title: Prevalence and correlates of atypical patterns of drug use progression: findings from the South African Stress and Health Study.
abstract: OBJECTIVE
  Atypical sequences of drug use progression are thought to have important implications for the development of substance dependence. The extent to which this assumption holds for South African populations is unknown. This paper attempts to address this gap by examining the prevalence and correlates of atypical patterns of drug progression among South Africans.
  
  
  METHODS
  Data on substance use and other mental health disorders from a nationally representative sample of 4351 South Africans were analysed. Weighted cross tabulations were used to estimate prevalence and correlates of atypical patterns of drug use progression.
  
  
  RESULTS
  Overall, 12.2% of the sample reported atypical patterns of drug use progression. The most common violation was the use of extra-medical drugs prior to alcohol and tobacco. Gender was significantly associated with atypical patterns of drug use with the risk pattern varying by the type of drug. None of the anxiety or mood disorders were associated with atypical patterns of use. Atypical patterns of drug use were not associated with increased risk for a lifetime substance use disorder.
  
  
  CONCLUSIONS
  Atypical patterns of drug use initiation seem more prevalent in South Africa compared to other countries. The early use of extra-medical drugs is common, especially among young women. Drug availability and social environmental factors may influence patterns of drug use. The findings have important implications for prevention initiatives and future research.
authors.affiliation: Alcohol and Drug Abuse Research Unit, Medical Research Council, Tygerberg, South Africa. bmyers@mrc.ac.za
authors.forename: B
authors.initials: B
authors.lastname: Myers
authors.forename: M S
authors.initials: MS
authors.lastname: van Heerden
authors.forename: A
authors.initials: A
authors.lastname: Grimsrud
authors.forename: L
authors.initials: L
authors.lastname: Myer
authors.forename: D R
authors.initials: DR
authors.lastname: Williams
authors.forename: D J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013019:South Africa / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control