Longitudinal associations between adolescent psychosocial vulnerabilities and young adult crystal methamphetamine use

Objective: Methamphetamine use has deleterious public health consequences. Given the mean age of initiation is 19.3 years (SAMHSA, 2010), identifying adolescent populations for early intervention may help prevent use in young adulthood. To determine priority populations for prevention and potential determinants of use, we examined longitudinal associations between psychosocial vulnerabilities in adolescence and crystal methamphetamine use in young adulthood. Design: Multivariate regression analyses of prospective cohort data collected for the National Longitudinal Study of Adolescent Health in adolescence (Wave I: 1994-1995) and young adulthood (Wave III: 2001-2002) (N=14,322). Measurements: Wave I (adolescence): Delinquency level, based on delinquency scale score; past year marijuana, crack/cocaine, and other illicit drug use; and depression (CES-D)/suicidality. Wave III (young adulthood): History of crystal methamphetamine use in adulthood. Findings: Each adolescent substance use variable, delinquency level, and suicidality were associated with more than twice the odds of adult crystal methamphetamine use; adolescent crack/cocaine use and high delinquency level were associated with nine times the odds of use. In adjusted analyses, adult crystal methamphetamine use was independently predicted by delinquency level (Low: OR: 1.50, 95% CI: 1.10-2.04; Moderate: OR: 1.57, 95% CI: 0.99-2.49; High: OR: 2.19, 95% CI: 1.26-3.83; versus no delinquency); each substance use variable, with strongest associations for crack/cocaine use; and adolescent suicidality (OR: 1.51, 95% CI: 1.16-1.97). Conclusions: Delinquent, substance using, and suicidal youth constitute priority populations for crystal methamphetamine prevention. Addressing adolescent crack/cocaine use and delinquent behaviors may prevent adulthood crystal methamphetamine use given the strong independent associations between these factors and use.