Polydrug Problems Research Articles

Substance use during and after pregnancy among a national cohort of pregnant women in opioid maintenance treatment and their partners

Background: Most individuals in opioid maintenance treatment (OMT) have had serious polydrug problems in addition to opiate addiction. Prospective studies on substance use among pregnant women in OMT and their male partners on a national level have been scarce and therefore deserve attention.Methods: The European Addiction Severity Index was used to map substance use history among a Norwegian national cohort (2005–2006) of pregnant OMT women (n = 37) and their partners (n = 23), as well as substance use during the last month of pregnancy and 1 year later.Results: Lifetime substance use indicated an average of 8 years of heroin abuse before entering OMT. During the last month of pregnancy one woman and two partners reported using illegal substances, while 1 year later, one women and one partner reported having used illegal substances. The use of legal substances among the partners was significantly reduced from pregnancy to 1 year later (38–20%, p < 0.01), while the use of legal substances among the women increased from 8% to 19%.Conclusion: The results suggest that a majority of OMT mothers in Norway and their partners are able to abstain from most illegal substances 1 year after pregnancy, but the tendency of problem drinking among the women is a concern.

Childhood adversity and poor mothering: consequences of polydrug abuse use as a moderator

Drug abuse consequences have been typically examined as a direct or main effect on various later outcomes. Drug abuse may also serve as a consequence that alters (moderates) critical developmental trajectories. This study examined the relationship between childhood adversity factors (parent alcohol and drug-related problems, childhood maltreatment) and future parenting practices through an analysis of the moderating effects of polydrug problems. Data from a community sample of mothers was divided into two groups based on the median split level of polydrug problems (alcohol, marijuana, cocaine) that they reported (low, N=123; high, N=114). Confirmatory factor models (CFAs) were developed for the two groups and compared with multiple group analyses (MGAs). Results revealed that mothers who had parents with alcohol or drug-related problems were more likely to become poor parents, if they themselves used drugs and had problems related to drug use.

Child maltreatment, parent alcohol and drug-related problems, polydrug problems, and parenting practices: a test of gender differences and four theoretical perspectives.

The authors tested how adverse childhood experiences (child maltreatment and parent alcohol- and drug-related problems) and adult polydrug use (as a mediator) predict poor parenting in a community sample (237 mothers and 81 fathers). These relationships were framed within several theoretical perspectives, including observational learning, impaired functioning, self-medication, and parentification-pseudomaturity. Structural models revealed that child maltreatment predicted poor parenting practices among mothers. Parent alcohol- and drug-related problems had an indirect detrimental influence on mothers' parenting and practices through self-drug problems. Among fathers, emotional neglect experienced as a child predicted lack of parental warmth more parental neglect, and sexual abuse experienced as a child predicted a rejecting style of parenting.

Social Work Practice with the Elderly Substance Abuser

ABSTRACT A surprising number of elderly people suffer from substance-related disorders. Many more are at risk for developing poly drug problems due to their misuse and abuse of alcohol in combination with prescription medications and over-the-counter preparations. The purpose of this article is to update social workers on advances in geriatric addictionology by reviewing current epidemiological studies and extracting practice principles. Particular emphasis is placed on what the social work practitioner needs to know about screening elderly clients for substance abuse. The article concludes with specific recommendations to advance social work education and research in the field of addictions treatment.

The Prospective Relations Between Drug Problems and Intimacy in a Community Sample of Adults

Three theories (Role Incompatibility Theory, problem behavior theory, and self-medication hypothesis) are tested to explain the prospective relationships between polydrug problems and adult intimacy in a community sample of adults. Polydrug Problems were negatively related to Good Intimate Relations and positively related to divorce. Polydrug Problems increased the degree to which an individual prescribed to a belief system that decreases one's ability to express affection. In contrast, Good Intimate Relations were related to Communality and decreased alcohol problems. Support for Relationship Problems was related to decreased alcohol problems. Although moderate cross-sectional support was found for the third variable hypothesis as Social Conformity eliminated the association between Polydrug Problems and adult intimate relations, Polydrug Problems and divorce remained significantly correlated despite the effect of Social Conformity. Adherence to traditionality was related to increased Good Intimate Relations 4 years later. Theoretical and developmental implications of these findings are discussed.

Prospective relationships between drug problems and work adjustment in a community sample of adults.

The prospective relationships between drug problems and work adjustment (e.g., job instability, job satisfaction) were examined in a community sample of 470 adults. Polydrug problems (alcohol, marijuana, and cocaine problem drug use) were both predictors and consequences of work adjustment. In partial support of the impaired functioning theory, polydrug problems predicted reduced job satisfaction 4 years later. Supporting the work-related strain theory, early job instability predicted polydrug problems 4 years later. In support of the theory of general deviance, low social conformity predicted later job instability. Finally, supporting social support theory, early support for drug problems reduced polydrug problems and increased job satisfaction 4 years later.

The drug-crime nexus in a community sample of adults.

The authors tested several theories using prospective data to explain the associations between drug abuse and crime in a community sample of 470 adults. Polydrug problems in early adulthood predicted both criminal behavior and polydrug problems in adulthood. Consequences of drug problems as a young adult included arrests and convictions for drug-related offenses, property damage, and driving under the influence of other drugs. Predictors of later polydrug problems included thefts, driving under the influence of alcohol and other drugs, arrests and convictions for drug-related offenses, and a lack of support for drug problems. Theoretical implications of these findings are discussed.

Drug problems and psychological distress among a community sample of adults: Predictors, consequences, or confound?

Although the comorbidity of drug abuse and psychological distress is well established in adult-treatment samples, the directionality of this association is in question. There is less evidence that this relationship exists among community samples of adults. The prospective relationships between psychological distress and drug problems (e.g., alcohol, marijuana, and cocaine) were examined in a community sample of 470 adults. Results addressed three theories—self-medication/self-derogation, impaired functioning, and general deviance—to explain the relationship between drug use and psychological distress. Although the latent constructs of Polydrug Problems was largely unaffected by Psychological Distress and generally had no effect on Psychological Distress, several specific effects emerged. Providing support for the impaired-functioning theory, adults who abused drugs early on experienced later impaired functioning, anxiety, suicidal ideation, psychoticism, hostility, and decreased purpose in life four years later. Providing support for both the self-medication and self-derogation theories, those who experienced aspects of psychological distress (e.g., dysphoria, suicidal ideation) reported drug problems four years later. Moderate cross-sectional support was also found for the general deviance theory in that Social Conformity reduced or eliminated the associations between Polydrug Problems and the measures of psychological distress. Implications of these findings are discussed. © 1999 John Wiley & Sons, Inc.

Poor parenting as an adult problem behavior: General deviance, deviant attitudes, inadequate family support and bonding, or just bad parents?

Theoretically appropriate constructs have not been fully established for deviant adult roles. The authors tested (a) whether poor parenting reflects general deviance, (b) whether associations between poor parenting and other adult deviant behaviors could be accounted for by deviant attitudes, and (c) whether these adult roles could be predicted from family support and bonding during adolescence. Data from a community sample of 199 ethnically diverse mothers revealed that Poor Parenting was related to more Polydrug Problems, more Property Crimes, and less Social Conformity. These correlations were accounted for by a higher order factor of General Deviance, although deviant attitudes did not explain the associations among behaviors. Specific correlations delineated associations between types of parenting and deviance. Adolescent family support and bonding reduced mother's Poor Parenting and was unrelated to other adult deviant behaviors.

Adolescent drug use and adult drug problems in women: direct, interactive, and mediational effects.

The authors studied effects of variables assessed in adolescence on problems from drug use in adulthood in a community sample of women. One focus of this 13-year longitudinal study was moderators, which were hypothesized to exacerbate, or attenuate, the effects of early drug consumption on later drug problems. Potential moderators were sensation seeking, social conformity, academic orientation, parental support, depression, and drug problems in parents. Direct and mediating effects of these variables, as well as of drug consumption, were also evaluated. Results showed that most of the significant effects involved sensation seeking and social conformity. In addition, adolescent drug use significantly predicted adult polydrug problems. The effects of sensation seeking are consistent with the view that this variable reflects a sensitivity to drug use, which makes it more likely that drug use gets translated into drug abuse.

Changes in the characteristics of clients admitted to an Australian therapeutic community, “The Buttery”, 1980‐92

Data are presented on the characteristics of clients admitted to an Australian therapeutic community, The Buttery, between 1980 and 1992. The typical client was a 28-year-old male with a primary opioid drug problem complicated by polydrug use, particularly of alcohol and stimulants. Prior treatment experience was common, with one in three having been enrolled in methadone maintenance treatment. The average age of clients increased by about 7 months per year, and there was an increase in the prevalence of alcohol, stimulant and polydrug problems over the period of study. There was also an increase in the exposure of clients to methadone maintenance treatment prior to admission to the Buttery. Overall, the characteristics of patients in this drug-free treatment programme were strikingly similar to those observed among patients in methadone maintenance treatment over the same period.

Psychoneurotic and Psychopathic Personalities of Polydrug Abusers and Effects of Didactic Instruction

An investigation into the use of psychometric assessment instruments to produce psychographic profiles which proved superior to the use of individual measures on drug accepting versus drug rejecting age generational gaps is appropriate when considering drug and alcohol education programs. Clinical studies show that polydrug abusers have many psychoneurotic and psychopathic traits which can be measured through valid personality tests. Cuevas (1989), employed the Western Personality Inventory (Manson 1963) to identify individuals whose behavior and personality structure indicated they were polydrug users or had serious polydrug problems. The instrument revealed that a combinative process utilizing comparison groups from known polydrug abusers as a discriminant analysis technique with controls provided a high degree of accuracy. A high degree of precision in prediction was maintained in validation trials on independent samples. The personality characteristics and traits were extracted from a combination of commonly ordered personality tests. Results of the investigation indicate that clinical usage of the screening procedure is readily available without sophisticated computer support or the need for trained psychometricians. Additional results identified the process as interventive, therefore providing a simple way to produce early didactic preventive instruction.