Patterns Of Substance Use Research Articles

Socio-demographic and Clinical Profile of Patients with Substance Use Disorder at a Tertiary Care Centre in Vindhya Region: A Hospital-based Study

Introduction: The rampant increase in substance use in India makes it a serious public health hazard, in consonance with the western trend. The upsurge of substance use is getting so alarming that the preventive strategies have become a matter of national priority. The youth constitute the most vulnerable section in the society. Similar to the unprecedented rise of substance use all over India, Madhya Pradesh did not remain untouched by this erosion. In the recent past, the pattern of substance use in this region has worsened leading to an increase in behavioural disturbances due to substance use, poor family dynamics, illegal issues and restrained interpersonal relationships. Aim: To study the clinical and socio-demographic profile of various substance users in the Vindhya region. Materials and Methods: The present hospital-based crosssectional study was conducted in the Department of Psychiatry, Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from January 2019 to May 2019. Patients of all ages, both genders, diagnosed under substance use disorders as per Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria were included in the study. A detailed assessment including socio-demographic and clinical history, physical examination and other relevant investigations were done. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS), version 21.0. Results: After the screening of 432 patients, 339 fulfilled the inclusion criteria. Total 92 (27.29%) patients were multiple substance users, followed by opioids 82 (24.33%), and benzodiazepines 66 (19.58%). Alcohol, tobacco, and cannabis users were 42 (12.46%), 29 (8.6%), and 28 (8.3%) respectively. Majority of the study participants 160 (47.2%) were in the younger age group (21-30 years). Most of them were males 303 (89.4%), single 230 (67.8%), from urban areas 204 (60.2%), and belonging to the lowermiddle socioeconomic class 108 (32%). The bulk participants were students 95 (28%), and well-educated (undergraduate and above). The chief reason for seeking the treatment was withdrawal symptoms. The majority of the subjects with substance use had onset within the age range of 10-20 years (149, 44%). Peer group influence was the most common factor responsible for the initiation of substance use overall (145, 42.7%). Strong craving (77, 22.7%) was the most important continuation/maintenance factor. Conclusion: The younger age groups with a family history were at a high risk of developing substance use disorders. Easy accessibility of substances along with peer motivation for substance-taking behavior has made increased the number of adolescent and young substance users.

Socio-demographic and Clinical Profile of Treatment-seeking Drug Abusers Attending a Hospital in South Kashmir: A Cross-sectional Hospital-based Study

Introduction: Substance abuse is one of the major public health problems in the present world, and so in Kashmir. The geographical location of Kashmir and the prevailing conflict has made the population vulnerable to drug abuse. Data from different areas of Kashmir has pointed out the changing pattern of substance abuse, and the rising trend of opioid use. However, there have been no studies from southern Kashmir. Aim: To study the socio-demographic and clinical profile of treatment-seeking drug abusers attending General Psychiatric Outpatient Department (OPD) at the newly established Government Medical College, Anantnag, Kashmir, India. Materials and Methods: This cross-sectional, hospital-based study was conducted from January 2020 to June 2021. A total of 213 treatment-seeking drug abusers were included in the study. Diagnosis of substance dependence was established by applying the International Classification of Disease version 10. The clinical and socio-demographic variables were studied using a semi-structured proforma, and the variables were presented as frequency and mean. The data were analysed using Epi Info software version 7.0. Results: The mean age of the study population was 23.4 years. Young adults were the most common population using substances. Opioids (25.3%) were the predominantly used drug, although polysubstance formed the majority at 48.8%. More than 60% of patients were intravenous drug users. Peer pressure and curiosity were the most common specified reasons for initiation of substance (47.4% and 12.2%, respectively). More than 50% of cases had past failed attempts at abstinence. Craving was still the most common reason for relapse (42.8%). Conclusion: The present study results reiterate the presence of a hazardous pattern of substance use in the young population. The intravenous drug use and the secondary infections arising out of that are alarming. The results encourage the conduct of large scale community-based studies and robust policy making and law enforcement.

Knowledge, attitude, practice, and pattern of substance use among adolescents and young adults from Aligarh, India

Background: Substance use disorders are significant public health problem among adolescents and young adults. Aim & Objective: We did this study to observe knowledge, attitude, and practice of substance use among school and college going adolescents and young adults. Material & Methods: A cross-sectional study was conducted at 10 schools and colleges from Aligarh. A total of 1431 students were approached with study tools comprising of pre-structured proforma on knowledge, attitude, and practice. Results: We observed that most of the students (89%) had some knowledge about substance use. The risk-taking attitude was common even against drugs like cocaine and charas (30.6% and 29.1% respectively). A high prevalence of ever user and current user was observed (33.3% and 12.9% respectively). The mean age of starting the drug in students and their friends was 15.5 ±2.7 and 16.2 ±2.8 years respectively. Among the ever users, tobacco smoking (56.6) and alcohol (47.6%) were most common. Stress (57.9%) was most common reason to use drugs. Males and college students (40.6% and 41.2% respectively) were using it more. Conclusion: This study found half-baked knowledge, propensity towards a risk-taking attitude, and a substantial prevalence of substance use practices. Proper action and further researches are required to explore variables associated for reducing the prevalence.

Changes in ICD-11: Disorders Due to Substance Use or Addictive Behaviours

ICD-11 will discriminate 3 subcategories of harmful patterns of substance use and 5 subcategories of dependence. According to a pre-version, the 6 diagnostic criteria of substance dependence in ICD-10 will be condensed in 3 pairs in ICD-11. The term "persistent substance use despite clear evidence of overly harmful consequence" shall be replaced by "substance use often continues despite the occurrence of problems". Pathological gambling and pathological gaming will be listed as addictive behaviors next to substance use disorders.The reduction from 6 to 3 criteria of substance dependence may be problematic in some cases. First studies report an increase of alcohol and cannabis dependence under use of ICD-11. The change of the description of "persistent substance use despite clear evidence of overly harmful consequence" to "substance use often continues despite the occurrence of problems" could imply legal and social problems, which could lead to pathologization of social problems.

Social Context of Cannabis Use: Associations with Problematic Use, Motives for Use, and Protective Behavioral Strategies among Sexual Minorities Assigned Female at Birth.

Sexual and gender minorities assigned female at birth (SGM-AFAB) are at heightened risk for problematic cannabis use compared to heterosexual cisgender women. Despite evidence that social context influences patterns of substance use, no known studies have examined context of cannabis use among SGM-AFAB. The current study examined two aspects of social contexts of cannabis use (locations and companions) and their associations with problematic use, motives for use, and protective behavioral strategies among SGM-AFAB. We utilized three waves of data from 358 SGM-AFAB from a larger study. We aimed to: (1) identify subgroups of SGM-AFAB based on contexts in which they used cannabis; (2) examine changes in contexts over time; and (3) examine associations between contexts, problematic use, motives for use, and protective behavioral strategies. Using latent class analysis, we identified four classes: those who used cannabis at home; those who used with friends; those who used alone and with friends; and those who used in all contexts. Those who used in all contexts reported more problematic use, higher coping motives, and used fewer protective behavioral strategies compared to other classes. Transitioning to using cannabis in fewer contexts was associated with a subsequent decrease in problematic use. Classes that were most stable over time (using in all contexts or alone and with friends) were also those that were associated with more problematic use. Social context has important implications for problematic cannabis use among SGM-AFAB. As such, interventions may benefit from attending to social context to reduce problematic use in this population.

COVID-19 Lockdown 2020 Changed Patterns of Alcohol and Cannabis Use in Swiss Elite Athletes and Bodybuilders: Results From an Online Survey.

Objectives: During the COVID-19 pandemic, increased patterns of substance use have been reported in the general population. However, whether this also applies to athletes is not yet clear. This study aimed to detect changes in alcohol consumption and cannabis use in elite athletes and bodybuilders during the first COVID-19 lockdown in Switzerland.Methods: Between April 25 and May 25, 2020, a cross-sectional online survey was conducted among bodybuilders and Swiss elite athletes who were active in Olympic sports and disciplines approved by the International Olympic Committee (IOC) on at least the national level. The collected data included information on alcohol and cannabis use during the last month (lockdown) and in the year before COVID-19 lockdown (pre-lockdown), daily training times, existential fears on a scale from 1 to 100, Patient Health Questionnaire-9 for depression (PHQ-9), Insomnia Severity Index (ISI), and State-Trait Anxiety Inventory (STAI).Results: N = 275 athletes (elite athletes: n = 193; bodybuilders: n = 82) was included in this study. Both pre-lockdown and during lockdown, more bodybuilders used cannabis (both time points: p < 0.001) than elite athletes, and more elite athletes drank alcohol (pre-lockdown: p = 0.005, lockdown: p = 0.002) compared to bodybuilders. During lockdown, fewer athletes drank alcohol compared to before, but those who continued drinking did so on more days per week (p < 0.001, Eta2 = 0.13). Elite athletes were more likely to increase their drinking with 17.7 vs. 8.2% in bodybuilders. When compared to pre-lockdown measures, the number of athletes using cannabis did not change during lockdown. Only three of 203 elite athletes reported using cannabis during lockdown; this contrasts with 16 of 85 bodybuilders. In a multivariate regression model, existential fears and a lower ISI score were significant predictors for increased alcohol consumption during the lockdown in the entire sample. In a model based on elite athletes only, male sex and a lower ISI score predicted increased alcohol consumption. In a bodybuilder-based model, predictors of increased alcohol consumption were existential fears and trait anxiety.Conclusion: We suggest identifying athletes who are at risk for increased alcohol and cannabis use; we suggest this to be able to professionally support them during stressful times, such as the COVID-19 pandemic.

Cannabis use, polysubstance use, and psychosis prodrome among first-degree relatives of patients with schizophrenia

ABSTRACT Background Cannabis use and Psychosis are closely associated. Polysubstance use is prevalent among cannabis users. However, previous literature majorly examined the relationship between only cannabis use and schizophrenia disorder. Little is known about the impact of polysubstance use on the onset of prodromal symptoms. There is a scarcity of studies comparing the severity and characteristics of prodromal symptoms between cannabis users and polysubstance users. Aim This study investigates the association between polysubstance use and prodromal symptoms. It also compares the severity and characteristics of prodromal symptoms among individuals with different substance use patterns. Method 246 first-degree relatives of patients with schizophrenia participated in the study, using purposive sampling method. Pattern of substance use and prodromal symptoms were assessed using the WHO ASSIST Scale and PROD-Screen respectively. Result Significant association was found between substance use and symptoms of prodrome (r = −0.57, p < .01). Individuals who consumed more than one substance experienced more severe prodromal symptoms. Prodromal symptoms viz. “hallucinatory and delusional symptoms” and affect and thinking difficulties discriminate the study groups effectively. Conclusion Cannabis plus other substance use increases the risk of prodrome among first-degree relatives of patients with schizophrenia. Polysubstance use causes more thinking, affective, delusionary, and hallucinatory symptoms of prodrome.

Associations between Longitudinal Patterns of Substance Use and Anxiety and Depression Symptoms among a Sample of Canadian Secondary School Students.

The objective of this study is to examine the longitudinal associations between latent classes of substance use and anxiety and depression scores among youth who use substances. This study uses data from three waves (Wave 1: 2017/18, Wave 2: 2018/19, and Wave 3: 2019/20) of the COMPASS study. Students in grades 9 and 10 who reported substance use at baseline (n = 738) report their substance use (alcohol, cannabis, cigarettes, and e-cigarettes) and anxiety and depression symptoms at each wave. A Repeated Measures Latent Class Analysis (RMLCA) is used to determine substance use classes, and mixed models are used to examine the associations between substance use classes and anxiety and depression. We identify three classes of substance use: (1) occasional alcohol and e-cigarette use, (2) escalating poly-substance use, and (3) consistent poly-substance use. After controlling for relevant covariates, consistent poly-substance use is associated with depression (Female OR: 1.24 [95%CI: 0.46, 2.02]; Male OR 1.13 [95%CI: 0.38, 1.87]) but not anxiety. Escalating poly-substance use is associated with depression among males (OR 0.72 [95%CI: 0.10, 1.33]). These findings should be taken into consideration when creating prevention programming and treatment strategies for adolescents. Substance use programming should be comprehensive, consider multiple substances, and be cognizant of symptoms of mental illness, particularly depression.

Women who Use Drugs: Pattern of Substance Use and Relapse

Women who Use Drugs: Pattern of Substance Use and Relapse

Project CHOICE: Choosing healthy options in coping with emotions, an EMA/EMI plus in-person intervention for alcohol use

Background: Emerging adulthood (18–25 years) represents a risky time for mental health and substance use. Emerging adults are particularly susceptible to problematic patterns of substance use, especially if they experience anxiety and/or depression and use substances as a way to cope with such issues. However, many mental health treatments do not address substance use. We developed an ecological momentary assessment and intervention (EMA/EMI) to specifically target the motive of drinking to cope with anxiety/depression. Methods: Project CHOICE was a 6-week intervention that paired in-person normative feedback with daily EMA and, if an individual reported negative affect and intent to drink, an EMI was immediately sent to their phone (a personally-chosen coping skill). We recruited n = 20 (55% female, mean age 21.74, 85% Caucasian and 75% non-Hispanic/Latino) individuals from a psychiatric partial hospitalization program for a 6-week open trial of the CHOICE intervention and re-assessed at the 6-week follow-up point. Results: Results indicated that drinking variables and coping motives were highly correlated at baseline. Days of drinking, alcohol-related problems, and coping motives significantly decreased over time following the intervention. Results indicated high levels of feasibility and acceptability. Conclusions: This open pilot represents a feasible, acceptable, and promising direction in delivering interventions in the moment when risk is highest, utilizing smartphone capabilities.

Individual Characteristics And The Gateway Hypothesis Among Drug User Patient In Indonesia

Drug abuse has become severe not just in the world but also in Indonesia. To address this problem, public policies and researcher try to understand the drug use pattern. One of the famous concept in drug use pattern is gatheway hypothesis. The gateway hypothesis refers to the pattern of substance use initiate softer drug lead to the harder drug. However, many literature shows drug use pattern is not just gateway pattern, there is reversal pattern and using both gateway and reversal pattern. Many studies have discussed the relationship between drug use and individual characteristics. However, few of them are relatively link between individual characteristics and the sequential order in drug use. The purpose of this study is to evaluate how individual characteristics are associated with the gateway pattern and other pattern for different types of drugs. We use a secondary dataset of individual drug user patients from the Rehabilitation Center of National Narcotics Board aged 14–67 years assessed using the Addiction Severity Index (ASI), employing probit and multinominal logit model. Duration are associated with initial soft drug user with gateway pattern. While alcohol use and have high education level related with initial hard drug user with reversal pattern. Interestingly, duration and alcohol use correlated with initial intermediate drug user with all kind of pattern. Prevention and intervention efforts should be targeting high-risk characteristics of people at an initial stage of drug use and progression to the next stage.

Priorities for addressing substance use disorder in humanitarian settings

BackgroundPopulations affected by humanitarian emergencies are vulnerable to substance (alcohol and other drug) use disorders, yet treatment and prevention services are scarce. Delivering substance use disorder treatment services in humanitarian settings is hampered by limited guidance around the preparation, implementation, and evaluation of substance use disorder treatment programs. This study aims to identify and prioritize key gaps and opportunities for addressing substance use disorder in humanitarian settings.MethodsUNODC convened a consultation meeting (n = 110) in coordination with UNHCR and WHO and administered an online survey (n = 34) to, thirteen program administrators and policymakers, eleven service providers, nine researchers, and one person with lived experience to explore best practices and challenges to addressing substance use disorder in diverse populations and contexts. Participants presented best practices for addressing substance use disorder, identified and ranked challenges and opportunities for improving the delivery of substance use disorder treatment interventions, and provided recommendations for guidelines that would facilitate the delivery of substance use disorder treatment services in humanitarian emergencies.ResultsParticipants agreed on key principles for delivering substance use disorder treatment in humanitarian settings that centered on community engagement and building trust, integrated service delivery models, reducing stigma, considering culture and context in service delivery, and an ethical ‘do no harm’ approach. Specific gaps in knowledge that precluded the delivery of appropriate substance use disorder treatment include limited knowledge of the burden and patterns of substance use in humanitarian settings, the effectiveness of substance use disorder treatment services in humanitarian settings, and strategies for adapting and implementing interventions for a given population and humanitarian context. Participants emphasized the need to strengthen awareness and commitment related to the burden of substance use disorder treatment interventions among communities, practitioners, and policymakers in humanitarian settings.ConclusionsResults from this consultation process highlight existing gaps in knowledge related to the epidemiology and treatment of substance use disorders in humanitarian emergencies. Epidemiological, intervention, and implementation research as well as operational guidance are needed to fill these gaps and improve access to substance use treatment services in humanitarian settings.

Qualitative examination of simultaneous alcohol and cannabis use reasons, evaluations, and patterns among heavy drinking young adults.

Use of alcohol and cannabis together so their effects overlap (simultaneous use) is common among college students and associated with numerous negative consequences. The aim of this study was to gain insight into college students' recent simultaneous use events in order to inform future studies (i.e., generate hypotheses, inform measures/assessments of simultaneous use, and identify factors influencing simultaneous use). Qualitative interviews of simultaneous use experiences among heavy drinking college students (n = 38) were conducted to better understand reasons for simultaneous use, evaluations of simultaneous use events, and patterns of substance use during simultaneous use events. Findings indicated that students' reasons for simultaneous use included traditional four-factor motive types (i.e., social, conformity, enhancement, and coping), cross-fading motives, harm reduction motives (e.g., to drink less), and reactive/situational reasons (e.g., because it was offered/available). There was variability in participants' subjective evaluations of how positive versus negative simultaneous use events were and how this compared to single-substance events. Evaluation of simultaneous use events depended on patterns of use, external and internal context, and consequences experienced. Additionally, patterns of simultaneous use including order of substances, timing of using each substance, and quantities of substances used were highly variable across participants. Notably, participants endorsed patterns of use they perceived to reduce negative consequences during simultaneous use events. Further research on reasons for simultaneous use and patterns of use may help identify simultaneous use occasions that result in greater risk; identification of high-risk simultaneous use occasions and evaluation of these occasions can then help inform targeted interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and Related Complications During the 2020 COVID-19 Pandemic.

Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and “lockdown” measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic.Design: Cross-sectional survey.Setting: Worldwide.Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries.Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic.Findings: Participants reported (among who answered “decreased” or “increased”) a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall.Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.

Latent class analysis of self-reported substance use during incarceration: Gender differences and associations with emotional distress and aggressiveness

IntroductionWe know little about the prevalence and patterns of substance use during incarceration, and we know even less about comparative substance use patterns by gender. To address these gaps in the literature, this study used latent class analysis (LCA) to identify substance use subgroups of incarcerated men (n = 1118) and women (n = 207). MethodsThe study drew data from six prisons in Spain. Participants completed a self-administered questionnaire with items probing for types of drugs used in the past three months, depression, anxiety, stress symptoms, aggressiveness, and perceived social support. ResultsSubstance use was common among incarcerated men and women, with tobacco, cannabis, and sedatives being most prevalent. LCA revealed different patterns of substance use by gender. Four- and two-class solutions best fitted the data for men and women, respectively. Aggressiveness and depression were associated with high depressant use membership for men. Among women, aggressiveness and anxiety symptoms were positively associated with high polydrug use membership. ConclusionsThe prevalent and patterned use of substances inside Spanish prisons and their association with aggressiveness and depression elevates the risk of harm during incarceration. In the interest of safety and wellness, correctional behavioral health services should include and expand the availability of gender-specific integrated mental health and substance use interventions that address maladaptive behaviors such as aggression.

Substance use patterns in 9-10 year olds: Baseline findings from the adolescent brain cognitive development (ABCD) study

BackgroundThe Adolescent Brain Cognitive Development ™ Study (ABCD Study®) is an open-science, multi-site, prospective, longitudinal study following over 11,800 9- and 10-year-old youth into early adulthood. The ABCD Study aims to prospectively examine the impact of substance use (SU) on neurocognitive and health outcomes. Although SU initiation typically occurs during teen years, relatively little is known about patterns of SU in children younger than 12. MethodsThis study aims to report the detailed ABCD Study® SU patterns at baseline (n = 11,875) in order to inform the greater scientific community about cohort’s early SU. Along with a detailed description of SU, we ran mixed effects regression models to examine the association between early caffeine and alcohol sipping with demographic factors, externalizing symptoms and parental history of alcohol and substance use disorders (AUD/SUD). Primary ResultsAt baseline, the majority of youth had used caffeine (67.6 %) and 22.5 % reported sipping alcohol (22.5 %). There was little to no reported use of other drug categories (0.2 % full alcohol drink, 0.7 % used nicotine, <0.1 % used any other drug of abuse). Analyses revealed that total caffeine use and early alcohol sipping were associated with demographic variables (p’s<.05), externalizing symptoms (caffeine p = 0002; sipping p = .0003), and parental history of AUD (sipping p = .03). ConclusionsABCD Study participants aged 9–10 years old reported caffeine use and alcohol sipping experimentation, but very rare other SU. Variables linked with early childhood alcohol sipping and caffeine use should be examined as contributing factors in future longitudinal analyses examining escalating trajectories of SU in the ABCD Study cohort.

Characterizing substance use typologies and their association with HIV viral load outcomes: A latent class analysis among sexual minority men living with HIV

BackgroundRacially diverse sexual minority men (SMM) are disproportionately impacted by the U.S. HIV epidemic. Substance use, particularly stimulant use, may impact viral suppression for SMM living with HIV. The current study sought to characterize patterns of substance use via latent class analysis (LCA) and test associations between those patterns and future viral load outcomes, among SMM living with HIV. MethodsData were drawn from Thrive With Me (TWM), an RCT of an mHealth intervention targeting ART adherence among SMM living with HIV. LCA was performed with six dichotomous indicators of substance use, derived from validated measures and urinalysis results, to determine substance use classes at baseline. Bivariate and multivariable logistic regression models tested associations between baseline substance use classes and HIV viral load 5-months post-baseline. ResultsAmong 383 SMM living with HIV, we identified a three-class model of substance use fit best: low probability substance use (81.3 %), high probability hazardous alcohol, marijuana, and cocaine use (7.5 %), and high probability methamphetamine and amphetamine use (11.2 %). Additionally, the high probability amphetamine use class was less likely to be virally suppressed at 5-month follow-up compared to the low probability substance use class [Adjusted Odds Ratio = 3.34, 95 % Confidence Interval = 1.39–7.99, p = .0069]. ConclusionWe identified that some patterns of substance use (i.e., methamphetamine and amphetamine use), but possibly not others (e.g., alcohol, marijuana, and cocaine use), are potentially important intervention targets for improving HIV-related outcomes among racially diverse SMM living with HIV.

Longitudinal effects of adverse childhood experiences on substance use transition patterns during young adulthood

BackgroundFew studies have investigated how adverse childhood experiences are associated with substance use patterns during young adulthood, a crucial developmental period. ObjectiveThe objective of this study was to extend current knowledge on the association between adverse childhood experiences and patterns of substance use among young adults. We also sought to understand how current mental health status and biological sex influences these patterns. Participants and settingThe current study utilized wave 8–wave 11 data of a longitudinal cohort study (N = 2880). MethodsWe used latent transition analysis (LTA) to understand stability and transition patterns of substance use across participants who reported adverse childhood experiences (ACEs+) versus those who did not (ACEs−). Latent class regression was used to assess contemporaneous effects of mental health and sex on classes over time. ResultsBoth groups had similar patterns of substance use emerge at each timepoint: High all; Binge, tobacco, cannabis; and Steady/increasing binge drinking. ACEs+ had a higher proportion of youth in the High all class and much higher stability in this class, compared to the ACEs− group. Those in the ACES+ group were less likely to transition out of a riskier class. Mental health and sex showed differential effects across ACEs groups. ConclusionResults point to increased risk of polysubstance use, including opioids and prescription medications, among those who reported adverse childhood events. Future work may explore protective, malleable, factors that may confer reduced risk of long-term polysubstance use.

Pattern of Substance Use in the Elderly

Background: There are many unique features related to substance abuse in the elderly, which is an underestimated problem in society. Objectives: A cross-sectional exploratory study was conducted in a North Indian tertiary care setting to assess the pattern of substance use in the elderly. Materials and Methods: Fifty cases were included in the study via purposive sampling; a Drug Abuse Monitoring System pro forma and a semistructured pro forma designed to gather information on sociodemographic and substance use characteristics were used. Descriptive statistics were applied. Continuous variables were summarized as means and standard deviations and categorical variables as counts and percentages. Results: The mean age of the samples was 64.12 ± 4.54 years. Alcohol use was noted in 66% of the cases, tobacco use in 76%, opioid use in 16%, cannabinoid use in 4%, and sedative/hypnotic use in 4%. Majority of the cases were married, studied up to high school, self-employed, and living in joint family. Majority of the cases had initiation of substance use in young age due to peer pressure, and the reason for change in pattern were in majority mainly family issues and tolerance. Majority of the cases were brought by family members for treatment seeking. Conclusions: The issue of substance abuse in elderly population is underestimated, and studies are scarce in finding the exact prevalence in the society.

Harmful drinking, tobacco, and marijuana use in the 2000–2015 National Alcohol Surveys: Examining differential trends by sexual identity

Background Population-based surveys document disparities in substance use among sexual minorities compared to heterosexuals, but few studies examine changes over time. This study compared changes in harmful drinking (including alcohol use disorders and high-intensity drinking), tobacco use, marijuana use, and simultaneous marijuana and alcohol co-use between heterosexual and sexual minority adults over a 15-year period. Methods: Gender-stratified logistic regression analyses using 4 waves of cross-sectional data from the National Alcohol Survey (2000, 2005, 2010, and 2015) were conducted to test overall trends over time and differences by sexual identity, as well as the interaction between survey year and sexual identity. Results: Among women, significant effects for sexual identity were present in all models, reflecting greater odds of use among sexual minorities across waves. Among men, significant effects for sexual identity were found for high-intensity drinking (reflecting less use among sexual minorities) as well as marijuana use and marijuana and alcohol co-use (reflecting more use among sexual minorities). For women and men, tobacco use generally decreased and both marijuana use and simultaneous marijuana and alcohol co-use increased during the study period. Although trends were largely driven by heterosexual respondents, only one instance of an interactive effect was found; reports of harmful drinking were generally stable over time among heterosexual women, but higher and more variable over time among sexual minority women. Conclusions: Findings highlight that differences in patterns of substance use by sexual identity persist and underscore the need for screening, prevention, and intervention, particularly for sexual minority women.