risk factors for substance abuse and dependence than later initiators [3,4,5,6,7,8]. Initiators are more likely to participate in risky behaviors while under

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