Early Substance Use and Subsequent DUI in Adolescents

Published in: Pediatrics, v. 136, no. 5, Nov. 2015, p. 868-875

Posted on RAND.org on November 18, 2015

by Brett Ewing, Joan Tucker, Jeremy N. V. Miles, Regina A. Shih, Magdalena Kulesza, Eric R. Pedersen, Elizabeth J. D'Amico

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Research Question

  1. How do adolescents' beliefs about alcohol and marijuana, their use of alcohol and marijuana, peer influence and family factors assessed in middle school affect their likelihood of driving under the influence (DUI) or riding with a drinking driver (RWDD) in high school?

OBJECTIVE: Little is known about risk factors in early adolescence that lead to driving under the influence (DUI) and riding with a drinking driver (RWDD). In a diverse group of adolescents, we longitudinally explored the influence of alcohol and marijuana (AM) use, AM beliefs, and peer and family factors (including familism) on DUI/RWDD in high school. METHODS: We conducted 3 surveys 2 years apart of 1189 students recruited from 16 middle schools in Southern California. We used multivariable models to evaluate the effects of AM use, AM beliefs, and peer and family factors at ages 12 and 14 on DUI/RWDD at age 16. RESULTS: At age 12, adolescents with more positive beliefs about marijuana (odds ratio [OR] = 1.63, 95% confidence interval [CI]: 1.20–2.20) and more ability to resist marijuana offers (OR = 1.89, 95% CI: 1.22–2.92) had significantly higher risk of DUI/RWDD 4 years later. At age 14, youth with more past month alcohol use (OR = 2.10, 95% CI: 1.07–4.11), positive beliefs about marijuana (OR = 1.67, 95% CI: 1.31–2.13), exposure to peer AM use (alcohol: OR = 1.01, 95% CI: 1.00–1.02; marijuana: OR = 2.41, 95% CI: 1.28–4.53), and family marijuana use (OR = 1.54, 95% CI: 1.12–2.11) had higher risk of DUI/RWDD at age 16. CONCLUSIONS: Findings indicate a need to target adolescents as young as sixth grade at multiple levels to help prevent DUI/RWDD in high school. Given recent changes in legislation in several states, research should begin to focus on the distinction between DUI/RWDD of AM.

Key Findings

  • At age 12, positive beliefs about marijuana and a stronger confidence in their own ability to resist marijuana use significantly predicted DUI/RWDD four years later.
  • Youth with a stronger confidence in their ability to resist marijuana use were more likely to report DUI/RWDD. This was an unexpected finding and future studies need to further investigate the association between adolescents' ability to resist marijuana use and DUI/RWDD.
  • By age 14, past month alcohol use, positive beliefs about marijuana, peer factors (perceived prevalence of alcohol use and exposure to peer marijuana use) and family marijuana use were statistically significant predictors of DUI/RWDD in high school.
  • The findings suggest the need for targeted interventions for youth as young as sixth grade to help prevent DUI/RWDD in high school.

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