Incidence Of Substance Abuse Research Articles

Poster 219: Incidence of Drug Abuse Over a 3-year Period in a Medicaid Population

PM&RVolume 1, Issue 9S p. S198-S199 Poster Presentation Poster 219: Incidence of Drug Abuse Over a 3-year Period in a Medicaid Population Rachelle Valenzuela BS, Rachelle Valenzuela BS LAGS Spine & Sportscare, Santa Maria, CASearch for more papers by this authorFrancis P. Lagattuta MD, Francis P. Lagattuta MD LAGS Spine & Sportscare, Santa Maria, CASearch for more papers by this authorRichard Martin MD, Richard Martin MD LAGS Spine & Sportscare, Santa Maria, CASearch for more papers by this author Rachelle Valenzuela BS, Rachelle Valenzuela BS LAGS Spine & Sportscare, Santa Maria, CASearch for more papers by this authorFrancis P. Lagattuta MD, Francis P. Lagattuta MD LAGS Spine & Sportscare, Santa Maria, CASearch for more papers by this authorRichard Martin MD, Richard Martin MD LAGS Spine & Sportscare, Santa Maria, CASearch for more papers by this author First published: 25 September 2009 https://doi.org/10.1016/j.pmrj.2009.08.240Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume1, Issue9SSeptember 2009Pages S198-S199 RelatedInformation

Psychosocial Risk Factors as Contributors to Pregnancy-Associated Death in Virginia, 1999–2001

To determine if substance abuse, mental illness, and domestic violence contributed to preventable pregnancy-associated death and to describe characteristics of women for whom these factors contributed to death. The medical records of 121 women who had pregnancy-associated deaths in Virginia between 1999 and 2001 were reviewed. The incidence of substance abuse, mental illness, and domestic violence was noted during systematic review. Multidisciplinary review of cases was conducted to determine if these factors contributed to death and if reasonable changes may have prevented death. The pregnancy-associated maternal mortality ratio for women experiencing substance abuse, mental illness, or domestic violence as contributors to death was 17.1. Thus, for every 100,000 live births in Virginia, 17.1 women had at least one of these factors directly contribute to death. Substance abuse contributed to death in 28.9% of all cases reviewed (pregnancy-associated maternal mortality ratio = 12.2); 45.7% of those deaths were considered preventable. Mental illness contributed to death in 16.5% of cases (pregnancy-associated maternal mortality ratio = 6.9), with 50.0% considered preventable. Domestic violence contributed to death in 14.0% of cases (pregnancy-associated maternal mortality ratio = 5.9), with 64.7% of cases considered preventable. Median household incomes and years of education completed varied widely. Pregnancy-associated maternal mortality ratios for each factor were higher among African American women than among white women. Psychosocial risk assessment with appropriate referral should be completed for all women seeking care regardless of social status, education, or race.

Multisystemic Therapy for Social, Emotional, and Behavioral Problems in Youth Aged 10–17

The aim of this Campbell Systematic Review was to evaluate the effect of multi‐systemic therapy (MST) on adolescents with social, emotional, and behavioural problems based on the best available evidence. The effect is measured by a range of behavioural and psychosocial outcomes, including the number of institutional placements and arrests, the incidence of drug abuse, and personal relationships, social skills, absence from school, etc.The review is exclusively based on randomised controlled trials in which random allocation between MST and usual treatment has taken place. 266 reports were selected on the basis of title and abstract. Of these 35 were found actually to be effect studies. And finally, eight of the 35 effect studies met the pre‐set quality criteria laid down in the original Campbell/Cochrane review.The Campbell/Cochrane review concludes that MST does not have consistently better effects than other types of interventions ‐ for example, restrictive institutional placement. On the other hand, nothing indicates that MST has any negative overall effects. All in all, MST does not seem to be any better or any poorer than other treatments. The Campbell/Cochrane review concludes that there are no consistent differences in outcome between the adolescents subject to MST and those subject to alternative treatment. This conclusion is based on the best available evidence on the effectiveness of MST.SynopsisResults of eight randomised controlled trials of Multisystemic Therapy (MST) conducted in the USA, Canada, and Norway indicate that it is premature to draw conclusions about the effectiveness of MST compared with other services. Results are inconsistent across studies that vary in quality and context. There is no information about the effects of MST compared with no treatment. There is no evidence that MST has harmful effects.AbstractBackgroundMultisystemic Therapy (MST) is an intensive, home‐based intervention for families of youth with social, emotional, and behavioral problems. Masters‐level therapists engage family members in identifying and changing individual, family, and environmental factors thought to contribute to problem behavior. Intervention may include efforts to improve communication, parenting skills, peer relations, school performance, and social networks. Most MST trials were conducted by program developers in the USA; results of one independent trial are available and others are in progress.ObjectivesTo provide unbiased estimates of the impacts of MST on restrictive out‐of‐home living arrangements, crime and delinquency, and other behavioral and psychosocial outcomes for youth and families.Search strategyElectronic searches were made of bibliographic databases (including the Cochrane Library, C2‐SPECTR, PsycINFO, Science Direct and Sociological Abstracts) as well as government and professional websites, from 1985 to January 2003. Reference lists of articles were examined, and experts were contacted.Selection criteriaStudies where youth (age 10–17) with social, emotional, and/or behavioral problems were randomised to licensed MST programs or other conditions (usual services or alternative treatments).Data collection & analysisTwo reviewers independently reviewed 266 titles and abstracts; 95 full‐text reports were retrieved, and 35 unique studies were identified. Two reviewers independently read all study reports for inclusion. Eight studies were eligible for inclusion. Two reviewers independently assessed study quality and extracted data from these studies.Significant heterogeneity among studies was identified (assessed using Chi‐square and I2), hence random effects models were used to pool data across studies. Odds ratios were used in analyses of dichotomous outcomes; standardised mean differences were used with continuous outcomes. Adjustments were made for small sample sizes (using Hedges g). Pooled estimates were weighted with inverse variance methods, and 95% confidence intervals were used.Main resultsThe most rigorous (intent‐to‐treat) analysis found no significant differences between MST and usual services in restrictive out‐of‐home placements and arrests or convictions. Pooled results that include studies with data of varying quality tend to favor MST, but these relative effects are not significantly different from zero. The study sample size is small and effects are not consistent across studies; hence, it is not clear whether MST has clinically significant advantages over other services.Reviewers' conclusionsThere is inconclusive evidence of the effectiveness of MST compared with other interventions for youth. There is no evidence that MST has harmful effects.

The profile of substance-using pregnant mothers and their newborns at a regional rural hospital in New South Wales.

We conducted an audit study of identified substance-using mothers and their neonates at Lismore Base Hospital in the Northern Rivers region of New South Wales between January 1995 and December 1999. Women using marijuana and/or alcohol only were excluded. The average number of total births during the study period was 1,363 per year. Forty-nine mothers were identified as substance users with an incidence of seven per 1,000 total births. Twenty-three (47%) were methadone users, 14 (29%) methadone and intravenous heroin users, 11 (22%) heroin users, and one (2%) used amphetamines. Twenty-seven (55%) had irregular antenatal visits. Forty-one (89%) were hepatitis C positive. Forty-seven neonates were live-born and there were two stillbirths. Thirty-seven (79%) required admission to the special care nursery, 40% of them for withdrawal alone. Twenty-seven (55%) babies had neonatal withdrawal and 23 (49%) required medication for withdrawal. The incidence of substance abuse among the pregnant women in this region is ten times higher than the previously quoted figures in metropolitan areas of Australia.

Health status and resources of rural homeless women and children. Iowa Homeless Research Team.

The purpose of this research is to describe the health status and health resources for homeless women and children in a Midwestern rural community. A group of 31 rural homeless women in a shelter participated in the study by answering questions on the Rural Homeless Interview developed by the investigators. The findings revealed higher than expected rates of illness, accidents, and adverse life events, with the incidence of substance abuse and mental illness being comparable to data from other homeless populations. The data on children were limited by lack of knowledge on the part of their mothers. Some mothers reported that their children were in foster care, had been adopted, or were being cared for by others. The inability to access health and dental care was reported by half of the participants.

Return to work for individuals with TBI and a history of substance abuse

The highest incidence of TBI is among young adult males who also have the highest incidence of substance abuse [1]. Since these individuals have long life expectancies, it is important that they are productive post injury; however, the employment rate is extremely low. This is understandable, given the fact that a person with either a TBI or substance abuse disorder would have difficulties with work. Naturally, the combination of the two compounds the problem and further complicates matters. This article provides an overview of how a Supported Employment approach can be used to assist persons with a TBI and substance abuse problems with returning to work.

Substance abuse and sexual trauma in a female veteran population.

An increasing number of researchers have explored connections between substance abuse, posttraumatic stress disorder (PTSD), and sexual assault histories in civilian women. Despite literature suggesting the prevalence of substance abuse and sexual assault for female veterans, few studies have investigated these variables in a female veteran population. Thus, this paper was designed to provide preliminary information about this group of women. The results of this preliminary study suggest a high incidence of PTSD related to sexual trauma in a substance-abusing population of female veterans and a high incidence of substance abuse among female veterans who presented requesting help for sexual trauma. Suggestions for future study include examination of comparison samples of female veterans with and without PTSD and substance abuse across a variety of dimensions, including psychiatric symptoms, substance use, treatment utilization, and impact of treatment. Implications for assessment are highlighted.

Pre-injury substance abuse among persons with brain injury and persons with spinal cord injury

Alcohol and drug use at the time of injury have been strongly implicated as causal factors of spinal cord injury (SCI) and traumatic brain injury (TBI). Researchers have only begun their efforts to investigate the pre-injury incidence of substance abuse in an effort to identify persons at risk for traumatic injury. No studies have compared brain and spinal cord injury populations. This investigation was based in an urban, level one trauma center federally designated as a model system of comprehensive rehabilitative services for persons with TBI and persons with SCI. Pre-injury patterns of alcohol and illicit drug use were compared among patients with SCI and patients with TBI, matched for age, gender, race, and mechanism of injury (n=52). In accordance with previous research, participants were primarily young, unmarried, males with at least a high school education. Eighty-one percent of patients with TBI and 96% of patients with SCI reported pre-injury alcohol use. The rate of pre-injury heavy drinking for both groups was alarmingly high. Fifty-seven percent of persons with SCI and 42% of persons with TBI were heavy drinkers. Implications for risk identification, treatment, and future research are discussed.

How to spot illicit drug abuse in your patients

PREVIEWAlthough the incidence of drug abuse may be stabilizing in some areas of the United States, many of your patients may present with telltale signs of a drug-induced condition. What are the clinical clues that suggest use of various types of drugs? How can you differentiate between drug-induced conditions and psychiatric illness? The authors of this article answer these questions and review the clinical pharmacology of the most common classes of illicit drugs. They also provide a handy list of contemporary street names and adverse effects of the five main types of drugs of abuse.

The Relationship Between the Use of Prescription Medication and Substance Abuse in College Students with Disabilities

The purpose of this study was to determine whether college students with disabilities who regularly take prescription medications were at risk of developing problems with substance abuse. Three hundred and twelve college students with disabilities volunteered to participate in the study. The participants completed the Substance Abuse Subtle Screening Inventory (SASSI), a demographic profile, and returned both to the investigator. A Chi square test of dependence was used to determine if a significant difference in the incidence of substance abuse existed between students who took prescription medications and those who did not. Results showed that college students with disabilities who regularly took prescription medications were more likely to be identified as substance abusers than those who did not regularly take prescription drugs.

Substance Abuse and Dependency in Gay Men and Lesbians

Research on the incidence, etiology and treatment needs of gay men and lesbians who abuse alcohol and drugs is limited. Recent studies challenge earlier beliefs that the incidence of substance abuse is higher among gay men and lesbians than in the general population. However, a substantial number of this population drink problematically. This article reviews the literature on the etiology of substance abuse among gay men lesbians, and details important assessment and treatment issues unique to this population. The strengths and limited of gay-specific treatment programs are discussed. Recommendations are made about how social workers can respond more appropriately to their gay and lesbian clients.

Developing Methods for Preventing and Detecting Substance Abuse in the Operating Room: A Disease Approach

Substance abuse is an occupational hazard for health care workers in the operating room setting. Anesthesiologists have a higher rate of substance abuse than their physician counterparts. Anesthesia residents have the highest incidence of substance abuse among anesthesia providers. By creating a disease model for substance abuse, pharmacists may be better able to understand, detect, and prevent substance abuse in the operating room area. The development of comprehensive methods for dispensing and monitoring controlled substance use in the operating room should include systems that limit exposure, provide accountability and consistency, and provide education for the medical staff.

Substance abuse and panic-related anxiety: A critical review

The relationship between substance abuse and panic-related anxiety can be divided into two broad areas: the incidence of anxiety disorders in substance abuse patients and the incidence of substance abuse in patients with panic-related anxiety disorders. Studies indicate that approx. 10–40% of alcoholics have a panic-related anxiety disorder, and about 10–20% of anxiety disorder patients abuse alcohol or other drugs. The majority of patients with both an anxiety and alcohol disorder report that anxiety problems preceded alcohol problems. In some cases substance abuse (e.g. cocaine) triggers the onset of panic attacks. Most patients believe that self-medication is efficacious despite the fact that they appear to have a more serious clinical condition (e.g. higher rates of depression). Directions for future research are outlined, including the proposal for a study to examine the effects of an anxiety intervention procedure for anxious alcoholics to reduce relapse rates.

AIDS and chemical dependency: special issues and treatment barriers for gay and bisexual men.

Because gay and bisexual men continue to be the largest at-risk group for human immunodeficiency virus (HIV) related conditions, the special role of substance abuse, and not just intravenous drug abuse, must be understood in order to provide adequate services and prevention. Gay men and women appear to have a higher incidence of substance abuse than the general population. Genetic, biochemical, societal, and cultural factors may all contribute to this increase, especially the overwhelming impact of societal homophobia. To address the treatment barriers to gay and bisexual men seeking or needing treatment for HIV-related conditions, chemical dependence or both, the gay community should be seen like any other minority community. The social and cultural norms of this widely varied community should be studied: the socialization of being gay in mainstream society, including the awareness of being different; the coming-out process; and dealing with internalized homophobia need to be understood. In addition, the resistance or anxiety health care providers may feel in working with gay or bisexual men or with HIV-related conditions should be addressed.

Newborn Infants With Drug Withdrawal Symptoms

The overall incidence of substance abuse is stable for all drugs except cocaine which is steadily increasing in popularity in all aspects of the population. Signs of neonatal abstinence are seen to varying degrees in infants exposed to any of the drugs of abuse. Polydrug use by pregnant women is the most common form of substance abuse, and this complicates the evaluation of the newborn infant. Infants exposed in utero to cocaine are markedly tremulous and irritable and have an increased rate of prematurity. All infants delivered to substance-abusing mothers should be considered at increased risk for sudden infant death syndrome and evaluated accordingly.

Newborn Infants With Drug Withdrawal Symptoms

The overall incidence of substance abuse is stable for all drugs except cocaine which is steadily increasing in popularity in all aspects of the population. Signs of neonatal abstinence are seen to varying degrees in infants exposed to any of the drugs of abuse. Polydrug use by pregnant women is the most common form of substance abuse, and this complicates the evaluation of the newborn infant. Infants exposed in utero to cocaine are markedly tremulous and irritable and have an increased rate of prematurity. All infants delivered to substance-abusing mothers should be considered at increased risk for sudden infant death syndrome and evaluated accordingly.

AIDS, HTLV-III diseases, minorities and intravenous drug abuse.

Minorities and women who are engaging in activities which place them at high risk for infection with HTLV-III are developing HTLV-III related illnesses including AIDS. In Northeastern urban areas the relatively large number of minorities who use intravenous drugs are responsible for producing large numbers of patients with AIDS (PWAs). Eighty percent of heterosexual male and female PWAs are Black or Hispanic. The development and implementation of effective prevention and education programs for these individuals rests upon an understanding of the less traditional approaches which may be necessary to reach these groups. The general public must be made aware of the hazards of HTLV-III related diseases and that the risk of infection is restricted to very well defined high risk groups. Minorities must be made to understand that they are at increased risk for HTLV-III related diseases only because of the high incidence of drug abuse in their community.

An educational-therapeutic group for drug and alcohol abusing combat veterans

Vietnam veterans have had a high incidence of substance abuse, resulting from attempts to control posttraumatic symptoms. Their recovery from drug and alcohol dependency has meant involvement in treatment for resolution of posttraumatic symptoms. The author found that the addition of a short-term educational-therapeutic group experience, focusing on the symptoms of posttraumatic stress disorder, was helpful for the participants. They “worked-through” important war-related experiences via the following phases: (1) Breaking through detachment and establishing control over disruptive symptoms, (2) Revealing experiences of death and dehumanization (3) Describing the internal “death of self” experience, and (4) Beginning the grief response.

Drug Addiction and Criminality: A Model for Predicting the Incidence of Crime among a Treatment Population

Although is has been posited that there is a causal relationship between drug abuse and crime, the determinative parameters of this phenomenon have not been adequately explored. Previous studies have failed to yield consistent results explaining the effects of drug abuse and subsequent treatment upon criminal behavior in terms of the direction and magnitude of the assumed relationship. Based on widely accepted methods for predicting the incidence of drug abuse among a treatment population (Hunt, 1976; Nakkash, 1977), the present study utilized this incidence technique to: (1) predict the expected incidence of crime among a drug abusing treatment population; (2) determine the impact of treatment upon the identified criminal activities; and (3) develop a probability model for determining the expected level of both drug abuse and crime subsequent to the treatment experience. The methodology modified the Incidence Model to include the variables of year of first criminal involvement, and number of crime-free and drug-free days before, during, and after treatment. The data used for this study was taken from two related sources: (1) the 1977 Client Oriented Data Acquisition Process (CODAP); and (2) the results from an Incidence, Prevalence and Cost-benefit Study conducted by Richard Katon Associates.

Female substance abusers: need for research.

A brief note describes the incidence of substance abuse by females as reported by state and national agencies and an additional description of the limited research available. The data reported by these agencies indicate a staggering number of women are involved in substance use and abuse. Despite the large number of women using and abusing substances, an inspection of the Research Issues Update, 1978 indicates that only 11% of the studies investigated behavior of females. Such results indicate a need for additional research.