Examination of the relationships among drug use, emotional/psychological problems, and crime among youths entering a juvenile detention center

Urine testing and confidential interviews of youths entering a juvenile detention center in a southeastern city produced some striking results in regard to their drug use, delinquent behavior, and emotional/psychological problems. Recent users of marijuana/hashish and cocaine had higher rates of referral to juvenile court for property and drug offenses than nonusers. The results suggest that interviewing and urine testing of youthful detainees for drug use at the point of entry into secure detention is a promising method for screening youngsters with histories of delinquent behavior. Implications of these findings are drawn.     

Recidivism among high-risk youths: study of a cohort of juvenile detainees

We report some results from an ongoing, longitudinal study of juvenile detainees. Analyses were directed toward determining whether the youth's alcohol or other drug use and their emotional/psychological problems at entry into the detention center predicted subsequent arrests for new offenses. Statistically significant relationships were found between the youths' demographic characteristics (age, race, gender), referral history, reason for placement in the detention center, and cocaine use (as measured by urinalysis) and recidivism. However, the magnitudes of these relationships were low to moderate in value, suggesting that a longer follow-up period is needed to more meaningfully study this issue.     

Executive functioning in preschool-age children prenatally exposed to alcohol,cocaine, and marijuana

BACKGROUND: Reports from clinical and experimental (animal) research converge on the suggestion that prenatal exposure to alcohol, cocaine, or marijuana undermines executive functioning (EF) and its neurological underpinnings. However, large, adequately controlled, prospective studies of alcohol and marijuana effects on EF have reported conflicting findings, and there have been no such studies of cocaine exposure. METHODS: EF was investigated in a cohort (n = 316) of 4-year-old children the majority of whose mothers had used varying combinations of cocaine, alcohol, and marijuana during pregnancy. With use of postpartum maternal report and biological assay, children were assigned to overlapping prenatal cocaine-exposed, alcohol-exposed, and marijuana-exposed groups and to complementary control groups. The postnatal environmental assessment included measures of maternal intellectual and psychosocial functioning, current drug or alcohol use, and home environment. RESULTS: The children in the alcohol-exposed group had worse tapping-inhibition performance than children in the non-alcohol-exposed group, and this effect persisted when potential confounding environmental variables, other drug variables, and concurrent verbal intelligence were controlled for. CONCLUSIONS: Prenatal alcohol is predictive of decreased EF in early childhood that could not be attributed to environmental factors. The results are discussed in terms of the age and overall high-risk status of the children.     

A longitudinal assessment of change in marijuana use with other substance use problems

Background: Despite increasing marijuana use rates over the past decade, the longitudinal association between marijuana use and other substance use problems among adults is unclear. Objectives: To examine associations of self-reported changes in marijuana use and marijuana use frequency with self-reported other substance use problems over a 12-month period. Methods: Two waves (W1 and W2) of the Population Assessment of Tobacco and Health Study provided data. The study sample (N = 26,204, female = 13,261; male = 12,943, aged 18+) included W1-W2 never marijuana users, W1-W2 ex-users (used prior to 12 months of W1), and those who either quit, initiated, resumed, or continued marijuana use between W1 and W2. We used multinomial and binary logistic regression analyses. Results: The past-year marijuana use rate was 12.4% at W2. A quarter of W1 users quit using marijuana in the 12 months preceding their W2 interview, and one-third of all the W2 users were new/resumed users since W1. Compared to W1-W2 ex-users, W2 quitters were more likely to report alcohol use problems and tobacco addiction at W2. Compared to quitters, continued users were more likely to report alcohol use problems (RRR = 1.62, 95% CI = 1.27–2.07) and tobacco addiction (RRR = 1.37, 95% CI = 1.11–1.69). New users (RRR = 2.05, 95% CI = 1.12–3.74), resumed users (RRR = 2.69, 95% CI = 1.55–4.70), and continued users (RRR = 3.40, 95% CI = 2.08–5.55) reported more drug use problems. Compared to less frequent marijuana users, frequent users had greater odds of reporting alcohol use problems (RRR = 1.44, 95% CI = 1.21–1.72) and drug use problems (OR = 1.63, 95% CI = 1.19–2.23). Conclusions: Given increased prevalence of marijuana use, polysubstance use problems among marijuana users should be assessed.     

The Relationship between parental alcohol use, early and late adolescent alcohol use, and young adult psychological symptoms: a longitudinal study

We tested the hypothesis that there is a mediational pathway from parental alcohol use during the participants' adolescence to the participants' psychological symptoms in young adulthood. This pathway includes the participants' alcohol use and their psychological symptoms, both during adolescence. The participants are inner city African American and Puerto Rican early adolescents followed until young adulthood. They reported their own and their parents' behavior. Structural equation modeling showed that parental alcohol use was related to early adolescent alcohol use, which was associated with late adolescent alcohol use. Late adolescent alcohol use was related to psychological symptoms in late adolescence, which predicted young adult psychological symptoms. Males reported more alcohol use and more psychological symptoms than females in late adolescence and more psychological symptoms in young adulthood. Findings suggest that parents' and adolescents' alcohol use should be a focus in interventions designed to prevent or treat psychological symptoms in late adolescence and young adulthood.     

Adolescent alcohol and marijuana use: a longitudinal assessment of a social learning perspective

A social learning model which incorporates measures from both the sociological perspective of differential association and the psychological perspective of behavior reinforcement is analyzed as an explanation of continued alcohol and marijuana use among youths. Data were gathered at two points in time from a sample of adolescents from New Jersey. The measurement and structural relationships among peer associations, attitudes, reinforcing and punishing consequences, and patterns of use were examined. It was found that, overall, the model fit the data for use of both substances, proving to be invariant across age and gender groups. The most pronounced difference between the alcohol and marijuana models was that differential associations exhibited the strongest relationship to maintenance of alcohol use while reinforcers were most salient to continued marijuana use.     

A meta-analysis of marijuana, cocaine and opiate toxicology study findings among homicide victims

Aim   To synthesize the results of marijuana, cocaine and opiate drug toxicology studies of homicide victims and examine variation in results across person and setting characteristics.
Methods   A meta-analysis of 18 independent studies identified from an extensive review of 239 published articles that met the inclusion criteria of reporting marijuana, cocaine and/or opiate toxicology test results for homicide victims. A total of 28 868 toxicology test results derived from 30 482 homicide victims across five countries were examined.
Results   On average, 6% of homicide victims tested positive for marijuana, 11% tested positive for cocaine, and 5% tested positive for opiates. The proportion of homicide victims testing positive for illicit drugs has increased over time. Age had a strong curvilinear relationship with toxicology test results, but gender differences were not apparent. Hispanic and African American homicide victims were more likely to test positive for cocaine; Caucasians were most likely to test positive for opiates. Cocaine use appeared to be related to increased risk of death from a firearm and was a greater risk factor for violent victimization in the United States than in Newfoundland and Scandinavia.
Conclusion   There are relatively few studies of illicit drug toxicology reports from homicide victims that allow for cross-cultural comparisons. This study provides a basis for comparing future local toxicology test results to estimates from existing research.     

The association between earlier marijuana use and subsequent academic achievement and health problems: a longitudinal study

In this prospective longitudinal study, the authors investigated the association between marijuana use over a period of 13 years and subsequent health problems at age 27. A community sample of 749 participants from upstate New York was interviewed at mean ages of 14, 16, 22, and 27 years. Marijuana use over time was significantly associated with increased health problems by the late twenties, including respiratory problems, general malaise, neurocognitive problems, and lower academic achievement and functioning. Effective prevention and intervention programs should consider the wide range of adverse physiological and psychosocial outcomes associated with marijuana use over time.     

A longitudinal study of substance use and violent victimization in adulthood among a cohort of urban African Americans

Aims This paper examines the effects of experiencing violent victimization in young adulthood on pathways of substance use from adolescence to mid‐adulthood. Design Data come from four assessments of an African American community cohort followed longitudinally from age 6 to 42 years. Setting The cohort lived in the urban, disadvantaged Woodlawn neighborhood of Chicago in 1966. Participants All first graders from the public and parochial schools were asked to participate (n = 1242). Measurement Dependent variables—alcohol, marijuana and cocaine use—came from self‐reports at age 42. Young adult violent victimization was reported at age 32, as were acts of violence, substance use, social integration and socio‐economic resources. First grade risk factors came from mothers' and teachers' reports; adolescent substance use was self‐reported. Findings Structural equation models indicate a pathway from adolescent substance use to young adult violent victimization for females and those who did not grow up in extreme poverty (betas ranging from 0.15 to 0.20, P < 0.05). In turn, experiencing violent victimization in young adulthood increased alcohol, marijuana and cocaine use, yet results varied by gender and early poverty status (betas ranging from 0.12 to 0.15, P < 0.05). Conclusions Violent victimization appears to play an important role in perpetuating substance use among the African American population. However, within‐group variations are evident, identifying those who are not raised in extreme poverty as the most negatively affected by violence.     

Drug abuse and alcohol problems among cocaine abusers in an assessment/referral service

This paper reports the social, demographic and drug abuse backgrounds of cocaine abusers seen at an alcohol and drug abuse assessment centre in Kitchener, Ontario. It compares cocaine abusers to cannabis users and alcoholics of the same age at the same centre. Cocaine and cannabis abusers are mainly young, single males while alcohol abusers are much older. The cocaine and cannabis abusers are both heavy drinkers but the cocaine group contained more high-risk drinkers, more drug injectors and had a higher alcohol consumption. Cocaine abusers are young poly-drug users for whom drinking is also a major problem. Treatment plans should take these problems into account.     

Outcomes for older trauma patients in the emergency department screening positive for alcohol,cocaine, or marijuana use

Background: Substance use among older adults is an increasing concern, with the prevalence of substance use in older populations expected to double in the next decade. Drug and alcohol use is associated with trauma risk and outcomes, but little is known about the specific risk for older trauma patients. Objectives: To evaluate the association between drug and alcohol use and trauma outcomes among adults aged 55 years and older. Methods: This retrospective observational study included older adults from the Illinois Trauma Registry between 1999 and 2009. Exclusion criteria were age younger than 55 years or absent date of birth, ethanol level, or urine drug screen (UDS). Alcohol intoxication was defined as ethanol level greater than 80?mg/dL. UDS was used to screen cocaine and marijuana use. Analyses, for both the alcohol and the marijuana/cocaine groups, compared outcomes for patients with negative vs. positive screens. Results: 21?320 patients were included in the alcohol analysis and 17?077 in the drug analysis. Compared to non-intoxicated patients, alcohol-intoxicated patients had significantly (p?0.001) lower in-hospital mortality, decreased ICU admission, decreased intubation rate, and shorter hospital length of stay. Patients screening positive for cocaine or marijuana had significantly longer lengths of stay with increased ICU admission compared with those who screened negative. Conclusion: Among older trauma patients, this study shows significant associations with multiple trauma outcomes, including one between elevated ethanol concentrations and improved outcomes. Future research into the causes of these findings could inform the care of older trauma patients and aid in prevention of injuries.     

Unemployment and use of drug and alcohol among young people: a longitudinal study in the general population

A prospective study of a representative sample of nearly 2000 young people aged 17–20 years was started in 1985. It was followed up twice, in 1987 and in 1989. The Central Bureau of Statistics in Norway was responsible for the data collection. Sixty-five per cent of the stratified sample (1985) participated in all the three surveys. The aim of this paper has been to explore the relationship between unemployment and the use of drugs and alcohol. The results show that unemployment does not appear to influence the consumption of alcohol. In a high consumption group, unemployment seems to lead to a decrease in alcohol consumption, though there was a clear tendency to increase use of cannabis. The results seem to indicate that there was no increase in use of alcohol or drugs in response to stress as a result of unemployment, though unemployment may lead to a stronger identification with or joining marginalized or deviant subcultures which in turn leads to an increased use of cannabis.     

Personality moderates the longitudinal relationship between psychological symptoms and alcohol use in adolescents

Background: A great deal of research has emerged on the comorbidity between alcohol misuse and psychological symptoms (e.g., depression, anxiety, and antisocial behavior or conduct disorder) in adolescence. Research has also shown that personality traits underlie vulnerability to alcohol use and psychological symptoms, but how personality moderates this association has not been comprehensively examined. The goals of this study are to clarify (i) whether early alcohol use effects the rate of change of psychological symptoms and vice versa, (ii) whether initial levels and rate of change in both domains vary according to individual differences in personality traits, and (iii) whether personality moderates the relationship between alcohol use and psychological symptoms. Methods: Self‐reported alcohol use, depression, anxiety, and antisocial behavior were collected from 393 adolescents at four separate time points across an 18‐month period. Parallel growth models were used to assess the main objectives of the study. Personality traits [anxiety sensitivity (AS), hopelessness (H), impulsivity (IMP), and sensation seeking (SS)] were included as time‐invariant predictors of initial levels and rates of change of each construct. Results: The results indicated that elevated levels of depression predicted faster rates of increase in alcohol use. Personality‐specific relationships were demonstrated across all models. IMP was shown to moderate the relationship between alcohol use and depression, suggesting that adolescents who showed a susceptibility to elevated levels of IMP, and heavier drinking were less likely to demonstrate a normative decline in depression. Adolescents with higher levels of AS and anxiety were more likely to show a faster rate of increase in alcohol use. Conclusions: These results highlight the importance of examining personality traits in studying the associations between alcohol use and psychological symptoms.     

A longitudinal study of cognitive functioning in patients with classical galactosaemia, including a cohort treated with oral uridine

Existing longitudinal data on patients with classical galactosaemia suggests that neurocognitive functioning is impaired and, in isolated case reports, may show a decline in performance over time. The present study explored whether there are long-term changes in cognitive abilities in patients with galactosaemia and whether oral uridine can improve neurocognitive performance. Thirty-five patients (18 males, 17 females), 29 of whom received oral uridine powder at 150 mg/kg per day (divided dose, three times daily), were evaluated over a 2-5-year period with the Woodcock-Johnson Revised Cognitive Abilities Test, three academic achievement tests, and the Beery Test of Visual Motor Integration. Results showed that the uridine cohort and a comparison group that received only dietary restriction made small gains in cognitive performance over the treatment period and the size of the gains did not differ significantly. Seven subjects who started uridine prior to the age of 14 months did not differ significantly in their cognitive test scores at an average age of 3.5 years from a group of older children who had begun treatment at 4.5 years of age. These results provide no support for any developmental or uridine-treatment-related change in cognitive functioning for this sample of galactosaemic subjects.     

A cluster-analytic study of substance problems and mental health among street youths.

Based on a cluster analysis of 211 street youths aged 13-24 years interviewed in 1992 in Toronto, Ontario, Canada, we describe the configuration of mental health and substance use outcomes. Eight clusters were suggested: Entrepreneurs (n = 19) were frequently involved in delinquent activity and were highly entrenched in the street lifestyle; Drifters (n = 35) had infrequent social contact, displayed lower than average family dysfunction, and were not highly entrenched in the street lifestyle; Partiers (n = 40) were distinguished by their recreational motivation for alcohol and drug use and their below average entrenchment in the street lifestyle; Retreatists (n = 32) were distinguished by their high coping motivation for substance use; Fringers (n = 48) were involved marginally in the street lifestyle and showed lower than average family dysfunction; Transcenders (n = 21), despite above average physical and sexual abuse, reported below average mental health or substance use problems; Vulnerables (n = 12) were characterized by high family dysfunction (including physical and sexual abuse), elevated mental health outcomes, and use of alcohol and other drugs motivated by coping and escapism; Sex Workers (n = 4) were highly entrenched in the street lifestyle and reported frequent commercial sexual work, above average sexual abuse, and extensive use of crack cocaine. The results showed that distress, self-esteem, psychotic thoughts, attempted suicide, alcohol problems, drug problems, dual substance problems, and dual disorders varied significantly among the eight clusters. Overall, the findings suggest the need for differential programming. The data showed that risk factors, mental health, and substance use outcomes vary among this population. Also, for some the web of mental health and substance use problems is inseparable.