ArticlePloS one2019
Predictors of alcohol use transitions among drug-using youth presenting to an urban emergency department.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- United States Emergency Department Screening for Drug Use Among Assault-Injured Individuals: A Systematic Review.The western journal of emergency medicine · 2022Pooled it
- A Bayesian Learning Model for Joint Risk Prediction of Alcohol and Cannabis Use Disorders.Statistics in medicine · 2026Article
- Experiencing violence and other predictors of within-person same-day use of multiple substances in youth: a longitudinal study in emergency settings.The American journal of drug and alcohol abuse · 2024Article
- Establishing the Relative Accuracy of Using City Directories as Proxies to Define and Reconstruct Historical Alcohol Environments.Journal of studies on alcohol and drugs · 2023Article
- Within-Person Predictors of Same-Day Alcohol and Nonmedical Prescription Drug Use Among Youth Presenting to an Urban Emergency Department.Journal of studies on alcohol and drugs · 2022Article
- Within- and between-person associations with drug use disorder among adolescents and emerging adults presenting to an urban emergency department.Drug and alcohol dependence · 2021Article
- Transitions into and out of post-traumatic stress among children involved in the child welfare system.Children and youth services review · 2020Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPrecipitants of alcohol use transitions can differ from generalized risk factors. We extend prior research by predicting transitions in alcohol use disorder (AUD) during adolescence and emerging adulthood.
methodsFrom 12/2009-9/2011, research assistants recruited 599 drug-using youth age 14-24 from Level-1 Emergency Department in Flint, Michigan. Youth were assessed at baseline and four biannual follow-ups, including a MINI Neuropsychiatric interview to diagnose AUD (abuse/dependence). We modeled AUD transitions using continuous time Markov Chains with transition probabilities modulated by validated measures of demographics, anxiety/depression symptoms, cannabis use, peer drinking, parental drinking, and violence exposure. Separate models were fit for underage (<21) and those of legal drinking age.
resultsWe observed 2,024 pairs of consecutive AUD states, including 264 transitions (119 No-AUD→AUD; 145 AUD→No-AUD); 194 (32.4%) individuals were diagnosed with AUD at ≥1 assessment. Among age 14-20, peer drinking increased AUD onset (No-AUD→AUD transition) rates (Hazard ratio-HR = 1.70; 95%CI: [1.13,2.54]), parental drinking lowered AUD remission (AUD→No-AUD transition) rates (HR = 0.53; 95%CI: [0.29,0.97]), and cannabis use severity both hastened AUD onset (HR = 1.18; 95%CI: [1.06,1.32]) and slowed AUD remission (HR = 0.85; 95%CI: [0.76,0.95]). Among age 21-24, anxiety/depression symptoms both increased AUD onset rates (HR = 1.35; 95%CI: [1.13,1.60]) and decreased AUD remission rates (HR = 0.74; 95%CI: [0.63,0.88]). Friend drinking hastened AUD onset (HR = 1.18, 95%CI: [1.05,1.33]), and slowed AUD remission (HR = 0.84; 95%CI: [0.75,0.95]). Community violence exposure slowed AUD remission (HR = 0.69, 95%CI: [0.48,0.99]). In both age groups, males had >2x the AUD onset rate of females, but there were no sex differences in AUD remission rates. Limitations, most notably that this study occurred at a single site, are discussed.
conclusionsSocial influences broadly predicted AUD transitions in both age groups. Transitions among younger youth were predicted by cannabis use, while those among older youth were predicted more by internalizing symptoms and stress exposure (e.g., community violence). Our results suggest age-specific AUD etiology, and contrasts between prevention and treatment strategies.
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