Concurrent Substance Use and Related Problems among African American Adolescents: A Daily Diary Study

Abstract

African American adolescents have historically been considered at low risk for substance use relative to the White adolescent majority based on national prevalence estimates. However, during the last decade, African American adolescents’ rates of marijuana use—alone and in combination with other substances—have increased disproportionately relative to those of their White peers. Given the strong relationship between marijuana use and other substance use and the functional consequences associated with concurrent substance use during adolescence, the increase in marijuana use among African American youth may contribute to increased substance-related health disparities across the lifespan. Thus, the current study examined daily associations between marijuana use and other substance use among African American adolescents relative to their White peers. It also examined whether those associations differentially predicted behavioral health consequences among African American adolescents. Participants (N = 35; 42.9% African American) were adolescents age 14-18 who reported past 30-day use of marijuana, alcohol, and/or tobacco products. Respondents completed daily diaries reporting their substance use for 14 consecutive days, followed by self-report measures of internalizing symptoms, externalizing symptoms, and substance use problems. Multilevel regression and structural equation models were used to account for the nesting of days within individuals. Participants completed 458 diaries for a completion rate of 93.5%. African American respondents reported greater daily- and individual-level rates of marijuana use and concurrent substance use than White respondents. However, in multilevel models controlling for demographics, marijuana use was not related to concurrent use of alcohol and/or tobacco use and this relationship did not vary by race. Racial differences in the relationship between concurrent substance use and behavioral health consequences were observed such that the relationship was positive among White youth but not African American youth. Findings suggest that African American youth are at high risk for engagement in problematic patterns of substance use but that daily diary methods may not be most appropriate for illuminating these patterns. Despite these unexpected results, disparities in substance-related consequences among African Americans adults persist. Future research should examine long-term rather than proximal consequences of concurrent substance use among African American adolescents.