Risk Factors For Substance Use Research Articles

Prevalence of and risk factors for substance use among Afghan refugees in Iran: An exploratory study

Afghan refugees may be a high-risk group for substance use problems. However, research is scarce in this area, specifically among Afghan refugees in one of their main host countries, Iran. This study aimed to estimate the prevalence of substance use among this population and explore the associated risk factors using a mixed-methods design. Findings suggest that 4.2% of the surveyed households had at least one adult member using illicit drugs. Moreover, results show that substance use among Afghans had statistically significant associations with illiteracy, lack of documentation, living in slum areas, and multidimensional poverty. Policy implications are discussed and recommendations provided.

Risk factors for substance use among youth experiencing homelessness

Background: Youth experiencing homelessness are at high risk for frequent substance use. This study examines individual, interpersonal, and contextual factors associated with substance use among such youth, age 13–24. Methods: Data were collected through computer-assisted structured interviews with participants (N = 474) recruited at service agencies in Los Angeles. Results: Youth had experienced over two years of homelessness on average. Almost a third used substances frequently; significant risk factors included delinquency, sensation seeking, and ongoing homelessness. Time spent in clubs and organizations was protective. Conclusions: Providing housing and services to curb delinquency may help protect youth from becoming frequent substance users.

Addressing Prevalence and Correlates Among a Sample of Egyptian University Students Who Suffer From Substance Use Disorders

Background: Substance use is a public health problem among adolescents and young adults in Egypt. Objective: The objective of this study was to estimate the prevalence and correlates of substance use among Egyptian university students. Methods: This study randomly included 1176 (57.4% were male individuals) university students, with almost two thirds from practical course majors, with the remaining students from theoretical course majors. They answered a questionnaire of sociodemographic and clinical characteristics, which included the drug use disorders identification test, which was used to estimate student drug-related problems and dependence. Results: Lifetime substance use among students is 22.5%, with 156 (58.9%) demonstrating a polysubstance need, 221 (83.4%) using cannabis, 145 (54.7%) using tramadol, and 106 (40%) using alcohol. There is a significant association between substance use and older age, male sex, those in theoretical education, those living in an urban residence, and those who smoke cigarettes. In the group that used substances, currently, 114 (43%) experience drug-related problems and 43 (16.2%) experience dependence. Students with both issues are more likely to use alcohol, tramadol, or polysubstance than those without them; students with drug dependence are more likely to come from theoretical colleges, to smoke cigarettes, or to use substances at a younger age than those with drug-related problems. Conclusions: One in 5 university students used substances at least once in their lives. The most common included cannabis, tramadol, and alcohol, respectively. The risk factors for substance use were older age, male sex, urban residence, theoretical education, and cigarette smoking.

Predictors of initiation of nicotine, alcohol, cannabis, and cocaine use: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

There may be substantial overlap in the risk factors for substance use and substance use disorders (SUD). Identifying risk factors for substance use initiation is essential for understanding the etiology and natural history of SUD and to develop empirically-based preventive interventions to reduce initiation. Analyses were done on Wave 1 participants of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) (n = 43,093). Estimates of the cumulative probability of substance use initiation were obtained separately for nicotine, alcohol, cannabis, and cocaine. Survival analyses with time-varying covariates were implemented to identify risk factors for substance initiation. The lifetime cumulative probabilities of substance initiation were 45.5% for nicotine, 82% for alcohol, 19.6% for cannabis, and 6.4% for cocaine. Among respondents with lifetime nicotine use, 50% had used it by age 15.3, whereas for alcohol, cannabis, and cocaine the respective ages were 17.8, 16.6, and 19.8. Previous use of another substance, being male, having a cluster B personality disorder, family history of SUD, and being separated, divorced, or widowed increased the risk of use of all the substances assessed, whereas social anxiety disorder and some personality disorders were associated with specific substances. Although the age of substance use initiation varies by substance, in more than 50% of cases initiation of use occurs in the first two decades of life. Although most risk factors for substance use initiation are common across substances, some are substance-specific. This information may help in the development of empirically-based preventive interventions. (Am J Addict 2018;27:477-484).

Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada

BackgroundPeople who use drugs have a significantly higher prevalence of chronic non-cancer pain compared to the general population, yet little is known about how various policy, economic, physical, and social environments may serve as risk or protective factors in the context of concurrent pain and substance use. Therefore, this study sought to explore perspectives, risks, and harms associated with pain among people who use drugs.MethodsThirteen focus group interviews were held across British Columbia, Canada, from July to September 2015. In total, 83 people who had lived experience with substance use participated in the study. Using an interpretive description approach, themes were conceptualized according to the Rhodes’ Risk Environment and patient-centered care frameworks.ResultsParticipants described how their experiences with inadequately managed pain in various policy, economic, physical, and social environments reinforced marginalization, such as restrictive policies, economic vulnerability, lack of access to socio-physical support systems, stigma from health professionals, and denial of pain medication leading to risky self-medication. Principles of patient-centered care were often not upheld, from a lack of recognition of patients as experts in understanding their unique pain needs and experiences, to an absence of shared power and decision-making, which often resulted in distrust of the patient-provider relationship.ConclusionsVarious risk environments and non-patient-centered interactions may contribute to an array of health and social harms in the context of inadequately managed pain among people who use drugs.

Who attends recovery high schools after substance use treatment? A descriptive analysis of school aged youth

Recovery high schools (RHSs) are an alternative high school option for adolescents with substance use disorders (SUDs), designed to provide a recovery-focused learning environment. The aims of this study were to examine the characteristics of youth who choose to attend RHSs, and to compare them with local and national comparison samples of youth in recovery from SUDs who were not enrolled in RHSs. We conducted secondary analysis of existing data to compare characteristics of youth in three samples: (1) adolescents with SUDs who enrolled in RHSs in Minnesota, Texas, and Wisconsin after discharge from treatment (RHSs; n = 171, 51% male, 86% White, 4% African American, 5% Hispanic); (2) a contemporaneously recruited local comparison sample of students with SUDs who did not enroll in RHSs (n = 123, 60% male, 77% White, 5% African American, 12% Hispanic); and (3) a national comparison sample of U.S. adolescents receiving SUD treatment (n = 12,967, 73% male, 37% White, 15% African American, 30% Hispanic). Students enrolled in RHSs had elevated levels of risk factors for substance use and relapse relative to both the local and national comparison samples. For instance, RHS students reported higher rates of pre-treatment drug use, past mental health treatment, and higher rates of post-treatment physical health problems than adolescents in the national comparison sample. We conclude that RHSs serve a population with greater co-occurring problem severity than the typical adolescent in SUD treatment; programming offered at RHSs should attend to these complex patterns of risk factors. SUD service delivery policy should consider RHSs as an intensive recovery support model for the most high-risk students with SUDs.

Contributing Risk Factors for Substance Use Among Youth in Postconflict Liberia.

Substance use is prevalent among youth in postconflict African countries and is associated with a number of public health problems such as poverty, child homelessness, and school truancy. This qualitative study explores the risk factors associated with substance use among Liberian youth from the perspective of public-school students. Nine focus groups were conducted with 72 Liberian public-school students (35 female, 37 male). Multiple risk factors for substance use among Liberian youth were identified through qualitative analysis, including emotional instability, gender, fear of academic failure, accessibility to substances within the school and community, poverty, and unintentional drug use. These findings are important to public health campaigns and postconflict recovery in Liberia, and may also inform prevention programs for substance use among Liberian youth.

Risk factors for substance use: perception of student leaders.

to analyze the perceptions of student leaders of the undergraduate course in Nursing about the motivations and/or risk factors for substance use in the university environment. qualitative, transversal, descriptive study developed in a university campus in the state of São Paulo. Thirty members of associations affiliated with the course in Nursing participated. A questionnaire and a semi-structured interview were used, and the information was subjected to content analysis. the influence of the social environment was the central element in the results. The circumstances of the context, some conditions that favor the use of substances and the students' expectations regarding their use were perceived as risk factors, among which the influence of friends (96%), curiosity and search for fun (93%) stood out. alternatives in the university context, in conjunction with student leaders, aimed at reducing the exposure to physical and psychological suffering, constitute important resources to prevent substance abuse.

Evaluation of Risk Factors Affecting Substance Use among Tenth-Grade Students.

Aim The aim of this study is to detect the prevalence of substance use among tenth-grade students; their thoughts, attitudes, behaviors, and tendencies towards substance use; and risk factors of substance use in tenth-grade students in general. Methods This study is descriptive and cross-sectional conducted between April and May 2016. Research population consists of tenth-grade students in 2015-2016 school year in the city of Ordu. Since the study involved all tenth-grade students, no sampling was done. Questions on substance use were prepared by Ordu Public Health Directorate and the authors by making use of European School Survey Project on Alcohol and Other Drugs (ESPAD) study questions, AMATEM's “Drugs and Addiction Youth Survey” study conducted on May 1996, and scientific studies conducted previously on similar subjects. Results 9825 tenth-grade students in 88 schools from 19 counties in the city of Ordu were included in the study. 8714 of the students participated in the survey. Being male, being over the age of 15, mother and father being separated, living with relatives, being in low income, negative feelings about school, perception of being unsuccessful in school, failing a year, absenteeism, and not being content with life are the risk factors for substance use. Conclusions The tendency of illegal substance use becoming more and more prevalent especially among youth requires the development of new treatment strategies.

Family-Related Stress versus External Stressors: Differential Impacts on Alcohol and Illicit Drug Use in Young Men

Intense stress increases substance use (SU). However, little is known about the extent to which distinctive forms of stress should be weighted with regard to their effects on SU. This study aimed to determine whether family-related stress factors (FSF) influenced SU in a different way than external stress factors (ESF). Data was drawn from a Swiss cohort study on SU risk factors (C-SURF), involving 5,308 young adult men. Twelve month use of alcohol and of illicit substances was assessed. FSF and ESF for the time period preceding SU were measured. FSF and ESF were both significantly associated with SU. FSF had a greater impact on the use of most substances than did ESF. The FSF with the strongest association with SU was lack of parental monitoring. Regarding ESF, the cumulative number of stressful external events had a higher impact on SU than previous physical or sexual assault by a stranger. In contrast, physical or sexual assault by a family member was not found to be associated with subsequent SU. These findings have important implications for SU prevention programmes focusing on male teenagers, as it is difficult to screen and intervene in subtle forms of maltreatment in families.

Substance Use in Individuals with Mild to Borderline Intellectual Disability: an Exploration of Rates and Risks in the Netherlands

Little is known about rates and risk factors of substance use (SU) in individuals with mild to borderline intellectual disabilities (MBID, IQ 50–85). This hinders targeted prevention and treatment. In this study we assessed SU rates and risk factors in individuals with MBID in 419 adults (63% male, average IQ = 66) in 16 Dutch disability services. Lifetime and current SU, SU picture recognition, knowledge, attitudes and modeling were assessed with the Substance use and misuse in Intellectual Disability - Questionnaire (SumID-Q). Lifetime licit SU (alcohol and tobacco) was 97%, lifetime illicit SU (predominantly cannabis) was 50%. Current users of tobacco (62%), alcohol (64%), and cannabis (15%) initiated SU at a younger age than those who desisted SU (ps < .001). Participants with mild ID and those with borderline ID did not differ in SU rates (ps .429–.812), or age at SU initiation (ps .221–.853). Current licit SU and lifetime illicit SU were related to male gender, younger age, and (for smoking and stimulant use) to lack of daytime activities. However, these factors did not contribute to multivariate models when recognition, knowledge, attitudes and modeling were added. The models correctly identified current SU in 84% (smoking) and 74% (drinking), and lifetime SU in 76% (cannabis) and 84% (stimulants) of the participants. As almost all participants reported lifetime use of licit, and about half reported lifetime illicit substance use, systematic screening for substance use, and development of preventative and treatment interventions targeted to this group are needed.

The association between early exposure to violence in emerging adulthood and substance use in early-adulthood among inner-city individuals.

This study investigated whether being exposed to violence early in life is a risk factor for substance use later in life. Tenets of the stress-coping model and the self-medication hypothesis guided the analyses. Participants included 850 individuals from an economically challenged, urban community in Flint, MI (83% Black/African American; 50% male). Exposure to violence was measured four times in sequential years during emerging adulthood (ages 20-23), and substance use four times during early-adulthood (ages 29-32). Multilevel growth models investigated the relationship between early exposure to violence and later rates of substance use. Youth who had above average exposure to violence during emerging adulthood had increasing substance use during early-adulthood compared to those with a below average score, after controlling for prior use. These findings may inform practitioners to screen for substance use among individuals exposed to violence, and intervene earlier before substance use becomes problematic.

Risk Factors for and Consequences of Substance Use in Post-Conflict Liberia: A Qualitative Study.

Substance use has a significant impact on post-conflict populations; however, little is known about this critical issue in Liberia. This study examined the current risk factors for and consequences of substance use in Monrovia, Liberia. In-depth interviews were conducted with 20 substance users and 21 key informants. Findings support that Liberia's civil war played a role in increasing substance use, but also that additional risk factors continue to generate substance use today. This study provides insights into the roles of civil war and additional risk factors for substance use in Liberia. Recommendations for substance use-related policies and programs are provided.

Neighborhood, Family, and Peer Factors Associated with Early Adolescent Smoking and Alcohol Use.

There is broad agreement that neighborhood contexts are important for adolescent development, but there is less consensus about their association with adolescent smoking and alcohol use. Few studies have examined associations between neighborhood socioeconomic contexts and smoking and alcohol use while also accounting for differences in family and peer risk factors for substance use. Data drawn from the Seattle Social Development Project (N = 808), a gender-balanced (female = 49%), multiethnic, theory-driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of smoking and alcohol use from 5th to 9th grade. Time-varying measures of neighborhood socioeconomic, family, and peer factors were associated with smoking and alcohol use at each wave after accounting for average growth in smoking and alcohol use over time and demographic differences. Results indicated that living in more socioeconomically disadvantaged neighborhoods, lower family income, lower family general functioning, more permissive family smoking environments, and affiliation with deviant peers were independently associated with increased smoking. Lower family functioning, more permissive family alcohol use environments, and deviant peers were independently associated with increased alcohol use. The effect of neighborhood disadvantage on smoking was mediated by family income and deviant peers while the effect of neighborhood disadvantage on alcohol use was mediated by deviant peers alone. Family functioning and family substance use did not mediate associations between neighborhood disadvantage and smoking or alcohol use. The results highlight the importance of neighborhood, family, and peer factors in early adolescent smoking and alcohol use. Future studies should examine the unique association of neighborhood disadvantage with adolescent smoking net of family socioeconomics, functioning, and substance use, as well aspeer affiliations. Better understanding of the role of contextual factors in early adolescent smoking and alcohol use can help bolster efforts to prevent both short and long harms from substance use.

Alexithymia in patients with substance use disorders

IntroductionAlexithymia is considered as a deficit in emotion processing. It includes difficulty to identify and describe feelings as well as discriminate between feelings and physical sensations. Alexithymia may be a risk factor for substance use (SUD).ObjectivesThe objective of this work is to identify the prevalence and correlates of alexithymia among patients with SUD.MethodsThis study concerns 40 subjects who were hospitalized in a rehabilitation center in Sfax. The subjects completed a form investigating sociodemographic and drug use characteristics. Alexithymia was assessed using the Toronto Alexithymia Scale TAS-20 a. The TAS-20 have three factors: difficulty in identifying feelings (F1), difficulty in describing feelings (F2), and externally oriented thinking (F3).ResultsThe mean age of 30.86 ± 8.07 years. The mean score of alexithymia was 65.39 ± 9.65 (42→83). The scores of its dimensions were 25.3 ± 6.10 for F1, 17.16 ± 3.3 for F2 and 23.16 ± 3.18 for F3. The prevalence of alexithymia was 62.8% among addicts. High alexithymic patients did not differ from low or moderate alexithymic patients in terms of, employment, education or the type of substance. TAS-20 was correlated to socio-economic status (P = 0.002). No correlation was observed between age and alexithymia (total TAS-20) when measured as a continuous variable (P = 0.802). High alexithymic patients exhibited a higher preference for poly-substance use compared with no alexithymic patients (P = 0.05).ConclusionFindings suggest that alexithymia is frequent in SUD patients. It should be noted in clinical practice that many patients with SUD may have a reduced capacity to identify and describe feelings during detoxification.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Criminogenic Needs, Substance Use, and Offending among Rural Stimulant Users.

There is a need to understand the determinants of both substance use and criminal activity in rural areas in order to design appropriate treatment interventions for these linked problems. The present study drew on a predominant model used to assess and treat offenders -- the Risk-Need-Responsivity (RNR) model -- to examine risk factors for substance use and criminal activity in a rural drug using sample. This study extends the RNR model's focus on offenders to assessing rural-dwelling individuals using stimulants (N=462). We examined substance use and criminal justice outcomes at 6-month (91%) and 3-year (79%) follow-ups, and used Generalized Estimating Equations to examine the extent to which RNR criminogenic need factors at baseline predicted outcomes at follow-ups. Substance use and criminal justice outcomes improved at six months, and even more at three years, post-baseline. As expected, higher risk was associated with poorer outcomes. Antisocial personality patterns and procriminal attitudes at baseline predicted poorer legal and drug outcomes measured at subsequent follow-ups. In contrast, less connection to antisocial others and fewer work difficulties predicted lower alcohol problem severity, but more frequent alcohol use. Engagement in social-recreational activities was associated with fewer subsequent arrests and less severe alcohol and drug problems. The RNR model's criminogenic need factors predicted drug use and crime-related outcomes among rural residents. Services adapted to rural settings that target these factors, such as telehealth and other technology-based resources, may hasten improvement on both types of outcomes among drug users.

Longitudinal Predictors of Synthetic Cannabinoid Use in Adolescents.

Synthetic cannabinoids (SCs) are a large, heterogeneous group of chemicals that are structurally similar to δ-9-tetrahydrocannabinol. Many SCs are high-efficacy full agonists of the CB1 and/or CB2 cannabinoid receptors, resulting in a potent group of chemicals with a variety of negative health effects, including death. SCs are available to adolescents at convenience stores and smoke shops and on the Internet. However, little is known about the risk factors that contribute to eventual use of SCs in adolescents, and no research has examined the psychiatric, personality, and substance-use risk factors that prospectively predict SC use. On the basis of extant cross-sectional research, we hypothesized that anxiety, depression, impulsivity, and marijuana use would prospectively predict eventual SC use. Data were collected across 2 time points 12 months apart on adolescents attending multiple public high schools in southeast Texas (n = 964). Path analysis indicated that depressive symptoms, marijuana use, alcohol use, and SC use at baseline were predictive of SC use at 1-year follow-up, whereas anxiety symptoms and impulsivity were not. In addition, SC use at baseline was not predictive of marijuana use at the 1-year follow-up. Females and African Americans were less likely to use SCs than males or those of other ethnicities. SC-use prevention programming should consider depressive symptoms, marijuana use, and alcohol use as risk factors for SC use. Of particular significance, traditional marijuana use was predictive of subsequent SC use, but SC use was not predictive of later marijuana use.

Is complicated grief a risk factor for substance use? A comparison of substance-users and normative grievers

Background: There are no studies to date which have examined complicated grief (CG) symptomatology in substance use disorder (SUD) populations specifically. This study aimed to determine if the presence of symptoms of CG is more frequent among drug dependent patients than a control group and identify which variables could be associated with the symptomatology of CG.Method: Sociodemographic variables, drug and bereavement related characteristics, CG symptomatology and perceived social support were examined in a sample of 196 bereaved SUD patients (78.1% men). The control group was formed by 100 bereaved non-addicted participants (73% men). A multiple linear regression analysis was conducted to identify which variables were associated with symptoms of CG.Results: The presence of symptoms of CG among SUD patients was 34.2%, in comparison to 5% in the control group. Respondents with a higher CG symptomatology include: those being widowed (β= 0.165), those who had lost a sibling (β = 0.253), those who had experienced a traumatic death (β = 0.158), those without working status (β= 0.005). By contrast, being from the control group (β= −0.157), reporting secondary education (β = −0.201) and perceived social support (β = −0.146) were found to be protective factors.Conclusions: These findings highlight the importance of diagnosing and treating those bereaved individuals with SUD who appear to be particularly vulnerable to develop CG symptomatology.

Substance Use in Young Swiss Men: The Interplay of Perceived Social Support and Dispositional Characteristics

ABSTRACTBackground: Social environment plays a central role in substance use behaviors. However, it is not clear whether its role varies as a function of individual dispositional characteristics. Objectives: To investigate the interaction between dispositional characteristics (i.e. sensation seeking, anxiety/neuroticism) and social environment (i.e. perceived social support [PSS]) in association with substance use. Methods: A representative sample of 5,377 young Swiss males completed a questionnaire assessing substance use, sensation seeking, anxiety/neuroticism, and PSS from friends and from a significant other. Results: Sensation seeking and anxiety/neuroticism were positively related to most substance use outcomes. PSS from friends was significantly and positively related to most alcohol and cannabis use outcomes, and significantly and negatively associated with the use of hard drugs. PSS from a significant other was significantly and negatively associated with most alcohol and cannabis use outcomes. The associations of sensation seeking with drinking volume, alcohol use disorder and the use of illicit drugs other than cannabis were stronger in individuals reporting high levels of PSS from friends than those with low levels. The associations of sensation seeking with risky single-occasion drinking and the use of hard drugs were weaker in participants reporting high levels of PSS from a significant other than in those with low levels. Conclusions: Sensation seeking and anxiety/neuroticism may constitute risk factors for substance use and misuse. PSS from friends may amplify the risk for alcohol and illicit drug use (other than cannabis) associated with high sensation seeking, whereas the PSS from a significant other may reduce it.

Internalizing symptoms and conduct problems: Redundant, incremental, or interactive risk factors for substance use during the first year of high school?

Internalizing symptoms and conduct problems: Redundant, incremental, or interactive risk factors for substance use during the first year of high school?