PMID- 38499496 OWN - NLM STAT- MEDLINE DCOM- 20240506 LR - 20240506 IS - 1360-0443 (Electronic) IS - 0965-2140 (Linking) VI - 119 IP - 6 DP - 2024 Jun TI - Transitions to polysubstance use: Prospective cohort study of adolescents in Australia. PG - 1100-1110 LID - 10.1111/add.16468 [doi] AB - BACKGROUND AND AIMS: Adolescent polysubstance use has been associated with adverse social and health outcomes. Our aim was to measure rates and transitions to polysubstance use during adolescence and identify factors associated with initiation and discontinuation of polysubstance use. DESIGN: Prospective cohort study. Multistate Markov modelling was used to estimate rates and identify correlates of transitions between substance use states. SETTING AND PARTICIPANTS: Adolescent-parent dyads (n = 1927; adolescents in grade 7, age approximately 13 years) were recruited from Australian schools during 2010/11 (Wave 1). Adolescents were surveyed annually until 2016/17 (n = 1503; age approximately 19 years; Wave 7) and parents were surveyed annually until 2014/15 (Wave 5). MEASUREMENTS: Alcohol, tobacco, cannabis and 3,4-methylenedioxymethamphetamine (MDMA) use outcomes were collected at Waves 3-7. Potential confounders were collected at Waves 1-6 and consisted of sex, anxiety and depression symptoms and externalizing problems, parental monitoring, family conflict and cohesion, parental substance use and peer substance use. Covariates were age and family socioeconomic status. FINDINGS: Few adolescents engaged in polysubstance use at earlier waves (Wave 3: 5%; Wave 4: 8%), but proportions increased sharply across adolescence (Waves 5-7: 17%, 24%, 36%). Rates of transitioning to polysubstance use increased with age, with few (<9%) adolescents transitioning out. More externalizing problems (odds ratio [OR] = 1.10; 99.6% confidence interval [CI] = 1.07-1.14), parental heavy episodic drinking (OR = 1.22; 99.6% CI = 1.07-1.40), parental illicit substance use (OR = 3.56; 99.6% CI = 1.43-8.86), peer alcohol use (OR = 5.68; 99.6% CI = 1.59-20.50) and peer smoking (OR = 4.18; 99.6% CI = 1.95-8.81) were associated with transitioning to polysubstance use. CONCLUSIONS: Polysubstance use in Australia appears to be rare during early adolescence but more common in later adolescence with low rates of transitioning out. Externalizing problems and greater parental and peer substance use are risk factors for adolescent polysubstance use that may be suitable intervention targets. CI - (c) 2024 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. FAU - Black, Nicola AU - Black N AD - Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia. FAU - Noghrehchi, Firouzeh AU - Noghrehchi F AUID- ORCID: 0000-0003-2263-2108 AD - Biomedical Informatics and Digital Health, The University of Sydney, Camperdown, Australia. FAU - Yuen, Wing See AU - Yuen WS AUID- ORCID: 0000-0002-2791-6858 AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia. FAU - Aiken, Alexandra AU - Aiken A AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia. FAU - Clare, Philip J AU - Clare PJ AUID- ORCID: 0000-0002-2009-7386 AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia. AD - Prevention Research Collaboration, The University of Sydney, Camperdown, Australia. FAU - Chan, Gary AU - Chan G AUID- ORCID: 0000-0002-7569-1948 AD - National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia. FAU - Kypri, Kypros AU - Kypri K AUID- ORCID: 0000-0002-9657-9904 AD - School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. FAU - McBride, Nyanda AU - McBride N AUID- ORCID: 0000-0003-1714-6631 AD - National Drug Research Institute, Curtin University, Shenton Park, Australia. FAU - Bruno, Raimondo AU - Bruno R AD - School of Psychological Sciences, University of Tasmania, Hobart, Australia. FAU - Slade, Tim AU - Slade T AUID- ORCID: 0000-0002-1725-9188 AD - The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia. FAU - Boland, Veronica AU - Boland V AUID- ORCID: 0000-0002-6872-7770 AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia. FAU - Mattick, Richard AU - Mattick R AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia. FAU - Peacock, Amy AU - Peacock A AUID- ORCID: 0000-0002-5705-2026 AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia. AD - School of Psychological Sciences, University of Tasmania, Hobart, Australia. LA - eng GR - APP1041867/National Health and Medical Research Council/ GR - APP1045318/National Health and Medical Research Council/ GR - APP1109366/National Health and Medical Research Council/ GR - APP1146634/National Health and Medical Research Council/ GR - APP1174630/National Health and Medical Research Council/ GR - GNT0188568/National Health and Medical Research Council/ GR - GNT1009381/National Health and Medical Research Council/ GR - GNT1064893/National Health and Medical Research Council/ GR - Australian Foundation for Alcohol Research and Education/ GR - DP1096668/Australian Research Council/ GR - Australian Rotary Health Mental Health Research Grant/ GR - National Drug and Alcohol Research Centre/ PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240318 PL - England TA - Addiction JT - Addiction (Abingdon, England) JID - 9304118 RN - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine) SB - IM MH - Humans MH - Adolescent MH - Male MH - Female MH - Australia/epidemiology MH - Prospective Studies MH - *Substance-Related Disorders/epidemiology MH - Adolescent Behavior MH - N-Methyl-3,4-methylenedioxyamphetamine MH - Alcohol Drinking/epidemiology MH - Young Adult MH - Peer Group MH - Underage Drinking/statistics & numerical data MH - Cohort Studies MH - Smoking/epidemiology MH - Parents MH - Markov Chains OTO - NOTNLM OT - adolescents OT - alcohol OT - cannabis OT - cohort study OT - longitudinal study OT - multistate Markov modelling OT - polysubstance OT - tobacco EDAT- 2024/03/19 00:42 MHDA- 2024/05/07 00:50 CRDT- 2024/03/18 23:54 PHST- 2022/11/06 00:00 [received] PHST- 2024/01/23 00:00 [accepted] PHST- 2024/05/07 00:50 [medline] PHST- 2024/03/19 00:42 [pubmed] PHST- 2024/03/18 23:54 [entrez] AID - 10.1111/add.16468 [doi] PST - ppublish SO - Addiction. 2024 Jun;119(6):1100-1110. doi: 10.1111/add.16468. Epub 2024 Mar 18.