Secular Trends in Hazardous Alcohol and Cannabis Use from 2015 to 2024 in Diverse Subgroups of Youth Entering Residential Care.

Background

Secular trends in adolescent alcohol and cannabis use in the general population have shown declines in both substances, but trends among high-risk youth placed in residential care are unclear. Understanding these differences could help address substance-related issues in this vulnerable population.

Objectives

This study examines subgroup differences in the secular trends in hazardous alcohol and cannabis use and co-use among youth entering residential care using clinical records data collected over a 10-year period from 2015 to 2024. Repeated cross-sectional data from 2,256 youth (ages 9-18 years) entering a Midwestern U.S. residential care facility (2015-2024) were analyzed. Hazardous alcohol and cannabis use were assessed using the AUDIT (Alcohol Use Disorders Identification Test) and CUDIT-R (Cannabis Use Disorders Identification Test-Revised), respectively. Subgroup differences were examined through product-term logistic regressions, testing trends by age, sex, and race/ethnicity.

Results

Hazardous alcohol use significantly increased over time among females (OR = 1.043, se = 0.026, p < 0.05) but decreased among males (OR = 0.981, se = 0.021, p < 0.05). Both Latinx youth (OR = 0.944, se = 0.038, p < 0.05) and American Indian youth (OR = 0.909, se = 0.066, p < 0.05) reported a significant decrease in hazardous alcohol use over time compared to a significant increase among White youth (OR = 1.021, se = 0.018, p < 0.05). A similar interaction pattern was shown for American Indian compared to White youth for comorbid use.

Conclusions

Results have implications for ongoing monitoring and development of tailored interventions for youth entering residential care.