Predictors Of Drug Use Research Articles

Transition from first substance use to crack-cocaine: Predictors of faster addiction progression, and clinical characteristics in crack-cocaine adolescents users

s / Drug and Alcohol Dependence 156 (2015) e102–e182 e177 vs. Non-Southern patients had a median viral load of 61,200 (vs. 9,519; p 200 copies/ml; aOR=3.10, 95% CI=2.34-4.11). Conclusions:Therewere substantial geographicaldifferences in HIV treatment, care retention and viral suppression despite fewer substance use risks among Southern patients. This suggests that social and structural interventions focused on care linkage and retention are needed to address these disparities. None of the study’s Southern States have expanded Medicaid, a decision that will disproportionately affect the poor and uninsured and prevent the full benefits of the Affordable Care Act. Financial support: NIDA CTN U10DA013720. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.479 Trait, state, and place: The role of personality and environment in drug use Karran A. Phillips1, Dexter Louie2, Melody A. Furnari1, William J. Kowalczyk1, David Epstein1, Kenzie L. Preston1 1 NIDA, Baltimore, MD, United States 2 UCSF, San Francisco, CA, United States Aims: Addiction is complex with both environmental and inherited causation factors. The environment, particularly neighborhood, and personality traits may contribute to drug use. We sought to determine the influence of trait, state, and place on drug use. Methods: Participants were administered the NEO Five Factor Inventory to assess 5 personality factors – neuroticism, extraversion, openness, agreeableness, and conscientiousness, and the Addiction Severity Index to assess personal and family drug use history. Environment was assessed with the Neighborhood Inventory for Environmental Typology (NIfETy) a standardized inventory assessing the incidence andprevalenceof environmental indicators of physical, social, and drug-related disorder (1 lowest to 8 highest disorder). Analysis was done with Stata 10 and included t tests, Pearson X2, Fisher’s exact and multivariate logistic regression. Results: Participants included 104 current opioid/stimulant users (CDUs) and 88 non drug users (NDUs). The groups differed in age (p<0.001) and gender (p<0.001) but not race (p=0.109). Neuroticism percentiles were higher in the CDUs (p<0.001); and extraversion, openness, agreeableness, and conscientiousness percentiles were lower (all p<0.001). NIfETy scores were higher for CDUs (mean (SD) 5.1(1.5) vs. 3.9(1.8), p<0.001). In the multivariate model predicting drug use status, age (OR 1.10, CI(1.05,1.17), p<0.001), gender (OR0.22, CI(0.07,0.66),p=0.007), years of cannabis use (OR1.26, CI(1.12,1.42, p<0.001), nuclear family history of addiction (OR 4.34, CI(1.49,12.6), p=0.007), openness (OR 0.97, CI(0.95, 0.99), p=0.007), agreeableness (OR 0.98, CI(0.96, 1.00), p=0.03), and NIfETy scores (OR 1.53, CI(1.08, 2.16), p=0.017) were significant. Conclusions: While state, trait, and place determined drug use status, a nuclear family history of addiction and neighborhood physical, social, anddrug-related disorderwere stronger predictors than personality. Financial support: This research was supported by the NIDAIRP. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.480 Transition from first substance use to crack-cocaine: Predictors of faster addiction progression, and clinical characteristics in crack-cocaine adolescents users Thiago G. Pianca2, Ronaldo L. Rosa3, A.P. Begnis4, P.B. Ferronatto5, Mariana Jensen4, Flavio P. Pechansky1, L.A. Rohde2, Claudia Szobot2 1 Psychiatry, Center for Drug and Alcohol Studies at HCPA/UFRGS, Porto Alegre, Brazil 2 Child & Adolescent Psychiatry Service, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil 3 Hospital Psiquiatrico Sao Pedro, Porto Alegre, Brazil 4 ULBRA, Canoas, Brazil 5 Universidade Federal do Rio Grande do Sul, Porto

Risk and protective factors for recreational and hard drug use among Malaysian adolescents and young adults

IntroductionThis study investigated risk and protective factors for recreational and hard drug use in Malaysian adolescents and young adults. MethodsParticipants (n=859; M age=17.24years, SD=2.75years, range=13–25years; 59% male) were recruited from secondary schools, technical colleges, a juvenile detention center and a national training center in Malaysia. A version of the Communities That Care survey validated for use in Malaysia (Razali & Kliewer, 2015) was used to assess study constructs. ResultsOne in 6 adolescents and 1 in 3 young adults reported lifetime recreational and hard drug use, with greater use reported by males across all drug categories. Structural equation modeling was used to determine the strongest risk and protective factors for recreational and hard drug use. The overall pattern of findings was similar for recreational and hard drug use. Shared risk factors for lifetime recreational and hard drug use included early initiation of antisocial behavior, peer antisocial behavior, and peer reinforcement for engaging in antisocial behavior; shared protective factors included religious practices and opportunities for prosocial school involvement. Multiple group analyses comparing adolescents and young adults indicated that patterns of risk and protective factors predicting drug use differed across these age groups. There were fewer significant predictors of either recreational or hard drug use for young adults relative to adolescents. ConclusionsResults suggest that interventions should target multiple microsystems (e.g., peer groups, family systems, school environments) and be tailored to the developmental stage of the individual.

Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood

To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16 years, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Eating disorders were ascertained at ages 14 and 16 years in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years after predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR]= 1.39, 95% CI =1.00-1.94; BN: OR=3.39, 95% CI= 1.25-9.20; BED: OR=2.00, 95% CI=1.06-3.75; and PD: OR= 2.56, 95% CI= 1.38-4.74). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR= 5.72, 95% CI= 2.22-14.72; PD: OR= 4.88, 95% CI= 2.78-8.57; subthreshold BN: OR= 3.97, 95% CI= 1.44-10.98; and subthreshold BED: OR= 2.32, 95% CI= 1.43-3.75). Although BED and BNpredicted obesity (respectively OR= 3.58, 95% CI=1.06-12.14 and OR= 6.42, 95% CI=1.69-24.30), AN was prospectively associated with underweight. Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents.

Associations between childhood adversity, adult stressful life events, and past-year drug use disorders in the National Epidemiological Study of Alcohol and Related Conditions (NESARC).

Stress sensitization, whereby CA lowers tolerance to later stressors, has been proposed as a potential mechanism explaining the association between exposure to childhood adversities (CA) and drug use disorders in adulthood. However, this mechanism remains untested. This paper begins to address this gap through exploring associations between CA exposure and stressful events in adulthood for predicting drug use disorders. We used data drawn from Wave 2 of the U.S. National Epidemiological Survey of Alcohol and Related Conditions (n = 34,653) to explore whether the association between past-year stressful life events and the 12-month prevalence of disordered cannabis, stimulant, and opiate use varied by the number of types of CA that an individual was exposed to. Past-year stressful life events were associated with an increased risk of cannabis, stimulant, and opiate use disorders among men and women. Exposure to CA was associated with increased risk for disordered cannabis use among men and women and opiate use among men only. Finally, we found significant associations between exposure to CA and past-year stressful life events in predicting disordered drug use, but only for women in relation to disordered stimulant and opiate use. Findings are suggestive of possible stress sensitization effects in predicting disordered stimulant and opiate use among women. Implications of these findings for the prevention and treatment of drug use disorders and for future research are discussed.

Use and abuse of prescribed opioids, central nervous system depressants, and stimulants among U.S. active duty military personnel in FY 2010.

This study establishes rates of use/abuse of Schedule II-IV prescription medications in U.S. active duty military personnel, and characterizes correlates of such use/abuse. All active duty personnel serving for 12 months during fiscal year 2010 were included. Data were obtained from medical and pharmacy claims and drug screening results. Logistic regression models were used to examine predictors of drug use, along with bivariate analyses to compare abuse of prescribed and illegal drugs. Nearly one-third of active duty service members received at least one prescription for opioids, central nervous system depressants, or stimulants, with 26.4% having received at least one prescription for opioids. About 0.7%, 1.4%, and 0.6% of the total force received >90-day prescriptions for opioids, central nervous system depressants, or stimulants, respectively. Battlefield injury, receipt of psychotropic medications, and substance abuse adverse events were predictive of >90-day supply of opioids. About 0.7% of the total force had documented known drug abuse for prescribed drugs compared to 0.4% for illegal drug abuse. We recommend systematic monitoring of prescriptions for controlled substances which may carry serious consequences, evaluation of the impact of controlled substances on military readiness, and examination of the rationale for prescribing controlled drugs.

Risk and Protective Factors for Drug Use Among Youth Living in Foster Care

Despite recent advances in understanding the individual and contextual development of youth substance abuse, limitations remain regarding the interplay of risk and protective factors—especially for highly vulnerable foster care youth. Using data available from the Communities That Care Youth Survey, we analyzed risk and protective factors for a sample of 1,595 foster youth. Structural equation modeling was used, and a three-factor confirmatory factory analysis was estimated to validate the survey measurement structure. To differentiate between risk and protective constructs, the researchers employed an orthogonalizing approach to deal with collinearity between risk and protection. Findings indicate a high correlation between the risk and protective constructs and suggest a single dimension for this sample and for the scales as they are currently constructed; however, the orthogonalizing approach used here also provided some support for considering these constructs separately. Findings generated from our study also suggest that risk factors play a greater role in predicting drug use than do protective factors among foster youth. If the differentiation of risks/protective factors is to serve fully in assessment and intervention, we need to disentangle constructs and learn more about their relative and interactive influence. These findings reveal an important distinction in the understanding of the role that risk and protection may play. Although either decreasing risk factors or increasing protective factors will mitigate drug use in foster care youth, our findings suggest that the development and implementation of targeted risk reduction strategies may result in a larger impact.

Maternal cigarette smoking during pregnancy predicts drug use via externalizing behavior in two community-based samples of adolescents.

Prenatal exposure to maternal cigarette smoking (PEMCS) is associated with a higher probability of substance use in adolescence. We explore if externalizing behavior mediates this relationship, while controlling for a number of potential covariates of this mediation process. We used data obtained in two geographically distinct community samples of adolescents. The first (cross-sectional) sample consisted of 996 adolescents (12-18 years of age) recruited from the Saguenay Youth Study (SYS) in Canada (47% with PEMCS). The second (longitudinal) sample consisted of 1141 adolescents (49% with PEMCS) from the Northern Finland Birth Cohort (NFBC1986). In both samples, externalizing behavior and substance use were assessed during adolescence. In the NFBC1986 cohort, externalizing behavior was also assessed in childhood. In both populations, PEMCS is associated with a higher likelihood of adolescent drug experimentation. In the NFBC1986 cohort, exposed (versus non-exposed) adolescents experiment with an extra 1.27 [B = 0.24, 95% confidence intervals (CI) = 0.15, 0.33 P < 0.001] drugs. In the SYS cohort, a clear protective effect of not being exposed is shown: non-exposed (versus exposed) adolescents are 1.5 times [B = -0.42, 95% CI = -0.75, -0.09, P = 0.013] less likely to take drugs. These associations between PEMCS and drug experimentation remain in the multivariate and mediational analyses. Prenatal exposure to maternal cigarette smoking appears to be associated with a higher probability of experimenting with drugs during adolescence, both directly and indirectly via externalizing behavior and the number of peers reported as using drugs.

Emotion regulation predicts drug use among college binge drinkers

Emotion regulation predicts drug use among college binge drinkers

Catecholamine levels and delay discounting forecast drug use among African American youths

To test hypotheses about the contributions of the catecholamines epinephrine and norepinephrine [which serve as biological markers of life stress through sympathetic nervous system (SNS) activation], delay discounting and their interaction to the prediction of drug use among young African American adults. A 1-year prospective study that involved assessment of SNS activity and collection of self-report data involving delay discounting and drug use. Rural communities in the southeastern United States. A total of 456 African Americans who were 19 years of age at the beginning of the study. At age 19, participants provided overnight urine voids that were assayed for epinephrine and norepinephrine. Participants were also assessed for hyperbolic temporal discounting functions (k) and drug use. At age 20, the participants again reported their drug use. Linear regression analyses revealed that (i) catecholamine levels at age 19 forecast increases in drug use [B = 0.087, P < 0.01, 95% confidence interval (CI) = 0.025, 0.148] and (ii) among young men, catecholamine levels interacted positively with delay discounting to forecast increases in drug use (simple slope = 0.113, P < 0.001, 95% CI = 0.074, 0.152). Higher urinary catecholamine concentrations in their adulthood predict higher levels of drug use a year later among young African American men in the United States who engage in high, but not low, levels of delay discounting.

Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners.

Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners. Transgender women and their male partners (N=191 couples; N=382 individuals) completed questionnaires. Participants' mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned <$500 per-month. The mean relationship duration was 37.9 months. Actor-Partner Interdependence Models were used to examine the associations between transgender-related discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads. Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use. Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions.

Correlates of Protective Motivation Theory (PMT) to Adolescents’ Drug Use Intention

Early onset and increasing proliferation of illicit adolescent drug-use poses a global health concern. This study aimed to examine the correlation between Protective Motivation Theory (PMT) measures and the intention to use drugs among adolescents. An exploratory quantitative correlation design and convenience sampling were adopted. A total of 318 students completed a self-reported questionnaire that solicited information related to their demographics and activities, measures of threat appraisal and coping appraisal, and the intention to use drugs. Logistic regression analysis showed that intrinsic and extrinsic rewards were significant predictors of intention. The odds ratios were equal to 2.90 (p < 0.05) and 8.04 (p < 0.001), respectively. The logistic regression model analysis resulted in a high Nagelkerke R2 of 0.49, which suggests that PMT related measures could be used in predicting drug use intention among adolescents. Further research should be conducted with non-school adolescents to confirm the application.

Drug Use and Sexual Arrangements Among Gay Couples: Frequency, Interdependence, and Associations with Sexual Risk

Rates of drug use among gay men are higher than their heterosexual counterparts and drug use is a prominent risk factor for HIV transmission. Studies using heterosexual samples have found that being partnered reduces the risk of drug use and individuals in a relationship tend to have similar use patterns. Studies among gay men suggest that sexual agreements may be an important predictor of drug use. Data from 322 partnered gay men were collected and the 161 matched couples were categorized as monogamous (52.8%), monogamish (14.9%), open (13.0%), and discrepant (19.3%). Patterns of significance and significant trends suggested that monogamous men reported lower rates of marijuana and other drug use compared to open and monogamish men. Men in discrepant relationships did not differ from any other group. Partners' marijuana and other drug use was significantly interdependent in the overall sample; however, substantial variation in the magnitude and significance of interdependence was observed across sexual arrangement categories. Sexual arrangement and the use of drugs during sex both contributed to the prediction of UAI with casual partners among non-monogamous men. Implications for substance use treatment and HIV prevention are discussed.

Coping styles and illicit drug use in older adults with HIV/AIDS.

The prevalence of HIV infection in older adults is increasing; by 2015, over half of adults living with HIV/AIDS in the United States will be over 50. This study describes the prevalence of drug use and examines psychosocial predictors of drug use in a sample of HIV-infected adults aged 50 and older. Participants were 301 HIV-positive older adults enrolled in a clinical trial of a coping intervention aimed to reduce their depressive symptoms. One-quarter used illicit drugs in the past 60 days (48% any cocaine, 48% weekly marijuana, 44% any other drugs) with an average of 36 days for marijuana and 15 days for cocaine. After controlling for demographics, self-destructive avoidance was positively associated and spiritual coping was negatively associated with drug use. These findings suggest that assessment of drug abuse should be a routine part of care for older patients in HIV clinics. Furthermore, interventions designed to increase spiritual coping and decrease self-destructive avoidance may be particularly efficacious for HIV-infected older adults.

Adolescent illicit drug use and subsequent academic and psychosocial adjustment: An examination of socially-mediated pathways

BackgroundQuestions remain regarding the consequences of illicit drug use on adolescent adjustment and the nature of mechanisms that may explain these consequences. In this study, we examined whether early-onset illicit drug use predicts subsequent academic and psychosocial adjustment and whether associations are socially-mediated by decreased school engagement and increased peer deviancy. Method4885 adolescents were followed throughout secondary school. We used regressions to determine whether illicit drug use in grade 7 predicted academic achievement, school dropout, depressive symptoms, and conduct problems in grades 10–11, adjusting for potential confounders. We used path analysis to test whether significant associations were mediated by school engagement and peer deviancy in grade 8. ResultsIllicit drug use predicted conduct problems and school dropout, but not academic achievement and depressive symptoms. The association between illicit drug use and conduct problems was fully mediated by increased peer deviancy. The association between illicit drug use and school dropout was partially mediated by increased peer deviancy, but remained mostly direct. No indirect association via decreased school engagement was found. Examination of reverse pathways revealed that conduct problems and academic achievement in grade 7 predicted drug use in grades 10–11. These associations were mediated by peer deviancy and school engagement (conduct problems only). ConclusionAdolescent illicit drug use influences the risk of school dropout and conduct problems in part by contributing to deviant peer affiliation. Reciprocal social mediation characterizes the association between drug use and conduct problems. A reverse mechanism best explains the association with academic achievement.

Drug use and HIV treatment outcomes among HIV-infected men who have sex with men accessing Ryan White services in New York: a cross-sectional study

BackgroundDrug use poses multiple challenges to maintenance of the physical health of HIV-infected individuals. Few studies have explored the association between drug use and HIV treatment outcomes among HIV-infected men who have sex with men (MSM). We aimed to examine the relation between drug use (defined here as use of crystal methamphetamine, crack cocaine or cocaine, heroin, or off-label prescription medications) and HIV treatment outcomes (unsuppressed viral load and a low CD4 count) among HIV-infected MSM. MethodsAnalyses were done on all HIV-infected MSM who received Ryan White part A funded services at provider agencies in the greater New York metropolitan area, and had: an enrolment in a Ryan White part A programme between November, 2010, and June, 2012; at least one substance use assessment; and a valid viral load measurement with or without CD4 count in the 6 months before the substance use assessment. The primary outcomes for this study were unsuppressed viral load (>200 copies per mL) and a low CD4 count (<350 cells per μL). Independent associations between substance use and HIV treatment outcomes were examined by multivariate logistic regression. The multivariate model adjusted for all other covariates associated with poor HIV outcomes with p values less than 0·05 in unadjusted analyses. Results are presented as adjusted odds ratios (aORs) with 95% CIs. This project was classified as a programme evaluation (not research) by legal counsel at the New York City Department of Health and Mental Hygiene. FindingsAmong 3287 HIV-infected MSM, 366 (11%) reported drug use. Most of the study population was aged 30–49 years (1798 [55%]; range 13–82 years), non-Hispanic black (1424 [43%]), and on antiretroviral therapy (2530 [79%]). In bivariate analyses, drug users were more likely than non-users to have unsuppressed viral load (234 of 340 [some missing values; 69%] vs 1044 of 2717 [38%]) and a low CD4 count (154 of 336 [46%] vs 924 of 2691 [34%]). In multivariate analyses controlling for sociodemographic and clinical characteristics, drug users were more likely to have unsuppressed viral load (aOR 2·74, 95% CI 2·09–3·59) and a low CD4 count (1·41, 1·10–1·80) than were non-users. InterpretationOur results show a significant relation between drug use and both low CD4 count and unsuppressed viral load. Future studies should examine biological and psychosocial predictors of drug use, to inform intervention development for MSM who are drug users in HIV care settings. Although the substance use data for this study were based on self-report, which could be limited by recall and social desirability bias, this study was strengthened by use of the New York City HIV Surveillance Registry, which is a comprehensive source of longitudinal HIV-related laboratory data for individuals diagnosed with HIV or receiving HIV care in New York City. FundingThis work was supported through a grant from the Health Resources and Services Administration(H89HA00015) to the New York City Department of Health and Mental Hygiene.

Predictors of drug use in prison among women convicted of violent crimes

Worldwide, some prisoners consume illicit drugs while in prison. There is now some recognition of risk factors for this among male but not female prisoners. The aim was to identify variables associated with drug use by women in prison after conviction for violent crimes. Data were obtained from 315 women serving a sentence for robbery or homicide in the Penitentiary of Sant'Ana, São Paulo State, Brazil. Mainly self-report assessments of alcohol and drug misuse, sexual and general impulsiveness, depression, and psychosocial and criminological features were completed. Data were analysed using descriptive statistics and multivariate logistic regression. Thirty-five (11%) women reported illicit drug use in prison. Younger age, history of childhood sexual abuse, having committed robbery (rather than homicide), earlier onset of criminal activities, higher scores on sexual impulsiveness, drug-related problems prior to incarceration and having same-sex relationships inside prison were associated with a higher risk of using drugs in prison. In a multiple logistic regression, only prior drug history and having same-sex relationships in prison were independently associated with in-prison drug use. Illicit drug use in prison impairs rehabilitative goals. Identification of risk factors for this can help to recognise people with high treatment needs. We found that in-prison drug users seemed to be an exceptionally needy group, likely to have more wide ranging historical problems than their similar offending peers. It is essential to check for history of drug use outside prison. The strong association with active sexual behaviour in the prison highlighted another area of vulnerability, requiring sensitive in-prison attention to safeguard these women. Further research to understand the reasons for this relationship is recommended.

Baseline [123I]FP-CIT SPECT (DaTSCAN) severity correlates with medication use at 3 years in Parkinson's disease

Presynaptic dopaminergic deficiency on dopamine transporter imaging supports a clinical diagnosis of Parkinson's disease and correlates with the severity of rigidity and bradykinesia. Baseline dopaminergic deficiency predicts clinical severity, but the relationship with subsequent medication use has not been reported. A randomly selected cross section of 83 Parkinson's disease (PD) patients who had [(123) I] FP-CIT SPECT at the time of clinical diagnosis was identified. Dopaminergic deficiency was graded 1, 2 or 3 with increasing severity using visual assessment and by semiquantitative analysis of putamen and caudate uptake. Antiparkinson medication usage and clinical severity by Hoehn and Yahr were noted annually to 3 years. In 83 patients (66% male, median age 65.0 years, IQ 55.4-71.8), [(123) I]FP-CIT SPECT was grade 1 in 20 (24%), grade 2 in 53 (64%) and grade 3 in 10 patients (12%). Dopamine transporter uptake ratios were inversely associated with antiparkinson medication usage (r = -0.26, P = 0.0201) and Hoehn Yahr stage (r = -0.32, P = 0.0029) at 3 years from baseline, but there was considerable variation in drug usage in individual patients. At 3 years, patients with grade 1 scans at baseline received a median dose of 325 levodopa equivalent units (LEU) (interquartile range 175-433); grade 2 scan patients 400 LEU (interquartile range 300-635); and grade 3 scan patients 460 LEU (interquartile range 252-658). The degree of reduction in presynaptic dopaminergic uptake at baseline is associated with higher antiparkinson drug dosage at follow-up, but the wide variation means that the baseline FP-CIT SPECT does not reliably predict drug use in individual cases.

HIV/AIDS stigma: Measurement and relationships to psycho-behavioral factors in Latino gay/bisexual men and transgender women

Despite the increased interest in HIV/AIDS stigma and its negative effects on the health and social support of people living with HIV/AIDS (PLWHA), little attention has been given to its assessment among Latino gay/ bisexual men and transgender women (GBT) living with HIV/AIDS. The purpose of this paper is twofold: to develop a multidimensional assessment of HIV/AIDS stigma for Latino GBT living with HIV/AIDS, and to test whether such stigma is related to self-esteem, safe sex self-efficacy, social support, and alcohol, and drug use. The sample included 170 HIV+ Latino GBT persons. The results revealed three dimensions of stigma: internalized, perceived, and enacted HIV/AIDS stigma. Enacted HIV/AIDS stigma comprised two domains: generalized and romantic and sexual. Generalized enacted HIV/AIDS stigma was related to most outcomes. Internalized HIV/AIDS stigma mediated the associations between generalized enacted HIV/AIDS stigma and self-esteem and safe sex self-efficacy. In addition, romantic and sexual enacted HIV/AIDS stigma significantly predicted drug use. Perceived HIV/AIDS stigma was not associated with any outcome. These findings expand the understanding of the multidimensionality of stigma and the manner in which various features impact marginalized PLWHA.

Predictors of the use of medications before and during pregnancy

Drug use in pregnancy is often reason of concern for mothers and their physicians. However, only few studies investigated predictors of drug use in pregnancy. To examine maternal characteristics as predictors of medication use in the 6 months before pregnancy and during the first 6 months of pregnancy. To examine whether prescription and over-the-counter (OTC) medication use in the 6 months before pregnancy had an impact on medication use in pregnancy. Six maternity care units and five community pharmacies. Data were collected using a specially designed self-reported questionnaire during the period March 2009-March 2010. Logistic regression was used to identify factors associated with medication use. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were used as association measures. A total of 236 women were included in the analysis. After controlling for maternal characteristics, parity of more than one was associated with lower prescription medication use in pregnancy (aOR 0.46; 95% CI 0.22-0.93), higher household income with higher OTC medication use before pregnancy (aOR 3.13; 95% CI 1.22-8.00), and miscarriage with higher C and D Food and Drug Administration (FDA) risk category medication use in pregnancy (aOR 3.65; 95% CI 1.30-10.25). Prescription medication use before pregnancy was associated with higher prescription medication use in pregnancy (aOR 2.49; 95% CI 1.12-5.52), OTC medication use before pregnancy with higher OTC medication use in pregnancy (aOR 35.95; 95% CI 7.95-162.49), and C and D FDA risk category medication use before pregnancy with the same category medication use in pregnancy (aOR 3.54; 95% CI 1.23-10.17). Different maternal characteristics were shown as predictors of medication use before and during pregnancy. However, medication use before pregnancy was shown as the most important predicting factor for the medication use in pregnancy.

Drug Use Among Gay and Bisexual Men at Weekend Dance Parties: The Role of Intentions and Perceptions of Peers’ Behaviors

Substance use is high among gay and bisexual men attending weekend dance events, yet little research has investigated motivations for drug use and contextual factors influencing use in these settings. We hypothesized that beliefs about peer drug use interact with individuals' own drug use intentions to predict use. 489 men attending weekend dance events completed an anonymous assessment asking about their own and their beliefs about other attendants' drug use intentions--47 % completed a follow-up assessment after the event. Forty-four percent reported intending to use ecstasy at the event; intentions to use GHB, marijuana, cocaine, unprescribed erectile dysfunction drugs, and poppers were also high. Perceptions about other attendant's drug use predicted use among those intending and those not intending to use drugs. Normative beliefs are important predictors of drug use at weekend dance events; event-specific prevention strategies should encompass messages that correct misperceptions of drug use among party attendants.