Lifetime Illicit Drug Use Research Articles

The relative importance of perceived substance misuse use by different peers on smoking, alcohol and illicit drug use in adolescence

BackgroundSubstance use by young people is strongly associated with that of their peers. Little is known about the influence of different types of peers. We tested the relationship between perceived substance use by five types of peers and adolescents’ use of illicit drugs, smoking, and alcohol consumption. MethodsWe used data collected from 1285 students aged 12–13 as part of a pilot cluster randomized controlled trial (United Kingdom, 2014–2016). The exposures were the perceived use of illicit drugs, smoking and alcohol consumption by best friends, boy or girlfriends, brothers or sisters, friends outside of school and online. Outcomes were self-reported lifetime use of illicit drugs, smoking and alcohol consumption assessed 18-months later. ResultsThe lifetime prevalence of illicit drug use, smoking and alcohol consumption at the 18-month follow-up were 14.3%, 24.9% and 54.1%, respectively. In the fully adjusted models, perceived substance use by friends outside of school, brothers or sisters, and online had the most consistent associations with outcomes. Perceived use by friends online was associated with an increased risk of ever having used illicit drugs (odds ratio [OR] = 2.43, 95% confidence interval [CI] = 1.26, 4.69), smoking (OR = 1.61, 95% CI 0.96, 2.70) and alcohol consumption (OR = 2.98, 95% CI = 1.71, 5.18). ConclusionsPerceived substance use by friends outside of school, brothers and sisters and online could be viable sources of peer influence. If these findings are replicated, a greater emphasis should be made in interventions to mitigate the influence of these peers.

Risk Factors for Illicit Drug Use Among Malaysian Male Adolescents.

This study was carried out to determine the prevalence of illicit drug use and its associated factors among male adolescents in Malaysia. Data of 13 135 adolescents were extracted from the National Health and Morbidity Survey 2017, a cross-sectional survey among school-going adolescents in Malaysia aged between 13 and 17 years, using a 2-stage stratified cluster sampling. A complex sample design analysis and multiple logistic regression analysis were applied. The overall prevalence of lifetime illicit drug use among male adolescents was 6.6%. The multivariable model showed that illicit drug use among male adolescents were associated with younger age, rural school area, marital status of parent, current smoker, ever having sex, truancy, involved in physical fight, and lack of peer support. The findings from this study can assist community and relevant authorities in their efforts to combat illicit drug usage among adolescents using intervention programs that diminishes risk factors and enhances the protective factors.

Illicit Drug Use and Social Victimization among Thai Sexual and Gender Minority Adolescents

Objectives: We examined the prevalence of lifetime illicit drug use and social victimization, and their association, among sexual and gender minority (SGM) and non-SGM Thai adolescents. Methods: In 2013, we conducted a school-based national survey among students grades 7–12 (aged 13–20 years) from 15 secondary schools (n = 2,070) around Thailand. We classified adolescents with same-sex attraction, sexual or gender non-conforming identities as SGM. Generalized estimating equations were used to estimate the odds of illicit drug use by SGM and non-SGM status. Results: Prevalence of lifetime illicit drug use was significantly higher among SGM adolescents than non-SGM adolescents (10.3 vs. 5.3%), but did not differ between those with same-sex attraction and SGM identity (10.3 vs. 10.8%). Among non-SGM adolescents, general social victimization, sexual experience and any school truancy were associated with lifetime illicit drug use (OR = 2.59, 95% CI: 1.53, 4.38; OR = 6.59, 95% CI: 4.90, 8.86; and OR = 4.93, 95% CI: 3.13, 7.75, respectively). Among SGM adolescents, SGM-based social victimization, depressive symptomology and suicidal ideation were associated with lifetime illicit drug use (OR = 3.17, 95% CI: 2.03, 4.95; OR = 5.03, 95% CI: 2.32, 10.90; and OR = 5.03, 95% CI: 2.76, 9.16, respectively). Conclusions: SGM adolescents have higher burden of illicit drug use. Moreover, illicit drug use among SGM adolescents is indicative of depressive symptomology and suicidal ideation. Tailored and comprehensive programs are needed to reduce the gap in burden of illicit drug use between SGM and non-SGM adolescents.

Psychiatric Diagnoses Differ Considerably in Their Associations With Alcohol/Drug-Related Problems Among Adolescents. A Norwegian Population-Based Survey Linked With National Patient Registry Data.

The aim of this study was to examine alcohol/drug use and problems across psychiatric diagnoses and to what extent associations between each psychiatric diagnosis and alcohol/drug use and problems were independent from the potential confounding effects of psychiatric comorbidity, socioeconomic status, sex and age. We used a dataset comprising a linkage between a large population-based and cross-sectional study among Norwegian adolescents (the youth@hordaland conducted in 2012) and national registry-based data on specialist mental health care use during the 4 years prior to the survey (2008 to 2011). The study sample included 16 to 19 year olds who participated in the youth@hordaland survey and consented to the linkage with patient registry data (n = 9,408). Among these, 853 (9%) had received specialist mental health care and comprised the clinical group, while the rest (n = 8,555) comprised the comparison group. The main outcome variables were several self-reported indicators for alcohol/drug use, including any alcohol use, frequent alcohol intoxication, high-level alcohol consumption, and lifetime illicit drug use, as well as one indicator for potential alcohol/drug-related problems: a positive CRAFFT-score. Adolescents receiving specialist mental health care (n = 853) reported more frequently alcohol/drug use and problems compared to adolescents not receiving these services (Cohens d’s ranging from 0.09 to 0.29, all p ≤ 0.01). Anxiety, depression, conduct disorders, eating disorders, ADHD, and trauma-related disorders were all associated with single measures of alcohol/drug use and problems, with odds ratios (ORs) ranging from 1.58 to 4.63, all p < 0.05) in unadjusted models. Trauma-related disorders, depression and conduct disorders were also positively associated with higher scores on a combined indicator of alcohol/drug use and problems (ORs ranging from 1.89 to 3.15, all p < 0.01), even after the full adjustment from psychiatric comorbidity and sociodemographic variables (adjusted odds ratios ranging from 1.61 to 2.79, p < 0.05). These results suggest that alcohol/drug use and problems were slightly more common among adolescents who received specialist mental health care during the past 4 years compared with the general adolescent population, and adolescents with trauma-related disorders, depression and conduct disorders were high-risk groups for alcohol/drug use and problems.

M26 - THE IMPACT OF BIPOLAR AND SCHIZOPHRENIA POLYGENIC RISK SCORES ON FAMILIAL FEATURES OF BIPOLAR DISORDER

Background In Bipolar Disorder (BD), some endophenotypes such as the occurrence of psychotic symptoms or suicide attempts, the level of psychosocial functioning, disorder subphenotypes like type I/II disorder and comorbidities like alcohol or drug abuse are highly familial. We explored whether polygenic risk scores for bipolar disorder (BD-PRS) or schizophrenia (SZ-PRS) can predict these phenotypes in a sample of German and Austrian patients diagnosed with BD according to DSM-IV-criteria. Methods The present study included 326 BD patients belonging to the German KFO/PsyCourse cohort (www.kfo241.de; www.PsyCourse.de). The study protocol was approved by the local ethics committees and is in accordance with the 1964 Declaration of Helsinki. Sociodemographic and clinical information on patients was assessed using a comprehensive inventory for phenotype characterization. Association of BD- and SZ-PRS with target variables was tested via logistic regression analyses at several inclusion p-value thresholds (0.00000005 to 1). Polygenic risk scores were calculated using imputed, quality-controlled genome-wide patient genotypes (Illumina Infinium PsychArray) and summary statistics of two large case-control genome-wide association studies (Hou et al., 2016; PGC-Schizophrenia-Working-Group, 2014). Results were corrected for age, sex, recruitment center, duration of illness and population stratification. Results A higher SZ polygenic burden was significantly associated with lifetime use of illicit drugs at several p-value thresholds (strongest association at threshold 0.0001, R2 change 2.7%, p-value=0.005). Only with one threshold a slightly positive association of SZ-PRS with alcohol abuse was observed (0.0000001, R2change 3.1%, p=0.026). Patients diagnosed with bipolar I disorder had higher SZ-PRS compared to patients with bipolar II disorder at several thresholds (strongest association at 0.05 threshold, R2 change= 2.4%, p=0.020, OR=1,6). We found no significant association of SZ-PRS with other target variables. Higher BD-PRS were significantly associated with higher levels of psychosocial functioning in our patient sample (measured by Global-Assessment-of-Functioning-scores, strongest effect at threshold 0.001, R2 change= 2.6%, p=0.014,), but not with any other target variable. Discussion Our results suggest that a higher polygenic SZ burden plays a bigger role for lifetime occurrence of substance abuse in BD patients than the polygenic BD burden. Also, there may be a stronger genetic overlap between schizophrenia and BD I disorder subtype than between schizophrenia and BD II disorder subtype. Interestingly, a higher polygenic BD burden may even have positive effects on overall psychosocial functioning in BD patients.

Illicit Drug Use, Cigarette Smoking, and Eating Disorder Symptoms: Associations in an Adolescent Twin Sample

Twin studies have shown that genetic factors in part explain the established relation between alcohol use (i.e., problematic use or abuse/dependence) and eating disorder symptoms in adolescent and adult females. However, studies have yet to elucidate if there are similar shared genetic factors between other aspects of substance involvement, such as illicit drug use and repeated cigarette smoking. For those sex-specific phenotypic correlations above our threshold of .20, we used a behavioral genetic design to examine potential shared genetic overlap between self-reported lifetime illicit drug use and repeated cigarette smoking and the eating disorder symptoms of drive for thinness (DT), bulimia (BU), and body dissatisfaction (BD), as assessed with the Eating Disorder Inventory-II, in 16- to 17-year-old female and male twin pairs. Only phenotypic correlations with illicit drug use met our threshold for twin modeling. Small to moderate genetic correlations were observed between illicit drug use and BU in both girls and boys and between illicit drug use and DT in girls. Similar etiological factors are at play in the overlap between illicit drug use and certain eating disorder symptoms in girls and boys during adolescence, such that genetic factors are important for covariance. Specifically, illicit drug use was associated with bulimia nervosa symptoms in girls and boys, which parallels previous substance use research finding a genetic overlap between alcohol use and bulimia nervosa symptoms. Future research should prospectively examine developmental trajectories to further understand the etiological overlap between substance involvement and eating disorder symptoms.

Illict drug use and academia in North Kosovo: Prevalence, patterns, predictors and health-related quality of life.

PurposeThe purpose of this study were to estimate the prevalence and patterns of illicit drug use in a sample of University students from North Kosovo, to assess factors associated with illicit drug use and to assess health-related quality of life (HRQoL) among students according to illicit drug use.MethodsA cross-sectional study was conducted at the Student Public Health Center, where 514 University students were enrolled from April to June 2015 in North Kosovo. Participants completed the general socio-demographic and behavioral questionnaire, Beck Depression Inventory (BDI) and the SF-36 questionnaire for HRQoL assessment. Data on lifetime illicit drug use were self-reported.ResultsAs much as 16.0% of students reported ever illicit drug use. The most frequently used drugs were marijuana (9.3%) and bromazepam (7.6%). Factors associated with ever illicit drug use were: being smoker and alcohol user, having chronic diseases and having higher depressive symptoms score. Ever illicit drug users reported all domains of HRQoL as worse.ConclusionThese results could serve as a tool for implementation of preventive strategies and University policies to promote healthy lifestyles and behaviors. Measurement of HRQoL could also be used as indicator of the effect of interventions designed to reduce and/or prevent illicit drug use at institutions of higher education.

Age-related prevalence and twelve-month incidence of illicit drug use in a cohort of Australian gay and bisexual men: Results from the Flux Study

BackgroundWe report prevalence and incidence of drug use initiation in Australian gay and bisexual men (GBM) participating in an online cohort study. MethodsBetween September 2014 and June 2015, 1,710 GBM were enrolled in the Following Lives Undergoing Change Study and followed-up six monthly. Participants were asked about measures of lifetime use at baseline and recent use (last six months) at all visits. Drug use initiation was defined as men who reported having never used a specific drug prior to baseline and reported recent use at follow-up. ResultsParticipants’ median age was 31 years (range: 16–81). Prevalence of lifetime use was significantly associated with older age for all individual drugs (p trend<0.001), and 84.1% reported lifetime use of any drugs. Just above half (51.9%) reported recent use at baseline, with the majority reporting occasional use (once or twice in the previous six-months). Among men who reported no history of drug use at baseline, drug initiation was highest for amyl nitrite, with an incidence of 10.5 per 100 person-years (95% CI 7.9–13.9), followed by cannabis (7.3 per 100 person-years, 95% CI 5.0–10.6) and ecstasy (5.0 per 100 person-years, 95% CI 3.6–7.0). Younger age was significantly associated with higher incidence of initiation of amyl nitrite, ecstasy, cocaine, ketamine, GHB, and LSD (p trend <0.05 for all). ConclusionPrevalence of lifetime illicit drug use is lower in younger GBM than in their older counterparts. However, incidence of drug use initiation is high among younger men, providing an opportunity for early intervention.

Consistency in Adults’ Self-Reported Lifetime Use of Illicit Drugs: A Follow-Up Study Over 13 Years

Surveys are considered the best source of data available on the prevalence of illicit drug use in the general adult population. The objective of the present study was to examine the consistency in self-reported lifetime use of illicit drugs. Data were obtained from the Danish Health and Morbidity Surveys. A nationally representative subsample of the individuals invited in 2000 was also invited to the subsequent three survey waves (2005, 2010, and 2013). The baseline sample size included 4,803 individuals between ages 16 and 64 years, of whom 3,053 completed a self-administered questionnaire. Recanting was defined as reporting lifetime use at baseline but denying such use in at least one of the subsequent survey waves. In all, 926 individuals reported lifetime use of cannabis in 2000 and 234 individuals reported lifetime use of hard drugs. After 5, 10, and 13 years, 10.2%, 15.6%, and 16.3% recanted their earlier reported use of cannabis, respectively. The prevalence increased with higher age. After 5 years, 20.4% recanted their earlier use of hard drugs. After 10 and 13 years, approximately 30% recanted their earlier use of hard drugs. This prevalence, too, increased with higher age. The validity of data on the lifetime use of illicit drugs derived from population surveys is questionable among adults in Denmark and perhaps in other countries. Future studies should take these findings into account when interpreting results, as such reporting patterns have considerable implications on the validity of the study results.

HIV prevalence among female sex workers in Guigang City, Guangxi, China: an 8-year consecutive cross-sectional study

BackgroundFemale sex workers (FSW) are a population that are at high risk for HIV infection, and their HIV/AIDS knowledge levels and sexual behaviors are of concern. This study describes changes in HIV prevalence and factors associated among female sex workers in Guigang City, Guangxi, one of the highest HIV prevalence areas in China.MethodsData were derived from an annual cross-sectional venue-based survey, 2008 to 2015, in the form of sentinel surveillance. The participants were recruited using cluster sampling. FSW aged 16 years and above who completed a questionnaire and HIV testing. Both descriptive and multi-level analyses were used to explore factors associated with changes in HIV prevalence.ResultsSeven thousand four hundred ninety-six FSW were recruited in this study. HIV prevalence among FSW in Guigang City fell into two periods, one with an increasing trend (2008–2011) and one with a decline (2012–2015). Differences between these time periods included age, relationship status, HIV knowledge, consistent condom use, lifetime illicit drug use, history of sexually transmitted infection in the past year, HIV testing, receipt of a condom distribution and education program or HIV counseling and testing, and peer education services.ConclusionsSince 2012, a reduction in HIV prevalence among FSW in Guigang City has been observed. The decline of HIV prevalence was associated with coinciding changes in demographic characteristics of FSW, improvement of HIV knowledge and safer sexual behaviors, and a program that promotes condom use, HIV counseling & testing, and peer education.

Risk and protective factors for adolescents’ illicit drug use: A population-based study

Objective: The use of illicit drugs by adolescents is a widespread problem in Taiwan. The aim of this study was to identify risk and protective factors. Design: Web-based survey of high school students. Setting: Senior high schools and vocational high schools in northern Taiwan. Method: Survey data were collected from 15,754 students. Logistic regression analysis examined potential risk and protective factors in individual, family and peer/school domains for lifetime, past-year and past-month illicit drug use and the single and/or multiple use of ketamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA) and marijuana. Results: The prevalence rates of illicit drug use varied from 1.18% to 2.19% by frequency and type of illicit drug use. Perceived availability of illicit drugs, betel nut chewing, drug use by a family member, peer drug use, missing classes and type of school were significant risk factors in lifetime, past-year and past-month use. Sensation seeking, family member and peer drug use were common factors in ketamine, methamphetamine, MDMA and marijuana use. Drug use by a family member increased the risk of multiple drug use. Smoking was a risk factor for ketamine use. Drug-related knowledge was a protective factor. Conclusions: These findings support the idea that there exist multilevel risk and protective factors for drug use, especially in the family and peer/school domains. School-based interventions should be designed to integrate different levels of risk and protective factors.

Depression and its correlations with health-risk behaviors and social capital among female migrants working in entertainment venues in China.

ObjectivesAmong the dramatic increased internal migration in China in past three decades, a considerable proportion of young females migrated to urban areas and found employment in “entertainment venues”, who may be vulnerable to psychological distress. This study examines the prevalence of depression and explores its associations with health-risk behaviors and social capital among this subgroup.Methods358 female migrants were recruited from entertainment venues in a rapidly growing urban city in China. A survey which included measures of depressive symptoms, health-risk behaviors, social capital, and socio-demographic characteristics was administered. Multivariable logistic regression was conducted to identify the independent correlates of depression.ResultsOf participants, 31.0% had clinically significant depressive symptoms (CES-D score ≥ 16). In multivariable models, greater likelihood of depressive symptoms was associated with working in massage centers/hotels (OR = 3.20, 95% CI: 1.80–5.70), having probable alcohol dependence (OR = 2.25, 95% CI: 1.22–4.16), self-reported lifetime use of illicit drugs (OR = 2.98, 95% CI: 1.26–7.06), growing up in a non-nuclear family (OR = 2.46, 95% CI: 1.18–5.16), and poor social capital (OR = 6.01, 95% CI = 2.02–17.87).ConclusionIntervention strategies to address the high prevalence of depression among female migrants are needed, and should also aim to reduce problematic alcohol and drug use, improve social capital, and target women working in massage centers or hotels.

Prevalence and factors associated with illicit drug use throughout life: National School Health Survey 2015.

The use of illicit drugs is a public health concern. This paper describes the prevalence and factors associated with the use of illicit drugs throughout life among 9th grade students attending public and private schools in daylight period in Brazil. Data from the Brazilian Adolescent School-based Health Survey (PeNSE) were analyzed. Use of illicit drugs at some point in life was assessed considering marijuana, cocaine, crack, solvent-based glue, ether-based inhalants, ecstasy, and oxy. Data were analized descriptively and by the Poisson's regression model. The use of illicit drugs at least once in life was reported by 9,0% of participants, being more prevalent among girls and associated with alcohol or tobacco use, active sexual life, feeling of loneliness, little or no contact between school and parents, and the experience of familial aggressions. The outcome was inversely associated with close contact with parents and their supervision. Prevalence was higher among participants whose mothers had higher educational levels and had, who had a payed job, and who attended public schools. The prevalence of lifetime use of illicit drugs was stable when the three PeNSE samples were compared, but it resulted more common among girls in 2015 for the first time and was associated with the same conditions found in prior studies. Family and school appear to be protective factors, especially when there is direct supervision and care. It is important that both girls and boys are given the same attention when it comes to this this subject.

Adapting the ASSIST model of informal peer-led intervention delivery to the Talk to FRANK drug prevention programme in UK secondary schools (ASSIST + FRANK): intervention development, refinement and a pilot cluster randomised controlled trial

BackgroundIllicit drug use increases the risk of poor physical and mental health. There are few effective drug prevention interventions.ObjectiveTo assess the acceptability of implementing and trialling two school-based peer-led drug prevention interventions.DesignStage 1 – adapt ASSIST, an effective peer-led smoking prevention intervention to deliver information from the UK national drug education website [see www.talktofrank.com (accessed 29 August 2017)]. Stage 2 – deliver the two interventions, ASSIST + FRANK (+FRANK) and FRANK friends, examine implementation and refine content. Stage 3 – four-arm pilot cluster randomised control trial (cRCT) of +FRANK, FRANK friends, ASSIST and usual practice, including a process evaluation and an economic assessment.SettingFourteen secondary schools (two in stage 2) in South Wales, UK.ParticipantsUK Year 8 students aged 12–13 years at baseline.Interventions+FRANK is a UK informal peer-led smoking prevention intervention provided in Year 8 followed by a drug prevention adjunct provided in Year 9. FRANK friends is a standalone informal peer-led drug prevention intervention provided in Year 9. These interventions are designed to prevent illicit drug use through training influential students to disseminate information on the risks associated with drugs and minimising harms using content from www.talktofrank.com. Training is provided off site and follow-up visits are made in school.OutcomesStage 1 – +FRANK and FRANK friends intervention manuals and resources. Stage 2 – information on the acceptability and fidelity of delivery of the interventions for refining manuals and resources. Stage 3 – (a) acceptability of the interventions according to prespecified criteria; (b) qualitative data from students, staff, parents and intervention teams on implementation and receipt of the interventions; (c) comparison of the interventions; and (d) recruitment and retention rates, completeness of primary, secondary and intermediate outcome measures and estimation of costs.Results+FRANK and FRANK friends were developed with stakeholders [young people, teachers (school management team and other roles), parents, ASSIST trainers, drug agency staff and a public health commissioner] over an 18-month period. In the stage 2 delivery of +FRANK, 12 out of the 14 peer supporters attended the in-person follow-ups but only one completed the electronic follow-ups. In the pilot cRCT, 12 schools were recruited, randomised and retained. The student response rate at the 18-month follow-up was 93% (1460/1567 students). Over 80% of peer supporters invited were trained and reported conversations on drug use and contact with trainers. +FRANK was perceived less positively than FRANK friends. The prevalence of lifetime illicit drug use was 4.1% at baseline and 11.6% at follow-up, with low numbers of missing data for all outcomes. The estimated cost per school was £1942 for +FRANK and £3041 for FRANK friends. All progression criteria were met.ConclusionsBoth interventions were acceptable to students, teachers and parents, but FRANK friends was preferred to +FRANK. A limitation of the study was that qualitative data were collected on a self-selecting sample. Future work recommendations include progression to a Phase III effectiveness trial of FRANK friends.Trial registrationCurrent Controlled Trials ISRCTN14415936.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 5, No. 7. See the NIHR Journals Library website for further project information. The work was undertaken with the support of the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer). Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK CRC, is gratefully acknowledged.

Predictors of illicit drug use among a national sample of adolescents

ABSTRACTBackground: Rates of illicit drug use are increasing among adolescents. This study was guided by Jessor’s problem behavior theory and explored the conceptual domains of risk factors for adolescent illicit drug use. The purpose of the present study was to investigate whether sex, age, race/ethnicity, authoritarian parenting, negative school experiences, ever been treated for depression, or legal involvement predicted lifetime illicit drug use, past year illicit drug use, or past month illicit drug use among adolescents nationwide. Method: The present study was a secondary data analysis of the 2012 National Survey on Drug Use and Health including 17,399 youth from 12 to 17 years of age nationwide. Results: Among adolescents, 25.3% reported using illicit drugs in their lifetime, 18.9% reported past year use, and 10.1% reported past month use. Predictors of lifetime illicit drug use were age, race/ethnicity, ever been treated for depression, authoritarian parenting, negative school experiences, and legal involvement. Predictors of past year and past month illicit drug use were age, ever been treated for depression, authoritarian parenting, negative school experiences, and legal involvement. Conclusions: A global approach targeting all problem behavior theory systems may reduce illicit drug use among adolescents nationwide. Recommendations for future studies are included.

Correlates of Blunt Smoking Among African American, Hispanic/Latino, and White Adults: Results From the 2014 National Survey on Drug Use and Health

ABSTRACTBackground: Blunt use is highly prevalent in the United States and has been associated with several negative health consequences, such as an increased risk for cardiovascular and pulmonary diseases. Although recent studies have identified characteristics (e.g., gender) that are associated with blunt use, it is unclear if these factors correlate with blunt use equally across racial/ethnic groups. Methods: Using cross-sectional data from the 2014 National Survey on Drug Use and Health, this study aimed to determine if demographic, health and substance use correlates of current (i.e., past 30-day) and lifetime blunt use were similar across 37,628 non-Hispanic African American, Hispanic/Latino and non-Hispanic White adults. Results: Findings revealed 8.3% of African American, 3.3% of Hispanic/Latino and 2.5% of White adults reported current blunt smoking. Across all racial/ethnic groups, age and current and lifetime cigarette and illicit drug use were associated with current and lifetime blunt use. However, gender, educational level, income, current alcohol use and self-reported health status were differentially associated with current and lifetime blunt use across racial/ethnic groups. Employment status and lifetime depression were not associated with blunt use behaviors among any of the racial/ethnic groups. Conclusions: The relationship between gender, socioeconomic status, alcohol use and self-reported health status and blunt use differs among African American, Hispanic/Latino and White adults. Researchers and providers should consider the heterogeneity in factors that are associated with blunt use when designing prevention and treatment interventions for African American, Hispanic/Latino and White adult blunt smokers.

Illicit Substance Use in US Adults With Chronic Low Back Pain.

A population-based cross-sectional survey. The aim of this study was to compare the prevalence of illicit drug use among US adults with and without chronic low back pain (cLBP). Although addictive medications, such as opioids and benzodiazepines, are frequently prescribed to patients with cLBP, little is known about illicit drug use among Americans with cLBP. We used data from the back pain survey, administered to a representative sample of US adults aged 20 to 69 years (N = 5103) during the 2009 to 2010 cycle of the National Health and Nutrition Examination Survey (NHANES). Participants with pain in the area between the lower posterior margin of the ribcage and the horizontal gluteal fold for at least 3 months were classified as having cLBP (N = 700). The drug use questionnaire was self-administered in a private setting, and included data on lifetime and current use of marijuana or hashish, cocaine, heroin, and methamphetamine. Chi-square tests, one-way analysis of variance, and logistic regression, adjusted for age, gender, race, and level of education, were used for comparisons. About 46.5% of US adults with cLBP used marijuana versus 42% of those without cLBP [Adjusted odds ratio (aOR) 1.36, 95% confidence interval (95% CI) 1.06-1.74]. About 22% versus 14% used cocaine (aOR 1.80, 95% CI 1.45-2.24), 9% versus 5% used methamphetamine (aOR 2.03, 95% CI 1.30-3.16), and 5% versus 2% used heroin (aOR 2.43, 95% CI 1.44-4.11). Subjects with cLBP who reported lifetime illicit drug use were more likely to have an active prescription for opioid analgesics than those without illicit drug use history: 22.5% versus 15.3%, P = 0.018. cLBP in community-based US adults was associated with higher odds of using marijuana, cocaine, heroin, and methamphetamine. Prescription opioid analgesic use was more common in cLBP sufferers with a history of illicit drug use. 2.

Substance Use and Sexual Risk Behavior in Sexual Minority Hispanic Adolescents

PurposeThis study examines substance use and sexual risk in sexual minority Hispanic adolescents (SMHAs) relative to their heterosexual counterparts. MethodsBaseline data (total, n=1,632; SMHA, n=195) from five completed trials of a family-based intervention for Hispanic adolescents were synthesized. SMHA were identified by self-reported anal/vaginal/oral sex with a partner of the same gender (SMHA vs. non-SMHA). Dichotomous outcomes were lifetime and past 90-day cigarette, alcohol and illicit drug use, past 90-day condomless sex, and condom use at last sex. Logistic regression models controlled for sociodemographic and study-level characteristics testing the association between sexual minority status and each outcome. ResultsSMHA reported significantly more substance use than non-SMHA, including lifetime cigarette and illicit drug use. Adjusted odds of lifetime use for all substances and past 90-day cigarette use (AOR = 3.07; 95% confidence interval: 1.50–6.31) were significantly higher in SMHA. ConclusionsSMHA substance use etiology should be explored to inform tailored intervention development.

Prison and Community Populations at Ultra-High Risk of Psychosis: Differences and Challenges for Service Provision.

The aim of the study was to explore the feasibility of expanding a community service for early detection of psychosis into a local London prison for men in the United Kingdom. All new receptions to a local prison for men in South London were approached for routine screening. Those who met criteria for being at ultra-high-risk of psychosis were compared with a help-seeking sample from the community who met the same criteria. Clinical and sociodemographic characteristics were compared to determine whether the prison and community populations had similar profiles and mental health needs. Of 891 prisoners screened, 44 (5%) met criteria for being at ultra-high risk of psychosis. The community sample consisted of 42 participants. Compared with the community group, prison participants had lower scores on almost all symptom measures, were less likely to have remained in school and completed exams, and were more likely to be in short-term accommodations and to be of black race-ethnicity. Lifetime use of illicit drugs was similar between the groups, but recent use was much higher in the prison group. Expanding community services into custodial settings should take into account the different environment and needs of the prisoner population. Specifically, early detection and intervention services should target a broad range of mental health problems rather than psychosis alone.

An Increasing Trend of Illicit Drug use among Romanian University Students from 1999 to 2011.

AimThe present study investigates the evolution of illicit drug use among Romanian university students from 1999 to 2011.MethodsThe study was performed in Cluj-Napoca, Romania, in three phases: in 1999 (T1), in 2003 (T2) and in 2011 (T3). The study was carried out by means of anonymous questionnaires among university students aged 19–24.ResultsThe results show that among girls the lifetime illicit drugs use increased statistically significantly from 2.5% in 1999 to 7.5% in 2003 and to 15% in 2011. Among boys the trend was also increasing, the prevalence of illicit drug use was 14.2% at T1, 18.1% at T2, and it increased dramatically to 30.6% at T3. The percentage of students reporting cannabis use was almost identical with the total prevalence of illicit drug use. Ecstasy was the second most frequent drug used by the students; its consumption had also an increasing trend during the examined periods (from 0 to 5.6% among girls and from 0.8% to 11.2% among boys). The results of the bivariate correlation analyses show that lifetime illicit drug use was associated with having friends who experimented with illicit drugs both among boys and girls. Moreover, girls who declared stress management problems and depressive episodes were more likely to try illicit drugs, while among boys illicit drug use was associated with poorer academic performance.ConclusionsThe data pointed out by our study call for comprehensive actions regarding the prevention of illicit drug use among Romanian young people.