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Delineating prototypical patterns of substance use initiations over time
Author(s) -
Dean Danielle O.,
Cole Veronica,
Bauer Daniel J.
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12816
Subject(s) - drug , psychological intervention , latent class model , medical prescription , ethnic group , medicine , population , substance abuse , substance use , psychology , clinical psychology , environmental health , psychiatry , computer science , pharmacology , machine learning , sociology , anthropology
Aims The purpose of this paper is to discover patterns of drug use initiations over time through a multiple event process survival mixture model (MEPSUM model), a novel approach for substance use and prevention research. Design The MEPSUM model combines survival analysis and mixture modeling—specifically latent class analysis—to examine individual differences in the timing of initiation and cumulative risk of substance use over time, and is applied to cross‐sectional survey data on drug initiations. Setting Data are drawn from the 2009 National Survey on Drug Use and Health. Participants The survey includes responses from 55 772 individuals (52.05% female). Measurements The age of first use of nine different types of substances are examined, including alcohol, tobacco, cocaine and non‐medical use of prescription drugs. Findings It is argued that six patterns parsimoniously describe the population's risk of initiating different substances over time, described colloquially as general abstainers; early, late and progressive soft drug users; and early and late hard drug users. Both gender and ethnicity significantly predict the patterns, with Caucasians and males having a higher risk for the hard drug‐using patterns. The MEPSUM model produced stable results in this application, as the patterns are validated in a split‐sample design. Conclusions The MEPSUM model provides a statistical framework from which to evaluate patterns of risk for drug initiations over time and predict substance use trajectories relevant to public health interventions. The patterns that result from the model can be used as outcomes for subsequent investigations of etiological and mediating mechanisms.