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.