Prenatal drug exposure, behavioral problems, and drug experimentation among African-American urban adolescents.
OBJECTIVE
To examine how prenatal drug exposure (PDE) to heroin/cocaine and behavioral problems relate to adolescent drug experimentation.


METHODS
The sample included African-American adolescents (mean age = 14.2 years, SD = 1.2) with PDE (n = 73) and a nonexposed community comparison (n = 61). PDE status was determined at delivery through toxicology analysis and maternal report. Internalizing/externalizing problems were assessed during adolescence with the Behavior Assessment System for Children, Second Edition. Drug experimentation was assessed by adolescent report and urine analysis. Logistic regression evaluated the likelihood of drug experimentation related to PDE and behavioral problems, adjusting for age, gender, PDE, perceived peer drug use, and caregiver drug use. Interaction terms examined gender modification.


RESULTS
Sixty-seven subjects (50%) used drugs: 25 (19%) used tobacco/alcohol only and 42 (31%) used marijuana/illegal drugs. Ninety-four subjects (70%) perceived peer drug use. PDE significantly increased the risk of tobacco/alcohol experimentation (odds ratio = 3.07, 95% confidence interval [CI] 1.09-8.66, p = .034) but not after covariate adjustment (adjusted odds ratio [aOR] = 1.16, 95% CI .31-4.33, p > .05). PDE was not related to the overall or marijuana/illegal drug experimentation. The likelihood of overall drug experimentation was doubled per SD increase in externalizing problems (aOR = 2.28, 95% CI 1.33-3.91, p = .003) and, among girls, 2.82 times greater (aOR = 2.82, 95% CI 1.34-5.94, p = .006) per SD increase in internalizing problems. Age and perceived peer drug use were significant covariates.


CONCLUSIONS
Drug experimentation was relatively common (50%), especially in the context of externalizing problems, internalizing problems (girls only), older age, and perceived peer drug use. Findings support the Problem Behavior Theory and suggest that adolescent drug prevention addresses behavioral problems and promotes prosocial peer groups.
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.
Yan
Y
Wang
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.
Stacy
S
Buckingham-Howes
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.
Prasanna
P
Nair
Office of Research, University of Maryland School of Nursing, Baltimore, Maryland.
Shijun
S
Zhu
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
Laurence S
LS
Magder
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: mblack@peds.umaryland.edu.
Maureen M
MM
Black
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014505:Urban Population
Behavioral problems; Drug experimentation; Gender; Prenatal drug exposure