Adult Substance Use Research Articles

Relations between Positive Temperament, Substance Use, and Internalizing Problems among Adolescents and Young Adults with and without Medical Conditions

ABSTRACTBackground: Substance use problems are prevalent during emerging adulthood and may be particularly harmful for individuals with medical conditions. Understanding the role of positive temperament in substance use for adolescents and young adults (AYAs) may facilitate the identification of intervention and prevention targets given the complex relations between positive emotions and substance use. Objective: To examine whether components of positive temperament differentially relate to substance use in a sample of AYAs with and without medical conditions. Internalizing problems were examined as a secondary outcome given their comorbidity with substance use. Method: In a cross-sectional study that took place in 2015–2016, 494 AYAs (Mage = 19.30 years, SD = 1.33, 73% female) who were enrolled in college completed online questionnaires in a laboratory regarding their levels of positive temperament (i.e., high intensity pleasure and positive affect) as well as their substance use and internalizing problems. The primary analyses were conducted using structural equation modeling. Results: For healthy AYAs, high intensity pleasure was positively associated with drug and alcohol use problems and positive affect was negatively associated with drug use problems. Among AYAs with medical conditions, high intensity pleasure was positively associated with alcohol use problems. Positive affect was negatively associated with internalizing problems for both groups. Conclusions/Importance: Findings identify paths between components of temperament and substance use and internalizing problems that may inform prevention and intervention efforts tailored to the unique and overlapping needs of AYAs with a range of healthcare demands.

Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study.

Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample. Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25. In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups. Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.

Prevalence and Correlates of Substance Use in Homeless Youth and Young Adults.

Prevalence and Correlates of Substance Use in Homeless Youth and Young Adults.

Prevalence and Correlates of Substance Use in Homeless Youth and Young Adults

Substance use is higher among homeless youth than among the general population. Although substance use has been well studied, little is known about the risk factors associated with specific substances used by homeless youth, particularly in the Houston, Texas, area. Therefore, we conducted this study to examine the rates of lifetime and past-month substance use in a sample of homeless youth in Harris County, Texas, and examine the relations between substance type and race/ethnicity, age, gender identity, sexual orientation, shelter status, stress, and trauma history. Participants were recruited during October and November 2014 as part of the study YouthCount 2.0! and completed a survey to assess demographics, stress, abuse, substance use, and risk behaviors. The sample (N = 416) was predominantly young adult (13-17 years old: 55 and 18-24 years old: 361), African American (54.5%), and male (55.9%). Nearly one quarter identified as lesbian, gay, bisexual, or questioning (n = 102). Over a third of youth had used alcohol (38%) or marijuana (36%) in the past month, and 36% had ever used synthetic marijuana. Bivariate analyses showed that substance use was significantly associated with race/ethnicity, age, gender identity, sexual orientation, shelter status, stress, and trauma scores. Youth in this study had lower rates of alcohol and some substance use than other samples of homeless youth, although use still exceeded national rates for housed youth. Substance use prevention interventions for homeless youth should be trauma informed and include housing navigation and stress management strategies. The most at-risk subgroups included street-dwelling and lesbian, gay, bisexual, or questioning youth.

Family-focused practices in addictions: a scoping review protocol

IntroductionFamilies are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping...

Benefits to Children Who Participate in Family Therapy with their Substance-Using Mother.

It is rare that family members other than the identified patient are followed over time in studies of therapy effectiveness. Family therapy is believed to be effective because it targets processes within the system that maintain symptoms. If these processes are changed, then all family members can benefit. Using a sample of 183 mother-child dyads from a study comparing family therapy for adult substance use versus an attention control, change in child's substance use (tobacco, alcohol, and marijuana) was estimated. Children who participated in family therapy with their mothers showed greater decreases in alcohol and tobacco use and were less likely to begin using compared to children whose mothers participated in the attention control condition.

Sleep correlates of substance use in community-dwelling Ethiopian adults.

The relationship between sleep disturbances and substance use can have harmful effects. Evidence shows widespread use of substances, including khat, in the Ethiopian population. However, to the best of our knowledge, no study has investigated the sleep correlates of substance use in community-dwelling Ethiopian adults. A cross-sectional study using simple random sampling was performed on community-dwelling adults (n=371, age=25.5±5.7years, body mass index=22.0±2.2kg/m2) in Mizan-Aman, Ethiopia. Dichotomized sleep measures (sleep quality and sleep latency) assessed by the Pittsburgh Sleep Quality Index (PSQI) were used in association analysis using binary logistic regression with substance use (khat, smoking, and alcohol). Sleep latency was associated with khat chewing (adjusted odds ratio (AOR)=2.8, 95% confidence interval (CI) 1.7-4.4) and tobacco smoking (AOR=2.1, 95% CI 1.4-3.0). Sleep quality was associated with khat chewing (AOR=3.1, 95% CI 1.8-5.2), tobacco smoking (AOR=1.7, 95% CI 1.2-2.5), and alcohol intake (AOR=1.9, 95% CI 1.1-3.1). Sleep correlates of substance use were found in community-dwelling Ethiopians. These findings may aid in the development of targeted strategies to manage substance use-related sleep disturbances.

Residential Proximity to Electronic Dance Music Nightclubs and Associations with Substance Use, Sexual Behaviors, and Related Problems.

This study examines the association between proximity of place of residence to preferred nightclub and substance use, sexual risk behaviors, and related problems, among a sample of 498 young adult substance users in Miami who report regular nightclub participation. Hierarchal linear models and logistic regressions were constructed to examine the impact of residential proximity to preferred nightclub on risk behaviors. Compared with participants residing in closer proximity to their preferred nightclub, participants residing further away reported higher intensities of alcohol and cocaine use (p < .01), greater condomless vaginal sex frequencies (p < .001), and more substance dependence symptoms (p < .05). Conversely, participants residing in closer proximity to their preferred nightclub had higher likelihood of arrest history (p < .05) than participants residing further away. Results suggest that participants residing further from their preferred nightclubs may be more invested in the nightclub outing and, therefore, engage in more risk behaviors.

Examining the Long-Term Consequences of Bullying on Adult Substance Use

Violence is a major concern in the school safety literature. With the potential negative impact of bullying victimization, it is imperative that bullying also be seen as an important social problem that has potential long-term mental and physical health consequences (CDC Surveillance Summaries, 65(6), 1-50, 2016). Numerous studies have documented the negative consequences of bullying in childhood, contending that bullying during childhood can lead to a variety of adulthood problems (Farrington, Loeber, Stallings, & Ttofi Journal of Aggression, Conflict and Peace Research, 3(2), 74-81, 2011; Rigby, 2007). Fewer studies have examined the long-term consequences of childhood bullying on adult substance use. This study uses Bureau of Labor Statistics’ National Longitudinal Survey of Youth (1997) data to examine the association between school-aged bullying (under the age of 19) and adult alcohol, cigarette, and drug use (using Wave 10 from 2007).

Commentary on Stewart et al. (2017): Stimulants and marijuana-the potential value in studying substance co-use.

Commentary on Stewart et al. (2017): Stimulants and marijuana-the potential value in studying substance co-use.

Conducting online focus groups on Facebook to inform health behavior change interventions: Two case studies and lessons learned

BackgroundOnline social media offer great potential for research participant recruitment and data collection. We conducted synchronous (real-time) online focus groups (OFGs) through Facebook with the target population of young adult substance users to inform development of Facebook health behavior change interventions. In this paper we report methods and lessons learned for future studies. MethodsIn the context of two research studies participants were recruited through Facebook and assigned to one of five 90-min private Facebook OFGs. Study 1 recruited for two OFGs with young adult sexual and/or gender minority (SGM) smokers (range: 9 to 18 participants per group); Study 2 recruited for three groups of young adult smokers who also engage in risky drinking (range: 5 to 11 participants per group). ResultsOver a period of 11 (Study 1) and 22days (Study 2), respectively, we recruited, assessed eligibility, collected baseline data, and assigned a diverse sample of participants from all over the US to Facebook groups. For Study 1, 27 of 35 (77%) participants invited attended the OFGs and 25 of 32 (78%) for Study 2. Participants in Study 1 contributed an average of 30.9 (SD=8.9) comments with an average word count of 20.1 (SD=21.7) words, and 36.0 (SD=12.3) comments with 11.9 (SD=13.5) words on average in Study 2. Participants generally provided positive feedback on the study procedures. ConclusionsFacebook can be a feasible and efficient medium to conduct synchronous OFGs with young adults. This data collection strategy has the potential to inform health behavior change intervention development.

Impulsivity as a mechanism linking child abuse and neglect with substance use in adolescence and adulthood.

Emerging developmental perspectives suggest that adverse rearing environments promote neurocognitive adaptations that heighten impulsivity and increase vulnerability to risky behavior. Although studies document links between harsh rearing environments and impulsive behavior on substance use, the developmental hypothesis that impulsivity acts as mechanism linking adverse rearing environments to downstream substance use remains to be investigated. The present study investigated the role of impulsivity in linking child abuse and neglect with adult substance use using data from (a) a longitudinal sample of youth (Study 1, N = 9,421) and (b) a cross-sectional sample of adults (Study 2, N = 1,011). In Study 1, the links between child abuse and neglect and young adult smoking and marijuana use were mediated by increases in adolescent impulsivity. In Study 2, indirect links between child abuse and neglect and substance use were evidenced via delayed reward discounting and impulsivity traits. Among impulsivity subcomponents, robust indirect effects connecting childhood experiences to cigarette use emerged for negative urgency. Negative urgency, positive urgency, and sensation seeking mediated the effect of child abuse and neglect on cannabis and alcohol use. Results suggest that child abuse and neglect increases risk for substance use in part, due to effects on impulsivity. Individuals with adverse childhood experiences may benefit from substance use preventive intervention programs that target impulsive behaviors.

ADHD in Adults and Comorbid Substance Use Disorder: Prevalence, Clinical Diagnostics and Integrated Therapy

Substance use disorders (SUD) are one of the most frequent mental disorders among adults. Attention-Deficit/Hyperactivity-Disorder (ADHD) is one of the most common mental health issues in childhood and adolescence, often persisting in adulthood. ADHD in childhood and adolescence is a robust predictor of tobacco, alcohol and illicit substance use in adulthood. Prevalence of comorbid ADHD in SUD patients is high. Nearly one quarter of these patients fulfill the DSM IV criteria for ADHD. Integrated concepts for treatment of SUD and ADHD are needed, but rare up to now. The aim of this review is to present and discuss recent scientific literature on the topic SUD and ADHD among adults and show its implications for clinical diagnostics and treatment.

Substance use behaviors and the timing of family formation during young adulthood.

The impact of substance use on the life course of young adults can be substantial, yet few studies have examined to what extent early adult substance use behaviors are related to the timing of family formation, independent of confounding factors from adolescence. Using panel data from the Monitoring the Future study (N~20,000), the current study examined the associations between three substance use behaviors (i.e., cigarette use, binge drinking, and marijuana use) and the timing of family formation events in young adulthood. Survival analysis and propensity score weighting addressed pre-existing differences between substance users and non-users in the estimation of the timing of union formation (i.e., marriage, cohabitation) and parenthood. Results for young adult substance users showed general patterns of reduced rates of marriage and parenthood, and increased cohabitation during young adulthood. Variations were evident by substance and sex.

Internet interventions for adult illicit substance users: a meta-analysis.

Background and AimsResearch has shown that internet interventions can be effective for dependent users of various substances. However, less is known about the effects of these interventions on users of opioids, cocaine and amphetamines than for other substances. We aimed to investigate the effectiveness of internet interventions in decreasing the usage of these types of substances.MethodsWe conducted a systematic literature search in the databases of PubMed, PsycINFO, Embase and the Cochrane Library to identify randomized controlled trials examining the effectiveness of internet interventions compared with control conditions in reducing the use of opioids, cocaine and amphetamines. No setting restrictions were applied. The risk of bias of the included studies was examined according to the Cochrane Risk of Bias assessment tool. The primary outcome was substance use reduction assessed through toxicology screening, self‐report or both at post‐treatment and at the follow‐up assessment.ResultsSeventeen studies with 2836 adult illicit substance users were included. The risk of bias varied across the included studies. Internet interventions decreased significantly opioid [four studies, n = 606, g = 0.36; 95% confidence interval (CI) = 0.20–0.53, P < 0.001] and any illicit substance use (nine studies, n = 1749, g = 0.35; 95% CI = 0.24–0.45, P < 0.001) at post‐treatment. Conversely, the effect of internet intervention for stimulant users was small and non‐significant (four studies, n = 481, P = 0.164). Overall, internet interventions decreased substance significantly use at post‐treatment (17 studies, n = 2836, g = 0.31; 95% CI = 0.23–0.39, P < 0.001) and at the follow‐up assessments (nine studies, n = 1906, g = 0.22; 95% CI = 0.07–0.37; P = 0.003).ConclusionsInternet interventions demonstrate small but significant effects in decreasing substance use among various target populations at post‐treatment and at the follow‐up assessment. However, given the small number of available studies for certain substances, the findings should be interpreted with caution.

How many or how much? Testing the relative influence of the number of social network risks versus the amount of time exposed to social network risks on post-treatment substance use

BackgroundHaving high-risk, substance-using friends is associated with young adult substance use disorder (SUD) relapse. It is unclear, however, whether it is the total number of high-risk friends, or the amount of time spent with high-risk friends that leads to relapse. Unclear also, is to what extent low-risk friends buffer risk. This study examined the influence of number of high-risk and low-risk friends, and the amount time spent with these friends on post-treatment percent days abstinent (PDA). MethodYoung adult inpatients (N=302) were assessed at intake, and 3, 6, and 12 months on social network measures and PDA. Mixed models tested for effects of number of high- and low-risk friends, and time spent with these friends on PDA, and for net-risk friend effects to test whether low-risk friends offset risk. ResultsWithin and across assessments, number of, and time spent with high-risk friends was negatively associated with PDA, while the inverse was true for low-risk friends. Early post-treatment, time spent with friends more strongly predicted PDA than number of friends. Participants were more deleteriously affected by time with high-risk friends the longer they were out of treatment, while contemporaneously protection conferred by low-risk friends increased. This interaction effect, however, was not observed with number of high- or low-risk friends, or number of friends net-risk. ConclusionsYoung adult SUD patients struggling to break ties with high-risk friends should be encouraged to minimize time with them. Clinicians should also encourage patients to grow their social network of low-risk friends.

The role of distress intolerance in the relationship between childhood sexual abuse and problematic alcohol use among Latin American MSM

BackgroundDespite the high prevalence of childhood sexual abuse (CSA) among men who have sex with men (MSM) and its well-documented association with substance use in adulthood, little research has examined the psychological mechanisms underlying this association. The current study utilized a large, multinational sample of MSM in Latin America to examine the role of distress intolerance (i.e., decreased capacity to withstand negative psychological states) in the relationship between childhood sexual abuse history and problematic alcohol use. MethodsAs part of an online survey conducted among members of the largest social/sexual networking website for MSM in Latin America, participants (n=19,451) completed measures of childhood sexual abuse history, distress intolerance, and problematic alcohol use (CAGE score>=2). ResultsParticipants who reported a history of childhood sexual abuse indicated higher levels of distress intolerance, which was in turn associated with greater odds of engaging in problematic alcohol use. A mediation analysis further showed that distress intolerance partially accounted for the significant association between childhood sexual abuse history and problematic alcohol use. ConclusionThese findings provide initial evidence for the role of distress intolerance as a process through which early trauma shapes MSM health later in life. These findings also underscore the potential utility of addressing distress intolerance in alcohol use prevention and intervention efforts that target MSM with a history of childhood sexual abuse.

Head Injury and Substance Use in Young Adults

ABSTRACTBackground: Prior studies suggest a link between head injuries and substance use but do not routinely capture mechanisms connecting the two. Objectives: The goal of the study was to explore whether past head injuries predicted current substance use among young adults, taking factors such as stress, self-esteem, temper, and risk-taking into consideration. Methods: Data were drawn from a web-based survey conducted in 2014 and 2015 at a public university in the United States (n = 897). Questions were asked about history of head injuries as well as past 12-month binge drinking, marijuana use, and prescription drug misuse. To evaluate the association between head injury and substance use, two logistic regression models were performed for each substance. Head injury was first regressed on the outcome, then related risk factors were entered into the models to determine whether they explained any association between injury and outcome. Results: A history of multiple head injuries was associated with increased odds of bingeing, marijuana, and prescription drug use. Prior delinquency and risk-taking accounted for the associations with bingeing and marijuana use. Taking all variables into consideration, multiple head injuries were associated with greater odds for prescription drug misuse. Conclusions: Results suggest the need to give consideration to a range of concomitant variables when considering behavioral outcomes associated with head injury. Head injuries may be a marker of a constellation of risk-taking behaviors that contributes to substance use. For those with multiple injuries, misuse of prescription drugs may be an attempt to cope with lingering side effects.

Sensitivity and specificity of the gain short-screener for predicting substance use disorders in a large national sample of emerging adults

Background and objectivesEmerging Adults (ages 18–25) have the highest prevalence of substance use disorders and rarely receive treatment from the specialty care system. Thus, it is important to have screening instruments specifically developed for emerging adults for use in Screening, Brief Intervention and Referral to Treatment (SBIRT) models. Optimal cutoffs for the widely-used GAIN Short-Screener’s (GAIN-SS) Substance Disorder Screener (SDScrY) are not established specifically for emerging adults. Therefore, this study examined the sensitivity and specificity of the SDScrY in predicting emerging adult (ages 18–25) substance use disorders. MethodsWe analyzed data from emerging adults in a large clinical sample (n=9,808) who completed both the five-item SDScrY (α=0.85) and the full criteria set for DSM-IV Substance Use Disorders. We estimated the sensitivity, specificity and area under the curve to determine optimal cutoffs. ResultsAnalyses revealed a high correlation between the SDScrY screener and its longer parent scale (r=0.95, p<0.001). Sensitivity (83%) and specificity (95%) were highest at a cutoff score of two (AUC=94%) on the SDScrY for any past year substance use disorder. Sensitivity (85%) was also high at a cutoff score of two on the SDScrY for any past year alcohol disorder. ConclusionsThe five-item Substance Use Disorder Screener is a sensitive and specific screener for emerging adults, and could be used to identify emerging adults who may benefit from SBIRT interventions.

Intergenerational consequences of adolescent substance use: Patterns of homotypic and heterotypic continuity.

Does substance use run in families? In this article, we examine both homotypic continuity in substance use-the impact of a parent's adolescent substance use on their child's adolescent substance use-and heterotypic continuity-the impact of a parent's adolescent substance use on their child's involvement in other adolescent problem behaviors. The analysis is based on data from the Rochester Youth Development Study (Thornberry, Lizotte, Krohn, Smith, & Porter, 2003) and its intergenerational component, the Rochester Intergenerational Study (Thornberry, 2009). The initial study began with a representative sample of 7th and 8th grade students followed until Age 31, and the intergenerational study is currently following their oldest biological child from childhood through adolescence. The final sample size in the current analysis consists of 341 parent-child dyads. For fathers, their adolescent substance use predicts both homotypic and heterotypic outcomes of their child. For mothers, however, there is no evidence of intergenerational continuity for either homotypic or heterotypic outcomes. In contrast, when the parent's adult substance use is examined, the opposite pattern emerges. The mother's adult substance use is a more consistent predictor of child behavioral outcomes, but there is little evidence that the father's adult behavior matters. Thus, it appears that the answer to the question of whether or not substance use runs in families is more nuanced than typically thought. Based on these results, continuity depends both on the sex of the parent and when in the parent's life-course substance use occurs. (PsycINFO Database Record