Abstract

INTRODUCTION: Substance use disorders (SUDs) affect millions globally, with family history emerging as a potent risk factor. This study leverages the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III) dataset to investigate how weighted family history density (FHD) influences the intergenerational transmission of SUDs, age at first substance use, and duration of substance in both sexes. By addressing limitations in previous research, we aim to provide insights for more effective prevention and intervention strategies for individuals and families impacted by SUDs.

METHODS: We conducted a cross-sectional analysis using data from NESARC-III survey (2012-2013), a nationally representative sample of 36,309 noninstitutionalized adults aged 18 and older. Weighted FHD was determined as substance use disorders among first- and second-degree relatives. We employed linear regression models to assess relationships between FHD with age at onset and duration of substance use, adjusting for demographic, socioeconomic, and geographic factors with statistical significance of p < 0.05.

RESULTS: We observed significant associations between weighted FHD and substance use patterns. Higher FHD was associated with earlier onset and longer duration of substance use. Each unit increase in FHD was associated with a 0.54-year earlier onset [β = -0.54, Standard Error (SE) = 0.02], and 0.48-year longer duration of use (β = 0.48, SE = 0.03). Adjusted regression models showed that weighted FHD significantly predicted substance use before age 18 and use duration exceeding half of one's current age, 5 years, and 10 years.

DISCUSSION:  Weighted FHD strongly predicts earlier initiation and longer substance use duration. These findings highlight the importance of family history assessments in prevention and intervention strategies. Future research should investigate these associations in diverse worldwide populations in longitudinal studies and examine the interaction between family history and other genetic and environmental risk factors.