Characterizing Heterogeneity in Substance Use in a Large Sample of Canadian Adolescents: A Multilevel Latent Class Analysis
Sophie G. Coelho, Jeffrey D. Wardell, David B. Flora, Sergio Rueda, Sameer Imtiaz, Hayley A. Hamilton
International Journal of Mental Health and Addiction·2025
LCA) to delineate patterns of adolescent substance use, though rarely in settings where non-medical cannabis is legal and using multilevel analytic frameworks to account for clustering of students within schools. This study used multilevel LA to identify subgroups of high school students based on substance use patterns and correlates of subgroup membership in Ontario, Canada, where cannabis use is legal for adults ages 19 years and older. Data were from a representative sample of N= 7189 grades 9-12 students. Multilevel LCA with past-year use of alcohol, cannabis, nicotine, illegal drugs, and prescription drugs as latent class indicators identified no/low use (68.99%), moderate alcohol use and infrequent cannabis use (15.73%), and polysubstance use (15.28%) student-level latent classes, which were differentiated by sociodemographic, academic, and health-related factors. In revealing heterogeneity in adolescent substance use patterns and their risk factors, findings underscore the importance of tailored interventions for substance-related harms among adolescents.