Comorbid alcohol and cannabis use disorders among high-risk youth at intake into residential care.

PURPOSE: Alcohol use disorder (AUD) and cannabis use disorder (CUD) are prevalent among high-risk adolescents, such as those referred for residential care. These disorders are often comorbid, and comorbidity is associated with heightened adverse consequences compared with each disorder alone. Little is known about factors that are associated with the development of comorbid AUD and CUD. This study tested individual, family, peer, school, and community variables as common versus specific correlates of singular and comorbid AUDs and CUDs among high-risk youth.

METHODS: Participants were 1,662 youth at entry into a large residential group home program. The average age of participants was 15.2 years, and 63% were male. Routine intake assessments, including standardized questionnaires (e.g., Diagnostic Interview Schedule for Children) and structured checklists, provided archival data for the analyses, conducted using multinomial logistic regression (with neither disorder as the reference group).

RESULTS: Male gender was a specific positive correlate of CUD-only. Several common positive correlates of the disorder groups were identified, including individual (e.g., anxiety/depression), family (e.g., family history of substance use), peer (e.g., hanging around troubled peers), and school (e.g., truancy) variables. Age at intake and troubled peers had stronger positive associations with comorbid AUD and CUD than with either disorder alone.

CONCLUSIONS: Many more common than specific correlates were identified; these variables may be associated with generalized risk for substance use disorders. Two variables were particularly strong positive correlates of comorbid AUD and CUD, and potentially could be targeted in interventions designed to prevent comorbid substance use disorders.