Hard Drug Use Research Articles

The Effect of Marijuana Legalization on the Trajectories of Hard Drug–Related Hospitalizations: A Growth Curve Analysis of the County-Level State Inpatient Database in Washington, 2009–2015

Two antithetical arguments have raised controversies over the effect of recreational marijuana legalization on hard drug use. The gateway perspective posits that marijuana use diffuses hard drug use; however, recent studies argue that marijuana legalization displaces hard drug use. This study examines these conflicting arguments by investigating temporal patterns of hard drug–related hospitalizations (HDHs) before and after marijuana legalization. Using county-level State Inpatient Database data from Washington State for the years 2009–2015, along with other federal data sources, this study assesses temporal changes in HDH using growth curve modeling. Initial findings show support for the displacement perspective, though controlling for other county-level factors (education and economic change) indicates that the legalization of recreational marijuana may be a gateway toward harder drugs. Considering the economic situation of the United States during the study period, this study concludes that marijuana legalization functioned as a gateway toward increased hard drug use.

For female offenders, how does increased intensity of discharge planning plus community-based case management impact drug and alcohol use after release?

Moderate‐certainty evidence shows that for female offenders, intensive discharge planning plus community‐based case management probably results in fewer arrests at 12 months (on average, 8 vs 42 per 1000 women) and fewer positive hair tests for marijuana (on average, 202 vs 269 per 1000 women) but has minimal or no effect on self‐reported marijuana use, hard drug use, positive hair tests for crack cocaine, drug charges at 12 months, or incarceration.

Gun access, ownership, gun-related experiences, and substance use in young adults: a latent class analysis

ABSTRACT Background Substance use is found to associate with gun violence. However, mixed findings have been reported for gun access/ownership. To date, studies have examined gun access/ownership and gun-related experiences (e.g., carrying) separately despite the fact that gun-related experiences often occur among gun owners. Objectives This study identifies groups of young adults based on their gun access/ownership and gun-related experiences (i.e., gun carrying, threatened someone with a gun, been threatened with a gun) and assesses whether these groups differ on their use of alcohol, cigarettes, e-cigarettes, marijuana, hard drugs, and nonmedical use of prescription medication. Methods This study uses cross-sectional data from Wave 8 of the study Dating it Safe. Participants were 663 young adults (Mean age = 22 years; 62% female). Latent class analysis (LCA) was performed. Results LCA identified three classes: (1) Minimal Gun Access/Experience (65.0%), (2) Gun Access without Experience (33.4%), (3) Gun Access with Experience (1.6%). Individuals in the Gun Access with Experience class reported more frequent few past month alcohol (17 days vs. 7 and 8 days, p < .001), episodic heavy drinking (13 days vs. 2 and 3 days, p < .001) and cigarette use (21 days vs. 10 and 10 days, p < .001) compared to these in the Minimal Gun Access/Experience and Gun Access without Experience classes, respectively. Conclusions Individuals who have access to/own guns with and without gun-related experiences face different risks of substance use. Findings highlight the need to examine gun access/ownership based on actual gun experiences and further emphasize the importance of addressing substance abuse for gun violence prevention.

Russian adolescent sexual behaviour and contraceptive knowledge

ABSTRACT Lack of sex education in schools has been an ongoing issue in Russia, mainly due to conservative opposition to providing accurate sexual health information openly. Many adolescents may be misinformed about contraceptive methods and may not have reliable access to effective contraception. This study assessed sexual behaviour and knowledge of contraceptives among Russian adolescents in the republic of Bashkortostan. Among a convenience sample of 716 Russian high school youth, 60% lacked information about modern contraceptive methods other than condoms. Being male, older, having had school disciplinary problems, and lifetime use of substances were associated with increased likelihood of having sexual intercourse in one’s lifetime. Of the sub-sample of participants who had engaged in sexual intercourse, 43.2% endorsed one or more items on an index of sexual risk taking (e.g. multiple partners, no condom use). Additionally, the use of hard drugs and being of other ethnicity relative to Russian (e.g., mixed, Bashkir, Tartar) was associated with risky sexual behaviour. Lack of knowledge of effective contraceptives and the high prevalence of risky sexual behaviours warrants further research into this topic, as well as a call for sexual education programmes in the country.

Cumulative Risk of Substance Use in Community College Students.

Substance use in community college students has been explored in only a handful of studies. Differences in population characteristics and substance use between 2- and 4-year students suggest that different factors may promote and thwart this behavior. Cumulative risk is a parsimonious methodology that provides better model stability and more statistical power, yet it has only been recently used in substance use research. The aim of this study is to investigate multiple aspects of substance use risk in a population in need of substance use prevention and intervention services. We conducted a cross-sectional study of community college students (N = 288; 75% female) examining the relative contributions of different domains of cumulative risk (eg, life stressors, academic stressors, and mental health diagnoses) to develop different profiles of risk across substance use classes (ie, alcohol, cigarette, marijuana, and hard drug use). Cumulative risk analyses indicated that alcohol and tobacco use were associated with the domains of life stressors and peer/family substance use, marijuana use with peer/family substance use and stressful childhood experiences, and hard drug use with peer/family substance use, lack of social support, low access to care, and stressful childhood experiences. Different strategies for prevention and intervention may be necessary to effectively address different forms of substance use in this population. The risk domain profiles related to specific drugs may lead to targeted interventions to reduce substance use in community college students. (Am J Addict 2020;29:97-104).

Assessment of Risky Lifestyle Behaviour Among Undergraduate Students of a Tertiary Institution in Delta State, South-South, Nigeria

Young persons are vulnerable to risky health behaviors which can predispose them to serious morbidities later in life. The objectives of this study were to identify risky lifestyle habits among college students and explore the relationship between unhealthy habits and self- reported academic performance. An adapted behavioral risk factor surveillance system (BRFSS) questionnaire was administered to 400 college students by systematic random sampling, Anonymously filled questionnaires were deposited at agreed safe locations after completion and retrieved thereafter. Data was analyzed using SPSS for windows version 21. Chi Square Test which was used to explore possible association between demographic variables and responses. Level of significance was set at 0.05. The median age of respondents was 22 years (range 17-30). Prevalence of prescription drug (codeine) abuse was 17.3% while use of tobacco, alcohol and hard drugs were 14%., 56.2% and 9.3% respectively. More than half of the students were sexually active with more males 79 (35%) reporting multiple sexual partners. More than half, 163 (68.5%) of those who had ever engaged in sexual intercourse claimed that they always or sometimes use some form of protection. More than three quarters ate breakfast regularly. More males 207 (91.6%) than females 339 (84.8%) claimed to eat fruits and vegetables regularly. Majority, 339 (84.8%) admitted eating nodules more than five times a week. The association between alcohol usage and self -reported academic performance was statistically significant but appears not to be negative. However, TV viewing for more than 2 hours a day was significantly associated with poor academic performance, Chi Square 22.940, df, 12, P=0.028. Conclusively, risky lifestyle habits among undergraduate students included smoking, alcohol usage, use of hard drugs and unprotected sexual intercourse. Poor habits that reduce sleep quality could negatively affect students’ academic performance.

Revisiting the Empirical Status of Social Learning Theory on Substance Use: A Systematic Review and Meta-Analysis

Background: Despite ample empirical research testing components of Akers’ Social Learning Theory (SLT) on substance use, no research to date has attempted to synthesize the empirical evidence. Objectives: The purpose of this article is to synthesize prior research that has examined the utility of SLT for predicting specific types of substance use, both legal and illegal. Methods: Using a systematic review and meta-analysis, the current study estimated the effect size results from 83 primary studies published between 1974 and 2018 that had empirically tested concepts of Akers’ SLT regarding substance use. In addition, moderator analyses examined variations in effect sizes across measurement constructs and among specific types of substance use. Results: Results indicated medium-sized weighted mean effect size estimates for SLT in relation to substance use. Regarding conceptualization of SLT, measures of Differential Association produced the strongest effect size estimates. Moderator analyses also revealed that mean effect size estimates were largest for soft drugs, for studies conducted in the context of the United States, and for adult samples. Conclusions: The authors conclude that SLT constructs may be better suited for explaining soft drug use than hard drug use. Given the relatively sparse primary research that has controlled for temporal ordering, collected data from multiple differential associates, or considered opportunity effects, caution in the interpretation of synthesis results is warranted.

A syndemic of psychosocial health problems is associated with increased HIV sexual risk among Nigerian gay, bisexual, and other men who have sex with men (GBMSM)

ABSTRACTNigerian gay, bisexual and other men who have sex with men (GBMSM) experience negative psychosocial health problems, which may increase their risk for HIV infection. Few studies have explored the syndemic effect of co-occurring psychosocial health problems on HIV sexual risk among Nigerian GBMSM. We investigated the co-occurrence of syndemic psychosocial health problems and their synergistic effect on HIV risk behaviors. We assessed depressive symptoms, post-traumatic stress disorder, alcohol dependence, tobacco use, and hard-drug use. The outcome variables were the number of male sexual partners and consistent condom use. In a multivariable model, experiencing 4 or more psychosocial health problems – compared to experience none or one psychosocial health problem – was significantly associated with increasing number of male sexual partners. We found no statistically significant association between the number of syndemic psychosocial health problems and consistent condom use. Our study findings provides evidence of a synergistic relationship between negative psychosocial health factors and HIV sexual risk behavior. These findings underscore the importance of developing HIV prevention programming aimed at reducing HIV transmission risk that incorporate substance use and mental health treatments, in order to improve the overall health and quality of life for Nigerian GBMSM.

Combining Alcohol with Benzodiazepines or Psychostimulants. Metaphoric Meanings and the Concept of Control in the Online Talk of Polydrug Use

ABSTRACTThe co-administration of different substances is a widespread practice in the context of hard drug use. Among others, alcohol combined with certain substances produces potentially dangerous interactions. This article explores how people who combine alcohol with benzodiazepines or psychostimulants perceive these practices and how they share their perceptions in Finnish and Swedish online discussions. This is carried out by analyzing discussants’ use of metaphoric expressions. We found that the metaphors given to the use of these substance combinations reflect their pharmacological characteristics. Through that, the metaphors and meanings were different depending on the substance alcohol was combined with. Moreover, we found that, in the realities the metaphors create, the control of use was differently conceptualized. The different aspects of control could be divided into three categories that, however, were not related to any specific substances but overarched all metaphors: 1) controlling pharmacological risks, 2) controlling social appearance and 3) ignoring control. As our findings bring out, often the actual health dangers and risks of the studied substance combinations were bypassed, and the control was rather understood either as a form of socially appropriate behavior or wholly ignored.

Risk and protective factors for heroin use in a nationally representative sample of Ecuadorian youth

IntroductionRecent reports from a variety of sources indicate that heroin use among Ecuadorian adolescents is on the rise. In order to design effective prevention and intervention programs, research is needed that quantifies use and assesses risk and protective factors associated with use. MethodsThis study analyzed the National Survey of Drug Use, a nationally representative survey of 50,145 adolescents (49.6% female; M age = 14.92 years, SD = 1.74) conducted in Ecuador in 2015. ResultsOverall, 2.3% of the sample reported lifetime heroin use. Logistic regression analysis revealed that higher lifetime heroin use was associated with lifetime use of alcohol (Adj OR = .71 CI[.58, .86]), marijuana (Adj OR = 3.79 CI[3.17, 4.52]), and hard drugs (Adj OR = 16.33 CI[13.89, 19.21]), as well as with greater perceived access to heroin (Adj OR = 2.13 CI[1.93, 2.36]) and repeating more school grades (Adj OR = 1.66 CI[1.37, 2.01]). Higher levels of parental involvement (Adj OR = .95 CI[.91, .99]) were associated with a reduced risk of use. Risk and protective factors operated similarly across age and gender. ConclusionThese data suggest that targeting substance use early in adolescence, focusing on school engagement, enhancing parenting skills, and improving family climate may be important approaches to curbing heroin use among Ecuadorian teens. The relative absence of age and gender differences in patterns of risk and protection suggest that a universal prevention approach versus a targeted approach may be most effective.

An Efficacy Trial of the Ho'ouna Pono Drug Prevention Curriculum: An Evaluation of a Culturally Grounded Substance Abuse Prevention Program in Rural Hawai'i.

This study reports on the drug use outcomes in an efficacy trial of a culturally grounded, school-based, substance abuse prevention curriculum in rural Hawai'i. The curriculum (Ho'ouna Pono) was developed through a series of pre-prevention and pilot/feasibility studies funded by the National Institute on Drug Abuse, and focuses on culturally relevant drug resistance skills training. The present study used a dynamic wait-listed control group design (Brown, Wyman, Guo, & Pena, 2006), in which cohorts of middle/intermediate public schools on Hawai'i Island were exposed to the curriculum at different time periods over a two-year time frame. Four-hundred and eighty six youth participated in the study. Approximately 90% of these youth were 11 or 12 years of age at the start of the trial. Growth curve modeling over six waves of data was conducted for alcohol, marijuana, cigarettes/e-cigarettes, crystal methamphetamine, and other hard drugs. The findings for alcohol use were contrary to the hypothesized effects of the intervention, but may have been a reflection of a lack equivalence among the cohorts in risk factors that were unaccounted for in the study. Despite this issue, the findings also indicated small, statistically significant changes in the intended direction for cigarette/e-cigarette and hard drug use. The present study compliments prior pilot research on the curriculum, and has implications for addressing Native Hawaiian and Pacific Islander health disparities.

Comparing the Impact of Bullying Victimization on Drug Use and Weapon Carrying among Male and Female Middle and High School Students: A Partial Test of General Strain Theory

ABSTRACT Prior research testing general strain theory (GST) suggests potential differences in how males and females respond to strain. Using a sample of 3,139 middle and high school students (1,515 males and 1,624 females), this study evaluates male and female delinquent coping behaviors to traditional bullying and cyberbullying victimization. Three delinquent coping behaviors are investigated: soft drug use, hard drug use, and weapon carrying. This study also examines the impact of bullying on anticipated strain and tests whether anticipated strain mediates the relationship between bullying and delinquency. Results from group-based structural equation models indicate sex differences in the effect of bullying on delinquent coping behavior. Specifically, bullying victimization has a significantly larger association with anticipated strain for males and cyberbullying victimization has a significantly larger association with drug use and weapon carrying for males. Anticipated strain partially mediates the relationship between bullying and delinquency. Policy implications and suggestions for future research are discussed.

Adolescent Homelessness and Associated Features: Prevalence and Risk Across Eight States.

This study utilizes data from the Youth Risk Behavior Survey to estimate the prevalence of adolescent homelessness and relations to five indicators of poor functioning among students attending public high school in eight states. About 3.27% of students experienced homelessness, and nearly 7% of teens who identified as lesbian, gay, or bisexual (LGB) experienced homelessness. Homelessness was related to higher rates of sexual/dating violence as well as having been bullied and feeling unsafe at school. Homelessness and LGB identification predicted higher rates of more-severe problems with alcohol, hard drug use, poor grades, suicidality, and risky sexual behavior, controlling for other factors. There was no interaction effect between homelessness and LGB status, suggesting that these risks are additive.

Nonmedical prescription drug use of analgesics and sedatives/hypnotics in Taiwan: Results from the 2014 National Survey of Substance Use

Nonmedical prescription drug use (NMPDU) has become a major public health issue but little is known in Asian populations. This study aimed to investigate the prevalence and correlates of NMPDU in Taiwan. Participants from the 2014 national survey of 17,837 individuals, aged 12 to 64 year, completed anonymously a computer-assisted self-interview. Past-year prescription drug use was divided into medical use only (MUO) and nonmedical use (NMU), defined as using the drug without a prescription, or more frequently, or in larger doses than prescribed. Problematic alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT), problematic drug use using the 20-item Drug Abuse Screening Test (DAST), and depressive symptoms using the Center for Epidemiological Study-Depression (CES-D). The prevalence of past-year NMU was 3.02% for analgesics, 0.71% for sedatives/hypnotics, and 3.66% for either drug, with a very small overlap of NMU between analgesics and sedatives/hypnotics (0.07%). When individuals with NMU were compared to those without NMU (Non-NMU) and those with MUO, respectively, some correlates consistently identified, including young adulthood, tobacco smoking, alcohol drinking, and greater AUDIT's scores for analgesics, as well as hard drug use and greater DAST's scores for sedatives/hypnotics. NMU was associated with greater CES-D's scores for both analgesics and sedatives/hypnotics when compared to Non-NMU but not to MUO. Robust correlates of NMPDU could offer implications for development of prevention strategies of NMPDU.

Substance use among individuals with mild intellectual disability or borderline intellectual functioning in residential care: Examining the relationship between drinking motives and substance use.

BackgroundThis study examined the relationship between substance use motives (i.e., social, conformity, coping and enhancement) and substance use in individuals with mild intellectual disability or borderline intellectual functioning (MID‐BIF).MethodData were collected among 163 clients with MID‐BIF using interactive questionnaires with visual cues on a tablet with a web application.ResultsResults show that social motives were positively related to frequency of alcohol use, while conformity, coping and enhancement motives were positively related to severity of alcohol use. Results for drug use show that social motives were positively related to frequency of cannabis and hard drug use and that conformity motives were negatively related to frequency of cannabis use. Coping motives were positively related to severity of drug use.ConclusionsInsight in substance use motives should be used when adapting interventions, as it could contribute to the prevention and reduction of substance use disorders in individuals with MID‐BIF.

Sex Differences in Risk for Substance Use Among High School Students in Myanmar

This study investigated sex differences in risk factors for alcohol and illicit drug use among high school students in Myanmar as part of a comprehensive substance abuse prevention approach. Participants ( N = 1,918; Mage= 15.35 years, SD = 1.07 years, range = 14–18 years; 44.3% male) were recruited from 10 high schools in Myitkyina Township, Kachin State, Myanmar. Study constructs were assessed with a version of the Communities That Care survey adapted for use in Myanmar. Structural equation modeling was used to determine the strongest risk factors for recreational and hard drug use. Multiple group analyses indicated that patterns of risk differed by sex. Poor family management practices and peer drug use were risk factors for all youth and all recreational drugs; depressed affect was an additional risk factor for glue/solvent use and misuse of over-the-counter medication. Additional risk factors were specific to sex and to particular substances. The model predicting hard drug use had no common risk factors across sex. Low perceived dangerousness of drugs elevated risk for female adolescents. Parental attitudes favoring drug use, peer drug use and peer antisocial behavior, and low school commitment elevated risk of hard drug use for male adolescents. These data suggest that as Myanmar develops substance abuse prevention strategies for youth, one of the subpriorities in the United Nations’ sustainable development goals, approaches that are tailored specifically to male and female adolescents in addition to universal approaches may be dual effective strategies in curbing drug use.

Headphones and other risk factors for hearing in young adults.

Background:Personal listening device (PLD) use with headphones is increasing in young adults and in most listening environments occur in background noise. Headphone choice can be important because certain headphones are more effective in limiting background noise than stock earbuds. Binge drinking, marijuana, and hard drug use have also been associated with high-volume PLD use. The purpose of this study was to explore the relationship between preferred headphone type, listening level, and other health risk behaviors.Methods:Two-hundred and twenty undergraduates were recruited and completed a PLD use and risk behavior survey. Survey data included self-reported alcohol and marijuana use. Bilateral otoscopy, tympanometry, and pure-tone threshold testing (0.25–8 kHz) were completed. Participants listened to one hour of music using preferred headphone type with a probe microphone in the ear canal to measure equivalent continuous sound level (LAeq).Results:Mean LAeq was similar for the three types of headphones used. Participants who reported higher amounts of drinks per month and smoking marijuana within the last month had significantly higher LAeq levels than those who reported lower amounts of drinks per month and not smoking marijuana in the last month. There was no significant interaction between headphone type and reported drinks per month or marijuana use.Conclusion:Young adults with normal hearing who have higher preferred listening levels also reported more alcohol and marijuana use, although headphone type was not associated with any of these variables.

Heterogeneous effects of adolescent violent victimization on problematic outcomes in early adulthood*

AbstractViolent victimization—particularly when it happens to young people—can inflict a wide array of negative consequences across the life course. Nevertheless, some victims are more likely to suffer these consequences than others, and we do not have a very good understanding of why that is. One promising avenue of research is to examine how individuals’ differential risks of being victimized affect the extent to which they experience negative outcomes. By using propensity score matching and data from the National Longitudinal Study of Adolescent to Adult Health (N = 8,323), in this study I estimate the heterogeneous effects of adolescent violent victimization on several problematic outcomes in early adulthood (violent and property offending, subsequent violent victimization, depressive symptoms, hard drug use, and low educational attainment). Individuals’ differential risks of adolescent violent victimization are estimated with a host of personal, social, and contextual factors, including prior experiences with crime and violence. The results show that the consequences of adolescent victimization in early adulthood are more pronounced for youth with the lowest risks of being victimized. These findings have important implications for theory, research, and practice, and they emphasize that the consequences of victimization cannot be understood separately from the sources of victimization.

Poly and Tricky Dick: The drug war origins of the term “polydrug use”

Polydrug use is presented as a particular drug-use phenomenon when the combination of substances is and always has been the practice. The origin of the term is found in the early years of the war on drugs under the Nixon administration in the US, when it was used to justify the intensification of repressive measures against drug users and to counter the growing accommodation and normalisation of cannabis. Only by presenting cannabis as the first step towards the use of harder drugs could the repression of this largely innocuous and widely used substance be justified. Drug users were presented as “polydrug users”, which offered an explanation of problematic use as rooted in the drug user, the addict, who would switch substances in accordance with availability and price. Having become established for political reasons, the term has become entrenched because it resonates and vividly describes social practice. Yet it does not add to understanding of social reality but occludes and confuses because it presents “polydrug” as a particular and peculiar pattern of consumption and not as the norm.

Longitudinal Heterogeneity in Handgun-Carrying Behavior Among Urban American Youth: Intervention Priorities at Different Life Stages

PurposeTo determine longitudinal patterns of handgun-carrying behavior among urban American youth and identify modifiable risk factors associated with distinct carrying patterns that should be targeted at different life stages. MethodsUsing panel data from the National Longitudinal Survey of Youth 1997, we estimated longitudinal trajectories of handgun carrying among urban Americans, who carried a handgun at least once between 1997 and 2011 (N = 1,574). Multinomial logistic regression analyses examined risk factors associated with handgun-carrying trajectory groups during late adolescence (ages 16–20), emerging adulthood (ages 20–24), and young established adulthood (ages 24–28). ResultsGroup-based trajectory analyses identified four groups: Declining (35.0%, N = 560), bell-shaped (35.5%; N = 561), late-initiating (19.6%; N = 303), and high-persistent (9.9%; N = 150). During late adolescence, lower risks of mental health problems, hard drug use, police arrest, and presence of a gang in the neighborhood or school differentiated the late-initiating group from the other higher risk groups. During emerging and young established adulthood, higher risks of alcohol use, police arrest, and presence of a gang in the neighborhood or school were associated with trajectory groups with higher likelihood of handgun carrying than the declining group. ConclusionsThere are more than one profile of adolescents and young adults who carry handguns. Preventive interventions should have distinct priorities that address different patterns of handgun-carrying behavior at different life stages.