The Transition of Sociodemographic and Substance Abuse Characteristics, Pairwise Co-occurrences and Factors Associated with Polysubstance Use Among US Adolescents and Young Adults.

Background: Substance abuse by adolescents and young adults is a major public health issue. This study aimed to (i) show the transition of sociodemographic and substance abuse characteristics from 1992 to 2017 among US adolescents and young adults, (ii) evaluate the likelihood of co-occurrence of substances, and (iii) identify significant sociodemographic characteristics in association with polysubstance abuse. Methods: This study extracted data for adolescents and young adults from 1992 and 2017 Treatment Episode Data Set-Admission (TEDS-A) datasets. The extracted sample included 337858 admissions in 1992 and 333322 in 2017. Findings: Both years experienced significant admissions. A significant transition in 2017 compared to 1992 was evident in education, living status, and ethnicity. Substance-specific transition showed alcohol was dominant in 1992, while marijuana/ hashish was dominant in 2017. Also, heroin, other opiates/synthetics, and methamphetamine experienced an increase, while cocaine/crack decreased. The pairwise co-occurrences exhibited a considerable variation in the likelihood of using one substance given another one. The odds ratios (ORs) obtained from generalized ordered logit models showed significantly higher odds of one or more substances with age, while education showed the opposite scenario. A mixed effect of gender was evident in 1992, whereas females were significantly less likely with one or more substances than males in 2017. Other significant vulnerable groups were those not in the labor force, homeless, white, and Mexican Americans. Conclusion: The findings may help to understand the overall changes between 1992 and 2017 and take necessary measures to reduce the burden of this public health problem.

Historical trends of admitted patients by selected substances and their significant patient's level factors.

The purposes of the study include (i) demonstrating the US national level historical trends of the number of admitted patients due to substance abuse and those reported the selected substances at the time of admission, and more importantly, (ii) identifying the significant covariates in the association of using each of the substances along with the dynamics of likelihood over the different levels of the covariates. The trend of total admitted patients shows an increasing pattern from 1992 to 2008 and later exhibits a decreasing pattern before experiencing a significant upturn again in the last two consecutive years. During the study period, the highest growth rate of around 1088% is evident for methamphetamine followed by heroin (192%) and marijuana or hashish (45%), while both cocaine or crack (-33%) and alcohol (-29%) show negative growth rates. The estimated logistic regression models show that every covariate, including age, education, employment, gender, living status, race, and ethnicity, has a significant effect on the status of using each of the five selected substances. In parallel, the dynamics of likelihood over the levels of each covariate on every substance unearth even more information. In conclusion, the findings on trend analysis suggest the immediate attention to the growth in admissions for substance abuse treatment, and in response to taking appropriate policy measures, the likelihood dynamics revealed for every substance would undoubtedly play a vital role in identifying the target group as per priority.