Stress Under Fire: Unpacking the Differential Effects of Combat Strain on Recent Substance Use Among Soldiers

The effects of cannabis on clinical outcomes of treatment services for other drug use disorders remains unclear. The primary aim of the current study was to investigate the effects of recent cannabis consumption on the severity of cocaine withdrawal and depressive symptoms during a 3-week inpatient treatment program for women with cocaine use disorder. The second goal of this study was to test the effect of recent alcohol or tobacco use on the aforementioned outcomes. This was a longitudinal study with 2 assessment time points: at enrollment and upon discharge from a medically managed intensive inpatient unit. The sample was composed of 214 early abstinence females with cocaine use disorder. Cocaine withdrawal and depressive symptoms were measured using the Cocaine Selective Severity Assessment (CSSA) and the Beck Depressive Inventory (BDI-II). Recent substance use was evaluated using the Addiction Severity Index (ASI-6). Patients with cocaine use disorder and with frequent recent cannabis use reported higher severity of cocaine withdrawal and depressive symptoms after 3 weeks of inpatient treatment. Neither recent alcohol nor tobacco use was associated with increased CSSA or BDI outcomes, suggesting these substances play a minor role compared to recent cannabis use in affecting withdrawal-related symptoms. The assessment of recent cannabis use may help identify patients in need of additional treatment to manage severe cocaine withdrawal symptoms and depressive symptoms during early abstinence.

This study of Alabama public school students sought urban-rural differences in social and spatial mechanisms connecting structural factors to recent use of alcohol and marijuana. Its dataset comprised a state-sponsored 2002 need-assessment survey of Alabama students; Alabama education department data; U. S. Census data; and alcohol-outlet locations listed by Alabama's Alcoholic Beverage Control Board. It measured structural-disadvantage factors (population disadvantages, community instability, alcohol-outlet density), social-organization factors (protective role of community, protective role of school), and recent-use factors. Using Geographic Information Systems (GIS), it generated maps of school catchment areas (SCAs)-the units of analysis for the study-that outline spatial patterns (across areas deemed urban or rural) of students' recent use of alcohol and marijuana. In the final sample of 370 SCAs, significant urban-versus-rural differences were observed for certain structural factors and in how these factors were associated with substance use. These differences aside, spatial analysis weighing the SCAs' particular geographic characteristics suggested location's importance, showing that a school playing a strong protective role significantly reduced not just its own students' recent substance use, but that of students in neighboring SCAs as well. The findings show students' recent use of alcohol and marijuana are associated with characteristics of the environment. (Am J Addict 2013; 22:188-196).

This study examined the relationship between recent substance use prior to intake and program graduation among young adults with early psychosis enrolled in coordinated specialty care. Participants (N=248) were from New Journeys, a network of coordinated specialty care programs in Washington State. Recent (i.e., past 30 days) alcohol, cannabis, and other substance use was collected at intake and process data (e.g., contact) was collected by clinicians across a 2-year period. At intake, 32% of participants reported alcohol use only, 26% cannabis use only, and 15% both alcohol and cannabis use. Participants who reported alcohol use only (p=.02), cannabis use only (p=.03), and any substance use (p=.02) had significantly lower chances of graduating from coordinated specialty care than individuals who do not use substances. Unlike prior work, recent substance use influences clients' potential to graduate from New Journeys. Additional focus on the implementation of substance use treatment, with an emphasis on alcohol use, in coordinated specialty care programs is needed improve program completion rates.

To estimate the joint effects of substance use disorder (SUD) and recent substance use on human immunodeficiency virus (HIV) non-suppression. Retrospective clinical cohort study with repeated observations within individuals. Baltimore, Maryland, United States. 1881 patients contributed 10 794 observations. The primary independent variable was the combination of history of SUD and recent substance use. History of SUD was defined as any prior International Classification of Diseases 9/10 code for cocaine or opioid disorder. Recent substance use was defined as the self-report of cocaine or non-prescribed opioid use on the National Institute of Drug Abuse-modified Alcohol, Smoking and Substance Involvement Screening Test or clinician-documented cocaine or opioid use abstracted from the medical record. The outcome was viral non-suppression, defined as HIV RNA >200 copies/mL on the first viral load measurement within 1year subsequent to each observation of substance use. We adjusted for birth sex, Black race, age, HIV acquisition risk factors, years in care and CD4 cell count. In secondary analyses, we also adjusted for depressive, anxiety and panic symptoms, cannabis use and cannabis use disorder. On their first observation, 31% of patients had a history of an SUD and 18% had recent substance use. Relative to no history of SUD and no recent substance use, the 1-year fully adjusted risk difference (RD) for viral non-suppression associated with cocaine and opioid use disorder and recent substance use was 7.7% (95% CI = 5.3%-10.0%), the RD was 5.5% (95% CI = 1.2%-9.7%) for history of cocaine use disorder without recent substance use, and the RD was 4.6% (95% CI = 2.7%-6.5%) for recent substance use without a SUD. Substance use and substance use disorders appear to be highly prevalent among, and independently associated with, viral non-suppression among people with HIV.

The main objective of the current study is to analyze how the unique perspectives from both parents and children in regards to parental knowledge of the child's whereabouts, activities, and friendships are related to the adolescent's recent substance use four months later. Differences between parents and children, as well as between male and female adolescents are examined. Data come from a Latinx sample (mostly Mexican-origin) of 523 parent-adolescent dyads from Arizona (US) using a multi-informant approach (parent and adolescent reports). The results indicate that parents, especially mothers, report higher levels of parental knowledge than adolescents do. The structural equation modeling (SEM) results for the total sample indicate that both parents' and adolescents' unique perception of the level of parental knowledge is negatively related to the adolescents' recent alcohol and cannabis use four months later. Further, multi-group SEM results split by gender indicate that parents' unique perception of higher levels of parental knowledge is only marginally related to lower alcohol use for both males and females, whereas adolescents' unique perception is negatively related to alcohol and cannabis use (significantly) and tobacco use (marginally) for both males and females. No significant gender differences were found in the effects of parental knowledge on substance use. Findings suggest that parents' and adolescents' perceptions seem to be quite distinctive and independent from each other. Implications of these results regarding intervention programs for preventing substance use are discussed.

This study aimed to examine associations between romantic involvement and depression symptoms, anxiety symptoms, substance use problems, and recent substance use, as well as assess the moderating roles of internalized stigma, parental acceptance, and demographic characteristics. Participants were drawn from the 2022 LGBTQ+ National Teen Survey, an online cross-sectional study of sexual and gender minority (SGM) adolescents; a total of 6248 participants were included in the present study. Multivariable linear and logistic regression models were performed to assess associations between romantic involvement and depression symptoms, anxiety symptoms, substance use problems, and recent alcohol, heavy alcohol, marijuana, and nicotine use, with additional models for each stigma-based or demographic moderator. Romantic involvement was significantly associated with increased depression symptoms, anxiety symptoms, recent substance use, and substance use problems. Both lower internalized stigma and higher parental acceptance diminished the associations between romantic involvement and substance use problems, but not other outcomes. Age also moderated the effect of romantic involvement across recent substance use measures. Given consistent associations between romantic involvement and adverse mental and behavioral health observed in this study, clinicians and researchers should further explore protective influences for SGM adolescents in romantic relationships and promote individual and relationship interventions for romantically involved SGM adolescents.

Objective This study investigated the association between intersectional oppression-based stressors and substance use among sexual and gender minority (SGM; queer and transgender [QT]) adolescents who are Black, Indigenous, and People of Color (QTBIPOC) and examined the potential moderating role of school safety. Method Data were a subset of QTBIPOC adolescents (N = 3,563) from a dataset of SGM adolescents in the United States ages 13–18 years old. Results Intersectional oppression-based stressors (OBS) were associated with greater likelihood of recent use of alcohol, cigarettes, cannabis, vaping, and other drugs; nonmedical use of prescription pain medicine; and heavy alcohol use. School safety was associated with lower likelihood of recent use of cigarettes, cannabis, vaping, and other drugs; nonmedical use of prescription pain medicine; and heavy alcohol use. School safety buffered the association between intersectional OBS and heavy alcohol use, but not other substances. Conclusions Intersectional OBS are prevalent in the lives of QTBIPOC adolescents and these experiences are associated with greater likelihood of recent substance use. Although higher levels of school safety were generally associated with lower likelihood of substance use, school safety does not appear to be a robust protective factor against substance use for QTBIPOC adolescents experiencing OBS. This study highlights the need for interventions reducing intersectional OBS and research identifying factors that protect against substance use in this population.

Substance Use Among Military-Connected Youth: The California Healthy Kids Survey

Recent tobacco use has widespread associations with adolescent white matter microstructure

Substance use and violence co-occur among adolescents. However, the extant literature focuses on the substance use behaviors of perpetrators of violence and not on victims. This study identifies patterns of school victimization and substance use and how they co-occur. The California Healthy Kids Survey was used to identify latent classes/clusters of school victimization patterns and lifetime and frequency of recent (past month) alcohol, tobacco, and marijuana use (N = 419,698). Demographic characteristics (age, gender, and race/ethnicity) were included as predictors of latent class membership. Analyses revealed four latent classes of school victimization: low victimization (44.4 %), moderate victimization (22.3 %), verbal/relational victimization (20.8 %), and high victimization (with physical threats; 12.5 %). There were also four classes of substance use: non-users (58.5 %), alcohol experimenters (some recent alcohol use; 25.8 %), mild poly-substance users (lifetime use of all substances with few days of recent use; 9.1 %), and frequent poly-substance users (used all substances several times in the past month; 6.5 %). Those in the high victimization class were twice as likely to be frequent poly-substance users, and mild poly-substance use was most salient for those in the verbal victimization class. Few studies have explored latent patterns of substance use and violence victimization concurrently. The findings indicate substantial heterogeneity in victimization and substance use among youth in California schools with implications for targeted and tailored interventions. Understanding how certain types of victimization are associated with particular patterns of substance use will provide schools with opportunities to screen for concurrent behavioral health problems among youth.

Using ecological risk and resiliency theory, this exploratory study examined the relationship between parental support and parental monitoring on male and female adolescents' lifetime and recent use of alcohol, cigarettes and marijuana among a sample of 980 adolescents from Tijuana, Mexico. The participants' ages ranged from 15 to over 22 years. Approximately 25% of the participants indicated that their families were of low socioeconomic status (SES) and majority of participants' mothers (74.2%) and fathers (68.6%) had less than a high school education.The results of this study indicated that parental support and parental monitoring were significant predictors of lower lifetime and recent substance use for males and females. Parental support significantly predicted lower lifetime and recent cigarette use among males and lower recent marijuana use among females. Parental monitoring, however, was a stronger predictor of lower recent alcohol, cigarette and marijuana use among adolescent females in the study. Because substance use in Mexico tends to be higher in cities that border the United States, understanding protective factors against adolescent substance use is important in the development of culturally appropriate substance abuse prevention programmes in Mexico. Implications for research and practice are discussed.

Adolescence is a critical period of biopsychosocial development often marked by engagement in risk behaviors, including psychoactive substance use and early sexual initiation. Emerging evidence suggests a robust association between these behaviors, particularly early sexual debut (i.e. before age 15). This cross-sectional analytical study draws on data from the 2019 National School Health Survey (PeNSE) to examine the relationship between recent psychoactive substance use and early sexual initiation among Brazilian adolescents aged 15–17 years (n = 72,679). Substance use in the past 30 days was assessed for nine substances: alcohol, conventional cigarettes, hookah, electronic cigarettes, clove cigarettes, hand-rolled cigarettes, marijuana, crack and other illicit drugs. Early sexual initiation was reported by 33.3% of participants. Use of all substances was significantly associated with early sexual debut, with the strongest associations observed for crack (adjusted OR = 1.91; 95% CI = 1.56–2.33), marijuana (OR = 1.58; 95% CI = 1.43–1.75), other illicit drugs (OR = 1.50; 95% CI = 1.37–1.64) and alcohol (OR = 1.47; 95% CI = 1.35–1.59). These findings highlight a strong association between recent substance use and early sexual initiation in Brazilian adolescents, underscoring the need for comprehensive, multisectoral public policies that integrate substance use prevention and sexual health education within school, family and healthcare contexts.

Specificity of personality relationships to particular forms of concurrent substance use among methadone maintenance therapy clients

Perceived discrimination, depressive symptoms, and substance use in young adulthood

The purpose of this research was to investigate the relationship between recent and long term substance use on adolescents' neuropsychological functioning. Subjects were 77 adolescents who were referred for outpatient treatment for drug and conduct problems. Subjects were administered the Luria-Nebraska Neuropsychological Battery-III, structured interviews to assess substance use, and urine tests. Subjects were divided into neuropsychologically impaired and nonimpaired groups. Results indicated no significant group differences for: self-reports of lifetime use of alcohol, cannabis, and hard drugs; self or collateral reports of recent (past 30 days) use of alcohol, cannabis, and hard drugs; or urinalysis detection of alcohol, cannabis, and hard drugs. Correlations between these dependent measures of substance use and neuropsychological functioning were also nonsignificant (all ps >. 05). Although neuropsychological impairment was observed for some subjects in this sample, it was unrelated to their cannabis, hard drug, or alcohol use. These results are consistent with those found in the adult literature, given the relatively short period of time that these youth have used such substances. However, given the severity of their absolute levels of substance usage, they may be at greater risk for developing future neuropsychological problems, related directly to the ingestion of alcohol and illicit drugs, and to their secondary effects (e.g., head traumas, malnutrition).