Types Of Substance Use Research Articles

Antecedents and outcomes of marijuana use initiation during adolescence

Background. This study identified similarities and differences in risk factors for marijuana use initiation from grades 7 to 8, grades 8 to 9, and grades 9 to 10, and examined differences between earlier initiates, later initiates, and nonusers on various problem behaviors at grade 10. Method. Longitudinal data were used to examine predictors and outcomes associated with marijuana initiation from grade 7 ( N = 1,955) to grade 10 ( N = 909). Participants completed yearly surveys to assess problem behaviors, social influences, and marijuana-related attitudes and behavior. Results. Earlier initiates were more likely than later initiates to exhibit problem-related marijuana use, hard drug use, polydrug use, poor grades, and low academic intentions at grade 10. Across ages, initiation was predicted by smoking, frequency of marijuana offers, and poor grades. Results provided some evidence for a shift from familial to peer influence on marijuana initiation with increasing age. Marijuana-related beliefs were relatively weak predictors of initiation at all ages after controlling for pro-marijuana social influences and engagement in other types of substance use and delinquent behavior. Conclusions. Results emphasize the importance of early intervention and identify a wide range of potentially modifiable risk factors that may be targeted.

Substance use/abuse and anxiety sensitivity: what are the relationships?

The eight articles in this special issue on anxiety sensitivity (AS) and substance abuse provide provocative new information on the relationships, or lack of relationships, between AS and several types of substance use and abuse. The eight articles provide data that extend our understanding of the role of AS in substance abuse with younger people, people who use substances other than alcohol, people who have disorders comorbid with substance use disorders, and people who experience chronic headaches. In addition, one of the articles attempts to determine how AS develops in relationship to parental substance abuse. Finally, several of the studies show that the three Anxiety Sensitivity Index (ASI) subscales (physical concerns, social concerns, and psychological concerns) are uniquely associated with different aspects of substance use/abuse. Each of the articles is discussed as to its merits and potential domains that may require additional research. Finally, several general suggestions are provided for new directions that research on the relations of AS and substance use/abuse should take.

Reason for Medical Hospitalization Among Adult Alcohol and Drug Abusers

This study attempts to identify the associations between types of substance use and particular medical problems as causes of acute hospital admission on an inpatient substance abuse consultation service. Records of all consultations performed from 1994 to 1998 were analyzed. A total of 4,526 complete records were available. Cocaine (p < .01), heroin (p < .001), and injection drug (p < .001) users were more likely to be admitted to the hospital for infection. Both alcohol (p < .001) and marijuana (p < .001) users were more likely to be hospitalized for trauma related injuries. Individuals that used alcohol were also more likely to be admitted for the treatment of gastrointestinal disorders (p < .001). Clinicians who treat patients with these diagnoses should have a high index of suspicion of co-morbid substance use disorders. Effective treatment of substance use disorders can lead to a decrease in medical morbidity, improved outcomes for individual patients, and decreased costs for the health care system.

TREATMENT COMPLIANCE AMONG PRENATAL CARE PATIENTS WITH SUBSTANCE ABUSE PROBLEMS

There is an insufficient number of substance abuse treatmentprograms available to pregnant women; however, even when women do enroll intreatment, they often choose not to comply with particular components of theirtreatment. To better understand what factors are associated with a woman'slikelihood of compliance with treatment, this study assesses 244 pregnant,substance-using women enrolled in a specialized substance abuse treatmentprogram. Women who complied with treatment referrals are compared with thosewho did not comply with referrals on various factors including their sociodemographiccharacteristics, types of substance use before and during pregnancy, experiencesof violence before and during pregnancy, and prior substance use treatment.Bivariate analysis found that outpatient treatment compliance was more likelyamong women who smoked cigarettes before pregnancy, women who had receivedprevious substance abuse treatment, and women whose partner had received previoussubstance abuse treatment. Outpatient treatment compliance did not vary bysociodemographic characteristics, any other type of substance use, or thewomen's experiences of violence. Inpatient treatment compliance was morelikely among women who received prior substance abuse treatment; however,no other characteristic was found to be associated with inpatient treatmentcompliance. Logistic regression analyses, which controlled for various factors,suggested that past experiences with substance abuse treatment by the womanor her partner were significantly associated with treatment referral compliance.These findings suggest that the previous treatment experiences of women andtheir partners are important factors in shaping a successful substance abusetreatment program for pregnant women.

Revisiting the self-medication hypothesis from a behavioral perspective

The self-medication hypothesis suggests that clients use substances as a means to reduce their psychiatric symptoms. However, substance use as a form of self-medication also can be interpreted as exacerbating symptoms. Behavioral principles may provide a useful perspective to understand this apparent contradiction. The authors investigated the relationship of types of substance use with psychiatric symptoms among 220 participants with co-occurring disorders in an acute care psychiatric unit. Participants were assessed for their use of 6 different classes of substances within 3 months of admission. Hierarchical logistic regression analyses found that particular substances were associated with each of the diagnostic categories and that the pattern of associated substances differed by diagnostic category in a way that supported both self-medication and symptom exacerbation hypotheses. Self-medication and symptom exacerbation can be defined and treated in cognitive-behavioral terms. Harm reduction strategies seem to offer great promise in this context.

Perceived Social Support from Parents and Peers: Which Is the Stronger Predictor of Adolescent Substance Use?

A number of factors influence adolescent substance use. The main goal of this study has been to investigate how sociodemographics, psychosocial health, and perceived support from parents and friends might predict smoking, drinking, and drug use in adolescence. Data were collected using self-administered questionnaires among secondary school students (n = 1,039) in Szeged, Hungary. Sociodemographics (gender, age, and the type of school) proved to be the key predictors of substance use. While neither friend nor mother support appeared to be strong predictors, a low level of perceived father support increased the chance of all types of substance use.

Geographic differences in noninjection and injection substance use among HIV-seropositive men who have sex with men: western United States versus other regions. Supplement to HIV/AIDS Surveillance Study Group.

To study the prevalence of and factors associated with the use of alcohol and nonprescription drugs by HIV-seropositive men who have sex with men (MSM) and to describe variations in alcohol and nonprescription drug use by geographic region, we analyzed data from a multistate, population- and facility-based interview study conducted in 12 U.S. states and metropolitan areas. Among 9735 MSM with HIV infection or AIDS who completed a 45-minute interview, nearly one third reported possible alcohol abuse. Large proportions of MSM also reported the use of marijuana (51%), noninjected cocaine (31%), and crack cocaine (16%) in the 5 years before the interview. Smaller proportions of MSM reported ever having injected cocaine (13%), stimulants (8%), and heroin (8%). Results of logistic regression indicated that in the 5 years before interview, white MSM were significantly (p < .01) more likely than referent (mostly Hispanic) MSM to report use of hallucinogens, marijuana, nitrites, noninjected amphetamines, and diazepam; black MSM were significantly more likely than referent MSM to report use of noninjected crack cocaine. Use of injected stimulants was significantly associated with white race versus referent MSM, and residing in the West versus East. The prevalence of alcohol and drug use among HIV-seropositive MSM is high, and prevalences and types of substance use differ by region and racial/ethnic group. To prevent HIV transmission in this population, health departments and community-based organizations must understand the unique local patterns of substance use to develop effective substance abuse prevention and treatment programs.

Differential prevalence of cigarette smoking in patients with schizophrenic vs mood disorders

Rates of substance-use disorders among psychiatric patients are consistently higher than in the general population, yet there is no clear specificity to the relationship between types of substance use and psychiatric diagnoses. Cigarette smoking may represent a substance-use behavior which has greater specificity for major psychiatric diagnoses. We examined the self-reported history of cigarette smoking vs marijuana, alcohol and cocaine use among 83 male veteran psychiatric patients with primary mood (major depression or bipolar disorder; n=20) or schizophrenic (schizophrenia or schizoaffective; n=63) disorders. Those in the SCZ group compared to those in the AFF group were more likely to be ever-smokers (OR 8.5, 95% CI [2.2, 32.3]), and current smokers (OR 12.0, 95% CI [3.6, 40]), independent of age differences between the groups. There were no significant differences in marijuana, alcohol or cocaine use between the two groups when age differences were controlled. Generalizability of the findings is limited by small number of subjects, male gender and veteran status; however, the significantly higher prevalence of smoking among individuals with schizophrenic disorders may support the growing evidence of linkages between the effects of nicotine and the neurobiology of schizophrenia.

Prevention of substance use problems: models, factors, and processes.

The use of substances for medical or nonmedical reasons occurs in most cultures. Regardless of the reason for use, however, most types of substance use (or drug-taking behaviors) have their associated problem states. The prevention of substance use problems is an important issue and need in every society. In this review we present and discuss various models and factors that purport to describe and predict patterns of drug use, and we discuss various strategies to prevent the occurrence of substance use problems.

Psychiatric Disorder and Substance Use in Adolescence

This article examines the relationship between psychiatric disorder and the use of tobacco, alcohol, marijuana and hard drugs during adolescence. The sample of 1,302 adolescents aged 12 to 16 came from households selected by stratified, cluster and random sampling of the 1981 Canada Census. Symptom checklists were used to approximate diagnoses of conduct disorder, attention deficit disorder and emotional disorder. Logistic regression analyses indicated that conduct disorder was strongly related to all types of substance use and that emotional disorder was related to the use of tobacco, alcohol and hard drugs. These relationships were true for the adolescents' self-assessments only; the parents' assessments of psychiatric disorder were not related to the adolescents' reports of substance use.

Validity of self-reports of alcohol and other drug use: A multitrait-multimethod assessment.

Four methods (self-reported rating, self-reported intake, peer-reported rating, peer-reported intake) and multiple analytical criteria were employed to assess the construct validity of reports of three types of substance use (alcohol, marijuana, and cigarettes) in a study of 194 college students who were members of friendship pairs. The resulting multitrait-multimethod matrix was analyzed in the traditional fashion as well as with confirmatory factor analysis. Convergent and discriminant validity for the three substance use traits were quite adequate, although the validity of one measure (the peer-reported intake measure of alcohol use) may be considered inadequate according to some criteria. This study demonstrates the usefulness of multimethod assessment and confirmatory factor analysis for research on construct validity and for derivation of more accurate measures of drug use.

Validity of self-reports of alcohol and other drug use: a multitrait-multimethod assessment.

Four methods (self-reported rating, self-reported intake, peer-reported rating, peer-reported intake) and multiple analytical criteria were employed to assess the construct validity of reports of three types of substance use (alcohol, marijuana, and cigarettes) in a study of 194 college students who were members of friendship pairs. The resulting multitrait-multimethod matrix was analyzed in the traditional fashion as well as with confirmatory factor analysis. Convergent and discriminant validity for the three substance use traits were quite adequate, although the validity of one measure (the peer-reported intake measure of alcohol use) may be considered inadequate according to some criteria. This study demonstrates the usefulness of multimethod assessment and confirmatory factor analysis for research on construct validity and for derivation of more accurate measures of drug use.