Time to regular substance use in alcohol dependent and non-dependent African Americans

INTRODUCTION: Onset of alcohol dependence usually occurs during late adolescence. Prior to alcohol dependence, an individual may start and continue to use substances such as tobacco or marijuana. This paper will examine if the time between initial and regular use of these substances plays a role in the progression to alcohol dependence. METHOD: The sample consisted of 323 African Americans, 174 were alcohol dependent (AD) and 149 non-alcohol dependent (ND). These participants used at least one substance, other than alcohol, regularly (marijuana, tobacco, opiates, cocaine, stimulants, sedatives, other). Differences in time to regular use were contrasted using Kaplan-Meier survival analysis with Mantel Cox log rank for significant differences. Significance was established at p<. 05. RESULTS: Only marijuana showed a significant difference in time to regular use (mean ± SD) with 2.60±5.64 years among ADs, compared to 4.21±9.61years in NDs. Additionally, both initial and regular marijuana use (mean ±SD = 15.72±4.24 years and 17.59± 5.34 years, respectively) occurred before regular alcohol use (mean ± SD= 18.05±5.81 years), which in turn occurred before alcohol dependence (mean ± SD =26.36±7.75 years). CONCLUSION: In the current African American sample, the data indicates that the period of substance use may be an indicator of development of alcohol dependence, particularly among populations with a late onset of alcohol dependence. Use of such substances may even precede regular alcohol use. This information is beneficial in tailoring substance use prevention and intervention to a specific community.