Examining Sequences of Adolescent Substance Use Initiation Involving Over-the-Counter (OTC) Drug Abuse

摘要

Over-the-counter (OTC) drug abuse among adolescents is an increasingly visible and meaningful trend in the United States, but little research has been done to contextualize OTC drug abuse. This study examined a large sample of 152,678 middle school and high school adolescents in an attempt to understand sequences of OTC drug abuse initiation, and the sociodemographic and risk factor-related precursors thereof. We found that while many adolescents who had ever abused an OTC drug and used one or more "gateway" drugs (alcohol, cigarettes, or marijuana) initiated the use of the gateway drug first, there was also a subset of adolescents whose sequence of initiation began with OTC drug abuse. We also found that different risk factors and sociodemographic characteristics predicted different sequences of use. For example, interaction with antisocial peers predicted initiating gateway drug use prior to OTC drug abuse, but not the reverse sequence. Other predictor variables, including gender, grade, and parental attitudes toward drug abuse also differentiated these sequences; we discuss both the theoretical and practical implications of these findings.