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Original Article
Nov 2011

Racial/Ethnic Variations in Substance-Related Disorders Among Adolescents in the United States

Author Affiliations

Author Affiliations: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center (Drs Wu and Blazer), and Social Science Research Institute, Duke University (Dr Yang), Durham, North Carolina; Department of Psychiatry, University of Pennsylvania School of Medicine, and Treatment Research Institute, Philadelphia (Dr Woody); and Veterans Health Administration, Washington, DC (Dr Pan).

Author Contributions: Data analyses were performed by Drs Wu and Yang. Dr Wu had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Author Affiliations: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center (Drs Wu and Blazer), and Social Science Research Institute, Duke University (Dr Yang), Durham, North Carolina; Department of Psychiatry, University of Pennsylvania School of Medicine, and Treatment Research Institute, Philadelphia (Dr Woody); and Veterans Health Administration, Washington, DC (Dr Pan).

Author Contributions: Data analyses were performed by Drs Wu and Yang. Dr Wu had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Arch Gen Psychiatry. 2011;68(11):1176-1185. doi:10.1001/archgenpsychiatry.2011.120
Abstract

Context While young racial/ethnic groups are the fastest growing population in the United States, data about substance-related disorders among adolescents of various racial/ethnic backgrounds are lacking.

Objective To examine the magnitude of past-year DSM-IV substance-related disorders (alcohol, marijuana, cocaine, inhalants, hallucinogens, heroin, analgesic opioids, stimulants, sedatives, and tranquilizers) among adolescents of white, Hispanic, African American, Native American, Asian or Pacific Islander, and multiple race/ethnicity.

Design The 2005 to 2008 National Survey on Drug Use and Health.

Setting Academic research.

Participants Noninstitutionalized household adolescents aged 12 to 17 years.

Main Outcome Measures Substance-related disorders were assessed by standardized survey questions administered using the audio computer–assisted self-interviewing method.

Results Of 72 561 adolescents aged 12 to 17 years, 37.0% used alcohol or drugs in the past year; 7.9% met criteria for a substance-related disorder, with Native Americans having the highest prevalence of use (47.5%) and disorder (15.0%). Analgesic opioids were the second most commonly used illegal drugs, following marijuana, in all racial/ethnic groups; analgesic opioid use was comparatively prevalent among adolescents of Native American (9.7%) and multiple race/ethnicity (8.8%). Among 27 705 past-year alcohol or drug users, Native Americans (31.5%), adolescents of multiple race/ethnicity (25.2%), adolescents of white race/ethnicity (22.9%), and Hispanics (21.0%) had the highest rates of substance-related disorders. Adolescents used marijuana more frequently than alcohol or other drugs, and 25.9% of marijuana users met criteria for marijuana abuse or dependence. After controlling for adolescents' age, socioeconomic variables, population density of residence, self-rated health, and survey year, adjusted analyses of adolescent substance users indicated elevated odds of substance-related disorders among Native Americans, adolescents of multiple race/ethnicity, adolescents of white race/ethnicity, and Hispanics compared with African Americans; African Americans did not differ from Asians or Pacific Islanders.

Conclusions Substance use is widespread among adolescents of Native American, white, Hispanic, and multiple race/ethnicity. These groups also are disproportionately affected by substance-related disorders.

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