Factors For Substance Use Research Articles

Characterizing the intersection of Co-occurring risk factors for illicit drug abuse and dependence in a U.S. nationally representative sample

Few studies have attempted to characterize how co-occurring risk factors for substance use disorders intersect. A recent study examined this question regarding cigarette smoking and demonstrated that co-occurring risk factors generally act independently. The present study examines whether that same pattern of independent intersection of risk factors extends to illicit drug abuse/dependence using a U.S. nationally representative sample (National Survey on Drug Use and Health, 2011–2013). Logistic regression and classification and regression tree (CART) modeling were used to examine risk of past-year drug abuse/dependence associated with a well-established set of risk factors for substance use (age, gender, race/ethnicity, education, poverty, smoking status, alcohol abuse/dependence, mental illness). Each of these risk factors was associated with significant increases in the odds of drug abuse/dependence in univariate logistic regressions. Each remained significant in a multivariate model examining all eight risk factors simultaneously. CART modeling of these 8 risk factors identified subpopulation risk profiles wherein drug abuse/dependence prevalence varied from <1% to >80% corresponding to differing combinations of risk factors present. Alcohol abuse/dependence and cigarette smoking had the strongest associations with drug abuse/dependence risk. These results demonstrate that co-occurring risk factors for illicit drug/abuse dependence generally intersect in the same independent manner as risk factors for cigarette smoking, underscoring further fundamental commonalities across these different types of substance use disorders. These results also underscore the fundamental importance of differences in the presence of co-occurring risk factors when considering the often strikingly different prevalence rates of illicit drug abuse/dependence in U.S. population subgroups.

Mapping risk factors for substance use: Introducing the YouthMap12

BackgroundIn adolescence, psychological problems and regular use of alcohol, cigarettes, cannabis and other drugs (AOD) tend to cluster together, strongly indicating that certain groups of young people are at elevated risk of developing a problematic use of AOD. ObjectiveThe aim of the present study was to develop an easy-to-implement screening instrument to identify subgroups of young people with different psychological problems at risk of problem use of AOD. Method3589 randomly selected young Danes between 15 and 25years of age, from a national survey (n=2702) and a municipality survey (n=887), answered a 12-item questionnaire (YouthMap12) with 6 items identifying externalizing problems (EP6) and 6 items identifying internalizing problems (IP6). Latent class analysis (LCA) was used to characterize groups at risk, and associations were estimated between EP6 and IP6 and regular use of AOD, and between latent class membership and regular use of AOD. ResultsLCA identified 6 classes with varying degrees of externalizing and internalizing problems: 70% of youth were in the low problem score class, and the remaining 30% were at various levels of risk. Regular use of cigarettes, cannabis and alcohol was strongly associated with classes characterized by externalizing problems, while over-the-counter and prescription medicine was strongly associated with classes characterized by internalizing problems. ConclusionsYouth at risk of problem use of AOD can be identified using a simple and easily administered instrument.

Risky substance use and peer pressure in Swiss young men: Test of moderation effects

BackgroundPeer pressure (PP) toward misconduct is a well-known risk factor for substance use. However, the way it interacts with social factors and the associations of the aspects of PP other than PP toward misconduct have been understudied. This study examined the associations of three aspects of PP with risky substance use and tested whether the associations of PP toward misconduct were moderated by social factors. MethodA representative sample of 5,680 young Swiss males completed a questionnaire assessing risky alcohol, cigarette, and cannabis use, PP toward misconduct, toward peer involvement, and toward peer conformity, as well as social support (SS) and neighbourhood cohesion. Multinomial logistic regression models were used. ResultsPP toward misconduct was positively associated with all substance use outcomes. The PP toward misconduct–risky alcohol use association was stronger in individuals reporting high than in those reporting low levels of PP toward peer involvement, SS, and neighbourhood cohesion. The PP toward misconduct–risky cannabis use association was stronger in individuals reporting high than in those reporting low levels of SS and neighbourhood cohesion. The PP toward misconduct–smoking association was stronger in individuals reporting high than in those reporting low levels of PP toward peer involvement. ConclusionsThe risk for substance use associated with PP toward misconduct varies as a function of social factors. Being well connected with others (high level of PP toward peer involvement and SS), and living in a cohesive neighbourhood may amplify the risk for risky substance use associated with PP toward misconduct.

The role of substance use motives in the associations between minority stressors and substance use problems among young men who have sex with men.

Young men who have sex with men (YMSM) report higher rates of substance use than their heterosexual peers and minority stress has been posited as a risk factor for substance use. The associations between specific types of minority stress and substance use have been inconsistent throughout the literature and few studies have examined mechanisms underlying these associations. Drawing on minority stress theory and the motivational model of alcohol use, we propose that one mechanism underlying these associations may be people's motivations for using substances, including using substances to cope with negative emotions and to enhance pleasure. The goals of the current study were: (1) to examine the associations among minority stressors, substance use motives, and substance use problems; and (2) to examine substance use motives as mediators of the associations between minority stressors and substance use problems. Baseline self-report data were used from a cohort of 370 YMSM enrolled in a larger study of substance use and sexual behavior. Results indicated that using marijuana to cope mediated the association between victimization and marijuana use problems. Using other drugs to cope mediated the associations between victimization and drug use problems and between internalized stigma and drug use problems. Drinking to cope and to enhance pleasure mediated the association between internalized stigma and alcohol use problems. In sum, substance use motives, especially using substances to cope, act as mechanisms through which certain types of minority stress influence substance use problems among YMSM.

Risk Factors for Substance Use Among Street Children Entering Treatment in India.

Background:Although empirical studies have reported on substance use in children in India, multivariable statistical models examining risk factors in children seeking treatment for substance use are largely lacking. The goal of this study was to test a conceptual model predicting age of first use, duration of use of any psychoactive substance, and primary substance of choice from child and family characteristics in a sample of children entering substance use treatment.Methods:This was a single-sample cross-sectional study of 159 children entering a treatment and rehabilitation center in Delhi that provides substance use treatment and teaches children the skills to allow for their re-integration into society. De-identified data were extracted from clinical case records. Summary statistics were used to describe the sample characteristics. Regression analyses were used to examine the proposed conceptual model.Results:Child's age, schooling, and age at first crime were unrelated to age at first use of a psychoactive substance, duration of use of such substances, or choice of primary substance. However, parental and family factors served as risk factors for predicting one or more of these three outcomes.Conclusions:Findings suggest that child psychoactive substance use may have a multidimensional set of possible family and parental origins, and that child factors such as age, education, and age at first crime may play a lesser or insignificant role in a child's psychoactive substance use.

Substance use capital: Social resources enhancing youth substance use

BackgroundSocial capital is described as a protective factor against youth substance use, but it may also be associated with behaviours that do not enhance health. The present study hypothesized that ‘substance use capital’, i.e. resources favourable to substance use, is a risk factor for substance use and misuse. MethodsWe used baseline data from the ongoing Cohort Study on Substance Use Risk Factors (C-SURF) that included a representative sample of young Swiss men (n=5623). Substance use (alcohol, cannabis, 15 illicit drugs, lifetime use, hazardous use and dependence), substance use capital (parental and peer attitudes towards substance use, parental and peer drug use, perceived norms of substance use) and aspects of social capital (relationships with parents and peers) were assessed. Logistic regressions were used to examine the associations between substance-related resources and social resources, and substance use. ResultsResults showed that substance-related resources were associated with an increased risk of substance use (OR between 1.25 and 4.67), whereas social resources’ associations with substance use were commonly protective but weaker than substance-related resources. Thus, a drug-friendly environment facilitated substance use and misuse. Moreover, the results showed that peer environments were more drug-friendly than familial environments. ConclusionIn conclusion, this study highlighted a concept of ‘substance use capital’, which may be useful for advancing both theoretical and applied knowledge of substance use. Indeed, substance use is not only associated with a lack of social resources, but also with specific drug-friendly social resources coming from environment and background.

Prevalence and risk factors for substance use among refugees, internally displaced people and asylum seekers: findings from a global systematic review

Prevalence and risk factors for substance use among refugees, internally displaced people and asylum seekers: findings from a global systematic review

Cigarette, alcohol, and marijuana use among adolescents in foster family homes

Data from a cross-sectional study conducted in a random sample of children who were placed in foster family homes were used to examine the prevalence and associated factors of substance use (i.e., cigarette, alcohol, and marijuana), and to explore if adolescents in foster family homes had different rates of substance use than those in the general population matched on age, gender and race/ethnicity. Logistic regression models were used to determine factors associated with substance use and McNemar tests were used to compare prevalence rates of substance use. Substance use was common among adolescents in foster family homes. A higher number of placement settings were significantly associated with current cigarette use (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.09–1.60), and being placed in special study homes (i.e., fictive kin) was significantly associated with current marijuana use (OR, 6.43; 95% CI, 1.40–29.52). Compared to adolescents in the general population, those in foster family homes had lower rates of current alcohol (9.1% vs. 38.3%, p<0.0001) and marijuana (13.6% vs. 29.7%, p=0.005) use. No significant difference was observed for current cigarette use (18.2% vs. 11.5%, p=0.08). More research is needed to confirm the lower rate of current substance use in foster family homes than those matched in the general population, and to explore why adolescents in special study homes were more vulnerable to marijuana use.

Homelessness and Addiction: Causes, Consequences and Interventions

Homeless individuals suffer from poverty, disaffiliation, personal vulnerability and often poor health. The main concerns from a public health point of view are poor health and barriers to health care. Reviews have identified substance use disorders as a priority among these disorders. Substance use disorders are under-treated and can constitute a barrier to treatment. The current review summarizes recent findings and up-to-date evidence on substance use disorders in this marginalized population. Focusing on treatment-relevant factors, the review will summarize the current evidence for substance use as a risk factor for homelessness, and on homelessness as a risk factor for substance use. The review will further focus on the impact of these findings have on interventions and the current best practices to treat homeless individuals with substance use disorders. Motivation to initiate and retention are major issues in addiction treatment and are they are even more of an issue for the treatment of homeless individuals. Similarly, the level of comorbidities in homelessness seems to be higher than in the general population increasing the need for an interdisciplinary approach. Research focused on this marginalized and stigmatized population, while still limited, has produced a number of findings which are helpful to developed more efficient interventions.

Substance Abuse, Relapse, and Treatment Program Evaluation in Malaysia: Perspective of Rehab Patients and Staff Using the Mixed Method Approach.

This study examined reasons for substance abuse and evaluated the effectiveness of substance treatment programs in Malaysia through interviews with rehab patients and staff. Substance rehab patients (aged 18–69 years; n = 30) and staff (ages 30–72 years; n = 10) participated in semi-structured interviews covering a range of topics, including family and peer relationships, substance use and treatment history, factors for substance use and relapse, motivation for entering treatment, work experience, job satisfaction, treatment evaluation, and patient satisfaction. Most patients did not demonstrate the substance progression trend and had normal family relationships. Most patients reported having peers from normal family backgrounds as well. Various environmental and personal factors was cited as contributing to substance abuse and relapse. There was no significant difference between patient and staff program evaluation scores although the mean score for patients was lower. A holistic treatment approach with a combination of cognitive–behavioral, medical, social, and spiritual components was favored by patients. Suggestions for improving existing programs include better tailoring treatment to individual needs, and providing more post-treatment group support.

Tobacco and alcohol use in adolescents with unplanned pregnancies: relation with family structure, tobacco and alcohol use at home and by friends.

Recent publications show that smoking and alcohol use among adolescents with unplanned pregnancy is increasing and the causes need to be further studied. To determine the association between living in a non-intact family household and the presence of smokers and consumers of alcoholic beverages in the adolescents' environment with smoking and consuming alcoholic beverages in adolescents with unplanned pregnancies. A cross-sectional study was carried out among 785 pregnant adolescents, aged 13-19 years. Data was collected by trained interviewers using a self-administered questionnaire. The association was determined using multivariate logistic regression analysis. In adolescents with unplanned pregnancies, the prevalence of active smoking was 21.2% and of alcohol consumption, 41.5%. The percentage of smoking at home was 57.4% and alcohol consumption, 77.5%. Approximately, 80.3% of adolescents with unplanned pregnancies had friends who smoked and 90.6% consumed alcoholic beverages. Multivariate logistic regression analysis shows that having friends who smoke or who consume alcoholic beverages is the most important risk factor for substance use in adolescents with unplanned pregnancies. Smoking and alcohol consumption at home are not associated with smoking in adolescents with unplanned pregnancies. Socializing with friends who smoke and/or consume alcoholic beverages constitutes the most important risk factor for substance use among adolescents with unplanned pregnancies.

Multi-Level Risk and Protective Factors for Substance Use Among Zambian Street Youth

ABSTRACTBackground: High rates of substance use have been reported among youth in Zambia. This is particularly concerning given that substance use is one of the biggest risk factors placing young people at risk for HIV infection. Objectives: The purpose of the current study is to examine how multi-level risk and protective factors (i.e., community, family, peers, individual) influence alcohol and marijuana use. Methods: A total of 250 street youth in Lusaka, Zambia were interviewed in the summer of 2014 about their alcohol and marijuana use and reasons for usage. Data were analyzed using descriptive and multivariate methods. Results: Youth reported high rates of alcohol use. At the multivariate level, peer and individual level variables (e.g., using alcohol or drugs for coping or for fun) explained the most variance, followed by family level factors. Community level variables explained the least variance in all models. Conclusion/Importance: A better understanding of multi-level risk and protective factors for young people's alcohol and marijuana use could lead to the development of better intervention strategies to reduce this behavior among Zambian street youth.

Relación entre conducta prosocial, resolución de problemas y consumo de drogas en adolescentes

&lt;p&gt;The objectives of the present study are the following ones: 1) to study the use of drugs, the prosocial behaviour and the problem-solving skills with respect to age and gender, and 2) to analyze the association of both the prosocial behaviour and the problem-solving skills with the use of drugs. An exploratory cross-sectional study was performed, amongst a sample of 567 students in Spanish Compulsory Secondary Education (48.14% males) with an age range from 14 to 17 years (&lt;em&gt;M &lt;/em&gt;= 14.92; &lt;em&gt;SD &lt;/em&gt;= 0.90). Statistically significant differences were found concerning alcohol use and the prosocial behaviour with respect to gender, as well as concerning alcohol and cannabis use with respect to age. Logistic regression analyses revealed statistical significance of the prosocial behaviour with respect to the use of alcohol and cannabis. The ability in problem-solving was the most important protective predictor with respect to the abuse of cannabis. The results from this study enhance the importance of tailored interventions based on the promotion of prosocial behaviours and/or problem-solving strategies as fundamental protective factors for substance use amongst adolescents.&lt;/p&gt;

Parents, Peers, Perceived Risk of Harm, and the Neighborhood: Contextualizing Key Influences on Adolescent Substance Use.

Recent research has affirmed the need to examine contextual influences on adolescent substance use in a multilevel framework. This study examined the role of neighborhood opportunities for substance use in promoting adolescent substance use. Data came from two components of the Project on Human Development in Chicago Neighborhoods: the Longitudinal Cohort Study, consisting of interviews with youth and their primary caregivers across three waves of data with an average span of 4.5years; and a Community Survey of neighborhood residents. Analysis used an Item-Response Theory-based statistical approach on 6556 substance use item responses from 1639 youth (49.0% female) within 80 neighborhoods to assess the extent to which neighborhood opportunities for substance use had direct and indirect effects on adolescent substance use. Neither direct nor mediated effects of neighborhood opportunities for substance use on adolescent substance use were detected. But, analyses revealed moderating effects such that higher levels of neighborhood opportunities for substance use: (1) amplified the detrimental effects of parental substance use and peer substance use on youth substance use; and (2) attenuated the protective effect of adolescents' perceived harm of substance use on adolescent substance use. The results suggest that the ways in which neighborhood characteristics impact adolescent behavior are nuanced. Rather than impact individual-level outcomes directly, neighborhood context may be particularly relevant by conditioning the effects of salient individual-level risk and protective factors for substance use.

Estilos educativos y uso de alcohol en adolescentes: un estudio longitudinal

Los estilos educativos han sido identificados como uno de los factores de riesgo y protección más importantes para el uso de sustancias en adolescentes. La evidencia sugiere que la influencia de cada estilo en el uso de sustancias varía entre países. Los estudios con población española se han basado en diseños transversales, limitando la interpretación de la direccionalidad en la relación entre los estilos educativos y el uso de sustancias en adolescentes. Este estudio longitudinal explora la validez predictiva de los estilos educativos percibidos en el uso posterior de sustancias y problemas relacionados con el alcohol. Los participantes fueron 346 adolescentes (53.64% varones) que fueron evaluados dos veces en un período de dos años. En la primera ola, los participantes tenían 12.89 años (DT = 0.54). Se realizaron análisis de regresión logística para estimar la relación entre los estilos educativos percibidos en la ola uno y las variables relacionadas con sustancias en la ola dos. Los adolescentes que percibían a sus padres como negligentes tenían un mayor riesgo de desarrollar trastorno por uso de sustancias dos años después: odds ratio (OR) = 2.14; 95% intervalo de confianza (IC): 1.18-3.86] (p = .012). Este estudio indica que se debería dar especial atención a aquellos adolescentes que perciben el estilo educativo de sus padres como negligente.

Risk and protective factors for adolescent substance use: a comparative study of secondary school students in rural and urban areas of Osun State, Nigeria.

Substance use is a leading adolescent health problem globally, but little is known regarding associated factors for adolescent substance use in Nigeria. This study compared the prevalence of substance use among in-school adolescents in urban and rural areas of Osun State, Nigeria, and identified risk and protective factors. This cross-sectional study involved 600 randomly selected adolescents (aged 10-19 years) from rural and urban areas of Osun State, Nigeria. Data were collected using the facilitated self-completed questionnaire method. Binary logistic regression was used to examine the association of individual, peer, and parental factors with adolescent substance use. Adjusted odds ratio (OR) and 95% confidence interval (CI) were obtained. About two-thirds of respondents had used substances in both rural (65.7%) and urban areas (66.0%) (p=0.93). Logistic analysis showed private school attendance as a risk factor for substance use (OR=2.32, 95% CI=1.20-4.46) and adolescent disapproval of adult substance use as a protective factor (OR=0.47, 95% CI=0.27-0.82) in rural areas. For urban areas, having friends who use substances (OR=4.04, 95% CI=1.39-11.6) and a mother having had tertiary education (OR=3.34, 95% CI=1.06-10.4) were risk factors while parental disapproval of substance use (OR=0.50, 95% CI=0.28-0.90) was a protective factor. Lifetime prevalence of substances is high among in-school adolescents in Osun State. The risk and protective factors for adolescent substance use somewhat differ for rural and urban areas, and these have implications for designing effective intervention strategies.

Population trends in smoking, alcohol use and primary prevention variables among adolescents in Iceland, 1997-2014.

To estimate linear time-trends in substance use and primary prevention variables in adolescents in Iceland from 1997 to 2014. Repeated, cross-sectional population-based school surveys with seven waves of pooled data. Iceland. All accessible students enrolled in the 9th and 10th grades in the national Icelandic school system during the spring of 1997, 2000, 2003, 2006, 2009, 2012 and 2014 (n=50412, boys=50%). Response rates ranged between 81 and 90% of the population. Measures on substance use included smoking and alcohol use. Primary prevention measures included parental monitoring, parental social involvement, participation in organized sports and reduced participation in a party life-style. Substance use decreased consistently during the study period. For example, 30-day drunkenness declined from 29.6 in 1997 to 3.6% in 2014 (linear trend: χ(2) (1) =2846.8, P<0.001), and daily smoking during the last 30days declined from 17.0 to 1.6% during the same period (linear trend: χ(2) (1) =1614.3, P<0.001). Primary prevention factors strengthened over time. For example, the mean score for parents knowing where their children are in the evenings rose from 2.44 in 1997 to 3.08 in 2014 (Ftrend(1, 42635) , 2538.3, P<0.001), and mean scores for participation in party life-style declined from 2.23 in 1997 to 1.71 in 2014 (Ftrend(1, 38773) , 2033.1, P<.001). Substance use among adolescents in Iceland has declined steadily from 1997 to 2014, while primary prevention factors for substance use have increased in strength during the same time-period.

Prevalence and correlates of substance use in Black, White, and biracial Black-White adolescents: Evidence for a biracial intermediate phenomena.

Most substance-use prevention interventions are based on the implicit assumption that risk and protective factors for substance use are the same for biracial and monoracial youth. However, preliminary research suggests this assumption may be untrue. This study compared the prevalence and correlates of substance use among Black, White, and biracial Black-White youth. Data were derived from the National Longitudinal Study of Adolescent and Adult Health, which is a longitudinal investigation using stratified random sampling to study health behaviors. After controlling for sociodemographic factors and using weighted Poisson and logistic regression, the authors found the substance-use prevalence rates of Black-White youth to be intermediate to the higher rates of Whites and lower rates of Blacks. In addition, Black-White youth's scores on most covariates were intermediate to those of the monoracial groups. Family factors were more important in explaining higher substance use than other contextual factors. School factors seem to be important in explaining lower substance use for Black-White youth. Correlates of substance use for Black-White youth were not identical to those of either Black or White youth. More research on the observed intermediate phenomena among biracial youth vis-à-vis prevalence, correlates, and causes of substance use is needed. (PsycINFO Database Record

Exploring the Positive Impact of Peers on Adolescent Substance Misuse

ABSTRACTBackground: Previous research has consistently shown the negative impact that peers can have on adolescent substance use patterns. Few studies have examined the positive influence adolescents can have on their peers. This study aimed to examine the relationship of positive peer influence with indices of substance use and also to compare abstinent adolescents and substance-using adolescents on positive peer influence. Method: One hundred fifty-four adolescents (age range 12–20 years) completed a questionnaire on positive peer influence and other correlates of adolescent substance use including mental health, family functioning, and social support. Results: Positive peer influence was a significant predictor of lower substance use behaviors in adolescents, with positive influence from close friends being the strongest predictor. Substance-using adolescents' scores were significantly different from abstinent adolescents' scores for positive peer support, mental health functioning, impulsivity, and social support. Conclusions: These results indicate that positive influence from adolescents' peers may act as a protective factor in substance use. This influence should be utilized to aid the design of prevention and intervention initiatives in adolescent substance use.

Adolescent Substance Use Following a Deadly U.S. Tornado Outbreak: A Population-Based Study of 2,000 Families

Despite conceptual links between disaster exposure and substance use, few studies have examined prevalence and risk factors for adolescent substance use and abuse in large, population-based samples affected by a recent natural disaster. We addressed this gap using a novel address-based sampling methodology to interview adolescents and parents who were affected by the 4th deadliest tornado outbreak in U.S. history. Postdisaster interviews were conducted with 2,000 adolescent–parent dyads living within a 5-mile radius of the spring 2011 U.S. tornadoes. In addition to descriptive analyses to estimate prevalence, hierarchical linear and logistic regression analyses were used to examine a range of protective and risk factors for substance use and abuse. Approximately 3% reported substance abuse since the tornado. Greater number of prior traumatic events and older age emerged as consistent risk factors across tobacco and alcohol use and substance abuse since the tornado. Tornado incident characteristics, namely, greater loss of services and resources after the tornado and posttraumatic stress disorder since the tornado, were associated with greater alcohol consumption. Service loss increased risk for binge drinking, whereas, for substance abuse, posttraumatic stress disorder increased risk and parent presence during the tornado decreased risk. Greater family tornado exposure was associated with a greater number of cigarettes smoked in female but not male teen participants. Both trauma and non-trauma-related factors are relevant to postdisaster substance abuse among adolescents. Future research should examine the role of broader ecological systems in heightening or curtailing substance use risk for adolescents following disaster exposure.