Role In Substance Use Research Articles

Police Harassment and Psychiatric, Sexual, and Substance Use Risk Among Black Sexual Minority Men and BlackTransgender Womenin the HIV Prevention Trials 061 Cohort.

Black sexual minority men and Black transgender women (BSMM/BTW) experience disproportionate levels of HIV/STI-related risk factors as well as police harassment (PH). PH is linked to psychiatric risk and could play a role in substance use, sexual risk behavior, and HIV/STI risk. We used data from the HIV Prevention Trials Network 061(HPTN 061) study to examine associations between PH and HIV/STI-related outcomes. Using PH exposure measured at baseline and 6-month study visits, we examined an ordinal exposure (PH reported at both visits, PH reported at either visit, versus PH reported at neither baseline nor 6months) and a binary exposure of persistent PH reported at both visits (yes versus no). We estimate risk ratios (RR) for associations between PH and depression, use of alcohol and methamphetamine, multiple partnerships, condomless sex, and syphilis. Persistent PH (binary) was associated with a 20% or greater increase in the risk of depression (RR, 1.26 (1.07, 1.47)) and multiple partnerships (RR, 1.20 (1.05, 1.39)). There was evidence that ordinal PH was associated with elevated risk of alcohol use (RR, 1.17 (1.00, 1.36)); the point estimate for the association between persistent PH and alcohol use was similar but the imprecision was greater (RR, 1.16 (0.95, 1.42)). PH may influence not only mental health but also behavioral risks that contribute to HIV/STI among BSMM/BTW, highlighting the potential wide-ranging and downstream effects of PH on health. Further research is required to confirm associations and elucidate pathways through which PH may influence HIV/STI among BSMM/BTW.

The Association of Frequency of Worry About Financial Debt With Substance Use Among Adults in Ontario, Canada

Background Financial debt and associated stress might increase the risk of substance use problems or exacerbate existing ones. Little evidence is available about the degree of debt stress and its association with substance use. The objective of this study was to examine the associations of the frequency of worry about debt with heavy episodic drinking (HED), daily smoking, e-cigarette use, and cannabis use in the past 30 days. Methods Data were utilized from the 2020/2022 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The surveys employed a web-based panel survey of 6038 adults and collected data on debt-related stress, HED, tobacco smoking, e-cigarettes, and cannabis use in the past 30 days. Odds ratios (OR) were estimated from logistic regression models accounting for sociodemographic factors. Results Overall, 18.4% of respondents reported that they were worried about their debt most or all of the time. Accounting for household income, educational status, employment status, and other factors, the results revealed that there was a dose-response relationship between the frequency of worry about debt and substance use including daily smoking, e-cigarette use, and cannabis use in the past 30 days compared to those who were not worried at all about their debt. Sex differences were also found in the association between worry about debt and e-cigarette use. Conclusions The frequency of worry about debt might have an important role in substance use, which suggests that financial well-being is vital in substance use prevention and harm reduction.

Prevalence of Substance Use Among Asian Sexual Minority Individuals in the United States, 2015-2020

ABSTRACT Asian sexual minorities (SMs) are an under-researched population. SMs are at higher risk for substance use problems than heterosexuals, but little research exists specifically on Asians who are SM. This study compared the prevalence of substance use among Asian SMs and among adults by race/ethnicity and sexual identity in the US. Data were analyzed from participants in the 2015–2020 National Survey on Drug Use and Health, a nationally representative cross-sectional survey of non-institutionalized adults. Controlling for demographic characteristics, logistic regression models were used to estimate odds of substance use 1) among Asian adults by sexual identity (N = 11,079) and 2) all adults by race/ethnicity and sexual minority status (N = 223,971). Among Asians, compared to heterosexuals, identifying as gay/lesbian was associated with higher odds of past-month use of marijuana. Bisexual Asians were at higher odds of engaging in past-year prescription opioid misuse and having past-year alcohol use disorder (AUD). Compared to White heterosexuals, Asian SMs were at lower odds for past-month binge drinking and cocaine use, but not for past-month marijuana use and past-year AUD, marijuana use disorder, and prescription opioid misuse. More research is needed to understand these disparities and address sexual identity’s role in substance use among Asians.

Substance use and participation in Temporary Assistance for Needy Families: the role of unobserved heterogeneity

ABSTRACT Background The 1996 Personal Responsibility and Work Opportunity Reconciliation Act created Temporary Assistance for Needy Families (TANF) and granted states permission to implement drug testing as an eligibility requirement. As more states pass legislation requiring suspected drug users submit to drug tests, it is necessary to understand how substance use impacts participation. While several studies have estimated the association between substance use and participation, the literature has generally ignored the potential endogeneity of substance use. Method Using data from the 1997 National Longitudinal Survey of Youth, we estimate the effect of substance use on mothers’ TANF participation using a system of equations, addressing the potential endogeneity of substance use via unobserved heterogeneity that affects both substance use and TANF participation decisions. Results Our estimates suggest past-30-day substance use decreases the probability of current participation. Unobserved characteristics that increase the probability of participation also increase the probability of substance use. Our results are consistent across a range of sensitivity analyses. Conclusions Endogeneity plays an important role in substance use and TANF participation decisions. At face value, our results suggest legislative efforts to identify and exclude substance users from TANF may be misplaced. More research is needed to understand the causal mechanisms at work before making definitive policy recommendations.

Residential Greenspace and Urban Adolescent Substance Use: Exploring Interactive Effects with Peer Network Health, Sex, and Executive Function.

While urban greenspace is increasingly recognized as important to mental health, its role in substance use is understudied. This exploratory study investigates the interaction of greenspace with peer network health, sex, and executive function (EF) in models of substance use among a sample of disadvantaged, urban youth. Adolescents and their parents were recruited from a hospital in the mid-Atlantic region of the U.S. Residential greenspace at the streetscape level was derived from analysis of Google Street View imagery. Logistic regression models were used to test the moderating effect of greenspace on the association between peer network health and substance use, as well as additional moderating effects of sex and EF. The significant negative association of peer network health with substance use occurred only among youth residing in high greenspace environments, a moderating effect which was stronger among youth with high EF deficit. The moderating effect of greenspace did not differ between girls and boys. Greenspace may play an important role in moderating peer influences on substance use among disadvantaged, urban adolescents, and such moderation may differ according to an individual’s level of EF. This research provides evidence of differences in environmental susceptibility regarding contextual mechanisms of substance use among youth, and it informs the development of targeted substance use interventions that leverage social and environmental influences on adolescent substance use.

Association between substance use and personality among Mexico City’s school children aged 10-13

Introduction: substance use is a problem that requires prevention strategies since childhood. It has been noticed that certain personality traits can play an important role in substance use in adolescence and early adulthood. It is essential to study the factors associated with substance use in order to develop and implement preventive interventions. Objective: to evaluate if hopelessness, sensation seeking, impulsivity and anxiety sensibility traits increase the risk of substance use (tobacco, alcohol, marihuana and inhalants) in a group of children enrolled in four primary schools in Mexico City. Methodology: cross sectional exploratory ex post facto survey in which substance use and a personality profile was assessed in a non-randomized sample of 182 children of age 10 to 13. Results: the lifetime prevalence of tobacco, alcohol and other drugs (marihuana and inhalants) use was of 4.4%, 28.6% y 5.5%, respectively. Logistic regression analysis showed that the hopelessness trait significantly increases the risk for use of tobacco (OR = 15.883) and other drugs (OR = 15.090), while the sensation seeking increases the risk of tobacco (OR = 20.856), alcohol (OR = 4.453) and other drugs (OR = 17.139). Discussion: substance use was greater than the estimation in the 2014 Nacional Survey of Drug Use in Students. Hopelessness and sensation seeking play an important role in substance use since late infancy. These results have implications that can help prevention.

Alcohol and Tobacco Consumption, Personality, and Cybervictimization among Adolescents.

Cyberbullying has emerged as a public health problem. Personality may play an important role in substance use and cybervictimization. The aim of this study was to examine whether tobacco and alcohol consumption and personality traits are associated with cybervictimization in Spanish adolescents. A cross-sectional study was conducted with 765 secondary students (aged 14–16) from 16 secondary schools in Spain. Participants completed a questionnaire assessing sociodemographic characteristics; tobacco and alcohol consumption; cybervictimization (Garaigordobil Scale); and personality traits (Big Five Questionnaire). A logistic regression model controlling for sex, age, parental education and personality traits was used to determine the independent associations and interactions between tobacco and alcohol consumption and cybervictimization. The results indicate that a total of 305 adolescents (39.9%) reported that they were cyberbullied in the past year. Girls were more likely to be cyberbullied than boys. Cybervictims had a significantly greater monthly alcohol consumption (OR = 1.51; 95% CI = 1.05–2.15), higher scores for extraversion (OR = 1.31; 95% CI = 1.06–1.63) and emotional instability (OR = 1.53; 95% CI = 1.27–1.83); as well as lower scores for conscientiousness (OR = 0.78; 95% CI = 0.63–0.95). These results suggest that personality traits and alcohol consumption are independently associated with cybervictimization. Our study suggests the existence of underlying common personality factors for cybervictimization and alcohol and tobacco use.

Factors Associated with Relapse in Men with Alcohol Dependence Versus Opioid Dependence: A Comparative Study From Western Nepal

Introduction: Drug abuse is a worldwide problem that affects millions of people and Nepal is no exception. Relapse is a major problem in management of substance use disorder. Hence it becomes important to understand the factors contributing to relapse in order to ensure relapse prevention. This study was done with the aim to compare clinico-demographic correlates of relapse in alcohol dependence and opioid dependence and also to know the reasons for relapse in both groups.
 Method: This is a cross sectional comparative study with the sample collected from three different rehabilitation centers from Nepalgunj. The sampleinclude those male clients with alcohol dependence and opioid dependence who had relapsed at least once in past after some period of abstinence. Total of 80 male subjects i.e. 40 in each group were enrolled in the study. Structured questionnaire was developed by the researcher and was used to collect the data from respondents. The data were statistically analyzed.
 Result: Some clinic-demographic disparity was observed in both groups. Alcohol group had more subjects from Bahun and Chettri caste, longer total duration of illness whereas opioid group had more Muslims, younger age and greater number of middle socio-economic clients, more number of substances used in past and higher prevalence of criminal act. The commonest reason for relapse in both groups found to be desire for positive mood. Peer pressure, social or family problems, craving, negative mood state and concentration difficulties were other factors found to be contributing to relapse. Narcotic Anonymous was the most preferred modality of treatment opted by both groups in past in order to quit substance whereas only 22.5% of subjects consulted to doctor.
 Conclusion: Social determinants play a critical role in substance use and its relapse and should be addressed alongside physical and psychological determinants for better outcome. Common factors play role for relapse in both groups. Study warrants increased need of mental health awareness programme among substance abusers.

Perceived racial/ethnic discrimination, marketing, and substance use among young adults

ABSTRACTPerceived experiences of discrimination have been linked to negative health behaviors including tobacco, alcohol, and marijuana use across various racial/ethnic groups. Tobacco and alcohol marketing exposure have also been linked with substance use. This study examined the independent and interacting effects of perceived experiences of discrimination and exposure to alcohol and tobacco marketing, and receptivity to marijuana marketing on substance use in an online survey of a multiethnic sample of young adults in 6 metropolitan areas (n = 505). African Americans (mean (M) = 1.96, 9% 5CI [1.84, 2.09]) and Hispanics (M = 1.98, 95% CI [1.87, 2.09]) reported higher levels of perceived discrimination than Whites (M = 1.52, 95% CI [1.40, 1.64]), p < .001. African Americans had higher levels of exposure to tobacco and alcohol marketing; Hispanics reported higher levels of exposure to alcohol marketing and receptivity to marijuana promotion. Discrimination and marketing exposure were independently associated with higher odds of all 3 outcomes, controlling for covariates (AOR from 2.1 to 3.4 for discrimination; AOR from 1.4 to 13.8 for marketing). Models showed a significant interaction of discrimination and tobacco marketing on past 30-day cigarette use (F = 5.5; p = .02). Individuals with high levels of tobacco marketing exposure were likely to report high past 30-day cigarette use regardless of level of discrimination, while those with low exposure were only at increased risk of reporting cigarette use at higher levels of discrimination. Both perceived discrimination and marketing exposure play a role in substance use. Interventions should consider discrimination as a significant risk factor underlying vulnerability to substance use among young adults.

The effect of cross-border mobility on alcohol and drug use among Mexican-American residents living at the U.S.–Mexico border

IntroductionLittle epidemiological evidence exists on alcohol or other substance use and related problems along the U.S.–Mexico border, although the border has been the focus of recent media attention related to the escalating drug/violence “epidemic”. The purpose of this study was to analyze the association of variables related to crossing the border (cross-border mobility) with three substance use outcomes reported for the last year: 1) heavy drinking (5+ drinks per day for men or 4+ for women), 2) alcohol use disorder (AUD), and 3) co-occurring heavy drinking and drug use (any use of illicit and/or non-medically prescribed drugs). MethodsHousehold surveys were conducted, using area probability sampling of 1565 Mexican-American residents, aged 18–65, living at the Texas–Mexico border in the metropolitan areas of Laredo and McAllen/Brownsville. ResultsAmong those 18–29, more frequent crossing of the border was significantly predictive of AUD (OR=1.61, p<0.01) and co-occurring heavy drinking and drug use (OR=1.70, p<0.01). Staying more than one full day was predictive of AUD (OR=3.07, p<0.001) and crossing to obtain over-the-counter or prescription drugs (“drug tourism”) or for nightlife/drinking were predictive of heavy drinking (ORs=4.14, p<0.001; 3.92, p<0.01, respectively), AUD (ORs=7.56, p<0.001; 7.68, p<0.01, respectively) and co-occurring heavy drinking and drug use (ORs=8.53, p<0.01; 4.96, p<0.01, respectively). Among those 30–65, staying more than a full day and crossing for pharmaceutical reasons were predictive of heavy drinking (OR=2.54, p<0.001; 2.61, p<0.05, respectively) and co-occurring heavy drinking and drug use (OR=3.31, p<0.001; 4.86, p<0.01, respectively), while none of the mobility variables were predictive of AUD in this age group. ConclusionsCross-border mobility may play an important role in substance use and problems, especially among those 18–29. Findings also highlight the importance of “drug tourism” in substance use across the age spectrum.

The Relationship Between Early Maladaptive Schemas, Depression, and Generalized Anxiety among Adults Seeking Residential Treatment for Substance Use Disorders

Previous research has shown that early maladaptive schemas (EMS) play an important role in substance use, depression, and anxiety. However, few studies have examined the role of EMS within the context of all three concurrently. The goal of this study was to determine the role of EMS in predicting symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among adults in residential treatment for substance dependence. We used pre-existing patient records of adults diagnosed with a substance use disorder from a residential substance use treatment facility (N = 122). The EMS domains of disconnection and rejection and impaired limits were associated with symptoms of MDD and the domain of impaired autonomy and performance was associated with symptoms of GAD, even after controlling for age, gender, years of education, alcohol use, drug use, and symptoms of MDD (when predicting GAD) and GAD (when predicting MDD). Findings suggest that EMS may play an important role in comorbid mental health problems among men and women in residential substance use treatment. Continued treatment outcome research is needed to examine whether modification of EMS results in improved mental health and substance use outcomes.

Young people in drug treatment in Ireland: their views on substance use aetiology, trajectory, parents' role in substance use and coping skills.

The aim of the current study was to gain insight into the process of initiation and progression to problematic use among young people who reach clinically significant levels of substance use requiring treatment. Twenty young people, aged between 15 and 19 years from two different drug treatment centres in Ireland were interviewed regarding their views on their pathway into substance use, their progress to more problematic use, their perception of their parents' role, if any, in their trajectory and their typical coping style before treatment. Content analysis was conducted on the resulting narratives. The use of substances to cope with life stressors emerged as a prominent theme at initial and problematic stages of use. Multiple maladaptive coping approaches were reported. Both direct and indirect influences from parents in their substance use problem were cited. However, some participants reported that parents had no causal role in their substance use trajectory, in particular regarding mothers. The current findings suggest that substance misuse is a multi-determined problem and a number of intervention strategies are suggested to delay onset and related harms associated with adolescent substance use.

Catechol‐O‐methyltransferase gene methylation and substance use in adolescents: the TRAILS study

Substance use often starts in adolescence and poses a major problem for society and individual health. The dopamine system plays a role in substance use, and catechol-O-methyltransferase (COMT) is an important enzyme that degrades dopamine. The Val(108/158) Met polymorphism modulates COMT activity and thus dopamine levels, and has been linked to substance use. COMT gene methylation, on the other hand, may affect expression and thus indirectly COMT activity. We investigated whether methylation of the COMT gene was associated with adolescents' substance use. Furthermore, we explored whether the COMT Val(108/158) Met polymorphism interacts with COMT gene methylation in association with substance use. In 463 adolescents (mean age=16, 50.8% girls), substance use (cigarette smoking, alcohol and cannabis use) was assessed with self-report questionnaires. From blood samples, COMT Val(108/158) Met genotype and methylation rates of membrane bound (MB) and soluble (S) COMT promoters were assessed. MB-COMT promoter methylation was associated with non-daily smoking [odds ratio (OR)=1.82, P=0.03], but not with daily smoking (OR=1.20, P=0.34), MB-COMT promoter methylation was not associated with alcohol use. Adolescents with the Met/Met genotype and high rates of MB-COMT promoter methylation were less likely to be high-frequent cannabis users than adolescents with the Val/Val or Val/Met genotype. S-COMT promoter methylation was not associated with substance use. These results indicate that there is an association between substance use and COMT gene methylation. Although this association is complex, combining genetic and epigenetic variation of the COMT gene may be helpful in further elucidating the influence of the dopamine system on substance use in adolescence.

Who guards the guards: Drug use pattern among medical students in a Nigerian University

Background:Several studies have examined the prevalence and pattern of substance use among medical students in Nigeria. Few of these studies have specifically examined the relationship between the psychological distress and psychoactive substance use among these students. Yet, evidence world-wide suggests that substance use among medical students might be on the rise and may be related to the level of stress among them.Aim:The present study is the first study aimed to determine the prevalence, pattern and factors associated with psychoactive substance use among medical students of Olabisi Onabanjo University, Ogun State, Nigeria.Subjects and Methods:The World Health Organization student drug use questionnaire was used to evaluate for substance use among 246 clinical medical students between September and October 2011. General health questionnaire (GHQ) 12 was used to assess for psychological distress among these students. Statistical analysis was performed using the SPSS version 16. (Chicago, USA). Proportions were compared using the Chi-square test while a value of P < 0.05 was considered statistically significant. Fisher exact test was used instead of Chi-square when the number in the cell is less than 5.Results:Lifetime prevalence of substance use among medical students was 65% (165/246). It was found that the most commonly used substances were alcohol 63.4% (156/246), mild stimulants 15.6% (38/246), tobacco 15% (37/246) and sedatives 6.1% (15/246). Substance use was associated with gender, frequency of participation in religious activities and GHQ scores.Conclusion:Psychoactive substance use is a major problem among medical students. Psychological well-being plays a significant role in substance use among these students. There is a need for adequate screening and assessment for substance use disorders among these students and incorporating stress management strategies in their curriculum.

Linking Childhood and Adult Criminality: Using a Life Course Framework to Examine Childhood Abuse and Neglect, Substance Use and Adult Partner Violence

Child abuse and neglect, considered criminal acts under the Criminal Code of Canada, play an important role in substance use, violence, and other criminal behaviour in adulthood. We adopted the life course perspective to identify modifiable contextual influences and co-occurring individual, social, and familial determinants associated with adult criminality. Using in-depth interview data, a sub-sample of 13 women who had recently experienced intimate partner violence, recounted their experiences of childhood abuse, their own substance use or criminality, as well as implications of these factors on their children’s life trajectories. For the purposes of this paper criminality was defined as child abuse and neglect, domestic violence, illegal substance use and underage alcohol use. Our objective was to explore, in our data: (1) patterns and trajectories of criminality from childhood to adulthood among women who were victims of violence, and (2) cumulative effects of early life exposures on experiences of criminality; with the aim of describing the life course perspective as a useful framework to understand criminality along the life trajectory. The analysis was not designed to demonstrate causal connections between early childhood and adulthood experiences of criminality. Rather we generated qualitative and quantitative hypotheses to guide future research in the field. Implications for research and interventions are discussed.

The interplay between parental monitoring and the dopamine D4 receptor gene in adolescent cannabis use.

BackgroundBoth environmental risk and genetic variation is believed to play a role in substance use. A candidate environmental variable is parenting. Recent studies have found support for the idea that the dopamine system affects the susceptibility to environmental influences. In the present study we will examine the interplay between effects of parental monitoring and the presence of the DRD4 7-repeat allele in adolescent lifetime cannabis use and the developmental course of cannabis use.MethodsA total of 311 adolescents participated in a five-wave longitudinal design. First, we conducted logistic regression analyses to examine the prospective associations between parental monitoring, the DRD4 polymorphism, their interaction and lifetime cannabis use. Second, individual growth parameters were calculated for frequency of cannabis use. Linear regression was used to assess the relationship between parental monitoring, the DRD4 polymorphism, their interaction, and the frequency of cannabis use.ResultsThere were no significant main effects of parental monitoring or the DRD4 polymorphism. However, both analyses showed that over a period of four years, a) when experiencing low levels of parental monitoring, individuals with the 7-repeat allele were more likely to show lifetime cannabis use and a stronger increase in frequency of cannabis use than individuals without this allele; b) when experiencing high levels of parental monitoring, individuals with the 7-repeat allele were less likely to show lifetime cannabis use and they showed a smaller increase in frequency of cannabis use than individuals without the 7-repeat allele.ConclusionsThis study shows that carriers of the DRD4 7-repeat allele are disproportionally affected by the negative and positive effects of parental monitoring such that carriers of the DRD4 7-repeat allele, as compared to non-carriers, are more likely to use cannabis when levels of parental monitoring are low, and less likely to use cannabis when parental monitoring levels are high.

Substance use initiation: The role of simultaneous polysubstance use

Simultaneous polysubstance use (SPU) is a common phenomenon, yet little is known about its role in substance use initiation. In the present study, 226 cannabis users completed structured interviews about their substance use history. For each substance ever used, participants provided details of their age of first use, their use in the preceding 30 days and whether they co-administered any other licit or illicit substances the first time they used the substance. For most illicit substances [powder cocaine, crack, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA; ecstasy), heroin, opium, gamma-hydroxybutyric acid (GHB), ketamine, psilocybin (magic mushrooms), mescaline, phencyclidine (PCP), peyote and inhalants], results showed that a clear majority of participants (≥75%) reported SPU during their first-ever use of the substance. While SPU was less common on occasions of first use of alcohol, tobacco and cannabis, a high proportion of SPU on occasions of first use of 'harder' drugs could be accounted for by the co-use of alcohol, tobacco and/or cannabis. Such findings raise the possibility that specific alcohol, tobacco and/or cannabis use episodes might directly contribute to the initiation of new substance use. Understanding the role of SPU on occasions of first use might help better identify risk factors for substance use progression and improve intervention efforts.

P03-225 - Exploring the role of cell receptors in substance use

Understanding the complex mechanisms in the development of substance use disorders lies at the receptor level - binding potential, ability of ligand to stimulate receptor autophosphorylation, degree of receptor activation/deactivation reactions - are the basis of the pathogenesis of alcohol/other drugs induced liver and brain damages, ischemic heart disease, allostatic load-effect, intoxication, addiction, tolerance, craving, relapse, and their associated complex chain of enzymatic reaction are key steps to developing effective prevention and treatment. Dose response inhibition of GP IIb/IIIa, P-selectin, CD 63 and CD 107a human platelet receptors by ethanol has been observed. The activation of GABA-B receptor, has recently been shown to be effective in inducing abstinence and reducing alcohol craving and consumption in alcoholics. The fact that alcohol reduces the activity of glutamate by interacting with NMDA receptors has shown promising effects in drug therapy. The anticonvulsant, Topiramate acts on AMPA-kainate receptors, and decreases glutamate activity while increasing GABA activity. Decreased activity of 5-HT3 serotonin receptor has been shown to reduce the frequency and quantity of drinking in humans. The dopamine receptors also play significant role in substance use. Another recent candidate of therapeutic target is the brain CB1 receptor that responds to endocannabinoids. Comprehensive research is needed to confirm and further explore the effects of new therapeutic agents and addictive substances on various cell receptors, which are implicated in substance use disorders.

Perceived Physical Maturity, Age of Romantic Partner, and Adolescent Risk Behavior

Early pubertal timing and advanced physical maturity for age confer elevated risk for problem behaviors for both boys and girls. However, examinations of possible biological and social mediators have been limited. Using more than 4,000 adolescents under age 15 who participated in Waves I and II of the National Longitudinal Study of Adolescent Health (Add Health), we examined the relationship between perceived physical maturity and membership in risk behavior clusters, and tested whether having a romantic partner mediates the maturity/risk behavior relationship. Results of multinomial regression models indicated that for both boys and girls, advanced physical maturity was associated with membership in higher risk clusters, and that having a romantic partner plays an important mediating role in this association. For females, the additional impact of having an older partner, versus any partner at all, was substantial and particularly important for the highest risk clusters. The role of partner age could not be tested for males. Because romantic partners elevate risk for young adolescent males and females, there is a need to identify and understand facets and developmental functions of adolescent romantic relationships that play a role in substance use and sexual decisions.