Transition from first substance use to crack-cocaine: Predictors of faster addiction progression, and clinical characteristics in crack-cocaine adolescents users

Abstract

s / Drug and Alcohol Dependence 156 (2015) e102–e182 e177 vs. Non-Southern patients had a median viral load of 61,200 (vs. 9,519; p 200 copies/ml; aOR=3.10, 95% CI=2.34-4.11). Conclusions:Therewere substantial geographicaldifferences in HIV treatment, care retention and viral suppression despite fewer substance use risks among Southern patients. This suggests that social and structural interventions focused on care linkage and retention are needed to address these disparities. None of the study’s Southern States have expanded Medicaid, a decision that will disproportionately affect the poor and uninsured and prevent the full benefits of the Affordable Care Act. Financial support: NIDA CTN U10DA013720. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.479 Trait, state, and place: The role of personality and environment in drug use Karran A. Phillips1, Dexter Louie2, Melody A. Furnari1, William J. Kowalczyk1, David Epstein1, Kenzie L. Preston1 1 NIDA, Baltimore, MD, United States 2 UCSF, San Francisco, CA, United States Aims: Addiction is complex with both environmental and inherited causation factors. The environment, particularly neighborhood, and personality traits may contribute to drug use. We sought to determine the influence of trait, state, and place on drug use. Methods: Participants were administered the NEO Five Factor Inventory to assess 5 personality factors – neuroticism, extraversion, openness, agreeableness, and conscientiousness, and the Addiction Severity Index to assess personal and family drug use history. Environment was assessed with the Neighborhood Inventory for Environmental Typology (NIfETy) a standardized inventory assessing the incidence andprevalenceof environmental indicators of physical, social, and drug-related disorder (1 lowest to 8 highest disorder). Analysis was done with Stata 10 and included t tests, Pearson X2, Fisher’s exact and multivariate logistic regression. Results: Participants included 104 current opioid/stimulant users (CDUs) and 88 non drug users (NDUs). The groups differed in age (p<0.001) and gender (p<0.001) but not race (p=0.109). Neuroticism percentiles were higher in the CDUs (p<0.001); and extraversion, openness, agreeableness, and conscientiousness percentiles were lower (all p<0.001). NIfETy scores were higher for CDUs (mean (SD) 5.1(1.5) vs. 3.9(1.8), p<0.001). In the multivariate model predicting drug use status, age (OR 1.10, CI(1.05,1.17), p<0.001), gender (OR0.22, CI(0.07,0.66),p=0.007), years of cannabis use (OR1.26, CI(1.12,1.42, p<0.001), nuclear family history of addiction (OR 4.34, CI(1.49,12.6), p=0.007), openness (OR 0.97, CI(0.95, 0.99), p=0.007), agreeableness (OR 0.98, CI(0.96, 1.00), p=0.03), and NIfETy scores (OR 1.53, CI(1.08, 2.16), p=0.017) were significant. Conclusions: While state, trait, and place determined drug use status, a nuclear family history of addiction and neighborhood physical, social, anddrug-related disorderwere stronger predictors than personality. Financial support: This research was supported by the NIDAIRP. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.480 Transition from first substance use to crack-cocaine: Predictors of faster addiction progression, and clinical characteristics in crack-cocaine adolescents users Thiago G. Pianca2, Ronaldo L. Rosa3, A.P. Begnis4, P.B. Ferronatto5, Mariana Jensen4, Flavio P. Pechansky1, L.A. Rohde2, Claudia Szobot2 1 Psychiatry, Center for Drug and Alcohol Studies at HCPA/UFRGS, Porto Alegre, Brazil 2 Child & Adolescent Psychiatry Service, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil 3 Hospital Psiquiatrico Sao Pedro, Porto Alegre, Brazil 4 ULBRA, Canoas, Brazil 5 Universidade Federal do Rio Grande do Sul, Porto