Body Composition,Gender, and Illicit Drug Use in an Urban Cohort

This cross-sectional study of adult (137 male, 128 female), urban, community dwelling users and nonusers of illicit drugs evaluated associations of demographic, medical, and drug factors with body composition. The population was 49% HIV-positive and 94% African-American. In multivariate analysis, there were no body composition differences among males based on drug use. Among females, the highest tertile of drug use had less fat (12.3 vs.19.9 kg, p = .01) and lower body mass index (21.9 vs. 25.1, p = .01) versus less frequent or nonusers. These data suggest a sex difference in body composition associated with drug use.     

Changes in the prevalence of alcohol use in rap song lyrics, 1979-97

AIMS: This paper explores the role of changing images of drinking and alcoholic beverage use in rap music from its beginnings in the United States in the late 1970s to the late 1990s. DESIGN: A sample of 341 rap music song lyrics released from 1979 to 1997 were selected using Billboard and Gavin rating charts. Song lyrics were coded for music genres, alcohol beverage types and brand names, drinking behaviors, drinking contexts, intoxication, attitudes towards alcohol and consequences of drinking. FINDINGS: From 1979 to 1997, songs with references to alcohol increased fivefold (from 8 to 44%); those exhibiting positive attitudes rose from 43% to 73%; and brand name mentions increased from 46% to 71%. There were also significant increases in songs mentioning champagne and liquor (mainly expensive brand names) when comparing songs released after 1994 with those from previous years. In addition, there were significant increases in references to alcohol to signify glamour and wealth, and using alcohol with drugs and for recreational purposes. The findings also showed that alcohol use in rap music was much more likely to result in positive than negative consequences. CONCLUSIONS: Many of these findings are consistent with the idea that rap music has been profoundly affected by commercial forces and the marketing of alcoholic beverages. In addition, it is possible that the increase in references to alcoholic beverages in rap music, particularly spirits, is a reflection of a broader advertising culture which increasingly associates African Americans with alcohol use.     

The Relationship Between Use of Alcohol,Other Drugs,and Crime Among Adolescents

Abstract

This study consisted of a stratified random sample of 3,550 adolescents selected from 55 public school districts from a statewide population in the Midwest. The purpose was to replicate a previous study that tested the delinquency syndrome construct by examining the amount of overlap between alcohol consumption, use of other drugs, and crime using log-linear analysis. The overlap in various forms of delinquency also was examined according to age, gender, and race, with the hypotheses that these factors interact with the amount of overlap between the behaviors examined. In agreement with the previous study, the results support the delinquency syndrome, but they indicate less overlap than the delinquency syndrome construct suggests. Moreover, overlap between these forms of delinquency is moderated with age, gender and race; however, age does not account for enough variance in the multiple contingency table to be selected by log-linear procedures in the most parsimonious model. Implications of these findings for the syndrome construct are discussed.     

Habit, Intention, and Drug Use as Interactive Predictors of Condom Use Among Drug Abusers

This three-wave study explored the prospective effects of habit (previous condom use), intentions to use condoms, past and proximal (before sex) drug use (alcohol, marijuana, cigarette, and hard drug use), and interactions among these variables on condom use among 211 men and women intravenous drug users. Several theoretical alternatives were evaluated. In one alternative, habit is thought to have preeminence over intentions and other variables in the prediction of behavior. In another alternative, drug use is thought to interact in its effects on condom use, by making individuals susceptible to not adhering to their previous intentions regarding safe sex practices. The results showed that condom use habit was a consistent and strong predictor of future condom use, whereas intention was a weak and inconsistent predictor. Neither past (long-term) nor proximal (before sex) drug use moderated (interacted with) the effects of either intention or habit on later condom use. The preeminence of habit in the prediction of condom use is similar to findings from other areas of health behavior, underscoring the need for more focused research on the underpinnings of health habit effects.Correspondence should be directed to Alan Stacy, Department of Psychology, UCLA, 1282A Franz Hall, Los Angeles, California 90095-1563.     

Syringe exchange, injecting and intranasal drug use

Objective   To assess trends in injecting and non-injecting drug use after implementation of large-scale syringe exchange in New York City. The belief that implementation of syringe exchange will lead to increased drug injecting has been a persistent argument against syringe exchange.
Methods   Administrative data on route of administration for primary drug of abuse among patients entering the Beth Israel methadone maintenance program from 1995 to 2007. Approximately 2000 patients enter the program each year.
Results   During and after the period of large-scale implementation of syringe exchange, the numbers of methadone program entrants reporting injecting drug use decreased while the numbers of entrants reporting intranasal drug use increased ( P  < 0.001).
Conclusion   While assessing the possible effects of syringe exchange on trends in injecting drug use is inherently difficult, these may be the strongest data collected to date showing a lack of increase in drug injecting following implementation of syringe exchange.     

Variations in Drinking Patterns in the Rural South: Joint Effects of Race,Gender, and Rural Residence

Objectives: To understand the relative contribution of gender, race (African-American vs. Caucasian), and rural residence on variations in drinking patterns, including past year abstinence, at-risk drinking, and recent drinking quantity and frequency for drinkers only. Methods: A brief health survey was administered by telephone to a probability sample of 11,529 residents of six southern states, over-sampling rural inhabitants. Results: Drinking patterns varied by gender, race, and rural residence in bivariate analysis. Gender effects were independent of rural residence, but race effects on abstinence and at-risk drinking were found only in urban residents and race differences in drinking quantity only in rural residents. Multivariate analysis, controlling for age and education, found gender and rural residence to be the strongest predictors, as well as being an African-American female. Conclusions: Female gender, African-American race, and rural residence appear protective for at-risk drinking but rural residence dominates racial differences.     

Psychometric properties of the perceived stigma towards substance users scale: factor structure,internal consistency,and associations with help-seeking variables

ABSTRACT

Background: Stigma toward substance users is a barrier to seeking treatment.

Objective: The aim for this paper was to examine the psychometric properties of the Perceived Stigma Toward Substance Users (PSAS) and its relationship with help-seeking variables.

Methods: College students (N = 791; n_females = 557, 70%) responded to the PSAS and other help-seeking-related measures in an online study.

Results: Confirmatory factor analysis supported a unidimensional factor structure and acceptable model fit after modifications (CFI = .961; TLI = .937; RMSEA = .067, 90% C.I. = .050 to .085; SRMR = .035). Results indicated good internal consistency estimates (α = .80; ω = .80). The PSAS was negatively associated with intent to seek treatment for substance issues and willingness to self-disclose negative emotions. The PSAS was also positively correlated with stigma associated with seeking help for mental health issues, attitudes concerning risk associated with help-seeking, self-concealment, anticipated risks associated with seeking treatment. When embedded within a larger path model that predicts intent to seek treatment for substance use issues (CFI = .925; TLI = .895; RMSEA = .061, 90%C.I. = .052 to .069; p _{close fit} = .019; SRMR = .049), the PSAS had an incremental contribution to predicting the criterion variable even after accounting for frequency of alcohol use-related problems, and stigma and attitudes associated with seeking help for general mental health issues.

Conclusion: These findings provide further reliability and validity evidence for PSAS, especially in relation to help-seeking variables. Reducing stigma toward substance users can help increase treatment utilization.     

Trends in Combinational Use of Alcohol and Illicit Drugs Among Minority Adolescents, 1983–1994 *

Combinational use of substances refers to taking two or more substances together so that they affect the person at the same time. This pattern of substance use presents unique health and safety risks. Trends in combinational use of alcohol and marijuana or alcohol and cocaine were determined using data from three large comparable samples of students in grades 7–12 in New York State, from surveys conducted in 1983, 1990, and 1994. Each of the three samples was demographically diverse, permitting detailed analysis of trends in various adolescent subgroups according to gender, grade level (age), and race/ethnicity. These two forms of adolescent combinational use of alcohol and illicit drugs dropped sharply from 1983 to 1990, but increased or remained stable from 1990 to 1994. Use of alcohol and marijuana together increased sharply from 1990 to 1994, much more for blacks and Hispanics than for whites, while use of alcohol and crack or cocaine together remained stable at a low level in the 1990s. Both forms of combinational use increased in the 1990s more among younger adolescents than among older ones. Analyses controlling for rates of use also suggest that these forms of combinational use are incidental to the use of the individual substances, rather than uniquely sought “highs.” Prevention programs should include warnings about the dangers of combinational use, especially for younger adolescents.     

Race,resource use,and survival in seriously III hospitalized adults

OBJECTIVE: To examine the association between patient race and hospital resource use. DESIGN: Prospective cohort study. SETTING: Five geographically diverse teaching hospitals. PATIENTS: Patients were 9,105 hospitalized adults with one of nine illnesses associated with an average 6-month mortality of 50%. MEASUREMENTS AND MAIN RESULTS: Measures of resource use included: a modified version of the Therapeutic Intervention Scoring System (TISS); performance of any of any of five procedures (operation, dialysis, pulmonary artery catheterization, endoscopy, and bronchoscopy); and hospital charges, adjusted by the Medicare cost-to-charge ratio per cost center at each participating hospital. The median patient age was 65; 79% were white, 16% African-American, 3% Hispanic, and 2% other races; 47% died within 6 months. After adjusting for other sociodemographic factors, severity of illness, functional status, and study site, African-Americans were less likely to receive any of five procedures on study day 1 and 3 (adjusted odds ratio [OR] 0.70; 95% confidence interval [CI] 0.60, 0.81). In addition, African-Americans had lower TISS scores on study day 1 and 3 (OR ?1.8; 95% CI ?1.3, ?2.4) and lower estimated costs of hospitalization (OR ?$2,805; 95% CI ?$1,672, ?$3,883). Results were similar after adjustment for patients’ preferences and physicians’ prognostic estimates. Differences in resource use were less marked after adjusting for the specialty of the attending physician but remained significant. In a subset analysis, cardiologists were less likely to care for African-Americans with congestive heart failure (p<.001), and cardiologists used more resources (p<.001). After adjustment for other sociodemographic factors, severity of illness, functional status, and study site, survival was slightly better for African-American patients (hazard ratio 0.91; 95% CI 0.84, 0.98) than for white or other race patients. CONCLUSIONS: Seriously ill African-Americans received less resource-intensive care than other patients after adjustment for other sociodemographic factors and for severity of illness. Some of these differences may be due to differential use of subspecialists. The observed differences in resource use were not associated with a survival advantage for white or other race patients.     

Sex-Specific Differences in Circumstances of Initiation into Injecting-Drug Use Among Young Adult Latinos in Harlem, New York City

Background: Data are limited that examine circumstances of initiation and risk for HIV infection among Latino injecting-drug users (IDUs) in the United States. Methods: Baseline data were obtained from a cohort study of young (aged 18–29 years) IDUs residing in Harlem, New York City, conducted during 1997–1999. Participants were administered standardized face-to-face interviews. Data collected included demographics, age and circumstances surrounding initiation of injecting-drug use, and lifetime and recent risk behaviors. Results: Of the 156 participants who self-identified as Latino, 145 (94%) were Puerto Rican, 112 (72%) were male, and 44 (28%) were female. The median number of years of injecting drug use was 3 for women and 5 for men (Wilcoxon ranks sums test p = .007). Significantly (p < .05) more women than men reported that at the first injection episode, they were injected by a sexual partner (26% versus 4%), were provided the syringe by their sexual partner (24% versus 4%), had sex with the initiator after being injected the first time (23% versus 5%), and were injected by a person 5 years older than themselves (50% versus 32%). Women were more likely than men to report having ever had unprotected sex with a person known to be HIV-positive (18% versus 4%, respectively; p = .006); however, women were just as likely as men to report having ever injected drugs with a person known to be HIV-positive (11% versus 10%). Conclusions: Latinas were more likely than their male counterparts to be initiated either directly (being injected) or indirectly (being provided a syringe) into injecting-drug use by their sexual partner. HIV and drug use prevention programs for Latinas in Harlem must address the interrelationship between drug use and sexual relations.