Estimates Of Substance Use Research Articles

Characterization of substance use pattern among secondary school students in Nasarawa State, Nigeria

BackgroundThe prevalence of substance use among secondary school children in Nasarawa State, North-Central Nigeria, is unknown.ObjectiveTo provide comprehensive prevalence estimates of substance use and associated factors among in-school adolescents in Nasarawa, Nigeria.Methods A cross-sectional, multi-stage survey was conducted among 1600 students in 26 schools. Students completed a self-administered questionnaire regarding socio-demographics and substance use habits. The questionnaire was adapted from a standardized questionnaire.ResultOf the 1518 who completed the questionnaire, there were more boys (51.3%) than girls. Most participants were 16–18 years old (55.3%), attending non-residential (70%), private (54.4%), and mixed-sex schools (79.3%). Most were Christians (83.4%) and from monogamous families (73.2%). The prevalence of ever-tried cigarette smoking was 14.8%, marijuana (13.6%), and inhalants (12.9%). Students > 18 years were more likely to ever try cigarette smoking (aOR 1.88, 95%CI 0.99–3.58), tried during the last 12 months (aOR 2.29, 95%CI 1.18–4.46), and tried during the last 30 days (aOR 2.41, 95%CI 1.12–4.84) than those younger. Students whose either parent smoked were more likely to ever try cigarette smoking (aOR 9.9, 95%CI 6.95–14.23), marijuana (aOR 9.74, 95%CI 6.78–13.99), inhalants (aOR 7.27, 95%CI 5.04–10.50), and other psychoactive substances (aOR 9.25, 995%CI 6.53–13.11) than students whose parents do not. Substance usage was influenced by factors such as being Muslim and in SS1 class, attending a public and non-residential school, coming from polygamous homes, and living with single parents.ConclusionSecondary school students in Nasarawa State exhibit variable substance use behaviors, influenced by socio-demographic factors, requiring consideration in substance use interventions.

Comparing single and multiple imputation strategies for harmonizing substance use data across HIV-related cohort studies

BackgroundAlthough standardized measures to assess substance use are available, most studies use variations of these measures making it challenging to harmonize data across studies. The aim of this study was to evaluate the performance of different strategies to impute missing substance use data that may result as part of data harmonization procedures.MethodsWe used self-reported substance use data collected between August 2014 and June 2019 from 528 participants with 2,389 study visits in a cohort study of substance use and HIV. We selected a low (heroin), medium (methamphetamine), and high (cannabis) prevalence drug and set 10–50% of each substance to missing. The data amputation mimicked missingness that results from harmonization of disparate measures. We conducted Monte Carlo simulations to evaluate the comparative performance of single and multiple imputation (MI) methods using the relative mean bias, root mean square error (RMSE), and coverage probability of the 95% confidence interval for each imputed estimate.ResultsWithout imputation (i.e., listwise deletion), estimates of substance use were biased, especially for low prevalence outcomes such as heroin. For instance, even when 10% of data were missing, the complete case analysis underestimated the prevalence of heroin by 33%. MI, even with as few as five imputations produced the least biased estimates, however, for a high prevalence outcome such as cannabis with low to moderate missingness, performance of single imputation strategies improved. For instance, in the case of cannabis, with 10% missingness, single imputation with regression performed just as well as multiple imputation resulting in minimal bias (relative mean bias of 0.06% and 0.07% respectively) and comparable performance (RMSE = 0.0102 for both and coverage of 95.8% and 96.2% respectively).ConclusionOur results from imputation of missing substance use data resulting from data harmonization indicate that MI provided the best performance across a range of conditions. Additionally, single imputation for substance use data performed comparably under scenarios where the prevalence of the outcome was high and missingness was low. These findings provide a practical application for the evaluation of several imputation strategies and helps to address missing data problem when combining data from individual studies.

Substance Use Descriptive Norms and Behaviors among US College Students: Findings from the Healthy Minds Study.

Social norms have been associated with alcohol use in college populations; however, more research is needed to confirm the associations between social norms and a range of substance use behaviors during the COVID-19 pandemic. We analyzed data from the Healthy Minds Study (September 2020-December 2020), a non-probability sample administered online to college students. We used multivariable logistic regression to test for associations between respondents' perceptions of substance use behaviors in their respective colleges and their own substance use behaviors, adjusting for age, gender, race/ethnicity, and international student status. We found that those who overestimated the prevalence of alcohol use, cigarette use, cannabis use, and vaping were significantly more likely to use these substances when compared with those who did not overestimate. These associations persisted even when using different prevalence estimates of substance use, though some associations lost statistical significance when applying the survey weights to account for non-response. College students overestimated the prevalence of substance use in their respective colleges, even during the early stages of the pandemic when social interactions were limited, and these beliefs were associated with substance use. Future studies may test the utility of campaigns to alter perceptions of social norms and interventions that use personalized normative feedback to reduce substance use during pandemics.

Comparison of a web-push survey research protocol with a mailed paper and pencil protocol in the Monitoring the Future panel survey.

AimsThe experiment tested the effects of a web‐push survey research protocol, compared with the standard mailed paper‐and‐pencil protocol, among young adults aged 19–30 years in the ‘Monitoring the Future’ (MTF) longitudinal study.Design, Setting and ParticipantsThe US‐based MTF study has measured substance use trends among young adults in panel samples followed biennially, using consistent mailed survey procedures from 1977 to 2017. In 2018, young adult participants in the MTF longitudinal component scheduled to be surveyed at ages 19–30 in 2018 (from high school senior cohorts of 2006–17, n = 14 709) were randomly assigned to receive the standard mail/paper survey procedures or new web‐push procedures.MeasurementsPrimary outcomes were responding to the survey and prevalence estimates for past 30‐day use of alcohol, cigarettes, marijuana and illicit drugs.FindingsThe web‐push response rate was 39.07% [95% confidence interval (CI) = 37.889, 40.258]; this was significantly better than the standard MTF response rate of 35.12% (95% CI = 33.964, 36.285). After adjusting for covariates, the web‐push condition was associated with a 19% increase in the odds of responding compared with standard MTF (adjusted odds ratio = 1.188; 95% CI = 1.096, 1.287). Substance use prevalence estimates were very similar and differences became negligible when using attrition weights and controlling for socio‐demographic characteristics.ConclusionsThe web‐push protocol produced a higher response rate than the mailed pencil and paper protocol in the Monitoring the Future panel study, without substantially affecting estimates of substance use once attrition weights and socio‐demographic variables were factored in.

National estimates of substance use, substance use disorders, and treatment among adolescent and young adult cancer survivors.

7042 Background: Adolescent and young adult (AYA) survivors of cancer are at an elevated risk of early-life morbidity and mortality due to the disease trajectory and treatment. Engagement in risk behaviors, including substance use, can exacerbate survivors’ vulnerabilities and place them at further risk for adverse health outcomes. This study provides national estimates of the prevalence of substance use and misuse, substance abuse or dependence (i.e., substance use disorders [SUD]), and receipt of treatment for SUD among AYA cancer survivors. Methods: We used 2015-2018 National Survey of Drug Use and Health data to identify a nationally-representative AYA sample (aged 12-34 years). Outcomes included past-year alcohol use, marijuana use, other illicit drug use, misuse of any prescription psychotherapeutic drugs (including opioid analgesics, stimulants, sedatives, or tranquilizers), and misuse of prescription opioid analgesics. Outcomes also assessed past-year SUD in aforementioned drug classes. Among those with SUD, we evaluated past-year receipt of SUD treatment. Multiple logistic regressions were estimated to compare outcomes between 846 AYAs who reported a cancer history and 142,870 AYAs who did not, adjusting for sociodemographic and need-related characteristics. Results: In bivariate analyses, AYAs with a cancer history were more likely than noncancer peers to use alcohol (78.6% vs. 63.4%; p< 0.001) and illicit drugs other than marijuana (11.2% vs. 7.8%; p= 0.02), misuse any prescription psychotherapeutic drugs (16.9% vs. 10.6%; p< 0.001) and prescription opioid analgesics (12.0% vs. 5.9%; p< 0.001), and have an illicit drug (other than marijuana) SUD (3.7% vs. 1.3%; p< 0.01) in the past year. In regression analyses, differences in past-year misuse of any prescription psychotherapeutic drug and prescription opioid analgesics persisted ( p= 0.02, p< 0.01, respectively). Among AYAs with SUD, those with a cancer history were more likely than noncancer peers to receive SUD treatment (21.0% vs. 8.1%; p= 0.01) in the past year; this difference persisted in regression analyses ( p= 0.03). Conclusions: AYAs with a cancer history had an elevated risk for misusing prescription psychotherapeutic medications, which was driven by misuse of prescription opioids; yet, only one in five AYAs with a cancer history and SUD received treatment. Our findings underscore the need for future interventions designed to reduce substance use and misuse and improve access to SUD treatment in AYA cancer survivors.

The Critical Lack of Data on Alcohol and Marijuana Use by Adolescents on the Autism Spectrum.

Why is this topic important?: Alcohol is the most commonly used substance among adolescents, and marijuana is the most commonly used illicit drug. Previous studies suggest that at least some autistic individuals may be at increased risk of substance use disorder compared with allistic counterparts, potentially to control social anxiety or facilitate social interaction. However, to the best of our knowledge, estimates of substance use by autistic youth in the United States are limited.What is the purpose of this article?: This study was performed to highlight the lack of data sets that collect information about alcohol and/or marijuana use by autistic youth in the United States. We systematically reviewed U.S. data sources on child and/or adolescent health, disability, and/or substance use to identify sources that could generate estimates of the prevalence of substance use among autistic adolescents in the United States, even if those estimates may not be stable due to small sample sizes or other methodological weaknesses.What is the perspective of the authors?: The authors are a team of allistic researchers. M.B.-M. and S.B.-F. are pediatricians. E.F.R. and A.A. are public health researchers. S.B.-F. has an extensive background in providing clinical health care services to children with autism and is an autism researcher. R.A.N.P. and A.C.S.-R. are master's level public health research assistants. E.F.R., A.A., and M.B.-M. are adolescent health research experts. E.F.R. has an adolescent daughter on the autism spectrum. Our collective positionality is that we identify as people who are not autistic and who select to focus on research that we hope will benefit autistic people and society in general.What did the authors find?: Based on our four-step investigation, we identified 19 U.S. data sources that had the potential to generate estimates of the prevalence of alcohol and/or marijuana use in autistic youth. Only one included information about both autism and substance use.What do the authors recommend?: The National Institutes of Health (NIH), and the National Institute of Alcohol Abuse and Alcoholism (NIAAA) and National Institute of Drug Abuse (NIDA), specifically, should prioritize funding data collection from autistic youth and adults on alcohol and marijuana use, misuse, hazardous use, dependence, and use disorders. In addition, it is critical that nationally representative surveys and data sources include robust questions on autism and substance abuse. This includes assessing autism status in multiple ways (e.g., self-report, diagnosis by a clinician, neuropsychology reports). Substance use questions should include age of first drink or use, frequency of use, quantity of use per day or within a certain number of hours, expectancies, consequences of use, and indicators of alcohol use disorder.How will these recommendations help autistic individuals?: These findings highlight a critical gap in the literature on substance use among autistic youth. Substance use is recognized as a pressing adolescent health problem, and autistic youth deserve evidence-based substance use prevention strategies. Without an estimate of substance use by autistic youth, it is difficult to justify to funding entities the expenditure of resources on the development of evidence-based substance use prevention strategies to benefit them.

Substance Use in Registered Nurses: "I Heard About a Nurse Who . . ."

BACKGROUND: Estimates of substance use (SU) in nurses is on par with that of the general population: between 6% and 8%. However, collecting sensitive information such as SU is difficult based on social desirability and fears of disclosure. AIMS: Part of a larger study surrounding nurses' self-reports of SU (n = 1,478), the purpose was to explore open-ended responses of nurses (n = 373) who were invited to "Please add any additional comments related to substance or alcohol use that you have experienced or witnessed in registered nurses." METHOD: This qualitative study employed a content analysis of 373 nurses' open-ended responses collected via an online survey. RESULTS: The majority of nurses (n = 250) forwarded comments that described SU in other nurses, while 24 comments reflected the nurse's past or current SU. Content analysis revealed the following four themes: (1) differing social network proximity to SU; (2) individual process: vulnerability to adaptive/maladaptive coping resulting in positive and negative outcomes; (3) bedside, system, and organizational spaces and effects; and (4) there are no SU issues in nursing. CONCLUSIONS: Although direct reports of SU constitute approximately one quarter of the comments forwarded, nurses reported peers' struggles with SU, including observing nurses working in patient care while impaired and the use of substances to cope with work and personal stressors. Individual factors and system-related failures appear to be contributors to SU in nurses.

Race/Ethnicity Differences in Trends of Marijuana, Cigarette, and Alcohol Use Among 8th, 10th, and 12th Graders in Washington State, 2004-2016.

Accurate estimates of substance use in the teenage years by race/ethnicity may help identify when to intervene to prevent long-term substance use disparities. We examined trends in past 30-day use of marijuana, cigarette, and alcohol among 8th, 10th, and 12th graders in Washington State, which passed a recreational marijuana law in 2012 and initiated retail marijuana sales in 2014. Data are from the 2004-2016 Washington Healthy Youth Surveys (n = 161,992). We used time series regression models to assess linear and quadratic trends in substance use for the full sample and stratified on race/ethnicity and grade level and examined relative differences in prevalence of use by race/ethnicity. In Washington, across all racial/ethnic groups, marijuana use peaked in 2012. Although there was not a significant overall change in marijuana use for the full sample across the study period, there was a statistically significant increase in use among 12th graders and a statistically significant decrease among 8th graders. Relative to Whites, Asians had a lower prevalence of marijuana use, whereas all other race/ethnicity groups had a higher prevalence of use. Prevalence of marijuana use is particularly high among American Indian/Alaska Native and Black youth and has increased most rapidly among 12th grade Hispanic/Latinx youth. There were large and statistically significant decreases in alcohol and cigarette use across the study period for the full sample, as well as for each race/ethnicity group. These findings highlight the need for continued monitoring of trends in use among these groups and potentially warrant consideration of selective interventions that specifically focus on students of color and that include developmentally-appropriate strategies relevant to each grade.

Prevalence of Substance Use and Associated Factors Among High School Adolescents in Rithepani, Lekhnath-2, kaski, Nepal

Background: Substance use is a major public health concern in global settings, and is very common during adolescence period leading to physical and/or mental health complications. This study assessed the prevalence of substance use and associated factors among high school adolescents in Rithepani 2, Lekhnath, Kaski, 2073.Objectives: The study was designed to provide estimates of substance use by school-going adolescents in Lekhnath and to identify risk factors associated with.Methods: A school based cross-sectional study was conducted from 17th October to 21st October, 2016 among eighth to 12th grade high school students in the Rithepani-2, Lekhnath. Participants were select­ed by purposive sampling techniques, and data were collected using questionnaire. Frequency, percentage, means, SD and chi-square test was performed to identify factors associated with substance use.Results: Majority of the respondents 93 (56.4%) belonged to the age group 15 - 18 years. Majority of the respondents 88 (53.3%) were males and 50 (30.3%) were studying in grade 11. Majority of the respondents 140 (84.8%) were Hindus and 104 (63%) of the respondents belonged to upper caste group. In terms of education of the respondents’ parents, majority of the respondents’ mothers 68 (41.2%) had completed their secondary education and similarly, majority of the respondents’ fathers 78 (47.3%) had completed their secondary education. Majority of the respondents’ mothers 129 (78.2%) were housewives and majority of the respondents' fathers 48 (29.1%) were businessmen. Majority of the respondents 136 (82.5%) belonged to nuclear family and 93 (56.4%) had per month family income more than Rs 15,000. Among 165 respon­dents prevalence of substance use was found to be 10 (6%).Regarding the associated factors majority of the respondents 162 (98.2%) had good relation with their parents, 101 (61.2%) respon­dents’ family members do not use substance, 128 (77.6%) respondents reported that substance use was not accepted in their culture. the prev­alence of substance use by the respondents is 6.1% in which five (50%) respondents consume alcohol, eight (80%) take cigarette, one (10%) use tobacco and two (20%) take ganja. Among the substance users, four (40%) reported imitating parents and four (40%) reported curiosity as the cause for them to initiate substance use. Regarding the accessibility of the substances among the respondents who use substances, three (30%) respondents said that it’s very difficult whereas one (10%) said that it’s very easy for them to have access to the substances. Majority of the respondents who use substances 6 (60%) avail the substance/s from their friends.Regarding the Association, there is a significant association between prevalence of substance and substance use by family members with the χ2 value of 7.61 and p-value 0.006 which is less than 0.05 significant level. There is also a significant association between the prevalence of substance use and its cultural acceptance with the χ2 value of 4.65 and p-value of 0.031 which is less than 0.05 significant level.There is a significant association between the prevalence of substance abuse and ethnicity with the χ2 value of 11.81and with the p-value 0.037 which is less than 0.05 significant level.Conclusions: The prevalence of substance use among high school ado­lescent students in selected higher secondary school was found to be 6.1%. There was significant association between prevalence of sub­stances use and cultural acceptance of participants, ethnicity and use of substances by the family members. Based on the findings of the study researcher suggests to initiate awareness and co-ordination program between the school and parents. Journal of Gandaki Medical College Vol. 10, No. 1, 2017, Page: 43-48

Comorbidity of Severe Psychotic Disorders With Measures of Substance Use

Although early mortality in severe psychiatric illness is linked to smoking and alcohol, to our knowledge, no studies have comprehensively characterized substance use behavior in severe psychotic illness. In particular, recent assessments of substance use in individuals with mental illness are based on population surveys that do not include individuals with severe psychotic illness. To compare substance use in individuals with severe psychotic illness with substance use in the general population. We assessed comorbidity between substance use and severe psychotic disorders in the Genomic Psychiatry Cohort. The Genomic Psychiatry Cohort is a clinically assessed, multiethnic sample consisting of 9142 individuals with the diagnosis of schizophrenia, bipolar disorder with psychotic features, or schizoaffective disorder, and 10,195 population control individuals. Smoking (smoked >100 cigarettes in a lifetime), heavy alcohol use (>4 drinks/day), heavy marijuana use (>21 times of marijuana use/year), and recreational drug use. Relative to the general population, individuals with severe psychotic disorders have increased risks for smoking (odds ratio, 4.6; 95% CI, 4.3-4.9), heavy alcohol use (odds ratio, 4.0; 95% CI, 3.6-4.4), heavy marijuana use (odds ratio, 3.5; 95% CI, 3.2-3.7), and recreational drug use (odds ratio, 4.6; 95% CI, 4.3-5.0). All races/ethnicities (African American, Asian, European American, and Hispanic) and both sexes have greatly elevated risks for smoking and alcohol, marijuana, and drug use. Of specific concern, recent public health efforts that have successfully decreased smoking among individuals younger than age 30 years appear to have been ineffective among individuals with severe psychotic illness (interaction effect between age and severe mental illness on smoking initiation, P = 4.5 × 105). In the largest assessment of substance use among individuals with severe psychotic illness to date, we found the odds of smoking and alcohol and other substance use to be dramatically higher than recent estimates of substance use in mild mental illness.

Substance Use and Other Mental Health Disorders Among Veterans Returning to the Inner City: Prevalence, Correlates, and Rates of Unmet Treatment Need

Estimates of substance use and other mental health disorders of veterans (N = 269) who returned to predominantly low-income minority New York City neighborhoods between 2009 and 2012 are presented. Although prevalences of posttraumatic stress disorder, traumatic brain injury, and depression clustered around 20%, the estimated prevalence rates of alcohol use disorder, drug use disorder, and substance use disorder were 28%, 18%, and 32%, respectively. Only about 40% of veterans with any diagnosed disorder received some form of treatment. For alcohol use disorder, the estimate of unmet treatment need was 84%, which is particularly worrisome given that excessive alcohol use was the greatest substance use problem.

Psychosocial Development and First Substance Use in Third and Fourth Grade Students: A Short-Term Longitudinal Study

Third and fourth grade students () completed measures of psychosocial development, substance use, and intentions to use in January, and again in May, 1998. A revised Erikson Psychosocial Inventory Scale (EPSI) was employed to assess psychosocial development while estimates of substance use and intentions were obtained from anonymous self-reports. The sample was split on the basis of change in substance use and intentions from January to May. Using this grouping scheme as an independent variable, scores on the EPSI subscales (trust, autonomy, initiative, industry, and identity) were compared over time. Interestingly, no differences in psychosocial development were evident for the initial substance use comparisons, but differences were evident five months later. Respondents who initiated substance use and/or increased intentions during the five-month interval exhibited small gains (averaging less than 2.0%) on measures of trust, autonomy, and initiative and modest declines in industry and identity (−1.2%). Respondents who neither initiated substance use nor increased intentions during the five-month interval experienced significant gains (averaging 6.0%) on all five of the EPSI subscales. These findings suggest that early substance use may impede psychosocial development, thus justifying prevention efforts in the earlier grades as well as efforts to delay onset.

Disparities in Adequate Mental Health Care for Past-Year Major Depressive Episodes Among Caucasian and Hispanic Youths

Disparities in Adequate Mental Health Care for Past-Year Major Depressive Episodes Among Caucasian and Hispanic Youths

Disparities in Adequate Mental Health Care for Past-Year Major Depressive Episodes Among Caucasian and Hispanic Youths

Following efforts made in recent years to provide effective mental health treatments based on evidence-based guidelines, a working definition was developed in the literature detailing a minimum level of "adequate mental health care" for serious mental illness. However, little is known about racial or ethnic disparities in receipt of adequate mental health care for individuals affected with serious mental illness. The objective of this study was to examine disparities among Caucasian and Hispanic youths in receipt of adequate mental health care for past-year major depressive episodes. Data for this study were drawn from the 2005 National Survey on Drug Use and Health. The study sample was composed of 1,169 Caucasian youths and 316 Hispanic youths aged 12 to 17 with past-year major depressive episodes. The percentages of youths in the sample who received adequate mental health care for past-year major depressive episodes were estimated, and the correlates of receipt of adequate mental health care were examined. Thirty-four percent of the full sample received adequate mental health care for past-year major depressive episodes, but separate analyses indicated that adequate mental health care was received by a significantly higher proportion of Caucasian youths (36%) than Hispanic youths (27%). The odds of receiving adequate mental health care for past-year major depressive episodes for Caucasians were 1.55 times that of Hispanics (p=.01). Having Medicaid or coverage via the State Children's Health Insurance Program significantly increased the odds of receiving adequate mental care for past-year major depressive episodes for both Hispanics and Caucasians. As mental health problems of adolescents from diverse racial or ethnic backgrounds become more easily identified and a larger proportion of these groups is referred to mental health treatment services, it is important to examine the degree to which treatment should be tailored to engage and retain specific racial or ethnic groups so that they will receive the minimum of adequate mental health care.

The utility of online panel surveys versus computer‐assisted interviews in obtaining substance‐use prevalence estimates in the Netherlands

Rather than using the traditional, costly method of personal interviews in a general population sample, substance-use prevalence rates can be derived more conveniently from data collected among members of an online access panel. To examine the utility of this method, we compared the outcomes of an online survey with those obtained with the computer-assisted personal interviews (CAPI) method. Data were gathered from a large sample of online panellists and in a two-stage stratified sample of the Dutch population using the CAPI method. The Netherlands. Participants The online sample comprised 57 125 Dutch online panellists (15-64 years) of Survey Sampling International LLC (SSI), and the CAPI cohort 7204 respondents (15-64 years). All participants answered identical questions about their use of alcohol, cannabis, ecstasy, cocaine and performance-enhancing drugs. The CAPI respondents were asked additionally about internet access and online panel membership. Both data sets were weighted statistically according to the distribution of demographic characteristics of the general Dutch population. Response rates were 35.5% (n = 20 282) for the online panel cohort and 62.7% (n = 4516) for the CAPI cohort. The data showed almost consistently lower substance-use prevalence rates for the CAPI respondents. Although the observed differences could be due to bias in both data sets, coverage and non-response bias were higher in the online panel survey. Despite its economic advantage, the online panel survey showed stronger non-response and coverage bias than the CAPI survey, leading to less reliable estimates of substance use in the general population.

A clinical validation of the National Survey on Drug Use and Health Assessment of Substance Use Disorders

Alcohol and illicit drug abuse and dependence continue to be of great national concern in the United States, as is true in other nations. The National Survey on Drug Use and Health (NSDUH) provides national annual estimates of substance use and abuse/dependence among the U.S. civilian, noninstitutionalized population aged 12 years or older. We conducted a clinical validation study of the substance use disorder questions of the NSDUH instrument using a sample of 288 adults and adolescents recruited from the community and outpatient substance abuse treatment programs in North Carolina. Using the Structured Clinical Interview for DSM-IV (SCID-IV) for adults and the Pittsburgh Adolescent Alcohol Research Center's Structured Clinical Interview (PAARC-SCID) for adolescents, we computed the psychometric properties of the NSDUH questions. We found the level of agreement between the NSDUH and the SCID/PAARC-SCID interviews to be fair to moderate overall. There was somewhat better agreement for dependence than for abuse and for adults than for adolescents.

Prevalence of Substance Use and Delinquent Behavior in Adolescents From Victoria, Australia and Washington State, United States

This article compares prevalence estimates of substance use and delinquent behavior in Washington State, United States and Victoria, Australia, two states chosen for their different policy environments around problem behavior. Few comparisons of international differences on rates of multiple problem behavior exist, and most are based on methods that are not matched, raising the question of whether findings are based on methodological differences rather than actual rate differences. The International Youth Development Study used standardized methods to recruit and administer an adaptation of the Communities That Care Youth Survey to representative state samples of fifth-, seventh-, and ninth-grade students in each state. Rates of delinquent behavior were generally comparable. However, striking differences in substance use were noted, with Victoria students reporting higher rates of alcohol use, alcohol misuse, smoking, and inhalant use, whereas Washington State students reported higher rates of marijuana use. Implications for conducting international comparisons are discussed.

Gender Similarities and Differences

Changes in women's social role over the past years likely influenced the gender gap in substance use and substance—related disorders, with potentially significant prevention and treatment implications. The authors reviewed the literature about gender differences in prevalence estimates and course of substance—related disorders. Male—to—female ratios of prevalence estimates of substance use are narrowing in different countries. The initiation of substance use is progressively taking place at younger ages, the trend being more dramatic among women as compared to men. Women's accelerated progression to dependence (so—called “telescoping effect”) is a robust finding among alcohol—dependent individuals, although the effect seems to be weaker among younger individuals. As for other drugs, the literature is weaker and further research is needed. It is concluded that women's earlier age of initiation of substance use, faster progression to dependence and under—representation in addiction treatments should be addressed in future health care planning.

Anonymity and Confidentiality in School Surveys on Alcohol, Tobacco, and Cannabis Use

School surveys are currently the most important method of collecting data on alcohol and drug use among youth. Although methodological studies suggest that school surveys yield reliable and valid estimates of substance use among youth, it has been argued that results will be affected by the level of perceived anonymity. Longitudinal research designs raise an important question in this respect since follow-up makes complete anonymity impossible. In fact, responses to such surveys should be regarded as confidential rather than anonymous. This study compares the reported use of cigarettes, alcohol and cannabis between an anonymous, cross-sectional survey and a confidential, longitudinal survey. Both females and males in the confidential survey have a slightly higher rate of non-response for lifetime cannabis use. Furthermore, females tend to be slightly less likely to admit to any use of alcohol and cannabis in the confidential survey, and those who do admit to having used cigarettes and alcohol, report slightly fewer occasions. The correlations between use of cigarettes, alcohol, and cannabis are not affected by this bias. These results add further support to earlier research that has found school surveys to be a robust method of data collection, and suggests that the bias introduced by identification numbers in longitudinal research has limited practical significance.

Epidemiology of substance use in adolescence: prevalence, trends and policy implications

This paper reviews the epidemiology of substance use among adolescents. There is a public health imperative in all countries to assess the population rates of tobacco, alcohol and illicit drug use among adolescents. In addition, monitoring trends over time may reflect the net effects of activities and programs carried out to prevent adolescent substance use. School based surveys provide prevalence estimates of substance use, but do not capture street and homeless youth and other high risk adolescents not found in the school environment. Overall, the results of this review suggest that tobacco, hazardous alcohol use, and most categories of illicit drug use have shown consistent increases in prevalence since about 1990 in most developed countries, for school-based adolescents, suggesting that the substance use problem among adolescents remains unsolved. These trends are remarkably similar across substance use behaviours, and among most developed countries, although limited data has emanated from adolescents in the developing world. Interventions to reduce or prevent substance use have shown mixed results, with those focusing on the adolescents’ social environment showing the most promise. Broader public health approaches, including the linkage to community-wide prevention, and greater enforcement or regulatory and legislative approaches to tobacco and alcohol access are future directions for research and practice.