Latent transition analysis with covariates: pubertal timing and substance use behaviours in adolescent females

We investigate the impact of pubertal development, age, and its interaction on female substance use behaviour. An extended latent transition model with two latent variables is used to reflect the dependency of adolescent substance use on pubertal development and age. A sample of females in grades 7-12 is analysed using maximum-likelihood estimation. Analyses indicate that experiencing puberty is related to increased substance use for all age groups. Among females aged 12-15, those who have experienced puberty are more likely to advance in substance use compared to their late-maturing counterparts. Particularly, among 12-year old non-substance users, those who have experienced puberty are approximately three times more likely to advance towards substance use than those who have not experienced puberty. In addition, among older females, those whose puberty is in progress are more prone to advance in substance use compared to those whose puberty has not occurred.     

Substance Use and Intimate Partner Violence: Clarifying the Relevance of Women’s Use and Partners’ Use

Research has shown that, when women and/or their partners are involved in substance use, women’s risk for intimate partner violence (IPV) is higher. Prior research has not examined whether substance use by both women and their partners contributes independently or interactively to women’s risk of victimization and has not identified factors moderating the effect of substance use by victim or partner. Mental health and social support are explored as moderators of the association between women’s victimization and substance use by victim or partner in a study of 590 impoverished women residing in the Los Angeles area. This study found that substance use by both the woman and her partner independently predicted IPV and that social support moderated the effect of women’s substance use. These findings clarify the relevance of substance use in the context of intimate relationships and that of social support as a buffer against IPV among impoverished women.     

Substance Abuse Treatment Participation and Employment Outcomes for Public Disability Beneficiaries with Substance Use Disorders

Quantitative research methods are used to examine the interaction among public disability benefit receipt, substance abuse, participation in substance abuse treatment, and employment among US adults. Using cross-sectional data from the 2002 and 2003 Survey on Drug Abuse and Health, the results demonstrate that disability beneficiaries who have substance use disorders are more likely to access treatment than persons with substance use disorders who are not beneficiaries. Results could not confirm, however, that those beneficiaries who access treatment are more likely to return to employment than those who do not access treatment.     

Substance Use by Immigrant Generation in a U.S.-Mexico Border City

Immigrant generation status has an impact on substance use, with lower use rates for recent immigrants. Substance use surveillance data are reported at the national and state levels; however, no systematic collection of data exists at the city level for the general population. In particular, rates of substance use have not been published for El Paso, Texas. The aims of this study are to estimate the prevalence of substance use among Hispanics in El Paso and to determine the association between substance use and immigrant generation. Hispanic residents of El Paso (N = 837) were interviewed. Demographic, immigration, and substance use data were collected. Bivariate analysis indicated that substance use increased as immigrant generation increased, while perceived problems with substance use decreased. In comparison to Texas and national data, our data showed that the rates of tobacco, marijuana, and illicit drug use were lower among young adults in El Paso.     

Psychopathology in dual-diagnosis and nonaddicted schizophrenics: are there differences?

Analysis of 447 schizophrenic inpatients found a lifetime prevalence for substance use of 42.9% (3-month prevalence 29%). While the overall differences were small between schizophrenics using (dual diagnosis) and those not using substances, dual-diagnosis patients in general reported more positive symptoms, especially more intense hallucinations. These differences were observed in patients with current (3-month) substance use on admission but not on discharge, possibly as a result of substance use. The most marked differencses were in previous suicide attempts and delinquency, which were more prevalent in dual-diagnosis schizophrenics. These findings indicate that patients with dual diagnosis are more disturbed than other schizophrenics. We discuss the implications for the self-medication hypothesis for substance use in schizophrenia and future research in this area are discussed.     

Pregnant women with substance use disorders: The intersection of history,ethics, and advocacy

Pregnant women with substance use disorders face many obstacles, including obtaining evidence-based treatment and care. This article (1) briefly reviews the history of pregnant women in clinical trials and substance use disorders treatment research; (2) identifies current ethical issues facing researchers studying pregnant women with substance use disorders; (3) presents and describes an ethical framework to utilize; and (4) identifies future directions needed to develop appropriate research and treatment policies and practices. Current research is not providing enough information to clinicians, policy-makers, and the public about maternal and child health and substance use disorders, and the data will not be sufficient to offer maximum benefit until protocols are changed.     

Co-morbidity of eating disorders and substance abuse review of the literature

The comorbidity of eating disorders and substance use and abuse has frequently been reported in the past 15 years. To date, however, no synthesis of this literature exists. Here, 51 studies reporting on these associations are reviewed. Studies of substance use and abuse in eating disordered women are considered, as are studies of eating disorders among women classified as substance abusers. The rates of substance abuse among eating disordered women are also examined. This review indicates that associations are stronger with bulimia, and “bulimic” behaviors, than with anorexia nervosa. Analogously, bulimic anorectics report more substance use and abuse than restricters. The prevalence of drug abuse was not found to differ between the relatives of bulimics and anorectics. Several mechanisms explaining the eating disorder–substance use/abuse link are considered, and suggestions for future research made. © 1994 by John Wiley & Sons, Inc.     

Health-as-a-Value, Spirituality, and Cigarette and Alcohol Use Among Russian High School Students

National estimates suggest that the prevalence of tobacco and alcohol use is higher among adolescents in Russia than among adolescents in the United States and other European countries. However, research on the psychosocial correlates of, as well as protective factors for, tobacco and alcohol use among Russian adolescents has been relatively limited. Research conducted primarily in the United States has shown that spirituality and health-as-a-value are plausible predictors of adolescent substance use. However, these constructs have not been extensively studied in regions outside the United States. In this study, we tested whether spirituality and heath-as-a-value had protective effects on past-month cigarette and alcohol use behaviors and next-year cigarette and alcohol use intentions among Russian high school students (N?=?354, mean age?=?15.7?years), after controlling for known predictors of adolescent substance use such as age, gender, socioeconomic status, peer substance use, and sensation seeking. We found a significant inverse relationship between health-as-a-value and recent cigarette and alcohol use as well as future cigarette use intentions. However, we did not find a significant relationship between spirituality and any substance use variables. Implications of these findings for school-based substance use prevention are discussed.     

Tobacco and Alcohol Use as an Explanation for the Association Between Externalizing Behavior and Illicit Drug Use Among Delinquent Adolescents

The prevalence and persistence of adolescent substance use and abuse is a national health issue, and substance use among adolescents is frequently comorbid with other psychiatric disorders. Most studies in this area utilize samples of middle or high school students or from inpatient settings. Less is known about substance use and psychiatric comorbidity among delinquent adolescents. The present study examined data from two cohorts of juvenile offenders collected over a 2-year period (n = 245, n = 299). Participants reported frequency of cigarette, alcohol, marijuana, and other substance use. Participants' parents completed a measure of behavior problems. Path analyses suggested that parental reports of externalizing problems were significantly related to self-reported substance use while parental reports of internalizing problems were not. Results also suggested that smoking and alcohol use act as mediators between externalizing problems and marijuana and other drug use. Although there were some mean differences by gender, the pattern of relationships amongst the variables did not differ by gender. Implications of the findings and future directions are discussed.     

Young people’s perceptions of substance use norms and attitudes in the LGBT community

Objectives : Sexual minority young people (SMYP) show higher levels of substance use than their heterosexual counterparts. This study aims to test potential LGBT community‐specific reasons assumed to affect substance use and their relationships to LGBT community participation/connectedness and substance use behaviour. Methods : Eight LGBT community‐specific reasons for substance use were tested in an online survey with 1,556 SMYP. Results : Respondents agreed that the LGBT community had liberal attitudes towards substance use (80.5%, n=1,079) and that the media portrayed substance use as a part of the community culture (66.5%, n=904). Participants disagreed that excessive partying is a part of the community (34.7%, n=470). Significant but weak correlations between reasons and community participation/connectedness or personal substance use behaviour were found. Subgroup analyses indicated male and gay/lesbian participants showed differential agreement levels to some of the reasons. Conclusion : Young people’s perceptions of substance use within the LGBT community are not associated with community participation/connectedness or personal substance use. Implications for public health : Further research is needed to better understand what factors lead to elevated levels of substance use in SMYP. This may assist in the development of adequate public health responses. Targeting problematic beliefs may have little impact on substance use in SMYP.     

Self-harm and substance use in a community sample of Black and White women with binge eating disorder or bulimia nervosa

OBJECTIVE: This study evaluated rates of self-harm and substance use in women with either bulimia nervosa (BN) or binge eating disorder (BED) and assessed whether differences in self-harm and substance use are related to sexual or physical abuse. METHOD: Alcohol abuse, self-harm, and use or abuse of various illicit drugs were evaluated in a sample of 53 women with BN and 162 women with BED. RESULTS: Self-harm and substance use generally did not differentiate BED and BN cases, but rates of self-harm and substance use were elevated among women with a history of sexual or physical abuse relative to women without such a history. DISCUSSION: Elevated rates of self-harm and substance use may not be related uniquely to BN diagnostic status, but may be related to a characteristic shared by women with BN and BED, such as a history of sexual or physical abuse.     

How all stars works: an examination of program effects on mediating variables.

Prevention research continues to focus on school-based substance use programs aimed at adolescents. These programs are designed to reduce substance use and risk behavior by targeting key mediators, such as normative beliefs, which in turn reduce substance use. All Stars is a newly developed program that was recently evaluated in a randomized field trial in 14 middle schools in Lexington and Louisville, Kentucky. The authors examined targeted and nontargeted variables as possible mediators of program effectiveness. Findings indicate that All Stars achieved reductions in substance use and postponed sexual activity when teachers were successful at altering targeted mediators: normative beliefs, lifestyle incongruence, and manifest commitment to not use drugs. The program was not successful when it was delivered by specialists. At least in part, this failure is attributable to specialists' inability to change mediators as intended by the program.     

Emerging Adults’ Discussion of Substance Use and Sexual Behavior with Providers

Emerging adulthood (ages 18–25) is a time of increased autonomy and associated with a high rate of risky substance use and sexual behavior. As emerging adults (EA) increasingly have more independence, they have the ability to make health decisions, including whether to see a provider (primary care (PCP) and/or gynecologist (GYN)) and whether to discuss substance use and sexual behavior. The current study aimed to determine: (1) factors associated with PCP and GYN health-care seeking by sexually active EA who use alcohol and/or marijuana; (2) gender differences in substance use and sexual risk topics initiated by providers; (3) whether PCPs compared to GYNs discuss different topics with women. Alcohol and/or marijuana-using, sexually active EA (n = 500) were recruited as part of a health behaviors study. Among participants, 39% did not see a PCP in the previous year. Women, White individuals, and EA with health insurance were most likely to attend a PCP appointment. Even among participants who saw a provider, many participants reported that providers did not initiate a discussion about substance use (approximately half discussed substance use) and sexual behavior (about half discussed STI history, two-thirds discussed condom use, and three-quarters discussed sexual partners). Among women with a PCP and GYN provider, discussions on substance use were more likely to be initiated by a PCP while sexual issues were more likely to be initiated by a GYN. Thus, even among sexually active, substance-using EA, central topics – specifically substance use and sexual behavior – are not routinely brought up by providers.     

Demographic and clinical correlates of client motivation among substance abusers

Understanding the role of motivation in substance abusers' acceptance of treatment is critically important to improving treatment outcomes. To examine this phenomenon a cohort of substance abuse treatment clients was recruited from two treatment programs whose services are funded by a state managed care system. Motivation at treatment entry was examined. Better motivation was consistently associated with severity of substance use. Neither the coercion that accompanies legal system involvement nor self-referral was significantly related to measured levels of motivation. Motivation was not related to alcohol and drug use severity six months later. The severity associated with motivation at treatment entry was, for the most part, not related to clients' success six months later. Implications for social work practice with substance abusers are discussed.     

Occupational Therapy and Substance Use Disorders: Are Practitioners Addressing These Disorders in Practice?

Occupational therapy practitioners across all practice settings were surveyed in order to determine whether practitioners were assessing substance use disorders, and what interventions were used with clients who have or were suspected to have substance use disorders. Reasons practitioners did not address a clients' substance use disorder were explored. The perceptions of practitioners regarding their competence to assess and treat substance use disorders were also examined. The results of this study indicated that the majority of occupational therapy practitioners sampled outside the mental health setting did not routinely assess or treat substance use disorders. The findings of this study suggest that practitioners need to incorporate assessment and treatment of substance use disorders and their subsequent occupational performance deficits into daily practice regardless of practice area to assure holistic and comprehensive treatment.     

Familial influences on substance use by adolescents and young adults

This study uses data from the Ontario Health Survey to examine within-family influences (sibship number, age and sex composition; family structure and parental substance use) on the use of tobacco, alcohol and marijuana in households (N = 4,643) among offspring aged 12 to 24 years. Using a modification of the kappa statistic, concordance among siblings is modest generally and undifferentiated across substance type. Concordance is stronger among sibships that are either all male or older (19-24 years) and is particularly strong for siblings < or = two years apart in age. The dominant influence of substance use behaviour appears to be from older siblings to younger siblings and not from parents to offspring. Sibling concordance for substance use suggests that the treatment and prevention of substance use (and abuse) among adolescents and young adults might be enhanced by including a family focus, especially where there are two or more siblings at home.     

Histories of substance use and risk behavior: precursors to HIV seroconversion in homosexual men.

OBJECTIVES: This study compared history of substance use and episodic use in terms of HIV seroconversion. METHODS: A sample of 337 baseline HIV-negative gay men was followed for 6 years. Bivariate and survival analyses were used to compare 39 converters with nonconverters on substance use behaviors. RESULTS: Seroconverters were consistently more likely to report use of marijuana, nitrite inhalants, amphetamines, and cocaine than nonconverters. Consistent use of nitrite inhalants and amphetamines increases the relative risk of seroconversion, while episodic use does not. Both patterns of cocaine use increase seroconversion risk. CONCLUSIONS: There are three potential mechanisms for an increased risk of conversion due to consistent substance use.     

Controlling for the endogeneity of peer substance use on adolescent alcohol and tobacco use

This study examines whether the effects of peer substance use on adolescent alcohol and tobacco use are due to endogeneity of adolescents selecting their peer group. We analyzed data collected for a longitudinal analysis of a drug-use prevention programme for upper elementary school students. We used a two-step probit regression to control for the potentially endogenous explanatory variable peer substance use. Rigorous tests of endogeneity and the validity of the instrumental variables showed that controlling for the endogeneity of peer substance use to reduce bias is not worth the reduction in mean squared error in these data. Peer substance use has a positive and significant effect on adolescent substance use for both drinking and smoking. These results imply that peer influence is empirically more important than peer selection (endogeneity) in our sample of adolescents in grades 6–9. Living in a single-parent family was by far the strongest predictor of adolescent drinking and smoking. © 1998 John Wiley & Sons, Ltd.     

Longitudinal Relationships of Executive Cognitive Function and Parent Influence to Child Substance Use and Physical Activity

Considered a set of neuro-cognitive skills, executive cognitive function (ECF) may serve to protect children from initiating substance use, although its role relative to other protective influences that parents and physical activity might provide is not known. As part of a large multiple health risk behavior trial for prevention of substance use and obesity, Pathways, the present study evaluated the relative impact of ECF on lifetime substance use (tobacco and alcohol) and physical activity in a panel of fourth grade children over a 6-month period (N?=?1005; 51 % female; 25 % on free/reduced lunch; 60 % Hispanic/Latino or multi-racial; 28 elementary schools). A self-report survey included measures of ECF, lifetime tobacco and alcohol use, out-of-school physical activity, exercising with parents, and parent rules about food/sedentary behavior, monitoring, and arguing, was adapted for use with children. A path analysis demonstrated that ECF was the major predictor of lower substance use and higher physical activity and exercising with parents. Physical activity and exercising with parents showed reciprocal positive relationships. Findings suggest that promoting ECF skills should be a major focus of child health promotion and substance use prevention programs, although the potential protective effects of physical activity and exercise with parents on substance use in this young age group are not yet clear.     

Postpartum Substance Use and Depressive Symptoms: A Review

National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression may be at high risk for substance use. Understanding postpartum substance use and its relationship to postpartum depression can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999–2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%–49%) and drug use (4.5%–8.5%) were lower than use among not pregnant, not postpartum women (41.5%–57.5%, 7.6%–10.6%, respectively) but higher than use among pregnant women (5.4%–11.6%, 3.7%–4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by blacks and Hispanics, but black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%–46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use.