Childhood characteristics associated with stage of substance use of American Indians: family background, traumatic experiences, and childhood behaviors
Open accessAbstract
The purpose of this analysis is to examine childhood characteristics associated with stage of substance use in adulthood in two American Indian (AI) populations. Data were drawn from an epidemiologic study of two AI reservation populations for persons age 18-44 years (n=2070). We used descriptive and multivariate analysis to examine correlates of four mutually exclusive stages of substance use: lifetime abstinence (Stage 0), use of alcohol only (Stage 1A), use of marijuana/inhalants with or without alcohol (Stage 1B), and use of other illicit drugs with or without the previously listed substances (Stage 2). Problematic substance use by parents, younger age of first substance use, initiating substance use with a drug (with or without alcohol), and adolescent conduct problems were associated with higher stage substance use. Persons who experienced sexual abuse, witnessed family violence, or experienced other traumatic events before the age of 18 were more likely to be at Stage 1B than Stage 1A. These findings underscore the importance of providing effective interventions during childhood and adolescence to reduce the risk of substance use progression.
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Witnessing family violence significantly contributed to alcohol use among AIANs.
“The same study also found that witnessing family violence significantly contributed to alcohol use [58].”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [58]
The Results (section 3) report that witnessing family violence was significantly associated with higher odds of alcohol-only use versus abstinence among Northern Plains participants (OR 1.85, p<0.01). The Methods (section 2) identify the sample as members of specific American Indian tribes, not AIANs generally. The study reports an association with a defined substance-use stage, not that family violence causally contributed to alcohol use across the broader population. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSexual abuse nearly doubled the odds of alcohol and other drug use among AIANs.
“Another study on the association between ACEs and substance use among AIANs found that sexual abuse nearly doubled the odds of alcohol and other drug use [58].”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [58]
The Results (section 3) say that sexual-abuse-related trauma nearly doubled the odds of Stage 1B substance use versus Stage 1A. The Methods (section 2) define that comparison as marijuana and/or inhalant use, with or without alcohol, versus alcohol use only—not the odds of alcohol and other drug use generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredParental divorce, family separation, and parental loss was also associated with alcohol use and other substances.
“Parental divorce, family separation, and parental loss was also associated with alcohol use and other substances [58].”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [58]
The family-background table (2. Methods; page unavailable) shows some differences by substance-use stage for parental divorce and family separation, but not for death of a parent. The Discussion (4. Discussion; page unavailable) says these three circumstances showed minimal associations with stage of use, so the claim overstates the evidence and is unsupported for parental loss. (LLM, conf=0.86)
Experimental — accuracy not yet measuredStrong associations have been observed between experiencing abuse in the family structure and substance use severity.
“Strong associations have been observed between experiencing abuse in the family structure and substance use severity [51,58].”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [58]
The Results (section 3; page unavailable) report strong associations between childhood trauma and stage of substance use, including sexual abuse and witnessing family violence. The paper does not establish that the sexual abuse occurred within the family, and witnessing family violence is not necessarily experiencing abuse directly; it measures stage of use rather than severity as such. (LLM, conf=0.82)
Experimental — accuracy not yet measuredEarly onset of substance use predicted subsequent and potentially higher rates of use.
“Additionally, early onset of substance use predicted subsequent and potentially higher rates of use [58,59]”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [58]
The Results (section 3; page unavailable) associate initiation by age 13 with higher odds of Stage 1B rather than Stage 1A substance use, and the Discussion (section 4; page unavailable) describes a strong relationship between younger initiation and higher stage. The stages classify lifetime types of substances used, not rates or frequency of use; the paper also reports an association rather than demonstrating that early onset predicted subsequent use. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Early puberty, problematic substance use by parents, and relationships with deviant peers have all been related to more problematic patterns of substance use.
“Finally, early puberty, problematic substance use by parents (O'Connell et al., 2007) and relationships with deviant peers have all been related to the more problematic patterns (Whitesell et al., 2014).”
From Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data (2018) · cites this paper as O'Connell et al., 2007
Traumatic events in the family were independently associated with various forms of substance use.
“While causal relationships cannot be asserted in these domains, research indicates that traumatic events in the family were independently associated with various forms of substance use [58].”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [58]
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- Authors
- O'Connell, J. M., Novins, D. K., Beals, J., Whitesell, N., Libby, A. M., Orton, H. D., & Croy, C. D.
- Affiliations
- University of Colorado Denver (US)
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2007-12
- Volume
- 32
- Issue
- 12
- Pages
- 3142-3152
- ISSN
- 0306-4603 (ISSN-L)
- PMC
- PMC2447861
- OpenAlex
- W1978822862
- Cited by
- 34
- References
- 12
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 4 · 2018: 3 · 2016: 2 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 1
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01-AA-13800, R01AA013800)
- National Institute of Mental Health (P01MH042473, P01-MH-42473, R01-MH48174, R01MH048174)
- National Institute on Drug Abuse (R01DA014817, R01-DA-14817)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Social Sciences › Demography › Youth, Drugs, and Violence
- Keywords
- Native Americans, substance use progression, childhood trauma, family background, alcohol consumption, cannabis use, inhalant use, illicit drug use, sexual abuse, adolescent conduct problems, childhood risk factors
- MeSH terms
- Adolescent, Adult, Child Abuse, Child Abuse, Sexual, Female, Humans, Indians, North American, Male, Risk Factors, Multivariate Analysis, Substance-Related Disorders
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