Reduce Illicit Drug Use Research Articles

Estimating Prevalence of Illicit Drug Use in Yunnan, China, 2011-15.

Background and Aims: Yunnan has been one of the provinces most afflicted by illicit drug use in China. However, there have been few systematic studies on the prevalence of illicit drug use in the area.Method: Using data on illicit drug users registered in the police system, this study aims to estimate the population size of illicit drug users and the annual prevalence of drug use in Yunnan from 2011 to 2015 using Zelterman's capture-recapture method.Results: In the 15–64 year-old population, the estimated prevalence rate of any illicit drug use was 0.81% (0.76–0.86%) in 2011 and 0.94% (0.90–0.98%) in 2014, representing a significant increase. The prevalence rate of heroin use decreased from 0.67% (0.63–0.73%) in 2011 to 0.57% (0.53–0.61%) in 2015, while the prevalence rate of methamphetamine use doubled from 0.20% (0.17–0.24%) in 2011 to 0.48% (0.46–0.50%) in 2015. The mean age of the 141,702 identified illicit drug users in Yunnan from 2011 to 2015 was 32.2 years, and the majority were male, low educated, and peasants; nearly half were single and ethnic minorities. The ratio of the number of identified illicit drug users to the number of hidden users increased from 1:12 in 2011 to 1:5 in 2015.Conclusion: The prevalence of illicit drug use in Yunnan has been increasing. Although the prevalence of heroin use decreased, methamphetamine use increased dramatically from 2011 to 2015. Preventive strategies that are more effective in reducing illicit drug use are urgently needed in Yunnan.

Positive reinforcement targeting abstinence in substance misuse (PRAISe): Study protocol for a Cluster RCT & process evaluation of contingency management

There are approximately 256,000 heroin and other opiate users in England of whom 155,000 are in treatment for heroin (or opiate) addiction. The majority of people in treatment receive opiate substitution treatment (OST) (methadone and buprenorphine). However, OST suffers from high attrition and persistent heroin use even whilst in treatment. Contingency management (CM) is a psychological intervention based on the principles of operant conditioning. It is delivered as an adjunct to existing evidence based treatments to amplify patient benefit and involves the systematic application of positive reinforcement (financial or material incentives) to promote behaviours consistent with treatment goals. With an international evidence base for CM, NICE recommended that CM be implemented in UK drug treatment settings alongside OST to target attendance and the reduction of illicit drug use. While there was a growing evidence base for CM, there had been no examination of its delivery in UK NHS addiction services. The PRAISe trial evaluates the feasibility, acceptability, clinical and cost effectiveness of CM in UK addiction services. It is a cluster randomised controlled effectiveness trial of CM (praise and financial incentives) targeted at either abstinence from opiates or attendance at treatment sessions versus no CM among individuals receiving OST. The trial includes an economic evaluation which explores the relative costs and cost effectiveness of the two CM intervention strategies compared to TAU and an embedded process evaluation to identify contextual factors and causal mechanisms associated with variations in outcome. This study will inform UK drug treatment policy and practice.Trial registration ISRCTN 01591254.

Concurrent drug use among methadone maintenance patients in mountainous areas in northern Vietnam

ObjectivesWith the rise in methadone maintenance therapy (MMT) for drug users in Vietnam, there has been growing interest in understanding if and how often MMT patients engage in concurrent illicit...

Bullying victimization and illicit drug use among students in Grades 7 to 12 in Manitoba, Canada: a cross-sectional analysis.

There is inconsistent evidence examining the relationship between bullying victimization and illicit drug use, with most studies only examining the association between bullying victimization and marijuana use. The current study aims to (1) determine the relationship between bullying victimization and six types of illicit drug use among boys and girls in grades 7 to 12 and (2) examine gender and grade differences in the relationships between bullying victimization and drug use. Data were drawn from the Manitoba Youth Health Survey (N = 64,174) collected in the 2012-2013 school year among students in grades 7 to 12 from Manitoba, Canada. Logistic regression models were used to analyze the relationships between nine different types of bullying victimization and marijuana, cocaine, methamphetamines, ecstasy, hallucinogens, and prescription/over-the-counter drugs used to get high. All analyses were stratified by gender and grade. Bullying victimization was associated with increased odds of all types of drug use among boys and girls in grades 7 to 12. A dose-response relationship was noted with more frequent bullying victimization corresponding to greater odds of drug use. Grade and gender differences were found for some drug use types. There are strong relationships between bullying victimization and illicit drug use among boys and girls in grades 7 to 12, indicating that reductions in bullying victimization may result in reductions in illicit drug use. Grade and gender differences may signify the need for early and gender-specific bullying prevention and intervention strategies.

Quality of Life and Substance Use over 1-year among Buprenorphine-treated Heroin Use Disorder Patients in Taiwan

Objective: Owing to the higher cost of Buprenorphine Maintenance Treatment (BMT) and harm reduction policy in Taiwan, the percentage of Heroin Use Disorder (HUD) patients receiving BMT is much lower than that of receiving methadone maintenance treatment in Taiwan despite the lower addictive, milder withdrawal symptoms and safer characteristics of BMT. As a consequence, the study on treatment outcomes of BMT in Taiwanese HUD patients is relatively limited. The purpose of this prospective, 1-year observational study was to investigate the effects of BMT on the quality of life, self-efficacy, substance use, and retention rate among HUD patients in Taiwan.Methods: Forty-two HUD patients aged between 20 and 60 years old without serious psychiatric illness were recruited from five medical centers and were given BMT for 12 months. Efficacy assessments using the Taiwan version of Brief Version of World Health Organization Quality of Life Instrument (WHOQoL-BREF-TW) and 8-item Drug-Taking Confidence Questionnaire (DTCQ-8), as well as urine drug test were performed at baseline and every 3 months thereafter.Results: Of the 25 subjects who comprised the Intent-To-Treat (ITT) population for efficacy analyses, significant improvements were seen in the psychological and social relation domains of the WHOQoL-BREF at 9 months. Significant improvements also observed in the DTCQ score under both pleasant and unpleasant emotions, testing self-control, and friend’s incitement circumstances throughout the study period. The 12 months retention rate was 36%. The positive rates of urine morphine maintained low during the study.Conclusion: This study indicated the long-term efficacy of BMT on the quality of life, self-efficacy, and reduction of illicit drug use in Taiwanese heroin use disorder patients who maintained in the BMT treatment.

Emotional Intelligence Training for Reducing Illicit Drug Use Potential among Iranian Nurses: A Pilot Study

Background: Some studies show that a low level of emotional intelligence (EI) is associated with self-destructive behaviors such as deviant behavior or smoking. Objective: The current study aimed at determining the effects of EI on the illicit drug use potential among nurses. Methods: The current quasi-experimental study was conducted in 2015 on 70 hospital nurses. Samples were randomly selected and divided into 2 groups (35 nurses in each group). Then, the experimental group subjects attended EI training sessions. Results: Illicit drug use potential in the experimental group had significant negative changes in comparison with that of the control group (P < 0.001) after the completion of the training sessions. Conclusions: Given the importance of EI to help nurses to avoid risky behaviors, holding training sessions on EI for nurses and nursing students appears necessary.

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.

12‐step programs for reducing illicit drug use

Illicit drug abuse has serious and far-reaching implications for the abuser, their family members, friends, and society as a whole. Preferred intervention programs are those that effectively reduce illicit drug use and its negative consequences, and are cost-effective as well. Current evidence shows that overall, 12-step programs are just as effective as alternative, psychosocial interventions. The costs of programs are, therefore, an important consideration. However, the strength of the studies is weak and further evidence regarding the effectiveness of 12-step programs is needed.

Cost-effectiveness of center-based compulsory rehabilitation compared to community-based voluntary methadone maintenance treatment in Hai Phong City, Vietnam

IntroductionIn Vietnam, two dominant approaches for heroin treatment are center-based compulsory rehabilitation (CCT), funded by the Vietnamese government and community-based voluntary methadone maintenance treatment (MMT), funded primarily by international donors. Recent reduction in international funding requires more efficient allocation of government funding for public health programs. A cost-effectiveness analysis comparing two approaches provides a useful source of evidence to inform the government about funding reallocation. MethodsThe study was a combined retrospective and prospective, non-randomized cohort comparison over three years of CCT and MMT in Vietnam, conducted between 2012 and 2014, involving 208 CCT participants and 384 MMT participants with heroin dependence. The primary end-point was drug-free days over three years. Total costs, including both program and participant personal costs were measured and cost-effectiveness compared. Mixed effects regression analyses were used to analyze effectiveness data and non-parametric bootstrapping method was used to compare cost-effectiveness. ResultsOver three years, MMT costed on average VND85.73 million (US$4108) less than CCT (95% CI: -VND76.88 million, -VND94.59 million). On average, a MMT participant had 344.20 more drug-free days compared to a CCT participant (p<0.001). The incremental cost-effectiveness ratio for MMT was -VND0.25 million (US$11.99) (95% CI: -VND0.34 million, -VND0.19 million) per drug-free day suggesting MMT is the more cost effective alternative. ConclusionsCompared to CCT, MMT is both less expensive and more effective in achieving drug-free days. If the government of Vietnam invests in MMT instead of CCT, it is potentially a cost-saving strategy for reducing illicit drug use among heroin dependent individuals.

Effectiveness of motivational interviewing to reduce illicit drug use in adolescents: a systematic review and meta-analysis.

Motivational interviewing (MI) is a commonly used intervention approach to promote reduction or cessation of substance abuse. Effects may be different for adolescents, so it is useful to assess the state of the evidence in this subpopulation. This paper aimed to assess evidence for MI effectiveness in adolescents. EBSCOhost, ProQuest and Digital Dissertation Consortium were searched using keywords. Ten randomized trials from the United Kingdom, United States and Taiwan, including 1466 participants, were identified and analysed using a random effects model. Primary outcome measures captured were: the extent of drug use, intention to use drugs and readiness to change. Each study received a high-quality score based on the Miller Quality Scoring Coding System. Moderator analyses were also conducted to examine the impacts of follow-up period, delivery setting and study design on the effectiveness of MI. No statistically significant effect of MI on was found change of drug use behaviours [d=0.05, 95% confidence interval (CI)=-0.06, 0.17, P=0.36]. A significant effect was found on attitude change (d=0.44, 95% CI=0.20, 0.67, P=0.0002). The funnel plot was asymmetrical, suggesting publication bias favouring small studies with higher effect sizes. Motivational interviewing has not been found thus far to reduce adolescent use of illicit drugs. It may influence intentions to change, but evidence of publication bias weakens confidence in this conclusion.

Systematic review of interventions to reduce illicit drug use in female drug-dependent street sex workers

ObjectivesMost female street-based sex workers (SSWs) are drug users and this group experience particularly poor outcomes in achieving and maintaining abstinence. In 2010 the UK adopted a recovery-orientated Drug Strategy....

Potential determinants of unique and co-occurring major depression and nonmedical use of prescription opioids

Aims: Reductions in illicit drug use during opioid agonist treatment (OAT) can result in improved health. The Veterans Aging Cohort Index (VACS) is a validated prognostic measure of health in HIV research that includes assessments of liver, kidney, hematologic function, age, CD4 count and HIV viral load. In HIV-infected (HIV+) individuals the VACS Index reflects abstinence in patients entering OAT, including those with an undetectable viral load. We sought to evaluate its performance in HIV uninfected patients. Methods:HIV uninfected patients initiating OAT between 2000 and 2011 were identified. Eligible patients had a VACS Index (with assumptions that CD4 count was >500 cells/ L and viral load was 1 opioid positive urine during the 6 weeks preceding each VACS Index score. We assessed the association between non-abstinent/abstinent intervals and VACS Index scores with linear mixed models using a univariate model and a multivariate model that adjusted for pre-treatment VACS Index score, age, and race/ethnicity. Patient was specified as a random effect to account for multiple observations per patient. Results: Among the 592 patients entering OAT, the mean age was 52 years, 99% were male, and 68% African-American. Sixteen percent initiated buprenorphine; 84%methadone.Mean VACS Index scores were 18.3 for abstinent intervals and 18.1 for nonabstinent intervals. Based on univariate and multivariate models, VACS Index scores did not differ between abstinent and nonabstinent intervals (p= .7, p= .4, respectively). Conclusions: Despite responsiveness to abstinence in HIV+ individuals, the VACS Index does not appear to reflect the health benefits of efficacious OAT in those uninfected. Financial support: R01DA035616, U01AA020790.

P04.30 A systematic review of interventions to reduce illicit drug use in female drug-dependent street sex workers

Introduction Sex work and drug use are inextricably linked. For drug dependent street sex workers (SSWs) it is the need to fund drug use that warrants exposure to the risks of selling sex. Despite evidence that SSWs have poor outcomes from drug treatment services, the recent recovery-orientated UK drug strategy did not identify SSWs as a group with complex treatment needs. Synthesis and critical appraisal of existing evidence is needed to guide service changes towards improving drug treatment outcomes for this group. Methods A systematic review of evidence of effectiveness of interventions to reduce illicit drug use in female SSWs experiencing problematic drug use was undertaken. Following the PRISMA guidelines, a structured search strategy was used. Searches included databases, organisational and government websites to identify published and grey literature, as well as hand-searching reference lists and journals and contacting experts in the field. Results Six studies, one experimental and five observational, were identified which met review inclusion criteria. Intervention approaches evaluated included substitute prescribing, educational sessions and motivational interviewing. All studies reported a positive intervention effect but the five observational studies were all subject to a relatively high risk of bias. By contrast, the only experimental study, provided little or no evidence of positive effect (odds ratio for reduction of illicit drug in intervention compared to controls 1.17 95% CI 0.84–1.66 at 3 months and 1.14 (95% CI 0.8–1.61) at six months follow-up). All studies described challenges and solutions to study recruitment, retention and follow-up which were influenced by issues affecting SSWs’ health and social stability. Conclusion There is currently no strong evidence for effectiveness of interventions to reduce illicit drug use in drug dependent female SSWs. The development and robust evaluation of effective interventions should be a priority if recovery is to become a realistic goal for this complex group. The first author is funded by an NIHR postdoctoral fellowship. No pharmaceutical grants were received in the development of this study.

The National Treatment Outcomes Research Study (NTORS) and its influence on addiction treatment policy in the United Kingdom.

This paper describes the political origins of the National Treatment Outcomes Research Study (NTORS) and the outputs and impacts of the study. NTORS was designed to meet the request of the Health Secretary and of a Government Task Force for evidence about the effectiveness of the national addiction treatment services. NTORS was a prospective cohort study which investigated outcomes over a 5-year period of drug users admitted to four major treatment modalities: in-patient treatment, residential rehabilitation, methadone reduction and methadone maintenance programmes. The study investigated treatments delivered under day-to-day operating conditions. Outcomes showed substantial reductions in illicit drug use and reduced injecting risk behaviours. These changes were accompanied by improved psychological and physical health and by reductions in criminal behaviour. However, not all outcomes were so positive. There was a continuing mortality rate in the cohort of about 1% per year, and many clients continued to drink heavily throughout the 5-year follow-up. NTORS findings informed and influenced UK addiction treatment policy both at the time and subsequently. The findings were influential in supporting an immediate increase in funding for treatment, and Government Ministers have repeatedly cited NTORS as evidence of the effectiveness of addiction treatment. One finding that received political attention was that of the cost savings provided by treatment through reductions in crime. This important finding led to an unanticipated consequence of NTORS; namely, the greater focus on crime reduction that has increasingly been promoted as a political and social priority for drug misuse treatment.

The Effectiveness of Family Interventions in Preventing Adolescent Illicit Drug Use: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

In order to quantify the effectiveness of family interventions in preventing and reducing adolescent illicit drug use, we conducted a systematic review and meta-analysis of randomized controlled trials. We searched the Cochrane Database of Systematic Reviews, Educational Research Information Centre (ERIC), MEDLINE, Embase, and PsycINFO for studies published between 1995 and 2013. Results were described separately for different outcomes (marijuana vs. other illicit drugs) and intervention types (universal, selective, and indicated prevention). Meta-analyses were performed when data were sufficient (e.g., marijuana and other illicit drug initiation in universal samples), using random effect models. Otherwise, we provided narrative reviews (e.g., regarding selective and indicated prevention). Thirty-nine papers describing 22 RCTs were eligible for inclusion. Universal family interventions targeting parent-child dyads are likely to be effective in preventing (OR 0.72; 95% CI 0.56, 0.94) and reducing adolescent marijuana use, but not in preventing other illicit drugs (OR 0.90; 95% CI 0.60, 1.34). Among high-risk groups, there is no clear evidence for the effectiveness of family interventions in preventing and reducing illicit drug use and drug disorders. The three small RCTs among substance-(ab)using adolescents gave some indication that programs might reduce the frequency of illicit drug use. Family interventions targeting parent-child dyads are likely to be effective in preventing and reducing adolescent marijuana use in general populations, but no evidence for other illicit drug use was found. We underline the need to strengthen the evidence base with more trials, especially among at-risk populations.

Prevention of Illicit Drug Use Through a School-Based Program: Results of a Longitudinal, Cluster-Randomized Controlled Trial

PurposeTo evaluate the long-term effects of an illicit drug use prevention program for adolescents that integrates life skills into the theory of planned behavior. MethodsWe conducted a cluster-randomized trial in which 24 participating schools were randomized to either an intervention group (12 schools, n = 1,176 students) or a control group (12 schools, n = 915 students). Participants were grade 7 students. The intervention comprised a main intervention of 10 sessions and two booster interventions. Booster 1 (four sessions) and booster 2 (two sessions) were performed at 6 months and 12 months, respectively, after completion of the main intervention. Assessments were made at baseline, after the main intervention, and after each booster session using specific questionnaires for measuring participants' attitudes, subjective norms, perceived behavioral control, and life skills. ResultsRetention rates were 71.9% (845/1,176) in the intervention group and 90.7% (830/915) in the control group after the 12-month follow-up. A significantly lower proportion of intervention group participants reported illicit drug use after the first and second booster sessions compared with control group participants (.1% vs. 1.7% and .2% vs. 1.7%, respectively; both p < .05). Attitudes, subjective norms, perceived behavioral control, life skills, and behavioral intention scores of the intervention group were significantly higher than those of control group after the first and second booster sessions (all p < .001), suggesting that intervention group students tended to avoid drug use. ConclusionsA drug use prevention program integrating life skills into the theory of planned behavior may be effective for reducing illicit drug use and improving planned behavior-related constructs in adolescents.

Substance use disorders in schizophrenia, bipolar disorder, and depressive illness: a registry-based study

To compare the prevalence and pattern of comorbid substance use disorders (SUD) between patients with schizophrenia, bipolar disorder, and depressive illness. Data on presence of alcohol use disorder (AUD) and non-alcohol drug use disorder (DUD) were retrieved from the Norwegian Patient Register for individuals born between 1950 and 1989 who in the period 2009-2013 were diagnosed with schizophrenia, bipolar disorder or depressive illness according to the 10th version of the WHO International Classification of Diseases. The prevalence of AUD only, DUD only, or both was compared between men and women across age and diagnostic groups. The prevalence of SUD was 25.1 % in schizophrenia (AUD: 4.6 %, DUD: 15.6 %, AUD and DUD: 4.9 %), 20.1 % in bipolar disorder (AUD: 8.1 %, DUD: 7.6 %, AUD and DUD: 4.4 %), and 10.9 % in depressive illness (AUD: 4.4 %, DUD: 4.3 %, AUD and DUD: 2.2 %). Middle-aged men with bipolar disorder had the highest prevalence of AUD (19.1 %) and young men with schizophrenia had the highest prevalence of DUD (29.6 %). Of the specific DUDs, all but sedative use disorder were more prevalent in schizophrenia than the other groups. Cannabis and stimulant use disorder was found among 8.8 and 8.9 %, respectively, of the men with schizophrenia. The alarmingly high prevalence of DUD among young patients with severe mental disorders should encourage preventive efforts to reduce illicit drug use in the adolescent population.

Risk Factors of Hepatitis C Virus Infection in Drug Users From Eleven Methadone Maintenance Treatment Clinics in Xi'an, China.

Background:Hepatitis C virus (HCV) infection rates in drug users vary among different regions of China. Drug users who are unaware of their HCV serostatus tend to engage in more risky behaviors.Objectives:This prospective study aimed to assess risk factors of HCV infection in drug users among 11 methadone maintenance treatment (MMT) clinics in Xi’an, China.Patients and Methods:Baseline characteristics and drug use information of patients were collected upon enrollment in the study and anti-HCV tests were performed within one month after the enrollment. Data on daily medication, monthly random urine morphine test results, illicit drug use and MMT retention time were recorded during a 5-year follow-up.Results:Of 10243 patients, 58.0% had positive results for anti-HCV. Injection drug use, longer duration of drug abuse, older age, female gender, unmarried status and unemployment were independent risk factors of HCV infection. Urine test positivity rate was lower (14.8% vs. 16.7%, χ2 = 100.235, P < 0.05), but MMT retention rate was higher (log-rank χ2 = 4.397, P < 0.05) in the anti-HCV positive group than anti-HCV negative one. However, multivariate regression revealed no significant association between anti-HCV serostatus and either MMT retention time or illicit drug use.Conclusions:The major risk factor of HCV infection was injection drug use. The patient’s awareness of his or her HCV status had a minor effect in reduction of illicit drug use and improvement in MMT retention. Therefore, adequate counseling is necessary for drug users in MMT clinics in Xi’an.

High-Dose Methadone Transfer to Buprenorphine in Outpatient Settings

Historically, methadone has been the favoured medication for treating opioid dependency and numerous trials have demonstrated that higher prescribed methadone doses result in reduced illicit drug use (Trafton et al. 2006). However, high-level dosing is also associated with increased risk of serious health problems, including the potentially fatal cardiac arrhythmia, torsades de pointes (Pimentel and Mayo 2007). Buprenorphine, also now used for the treatment of opioid dependence, is less likely to produce these side effects and some cardiologists now request that methadone patients with prolonged QTc be transferred to this agent (Wedam et al. 2007). Owing to the partial agonist and antagonist actions of buprenorphine, transfer is not a straightforward procedure because the differing modes of action can lead to withdrawal symptoms, as buprenorphine displaces methadone at the μ-receptors. To avoid the risk of precipitated withdrawal, current guidelines (Lintzeris et al. 2006) recommend that methadone doses should be tapered to 30 mg/day before patient transfer to buprenorphine. This process may lead to risk of relapse to illicit drug use, which makes extensive dose reductions unachievable (Wallace 2011). Attempts to identify efficient transfer procedures for high-dose methadone patients through the elucidation of clinical symptoms and biochemical measures that indicate when transfer is optimal have produced debate but little evidence as to which measures most reliably predict the optimal time for the first buprenorphine administration. Many patients are now being transferred to buprenorphine and this is most commonly achieved by admitting the patient to hospital, an expensive but effective option. Outpatient transfer has been described and we sought to define appropriate measures to identify when a patient can safely be given a first dose of buprenorphine in an outpatient department (OPD) setting. Despite recommendations to taper methadone, there are conflicting opinions as to whether a correlation between methadone dose and blood serum concentrations exists. Studies by Okruhlica and colleagues (2005) and Wolff and colleagues (1991) support a linear relationship only at doses <80 mg. Adelson and colleagues (2007) report good correlation in patients receiving methadone doses of 40–290 mg and without illicit substance use. With a doseInt J Ment Health Addiction (2015) 13:194–203 DOI 10.1007/s11469-014-9521-2

Perceived neighborhood illicit drug selling, peer illicit drug disapproval and illicit drug use among U.S. high school seniors.

BackgroundThis study examined associations between perceived neighborhood illicit drug selling, peer illicit drug disapproval and illicit drug use among a large nationally representative sample of U.S. high school seniors.MethodsData come from Monitoring the Future (2007–2011), an annual cross-sectional survey of U.S. high school seniors. Students reported neighborhood illicit drug selling, friend drug disapproval towards marijuana and cocaine use, and past 12-month and past 30-day illicit drug use (N = 10,050). Multinomial logistic regression models were fit to explain use of 1) just marijuana, 2) one illicit drug other than marijuana, and 3) more than one illicit drug other than marijuana, compared to “no use”.ResultsReport of neighborhood illicit drug selling was associated with lower friend disapproval of marijuana and cocaine; e.g., those who reported seeing neighborhood sales “almost every day” were less likely to report their friends strongly disapproved of marijuana (adjusted odds ratio [AOR] = 0.38, 95% CI: 0.29, 0.49) compared to those who reported never seeing neighborhood drug selling and reported no disapproval. Perception of neighborhood illicit drug selling was also associated with past-year drug use and past-month drug use; e.g., those who reported seeing neighborhood sales “almost every day” were more likely to report 30-day use of more than one illicit drug (AOR = 11.11, 95% CI: 7.47, 16.52) compared to those who reported never seeing neighborhood drug selling and reported no 30-day use of illicit drugs.ConclusionsPerceived neighborhood drug selling was associated with lower peer disapproval and more illicit drug use among a population-based nationally representative sample of U.S. high school seniors. Policy interventions to reduce “open” (visible) neighborhood drug selling (e.g., problem-oriented policing and modifications to the physical environment such as installing and monitoring surveillance cameras) may reduce illicit drug use and peer disapproval of illicit drugs.