Contribution Of Substance Use Research Articles

Driving under the influence of substances and motor vehicle fatalities among older adults in the United States

Objective This study examines contribution of substance use (including alcohol, cannabinoids, stimulants, narcotics, depressants, and hallucinogens) on the probability of drivers being at-fault for a crash on U.S. public roads, with specific emphasis on older adult drivers. Methods Data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS) for the years 2010–2018 were employed for 87,060 drivers (43,530 two-vehicle crash pairs) involved in two moving vehicle crashes. The quasi-induced exposure (QIE) method was used to compute the relative crash involvement ratios (CIRs) for each relevant substance and illicit drug. Mixed-effect generalized linear regression models were fit to examine the effect of substance use on the probability of a driver being at-fault for a crash. Results There were 75.51% males and 73.88% Non-Hispanic Whites in our sample. The CIR for those aged 70–79 years was 1.17, and more than double (2.56) for the ≥80 years old drivers, while being relatively low among drivers of ages 20 to 69. Substance use, in general, disproportionately increased the probability of being at-fault during a crash, regardless of driver’s age. Though older drivers are less likely than other age groups to report substance use, presence of substances among older drivers increased the probability of their being at-fault two to four times during a crash across almost all substances. The regression models, after adjusting for driver’s sex, road grade, weather, light conditions, distraction, and speeding at time of crash, revealed that older drug-impaired drivers were twice as likely to be at fault in a fatal crash (aOR = 1.947; 95% CI = 1.821, 2.082; <0.0001) compared to their middle-aged counterparts. Similarly, most substance use categories were responsible for the probabilities of higher CIRs among the drivers. Conclusion These findings necessitate continued efforts to bring awareness to the deadly consequences of “drugged driving,” especially among older adult drivers.

The influence of the frequency of cannabis use and of the five impulsivity traits on risky driving behaviors among young drivers

Concerns about road safety are at the forefront of discussions given the recent legalization of cannabis in many areas. Some studies have demonstrated that the frequency of cannabis use is a significant predictor of risky driving among young drivers. However, it is difficult to isolate the specific contribution of substance use from the influence of certain individual personality traits such impulsivity. Indeed, impulsivity traits (i.e., positive urgency, negative urgency, lack of premeditation, lack of perseverance, sensation seeking) are also correlated with risky driving. The present study examined the effect of the frequency of cannabis use on risky driving while taking into account the effect of five impulsivity traits. A community sample of 209 young drivers (aged 17–25 years) completed self-report questionnaires about their road behaviors, their cannabis use, and their impulsivity traits. The results showed that the frequency of cannabis use was significantly associated with risky driving beyond the five impulsivity traits measured. Positive urgency was the only impulsivity trait that remained significantly associated with risky driving once all covariates were entered into the model. Moreover, the frequency of cannabis use acted as a mediator in the relationship between sensation seeking and risky driving.

Contribution of Substance Use in Acute Injuries With Regards to the Intent, Nature and Context of Injury: A CHIRPP Database Study.

IntroductionUsing the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) sentinel surveillance system, the objective of this study was to compare intent, circumstances, injury type and patient demographics in patients who used a substance prior to the injury versus those who did not use any substances.MethodsData were retrospectively collected from November 1st 2016 to October 31st 2017. All patients presenting to the Hôpital de l’Enfant-Jésus ED following trauma were included, aside from those who left without seeing a physician or had no physical injury (e.g., overdose without any trauma was excluded). Patients voluntarily completed a standardised form or agreed to be contacted later. Medical charts of all attendances were reviewed by the CHIRPP’s program coordinator. Substance use included illicit drugs, medications for recreational purposes, alcohol or other used either by the patient or another person involved.ResultsA total of 12,857 patients were included. Substance use was involved in 701 (5.5%) cases and was associated with injuries sustained by males (p < .001). The mean age of patients injured while using substances was 42.8 years, compared to 45.5 years in those who did not use substances (p < .001). Substance use was involved in 3.6% of unintentional injuries, compared to 26.2% of injuries intentionally inflicted by other and 38.9% for self-inflicted injuries (p < 0.0001). When substances were used, the odds of intentional injuries were 7.5 times greater compared to non-intentional injuries (95% CI 6.7, 8.5). Burns, head injuries and polytraumas were more prevalent when drugs or alcohol were involved.ConclusionThis study outlines the significant contribution of substance use in intentional injuries, suggesting that it could potentially be beneficial to specifically target patients who present with deliberate physical injuries in preventive and therapeutic interventions offered in the ED.

Contribution of Behavioral Health Factors to Non-AIDS-Related Comorbidities: an Updated Review.

We summarize recent literature on the contribution of substance use and depression to non-AIDS-related comorbidities. Discussion of recent randomized clinical trials and implementation research to curtail risk attributed to each behavioral health issue is provided. Smoking, unhealthy alcohol use, opioid use, and depression are common among PWH and individually contribute to increased risk for non-AIDS-related comorbidities. The concurrence of these conditions is notable, yet understudied, and provides opportunity for linked-screening and potential treatment of more than one behavioral health factor. Current results from randomized clinical trials are inconsistent. Investigating interventions to reduce the impact of these behavioral health conditions with a focus on implementation into clinical care is important. Non-AIDS-defining cancers, cardiovascular disease, liver disease, and diabetes are leading causes of morbidity in people with HIV. Behavioral health factors including substance use and mental health issues, often co-occurring, likely contribute to the excess risk of non-AIDS-related comorbidities.

Gender Differences in Smoking Among an Urban Emergency Department Sample.

Background:Urban emergency department (ED) patients have elevated smoking and substance use compared with the general population. We analyzed gender differences in smoking among an urban ED sample and assessed the contribution of substance use, demographic, and couple factors.Methods:We conducted a secondary analysis of data obtained from a cross-sectional, observational survey (N = 1037 participants) on drinking, drug use, and intimate partner violence (IPV). Gender-specific logistic regression models for current (past 30-day) smoking and multinomial regression models for smoking intensity (light: ⩽5 cigarettes per day [CPD]; moderate: 6 to 10 CPD; heavier: >10 CPD) were estimated.Results:Smoking prevalence was higher among men than women (35.5% vs 18.9%; P < .001). Substance use (frequency of intoxication, marijuana, amphetamine, and cocaine use), demographic (food insufficiency, unemployment), and couple-related factors (having a spouse/partner who smoked, IPV involvement, being in a same-gender couple) were differentially associated with current smoking and level of intensity among men and women.Conclusions:Emergency department staff should consider the impact of polysubstance use, food insufficiency, unemployment, and whether both partners in the couple smoke when screening patients for smoking and formulating cessation treatment plans. Women in same-gender relationships and those who have experienced IPV involvement may require additional referral.

Stress, stressors, and substance use: Differential risk for hookah use among African American college students

Using differential, multivariable risk models, we assessed the contribution of substance use and stress/traumatic events to hookah use among African American college students (n = 1,402) using data from the Fall 2012 American College Health Association-National College Health Assessment (ACHA-NCHA) II. Lifetime hookah use was 24.8%, with 34.2% of lifetime users having done so in the past 30 days. Compared to nonusers, hookah users had significantly higher use rates of alcohol, marijuana, other tobacco, and other drugs. Furthermore, hookah use was more likely among those with cumulative stress, yet less likely among older students. An implication is that prevention messages may need to be tailored for African American college students and particularly target younger students, substance users, and those with cumulative stress. These findings also inform policy discussions regarding hookah use on college campuses.

Adolescent substance use behavior and suicidal behavior for boys and girls: a cross-sectional study by latent analysis approach

BackgroundAdolescent suicidal behavior may consist of different symptoms, including suicidal ideation, suicidal planning and suicidal attempts. Adolescent substance use behavior may contribute to adolescent suicidal behavior. However, research on the relationships between specific substance use and individual suicidal behavior is insufficient, as adolescents may not use only one substance or develop only one facet of suicidal behavior. Latent variables permit us to describe the relationships between clusters of related behaviors more accurately than studying the relationships between specific behaviors. Thus, the aim of this study was to explore how adolescent substance use behavior contributes to suicidal behavior using latent variables representing adolescent suicidal and substance use behaviors.MethodA total of 13,985 adolescents were recruited using a stratified random sampling strategy. The participants indicated whether they had experienced suicidal ideation, planning and attempts and reported their cigarette, alcohol, ketamine and MDMA use during the past year. Latent analysis was used to examine the relationship between substance use and suicidal behavior.ResultsAdolescents who used any one of the above substances exhibited more suicidal behavior. The results of latent variables analysis revealed that adolescent substance use contributed to suicidal behavior and that boys exhibited more severe substance use behavior than girls. However, there was no gender difference in the association between substance use and suicidal behavior.ConclusionSubstance use behavior in adolescents is related to more suicidal behavior. In addition, the contribution of substance use to suicidal behavior does not differ between genders.

Developmental Patterns of Adolescent Marijuana and Alcohol Use and Their Joint Association with Sexual Risk Behavior and Outcomes in Young Adulthood.

Urban populations disproportionately experience poor sexual outcomes, including high rates of teenage pregnancy and sexually transmitted infections. However, the contribution of substance use across adolescence to poor sexual outcomes in young adulthood has not been investigated in depth, despite offering opportunities for more targeted prevention. This study aimed to estimate joint trajectories of adolescent alcohol and marijuana useto determine if they relate differently to four sexual outcomes: multiple sexual partners, sex without a condom, teenage pregnancy, and contraction of a sexually transmitted infection in young adulthood (by age 25). Data came from a longitudinal study of urban youth followed from age 6 to age 25, with annual assessments during adolescence and young adulthood (n = 608). The sample showed high levels of sexual risk, with young adults on average having sex without a condom once in the past month, 28.5% having multiple sexual partners in the past month, one quarter having contracted a sexually transmitted infection, and over 60% of the women being pregnant as a teenager and 36% of the men having gotten a partner pregnant. Applying longitudinal latent profile analysis to estimate joint trajectories of alcohol and marijuana use from grades 8-12, we identified four classes representing high dual use, moderate alcohol use, moderate alcohol use with increasing marijuana use, and non-use. Class membership differently predicted all four outcomes investigated with high dual users having the highest level of teenage pregnancy and the increasing marijuana trajectory having the highest risk of engaging with multiple sexual partners in the past month. Results suggest implications for both sexual risk and substance use prevention for urban youth.

¿Por qué una nueva revista de investigación científica en adicciones?

THE RELEVANCE OF ADDICTION RESEARCH AT AN INTERNATIONAL LEVEL Alcohol, tobacco and illicit drug use have a considerable impact on the mortality and morbidity of the global population, positioning them amongst the leading causes of early mortality and years lived with disability in most of the countries included in worldwide epidemiological studies (Degenhardt et al., 2008; Whiteford et al., 2013). The contribution of substance use to the global burden of disease supports the need for a coordinated international response to counter its harmful effect on public health.

Early Adolescent Substance Use as a Risk Factor for Developing Conduct Disorder and Depression Symptoms

Objective: Conduct disorder and depression symptoms are well-established risk factors for substance use during adolescence. However, few investigations have examined whether early substance use increases adolescents’ risk of developing conduct disorder/depression symptoms. Method: Using the Developmental Pathways Project sample of 521 middle school students (51.6% male), we tested whether substance use (indicated by alcohol and marijuana use, and use-related impairment) in 8th and 9th grade increased risk of conduct disorder and depression symptoms in 9th and 12th grade over and above prior symptoms. We examined whether associations between substance use and conduct disorder/depression symptoms were consistent across self- or parent-reported symptoms and whether associations were moderated by gender. Results: Analyses indicated that, over and above prior symptoms, elevated substance use in 8th grade predicted elevated conduct disorder symptoms in 9th grade, and substance use in 9th grade predicted conduct disorder symptoms in 12th grade. In contrast, substance use failed to predict later depression symptoms independent of prior symptoms. These findings were consistent across self- and parent-reported conduct disorder/depression symptoms. With one exception (association between substance use in 8th grade and self-reported conduct disorder symptoms in 9th grade), relations between early substance use and later conduct disorder symptoms did not differ between boys and girls. Conclusions: Study findings underscore the unique contribution of substance use during early adolescence to the development of conduct disorder symptoms by late adolescence.

Early Adolescent Substance Use as a Risk Factor for Developing Conduct Disorder and Depression Symptoms

Conduct disorder and depression symptoms are well-established risk factors for substance use during adolescence. However, few investigations have examined whether early substance use increases adolescents' risk of developing conduct disorder/depression symptoms. Using the Developmental Pathways Project sample of 521 middle school students (51.6% male), we tested whether substance use (indicated by alcohol and marijuana use, and use-related impairment) in 8th and 9th grade increased risk of conduct disorder and depression symptoms in 9th and 12th grade over and above prior symptoms. We examined whether associations between substance use and conduct disorder/depression symptoms were consistent across self- or parent-reported symptoms and whether associations were moderated by gender. Analyses indicated that, over and above prior symptoms, elevated substance use in 8th grade predicted elevated conduct disorder symptoms in 9th grade, and substance use in 9th grade predicted conduct disorder symptoms in 12th grade. In contrast, substance use failed to predict later depression symptoms independent of prior symptoms. These findings were consistent across self- and parent-reported conduct disorder/depression symptoms. With one exception (association between substance use in 8th grade and self-reported conduct disorder symptoms in 9th grade), relations between early substance use and later conduct disorder symptoms did not differ between boys and girls. Study findings underscore the unique contribution of substance use during early adolescence to the development of conduct disorder symptoms by late adolescence.

Substance Use in Adolescence and Early Adulthood: Which Best Predicts Violence in Early Adulthood?

Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health) were used to test the contributions of alcohol, tobacco, marijuana, cocaine, LSD, PCP, and other illicit drugs to violence in early adulthood (e.g., took part in a gang fight, pulled a knife or gun, used a weapon in a fight, used a weapon to get something). The two main hypotheses were that well-known, non-substance abuse risk factors for violence in adolescence (e.g., gender, race/ethnicity, poverty, adolescent violence, school failure) would continue to elevate the risk for violence in early adulthood. Furthermore, substance use in early adulthood would eclipse the contribution of substance use in adolescence, thus increasing the risk for early adult violence. Results supported both hypotheses. Substance use in adolescence may not have a lasting influence on adult violence. In addition, the risk for early adult violence may be subject to contemporaneous influences of substance use as well as historical and contemporaneous non-substance use risk factors.

Toxicology Testing and Results for Suicide Victims—13 States, 2004

In 2003, an estimated 31,484 suicides (10.7 per 100,000 population) occurred in the United States. Suicide was the fourth leading cause of death among persons aged 10-64 years and the second and third leading causes of death among persons aged 25-34 and 10-24 years, respectively. Few studies have attempted to determine the contribution of substance use to suicide. To assess toxicology testing practices and to determine the prevalence of positive results for alcohol or other drugs, CDC analyzed test results of suicide victims in the 13 states that collected data for the National Violent Death Reporting System (NVDRS) in 2004. This report summarizes the results of that analysis, which determined that 1) the percentage of suicide victims tested varied among states, ranging from 25.9% to 97.7%; 2) of those victims tested, 33.3% were positive for alcohol, and 16.4% were positive for opiates; and 3) similar percentages of poisoning suicide (i.e., suspected intentional overdose) and nonpoisoning suicide victims tested positive for alcohol or other drugs, with the exception of opiates. These results underscore the need to continue monitoring toxicology test results of suicide victims, which might identify patterns of substance use that can help guide development of effective suicide interventions. Such data can be enhanced by uniform, comprehensive, toxicology testing practices on a state and national basis.

Gallinyalla: a town of substance? A descriptive study of alcohol, tobacco, medicines and other drug use in a rural setting

This study investigates substance use in a regional town in South Australia. The study objectives were to identify Aboriginal and non-Aboriginal views on and individual practices in substance use, and its impact on the community. Working together, Aboriginal and non-Aboriginal community members identified the scope of the issue of substance use using four broad questions, and where solutions might lie. Individuals also reported their personal substance use. Qualitative methods involving 24 focus groups (n = 211) and 285 key informant interviews (Aboriginal n = 160, non-Aboriginal n = 125) were used to obtain the data. Quantitative data were generated from structured elements of the key informant interviews. Alcohol was the main substance of concern, especially among young people. High marijuana use was also identified. The contribution of substance use to relationship breakdown and the impact this has on families and the community was an important theme. There was agreement on the need for broad community strategies to link and strengthen agencies that deal with substance use issues in Gallinyalla, and to promote the reconciliation process. The implications for policy and practice from this project support the need for substance use strategies in which the community plays a major role.

Substance use and psychopathology in African American men at risk for HIV infection

Recent epidemiologic surveys of the prevalence of and primary risk factors for psychiatric morbidity suggest that socioeconomic status, age, ethnicity, and gender represent significant risk factors for both primary psychiatric and substance use disorders. Further, evidence of concurrent disorders continues to mount, particularly among inpatients. The present study is designed to address the association between heavy substance use and major mental disorders in a large sample of non-HIV-infected community-resident African American men. Three hundred eleven seronegative participants in a study of neurobehavioral sequelae of substance use and HIV in African American men in the metropolitan Los Angeles area were used to investigate the relative contribution of substance use and other cofactors in predicting psychiatric morbidity. Results indicate significantly higher rates of 30-day and 12-month Axis I disorders in this sample than reported in the most recent epidemiologic studies, but consistent with rates observed in seronegative subjects in other HIV/AIDS studies. Further, positive associations between select indices of heavy substance use and both 30-day and 12-month psychopathology were found. Finally, heavy cocaine use was the primary predictor of mood disorder, whereas gay/bisexual orientation and prior history of psychopathology were the primary predictors of anxiety disorder and of any recent Axis I disorder. These findings are discussed in light of the primary goals of this community-based study. © 1997 John Wiley & Sons, Inc.