Affect Drug Use Research Articles

Beliefs About Resistance Self-Efficacy and Drug Prevalence: Do They Really Affect Drug Use?

Testing the same structural equation model for eighth-grade users and nonusers, this study examines social influence and cognitive precursors of adolescent drug use among 1138 West Coast students. For the eighth-grade nonusers of alcohol, cigarettes, and marijuana (n = 518), low resistance self-efficacy and prodrug social influences directly predicted generic expectations of using drugs and actual use nine months later. For the users (n = 620), both variables directly affected expectations and indirectly affected actual use. While the latent variable measure of drug use prevalence did not predict either outcome, specific estimates of peer alcohol use directly affected later drinking. Estimates of several other drug-specific relations were required to fit the model, indicating that both general and drug-specific effects are needed to explain adolescent drug use.

Developmental pharmacology: relationship to drug use.

The pharmacodynamics of drugs in children have been poorly understood, and only recently have technological advances permitted the issue to be studied. Factors that affect drug use in infants include absorption, distribution, protein binding, metabolism, renal elimination, and volume of distribution. Selection of antibiotics in this patient population should reflect commonly isolated organisms, such as staphylococci, group B streptococci, Escherichia coli, and gram-negative bacteria. An antibiotic must also have good penetration into the central nervous system. Displacement of bilirubin from its albumin-binding sites by drugs or endogenous substrates can lead to kernicterus, or bilirubin encephalopathy. The free bilirubin, rather than total concentration, appears to be only partly responsible for the development of kernicterus.

Controversies in antimicrobial therapy: Critical analysis of clinical trials

Problems with design and statistical evaluation of clinical efficacy trials of antimicrobial agents are reviewed. Of the three major criteria used for evaluating antimicrobial agents (efficacy, toxicity, cost), the most important is efficacy. Clinical efficacy can be evaluated in uncontrolled or controlled clinical trials. Uncontrolled trials are often conducted to satisfy Food and Drug Administration requirements during premarketing testing; the response rate is typically high because only patients with susceptible infections may be treated and large doses are given. Controlled antibiotic trials should be randomized, blinded, parallel comparisons of an investigational agent versus the best available agent at an accepted dose. However, interpretation of these studies is frequently clouded by poor study design, small sample sizes, and heterogeneous patient populations. Controlled trials are usually centered around a null hypothesis (i.e., that no difference will be found between the agents being compared). All conclusions (to reject or not reject the null hypothesis) should be carefully evaluated by clinicians seeking to apply the available data to patient care. Researchers can incorrectly conclude that two therapies have equal efficacy because of insufficient statistical power (i.e., small sample size) or poor study design. Likewise, researchers may incorrectly conclude that there is a statistical difference between two therapies because of poor design or improper sample selection. For the clinician, clinical relevance takes precedence over statistical significance. Before the results of a study are allowed to affect drug use in an institution, strong similarities between subjects and methods in the study and patients and care in the institution should be demonstrated.

Drug use by alcoholics in outpatient treatment.

Although increasing attention has been paid to the problems of combined and sequential alcohol and drug abuse, data about drug use by alcoholics during the course of outpatient treatment are not available. Urine testing for commonly abused drugs was obtained on 112 alcoholic outpatients during a 2-week period. Ten urine samples were positive for abuseable drugs. Patients' age, length of treatment involvement, and history of drug use prior to treatment appeared to affect drug use during treatment. At 4 month follow-up of the 10 patients with positive urine tests, five were drug free, three had discontinued but then returned to drug use, and two had been discharged. Given the limitations of such a cross-sectional study, the incidence of drug use by alcoholics during outpatient treatment seems high enough to warrant further study.

Drug Abuse in Sports: Denial Fuels the Problem.

A young athlete often sees his heroes on the sports pages linked with drugs, yet many authorities deny that drug abuse is a problem. How does this affect drug use by amateur athletes?

Variables Affecting Drug Use: Longitudinal Research on Drug Use . Empirical Findings and Methodological Issues. Papers from a conference, San Juan, P.R., April 1976. Denise B. Kandel, Ed. Hemisphere, Washington, D.C., and Halsted (Wiley), New York, 1978. x, 314 pp. $22.50.

Variables Affecting Drug Use: <i>Longitudinal Research on Drug Use</i> . Empirical Findings and Methodological Issues. Papers from a conference, San Juan, P.R., April 1976. Denise B. Kandel, Ed. Hemisphere, Washington, D.C., and Halsted (Wiley), New York, 1978. x, 314 pp. $22.50.