Factors associated with initiation of ecstasy use among US adolescents: Findings from a national survey

AimsTo investigate adolescent pathways to ecstasy use by (1) examining how early onsets of smoking, drinking, and marijuana use are related to a child's risk of initiation of ecstasy use and (2) assessing the influence of other individual and parental factors on ecstasy use initiation.MethodsData on 6426 adolescents (12–17 years old at baseline) from the National Survey of Parents and Youth (NSPY), a longitudinal, nationally representative household survey of youth and their parents, were used in the analyses. Information on youth substance use, including ecstasy use, as well as familial and parental characteristics, was available.ResultsInitiation of ecstasy use is predicted by an adolescent's early initiation of smoking, drinking, or marijuana use. In particular, early initiation either of marijuana use, or of both smoking and drinking, increases a child's risk for ecstasy use initiation. Among the familial and parental variables, parent drug use emerged as significantly predictive of child initiation of ecstasy use; living with both parents and close parental monitoring, on the other hand, are negatively associated with ecstasy use initiation, and may be protective against it. At the individual level, sensation seeking tendencies and positive attitudes towards substance use, as well as close associations with deviant peers, are predictive of adolescent initiation of ecstasy use.ConclusionOur findings on the risk and protective factors for initiation of ecstasy use, especially with regard to factors that are modifiable, will be useful for prevention programs targeting youth use not only of ecstasy, but also of other drugs.     

A national study of risk and protective factors for substance use among youth in the child welfare system

While child welfare services are intended, in part, to diminish maltreatment's negative impact on adolescents' development, there is evidence that receiving child welfare services affects adolescents' substance use adversely. The literature on the extent and correlates of this problem is still emerging. The present study aims to fill part of this gap by examining the association between baseline psychosocial risk and protective factors on engagement in substance use behavior over a period of 36 months for child welfare involved youth. It further compares substance use behavior between youth placed in out-of-home care and those who remained with their biological families. Data come from the National Survey of Child and Adolescent Well-Being (NSCAW), a national probability study of children and adolescents undergoing investigation for abuse or neglect. The sample for this analysis was restricted to 827 youth who were 11 years or older at baseline data collection. Key findings include a high rate of social substance use (47.7%) and illicit substance use (17.4%). There was a limited role of protective factors in mitigating risk behavior for social substance use (caregiver connectedness; OR=0.51, p<0.05). Avoiding foster care placement was a protective factor for illicit substance use (OR=0.43, p<0.05). Delinquency was a risk factor associated with both social substance use (OR=1.06, p<0.01) and hard substance use (OR=1.10, p<0.001). Given the high prevalence of substance use among child welfare involved youth, prevention efforts for this population require a better understanding of biological, psychological, and social protective factors. The child welfare system is an untapped resource that has the potential to be a gateway to and a platform for substance abuse prevention services that should be incorporated into child welfare safety and permanency interventions.     

Volatile substance misuse among youth in Israel: results of a national school survey

Volatile substance misuse (VSM) among Israeli youth has been identified as widespread and growing. Using data from the 2009 National School Survey of 12-18 year olds (N = 7,166), this study describes VSM prevalence among Jews and Arabs, examining relationships between past-month VSM and sociodemographic, behavioral, psychological, and interpersonal characteristics. Past-month VSM, reported by 7.5% of respondents, was significantly associated with other risky behaviors including past-month illicit drug use (Adjusted odds ratios (AOR) = 5.41, 95% CI: 3.5-8.1), Internet gambling (AOR = 2.12, 95% CI: 1.5-3.1), smoking, binge drinking, and truancy. National drug policy must address VSM and develop strategies to reduce demand and supply. Potential study limitations are noted.     

Cigarette use and smoking beliefs among older Americans: findings from a nationally representative survey*

Background: Between 2005 and 2015, the prevalence of smoking among US adults has decreased for all age subgroups, except those aged 65 and older.

Aim: In order to identify potential correlates of smoking behaviors in older adults, this research examined associations between age, smoking beliefs, and quitline utilization.

Methods: Self-reported, nationally representative data from the Health Information National Trends Survey 2015 cycle (HINTS-FDA) were used (n?=?3738). Multivariable logistic regression analyses examined associations between sociodemographic characteristics and beliefs about smoking behaviors. All analyses were conducted with jackknife estimation using sampling weights.

Results: Among all survey respondents, 10.5% of those aged 65+ were current smokers (smoked 100 lifetime cigarettes and currently smoked every day or some days). These older adults, compared to those aged 18–29 years, had significantly higher odds of agreeing that smoking behavior is something one can do little to change (AOR?=?1.89, 95% CI =1.08, 3.28) and agreeing that nicotine is the substance that causes cancer (AOR?=?3.93, 95% CI?=?2.17, 7.12). Post hoc analyses compared midlife adults (ages 50–64) with older adults (ages 65+), and indicated older adults had lower odds of having used a quitline/smoking cessation website (AOR?=?0.36, 95% CI?=?0.14, 0.94, p?=?0.04) compared to their midlife peers.

Discussion: US adults aged 65 and older hold erroneous beliefs about cigarette smoking behaviors and are less likely to utilize quitline supports. This may be contributing to the stagnant smoking rates among older adults. Smoking cessation efforts targeting older adult Americans are critical in order to stem tobacco use among all Americans.     

High willingness to use drug consumption rooms among people who inject drugs in Scotland: findings from a national bio-behavioural survey among people who inject drugs

BackgroundTo address rising drug-related harms (including significant transmission of HIV) among people who inject drugs (PWID) in Glasgow, officials have proposed the introduction of the UK's first drug consumption room (DCR) in Glasgow city centre. Using a nationally representative sample, this study aimed to determine willingness to use a DCR among PWID nationally, in Glasgow city centre (the proposed DCR location), other Scottish city centres (excluding Glasgow) and the rest of Scotland (excluding city centres).MethodsBio-behavioural survey, of 1469 current PWID (injected in last 6 months) across Scotland during 2017-18. Willingness to use DCRs was examined by drug-related risk behaviours and harms overall in Scotland, and then stratified by Glasgow city centre (n = 219), other Scottish city centres (n = 226) and the rest of Scotland (n = 1024).ResultsThe majority of PWID overall in Scotland (75%) were willing to use a DCR; willingness was higher among those recruited in Glasgow city centre (83%) and other Scottish city centres (83%), compared to the rest of Scotland (72%) (p < 0.001). Willingness was greater among PWID who reported (compared to those who did not report) injecting heroin (76%, p = 0.002), cocaine injecting (79%, p = 0.014), homelessness (86%, p < 0.001), public injecting (87%, p < 0.001) and an overdose (80%, p = 0.026). Willingness was found to be associated with a cumulative multiple risk variable: increased from 66% among those with a score of zero to 85% with a score of at least three (p < 0.001).ConclusionsThe vast majority of PWID at greatest risk of drug-related harm in Glasgow and elsewhere in Scotland would be willing to use a DCR, supporting proposals for the introduction of DCRs nationally.     

Drug and alcohol consumption and sexual risk behaviour among young adults: results from a national survey.

To study the association of the consumption of alcohol and other psychoactive drugs with sexual risk behaviour for HIV infection, data from a representative sample of the Spanish population aged 18-39 years were analysed. A national household survey was carried out in 1996 using a combination of face-to-face interviews and self-administered questionnaires. The survey included 5253 subjects aged 18-39 years who provided information on alcohol and drug consumption, number of sexual partners and condom use with the steady partner and with casual partners in the 12 months before the survey. Of those surveyed, 27.4% had been drunk at least once and 20.5% had consumed drugs. Both behaviours were associated with male sex, younger age, higher educational level, being single and having had more than one sexual partner. In the logistic regression analysis adjusting for the sociodemographic variables, the greater frequency of drunkenness and cannabis use were associated with having more than one sexual partner. Regular condom use was significantly less frequent among cocaine users and more frequent among opiate users, but was not associated with the use of other drugs. Sexual risk behaviour (i.e. more than one partner and failure to use a condom regularly) was more frequent among persons who had been drunk or used cannabis or cocaine. Excessive consumption of alcohol, and cannabis and cocaine use are independently associated with sexual behaviour involving greater risk of HIV infection or transmission.     

Hypovitaminosis D and cardiometabolic risk factors among non-obese youth

Hypovitaminosis D and increased cardiometabolic risk have been well established in adults. This study aims to determine whether or not vitamin D also influences cardiometabolic risk in children and adolescents. To test this hypothesis, we recruited 186 boys (mean age 12.4 ± 3.7 years) and 114 girls (11.6 ± 3.7) in a cross-sectional observational study. Anthropometrics were obtained and morning fasting blood samples were collected. Serum glucose and lipid profile were determined using routine methods. Serum 25-hydroxyvitamin D was quantified using an enzyme-linked immunosorbent assay. In our population, approximately 10% of subjects had severe 25-hydroxyvitamin D deficiency (< 12.5 nmol/L), while 50% of the boys and 40% of the girls had mild vitamin D deficiency (12.5–24.9 nmol/L). Circulating 25-hydroxyvitamin D concentrations were inversely correlated with age, body mass index (BMI), blood pressure, waist and hip circumferences and serum triglyceride concentrations, and positively associated with HDL-cholesterol. Age and systolic blood pressure were significant predictors of 25-hydroxyvitamin D, explaining about 30% of the variance (p = 0.0005). In conclusion, significant associations between serum 25-hydroxyvitamin D and cardiometabolic parameters support promising cardioprotective benefits from vitamin D sufficiency at an early age. Follow-up with prospective clinical intervention studies are needed to validate this hypothesis.     

Ecstasy use in Australia: patterns of use and associated harm.

This study explored patterns of ecstasy use and associated harm through the administration of a structured interview schedule to 329 ecstasy users, recruited from three Australian cities. A broad range of ecstasy users were interviewed, but on the whole, the sample was young, relatively well educated and most were employed or students. Patterns of use were varied, although extensive polydrug use was the norm. High rates of intravenous drug use were recorded, which may relate to an over-representation of chaotic intravenous polydrug users. Subjects had experienced an average of eight physical and four psychological side-effects, which they attributed to their ecstasy use in the preceding 6 months. Approximately 40% of the sample also reported financial, relationship and occupational problems. Young, female, polydrug users and those who binged on ecstasy for 48 h or more appeared most at risk of experiencing harm that they related to their ecstasy use. One-fifth of the sample had received treatment for an ecstasy-related problem, most often from a GP or natural therapist, and 7% were currently in treatment. One quarter wanted to reduce their use because of financial, relationship and psychological problems. A total of 15% wanted formal treatment for an ecstasy-related problem and 85% requested more information. These results have implications for the development of policies to respond to drug use among this population.     

MDMA/Ecstasy use among young people in Ohio: perceived risk and barriers to intervention

In the past several years, the use of MDMA (Ecstasy) has increased substantially in the United States and in many countries around the world. Although this increase has been associated with the dance club and rave scenes, Ecstasy use has expanded into new settings. At the same time, the diversity of people using the drug has also grown. Given the increasing, although unclear, evidence that MDMA has the potential to cause neurotoxicity and various psychological problems under certain conditions among humans, understanding how active users perceive the risks associated with Ecstasy use can help to inform prevention and intervention approaches. Based on audiotaped focus groups and individual interviews conducted with 30 Ecstasy users in Dayton and Columbus, Ohio, this article explores these and other issues. Results demonstrate that beyond the risk of obtaining something potentially deadly instead of MDMA, most users do not associate risks of neurotoxicity or psychological problems with Ecstasy use. Active users look to harm-reduction approaches for answers to using Ecstasy safely; prevention messages like, "just say no to drugs" are largely ignored. Because Ecstasy is commonly used among small groups of friends, peer leader or other social network intervention approaches may be promising.     

Correlates of perceiving a need for treatment among adults with substance use disorder: results from a national survey

Although millions of adults meet criteria for substance use disorder (SUD) in the U.S., only a fraction receive treatment. This may be due to individuals with SUD not perceiving a need for treatment. In order to distinguish persons with SUD who perceive a need for treatment from those who do not, correlates for the perceived need for treatment were assessed for respondents with alcohol use disorder only, drug use disorder only and both alcohol and drug use disorder. Data were from the combined 2005-2009 datasets of the National Survey on Drug Use and Health. Logistic regression models were used to calculate odds ratio and 95% confidence intervals. Results demonstrated that among respondents who need treatment but did not receive treatment for alcohol use disorder, drug use disorder and both alcohol and drug use disorders, 3.3%, 8.3% and 12.4% perceived a need for treatment, respectively. No single socio-demographic correlate was predictive of perceiving a need across the three subpopulations suggesting that screenings for substance use disorder should be done in a setting where the general population may be accessed, e.g. primary care settings. Correlates associated with perceiving a need for treatment for all three subpopulations included psychological distress, disorder severity and substance type. Although respondents with greater disorder severity were more likely to perceive a need for treatment, a large proportion of those still do not perceive a need for treatment. Screening and brief interventions would facilitate treatment entry among those with the most severe disorders.     

Risk factors for substance use among youth experiencing homelessness

Abstract

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.     

Drinking patterns among Hispanic adolescents: results from a national household survey

OBJECTIVE: This is one of the first studies to examine and compare alcohol use for adolescent Cubans, Mexican Americans, Puerto Ricans and other Hispanics. METHOD: The data come from the 1993 National Household Survey on Drug Abuse (NHSDA), a national probability sample of the U.S. household population. The sample examined here (N = 1,865, 52% male) comprises 200 Cubans, 1,133 Mexican Americans, 255 Puerto Ricans and 277 Central/South Americans who were 12 to 17 years old. Drinking patterns are measured using a quantity-frequency index, and analyses are conducted using Stata. RESULTS: In the cross-tabulations, no ethnic differences in drinking patterns are found for males or females, nor is there evidence of gender differences within ethnic groups, although there are some age differences in alcohol use. In the logistic regression analyses, two ethnic differences emerge, although the factors most consistently associated with drinking behaviors in these analyses are age, Spanish language use and urban residence. Additional analyses using the 1998 NHSDA suggest that ethnic differences in alcohol use may emerge in late adolescence/early adulthood. CONCLUSIONS: Given the established findings of ethnic and gender differences in drinking among adult Hispanics, it is surprising that few differences are evidenced in adolescence. Future research should explore whether such differences emerge during the transition into adulthood and, if so, identify factors that produce them. In addition, to increase understanding of these ethnic groups' drinking patterns, future research should further investigate the factors associated with Hispanic adolescents' alcohol use, including both consideration of whether the predictors are the same across groups and of the role of sociocultural factors.     

Nurses' use of alcohol and other drugs: findings from a national probability sample

This study examined the prevalence of alcohol and other drug (AOD) use among nurses in the 1984 National Longitudinal Survey of Youth (NLSY) using methods similar to those employed in a study comparing nurses and nonnurses from the 1980-1984 Epidemiological Catchment Area program (ECA). Conditional logistic regression was used to estimate the degree to which AOD use was associated with occupation. Results indicating that substance use is unrelated to occupation lend support to earlier findings from the ECA.     

The use of caffeinated alcoholic beverages among underage drinkers: Results of a national survey

Objective

The mixing of alcoholic beverages with caffeine has been identified as a public health problem among college students; however, little is known about the consumption of such drinks among younger adolescents. We estimated the prevalence of caffeinated alcoholic beverage (CAB) use among a wide age range of underage drinkers, examined differences in traditional (i.e. self-mixed alcoholic beverages with soda, coffee and tea) and non-traditional CAB use (pre-mixed caffeinated alcoholic beverages or self-mixed alcoholic beverages with energy drinks or energy shots) among underage drinkers by age and other demographic characteristics, and examined differences in hazardous drinking behavior between CAB and non-CAB users.

Methods

We used an existing Internet panel maintained by Knowledge Networks, Inc. to assess the use of pre-mixed and self-mixed CABs in the past 30 days among a national sample of 1031 youth drinkers age 13–20. We conducted logistic regression analyses to estimate the relationship between traditional and non-traditional CAB use and risky drinking behavior as well as adverse outcomes of drinking, while controlling for age, gender, race/ethnicity, income, and general risk-taking (seat belt use).

Results

The overall prevalence of CAB use in the sample of underage drinkers was 52.4% (95% confidence interval [CI], 47.4%–57.4%). CAB prevalence was 48.4% among 13–15 year-old drinkers, 45.3% among 16–18 year-old drinkers, and 58.4% among 19–20 year-old drinkers. After controlling for other variables, we found a continuum of risk with non-traditional CAB use most significantly associated with binge drinking (odds ratio [OR] = 6.3), fighting (OR = 4.4), and alcohol-related injuries (OR = 5.6).

Conclusions

The problem of caffeinated alcoholic beverage use is not restricted to college-aged youth. The prevalence of CAB use among underage drinkers is higher than previously thought and begins in early adolescence. Adolescents who consume CABs, and particularly non-traditional CABs, are at increased risk of adverse outcomes.