Influence Drug Use Research Articles

The life-course of methamphetamine users in Aotearoa/New Zealand: School, friendship and work

As part of the first qualitative-based research on the life-course of methamphetamine users in Aotearoa/New Zealand, this paper analyses the life domains of school, friendship and work. Through application of interactional theory, this paper increases understanding of the situational contexts and interpersonal factors that influence drug use trajectories and the transition from one life domain to another by identifying the patterns within each domain and the influence school, friendship and work exerts on drug use and, conversely, how drug use impacts on school, friendship and work. The analysis discovered 20 commonly shared adverse experiences that hindered educational and employment success and contributed to drug use, including: negative school transitions, significant turning point events, weak commitment to school, poor school attitude and performance, low academic achievement, low school and work ambition, low parental expectations, and high levels of mental health issues, delinquency, delinquent peer involvement, bullying victimisation, work victimisation, unstable careers and illegal economic activities. Specifically, it was common for interviewees to ‘track backwards’ in high school. This study highlights the importance of the educational domain for altering drug use trajectories, especially high school.

How urban and rural built environments influence the health attitudes and behaviors of people who use drugs.

Research suggests that the built environment is associated with drug use. However, there is limited scholarship focusing on specific features of the built environment that influence drug use behaviors, experiences, and patterns and how risk factors for drug use are placed in distinctive urban and rural settings. Applying Neely and Samura's conceptual theory that describes space as contested, fluid and historical, interactional and relational, and defined by inequality and difference, we assessed data from semi-structured qualitative interviews conducted between 2019 and 2020 with consumers at syringe exchange programs (SEPs) in an urban location (New York City) and a rural location (southern Illinois). We aimed to contextualize how drug use manifests in each space. In total, 65 individuals, including 59 people who use drugs (PWUD) and six professionals who worked with PWUD, were interviewed. Findings illustrate that, in both the urban and rural setting, the built environment regulates the drug use milieu by mediating social reproduction, namely the degree of agency PWUD exert to acquire and use drugs where they desire. Processes of "stigma zoning," defined as socio-spatial policing of boundaries of behavior deemed undesirable or deviant, impacted PWUD's socio-geographic mobility, social conditions, and resource access, and modulated PWUD's broader capacity and self-efficacy. Similar patterns of drug use, according to social and economic inequities chiefly related to housing instability, were further observed in both settings.

Analysis of associations between emotions and activities of drug users and their addiction recovery tendencies from social media posts using structural equation modeling

BackgroundAddiction to drugs and alcohol constitutes one of the significant factors underlying the decline in life expectancy in the US. Several context-specific reasons influence drug use and recovery. In particular emotional distress, physical pain, relationships, and self-development efforts are known to be some of the factors associated with addiction recovery. Unfortunately, many of these factors are not directly observable and quantifying, and assessing their impact can be difficult. Based on social media posts of users engaged in substance use and recovery on the forum Reddit, we employed two psycholinguistic tools, Linguistic Inquiry and Word Count and Empath and activities of substance users on various Reddit sub-forums to analyze behavior underlining addiction recovery and relapse. We then employed a statistical analysis technique called structural equation modeling to assess the effects of these latent factors on recovery and relapse.ResultsWe found that both emotional distress and physical pain significantly influence addiction recovery behavior. Self-development activities and social relationships of the substance users were also found to enable recovery. Furthermore, within the context of self-development activities, those that were related to influencing the mental and physical well-being of substance users were found to be positively associated with addiction recovery. We also determined that lack of social activities and physical exercise can enable a relapse. Moreover, geography, especially life in rural areas, appears to have a greater correlation with addiction relapse.ConclusionsThe paper describes how observable variables can be extracted from social media and then be used to model important latent constructs that impact addiction recovery and relapse. We also report factors that impact self-induced addiction recovery and relapse. To the best of our knowledge, this paper represents the first use of structural equation modeling of social media data with the goal of analyzing factors influencing addiction recovery.

Better Together? Intimate Partner Effects on Offending Women

The role of marriage has been extensively studied for its positive impacts on male desistance. However, the role of romantic partners for women is less understood. Do partners exert a prosocial “protective” effect or are they criminogenic? The present study empirically drills down on this question. Specifically, we assess the character and quality of romantic relationships on substance use and illegitimate income using a sample of incarcerated women. Drawing from social control, social learning, and strain theory, we hypothesize that the effects of both being in and breaking up from a relationship on illicit behavior are conditional on the quality of the relationship and behavior/characteristics of the partner. Using data from the Women’s Experience of Violence (WEV) project, consisting of a custodial sample of criminal justice-involved women (N = 770), we examine how relationship status and quality, as well as partner offending, influence drug use and illicit earnings. A series of multi-level random effects models are estimated to explore how within-person changes in relationship/breakup status are related to changes in the two dependent variables. Contrary to expectations, we find that romantic dissolution (of either a high- or low-quality relationship) does not negatively impact this sample of women and that being in a high-quality relationship is not a protective factor, as has been found often in male samples. Findings suggest partner behavior may be more important than the quality of the relationship with the partner. Our results link drug use and participation in the illicit economy to factors mostly outside of a woman’s relationship status and quality, thereby challenging some commonly understood mechanisms of desistance.

DOMINANT FACTORS CAUSES OF DRUG ABUSE IN ADOLESCENTS AT THE LAMONGAN DISTRICT PENITENTIARY

Introduction: The use of illegal drugs is increasing in adolescents and the consequences that will damage the generation so that it must be sought or known influencing factors as preliminary data in determining intervention. According to a preliminary survey at the Lamongan District Penitentiary in 2011, the number of suspects and defendants of drug abuse was 115 people, of whom 63 were teenagers. This study aims to determine the dominant factors that influence drug use in adolescents. Methods: The research design used in this study study uses a descriptive method, namely describing or explaining the factors that cause drug abuse in adolescents. The population in this study were all adolescent drug users in the Lamongan District Correctional Institution in May 2012 as many as 63 people. In this study the sampling technique used was purposive sampling, namely the technique of determining the sample by selecting samples among the population according to what the researcher wanted. In this study the instrument used was a closed questionnaire sheet. Data processing and data analysis by editing, coding, scoring, tabulating and analyzed purposively. Results: Based on the study, several factors were found to be the causes of drug users in adolescents at the Lamongan Penitentiary, including: Social environment (23%), personality (20%), family (8%), education (21%), and presence Drug (19%). Conclusion: Social environmental factors are the dominant factor causing drug abuse in adolescents at the Lamongan Penitentiary.

Narcotization as a Social Problem and the Factor of Destruction of Youth Society (on the Results of Annual Monitoring of Drug Situation in the Krasnoyarsk Region)

The article considers the problem of drug addiction and the drug situation in the youth environment by the example of the Krasnoyarsk Territory as a typical Siberian territorial subject of the Russian Federation. The authors draw attention to the harmful influence of drug use on the health of the nation, on its most active part – young people, on impairment of work productivity of the population, criminalization of the society as a result of the illegal distribution of narcotic drugs and psychotropic substances. The importance of annual monitoring of the drug situation in order to timely identify emerging changes in drug addiction in the society and to develop effective measures to improve the drug situation is also shown.

Study of Factors Influencing Drug Use Among Commercial Drivers in Suburban Public Transport

AbstractBackground and aims: This study was conducted to determine the economic, social, and culturalfactors influencing the consumption of drugs by drivers of public vehicles in 2013.Materials and Methods: The capture-recapture method was employed to determine drug use, its type,and the time of consumption among drivers of public transport. At the capture stage, 384 of the sampleswere surveyed and then (15 days later) at the recapture stage, 1176 drivers were randomly selected.All drivers who crossed the boundaries of Hormozgan, Khuzestan, Khorasan Razavi, West and EastAzarbaijan, Sistan and Baluchestan, and Gilan during the defined time were randomly selected. Thesample size was 196 drivers for each boundary based on the traffic volume of each boundary and typeof vehicle.Results: The mean age of the addicted and non-addicted subjects was 41.65 ± 3.41 years and39.63 ± 2.11 years, respectively, with a significant difference (P = 0.01). There were significantdifferences between addicted and non-addicted subjects with respect to some of the socioeconomicvariables such as monthly income (P = 0.001), owning home (P = 0.001), owning car (P = 0.001),ethnicity (P = 0.016), and education (P = 0.01). There were significant differences in the economic andcultural factors affecting addictive drug use between non-addicted and addicted subjects (P = 0.001).Conclusion: A significant difference in economic and cultural factors, ethnicity, and levels of educationwas observed between non-addicted and addicted subjects.

Neurofunctional Differences Related to Methamphetamine and Sexual Cues in Men With Shorter and Longer Term Abstinence Methamphetamine Dependence

BackgroundStimulant use and sexual behaviors have been linked in behavioral and epidemiological studies. Although methamphetamine-related neurofunctional differences have been investigated, few studies have examined neural responses to drug and sexual cues with respect to shorter or longer term methamphetamine abstinence in individuals with methamphetamine dependence.MethodsForty-nine men with shorter term methamphetamine abstinence, 50 men with longer term methamphetamine abstinence, and 47 non–drug-using healthy comparison men completed a functional magnetic resonance imaging cue-reactivity task consisting of methamphetamine, sexual, and neutral visual cues.ResultsRegion-of-interest analyses revealed greater methamphetamine cue–related activation in shorter term methamphetamine abstinence and longer term methamphetamine abstinence individuals relative to healthy comparison men in the ventromedial prefrontal cortex. A significant interaction of group and condition in the anterior insula was found. Relative to healthy comparison participants, both shorter term methamphetamine abstinence and longer term methamphetamine abstinence groups displayed greater sexual cue–related anterior insula activation relative to methamphetamine cues and neutral cues, but there were no differences between shorter term methamphetamine abstinence and longer term methamphetamine abstinence groups in anterior insula responses. Subsequent whole-brain analyses indicated a group-by-condition interaction with longer term methamphetamine abstinence participants showing greater sexual-related activation in the left superior frontal cortex relative to healthy comparison men. Shorter term methamphetamine abstinence participants showed greater superior frontal cortex activation to sexual relative to neutral cues, and longer term methamphetamine abstinence participants showed greater superior frontal cortex activation to sexual relative to neutral and methamphetamine cues.ConclusionsThe findings suggest that abstinence from methamphetamine may alter how individuals respond to drug and sexual cues and thus may influence drug use and sexual behaviors. Given the use of methamphetamine for sexual purposes and responses to natural vs drug rewards for addiction recovery, the findings may have particular clinical relevance.

Patterns of social determinants of health associated with drug use among women living with HIV in Canada: a latent class analysis.

Identifying typologies of social determinants of health (SDoH) vulnerability influencing drug use practices among women living with HIV (WLWH) can help to address associated harms. This research aimed to explore the association of SDoH clusters with drug use among WLWH. Latent class analysis (LCA) was used to identify the distinct clusters of SDoH. Inverse probability weighting (IPW) was employed to account for confounding and potential selection bias. Associations were analyzed using generalized linear model with log link and Poisson distribution, and then weighted risk ratio (RR) and 95% confidence intervals (CI) were reported. Data from 1422 WLWH recruited at time-point 1 of the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS, 2013-15), with 1252 participants at 18months follow-up (time-point 2). Drug use was defined as use of illicit/non-prescribed opioids/stimulants in the past 6months. SDoH indicators included: race discrimination, gender discrimination, HIV stigma, social support, access to care, food security, income level, employment status, education, housing status and histories of recent sex work and incarceration. LCA identified four SDoH classes: no/least SDoH adversities (6.6%), discrimination/stigma (17.7%), economic hardship (30.8%) and most SDoH adversities (45.0%). Drug use was reported by 17.5% and 17.2% at time-points 1 and 2, respectively. WLWH with no/least SDoH adversities were less likely to report drug use than those in economic hardship class (weighted RR=0.13; 95% CIs=0.03, 0.63), discrimination/stigma class (weighted RR=0.15; 95% CIs=0.03, 0.78), and most SDoH adversities class (weighted RR=0.13; 95% CIs=0.03, 0.58). Social determinants of health vulnerabilities are associated with greater likelihood of drug use, underscoring the significance of addressing interlinked social determinants and drug use through the course of HIV care and treatment.

Impact of interactions between drugs and laboratory test results on diagnostic test interpretation - a systematic review.

Intake of drugs may influence the interpretation of laboratory test results. Knowledge and correct interpretation of possible drug-laboratory test interactions (DLTIs) is important for physicians, pharmacists and laboratory specialists. Laboratory results may be affected by analytical or physiological effects of medication. Failure to take into account the possible unintended influence of drug use on a laboratory test result may lead to incorrect diagnosis, incorrect treatment and unnecessary follow-up. The aim of this review is to give an overview of the literature investigating the clinical impact and use of DLTI decision support systems on laboratory test interpretation. Particular interactions were reported in a large number of articles, but they were fragmentarily described and some papers even reported contradictory findings. To provide an overview of information that clinicians and laboratory staff need to interpret test results, DLTI databases have been made by several groups. In a literature search, only four relevant studies have been found on DLTI decision support applications for laboratory test interpretation in clinical practice. These studies show a potential benefit of automated DLTI messages to physicians for the correct interpretation of laboratory test results. Physicians reported 30-100% usefulness of DLTI messages. In one study 74% of physicians sometimes even refrained from further additional examination. The benefit of decision support increases when a refined set of clinical rules is determined in cooperation with health care professionals. The prevalence of DLTIs is high in a broad range of combinations of laboratory tests and drugs and these frequently remain unrecognized.

Patrones de consumo de drogas en las cárceles en el Perú

El presente estudio tuvo como objetivo determinar los patrones de consumo de drogas en sujetos recluidos en un establecimiento penitenciario de Lima. Es un estudio transversal descriptivo y la muestra estuvo conformada por 330 internos varones, de los cuales se pudo validar la información de 279 internos. La edad entre los internos vario desde los 18 a más de 65 años, siendo la edad de mayor prevalencia (31,2%) entre 31 a 40 años, el interno con menor edad tiene 18 años y el de mayor edad fue de 75 años. Se utilizó un cuestionario de opciones múltiples, adaptados para la presente investigación, la cual está dividida en cinco áreas: a) nivel educativo, b) estado civil, c) situación jurídica, d) delito y e) consumo de drogas. Asimismo se utilizó el cuestionario de uso de Drogas (DAST-20), cuya confiabilidad varía entre un 0,92 a 0,94. También se utilizó el cuestionario de Identificación de Trastornos por consumo de alcohol (AUDIT), cuyo nivel de confiabilidad se situaba por encima de 0,90. Entre las conclusiones más importantes destacan que las drogas de mayor prevalencia entre de las personas recluidas son el alcohol, tabaco, marihuana, clorhidrato de cocaína y pasta básica de cocaína, siendo estas mismas las de mayor consumo en los últimos 30 días. La edad, el grado de instrucción y el delito influyen significativamente en el consumo de drogas al interior del centro penitenciario.

The impact of drug policy liberalisation on willingness to seek help for problem drug use: A comparison of 20 countries

BackgroundWhile the impact of changing drug policies on rates of drug use has been investigated, research into how help-seeking behaviour changes as drug policies become more public-health focused is limited. This paper investigates reported changes in confidence to utilise drug services following hypothetical changes in national drug policy among a sample of individuals who report recent illicit drug use. We predict that liberalising national drug policy will increase the propensity for people who take illegal drugs to utilise health services. MethodsThe data were drawn from a sample of self-reported responses to the 2014 Global Drug Survey. Respondents were asked if they would be more confident seeking help if each of the following policy changes were made in their country; a) drugs were legalised; b) penalties for possession of small amounts of drugs were reduced to a fine only; c) drugs were legally available through governments outlets. Multiple correspondence analysis and multinomial logistic regression with post-estimation linear hypothesis testing were conducted. ResultsIndividuals residing in countries with relatively liberal drug policy regimes report their help-seeking behaviour is unlikely to change given the hypothetical policy amendments. Individuals from countries with prohibition-based drug policies reported a far greater propensity for changing their help-seeking behaviour in the event of hypothetical policy amendments, citing reduced fear of criminal sanctions as the major reason. Age and sex differences were also found. ConclusionThe current study demonstrates the capacity for national drug policy reform to influence drug use risk by facilitating or impeding health service engagement among individuals who use illicit substances. We suggest national drug policy requires careful consideration of both prevention goals and the needs of individuals already engaged in illicit substance use; more liberal drug policies may actually encourage the adoption of harm reduction strategies such as health service engagement.

Drug Use as a Risk Factor of Moral Disengagement: A Study on Drug Traffickers and Offenders against Other Persons

This study investigates the moral-disengagement strategies and influence of drug use in adolescence on 49 offenders in Italian jails, 30 of which are drug traffickers and 19 of which are offenders against other persons. A semi-structured interview was conducted to collect data on family, social and medical histories and the manner in which the deviant act was carried out, and the Moral Disengagement Scale was used to identify specific moral disengagement mechanisms. The results show that the traffickers reported higher levels of general moral disengagement, dehumanization of victims, and advantageous comparison with respect to offenders against other persons. However, the offenders who used drugs in adolescence reported higher levels of advantageous comparison with respect to offenders who did not use drugs. Studying self-regulatory mechanisms is important for enriching the literature about risk factors connected with moral disengagement and deviant behaviour committed by offenders in order to implement the promotion of effective and targeted treatment and educational strategies.

Influence of drug use on student academic performance among secondary school students in Matinyani district, Kenya

The purpose of the study was to investigate the influence of drug use on student interest in learning and identify counselling interventions that can be used when dealing with drug use among secondary school students in Matinyani district. Descriptive survey was used in this study. Fourteen public secondary schools were involved with population of 1701 students. Purposive sampling was used in the sample selection to select 5 schools which included a girls’ boarding, a boys’ boarding school, a mixed day school, a mixed boarding school and a mixed day and a boarding school. A sample size of 269 was used. The data was collected by use of a Core Alcohol and Drug Survey Questionnaire. Validity and reliability of the study instrument was established through a pilot study. A correlation coefficient alpha of 0.7408 was obtained. According to, Fraenkel and Wallen (2002) a reliability co efficient of 0.7 or more implies high degree of reliability. Data was analysed by use of descriptive statistics with the aid of Statistical Package for Social Science (SPSS). The descriptive analysis, percentages, tables, bar graphs and charts were used in presenting and summarizing the findings. The study established that drug use lead to increased lack interest in learning among students. The study further established that it is the responsibility of all members of society to fight drug use in our country. This is so because when students use drugs, the effects are felt all over. The study recommends that; teacher counselors should adopt group counseling and peer counseling techniques in assisting adolescents overcome the problem of drug use; schools should have active and working guidance and counseling departments with well trained personnel to handle drug related case; school administrators should discourage transfers/admissions of indiscipline students from one school to another; among other recommendations. Article visualizations:

Drug Use Among Juveniles In The Observation, Protection Centers And Training Schools In Thailand: An Analysis Of Causal Factors

The problem of drugs is considered to be crucial and it has become a significant issue in Thailand. This study aims to study drug use behavior and causal factors influencing drug use behaviors of children and juveniles in the Juvenile Observation and Protection Center and the Juvenile Training Schools. Quantitative research method was adopted for this study. The sample groups were children and juveniles in the Juvenile Observation and Protection Center and in the Juvenile Training Schools. The results of the study found that, all causal factors; attitude towards drugs use behavior, perceived behavioral control, intention to commit to drug use behavior and outweighing factor could explain the variability of intent at 51% and could also explain the variability of drug use behaviors of children and juvenile at 54%, whereas, independent variables in relation to perceived behavioral control do significantly influence intent towards drug use behaviors. This study recommends guidelines for executives in planning a policy for those involved in the implementation of prevention, providing a therapeutic and rehabilitative solution for children and youths involved with drugs. Eventually, this study will be useful and beneficial for taking care of children and youths in the future.

Drug Use among Juveniles in the Observation, Protection Centers and Training Schools in Thailand: An Analysis of Causal Factors

The problem of drugs is considered to be crucial and it has become a significant issue in Thailand. This study aims to study drug use behavior and causal factors influencing drug use behaviors of children and juveniles in the Juvenile Observation and Protection Center and the Juvenile Training Schools. Quantitative research method was adopted for this study. The sample groups were children and juveniles in the Juvenile Observation and Protection Center and in the Juvenile Training Schools. The results of the study found that, all causal factors; attitude towards drugs use behavior, perceived behavioral control, intention to commit to drug use behavior and outweighing factor could explain the variability of intent at 51% and could also explain the variability of drug use behaviors of children and juvenile at 54%, whereas, independent variables in relation to perceived behavioral control do significantly influence intent towards drug use behaviors. This study recommends guidelines for executives in planning a policy for those involved in the implementation of prevention, providing a therapeutic and rehabilitative solution for children and youths involved with drugs. Eventually, this study will be useful and beneficial for taking care of children and youths in the future.

Until I get off parole … then I can swim in it if I want to: Facilitators of and barriers to drug use among formerly incarcerated Black drug offenders

ABSTRACTBlack Americans are overrepresented among those incarcerated for drug-related offenses. Drug use, postincarceration, is associated with high risk of recidivism and overdose deaths. We explored factors influencing drug use among former Black drug offenders. Qualitative interviews with 30 Black Americans released from prison within the past year explored drug behavior as well as institutional, environmental, and social factors that influence drug use. Findings show participants reentered drug-enticing environments and social networks. Being on parole, drug programs, and social support influenced abating drug use. Drug interventions postincarceration should consider the environment and social networks as leverage points for behavior change.

Drug Use Status in Youth: The Role of Gender and Delay Discounting

ABSTRACTBackground: Evidence from gender and delay discounting studies suggests these variables may influence drug use in youth. However, no studies to date have examined sexual discounting with regard to drug use in youth. Objectives: The present study examined gender and delay discounting, both monetary and sexual, with regard to the drug use status of alcohol, tobacco, and marijuana. Methods: Youth aged 14–21 years (n = 155) provided demographic and drug use information and completed behavioral tasks assessing monetary and sexual discounting in a single laboratory session. Chi-square and analysis of variance were used to assess group differences. Results: Across drug use status, differences in gender and sexual discounting but not monetary discounting were found. Moderate drinkers and smokers were more likely to be male and displayed steeper sexual discounting rates. However, no interaction effect between gender and discounting differences on drug use status was observed. Conclusions: Findings suggest that drug use may manifest differently by gender and highlight the domain specificity of sexual discounting. These findings further highlight the need to incorporate gender and domain-specific discounting measures when investigating drug use pathology and interventions in youth.

Baked Sex: the Exploration of Sex-Related Drug Expectancies of Marijuana Users

This study describes a modification of a sex-related expectancy measure to measure sex-related marijuana expectancies, and results were significant. Original research on expectancies for marijuana was conducted over 25 years ago. During this time period, attitudes, values, and beliefs regarding marijuana use are rapidly changing. This study examined if sex-related drug expectancies (SRDEs) predicted the frequency of marijuana use. By changing the prompt of a sex-related alcohol expectancy measure that instructed participants to focus on drug use, the study sought to measure SRDEs in a general adult population. An online survey was advertised on social media sites like Facebook and Craigslist. The SRDEs were assessed on N = 419 individuals (326 women, 93 men) who indicated using marijuana over the past 12-month period. A one-way ANOVA for women (p < .001) determined there were significant differences between SRDE scores for individuals, and post hoc analysis determined significant differences between infrequent and frequent marijuana users. Similar results were found for men using independent t tests. According to the SRDE, both male and female frequent marijuana users have higher sex-related expectancies when compared to infrequent marijuana users. With cultural changes influencing use of marijuana, measures like the SRDE that assess sex-related drug expectancies will help researchers understand how sex-related drug expectancies influence drug use.

Statistical Effects of Religious Participation and Marriage on Substance Use and Abuse in Racial and Ethnic Minorities.

Substance use and abuse, which includes alcohol use, alcohol dependence, drug use, and drug dependence, inflicts a substantial toll on Americans. Although studies have demonstrated the protective effect of social support, such as religious participation and via marriage, understanding their influence on racial and ethnic minorities is limited. Thus, the aim of this study is to assess the impact of social support on substance use and abuse in racial and ethnic minorities. The Collaborative Psychiatric Epidemiology Surveys, sponsored by the National Institute of Mental Health, a repository of race, ethnicity, and mental health data, was leveraged to develop four models using multivariate analysis, specifically logistic regression to estimate the probability of meeting the criteria for substance use and abuse. Racial and ethnic minorities were found to have lower rates of substance use and abuse compared to Whites, and foreign-born individuals were consistently less likely to use or abuse substances compared to American-born minorities. Mental health conditions were highly associated with substance use and abuse, and social support by way of religious participation and marriage was protective against substance use and abuse. In racial and ethnic minorities, nativity and social support were protective against substance use and abuse; however, these protective factors did not completely eliminate risk. Thus, although race and ethnicity are important to understanding health outcomes and health behaviors, such as substance use and abuse, it is the intersection of multiple factors, representing internal and external forces, which may be more informative and offer a more comprehensive picture of the landscape influencing drug and alcohol use and dependence. Targeted interventions should consider leveraging religious spaces and bilingual materials when attempting to reach racial and ethnic minorities.