[1675.6] The Association between At-School Substance Use and Serious Health Risks

Rebecca N. Dudovitz, Kelsi McCoy, Paul J. Chung. University of California Los Angeles, Los Angeles, CA; RAND, Santa Monica, CA.

BACKGROUND: Nationally, over 5% of teens report using alcohol or marijuana on school campus. Although teachers and school administrators are well aware of at-school substance use, most report uncertainty about how to respond to specific drug and alcohol offenses. This may be, in part, due to a lack of consensus on whether at-school substance use is primarily a disciplinary problem or a sign of serious health risks in need of additional support.
OBJECTIVE: To determine whether students who use alcohol or marijuana at school are more likely than out-of-school users to exhibit 9 serious health risks, and whether these relationships differ by gender and by alcohol versus marijuana use.
DESIGN/METHODS: We analyzed data from the national 2011 Youth Risk Behaviors Survey of 15,698 9th-12th grade students. Multivariate regressions controlling for age and race evaluated whether at-school marijuana and alcohol users were more likely than out-of-school users to exhibit 9 serious health risks (exposure to intoxicated driving, fighting, carrying a weapon at school, substance use with intercourse, experiencing intimate partner violence, being forced to have intercourse, having symptoms of depression, suicidal ideation and attempting suicide). We included interaction terms to determine whether associations varied by gender or substance. We also described the sensitivity, specificity, positive predictive value, and negative predictive value of any at-school alcohol or marijuana use for identifying each serious health risks.
RESULTS: Compared to out-of-school use, at-school use of alcohol or marijuana was associated with increased odds of all 9 serious health risks. Associations did not vary by substance. The association between at-school substance use and both fighting and being forced to have sex was higher for boys than for girls. Specificity of at-school substance use for serious health risks ranged from 0.93-0.96, and positive predictive values ranged from 0.23-0.69. For example, if a student reported using alcohol or marijuana at school, there was a 46% chance they had a positive depression screen, a 25% chance they experienced intimate partner violence in the last 12 months and a 25% chance they attempted suicide in the last 12 months.
CONCLUSIONS: Students found using alcohol or marijuana at school should be immediately and carefully screened for other serious health risks that pose significant dangers, as this may represent a critical opportunity to identify troubled youth.


Session: Platform Session: Male Health & Substance Use (2:45 PM - 4:45 PM)
Date/Time: Saturday, May 3, 2014 - 4:00 PM
Room: East 9 - Vancouver Convention Centre
Course Code: 1675


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