Trajectories Of Drug Use Research Articles

Trajectories of Drug Use and Depressive Symptoms among Latinx Youth and Sexual Minority Youth.

Drug use and depression co-occur and disproportionately affect Latinx sexual minority youth relative to their heterosexual Latinx peers. However, heterogeneity in co-occurring patterns of drug use and depressive symptoms is unknown. The objective of the current study was to identify patterns of drug use and depressive symptom trajectories and examine how these patterns varied between Latinx sexual minority youth and Latinx non-sexual minority youth. Latent class trajectory analysis identified distinct patterns of drug use and depressive symptom trajectories among 231 Latinx adolescents (Latinx sexual minority youth: n = 46, 21.4%; Latinx non-sexual minority youth: n = 169, 78.6%). After identifying class mean trajectories, we examined differences in mean trajectories across groups. A 3-class model was selected as the optimal class trajectory model for both groups, yet classes and trajectories differed. There were differences in initial levels of depression and drug use trajectories between both groups, as well as differences in patterns of drug use trajectories between both groups in two of the three classes. Given the variation in trajectory patterns, there is a need for practitioners to consider the unique needs of both groups to inform the development of preventive interventions for these two populations.

Trends in Drug Tests among Children: A 22-Year Retrospective Analysis.

There are several pathophysiological outcomes associated with substance abuse including metabolic disbalance, neurodegeneration, and disordered redox. Drug use in pregnant women is a topic of great concern due to developmental harm which may occur during gestation and the associated complications in the neonate after delivery. We sought to determine what the trajectory of drug use is like in children aged 0-4 years and mothers of neonates. Urine drug screen (UDS) results were obtained of our target demographic during 1998-2011 and 2012-2019 from LSU Health Sciences Center in Shreveport (LSUHSC-S). Statistical analysis was performed using R software. We observed an increase in cannabinoid-positive UDS results in both Caucasian (CC) and African American (AA) groups between 1998-2011 and 2012-2019 periods. Cocaine-positive UDS results decreased in both cohorts. CC children had higher UDS positive results for opiates, benzodiazepines, and amphetamines, while AA children had a higher percentage for illicit drugs such as cannabinoids and cocaine. Neonate's mothers had similar UDS trends to that in children during 2012-2019. Overall, while percentage of positive UDS results for both AA and CC 0-4 year old children started to decline for opiate, benzodiazepine, and cocaine during 2012-2019, cannabinoid- and amphetamine (CC)-positive UDS steadily increased. These results suggest a shift in the type of drug use by mothers from opiates, benzodiazepines, and cocaine to cannabinoids and/or amphetamines. We also observed that 18-year-old females who tested positive for opiates, benzodiazepine, or cocaine had higher than average chances of testing positive for cannabinoids later in life.

Prescription Drug and Cannabis Use among Recent Latinx Immigrants Pre- and Post-Immigration to the US

ABSTRACT Introduction: Shifts in the sociopolitical context of Latin America have led to steep increases in recent Latinx immigrants (RLI) arriving in the US within the context of forced migration. Yet, little is known about how adverse experiences of RLIs before and after immigration may impact their health including drug use. The purpose of this study was to examine prescription drug and cannabis use before and just after immigration among RLIs and how this drug use is influenced by pre-and post-immigration factors. Methods: This study utilized baseline data from a study examining pre- to post-immigration drinking and driving trajectories among RLI in the United States (US). Baseline criteria included: self-identifying as a Latinx immigrant, 18 − 34 years old, who recently immigrated from a Latin American country. Multivariate logistic regression was conducted to determine predictors of drug use both prior to and after immigrating. Results: There were 540 RLI, 50.2% male and 47.8% subjected to forced migration. Prescription and illicit drug use decreased post-immigration with sedatives being the most common. Higher levels of education was associated with increased odds of pre-immigration prescription drug use and cannabis use. Those experiencing forced migration were more likely to engage in prescription drug use before and after immigration, while no associations were found for cannabis use. Conclusion: Findings suggest a need for increased substance use and mental health services among RLIs arriving within the context of forced migration. More research is needed to understand the trajectories of drug use among RLI as their time in the US increases.

The chippers, the quitters, and the highly symptomatic: A 12-month longitudinal study of DSM-5 opioid- and cocaine-use problems in a community sample

BackgroundIndividual trajectories of drug use and drug-related problems are highly heterogeneous. There is no standard taxonomy of these trajectories, but one could be developed by defining natural categories based on changes in symptoms of substance-use disorders over time. MethodsOur study was conducted in a community sample in Baltimore, Maryland. At baseline, all participants were using opioids and/or cocaine, but none were in treatment. Drug use and symptomatology were assessed again at 12 months (N = 115). ResultsWe defined Quitters as participants who had not used for at least 30 days at follow-up (17%). For the remaining participants, we performed longitudinal cluster analysis on DSM symptom-counts, identifying three trajectory clusters: newly or persistently Symptomatic (40%) participants, Chippers (21.5%) with few symptoms, and Converted Chippers (21.5%) with improved symptom counts.Logistic regression showed that profiles of Quitters did not resemble Chippers, but instead resembled Symptomatic participants, having high probability of disorderly home neighborhood, nonwhite race, and negative mood. Quitters tended to have two protective factors: initiating opioid-agonist treatment during the study (reffect = 0.25, CL95 0.02–0.48) and lack of polydrug use (reffect = 0.25, CL95 0.004–0.49). Converted Chippers tended to be white, with orderly home neighborhoods and less negative mood (reffects 0.24 to 0.31, CL95 0.01–0.54). ConclusionsChanges in DSM symptomology provided a meaningful measure of individual trajectories. Quitters shared psychosocial characteristics with Symptomatic participants, but not with participants who continued to use with few symptoms. This suggests that Quitters abstained out of necessity, not because their problems were less severe.

Orgullo y vergüenza en el registro biográfico de varones que se inyectan drogas en Hermosillo, Sonora.

A partir de nueve relatos biográficos de varones que se inyectan drogas de Hermosillo, Sonora, se analizan las fluctuaciones entre orgullo y vergüenza, como indicadores de la calidad de los vínculos sociales en diferentes momentos de sus trayectorias de uso de drogas. Las situaciones de carencia y violencia que enfrentaron los participantes durante su infancia generaron sentimientos de vergüenza e inadecuación. A lo largo de sus biografías los sujetos buscaron construir nuevos relatos de sí mismos para compensar las heridas al self generadas por esa vergüenza temprana. La pertenencia a grupos desviados y el uso de drogas fueron estrategias que les permitieron ganar estatus y poder. Sin embargo, con el afianzamiento de las trayectorias de uso de drogas, creció el costo emocional de portar el estigma de adicto y la desvinculación social. El análisis de la experiencia socioemocional de los participantes permite visibilizar los mecanismos a través de los cuales se internaliza el estigma de ser usuario de drogas y las estrategias que emplean los sujetos para administrarlo, así como los anclajes sociales que hacen posible realizar dinámicas de uso de drogas menos riesgosas.

A latent transition analysis of a cluster randomized controlled trial for drug use prevention.

The objective of the study was to evaluate the impact of #Tamojunto, a Brazilian adaptation of the Unplugged prevention program, on patterns of drug use among adolescents and to characterize their trajectories of drug use over time. An in-cluster randomized controlled trial was conducted in 2014-2015 with 2 parallel arms (intervention and control). The intervention group attended 12 weekly classes of the #Tamojunto intervention. The control schools did not offer a prevention program. The target population was students attending seventh and eighth grades. The primary dichotomous outcome measures were use of drugs (any alcohol use, binge drinking, tobacco, marijuana, inhalants, and cocaine) in the past year assessed using a questionnaire before intervention and in 2 waves of follow-up (9 and 21 months). A latent transition analysis in 6,391 students from 72 public schools in 6 Brazilian cities revealed 3 distinct patterns of drug use behavior: abstainers/low users (81.54% at baseline, 70.61% after 21 months), alcohol users/binge drinkers (16.65% at baseline, 21.45% after 21 months), and polydrug users (1.80% at baseline, 7.92% after 21 months). No differences in the probabilities of transitions between these drug use patterns were found between the intervention and control groups. The most likely trajectory was no transition between patterns, regardless of the intervention and baseline pattern. The intervention was not successful in changing adolescent drug use patterns over time, showing that the components of the Brazilian adaptation of the Unplugged prevention program should be reevaluated. (PsycINFO Database Record

Qualitative research.

This narrative review aims to highlight key insights from qualitative research on drug use and drug users by profiling a selection of classic works. Consensus methods were used to identify and select four papers published in 1938, 1969, 1973 and 1984 considered to be classics. These landmark qualitative studies included the first account of addiction as a social process, demonstrating that people have meaningful responses to drug use that cannot be reduced to their pharmacological effects; the portrayal of inner-city heroin users as exacting, energetic and engaged social agents; identification of the interactive social learning processes involved in becoming a drug user; the application of the 'career' concept to understanding transitions and trajectories of drug use over time; and the articulation of a framework for understanding drug use that incorporates the interaction between pharmacology, psychology and social environments. These classic sociological and anthropological studies deployed qualitative research methods to show how drug use is shaped by complex sets of factors situated within social contexts, viewing drug users as agents engaged actively in social processes and worlds. Their findings have been used to challenge stereotypes about drug use and drug users, develop a deeper understanding of drug use among hidden, hard-to-research and under-studied populations, and provide the foundations for significant developments in scientific knowledge about the nature of drug use. They continue to retain their relevance, providing important correctives to biomedical and behaviourist paradigms, reminding us that drug use is a social process, and demonstrating how the inductive approach of qualitative research can strengthen the way we understand and respond to drug use and related harms.

Trajectories of drug use among French young people: Prototypical stages of involvement in illicit drug use

Aims: This study investigated patterns and trajectories of substance use, with a special focus on illicit drugs other than cannabis. It examined both patterns and trajectories of use among a general population-based sample. Methods: We used data from the 2011 French ESCAPAD survey of French 17-year-olds to assess exposure and age of initiation of 14 licit and illicit drugs (N=23,882). Latent class analysis (LCA) and survival analyses were performed. Results: The results of the LCA showed that patterns of illicit drug use clearly distinguished between two groups of other illicit drugs: 1) amphetamines/speed, cocaine, ecstasy/MDMA, magic mushrooms, poppers, and solvents; 2) crack/freebase, GHB/GBL, heroine, LSD, and ketamine. Survival analyses highlighted that trajectories involved the first group before the second one. Conclusions: Prototypical drug use patterns and trajectories should include a distinction between two groups of illicit drugs. Preventive actions should focus on young people in their early teens, since very young users are more likely to progress to illicit drug use, and further studies should include this distinction instead of aggregating other illicit drugs into a single category.

Intergenerational Approach of Crack Users by Using Genograms

BACKGROUND: It is known that family history of drug use is considered an important risk factor for drug use. However, studies that depict the intergenerational trajectory of drug use, especially with crack cocaine users, are still need. OBJECTIVE: to analyze the use of drugs among the generations of crack cocaine users. METHODS: It is a descriptive and qualitative study that was conducted from May to June of 2014, with 10 users, through interviews and genograms. RESULTS: It was evidenced that the consumption of alcohol, tobacco and marijuana is a reality since the generation of grandparents, highlighting the consumption of alcohol by woman with a progressive increase on the following generations. Cocaine, crack cocaine, and other drugs emerge from the generation of parents. On the horizontal line, drug use is a common practice among brothers. Family ties vary among “close”, “hostile” and “broken” between father and mother; “close” with mothers, and “broken” or “distant” with fathers. The present drug use across all the generations reaffirms historical trends as a social practice described in different cultures for decades. CONCLUSION: Crack cocaine, as a new product, inexpensive and easy to purchase, comes changing the pattern of consumption. The differentiated approach to drug users, with emphasis on intergenerational context is the main contribution of this study to the advancement of scientific knowledge in this area.

‘Allowing the right’ and its currency in managing drug stigma in Greece

BackgroundEvidence suggests that problem drug users are still subject to high levels of stigmatization. In countries, like Greece, where families occupy a central position and honour is collectively attained, secondary drug stigma is also highly prevalent. However, little is known about how drug users and their families manage drug stigma in the specific cultural milieu that makes up Greece. This article presents findings from a qualitative study exploring how drug stigma both manifests itself and is managed by drug users and parents in the context of Greek familial culture. MethodsThe study was conducted in two state drug agencies in Thessaloniki – Greece and involved the participation of 40 problem drug users (PDU) (23 male/17 female) and 8 parents of PDU. Qualitative, in-depth, interviews were used to collect narrative accounts about experiences of managing addiction, drug stigma and secondary stigma in the Greek parental home. Results‘Allowing the right’ – broadly understood as referring to passing to others information which might devalue a person and consequently that person's family – is discussed in terms of drug stigma management in Greece. We highlight how this culturally specific notion can be viewed as an active strategy adopted by both individual drug users and parents of PDU to manage stigmatization by illustrating the various way in which not ‘allowing the right’ was described by participants, including drug problem discovery or disclosure and subsequent management of drug using careers and drug stigma within the Greek family context. ConclusionGiven the significance of the cultural notion of ‘allowing the right’ in the trajectory of drug use amongst PDU and more particularly in stigma management and secondary stigma management, the paper highlights the need for further research into the field in Greece. The need for targeted culturally specific and culturally relevant interventions aimed at reducing drug stigma is also highlighted in relation to both policy and practice.

Can Parents Provide Brief Intervention Services to Their Drug-Abusing Teenager?

The importance of parents as “interventionists” is supported by reviews of the treatment literature (e.g., Smit, Verdurmen, Monshouwer, & Smit, 2008; Winters, Botzet, Fahnhorst, & Koskey, 2009) as well as the emerging science that home-based initiatives by parents can contribute to desired health changes in adolescents (Fearnow, Chassin, Presson, & Sherman, 1998; Jackson & Dickinson, 2006). Parental influences on an adolescent can include reducing initiation, as well as altering its maintenance if it has started. This article describes a project aimed at helping parents to deal with a teenager who has already started to use alcohol or other drugs. Home Base is a home-based, parent-led program aimed at reversing the trajectory of drug use in an already drug-using adolescent. The program’s content is organized around motivational enhancement and cognitive behavioral techniques. The ongoing study is also discussed.

OR14-1 * PATTERNS AND TRANSITIONS IN SUBSTANCE USE AMONG YOUNG SWISS MEN

Introduction. The stages of involvement in illicit drugs other than cannabis remain vague and few studies focused on the last steps of drug-use trajectories. This study investigated this topic. Methods. We used data from the Swiss Longitudinal Cohort Study on Substance Use Risk Factors (C-SURF) to assess exposure to drug use (alcohol, tobacco, 16 illicit drugs including heroin, and five prescription drugs including opioids) at two times point (N = 5,041). Patterns and trajectories of drug use were studied using latent transition analysis (LTA) and cross-lagged panel models. Results. The LTA identified five classes of drug users showing a pattern involving adding alcohol, tobacco, cannabis, drugs (uppers, hallucinogens, inhaled drugs), and drugs (e.g. heroin, ketamine, crystal meth). The most common transition was to remain in the same latent class. Heroin use predicted later opioid use (b = .071, p = .003) but not the reverse (b = -.005, p = .950). Conclusion. The pattern of drug use displayed the well-known sequence of drug involvement (licit drugs/cannabis/other illicit drugs), but added a distinction between middle-stage and final-stage drugs. Progression along the whole drug course remained rare among participants in their twenties. For the final stage, heroin appeared as to be a step for opioid use.

Patterns and Transitions in Substance Use Among Young Swiss Men

This study investigates the potential stages of drug use. Data from the longitudinal Cohort Study on Substance Use Risk Factors were used ( N = 5,116). Drug use (alcohol, tobacco, and 16 illicit drugs) over the previous 12 months was assessed at two time points. Patterns and trajectories of drug use were studied using latent transition analysis (LTA). This study’s substantive contributions are twofold. First, the pattern of drug use displayed the well-known sequence of drug involvement (licit drugs to cannabis to other illicit drugs), but with an added distinction between two kinds of illicit drugs (“middle-stage” drugs: uppers, hallucinogens, inhaled drugs; and “final-stage” drugs: heroin, ketamine, GHB/GBL, research chemicals, crystal meth, and spice). Second, subgroup membership was stable over time, as the most likely transition was remaining in the same latent class.

Drug Use Trajectories After a Randomized Controlled Trial of MTFC: Associations with Partner Drug Use.

Trajectories of drug use were examined in a sample of women with prior juvenile-justice system involvement. One hundred fifty-three young women who participated in a randomized controlled trial of Multidimensional Treatment Foster Care (MTFC) in adolescence were assessed on five occasions over a 24-month period in young adulthood (mean age = 22.29 years at T1). Participants assigned to the MTFC condition during adolescence reported greater decreases in drug use than girls assigned to the treatment as usual (TAU) condition. Partner drug use was significantly associated with women's concurrent drug use, although participants in the MTFC condition were more resilient to partner drug use than in the TAU condition. Implications for drug use prevention and intervention programs during adolescence are discussed.

Receiving versus being denied an abortion and subsequent drug use

BackgroundSome research finds that women receiving abortions are at increased risk of subsequent drug use and drug use disorders. This literature is rife with methodological problems, particularly inappropriate comparison groups. MethodsThis study used data from the Turnaway Study, a prospective, longitudinal study of women who sought abortions at 30 sites across the U.S. Participants included women presenting just prior to an abortion facility's gestational age limit who received abortions (Near Limit Abortion Group, n=452), just beyond the gestational limit who were denied abortions (Turnaways, n=231), and who received first trimester abortions (First Trimester Abortion Group, n=273). This study examined the relationship between receiving versus being denied an abortion and subsequent drug use over two years. Trajectories of drug use were compared using multivariate mixed effects regression. ResultsAny drug use, frequency of drug use, and marijuana use did not change over time among women in any group. There were no differential changes over time in any drug use, frequency of drug use, or marijuana use between groups. However, Turnaways who ultimately gave birth increased use of drugs other than marijuana compared to women in the Near Limit Abortion Group (p=.041), who did not increase use. ConclusionWomen receiving abortions did not increase drug use over two years or have higher levels of drug use than women denied abortions. Assertions that abortion leads women to use drugs to cope with the stress of abortion are not supported.

Short-term trajectories of substance use in a sample of drug-involved probationers

The current study estimates trajectories of illegal substance use in a sample of 251 drug-involved probationers to identify risk profiles that predict group membership and explores the impact of treatment participation across these trajectories. Trajectory analyses reveal five patterns of drug use during probation supervision. Age and the use of hard drugs are identified as the strongest predictors of involvement in illicit drug use while on probation. The effect of participation in substance use treatment varies across treatment settings and trajectory groups. Prior research has tended to treat drug abusers as a homogeneous population, but the current study findings suggest considerable heterogeneity amongst drug users involved in the criminal justice system. Identifying trajectories of drug use during supervision can help identify individuals who may be more likely to persist in drug use, can inform practice by identifying individuals in need of more intensive treatment services, and can assist in developing new drug treatment strategies.

An Epidemiological Model for Examining Marijuana Use over the Life Course.

Trajectories of drug use are usually studied empirically by following over time persons sampled from either the general population (most often youth and young adults) or from heavy or problematic users (e.g., arrestees or those in treatment). The former, population-based samples, describe early career development, but miss the years of use that generate the greatest social costs. The latter, selected populations, help to summarize the most problematic use, but cannot easily explain how people become problem users nor are they representative of the population as a whole. This paper shows how microsimulation can synthesize both sorts of data within a single analytical framework, while retaining heterogeneous influences that can impact drug use decisions over the life course. The RAND Marijuana Microsimulation Model is constructed for marijuana use, validated, and then used to demonstrate how such models can be used to evaluate alternative policy options aimed at reducing use over the life course.

Trajectories of Drug Use and Mortality Outcomes Among Adults Followed Over 18 Years

For adults in general population community settings, data regarding long-term course and outcomes of illicit drug use are sparse, limiting the formulation of evidence-based recommendations for drug use screening of adults in primary care. To describe trajectories of three illicit drugs (cocaine, opioids, amphetamines) among adults in community settings, and to assess their relation to all-cause mortality. Longitudinal cohort, 1987/88-2005/06. Community-based recruitment from four cities (Birmingham, Chicago, Oakland, Minneapolis). Healthy adults, balanced for race (black and white) and gender were assessed for drug use from 1987/88-2005/06, and for mortality through 12/31/2008 (n = 4301) Use of cocaine, amphetamines, and opioids (last 30 days) was queried in the following years: 1987/88, 1990/91, 1992/93, 1995/96, 2000/01, 2005/06. Survey-based assessment of demographics and psychosocial characteristics. Mortality over 18 years. Trajectory analysis identified four groups: Nonusers (n = 3691, 85.8%), Early Occasional Users (n = 340, 7.9%), Persistent Occasional Users (n = 160, 3.7%), and Early Frequent/Later Occasional Users (n = 110, 2.6%). Trajectories conformed to expected patterns regarding demographics, other substance use, family background and education. Adjusting for demographics, baseline health status, health behaviors (alcohol, tobacco), and psychosocial characteristics, Early Frequent/Later Occasional Users had greater all-cause mortality (Hazard Ratio, HR = 4.94, 95% CI = 1.58-15.51, p = 0.006). Study is restricted to three common drugs, and trajectory analyses represent statistical approximations rather than identifiable "types". Causal inferences are tentative. Four trajectories describe illicit drug use from young adulthood to middle age. Two trajectories, representing over one third of adult users, continued use into middle age. These persons were more likely to continue harmful risk behaviors such as smoking, and more likely to die.

Contrasting Trajectories of Heroin, Cocaine, and Methamphetamine Use

ABSTRACT Current literature has shown that heroin addiction is characterized by long periods of regular use persisting over the life course, whereas the course of stimulant use is less understood. The current study examined long-term trajectories of drug use for primary heroin, cocaine (crack/powder cocaine), and methamphetamine (meth) users. The analyses used data from five studies that collected longitudinal information using the Natural History Instrument, including 629 primary heroin users, 694 cocaine users, and 474 meth users. Drug use trajectories over the 10 years since initiation demonstrated the persistence of use over time for all three drugs, with heroin use at the highest level (13 to 18 days per month), cocaine at the lowest level (8 to 11 days), and meth in between (approximately 12 days per month). Application of growth mixture models revealed five distinctive groups: Consistently High Use (n = 545), Increasing Use (n = 260), Decreasing Use (n = 254), Moderate Use (n = 638), and Low Use (n = 100). Heroin users were disproportionately overrepresented in the Consistently High Use group and underrepresented in the Low Use group; cocaine and meth users were mostly in the Moderate Use group. Users in the High Use group also had earlier onsets of drug use and crime, longer incarceration durations, and were the least employed. Clinical/service policy and practice need to recognize and adapt to the specific patterns and needs of users of different drugs while being mindful of the stage drug users are at in their life course.

Transition to injection drug use among street youth—A qualitative analysis

Objectives To examine social contexts and processes influencing transition to drug injection among street youth. Methods 42 street youth participated in in-depth interviews. A typology of experiences was built founded on youth's street life and drug use trajectories. The transition to drug injection was examined through these experiences. Results We identified five types of mutually exclusive experiences. The “downtowner's” experience is characterised by early street life and drug consumption trajectories, and a strong identification with the downtown milieu. These youth progress from one drug to another and, in a milieu where drug injection is omnipresent, this escalation culminates in transition to injection. The “tripper” street life and substance use trajectories begin later and are less intense. Most “tripper” youth are already chronic hallucinogens users when they arrive in downtown Montréal. Although they judge “junkies” severely, they show some ambivalence towards injection. The “on the go” experience is characterised by trajectories of drug use and street life that are intermingled, leading to a loss of control. These youth, who often have serious delinquent behaviours, come to downtown Montréal to party and consume drugs, mostly stimulants. Their drug use pattern and network make them at high risk of starting cocaine injection. The “hard-luck's” experience is characterised by a lack of identification with the downtown milieu. These youth who use drugs recreationally, end up in the streets accidentally, often because of unemployment. The “alcoholic’ experience is related to alcohol misuse. These youth usually end up in the streets due to this dependence. Their street involvement is mostly an experience of solitude. The risk of transitioning to injection for both these types is low. Conclusions Some combinations of street life and drug use trajectories seem to contribute to injection among street youth. Some important factors interact and increase the risk of street youth transitioning to injection: poor personal assets; early rupture with primary social institutions; social integration into subcultures where both street life and “drug trips” are fashionable, drug preferences and the local drug market.