Age Substance Use Research Articles

Patterns of substance use and initiation timing in adults with substance abuse: a comparison between those with and without attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in childhood and adolescence, persisting into adulthood in 60% of cases, with an adult age prevalence rate of 4%. substance use disorder (SUD) is a recognized comorbidity with significant social and financial implications, necessitating detailed investigation. This longitudinal study focused on adults with SUD in addiction detention in two camps including Toska and Chitgar in the west and south of Tehran during 2021-2022. Participants underwent assessment using the Structured Clinical Interview for DSM Disorders (SCID) to identify individuals with SUD, excluding those with major mental problems. The remaining subjects were assessed by Conner's questionnaire. And positive cases underwent a comprehensive ADHD interview. The study comprised 50 individuals with ADHD and 90 without ADHD, allowing for a comparative analysis of the onset age of substance use and patterns across both groups. The substances examined included alcohol, cannabis, crack, methamphetamine, tramadol, methadone, opium, ecstasy, morphine, and hypnotics. The study revealed a lower age of onset of substance use in the ADHD group. Furthermore, individuals with ADHD exhibited higher rates of alcohol, cannabis, methamphetamine, and tramadol use, while the non-ADHD group showed elevated usage of Ritalin, methadone, ecstasy, morphine, and hypnotics. Prompt diagnosis and treatment of ADHD regarding the lower onset age of substance use and a further range of high-risk substances, such as alcohol, methamphetamine, and crack, would be crucial. Additionally, based on these findings, policy recommendations should emphasize early ADHD screening and intervention strategies to mitigate the risk of substance use disorders, thereby addressing the associated social and financial burdens.

Hospital Admission Rate, Cumulative Hospitalized Days, and Time to Admission Among Older Persons With Substance Use and Psychiatric Conditions.

BackgroundSubstance use among older persons occurs with medical and psychiatric comorbidities. This study examined the associations of substance use disorder (SUD), psychiatric, and dual diagnoses with 12-month cumulative hospitalized days, hospital admission rate and number of days to first hospitalization.MethodsThe cohort of 3,624 individuals (28.2% women) aged 50 years or older was assessed for substance use severity in 65 Swedish municipalities during March 2003–May 2017. Addiction Severity Index data were linked to hospital discharge records and crime statistics. The outcomes were (a) 12-month cumulative hospitalized days; (b) Hospital admission rate, and (c) days to first hospitalization. Generalized linear regression techniques investigated associations between outcomes and SUD, psychiatric and dual diagnoses at admission.ResultsDuring 2003–2017, 73.5% of the participants were hospitalized. Twelve-month hospitalized days were positively associated with SUD (Incidence rate ratio (IRR) = 1.41, 95%CI: 1.26–1.58), dual diagnosis (IRR = 2.03, 95%CI: 1.74–2.36), and psychiatric diagnoses (IRR = 2.51, 95%CI: 2.09–3.01). Hospital admission rate was positively associated with SUD (IRR = 4.67, 95%CI: 4.28–5.08), dual diagnosis (IRR = 1.83, 95%CI: 1.64–2.04), and psychiatric diagnoses (IRR = 1.73, 95%CI: 1.55–1.92). Days to first hospitalization were negatively associated with SUD (IRR = 0.52, 95%CI: 0.47–0.58), dual diagnosis (IRR = 0.57, 95%CI: 0.50–0.65), and psychiatric diagnoses (IRR = 0.83, 95%CI: 0.73–0.93). The marginal effects of SUD and/or mental disorders increased with age for all outcomes, except for days to first hospitalization.ConclusionThree of four older persons assessed for substance use severity were later hospitalized. Substance use disorders, dual diagnoses and other mental disorders were the primary reasons for hospitalization and were associated with longer stays, earlier hospitalization, and repeated admissions. Sensitizing service providers to old age substance use and sharing data across the care continuum could provide multiple points of contact to reduce the risk of hospitalizations among older persons with problematic substance use.

Characteristics of depression, anxiety, impulsivity, and aggression among various types of drug users and factors for developing severe depression: a cross-sectional study

BackgroundMood disorder, impulsivity and aggression are common in drug users compared to healthy controls. However, no study has focused on the difference in various types of drug users. Therefore, the objective of this study was to explore the differences in depression, anxiety, impulsivity, and aggression among methamphetamine, heroin and polysubstance users and to further explore the risk factors for severe depression in the three groups.MethodsDrug users over 18 years old who met the DSM-V diagnostic criteria for substance -related disorders were included in the study. All participants completed a general questionnaire, the Zung Self-Rating Depression Scale (SDS), the Zung Self-Rating Anxiety Scale (SAS), Barratt impulsiveness Scale Version 11 (BIS-11), and the Buss-Perry Aggression Questionnaire (BPAQ). One-way ANOVAs or Chi-square tests were used to test the differences among the groups, correlation analysis was used to test the relationship between drug use and other parameters, and multiple logistic regression was conducted to assess the risk factors for severe depression.ResultsA total of 1,486 participants were included, comprising 86.3% males with a mean age of 38.97 years. There was a significant difference in the percentage of severe depression and SDS scores among the three groups, but no significant difference was found in SAS, BIS-11 and BPAQ scores. Using methamphetamines, hostility and anxiety were risk factors for developing severe depression in all the participants and anxiety remained constant in the other three groups. Moreover, methamphetamine use was 2.16 and 3.35 times more likely to cause severe depression than heroin and polysubstance use, respectively. The initial age of substance use was negatively correlated with BPAQ, SAS, and SDS scores, whereas the drug use duration and addiction duration were positively correlated.ConclusionsIn this study, we found that the highest prevalence of severe depression was in participants using methamphetamines and that using methamphetamines, hostility, and anxiety were risk factors for developing severe depression. This result addressed an important gap in our knowledge of the different characteristics of depression, anxiety, impulsivity and aggression in various types of substance users and provides clinicians and policy-makers with directions for intervention and preventing relapse.

Onset Age of Substance Use and Neuropsychological Performance in Hospital Patients.

ObjectiveSeveral studies have found neurocognitive deficits in adolescents following substance abuse. Predisposing risk factors may further impact vulnerability to neurocognitive deficits. Little is known about the cognitive performance of adult onset substance users compared to earlier onset users. This study aims to explore differences in neuropsychological functioning between early (EOAs) and late onset substance abusers (LOAs) when the effects of confounding factors are controlled.MethodData for this cross-sectional study was collected from hospital patients. A total of 164 patients with substance use disorder (SUD) aged 19 to 65, 76 with single-drug diagnosis and 88 with multidrug diagnosis, underwent neuropsychological tests for verbal capacity, attention, speed of processing, perceptual reasoning, memory and learning, executive functioning, and inhibitory capacity. Associations between regular onset age and neuropsychological measures were analysed using in multi-way ANCOVA, and the effect of age, multiple substance abuse, education level and learning difficulties were controlled.ResultsCompared with LOAs, EOAs had weaker performance in the Digit Symbol test for mono-substance users. Meanwhile, compared with EOAs, LOAs had weaker performance in the Delayed Visual Memory test and the Raven test for mono-substance users, and the Block Design test for poly-substance users. From the confounding factors, early onset age of substance use is heightened among individuals with learning disabilities.ConclusionsOnset age of substance use is related to the deterioration of performance in neuropsychological tests. Premorbid poor learning and inhibitory capacity may be important predisposing risk factors of SUD. Conversely, high level of education may be a protective factor for cognitive performance in patients with SUD.

Premorbid Personality Disorders in Male Schizophrenic Patients with or without Comorbid Substance Use Disorder: Is Dual Diagnosis Mediated by Personality Disorder?

Although substance abuse is an important clinical problem in schizophrenic patients, very little evidence explains why these patients use drugs and alcohol. This study therefore aimed to examine whether premorbid personality disorders affect substance abuse. The sample included 40 male schizophrenic patients with and 40 male schizophrenic patients without substance use disorder comorbidity who had applied to Ankara Numune Research and Training Hospital. Each participant and a family member were interviewed in a structured clinical interview that addressed premorbid personality disorders. Altogether, 32 patients (80%) in the group with comorbidity and 28 (70%) in the group without comorbidity had a premorbid personality disorder. Antisocial (35% vs. 0%; p<.001) and borderline (37.5% vs. 5%; p=.001) personality disorders were more often detected in the group with comorbidity, while avoidant (10% vs. 35%; p=.014) and obsessive-compulsive (0% vs. 15%; p=.026) personality disorders were less frequently found in this group. Comparing the group with comorbidity with premorbid personality types, schizophrenic patients with premorbid antisocial personality disorder were more frequently unemployed and hospitalized as well as had an earlier onset age of schizophrenia (p=.034, p=.038 and p=.035, respectively). Schizophrenic patients with premorbid borderline personality disorder had a significantly earlier onset age of substance use (19±5; p=.028). Schizophrenic patients with substance use comorbidity variously differ from those without comorbidity and some of these differences may be associated with premorbid personality disorders.

A retrospective analysis focusing on a group of patients with dual diagnosis treated by both mental health and substance use services.

ObjectiveTo highlight which demographic, familial, premorbid, clinical, therapeutic, rehabilitative, and assistance factors were related to dual diagnosis, which, in psychiatry, means the co-occurrence of both mental disorder and substance use in the same patient.MethodsOur sample (N=145) was chosen from all outpatients with a dual diagnosis treated from January 1, 2012 to July 31, 2012 by both the Mental Health Service and the Substance Use Service of Modena and Castelfranco Emilia, Italy. Patients who dropped out during the study period were excluded. Demographic data and variables related to familial and premorbid history, clinical course, rehabilitative programs, social support and nursing care, and outcome complications were collected. The patients’ clinical and functioning conditions during the study period were evaluated.ResultsOur patients were mostly men suffering from a cluster B personality disorder. Substance use was significantly more likely to precede psychiatric disease (P<0.001), and 60% of the sample presented a positive familial history for psychiatric or addiction disease or premorbid traumatic factors. The onset age of substance use was related to the period of psychiatric treatment follow-up (P<0.001) and the time spent in rehabilitative facilities (P<0.05), which, in turn, was correlated with personality disorder diagnosis (P<0.05). Complications, which presented in 67% of patients, were related to the high number of psychiatric hospitalizations (P<0.05) and professionals involved in each patient’s treatment (P<0.05). Males more frequently presented familial, health, and social complications, whereas females more frequently presented self-threatening behavior (P<0.005).ConclusionIt was concluded that the course of dual diagnosis may be chronic, severe, and disabling, requiring many long-term therapeutic and rehabilitative programs to manage various disabilities.

Frequency of attention-deficit hyperactivity disorder in substance-dependent patients hospitalised in Mashhad Ebn-e-Sina hospital

Dual diagnosis of attention-deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) in adults has been an area of clinical and research interest. In the present study, we assessed the frequency of ADHD in drug-dependent patients. This is a descriptive cross-sectional study. We assessed the frequency of ADHD in 144 drug-dependent patients who were admitted for detoxification at Ebn-e-Sina psychiatric hospital between August 2007 and June 2008. All patients met DSM-IV-R criteria for substance dependency; diagnosis was made by two psychiatrists. Patients completed demographic characteristics questionnaire and were rated on Wender Utah Rating Scale and adult ADHD measurement scale. Those with higher than cut-off point of both scales were interviewed directly by a psychiatrist based on DSM-IV-R criteria for the best estimate diagnoses of ADHD. Eighteen (12.5%) of the substance-dependent patients were found to have ADHD as a child that persists to adulthood. Starting age of substance use was 22.0...

Domestic Violence and child abuse as risk factors for heroin addiction

Youth with a history of child maltreatment use substances and develop substance use disorders at rates above national averages. Thus far, no research has examined pathways from maltreatment to age of substance use initiation for maltreated youth. We examined the longitudinal impact of maltreatment in early childhood on age of alcohol and marijuana use initiation, and whether internalizing and externalizing behaviors at age 8 mediates the link between maltreatment and age of substance use initiation.Data were drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) at ages 4, 8, 12, and 18. Maltreatment was assessed through reviews of administrative records and youth self-reports. Behavior problems were assessed with the Child Behavior Checklist. Age of substance use initiation was assessed with the Young Adult version of the Diagnostic Interview Schedule for Children.Path analyses indicated mediated effects from a history of maltreatment to age at first alcohol and marijuana use through externalizing behaviors. Considering type of maltreatment, direct effects were found from physical abuse to age of alcohol initiation, and mediated effects were found from sexual abuse and neglect to initial age of alcohol and marijuana use through externalizing behaviors. Direct effects for marijuana use initiation and indirect effects through internalizing behavior problems were not significant for either substance.Externalizing behavior is one pathway from childhood maltreatment to age of substance use initiation. Services for maltreated youth should incorporate substance use prevention, particularly among those with early externalizing problems.

Early Childhood Predictors of Early Substance use and Substance use Disorders: Prospective Study

The purpose of the present study was to examine the longitudinal association between early childhood factors and early initiation of use of substances and substance use disorders in a large prospective study. Data were from the Mater Hospital University of Queensland Study of Pregnancy, a prospective birth cohort study in Brisbane, Australia. Use of nicotine, alcohol and cannabis and age of initiation of such use were reported at the 21 year follow up. DSM-IV diagnosis of nicotine, alcohol and cannabis use disorders was assessed at 21 years using a computerized version of the Composite International Diagnostic Interview (CIDI-Auto). Early childhood factors were measured between mother's pregnancy and child age 5 years. Of the 3647 respondents with complete data, 15.4% had started to smoke cigarettes before 15 years. Another 17.4% and 12.2% reported having started to consume alcohol or use cannabis in early adolescence, respectively. Some 16.2%, 27.8% and 21.9% had ever had nicotine, alcohol or cannabis abuse or dependence (disorder) by 21 years, respectively. In multivariate models early initiation of use of substances, and substance use disorders were associated with disrupted families or drug-using parents, childhood problem behaviours, and poor parental monitoring and supervision in childhood. There are four independent factors in early or middle childhood that predict early initiation of use of substances and subsequent substance use disorders by early adulthood. There is a need to consider whether what is known about the risk factors that predict young age of substance use, and substance use disorders, may be incorporated into treatment and/or prevention initiatives.

Früher Einstieg in den Alkohol- und Tabakkonsum - Indikator für eine erhöhte Suchtgefährdung?

The early onset of substance use is considered to be one of the best predictors of later addiction problems according to a number of U.S.-American studies. The current study investigates the influence of an early age of substance use on addiction behavior in a culture whose attitude towards it is relatively permissive and in which adolescents thus begin to use the substances earlier and exhibit higher rates of consumption. In a prospective longitudinal study of a birth cohort of 384 children at risk, the age at first use of tobacco and alcohol and at begin of regular consumption, as well as different parameters of alcohol and tobacco consumption were assessed at the age of 15 years. The age at first use proved to be a significant predictor of consumption behavior (frequency and amounts), as well as of binge drinking as a specific consumption pattern, and of initial symptoms of tobacco dependency at the age of 15 years. The correlation is higher in general for tobacco consumption and for female adolescents. The findings replicate in a German sample the role of the age of first use as a significant risk factor for consumption of alcohol and tobacco even at a very early stage of substance use. It remains for future studies to investigate whether the relationship is causal or noncausal.

The reliability of self-reported age of onset of tobacco, alcohol and illicit drug use.

To examine the reliability of self-reported age of first substance use experiences among national samples of adult and child respondents. Survey responses from seven waves of the National Longitudinal Survey of Youth (NLSY) were examined. Adult and child NLSY respondents reporting age of first tobacco, alcohol, marijuana, cocaine and/or crack use during two or more survey interviews. Four indicators of reliability: intraclass correlation coefficients (ICC), mean and absolute mean differences in reported age and reports consistent within 1 year. The adjusted mean ICC for all comparisons was 0.69. The adjusted mean difference in self-reported age of first substance use was -0.52 years and the adjusted absolute mean difference was 2.00 years. The adjusted percentage of all comparisons reporting ages consistent within 1 year was 55.28%. More consistent reports were provided by adults, and in response to questions posed over 2 years as opposed to longer time intervals. Respondent answers to questions concerned with first use of marijuana were generally found to be most reliable; questions concerned with first use of crack were least reliable and reports of tobacco, alcohol and cocaine were intermediate. Logistic regression analyses also identified age, race, gender, education and poverty status as predictors of consistent reporting. Self-reports of age of first substance use experiences, as currently collected via survey questionnaires, are of sufficient reliability for most current epidemiological applications. For inquiries where age of substance use onset is itself a research focus, however, researchers should invest additional effort in improving the reliability of measurement.

The influence of paternal substance abuse and difficult temperament in fathers and sons on sons' disengagement from family to deviant peers

This study was undertaken to examine the relative contribution of paternal history of substance abuse and difficult temperament in fathers and sons on a panel of individual, family, and interpersonal risk factors shown to be associated with deviant peer affiliations among boys. Deviant peer affiliations among boys have been associated with development of a conduct disorder and early age substance use. In a sample of sons of substance abusing fathers (n =56) and normal fathers (n=94), a structural equation path analysis revealed that the conjoint influence of paternal history of substance abuse and difficult temperament in fathers and sons influenced family and interpersonal processes that, in turn, influenced the developmental trajectory of the child toward deviant peer affiliations. The full model (F=74.49, p<.001, Stability Index=0.70) explained 50% of the variance on sons' Peer Delinquency Scale scores. Implications for primary prevention are discussed.

Temperament and IQ mediate the effects of family history of substance abuse and family dysfunction on academic achievement.

In this study of sons of substance-abusing (n = 57) and normal (n = 71) fathers, it was hypothesized that sons' positive affective temperament (PAT) and intellectual ability (FSIQ) would mediate the effects of paternal substance abuse and family dysfunction on sons' reading achievement scores. Hierarchical, linear, and path analytic regression analyses were computed to test the hypotheses. It was found that (1) sons' FSIQ and PAT each partially mediated the effects of paternal substance abuse on sons' reading achievement scores and (2) that sons' PAT mediated the relationship between family dysfunction and their reading achievement scores. Because reading achievement is pivotal to academic success and school failure is associated with early age substance use, the importance of identifying processes that promote academic success is discussed.