Initiation Of Substance Use Research Articles

Substance-use initiation moderates the effect of stress on white-matter microstructure in adolescents.

While childhood stress may contribute risk to substance-use initiation and differences in brain white-matter development, understanding of the potential impact of substance-use initiation on the relationship between experienced stress and white-matter microstructure remains limited. This study examined whether substance-use initiation moderated the effect of perceived stress on white-matter differences using measures of primary white-matter fiber anisotropy. Forty adolescents (age 14.75 ± .87 years) were assessed on the Perceived Stress Scale, and 50% were determined to have presence of substance-use initiation. White-matter microstructure was examined using primary-fiber orientations anisotropy, which may reflect white-matter integrity, modeled separately from other fiber orientations in the same voxels. Analyses were conducted on regions of interest previously associated with childhood stress and substance use. Lower perceived stress and presence of substance-use initiation were related to greater right cingulum primary-fiber measures. Substance-use-initiation status moderated the association between perceived stress and right cingulum primary-fiber measures, such that higher perceived stress was associated with lower right cingulum primary-fiber anisotropy in adolescents without substance-use initiation, but not in those with substance-use initiation. Findings in primary-fiber anisotropy suggest differences in right cingulum white-matter integrity is associated with substance-use initiation in higher-stress adolescents. This reflects a possible pre-existing risk factor, an impact of early substance use, or a combination thereof. Examination of potential markers associated with substance-use initiation in white-matter microstructure among stress-exposed youth warrant additional investigation as such biomarkers may inform efforts relating to tailored interventions. (Am J Addict 2018;27:217-224).

Diminished Cortical Thickness Is Associated with Impulsive Choice in Adolescence.

Adolescence is characterized by both maturation of brain structure and increased risk of negative outcomes from behaviors associated with impulsive decision-making. One important index of impulsive choice is delay discounting (DD), which measures the tendency to prefer smaller rewards available soon over larger rewards delivered after a delay. However, it remains largely unknown how individual differences in structural brain development may be associated with impulsive choice during adolescence. Leveraging a unique large sample of 427 human youths (208 males and 219 females) imaged as part of the Philadelphia Neurodevelopmental Cohort, we examined associations between delay discounting and cortical thickness within structural covariance networks. These structural networks were derived using non-negative matrix factorization, an advanced multivariate technique for dimensionality reduction, and analyzed using generalized additive models with penalized splines to capture both linear and nonlinear developmental effects. We found that impulsive choice, as measured by greater discounting, was most strongly associated with diminished cortical thickness in structural brain networks that encompassed the ventromedial prefrontal cortex, orbitofrontal cortex, temporal pole, and temporoparietal junction. Furthermore, structural brain networks predicted DD above and beyond cognitive performance. Together, these results suggest that reduced cortical thickness in regions known to be involved in value-based decision-making is a marker of impulsive choice during the critical period of adolescence.SIGNIFICANCE STATEMENT Risky behaviors during adolescence, such as initiation of substance use or reckless driving, are a major source of morbidity and mortality. In this study, we present evidence from a large sample of youths that diminished cortical thickness in specific structural brain networks is associated with impulsive choice. Notably, the strongest association between impulsive choice and brain structure was seen in regions implicated in value-based decision-making; namely, the ventromedial prefrontal and orbitofrontal cortices. Moving forward, such neuroanatomical markers of impulsivity may aid in the development of personalized interventions targeted to reduce risk of negative outcomes resulting from impulsivity during adolescence.

Adverse Childhood Experiences and Early Initiation of Marijuana and Alcohol Use: The Potential Moderating Effects of Internal Assets

ABSTRACTIntroduction: Early adolescence is a critical risk period for initiation of substance use. Internal assets (IAs), which are individual qualities guiding positive choices, and adverse childhood experiences (ACEs) are important protective and risk factors, respectively, against substance use. The purpose of this study is to investigate whether IAs modify associations between ACEs and early initiation of alcohol and marijuana use. Method: Data were from 9th and 11th graders who completed the 2013 Minnesota Student Survey (n = 79,339). Students reported on experiences of abuse, household dysfunction, and substance use. Multivariable logistic regressions examined associations between different types of ACEs and substance use. Interactions between IAs and ACEs were added to models to test effect modification. For significant interactions, main effects models were re-estimated at different percentiles of IAs. Result: IAs moderated associations of both abuse and household dysfunction with early initiation of marijuana (p <.003) and alcohol (p =.007) for females but not for males. For females with low IAs, odds of early initiation of marijuana were approximately twice as high as students without any ACEs. A similar pattern was detected for females' initiation of alcohol use. No effect modification was detected for IAs and experiencing only abuse or household dysfunction on initiation. Conclusion: Special attention should be paid to improving IAs among girls who have already experienced ACEs. Future research should examine protective factors that buffer the effects of ACEs for boys.

Social Determinants of Alcohol Use and Heaving Episodic Drinking Among Hispanic Young Adults

Background: Although there are numerous preventive measures in the literature, a vast percentage of Hispanic young adults continue to engage in alcohol use and heavy episodic drinking. The purpose of the study was to examine social determinants of recent alcohol use and heavy episodic drinking among Hispanic young adults 18-25 years of age. Methods: In 2016, a secondary analysis (N = 3,452) was performed of 2012 National Survey on Drug Use and Health data. A series of logistic regression analyses were performed to determine whether recent alcohol use and heavy episodic drinking differed based on sex, education level, family income, employment status, location of residence (type of metro area), self-reported health status, first use of alcohol before age 21, first use of tobacco before age 21 and first use of marijuana before age 21. Results: Regarding alcohol use, 51.8% of Hispanic young adults reported that they had consumed alcohol in the past month and 35.0% reported that they had engaged in heavy episodic drinking. Hispanic young adults at highest risk for recent alcohol use were male, had some college or more, had high family income, were employed, lived in a large metropolitan area, had excellent/very good health status, and had early initiation of substance use. Those at highest risk for heavy episodic drinking were male, were employed, and had early initiation of substance use. Discussion: The present study found that a sizeable percentage of Hispanic young adults are involved in recent alcohol use and heavy episodic drinking. Since Hispanic young adults are disproportionately at risk for substance use and scarce resources are available to effectively address the needs of this population, further interventions are warranted. Findings may aid prevention scientists in developing, implementing and evaluating alcohol use programs for this population.

Common and differential factors associated with abstinence and poly drug use among Australian adolescents

BackgroundSocial norms relating to youth substance use are changing. In Australia, alcohol use among adolescents has fallen dramatically and tobacco and cannabis use have also reduced, albeit more moderately. The aim of the present study was to identify (i) factors associated with compliance with recommendations for zero intake of alcohol, tobacco, and cannabis and (ii) factors associated with poly drug use (intake of all three substances). MethodsAs part of the Young Minds Matter Study, a self-report survey was administered to 1661 Australian adolescents aged 15–17 years. The survey included items relating to: substance use; psychological, social, and protective factors; and demographic characteristics. Probit regression analyses were conducted to generate a model of factors associated with abstinence from all three substances and a model of factors associated with the use of all three substances. ResultsWhile there were substantial differences between the two models indicating that different factors may influence the initiation of substance use versus poly drug use, there were also several common factors that operated in opposite directions. These were child age, degree of parental supervision and monitoring, the experience of externalising problems, and a diagnosis of major depression. ConclusionThe results highlight the potential utility of targeting high-risk youth by identifying (i) parents’ supervision and monitoring behaviours and (ii) children’s externalising problems and symptoms of depression. Directly addressing these factors in substance-use interventions may delay or prevent initiation while also reducing the likelihood of adolescents engaging in poly drug use.

Knowledge and attitude of the secondary school and college students about drug abuse and participation in prevention programs in Tanta city, Egypt

Adolescence is a transitional stage of physical and mental human development with substantial risk for initiating substance use. The aim of this study was to assess knowledge and attitude of the secondary school and college students about drug abuse and participation in prevention programs. Design and Methods: descriptive comparative study. The study was carried out in technical secondary school in Tanta city and Faculty of Nursing, Tanta University, Egypt. The sample consisted of two groups where their total number constituted 406 students. The tools of the study: The first, structured interview sheet concerning socio-demographic data and knowledge of students regarding knowledge about 1) Drug abuse, 2) Participation in prevention programs. The second tool, it was used to measure the students' attitudes towards abuse and participate in prevention programs of it. Results: the study reveals that about two-thirds of the college students (65.02%) had information about the drug abuse dangers through various media as a main source of information, followed by (30.54% and 21.18%) from professors and subjects at the school and family respectively, compared to (35.47%) of the secondary school students who had information from colleagues and friends, while the information from family constituted 28.08%. (74.88%) of college students and (98.03%) of the secondary school students had poor score knowledge regarding drug abuse, there was statistically significant difference found. While (63.05%) of the college students and (63.55%) of the secondary school students had fair score knowledge regarding participation in prevention programs, there wasn't difference found. The students from two groups had a negative attitude toward drug abuse which represented about (96.55%) for college students and (100%) for the secondary school students, while the college students and secondary students had positive attitude toward participation in prevention programs (87.19% and 94.09% respectively), there were statistically significant difference were found. Conclusion: The students from college and the secondary school students had poor knowledge regarding drug abuse and both groups had fair knowledge regarding participation in prevention programs. On the other hand, the students from two groups had negative attitude toward drug abuse and participation in prevention programs. Recommendations: Secondary school and college based education program as a part of school and college curriculum and through community activities involving parents and faith- based organization. There is also a need for accompanying campaigns to increase the public awareness of the rationale for the drug abuse prevention and intervention initiatives proposed by the current study. This would make it easy to plan and implement them.

Prenatal Exposure Effects on Early Adolescent Substance Use: Preliminary Evidence From a Genetically Informed Bayesian Approach.

Given the controversy surrounding the question of whether there are direct or causal effects of exposure to maternal smoking during pregnancy (SDP) on offspring outcomes such as substance use during the adolescent years, we sought to test, on a preliminary basis, within- and between-family associations of SDP and initiation of substance use early in adolescence (by age 15 years) using a discordant sibling design. We used a sibling-comparison approach in a sample of 173 families drawn from the state of Missouri, wherein mothers were discordant for smoking behaviors between two different pregnancies, to test for associations of SDP and initiation of substance use in a younger adolescent cohort. The discordant sibling comparison approach allows for disentangling familial effects from direct effects of SDP through the purposeful collection of data from siblings within the same family with differential exposure. There were no between- or within-family effects of SDP on initiation of any type of substance use (alcohol, marijuana, smoking, and other drug classes), suggesting that SDP does not exert a direct effect on substance use in early adolescence. Preliminary findings did not support an association of SDP and initiation of substance use in this younger adolescent sample. Studies such as this one can help build a body of evidence to explain whether associations of SDP and adolescent outcomes reflect a direct effect of SPD or may instead be attributable to familial confounders that are controlled in the discordant sibling design.

Altered functional connectivity to stressful stimuli in prenatally cocaine-exposed adolescents

BackgroundPrenatal cocaine exposure (PCE) is linked to addiction and obesity vulnerability. Neural responses to stressful and appetitive cues in adolescents with PCE versus those without have been differentially linked to substance-use initiation. However, no prior studies have assessed cue-reactivity responses among PCE adolescents using a connectivity-based approach. MethodsTwenty-two PCE and 22 non-prenatally drug-exposed (NDE) age-, sex-, IQ- and BMI-matched adolescents participated in individualized guided imagery with appetitive (favorite-food), stressful and neutral-relaxing cue scripts during functional magnetic resonance imaging. Subjective favorite-food craving scores were collected before and after script exposure. A data-driven voxel-wise intrinsic connectivity distribution analysis was used to identify between-group differences and examine relationships with craving scores. ResultsA group-by-cue interaction effect identified a parietal lobe cluster where PCE versus NDE adolescents showed less connectivity during stressful and more connectivity during neutral-relaxing conditions. Follow-up seed-based connectivity analyses revealed that, among PCE adolescents, the parietal seed was positively connected to inferior parietal and sensory areas and negatively connected to corticolimbic during both stress and neutral-relaxing conditions. For NDE, greater parietal connectivity to parietal, cingulate and sensory areas and lesser parietal connectivity to medial prefrontal areas were found during stress compared to neutral-relaxing cueing. Craving scores inversely correlated with corticolimbic connectivity in PCE, but not NDE adolescents, during the favorite-food condition. ConclusionsFindings from this first data-driven intrinsic connectivity analysis of PCE influences on adolescent brain function indicate differences relating to PCE status and craving. These findings provide insight into the developmental impact of in utero drug exposure.

Early Initiation of Substance Use as an Indicator of Problematic Substance Use Among Young Men Who Have Sex with Men (YMSM)

ABSTRACTBackground and Objectives: Much research has documented that young men who have sex with men (YMSM) are at higher risk for substance use-related problems. This study examined the age of substance use initiation and it's relationship to current substance use-related problems among substance-using YMSM. Design and Methods: A cross-sectional survey of 191 YMSM (aged 18 to 29) with recent histories of prescription drug misuse was conducted in Philadelphia in 2012-13. Participants were surveyed about age of initiation of cigarette smoking, alcohol use to the point of intoxication, marijuana, prescription, and illicit drugs, and about alternate modes of prescription drug administration. The severity of participants' current substance use related problems was measured using the Drug Abuse Screening Test (DAST-10). Results: Mean age of initiation was 14.6 years for cigarette smoking, 15.3 years for alcohol use to the point of intoxication, 15.2 years for marijuana, 16.8 years for prescription drugs, and 17.9 years for illicit drugs. Use of 2 or more substances by the age of 15 was reported by 56% of the participants. Odds of substance-related problems were significantly greater among those who reported earlier initiation of alcohol, prescription drugs, or polysubstance use. Odds of prescription drug misuse via altered routes of administration were significantly greater among participants with earlier onset of alcohol, marijuana, prescription, illicit drugs, or polysubstance use. Discussion and Conclusions: This study demonstrates that earlier initiation of substance use is associated with higher risk of substance-related problems among substance-using YMSM. Early interventions addressing substance use initiation could benefit this population.

Prevalence of Substance Use and Associated Factors Among High School Adolescents in Rithepani, Lekhnath-2, kaski, Nepal

Background: Substance use is a major public health concern in global settings, and is very common during adolescence period leading to physical and/or mental health complications. This study assessed the prevalence of substance use and associated factors among high school adolescents in Rithepani 2, Lekhnath, Kaski, 2073.Objectives: The study was designed to provide estimates of substance use by school-going adolescents in Lekhnath and to identify risk factors associated with.Methods: A school based cross-sectional study was conducted from 17th October to 21st October, 2016 among eighth to 12th grade high school students in the Rithepani-2, Lekhnath. Participants were select­ed by purposive sampling techniques, and data were collected using questionnaire. Frequency, percentage, means, SD and chi-square test was performed to identify factors associated with substance use.Results: Majority of the respondents 93 (56.4%) belonged to the age group 15 - 18 years. Majority of the respondents 88 (53.3%) were males and 50 (30.3%) were studying in grade 11. Majority of the respondents 140 (84.8%) were Hindus and 104 (63%) of the respondents belonged to upper caste group. In terms of education of the respondents’ parents, majority of the respondents’ mothers 68 (41.2%) had completed their secondary education and similarly, majority of the respondents’ fathers 78 (47.3%) had completed their secondary education. Majority of the respondents’ mothers 129 (78.2%) were housewives and majority of the respondents' fathers 48 (29.1%) were businessmen. Majority of the respondents 136 (82.5%) belonged to nuclear family and 93 (56.4%) had per month family income more than Rs 15,000. Among 165 respon­dents prevalence of substance use was found to be 10 (6%).Regarding the associated factors majority of the respondents 162 (98.2%) had good relation with their parents, 101 (61.2%) respon­dents’ family members do not use substance, 128 (77.6%) respondents reported that substance use was not accepted in their culture. the prev­alence of substance use by the respondents is 6.1% in which five (50%) respondents consume alcohol, eight (80%) take cigarette, one (10%) use tobacco and two (20%) take ganja. Among the substance users, four (40%) reported imitating parents and four (40%) reported curiosity as the cause for them to initiate substance use. Regarding the accessibility of the substances among the respondents who use substances, three (30%) respondents said that it’s very difficult whereas one (10%) said that it’s very easy for them to have access to the substances. Majority of the respondents who use substances 6 (60%) avail the substance/s from their friends.Regarding the Association, there is a significant association between prevalence of substance and substance use by family members with the χ2 value of 7.61 and p-value 0.006 which is less than 0.05 significant level. There is also a significant association between the prevalence of substance use and its cultural acceptance with the χ2 value of 4.65 and p-value of 0.031 which is less than 0.05 significant level.There is a significant association between the prevalence of substance abuse and ethnicity with the χ2 value of 11.81and with the p-value 0.037 which is less than 0.05 significant level.Conclusions: The prevalence of substance use among high school ado­lescent students in selected higher secondary school was found to be 6.1%. There was significant association between prevalence of sub­stances use and cultural acceptance of participants, ethnicity and use of substances by the family members. Based on the findings of the study researcher suggests to initiate awareness and co-ordination program between the school and parents. Journal of Gandaki Medical College Vol. 10, No. 1, 2017, Page: 43-48

Trajectories of risk behaviors across adolescence and young adulthood: The role of race and ethnicity

IntroductionDespite important advances of longitudinal research in substance use behaviors, most studies stratify analyses by gender or race, which limits the ability to directly compare the likelihood of a particular developmental pathway across demographic groups. Thus, there is critical need for well-designed research to examine the associations of race/ethnicity with developmental trajectories of substance use behaviors across adolescence through adulthood. MethodsUsing an accelerated longitudinal design, we examined behaviors across ages 12–31 from Waves I–IV of the National Longitudinal Study of Adolescent to Adult Health. We performed growth mixture modeling, resulting in estimated trajectories over time. Next, we assessed the association between race/ethnicity and trajectory membership using multinomial logistic regression. ResultsFive trajectories resulted for marijuana use, four for cigarette smoking, three for smokeless tobacco use and number of days drunk, and two trajectories for heavy episodic drinking. Controlling for gender and family socioeconomic status, African Americans and Hispanics were less likely than non-Hispanic Whites to use cigarettes or smokeless tobacco early or to use alcohol heavily. ConclusionsSubstance use behavior development follows different pathways for US adolescents and young adults, with some individuals experimenting earlier in adolescence and others beginning to use later in adolescence or in early adulthood. We extend developmental knowledge about these behaviors by demonstrating that the patterns of behavior vary by race/ethnicity; members of lower-risk trajectories (those involving later or no initiation of substance use) are more likely to be African American or Hispanic than to be non-Hispanic White.

Did the dependent coverage expansion increase risky substance use among young adults?

BackgroundThe dependent coverage expansion (DCE) enacted through the Affordable Care Act increased health insurance coverage among young adults. Increasing insurance coverage in this age group has the potential for unintended consequences on risky substance use. MethodsRepeated cross-sectional surveys were used to compare change in substance use during the period the DCE was implemented in the 19–25year old target age group (Pre-DCE n=15,772, Post-DCE n=22,719) with contemporaneous change in a slightly older age group that was not targeted by the policy (Pre-DCE=19,851, Post-DCE n=28,157). Outcomes include 11 measures of alcohol, illicit drug and cigarette use. Statistical controls were included for demographic and socioeconomic factors and for early initiation of substance use to adjust for historical trends in developmental trajectories. ResultsRisky substance use decreased in young adults relative to the older age group over the period that the DCE was implemented. However, statistical adjustment for initiation of substance use prior to age 18, which is prior to exposure to the DCE, accounted for the differences between the age groups. In adjusted models, associations between the DCE and substance use outcomes range from 0.96 to 1.08 with p-values ranging from 0.330 to 0.963. ConclusionsHistorical trends in initiation of substance use prior to age 18, not the DCE, account for change in risky substance use among 19–25year olds relative to 26–34year olds. The evidence does not support the suggestion that health insurance coverage would increase risky substance use among young adults.

A preliminary needs assessment of American Indians who inject drugs in northeastern Montana

BackgroundInjection drug use has not been well documented in American Indians living in the USA. American Indian and Alaskan Natives (AI/ANs) show higher rates of substance use compared to the general population, and have historically been subject to a number of risk factors that are known to increase the likelihood of substance use. AI/ANs also experience increased risk for infectious diseases that are transmitted via injection drug use and/or sexual activity. Harm reduction approaches have been shown to be effective for decreasing risk of disease transmission in at-risk populations, and may be well suited for AI/AN injection drug users residing in rural reservation communities. In this study, we aimed to examine the characteristics of American Indians (AI) who use injection drugs (PWUID) in northeastern Montana to identify needs that could be addressed with harm reduction programming.MethodsFor the present study, we used a respondent-driven sampling approach to generate a sample of 51 self-identified male and female injection drug users ≥18 years of age who were American Indians living on the Fort Peck Indian Reservation. Sampling weights were applied to all analyses using Respondent-Driven Sampling Analysis Tool (RDSAT).ResultsThere were no strong recruitment patterns by age, sex, or ethnic identity status of the recruiter or participant, but there were strong within-group recruitment patterns by location within the reservation. The majority of the sample reported initiating substance use before the age of 18. Participants reported significant risk for HIV, hepatitis, and other infectious diseases through their drug use and/or risky sexual behavior. Sixty-five percent reported having reused syringes, and 53% reported drawing from the same filter. Seventy-five percent reported inconsistent condom use during the 3 months preceding the survey, and 53% reported injecting drugs during sex during the 3 months preceding the survey. Only 66% of participants reported having been tested for HIV in the 12 months preceding the survey. The vast majority (98%) of respondents expressed interest in a harm reduction program. Seventy-six percent reported that it was easy or very easy to obtain new syringes.ConclusionsWe documented several risks for blood-borne pathogens, including elevated levels of syringe reuse. Further, we documented significant interest in harm reduction interventions in the present sample of AI/AN injection drug users. Findings suggest a need for increased access to harm reduction programming for AI/AN injection drug users to reduce the transmission of infectious disease and increase access to compassionate care.

Substance abuse in Children and adolescent: A Retrospective Study

Introduction: Drug addiction among children and adolescents is spreading very fast. The age of initiation of substance use is falling progressively. Aims and Methods: The aim of the study was to know about the socio demographic profile of children and adolescents diagnosed with substance dependence and to assess the pattern of drug dependence. So we conducted a retrospective study in Swami Vivekananda Drug De addiction centre at Amritsar in Punjab. The diagnosis of substance dependence was made by a consultant psychiatrist after direct interview with the patient and the relatives according to International Classification of Diseases (ICD-10). Results: The study comprised 446 children and adolescents who reported for de addiction during the study period. Majority were in the age group 16-19(95.73%), 49.5% were from urban areas and 50.5% patients were from rural areas. Out of these 36.09% were employed, 24.43% were unemployed and 39.46% were students. Our results showed more involvement of male as compared to females. As far as education status is concerned, 47.53% studied up to matric, 23.99% up to Secondary school, 12.78% up to middle, 6.95% up to primary and 5.38% were illiterate. Opioids and polysubstance use are common among them. Conclusion: The need of the hour is to educate and counsel young children and adolescents and create awareness among the public regarding drug addiction.

Age of First Arrest, Sex, and Drug Use as Correlates of Adult Risk Behaviors Among Rural Women in Jails

Incarcerated women frequently report initiation of substance use and sexual encounters at an early age, and often engage in high-risk drug use and sexual behaviors as adults. This study examined the timing of first sex, drug use, and arrest, as well as their unique influences on specific risky behaviors in adulthood, among a high-risk population of rural women recruited from jails. Ages of initiation were all positively and significantly correlated, and each independently increased the likelihood of several risky behaviors in adulthood. Implications are discussed for screening, intervention, and treatment targeting high-risk women and girls in rural areas, particularly within criminal justice settings.

White-matter crossing-fiber microstructure in adolescents prenatally exposed to cocaine

BackgroundPrenatal cocaine exposure (PCE) is associated with risk-taking behaviors, including increased initiation of substance use in adolescence. The neurobiological underpinnings of these behaviors in adolescents with PCE are not well understood. The goal of this study was to compare diffusion-weighted imaging data between adolescents with and without PCE using crossing-fiber models, which may provide more comprehensive estimates of white-matter microstructure within regions of multiple (e.g., primary and secondary) fiber orientations. MethodsThirty-nine PCE individuals and 17 comparably aged prenatally non-drug-exposed (NDE) youths were recruited from a longitudinal cohort followed since birth. White matter was examined using tensor-derived and crossing-fiber models. Whole-brain investigations were performed, as were analyses on seven white-matter regions, which included the splenium, body and genu of the corpus callosum, bilateral cingulum, and the right and left superior longitudinal fasciculus (SLF). ResultsWhole-brain analyses revealed no group differences. However, ROI analyses for anisotropy estimates derived from the crossing-fiber model revealed significant group differences for secondary fibers, with reduced anisotropy among PCE adolescents compared to prenatally non-exposed youth in the right cingulum and the left SLF, and increased anisotropy in the genu. ConclusionsOur findings suggest that white-matter differences in PCE adolescents are subtle and localized primarily within secondary fiber orientations, perhaps arising from altered white-matter development.

A Qualitative Study of the Context of Child and Adolescent Substance Use Initiation and Patterns of Use in the First Year for Early and Later Initiators.

Individuals who initiate substance use before high school are at higher risk of negative outcomes. Eighty-six young adults between the ages of 18 and 28 participated in semi-structured qualitative interviews focused on the circumstances surrounding participants’ first use of substances and their pattern of use in the year following initiation in order to investigate similarities and differences between early versus later initiators. Initiation and use among early initiators were more likely to be encouraged by poor parental monitoring or active facilitation of use by parents. Early initiators were more likely to report risky patterns of use such as daily use and using alone. The data suggest that interventions targeting this population should focus on improving parental monitoring and decreasing positive parental attitudes toward adolescent substance use and efforts to increase identification and intervention by middle school staff to reach youth from high-risk families.

The role of adverse childhood experiences in initiation of substance use and sexual behaviors among opioid-using young adults

The role of adverse childhood experiences in initiation of substance use and sexual behaviors among opioid-using young adults

Sociodemographic profile of substance users attending Urban Health Training Centre in Srinagar Garhwal, India

Background: Recent trends indicate that the use of substances has dramatically increased worldwide, particularly in developing countries including India. Limited studies have been conducted on substance use in Uttarakhand state of India. Objectives: To study the sociodemographic profile of substance users and to assess the pattern of substance use among the study subjects attending Urban Health Training Centre in Srinagar Garhwal of Uttarakhand, India. Materials and Methods: This cross-sectional study was conducted among substance users attending Urban Health Training Centre under the Department of Community Medicine, Government Medical College in Srinagar, Garhwal, Uttarakhand, India. Over a period of 6 months (July 2014–December 2014), 219 substance users were enrolled in the study. Statistical analyses were performed using r statistical software. Results: The mean age was 33.9 ± 10.9 years. Of total 219 subjects selected for the study, maximum 97 (44.3%) were in the age group of 21–30 years. Mostly 108 (68.5%) subjects were married. About half of the subjects 108 (49.3%) were educated up to graduation or above followed by 53 (24.2%) whose education was up to high school and intermediate. Maximum 53 (24.2%) study subjects were student. The most common current substance use identified includes alcohol (74.9%), nicotine (45.7%), cannabis (14.6%), opium (8.6%), and sedative-hypnotics (5.5%). Maximum response 196 (89.5%) was that friends using substance was the main reason for initiating substance use among study subjects. Conclusion: The present study highlights the recent patterns of substance use and indicates the high level of alcohol use among the participants.

The Prospective Association Between Sleep and Initiation of Substance Use in Young Adolescents

PurposeThis study aimed to determine the unique utility of poor sleep health in predicting the onset of substance use in adolescents. MethodsMiddle school students (N = 829, mean (M)age = 12.6 years, 52% female, 73% white) who participated in an ongoing prospective study of alcohol onset and progression completed a set of Web-based health behavior surveys over a 4-year period, with recruitment beginning in 2009. Surveys included assessments of alcohol, cigarette, and marijuana use as well as sleep duration, bedtime delay (from weekdays to weekends), and daytime sleepiness. Data were analyzed using discrete-time Cox Proportional hazard's regression. ResultsControlling for participant age at sleep assessment, gender, and internalizing and externalizing behaviors, shorter sleep duration and greater daytime sleepiness in year 1 were associated with increased odds of having had a full drink of alcohol, having engaged in heavy episodic drinking, and having experienced alcohol-related consequences by year 4. Shorter sleep duration was also associated with increased odds of marijuana use by year 4. No sleep parameter was uniquely associated with increased odds of cigarette use (first puff or first full cigarette). Effects were evident for both males and females. Age at sleep assessment did not moderate effects. ConclusionsSleep health is a prospective predictor of the onset of alcohol and marijuana use among adolescents. Increased efforts to prevent and intervene in sleep problems among adolescents are warranted.