Individual and Contextual Determinants of Substance Use among Refugees in Shared Accommodations: A Cross-Sectional Multilevel Analysis

ABSTRACTAlthough women who use substances are often also facing severe economic and social problems, little is known about the relationship between social determinants of health and substance use among women. Furthermore, despite their increased visibility in substance use programs and policies in Canada, little is known about the social contexts of substance use among Aboriginal women. I systematically reviewed empirical research published from 1997 through March 2013 that examined the relationship between social determinants of health and substance use among Aboriginal women. Studies that were peer-reviewed, published in English, and had an abstract were included. Of an initial 261 studies, only sixteen studies met the inclusion criteria (fourteen quantitative, one qualitative, one mixed methods). The social determinants of health that were explored in these studies were socio-demographics factors, trauma, gender, social environments, colonialism, culture, and employment. The studies identified significant relationships between the social determinants of health and substance use among Aboriginal women. The almost exclusive use of quantitative methods and the prioritization of certain social determinants of health over others prevented a comprehensive and contextual understanding of substance use among Aboriginal women. Further research is needed to understand these significant relationships, particularly in relation to Aboriginal-specific determinants of health.

Does the association between substance use and sexual risk behaviors among high school students vary by sexual identity?

This study examined determinants of substance use derived from the theory of planned behavior as influenced by acculturation. Latino adolescents (n= 448) completed measures of attitudes, subjective norms, perceived behavioral control, intentions toward substance use, and 2 acculturation components. The degree to which Latino adolescents were exposed to as well as use Spanish was unrelated to determinants of future substance use, whereas the degree to which they interact with non‐Latino peers exerted a protective effect regarding future substance use. However, both acculturation components influenced the extent social influence determinants predicted future substance use. Intervention strategies may need to consider acculturation in order to effectively direct resources toward those psychosocial determinants of substance use of greatest relevance to Latino populations.

Objective. The influence of religion, acculturation, and incarceration on substance abuse has been studied, though predominantly among adolescents. Little research exists on how such factors influence substance use among Hispanic adults. The objective of this study was to assess key determinants of substance use among Hispanic adults. Methods. Public access 2012 National Survey on Drug Use and Health was utilized. Univariate and multivariable logistic regression analyses were conducted while accounting for complex survey design to obtain population-weighted estimates. Receiver operator curve analysis was used to evaluate the relative contribution of each variable. Results. Importance of religious influence in life and Spanish language interview were associated with lower odds of substance use, while history of incarceration increased the likelihood of substance use among Hispanic adults. Other factors associated with lower odds were increasing age, being female, and currently married. Other factors associated with increased odds were high school graduate and some college in addition to living above the 200% federal poverty level. Discussion. Results from this study add to the limited body of the literature on determinants of substance use among Hispanic adults. Health education measures should target acculturated Hispanic adults and those with incarceration history to reduce substance use.

The social determinants of substance use associated with deaths of despair: Individual risks and population impacts

Externalizing and internalizing pathways may lead to the development of substance use behaviors (SUBs) and substance use disorders (SUDs), which are all heritable phenotypes. Genetic correlation studies have indicated differences in the genetic susceptibility between SUBs and SUDs. We investigated whether these substance use phenotypes are differently related to externalizing and internalizing problems at a genetic level. We analyzed data from genome-wide association studies (GWAS) of four SUBs and SUDs, five externalizing traits, and five internalizing traits using the bivariate causal mixture model (MiXeR) to estimate genetic overlap beyond genetic correlation. Two distinct patterns were found. SUBs demonstrated high genetic overlap but low genetic correlation of shared variants with internalizing traits, suggesting a pattern of mixed effect directions of shared genetic variants. Conversely, SUDs and externalizing traits exhibited considerable genetic overlap with moderate to high positive genetic correlation of shared variants, suggesting concordant effect direction of shared risk variants. These results highlight the importance of the externalizing pathway in SUDs as well as the limited role of the internalizing pathway in SUBs. As MiXeR is not intended for the identification of specific genes, further studies are needed to reveal the underlying shared mechanisms of these traits.

The current study examined developmental changes in substance use behaviors (SUBS) based upon sexual orientation. The analyses also attempted to address a number of methodological limitations in the extant longitudinal literature (i.e. distinct operationalizations of sexual orientation, timing of sexual orientation assessment with respect to reports of SUBs, non-linear growth). Data were drawn from a longitudinal study of incoming first-time college students at a large public university (n = 3720). After a paper-and-pencil assessment just prior to matriculation, participants completed a web-based survey every fall and spring for 4 years (sub-sample n = 2854). Latent growth models revealed that sexual minorities demonstrated significant heterogeneity with regard to substance use trajectories. Initial levels and trajectories of the frequency of substance use for sexual minority individuals were distinct, generally, from their exclusively heterosexual peers. Methodologically, the timing of the assessment of sexual orientation influenced the results, and modeling non-linear components indicated that sexual minorities are at risk for exponential increases in their frequency of certain SUBs over time (i.e. drunkenness; cannabis use). Sexual minority and majority individuals exhibited differences in SUBs during emerging adulthood, especially when using self-identification to define sexual orientation. Individuals who endorsed a sexual minority self-identification at the onset of emerging adulthood, as opposed to 4 years later, evidenced exponential increases in rates of drunkenness and cannabis use. These results support that the timing of assessment is important and that some trajectories of sexual minority SUBs are non-linear during this developmental period.

ABSTRACTThere is a dearth of knowledge about the social determinants of substance use among young pregnant-involved Indigenous women in Canada from their perspectives. As part of life history interviews, 17 young pregnant-involved Indigenous women with experiences with substances completed a participant-generated mapping activity CIRCLES (Charting Intersectional Relationships in the Context of Life Experiences with Substances). As women created their maps, they discussed how different social determinants impacted their experiences with pregnancy and substance use. The social determinants identified and used by women to explain determinants of their substance use were grouped into 10 themes: traumatic life histories; socioeconomic status; culture, identity and spirituality; shame and guilt; mental wellness; family connections; romantic and platonic relationships; strength and hope; mothering; and the intersections of determinants. We conclude that understanding the context and social determinants of substance use from a woman-informed perspective is paramount to informing effective and appropriate programs to support young Indigenous women who use substances.

This study investigated the relationship between peer influence and substance use among school-going adolescent refugees in the Kyaka II and Kyangwali refugee settlements in Western Uganda. The primary objective was to assess the extent to which peer influence is associated with substance use among adolescents in these settlements. A total of 136 students (48 males and 88 females) from Senior One to Senior Four were selected using a simple random sampling method from two secondary schools in the settlements. A correlational research design was employed, and data were collected using structured questionnaires. Pearson’s correlation analysis revealed no statistically significant relationship between peer influence and substance use (r = -0.101, p > 0.05). These findings suggest that peer influence does not directly predict substance use among adolescent refugees in this context. The study concludes by emphasizing the importance of exploring other contextual factors that may influence substance use behaviours and recommends the development of school-based programs aimed at addressing the broader psychosocial needs of refugee adolescents. Further research is needed to identify additional determinants of substance use in this vulnerable population.

Substance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi. Systematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI). The mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5-22), 19 (IQR: 13.5-25) and 22.5 (IQR: 22-23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13-21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65-118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27-5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15-25.4). Residential and marital status were not significantly associated with substance use. Male sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.

Genome-wide association studies (GWAS) have identified genetic variants associated with brain morphology and substance use behaviors (SUB). However, the genetic overlap between brain structure and SUB has not been well characterized. We leveraged GWAS summary data of 71 brain imaging measures and alcohol, tobacco, and cannabis use to investigate their genetic overlap using linkage disequilibrium score regression. We used genomic structural equation modeling to model a "common SUB genetic factor" and investigated its genetic overlap with brain structure. Furthermore, we estimated SUB polygenic risk scores (PRS) and examined whether they predicted brain imaging traits using the Adolescent Behavior and Cognitive Development (ABCD) study. We identified 8 significant negative genetic correlations, including between (1) alcoholic drinks per week and average cortical thickness, and (2) intracranial volume with age of smoking initiation. We observed 5 positive genetic correlations, including those between (1) insula surface area and lifetime cannabis use, and (2) the common SUB genetic factor and pericalcarine surface area. SUB PRS were associated with brain structure variation in ABCD. Our findings highlight a shared genetic etiology between cortical brain morphology and SUB and suggest that genetic variants associated with SUB may be causally related to brain structure differences.

Despite adolescents making up a significant part of the global population, they have high rates of substance use, linked to various health problems and risky behaviours and increased risk of negative social, cognitive, and physical consequences. Studies on substance use and related risk behaviours among adolescents in Tanzania are crucial for informing targeted interventions and policies to safeguard the health and development of this vulnerable population. We aimed to assess the prevalence and determinants of substance use among adolescents in the Tanga region, eastern in Tanzania. We conducted a secondary analysis of cross-sectional survey data among 1,262 in-school (n = 1,031) and out-of-school (n = 231) adolescents conducted in Tanga, Tanzania in 2021. Data was collected using the Global School Health Survey (GSHS) questionnaire that included questions on substance use, specifically alcohol, smoking marijuana and tobacco, and recreational drugs like cocaine and heroin. Modified Poisson regression models estimated the factors influencing lifetime and current (within the past 30 days preceding the survey) substance use using Stata software version 17. Among 1,262 adolescents, the lifetime and current prevalence of substance use were 8.6% and 3.2%, respectively (4.1% and 0.8% among in-school vs. 29% and 13.9% among out-of-school adolescents). The most reported substance used over a lifetime among both in-school and out-of-school adolescents was smoking (2.3% and 27.7%), followed by alcohol drinking (2% and 10.4%). A higher likelihood of lifetime and current substance use was found among older adolescents (15-19 years), males, and who owned a mobile phone, with a social media account, with history of sexual activity, and out-of-school adolescents. Substance use is common among the adolescent population in eastern Tanzania. Policies to keep adolescents in school are instrumental in reducing risk behaviours during adolescence. Targeted behaviour change interventions should be considered for older adolescents (15-19 years), out-of-school, males, and those exposed to sexual activities.

ABSTRACTThe present study examines the role of communication in shaping norms and behaviors with significant personal and societal consequences. Based on primary socialization theory and the general theory of family communication, parental anti-substance-use socialization processes were hypothesized to influence early adolescents’ substance-use norms and behaviors. Using longitudinal data (N = 1059), the results revealed that parent-adolescent prevention communication about substance use in the media and parental anti-substance-use injunctive norms were positively associated with early adolescents’ personal anti-substance-use norms, which, in turn, led to decreases in recent alcohol, cigarette, and marijuana use. It was also found that family expressiveness and structural traditionalism positively related to the hypothesized association between parental socialization processes and early adolescents’ norms and behaviors.

Background: Substance use is an increasing global public health and socioeconomic concern. Commonly used substances such as marijuana, alcohol, vape, nicotine, and cannabis are classified as drugs (United Nations Office on Drugs and Crime, 2018). These psychoactive substances pose serious health and social risks not only to the users but also to their families and communities. This study aimed to examine the determinants of substance use among undergraduates in a private university located in Ilishan-Remo, Ogun State, Nigeria. The study assessed four key factors knowledge, attitude, perception, and religion using a cross-sectional research design. A multistage sampling procedure was adopted, and data were collected through structured questionnaires. The instruments were validated by the researchers’ supervisors, and both descriptive and regression analyses were used to interpret the data at a 0.05 significance level. Results showed that 63.7% of respondents were aged 16–20 years, with a mean age of 20. Most respondents were male (64.5%), and a slight majority identified as Christians (53.5%). A significant proportion (82.5%) had good knowledge of substance use. Knowledge (r = -0.145, p = 0.006), attitude (r = -0.245, p < 0.001), and religion (r = -0.227, p < 0.001) were significantly and negatively correlated with substance use, while perception (r = 0.083, p = 0.118) was weak and not significant. In conclusion, knowledge, attitude, and religion had significant influence on substance use among undergraduates, while perception did not. Despite a generally low prevalence and high awareness, continuous intervention is necessary. Programs that reshape attitudes and reinforce knowledge especially through education and faith-based initiatives can promote healthier, informed decisions among students.

Background Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10–24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.