Prospective association of interventions for at-risk families with illicit drug use among young students in Taiwan

Background: Young people who use illicit drugs disproportionately experience multiple problems in individual, family, and school domains. With a focus on illicit drug-using middle schoolers, the present study aims to characterize intervention services for risk indicators and to examine the prospective associations with reinitiated use throughout adolescence.

Methods: A retrospective cohort of 1605 adolescents was identified from the 2013 to 2016 national school-based indicated prevention program serving illicit drug-using students in Taiwan. Reinitiated use of illicit drugs was confirmed by the Drug Abuse Big Datasets comprising police arrest records. Information concerning the history of intervention services-attention deficit hyperactivity disorder (ADHD) treatment, intervention for at-risk families, and school dropout consultation-was ascertained from national administrative data. A cohort of young adolescents from the general population (n = 809,477) was sampled for comparison. The Cox proportional hazards model was used to evaluate the risk of drug use.

Results: Nearly 80 % of illicit drug-involved middle schoolers used ketamine only, and 17 % used amphetamine or methamphetamine. Over a four-year follow-up, 35 % of middle schoolers were re-reported for drug use, with police arrest being the major source. A history of ADHD treatment was not linked with illicit drug use, whereas dropping out in early schooling can elevate middle schoolers' hazard by 46 %. Notably, receiving services targeting at-risk families in late childhood can lower the hazard by 43 %, with the reduction even greater when non-school-attending adolescents were included.

Discussion: To reduce progression into advanced drug involvement and substance use disorders, an integrated model of school-based interventions is urgently needed.