Social contextual risk factors for stimulant use among adolescent American Indians

- We know very little about stimulant misuse among American Indian (AI) adolescents.
- Being prescribed stimulants increases the likelihood of using misusing stimulants.
- Being prescribed stimulants increase the frequency of past month stimulant use.
- Other important factors included social, contextual factors, peers and family.
- Professionals who prescribe stimulants should be aware of the abuse potential.

ObjectiveStimulants are the most common and efficacious treatment for Attention-Deficit Hyperactivity Disorder (ADHD). We examined the relationship between stimulant misuse and social factors that could be malleable to prevention among American Indian (AI) adolescents.MethodParticipants were AI students (N = 3498) sampled from 33 schools in 11 states. Participants completed the American Drug and Alcohol Survey. A multilevel analytic approach was used to evaluate the effects of participant-level (level 1) variables (i.e., gender, grade, peer, school, family, stimulant prescribed by doctor) on lifetime and current simulant use to 'get high.'ResultsNearly 7% of our sample had been prescribed stimulants and nearly 6% of the sample reported using stimulants to get high. Age [OR = 1.22; 95% CI = 1.09, 1.36, p < 0.001], perception of peer substance use [OR = 1.19; 95% CI = 1.14, 1.23, p < 0.001], parental monitoring [OR = 0.96; 95% CI = 0.92, 1.99, p = 0.04], and stimulants prescribed by a doctor [OR = 8.79, 95% CI = 5.86, 13.18, p < 0.001] were associated with ever using stimulants to get high. Perception of peer substance use, [b = 0.09, SE = 0.02, p < 0.001, 95%CI [0.05, 0.13], and having stimulants prescribed by a doctor, [b = 0.58, SE = 0.21, p = 0.006, 95%CI [0.17, 0.99], were associated with frequency of past month use to get high. There was also a significant quadratic effect for parental monitoring, suggesting that low and high levels were associated with increased stimulant use.ConclusionsOur results suggest a need for prevention efforts to be directed to AI youth who are prescribed stimulants.