Frequent Substance Use Research Articles

SUBSTANCE USE AND EDUCATIONAL ATTAINMENT

SUBSTANCE USE AND EDUCATIONAL ATTAINMENT

Psychosocial and Spiritual Factors Associated With Smoking and Substance Use During Pregnancy in African American and White Low-Income Women

To determine the associations between sociodemographic, psychosocial, and spiritual factors to health risk behaviors during pregnancy in African American and White low-income women. Descriptive, using prenatal interviews and medical record review as data sources. An urban prenatal clinic in the Midwestern United States. One hundred thirty ethnically diverse low-income women. Smoking and substance use in pregnancy. For the total sample, 39% reported smoking and 28% reported substance use in pregnancy. Significant predictors of smoking were White race, less than high school education, abuse, and religiosity. Abuse and depressive symptoms predicted substance use. African American women were significantly less likely to report smoking in pregnancy (28%) than were White women (55%) (p < .05). African American women who smoked during pregnancy were significantly more likely to report lower levels of education (p < .01), less social support from others (p < .01) and total social support (p < .01), higher levels of stress (p < .05), and more frequent substance use (56.5%) than African American women who did not smoke (12%) (p < .001). White women who used substances were significantly more likely to report smoking (p < .01), abuse (p < .05), and a history of delivering a preterm or low-birthweight infant (p < .01) than the White women who did not. Integrating social support and stress-relieving activities in smoking cessation interventions, particularly for African American women, may reduce health risk behaviors, eliminate health disparities, and improve maternal and infant quality of life.

Comparative Description of Migrant Farmworkers versus Other Students Attending Rural South Texas Schools: Substance Use, Work, and Injuries

Little is known about substance use, work characteristics, and injuries of youth from migrant farmworker families. Some evidence suggests that migrant youth may be at greater risk for substance use and work-related injuries than nonmigrant youth. The aim of this study is to compare substance use, employment, and injury data from migrant and nonmigrant youth residing in rural South Texas. Anonymous cross-sectional survey data were collected from 7,302 middle and 3,565 high school students during a regular class. Classification as a migrant student occurred if the student responded positively to: "Does your family move around the state or nation to pick fruits or vegetables for work?" About 5% of South Texas middle and high school students reported belonging to a migrant family. Compared to nonmigrant students, migrant youth were more likely to report frequent substance use. Youth belonging to migrant families were less likely to work for pay on weekends but more likely to work for pay on weekday mornings before school. These youth were also more likely to have ever been injured while working than nonmigrant students. These results demonstrate a need for additional interventions in this most vulnerable rural population. Specifically, targeted educational programs to enhance the occupational safety and health of migrant youth, further research into effective substance abuse treatment and prevention programs in rural areas, and enhancement of child labor laws are recommended.

The association between childhood and adolescent sexual abuse and proxies for sexual risk behavior: A random sample of the general population of Sweden

Objective Several studies with small and “high risk” samples have demonstrated that a history of childhood or adolescent sexual abuse (CASA) is associated with sexual risk behaviors (SRBs). However, few studies with large random samples from the general population have specifically examined the relationship between CASA and SRBs with a comprehensive set of measures. Design The study was a cross-sectional retrospective survey of past and current sexual health and behavior. Methods A random sample of 4781 persons from the Swedish Post Address Register was obtained, which included 6,119,000 Swedish citizens in 1996. Of those persons, 2810 participants agreed to participate in the study. Participants were interviewed as well as administered a questionnaire regarding their sexual health and behavior. Results Using Mann-Whitney U tests, a history of CASA was found to be associated with younger age at first intercourse; younger age at diagnosis of first sexually transmitted infection (STI); greater frequency of unintended pregnancy; greater likelihood of participation in group sex; higher likelihood of not interrupting sexual intercourse despite the risk of pregnancy or risk of an STI; greater likelihood of exchanging sex for money or other necessities/drugs; more frequent substance use in the last 48 hours; and higher likelihood of adult sexual and physical assault. Conclusions The findings of this study confirm previous research, which has reported an association between CASA and SRBs in smaller and high-risk samples. Clinicians working with adults with a history of CASA should be aware of the relationship between CASA and SRBs and be prepared to address such issues during therapy.

Contrast Effects in Perceived Risk of Substance Use

Adolescent perceptions of the risks associated with the use of licit and illicit substances have important implications for policy and research. However, the methodological properties of the most popular risk measures in school surveys in Europe and the United States are not well understood. This study examines the potential contrast effects of risk measures of “heavy” and frequent substance use on perceived risks of occasional, moderate, and “experimental” use. Responses to 11 measures of the perceived risk of occasional smoking, moderate drinking, and experimental use of illicit substances were compared between two question forms administered to a split-half sample of all Icelandic ninth (14–15 years of age) and tenth (15–16 years of age) grade students present in class on the day of administration in March 2003 (N = 7099). In one form, only these 11 questions were used, while the other form also contained 13 questions on the perceived risk of heavy smoking, heavy drinking, and regular use of illicit substances. The longer form is found to decrease response rates and suppress estimates of perceived risk of experimental illicit substance use. Question form and perceived risks of heavy and regular use generally do not affect the multivariate effects of perceived risks of occasional, moderate, and experimental substance use on lifetime abstinence from each substance. It is argued that measures of perceived risks of heavy and regular substance use are less useful for prevention policy and research than are corresponding measures of occasional, moderate, and experimental substance use, and including the former in the same instrument may adversely affect the measurement of the latter constructs.

Mental Health Status of Infrequent Adolescent Substance Users

ABSTRACT Frequent substance use has a strong association with poor mental health. The relationship between infrequent substance use and mental health is less clear. The present study investigated this relationship in a large group (n = 2118) of 12–19-year-olds from Alberta, Canada. Results indicated that adolescents who used tobacco or alcohol once a month or less tended to have equivalent mental health status to abstainers. Using cannabis 3–5 times/year or less had no adverse mental health associations. However, poorer mental health was associated with single time use of hallucinogens or other drugs. In general, substance usage tended to have more negative mental health associations for younger compared to older adolescents.

Teasing Apart the Developmental Associations Between Alcohol and Marijuana Use and Violence

This study explored the longitudinal associations of alcohol and marijuana use and violence over ages 11-20 in the youngest sample of males from the Pittsburgh Youth Study ( N= 503). We examined trends in alcohol and marijuana use and violence, howthey covaried both concurrently and over time, and whether frequent substance use predicted violence and vice versa in multivariate models controlling for common risk factors. The analyses focused on frequent alcohol or marijuana users, those who scored in the highest 25% of frequency. Throughout adolescence, substance use was more prevalent than violence. Most substance users did not engage in violence, and the proportion of substance users who engaged in violence was smaller than the proportion of violent offenders who were also substance users. Concurrently, frequent use of alcohol and marijuana were both significantly associated with violence. Longitudinal associations between frequent drinking and violence were weak, whereas longitudinal associations between frequent marijuana use and violence were more consistent. However, the relationship between frequent marijuana use and violence (and vice versa) was spurious; itwas no longer significant when common risk factors such as race/ethnicity and hard drug use were controlled for. We conclude that the marijuana-violence relationship is due to selection effects whereby these behaviors tend to co-occur in certain individuals, not because one behavior causes the other; rather, both are influenced by shared risk factors and/or an underlying tendency toward deviance.

Correlates of stages of change for substance abuse among psychiatric outpatients.

Brief algorithms are used to determine stage of change; however, psychometric support in substance users other than smokers is minimal. The authors examined the reliability and validity of a self-report algorithm in a sample of 84 persons with both psychiatric and substance use disorders. A 1-week retest resulted in 75% of persons being reassigned to the same stage. Compared with precontemplators, participants in the preparation stage reported higher problem recognition, steps taken toward change, cons of using, and benefits of quitting. The pros of using did not differ across stages. The action stage was marked by less frequent substance use and lower perceived costs of quitting. These results support the reliability and validity of staging algorithms in patients with comorbid disorders.

One-Year Follow-Up of Dual Diagnosis Patients Attending a 4-Month Integrated Inpatient Treatment

The purpose of this study was to assess a 4-month inpatient treatment program based on integrated models for patients with substance use and psychiatric disorders (dual diagnosis patients). On admission and at the 1-year follow-up, a consecutive sample of 118 dual diagnosis patients who entered the program were assessed by interview. Eighty-four patients (70.6%) completed the 1-year follow-up interview, reporting less frequent substance use, less severe psychiatric symptoms, a lower rehospitalization rate, and better housing conditions than on admission. Patients diagnosed with a comorbid personality disorder had a better improvement in the frequency of drinking and were less likely to be rehospitalized than patients with schizophrenia or depression. The results suggest that the integrated inpatient program may be a promising treatment approach for dual diagnosis patients. The results await replication in controlled studies that need to include an assessment of outpatient treatment following inpatient programs.

Sexually transmitted diseases in a health maintenance organization teen clinic: associations of race, partner's age, and marijuana use.

To determine the role of sociodemographic risk markers and behavioral risk factors associated with sexually transmitted diseases (STDs) in sexually experienced youth seeking care at an urban, general health maintenance organization teen clinic. Cross-sectional. A consecutive, racially and ethnically diverse sample of 285 sexually experienced youth who were preponderantly female (58.6%) and who were aged 16.7 years on average. All participants completed a self-report questionnaire and were screened for Chlamydia trachomatis using the ligase chain reaction technique and for Neisseria gonorrhoeae and other STDs using conventional methods. Many of these youth were at high risk for STDs, having a self-reported history of sex with multiple partners (49.1%), sex with a new partner (42.5%), inconsistent use of condoms (71.9%), and frequent substance use (24.5% used marijuana 1-2 times per week or more). Sexually transmitted disease screening revealed that 11.6% of the participants had 1 or more STDs. A logistic regression analysis to determine the best model for predicting STDs indicated that youth who are African American (odds ratio, 3.34; 95% confidence interval, 1.52-7.35), had sexual partners who were 2 or more years older (odds ratio, 2.63, 95% confidence interval, 1.22-5.67), and used marijuana 1 to 2 times or more per week (odds ratio, 2.27; 95% confidence interval, 1.01-5.13) were more likely to have STDs at screening. A brief sociodemographic and behavioral risk assessment that includes these factors may be useful for clinicians in deciding when to screen for STDs in sexually active youth seeking care for reasons not related to reproductive health.

Predicting initiation to and cessation of buprenorphine and temazepam use amongst adolescents.

Two interviews separated by 12 months (mean) were conducted with a purposive sample of Glaswegian adolescent drug misusers. Across that interval, beginning to use buprenorphine and temazepam were predictable by prior extent of other substance use, especially cannabis and tobacco, and by the Drug Misuse Scale, using selected MMPI items. About 50% of those who had been using either drug prior to first interview did not use at all between first and second interview. For temazepam, this cessation was not predictable, but ceasing to use buprenorphine was more likely the less time subjects had used this drug and if they had never injected. It is concluded that personality and frequent substance use predispose to drug misuse, but that additional factors must lead to dependence.