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Substance Use in Adolescents and Young Adults with Inflammatory Bowel Diseases

An Exploratory Cluster Analysis

Plevinsky, Jill M.*; Maddux, Michele H.; Greenley, Rachel N.

Journal of Pediatric Gastroenterology and Nutrition: April 9, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002365
Original Article: Gastroenterology: Inflammatory Bowel Disease: PDF Only

Objectives: Adolescents and young adults (AYAs) with chronic illnesses use substances at similar, if not greater, rates compared to healthy peers. The present study aimed to examine rates and patterns of tobacco use, marijuana use, and binge drinking in AYAs with inflammatory bowel diseases (IBD). We expected that substance use would be associated with poorer physical health, psychosocial functioning, and disease management.

Methods: One hundred thirty-two AYAs completed a single set of surveys assessing demographics, disease activity, healthcare utilization, health-related quality of life (HRQoL), IBD-specific self-efficacy, adherence barriers, disease management skills, and substance use in the last 30 days (e.g., tobacco use, marijuana use, binge drinking). Exploratory cluster analyses, followed by chi-square tests and analyses of variance examined patterns of substance use and correlates of cluster membership.

Results: Four patterns emerged from the sample: Global Users (n = 17), Marijuana Users Engaging in Binge Drinking (n = 18), Exclusive Binge Drinkers (n = 21), and Global Abstainers (n = 76). Groups differed by age, gender, disease activity, healthcare utilization, HRQoL, self-efficacy, and adherence barriers with medium and large effect sizes (p's < .05).

Conclusions: Older age, male gender, active disease, at least one hospitalization in the past year, low self-efficacy, low HRQoL, and high adherence barriers were significantly more likely for those reporting multi-substance use. Additionally, all those reporting both marijuana use and binge drinking also reported tobacco use. Future research ought to examine these associations longitudinally and throughout the transition to adult care.

*Cincinnati Children's Hospital Medical Center

Children's Hospital Kansas City

Rosalind Franklin University of Medicine and Science.

Address correspondence and reprint requests to Jill M. Plevinsky, PhD, Center for Treatment Adherence and Self-Management, Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229 (e-mail:

Received 29 January, 2019

Accepted 28 March, 2019

Disclosure of Funding: This work was supported by Division 54 of the American Psychological Association, the Society of Pediatric Psychology Marion Routh Student Research Grant.

Conflicts of Interest and Source of Funding

The authors have indicated they have no potential conflicts of interest nor financial relationships relevant to this article to disclose.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,