Trends in combinational use of alcohol and illicit drugs among minority adolescents, 1983-1994.

Combinational use of substances refers to taking two or more substances together so that they affect the person at the same time. This pattern of substance use presents unique health and safety risks. Trends in combinational use of alcohol and marijuana or alcohol and cocaine were determined using data from three large comparable samples of students in grades 7-12 in New York State, from surveys conducted in 1983, 1990, and 1994. Each of the three samples was demographically diverse, permitting detailed analysis of trends in various adolescent subgroups according to gender, grade level (age), and race/ethnicity. These two forms of adolescent combinational use of alcohol and illicit drugs dropped sharply from 1983 to 1990, but increased or remained stable from 1990 to 1994. Use of alcohol and marijuana together increased sharply from 1990 to 1994, much more for blacks and Hispanics than for whites, while use of alcohol and crack or cocaine together remained stable at a low level in the 1990s. Both forms of combinational use increased in the 1990s more among younger adolescents than among older ones. Analyses controlling for rates of use also suggest that these forms of combinational use are incidental to the use of the individual substances, rather than uniquely sought "highs." Prevention programs should include warnings about the dangers of combinational use, especially for younger adolescents.