Abstract
The objective of this study is to examine the longitudinal associations between latent classes of substance use and anxiety and depression scores among youth who use substances. This study uses data from three waves (Wave 1: 2017/18, Wave 2: 2018/19, and Wave 3: 2019/20) of the COMPASS study. Students in grades 9 and 10 who reported substance use at baseline (n = 738) report their substance use (alcohol, cannabis, cigarettes, and e-cigarettes) and anxiety and depression symptoms at each wave. A Repeated Measures Latent Class Analysis (RMLCA) is used to determine substance use classes, and mixed models are used to examine the associations between substance use classes and anxiety and depression. We identify three classes of substance use: (1) occasional alcohol and e-cigarette use, (2) escalating poly-substance use, and (3) consistent poly-substance use. After controlling for relevant covariates, consistent poly-substance use is associated with depression (Female OR: 1.24 [95%CI: 0.46, 2.02]; Male OR 1.13 [95%CI: 0.38, 1.87]) but not anxiety. Escalating poly-substance use is associated with depression among males (OR 0.72 [95%CI: 0.10, 1.33]). These findings should be taken into consideration when creating prevention programming and treatment strategies for adolescents. Substance use programming should be comprehensive, consider multiple substances, and be cognizant of symptoms of mental illness, particularly depression.
Highlights
Accepted: 2 October 2021Risk factors and negative outcomes associated with substance use have been well studied for individual substances in isolation [1,2,3]
There were no significant interactions between substance use classes and time indicating that any differences in depression and anxiety scores were consistent across time
Our data suggest that while poly-substance use may have a role in the worsening of depression symptoms, depression plays a larger role in the worsening of anxiety symptoms than poly-substance use, additional investigation is required to strengthen the evidence on the temporality of these associations
Summary
Accepted: 2 October 2021Risk factors and negative outcomes associated with substance use have been well studied for individual substances in isolation (i.e., alcohol, cigarettes, cannabis) [1,2,3]. Longitudinal research indicates that adolescents typically maintain substance use patterns over time but if they make a change, adolescents are more likely to increase than decrease the number of substances they use over time [6,7,8,9]. No studies to date have examined the role of recent increases in e-cigarette use among adolescents [10] in poly-substance use over time. This knowledge is vital in order to better understand the reality of youth substance use and to plan appropriate interventions and prevention programming
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