The Transition of Sociodemographic and Substance Abuse Characteristics, Pairwise Co-occurrences and Factors Associated with Polysubstance Use Among US Adolescents and Young Adults.

Background:Substance abuse by adolescents and young adults is a major public health issue. This study aimed to (i) show the transition of sociodemographic and substance abuse characteristics from 1992 to 2017 among US adolescents and young adults, (ii) evaluate the likelihood of co-occurrence of substances, and (iii) identify significant sociodemographic characteristics in association with polysubstance abuse. Methods:This study extracted data for adolescents and young adults from 1992 and 2017 Treatment Episode Data Set-Admission (TEDS-A) datasets. The extracted sample included 337858 admissions in 1992 and 333322 in 2017. Findings:Both years experienced significant admissions. A significant transition in 2017 compared to 1992 was evident in education, living status, and ethnicity. Substance-specific transition showed alcohol was dominant in 1992, while marijuana/ hashish was dominant in 2017. Also, heroin, other opiates/synthetics, and methamphetamine experienced an increase, while cocaine/crack decreased. The pairwise co-occurrences exhibited a considerable variation in the likelihood of using one substance given another one. The odds ratios (ORs) obtained from generalized ordered logit models showed significantly higher odds of one or more substances with age, while education showed the opposite scenario. A mixed effect of gender was evident in 1992, whereas females were significantly less likely with one or more substances than males in 2017. Other significant vulnerable groups were those not in the labor force, homeless, white, and Mexican Americans. Conclusion:The findings may help to understand the overall changes between 1992 and 2017 and take necessary measures to reduce the burden of this public health problem.