Risk Factors For Substance Use Research Articles

A Qualitative Exploration on Risk and Protective Factors of Substance Use Among Black Adolescent Girls

ABSTRACT Objective While Black adolescent girls use drugs at much lower rates than White and Hispanic girls, Black adolescent girls often have worse health outcomes due to drug use. This study seeks to highlight the voices of Black adolescent girls in order to understand their unique risk factors for substance use and misuse. Methods Utilizing the intersectionality and ecological systems theoretical frameworks, the research team conducted twelve focus groups among a sample of Black adolescent girls (N = 62) between the ages of 13–18 (M = 15.6 years SD = 1.50). Results Thematic analysis was conducted to analyze the participant narratives. Four main themes arose: 1) stereotypes of Black adolescent girls; 2) the role of the physical and social environment (feeling unsafe in neighborhoods where they reside); 3) using drugs as a coping mechanism; 4) input on prevention programming for girls with a sub-theme involving family as a protective factor. Discussion Study findings deepen our qualitative understanding of risk and protective factors for substance use among Black adolescent girls. These findings provide insight on girls’ lived experiences for researchers and intervention development to create and implement substance abuse prevention programs that are race- and gender-specific for Black adolescent girls.

The Mediating Effect of Depression on the Relationship between Loneliness and Substance Use in Korean Adolescents.

Substance use among adolescents is a major emerging health problem worldwide. Although loneliness and depression are major risk factors for substance use, few studies have examined the relationship between loneliness, depression, and substance use in adolescents. This study aimed to determine the mediating effect of depression on the relationship between loneliness and substance use among Korean adolescents, based on the data from 53,310 adolescents from the 17th Korea Youth Risk Behavior Web-based Survey in 2021. Using a complex sample analysis module, hierarchical logistic regression analysis was employed to confirm the mediating effect of depression on the relationship between loneliness and substance use. The results showed that loneliness and depression have a significant effect on substance use (smoking, drinking alcohol, and drug use). Depression was found to have a partial mediating effect on the relationship between loneliness and substance use. Overall, the results suggested that loneliness and depression in adolescents increase substance use, and loneliness can affect substance use through depression. Therefore, proactive strategies to prevent and reduce loneliness and depression in adolescents can be effective in preventing substance use.

Multiple risk factors of substance use among lesbian, gay, bisexual (LGB) adults: A comparison study

ABSTRACT The aim of this study was to identify and compare risk factors of substance use between heterosexual and LGB adults. Using data from the 2020 National Survey on Drug Use and Health (NSDUH), Chi-square, t-test, and standard multiple regressions were employed to analyze the data. The findings showed that LGB participants had significantly higher experiences with substances and initiated substance use earlier than heterosexual participants. Some risk factors were related to experiences with substance use for both groups (i.e. depression, emotional distress, age of first alcohol and marijuana use), but these factors accounted for more of the variance for LGB participants. Additionally, overall health was uniquely associated with experiences with substance use for LGB participants. These results have important implications for the design of culturally appropriate substance use prevention and intervention services for LGB individuals.

Experiencing violence and other predictors of within-person same-day use of multiple substances in youth: a longitudinal study in emergency settings

ABSTRACT Background: Although experiencing violence is a risk factor for substance use among youth, its association with same-day use of multiple substances (a form of polysubstance use) and mitigating factors is less well understood. Objectives: To identify whether prosocial factors modified the effect of experiencing violence on the frequency of same-day use, and examine gender-specific risk/protective factors for same-day use. Methods: We analyzed longitudinal data from a cohort of youth who use drugs aged 14–24 (n = 599; 58% male) presenting to an urban emergency department between 2009–2011 and assessed biannually for two years. Using Poisson-generalized linear models with person-level fixed effects, we estimated within-person associations between self-reported experiencing violence and same-day use and analyzed gender and peer/parent support as effect modifiers. We adjusted for negative peer influence, parental drug and alcohol use, family conflict, anxiety and depression, and age. Results: Overall, positive parental support corresponded to lower rates of same-day use (rate ratio [RR]:0.93, 95% CI:0.87–0.99) and experiencing violence was associated with higher rates of same-day use (RR:1.25, 95% CI:1.10–1.41). Violence exposure was a risk factor among males (RR:1.42, 95% CI:1.21–1.66), while negative peer influences and parental substance use were risk factors among females (RR:1.63, 95% CI:1.36–1.97 and RR:1.58, 95% CI:1.35–1.83, respectively). Positive peer support reduced the association between violence exposure and same-day use among males (RR:0.69, 95% CI:0.57–0.84, p < .05). Conclusions: Tailored interventions may address gender differences in coping with experiencing violence – including interventions that promote parental support among males and reduce influence from parental substance use among females.

Epidemiology of substance and opium use among adult residents of Tehran; a comprehensive report from Tehran cohort study (TeCS)

BackgroundThe prevalence and burden of substance and opium use have increased worldwide over the past decades. In light of rapid population changes in Tehran, we aimed to evaluate the prevalence of opium and other substance use among adult residents in Tehran, Iran.MethodFrom March 2016 to March 2019, we utilized data from 8 296 participants in the Tehran Cohort Study recruitment phase (TeCS). We calculated the age-sex-weighted prevalence of substance use and the geographic distribution of substance use in Tehran. We also used logistic regression analysis to determine possible determinants of opium use.ResultWe analyzed data from 8 259 eligible participants with complete substance use data and the average age of participants was 53.7 ± 12.75 years. The prevalence of substance use was 5.6% (95% confidence interval [CI]: 4.6- 7.1%). Substance use was more common in males than females (Prevalence: 10.5% [95% CI: 8.6- 12.6%] vs. 0.5% [95% CI: 0.2- 1.2%], respectively). The age-sex weighted prevalence of substance use was 5.4% (95% CI: 4.6-7.1%). Moreover, opium was the most frequently used substance by 95.8% of substance users. Additionally, we found that male gender (Odds ratio [OR]: 12.1, P < 0.001), alcohol intake (OR: 1.3, P = 0.016), and smoking (OR: 8.5, P < 0.001) were independently associated with opium use.ConclusionsWe found that the prevalence of substance use in Tehran was 5.6%, and opium was the most frequently used substance. In addition, male gender, lower levels of education, alcohol, and tobacco consumption are the main risk factors for substance use in Tehran. Healthcare providers and policymakers can utilize our results to implement preventive strategies to minimize substance use in Tehran.

Food hardship as a strong predictor of tobacco and cannabis use among youth in WA state

This brief report examines data from The Healthy Youth Survey to understand the likelihood of tobacco and cannabis use for students in Washington state who experienced poverty as measured by participating in the free and reduced lunch (FRL) program or reported food hardship. We conducted descriptive and exploratory statistics and trend analysis of the data to understand differences in substance use between ethnic/racial groups by poverty status. While historically research has documented that experiencing poverty and being from marginalized ethnic/racial minorities are risk factors for substance use among youth, our study is unique because few studies look at the intersection of racial/ethnic differences and poverty and their impact on substance use. Our results align with previous research when the intersectional analysis was by ethnicity and FRL – White students reported significantly higher tobacco and cannabis use, and Black and Mixed-race students had a significantly higher likelihood of cannabis use if they received FRL. However, when the intersectional analysis utilized perceived food hardship and cannabis and tobacco use there were significantly higher rates of use within all race/ethnic categories. Therefore, FRL status may not be a sensitive enough measure to predict tobacco and cannabis use and we recommend additional screening for food hardship.

Determinants of substance use among young people attending primary health centers in India

Abstract Background Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10–24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.

Predictors and Correlates of Positive Urine Drug Screening in a Retrospective Cohort Analysis of Child and Adolescent Psychiatry Inpatients Throughout the COVID-19 Pandemic.

Youth substance use is associated with significant psychological, neurological, and medical complications. Risk factors for substance use among children and adolescents in the general population include peer and/or parental substance use, certain psychiatric illnesses (eg, Attention-Deficit/Hyperactivity Disorder, depression), and history of maltreatment. Co-occurring substance use and psychiatric illness have been associated with increased suicidality, but few prior studies have characterized substance use among child/adolescent inpatients. As such, it remains unclear how substance use contributing to acute psychiatric presentations has changed since the start of the COVID-19 pandemic. This is a retrospective cohort study of 816 unique child/adolescent psychiatry inpatients with urine drug screening (UDS) results from a diverse urban setting. Charts of patients hospitalized between June 1, 2018 and November 30, 2021 were reviewed for sociodemographic characteristics, indication for admission, psychiatric history, hospital course, treatment plan, and discharge diagnosis. Differences in sociodemographic and clinical characteristics, such as age, race, and diagnoses, between patients with and without positive UDS were explored throughout various periods of the COVID-19 pandemic. Descriptive and comparative statistics were performed, as well as a logistic regression model to identify the predictors of positive UDS. Of the study sample, 18% had a positive UDS. Older age, diagnosis of impulsive or behavioral disorder, and a history of violence were found to be predictors of positive UDS. Asian/South Asian or Hispanic/LatinX race and history of a developmental or intellectual disability were found to be negative predictors. The frequency of positive UDS in this population did not change based on COVID-19. Multiple factors may predispose children and adolescents to substance use. Though no impact of COVID-19 was found in this sample, longer-term studies are needed. This study identifies independent predictors of active substance use in the child and adolescent psychiatric inpatient population.

The Association Between Sexual Identity, Depression, and Adolescent Substance Use.

Sexual minority youth (SMY) represent a population vulnerable to several adverse health consequences. Specifically, SMY experience depression and substance use at substantially higher rates than heterosexual peers. Better understanding the relationship between depression and substance use among SMY may help reduce morbidity and mortality. We hypothesize that depression will moderate increased substance use rates seen in SMY. Weighted logistical analyses of covariance, adjusted for race/ethnicity, sex, and age, compared the relationship between sexual identity, depression, and substance use (14 outcomes), using data from the 2019 Youth Risk Behavior Survey (n = 13,677) of high school students. SMY reported depression at rates nearly double than heterosexual peers (63.9% vs 33.0%). Except for vaping and alcohol, SMY had significantly higher odds of all SU (aORs 1.41-2.45, p < 0.001-0.0011). After adjusting for depression, odds of all SMY substance use decreased; most relationships remained significant (aORs 0.73-1.89), though the relationship between SMY and lifetime cannabis use became non-significant. The relationship between SMY and current vaping became significant and the relationship between SMY and alcohol and binge-drinking remained non-significant. SMY are at higher risk for use of most substances and depression compared to heterosexual youth. As depression consistently plays a role in the relationship between sexual minority status and adolescent substance use across a wide variety of substances, it may be a modifiable risk factor for substance use among sexual minority youth that should be screened for and treated. This study additionally provides important information for future studies examining nuances of SMY substance use patterns.

Early life adversity and substance use: The mediating role of mood and the moderating role of impulsivity

IntroductionEarly life adversity (ELA) is a risk factor for substance use and misuse, and multiple factors mediate and moderate this association. We examined whether moods mediate the relationships between ELA and nicotine use, cannabis use, and co-use, and whether these mediation effects varied as a function of delay discounting. MethodsA total of 2555 adults completed a delay discounting task and responded to questions related to demographics, ELA, mood, and substance use. Data were analyzed using Pearson correlations and moderated mediation using Hayes’ PROCESS macro (V3.4, Model 15). ResultsELA was positively associated with cannabis use, nicotine use, co-use of both substances, depressed and stressed moods, and it was negatively associated with positive mood. While cannabis use was associated negatively with stressed and depressed moods and positively with positive mood, nicotine use was associated negatively with positive mood. Moderated mediation analyses indicated that positive mood mediated the relationship between ELA and cannabis use for those with average and above average delay discounting. Positive mood also mediated the relationship between ELA and co-use among those with above average delay discounting. ConclusionThe results suggest that ELA's associations with cannabis use and cannabis-nicotine co-use may be partially attributable to ELA's effects on positive mood among those who are predisposed to moderately to highly impulsive decision making.

Moral Injury is a Risk Factor for Substance Use and Suicidality Among US Military Veterans with and withoutTraumatic Brain Injury.

A national survey of United States veterans was conducted, yielding 252 veterans with TraumaticBrain Injury (TBI) and 1235 veterans without TBI. Participants were asked questions about moral injury, suicidality, substance use, and other sociodemographic variables. Multivariable linear regression analysis was used to examine the previously described relationships. Increasing severity of moral injury was associated with higher scores on the substance use tool (b = 0.02, p = 0.04), although the magnitude of effect was not different from those without TBI (Z = - 0.57, p = 0.72). Increasing severity of moral injury was positively associated with suicidal behavior scores (b = 0.10, p < 0.01). The strength of this relationship was stronger in veterans with TBI than those without TBI (Z = 1.78, p = 0.04). Rehabilitation programs that treat veterans for TBI may need to consider the evaluation of moral injury given its association with adverse events in this population.

Sleep duration as a mediator of the effects of risk factors for substance use

PurposePrior research reveals many risk factors related to adolescent substance use. In this study, we build an argument that insufficient sleep partially explains the effects of multiple risk factors (neighborhood disorder, unstructured socializing, bullying victimization, family conflict, and weak family social control) on substance use. MethodWe tested this argument with a large sample of middle and high school students. The causal pathway for each risk factor was estimated with a series of negative binomial models and generalized structural equational modeling. Indirect effects were also estimated. ResultsThe analysis revealed that each risk factor and shorter sleep duration significantly increased adolescent substance use. Moreover, it was found that sleep duration partially mediated each risk factor's effect on substance use. The degree of mediation varied by the risk factor that was examined. ConclusionsFindings from this study indicate that sleep duration is an important risk factor for adolescent substance use. Moreover, sleep duration appears to explain a portion of the effect of the other risk factors on substance use. In considering these issues, this study offers new insights into the predictors of insufficient sleep and its consequences on adolescent development.

Parental practices and addictions in the adolescent population

Objectives: Identify the protection and risk factors for substance use based on parenting practices. Methodology: The research carried out was descriptive in scope, from a mixed approach (qualitative and quantitative) using the observational, descriptive and cross-sectional method, in turn, the quantitative cut is integrated by applying standardized instruments such as the Parental Practice Scale for adolescents and Depression Scale of the Center for Epidemiological Studies CES-DR, for this, a sample of 57 adolescents aged 15 to 17 years was obtained. Contribution: It was found in the results that the nuclear family is a protection factor, however, in some cases it is the same that becomes a latent risk factor in adolescents, through the impositions generated by the parents, using a parentage style of authoritarianism, coupled with the little communication that exists between family members.

Earlier Sexual Debut as a Risk Factor for Substance Use Among Men Who Have Sex with Men (MSM) in Kazakhstan

Earlier Sexual Debut as a Risk Factor for Substance Use Among Men Who Have Sex with Men (MSM) in Kazakhstan

The Effects of Neighborhood Disorder on Polydrug Use: Examining Depressive Symptoms and Deviant Peer Association as Mediating Mechanisms

ABSTRACT Neighborhood disorder is a risk factor for substance use, but research is limited with regard to the effect of such disorder on polydrug use. Further, research on potential mechanisms underlying this relationship is similarly limited. The current study examined the direct effect of neighborhood disorder on drug use variety and examined deviant peer association and depressive symptoms as mediators among a sample of justice-involved youth. The first three waves of the Pathways to Desistance study were analyzed. Generalized structural equation modeling was used to test for direct and indirect effects of interest. A bootstrap resampling process was used to compute standard errors and significance of hypothesized mediation effects. Findings indicated that greater levels of neighborhood disorder were associated with increased drug use variety. This effect was attenuated by 15% when mediating pathways were included in the model. Only deviant peer association significantly mediated this relationship and accounted for the majority of the total mediating effect. These results indicated that justice-involved youth exposed to neighborhood disorder are at elevated risk for polydrug use and that increased deviant peer association helps to explain this relationship.

Associations Between Personality Traits and Energy Balance Behaviors in Emerging Adulthood: Cross-Sectional Study.

Internalizing and externalizing personality traits are robust risk factors for substance use and mental health, and personality-targeted interventions are effective in preventing substance use and mental health problems in youth. However, there is limited evidence for how personality relates to other lifestyle risk factors, such as energy balance-related behaviors, and how this might inform prevention efforts. This study aimed to examine concurrent cross-sectional associations between personality traits (ie, hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) and sleep, diet, physical activity (PA), and sedentary behaviors (SB), 4 of the leading risk factors for chronic disease, among emerging adults. Data were drawn from a cohort of young Australians who completed a web-based, self-report survey in 2019 during early adulthood. A series of Poisson and logistic regressions were conducted to examine the concurrent associations between the risk behaviors (sleep, diet, PA, and sitting and screen time) and personality traits (hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) among emerging adults in Australia. A total of 978 participants (mean age 20.4, SD 0.5 years) completed the web-based survey. The results indicated that higher scores on hopelessness were associated with a greater daily screen (risk ratio [RR] 1.12, 95% CI 1.10-1.15) and sitting time (RR 1.05, 95% CI 1.0-1.08). Similarly, higher scores on anxiety sensitivity were associated with a greater screen (RR 1.04, 95% CI 1.02-1.07) and sitting time (RR 1.04, 95% CI 1.02-1.07). Higher impulsivity was associated with greater PA (RR 1.14, 95% CI 1.08-1.21) and screen time (RR 1.06, 95% CI 1.03-1.08). Finally, higher scores on sensation seeking were associated with greater PA (RR 1.08, 95% CI 1.02-1.14) and lower screen time (RR 0.96, 95% CI 0.94-0.99). The results suggest that personality should be considered when designing preventive interventions for lifestyle risk behaviors, particularly in relation to SB, such as sitting and screen time. Australian New Zealand Clinical Trials Registry ACTRN12612000026820; https://tinyurl.com/ykwcxspr.

Community-Based Prevention of Substance Use in Adolescents: Outcomes Before and During the COVID-19 Pandemic in Santiago, Chile.

A primary community prevention approach in Iceland was associated with strong reductions of substance use in adolescents. Two years into the implementation of this prevention model in Chile, the aim of this study was to assess changes in the prevalence of adolescent alcohol and cannabis use and to discuss the impact of the COVID-19 pandemic on the substance use outcomes. In 2018, six municipalities in Greater Santiago, Chile, implemented the Icelandic prevention model, including structured assessments of prevalence and risk factors of substance use in tenth grade high school students every 2years. The survey allows municipalities and schools to work on prevention with prevalence data from their own community. The survey was modified from an on-site paper format in 2018 to an on-line digital format in a shortened version in 2020. Comparisons between the cross-sectional surveys in the years 2018 and 2020 were performed with multilevel logistic regressions. Totally, 7538 participants were surveyed in 2018 and 5528 in 2020, nested in 125 schools from the six municipalities. Lifetime alcohol use decreased from 79.8% in 2018 to 70.0% in 2020 (X2 = 139.3, p < 0.01), past-month alcohol use decreased from 45.5 to 33.4% (X2 = 171.2, p < 0.01), and lifetime cannabis use decrease from 27.9 to 18.8% (X2 = 127.4, p < 0.01). Several risk factors improved between 2018 and 2020: staying out of home after 10 p.m. (X2 = 105.6, p < 0.01), alcohol use in friends (X2 = 31.8, p < 0.01), drunkenness in friends (X2 = 251.4, p < 0.01), and cannabis use in friends (X2 = 217.7, p < 0.01). However, other factors deteriorated in 2020: perceived parenting (X2 = 63.8, p < 0.01), depression and anxiety symptoms (X2 = 23.5, p < 0.01), and low parental rejection of alcohol use (X2 = 24.9, p < 0.01). The interaction between alcohol use in friends and year was significant for lifetime alcohol use (β = 0.29, p < 0.01) and past-month alcohol use (β = 0.24, p < 0.01), and the interaction between depression and anxiety symptoms and year was significant for lifetime alcohol use (β = 0.34, p < 0.01), past-month alcohol use (β = 0.33, p < 0.01), and lifetime cannabis use (β = 0.26, p = 0.016). The decrease of substance use prevalence in adolescents was attributable at least in part to a reduction of alcohol use in friends. This could be related to social distancing policies, curfews, and homeschooling during the pandemic in Chile that implied less physical interactions between adolescents. The increase of depression and anxiety symptoms may also be related to the COVID-19 pandemic. The factors rather attributable to the prevention intervention did not show substantial changes (i.e., sports activities, parenting, and extracurricular activities).

Clinician’s perspective about risk and protective factors of substance use: a qualitative exploration

ABSTRACT Objective The present study primarily examines the clinician’s perspective on the initiation of substance use among Pakistani adolescents by using bio-psycho-social correlates. Method Qualitative research design was used to explore the risk and protective factors of substance use. For this purpose, twelve clinical experts i.e., clinical psychologists (N = 6 with HEC-recognized MS Clinical Psychology degree) and psychiatrists (N = 6 with valid PMC) were approached for in-depth interviews. The inclusion of experts with at least five years of experience in dealing with Substance Use Disorders (SUD). Their verbatim was transcribed and thematically analyzed by using NVIVO v.12. Results The findings of this study revealed three main themes for risky behavior i.e., temperamental factors (self-esteem-related problems, anxiety sensitivity, experimentation, and assertiveness issue), family-level factors (parenting style, family conflict, and genetic transmission), and environmental risk factors (peer influence, role of media, and easy access of substance). In addition, the protective factor of substance use also emerged i.e., religiosity or spirituality along with the appropriate parenting which can overcome the risk tendencies of substance use in adolescents. Conclusion The study concluded that appropriate parenting can make a bridge between risk factors of substance use.

Fatalities Involving Substance Use Among US Oil and Gas Extraction Workers Identified Through an Industry Specific Surveillance System (2014-2019).

Characteristics of oil and gas extraction (OGE) work, including long hours, shiftwork, fatigue, physically demanding work, and job insecurity are risk factors for substance use among workers. Limited information exists examining worker fatalities involving substance use among OGE workers. The National Institute for Occupational Safety and Health's Fatalities in Oil and Gas Extraction database was screened for fatalities involving substance use from 2014 through 2019. Twenty-six worker deaths were identified as involving substance use. Methamphetamine or amphetamine was the most common substances (61.5%) identified. Other contributing factors were lack of seatbelt use (85.7%), working in high temperatures (19.2%), and workers' first day with the company (11.5%). Employer recommendations to mitigate substance use-related risks in OGE workers include training, medical screening, drug testing, and workplace supported recovery programs.

The COVID-19 pandemic and parental substance use: a cross-sectional survey of substance use among pregnant and post-partum individuals and their partners

ABSTRACT Background This study was designed to investigate patterns and risk factors for substance use among obstetrical patients who gave birth during the early period of the pandemic, and their partners. Methods Cross-sectional survey of obstetrical patients between March 17th and June 16th, 2020, at The Ottawa Hospital, Ottawa, Canada. Substance use was a composite measure of any alcohol, tobacco, or cannabis use since COVID-19 began. Four outcomes included: any participant substance use or increase in substance use, any partner substance use or increase in substance use. Adjusted risk ratios (ARR) and 95% confidence intervals (CI) are presented. Findings Of 216 participants, 113 (52.3%) and 15 (6.9%) obstetrical patients reported substance use and increased use, respectively. Those born in Canada (ARR: 2.03; 95% CI: 1.27–3.23) and those with lower household income (ARR: 1.38; 95% CI: 1.04–1.85) had higher risk of substance use. Those with postpartum depression (ARR: 5.78; 95%CI: 2.22–15.05) had the highest risk of increased substance use. Families affected by school/daycare closure reported a higher risk of increased partner substance use (ARR: 2.46; 95% CI:1.38–4.39). Conclusion This study found that risk factors for substance use included demographics (i.e., being born in Canada, income), mental health (postpartum depression), and school/childcare closures.