Sociocultural and Psychological Factors in American Indian Drug Use: Implications for Treatment

Use of alcohol and other drugs has been acknowledged as a serious problem among American Indian populations. This study was designed to 1) compare female and male American Indian substance users in residential treatment on psychological (self-esteem, depression, attributional style) and sociocultural (demographics, personal drug use history, family history, acculturation) variables, and 2) examine relationships of the psychological and sociocultural variables with program completion. Results showed that females experienced more family dysfunction (family members misuse of substances, and emotional, physical, and sexual abuse) than males. Both females and males showed positive change on the psychological measures from treatment entry to treatment completion. The factors predicting dropout before program completion were divorce, use of cocaine and depressants, and living in foster care as a child. Implications for prevention, intervention, and training of treatment service providers are discussed.     

Infusing Neuroscience Into the Study and Prevention of Drug Misuse and Co-Occurring Aggressive Behavior

The etiology of behavioral precursors to substance misuse and aggression is viewed from the perspective of a developmental, multifactorial model of complex disorders. Beginning at conception, genetic and environmental interactions have potential to produce a sequence of behavioral phenotypes during development that bias the trajectory toward high-risk outcomes. One pathway is theorized to emanate from a deviation in neurological development that predisposes children to affective and cognitive delays or impairments that, in turn, generate dysregulatory behaviors. The plasticity of these neurobiological systems is highly relevant to the prevention sciences; their functions are reliant upon environmental inputs and can be altered, for better or for worse, contingent upon the nature of the inputs. Thus, social contextual factors confer significant influence on the development of this neural network and behavioral outcomes by increasing risk for, or protecting against, dysregulatory outcomes. A well-designed intervention can exploit the brain's plasticity by targeting biological and social factors at sensitive time points to positively influence emergent neurobiological functions and related behaviors. Accordingly, prevention research is beginning to focus on perturbations in developmental neural plasticity during childhood that increase the likelihood of risky behaviors and may also moderate intervention effects on behavior. Given that the more complex features of neurobiological functions underlying drug misuse and aggression (e.g., executive cognitive function, coping skills, affect regulation) do not coalesce until early adulthood when prefrontal-limbic brain networks consolidate, it is critical that mechanisms underlying developmental risk factors are identified. An empirically driven prevention approach, thus, may benefit from consideration of (i) the type, effect, and developmental timing of the environmental impact on the brain, and (ii) the type and effect on brain function, and developmental timing of the intervention. This translational approach promises to eventually offer some direction for the design of effective interventions to prevent drug misuse and concomitant aggression.     

Drug Identity Change Processes,Race, and Gender. I. Explanations of Drug Misuse and a New Identity-Based Model

The present paper explores race and gender differences in a recent theoretical model (Anderson, 1994), consisting of several micro- and macrofactors, that helps explain the identity-related processes of drug misuse. The approach is qualitative, featuring in-depth interviewing with 45 self-identified drug addicts. The study uncovered support for the general concepts of the identity-based model across four subgroups: Black females, White females, Black males, and White males. However, important race and gender differences emerged. Gender and race-related socialization and stratification explain most of the differences and suggest reconceptualization of the model. The investigation further demonstrates the promise of identity-based approaches in extending our knowledge of the etiology of drug misuse and related intervention policies.     

A Natural Response to Drug Misuse Problems: A Review of Drug-User Treatment Services of Bangladesh

This paper reviews and describes the natural processes through which the people of a Third World country, Bangladesh, have been trying to provide treatment to drug misusers. As the demand for medical help increases, different organizations develop to cater to the needs. Bangladesh has followed the age-old ashram model and the contemporary medical hospital model to provide services to its addicts. In reality the drug misuse treatment providers are still evolving through different learning stages about the biopsychosocial manifestations of addiction. According to the authors, the stages of learning can be divided into three phases: 1) the early period of confusion and enthusiasm, 2) the period of truism, and 3) the period of pragmatism. The people who have gained experience in running treatment centers in the last decade need to form alliances to share their experiences in order to develop rational models for drug treatment programs in Bangladesh. It is also important that they develop methods to monitor providers' activities and to protect clients' safety and interests.     

Gender Differences in Drug Misuse and Related Problem Behaviors among Arrestees in the UK

Traditionally, the addiction literature has focused on male drug users and less attention has been given to female users. More recently, research investigating gender differences in drug use and associated problem behaviors has emerged. This article contributes to the growing research base by drawing on data collected from structured interviews with 2,682 male and 453 female arrestees conducted as part of the New English and Welsh Arrestee Drug Abuse Monitoring (1999–2002) program. Clear gender differences in drug use and associated behaviors are identified. Women were found to be more serious drug users and to experience more associated problems than men. The research and policy implications of the research are discussed and the study's limitations are noted.     

Gratitude and Drug Misuse: Role of Coping as Mediator

Background: Positive emotions, such as gratitude has been found to be beneficial to both physical and mental well-being but so far, drug misuse research has yet to identify important emotive predictors related to drug use. Objectives: This study aimed to examine the relationship between gratitude and drug use among a group of drug misusers. It was hypothesized that greater dispositional gratitude was associated with lesser drug use through greater use of adaptive coping methods and lesser use of maladaptive coping methods. Methods: This study utilized a cross-sectional design to examine the relationship between gratitude, coping, and drug use among a sample of drug misusers (N = 105) at a drug rehabilitation center. Participants completed the gratitude questionnaire (GQ-6), the joy subscale of the Dispositional Positive Emotion Scale (DPES), the Brief COPE, and a questionnaire on their drug use. Data were collected in 2015. Results: Mediation analysis supported the hypothesis and found that adaptive coping mediated the relationship between gratitude and drug use. However, mediation was not found for maladaptive coping. Additional analysis found that adaptive coping as a mediator was not found for joy. Conclusion: Results suggested that gratitude has utility in reducing drug use through the use of more adaptive coping strategies and this relationship was not simply due to positive affect. Interventions targeting drug use behavior could consider introducing gratitude to increase adaptive coping abilities to reduce drug use.     

Alcohol Use and Misuse among Hispanic Women: Selected Factors,Processes, and Studies

Two perspectives have dominated the study of social problems: the objec-tivist and the constructionist. The objectivist approach defines social problems by the concrete, scientifically-measurable damage conditions cause, or the objective dangers they pose, to human life. The constructionist approach defines social problems by the public concern that conditions or issues generate. Constructionists often exaggerate the discrepancies that exist between the objective and the subjective dimensions-that is, for specific conditions, they argue that objectively damaging conditions may generate little or no concern, or that public concern erupts over a condition that may be stable or actually declining in objective seriousness. The American drug crisis or panic of the 1980s is used as a specific issue or condition to illuminate the viability of these two approaches. Some constructionists have minimized the objective harm caused or threat posed by drug misuse during this period, and argue that it actually diminished during the course of the 1980s, while public concern erupted. Using concrete indicators, I show that, although public concern did indeed increase dramatically, in fact, key indicators point to a concomitant increase in drug misuse during this decade, even though use indicators are actually down. While not minimizing the importance of the construction of social problems, I suggest that something of a synthesis of the objective and the subjective approaches may be necessary to understanding social problems.     

Drug Misuse Among University Students in the UK: Implications for Prevention

Aims: The aim of the research was to identify the types of drugs currently being used by university students, their involvement in multiple drug misuse and drug combinations, and the consequences of drug misuse in terms of associated harms. Methods: The research was based on an email survey of all first- and second-year students registered as undergraduates at a university in south Wales during October 2012. Results: The results of the research showed that drug misuse on the university campus studied was widespread in terms of the types and patterns of drug misuse. The most troublesome findings concern the high levels of multiple drug use, the use of some of the most dangerous drugs (including crack and powder cocaine and heroin, as well as ketamine), and the list of recorded harms experienced as a result of drug misuse. Conclusions: The article concludes that little attention has been paid outside of the United States to drug use among university students or to interventions designed to prevent it. However, there are signs that government policy in the United Kingdom is beginning to pay attention to the specific problems of drug misuse among university students.     

Chronic Drug Use and Crime

This paper used bivariate and multivariate analyses to estimate the relationships between chronic drug use and various measures of criminal activity. The data for these analyses were derived from the 1993 (1) and 1995 (2) National Household Surveys on Drug Abuse (NHSDA). Measures of criminal justice system contact and criminal activity included ever arrested, arrested during the previous year, commission of a predatory crime (e.g., assault, fighting) during the previous year, and commission of a property crime (e.g., theft, property damage, car theft, breaking and entering) during the previous year. The analysis was conducted separately for males, females, and age groups, and it distinguished between chronic drug users, nonchronic drug users, and nondrug users. The results consistently showed a significant linear relationship between criminal activity and frequency of drug use. These findings have implications regarding the potential reduction in predatory and property crime that could occur from a decrease in drug use. Significant differences in criminal behavior between chronic drug users and other cohorts may signal a critical need to develop targeted interventions for this particular type of drug user.     

Meperidine in Detoxification of Hospitalized Heroin Addicts

Forty-six heroin abusers were hospitalized and treated with meperidine either alone or in association with clonidine. Meperidine was given orally in rapidly decreasing doses according to three different schedules. The majority of patients (87 %) successfully completed the detoxification program. The best meperidine starting posology was 200 mg four times daily, which allowed stoppage of the opioid treatment after gradual reduction of the daily dose in a mean time of 9.5 days. Association with clonidine was not proven to be useful. This study shows that meperidine can be effectively used in rapidly decreasing doses in the pharmacological detoxification treatment of hospitalized heroin addicts.     

The Substance Use System: Social and Neighborhood Environments Associated with Substance Use and Misuse

Substance use theory and practice have traditionally focused on individuals who misuse substances or who are at risk for substance misuse, but this emphasis is shifting. The present study views both substance use and misuse systematically, assessing the relationships between the physical and social environments and substance use and misuse in dynamic interplay. This substance use system was examined through a survey of approximately 10,000 persons, aged 22–44, from primarily inner-city neighborhoods in the United States. Individual indicators such as race, sex, age, socioeconomic status, education, and religious service attendance relate to both the physical and interpersonal environments, even when each is controlled for the others. Qualities of both environments are strongly associated with substance dependency, even after individual indicators are controlled. These findings suggest the difficulty of bringing about change in drug and alcohol use without hndamental change in the environments where use takes place.     

Mortality,Causes of Death and Risk Factors for Death Among Primary Amphetamine Users in the Swedish Criminal Justice System

This study examined mortality and predictors of death in 1,396 primary amphetamine users (85% males) who were interviewed with the Addiction Severity Index in the Swedish criminal justice system during 2000–2006 and followed through 2008. Forty-nine clients deceased (standardized mortality ratio 4.1 [3.0–5.4]), at least 84% of deaths were violent or drug-related (12% suicides), and Cox regression analysis indicated that death was associated with frequent use of sedatives and less frequent use of amphetamine. No female deaths were observed; death and male gender were associated in binary analysis. Implications for diagnostics and treatment are discussed.     

Reliability Testing and Validation of the Drug Attitude Scale

This study was designed to provide reliability testing and validity information of the Drug Attitude Scale (DAS). One hundred twenty-eight subjects were drawn from a residential substance abuse treatment program within a community mental health center. Seventy-five percent of the subjects were males and 25% were females. Age ranged from 18 to 58 years. For the entire sample, coefficient alpha was found to be 0.87. Reliability estimates for the two subscales were also found to be quite similar. Clinical construct validity utilizing factor analysis strongly support the two-dimensional nature of the DAS and the accuracy of the instrument's scoring key. Initial testing of the DAS suggests that the scale represent a useful addition to the area of substance user assessment and rehabilitation.     

Women in Recovery from Drug Misuse: An Exploratory Study of Their Social Networks and Social Support

This cross-sectional research examined the effects of ethnicity, age, and primary drug (alcohol or other drug) on recovering women's social network size and social support. Study participants included 21 African-American, 39 Anglo-American, and 3 Mexican-American women in continuous recovery for a minimum of 6 months. Study findings demonstrated statistically significant increases in social network size and in the amount of social support received from pretreatment to posttreatment recovery periods. Ethnicity, age, and primary drug had little effect on social network size and amount of social support received.     

Homelessness and Substance Misuse: A Tale of Two Cities

In this article we examine the relationship between alcohol and drug misuse among the literally homeless (those living out of doors and in emergency shelters) in Hartford, Connecticut and Providence, Rhode Island, two northeastern U.S. cities of comparable size. We worked with homeless advocacy organizations in both cities, using a point-in-time census (N = 1058) and random sample (N = 66) in Hartford, and a sampling of clients (N = 82) of six shelters serving residents of Providence (N = 82). We found substance misuse relevant in 47.2% of the homeless in Hartford and in 45.1% of the homeless in Providence. We conclude that there is a great need for substance treatment services inside shelters, soup kitchens, and day centers so that homeless individuals have an opportunity to engage in treatment within their own milieu.     

Radioimmunoassay of Hair for Determination of Cocaine,Heroin, and Marijuana Exposure: Comparison with Self-Report

Radioimmunoassay of hair (RIAH) was compared with self-report for cocaine, heroin, and marijuana in two populations: 109 persons entering residential drug user treatment and 86 at follow-up posttreatment. Among treatment entrants, 89% of 87 RIAH cocaine-positives and 96% of 45 RIAH heroin-positives were confirmed by self-report. However, among those followed-up posttreatment, only 51% of 43 RIAH cocaine-positives and 67% of 18 RIAH heroin-positives were so confirmed. Whereas 95% of 104 self-reports of cocaine use in the combined population were confirmed by RIAH, only 69% of 80 self-reports of heroin use were. Self-report and RIAH for marijuana were weakly associated.