Problematic use of psychoactive substances in undergraduates: a comparison of four patterns of substance use

The aim of the study was to examine the difference between alcohol-related and illicit drug-related negative consequences in a sample of undergraduates. The survey study was conducted on a sample of 458 lifetime drug users among second-year students, aged between 19 and 25 years (M?=?21.24, SD?=?1.15). The Chi-square test of independence revealed a significant dominance of alcohol-related consequences, in comparison to drug-related ones. Separate repeated measures analyses of variance (ANOVAs) were performed to examine mean differences between substance-related consequences (alcohol-related and illicit drug-related) among the groups of current substance users in four patterns: (1) frequency of alcohol use (non-users, occasional, regular), (2) quantity of alcohol use (non-users, moderate, binge), (3) frequency of illicit drug use (non-users, occasional, regular) and (4) concurrent alcohol and illicit substance use (non-user, alcohol only user, concurrent alcohol and drug user). The strongest association was found between regular illicit drug users and substance-related consequences, when comparing four models of multivariate analysis of variances (MANOVAs). Collectively, these results extend previous findings that identification of regular illicit drug users among undergraduates may be a powerful tool for predicting both alcohol-related and drug-related negative consequences and a potential target for clinical intervention and prevention efforts at universities.     

Nonfatal overdose from alcohol and/or drugs among a sample of recreational drug users

Abstract

The purpose of this study was to examine nonfatal overdose events experienced among a sample of recreational drug users. We sought to determine predictors of nonfatal overdose from alcohol and/or drugs among a sample of recreational drug users. In addition, we examined the substance(s) used at the last overdose event. Methods: Participants were 637 recreational illicit drug users (had used illicit drugs other than marijuana, in a club or party setting), aged 19 or older, from Victoria or Vancouver, British Columbia, Canada. Data were obtained in structured interviews conducted from 2008 to 2012 as part of the Canadian Recreation Drug Use Survey (CRDUS). Results: In the 12 months prior to interview, 19.3% (n?=?123) of the participants had experienced an overdose. In multivariate analysis, younger age, unstable housing, and usually consuming eight or more drinks containing alcohol, when drinking, significantly increased overdose risk. In addition, polysubstance use was reported by 67.5% (n?=?83) participants at their last overdose event. Conclusions: Intervention and prevention measures seeking to reduce overdoses among recreational drug users should not only address illicit drug use but also alcohol and polysubstance use. In addition, measures may target those who usually consume high amounts of alcohol when drinking are younger and who experience housing instability.     

Readiness to change alcohol and illicit drug use among a sample of emergency department patients

Objective: This study sought to (1) provide estimates of alcohol and illicit drug use, alone and in combination, among a sample of adult emergency department patients and (2) examine readiness to change.

Methods: Consecutive emergency department patients ≥18 years of age from a large regional hospital in Camden, NJ, were enrolled from May to December 2005. Patients provided information on alcohol and illicit drug use, as well as on interest in quitting each of these substance classes.

Results: Of the 1549 subjects surveyed, 98 (6%) indicated weekly use of both alcohol and illicit drugs, and 58 (4%) indicated problems associated with use of both substance classes. Problem users of illicit drugs felt that quitting drugs was more important, that they were more ready and that they were more confident in quitting than problem users of alcohol.

Conclusion: Problem use of multiple substances was relatively common in this emergency department sample. A substantial proportion of problem users of both substance classes were highly motivated to quit the use of one, but not the other, substance class. Further longitudinal and clinical trial research is needed to study the implications of multiple substance use, motivation to change and cessation.     

Use of Drugs,Tobacco, Alcohol and Illicit Substances in a French Student Population

ObjectiveTo investigate perceived health status and prevalence of drug use, tobacco smoking, consumption of alcohol and illicit substances in a student population.MethodsData were obtained from an anonymous questionnaire distributed to first-year students of the Toulouse University. Collected data concerned socio-demographic characteristics, perceived health status, and consumption of tobacco, alcohol, illicit substances and drugs.ResultsFifty seven percent of the 3 561 responders declared to have taken at least one drug during the week preceding the questionnaire. Most commonly Anatomical, Therapeutic and Chemical (ATC) classes used were genito-urinary system and sex hormones (29.6%), nervous system (16.4%) and alimentary tract and metabolism (14.1%). Twenty three percent of students were smokers. Differences according to health perception were found for tobacco and cannabis consumption. Anxiety was significantly more prevalent among students reporting that they did not consume alcohol (p < 0.05)ConclusionMore than half of students use drugs. Other consumptions (tobacco, alcohol and illicit substances) are related with perceived health status.     

Do severity levels of substance use relate to self-reported variations in psychosocial distress?

This study aimed to examine whether patients who reported different severity levels of illicit substance use and alcohol differed in contemporary psychological distress and interpersonal problems. A patient sample (n = 352) was established from 16 treatment facilities for substance use disorders in Norway and by mailed questionnaires to patients at waiting lists and individuals who had completed their treatment. The response rates were 53 and 28% for data collected at the clinics and by mailed questionnaires, respectively. The questionnaire consisted of validated measures of substance use and the psychological constructs. The results showed stronger symptom load in the group manifesting severe levels of illicit substance use. Differences in alcohol consumption also reached significance. For illicit substances these differences were stronger for symptoms related to depression, anger and somatic issues, whereas differences were more substantial in anxiety symptoms related to alcohol consumption. Differences in interpersonal problems were marginal both for illicit substance use and alcohol. The results indicate that psychological distress is more directly associated with substance use than interpersonal problems. The role of interpersonal problems for substance consumption may be of a more indirect character than the connection between psychological distress and substance use.     

The effect of personal use and family history on the attitudes of medical students toward alcohol and drug users

Objective: To investigate the effects of the personal exposure/usage of alcohol and drugs in medical students on their attitudes toward alcohol and drug users. Negative attitudes in health care practitioners about alcohol and drug users may lead to poor patient care. Personal experience on alcohol and drug use can influence the attitudes of health care professionals.

Method: This study used a quantitative cross-sectional methodology, utilizing a self-report survey on the personal use of alcohol and drug use, and the family history of alcohol and tobacco use. The “Substance Abuse Attitude Survey” (Chappel J. N., Veach, T. L., & Krug, R. S. (1985). The Substance Abuse Attitude Survey: An instrument for measuring attitudes. Journal of Studies on Alcohol, 46, 48–52.) measured attitudes (n = 417).

Results: The attitudes of medical students towards alcohol and drug users were weakly linked to their own personal use, and family history of alcohol and drug use. Increased use of alcohol was positively correlated with non-stereotyping. Length of time in medical school, number of years drinking alcohol, and high frequency of binge drinking were negatively correlated with non-moralism.

Conclusions: This study demonstrated that the attitudes of future medical professionals are fairly neutral toward alcohol and drug users. Given that alcohol and drug abuse are now considered medical illnesses health professionals themselves may attach fewer stigmas and stereotypes to the use and abuse of alcohol.     

Trajectories of drug use among French young people: Prototypical stages of involvement in illicit drug use

Aims: This study investigated patterns and trajectories of substance use, with a special focus on illicit drugs other than cannabis. It examined both patterns and trajectories of use among a general population-based sample. Methods: We used data from the 2011 French ESCAPAD survey of French 17-year-olds to assess exposure and age of initiation of 14 licit and illicit drugs (N=23,882). Latent class analysis (LCA) and survival analyses were performed. Results: The results of the LCA showed that patterns of illicit drug use clearly distinguished between two groups of other illicit drugs: 1) amphetamines/speed, cocaine, ecstasy/MDMA, magic mushrooms, poppers, and solvents; 2) crack/freebase, GHB/GBL, heroine, LSD, and ketamine. Survival analyses highlighted that trajectories involved the first group before the second one. Conclusions: Prototypical drug use patterns and trajectories should include a distinction between two groups of illicit drugs. Preventive actions should focus on young people in their early teens, since very young users are more likely to progress to illicit drug use, and further studies should include this distinction instead of aggregating other illicit drugs into a single category.     

Effectiveness of the rehabilitation for addicted prisoners trust (RAPt) programme

Alcohol and drug use are major health concerns on university and college campuses. It has previously been found that parental rearing patterns are related to the frequency of substance use. Further, perceptions that drug use is dangerous have been found to be related to less substance use. However, little research has directly examined the impact of parental rearing patterns on substance use by university students, and no research has examined the effects of both risk perception and parenting on substance use. Therefore, this research surveyed the frequency and extent of alcohol, cigarette and illicit drug use by students (N = 336) at a Canadian university residence, classes and health services and examined the relationship between the results with parental bonding and risk perception. It was found that “affectionless control” parenting patterns in the mother, but not the father, were related to greater drinking and drinking problems and to the use of illicit substances. Lower perceptions of risk were related to greater use of alcohol, cigarettes, cannabis and other illicit substances. Unexpectedly, there was little relationship between parental rearing and risk perceptions, suggesting that there are other avenues whereby parenting leads to greater alcohol use. Implications are discussed.     

French validity of two substance‐use screening tests among adolescents: A comparison of the CRAFFT and DEP‐ADO

Aim: The objective of this study was to compare the criterion validity of the CRAFFT and DEP‐ADO.

Method: One hundred and sixty‐three adolescents (80 from the general population and 83 regular substance users) completed the ADAD and the MINI questionnaires, as well as either the CRAFFT or the DEP‐ADO in roughly equal proportions, between March 2002 and August 2003. Sensitivity and specificity were calculated.

Results: Both questionnaires had high sensitivity but the DEP‐ADO showed a better specificity than CRAFFT. A score equal or higher than 8 on the scale of DEP‐ADO appeared to be an appropriate threshold for problems related to substance use. DEP‐ADO had a sensitivity of 92.0% and a specificity of 80.6% with severity rating scores of ADAD (alcohol and drug areas combined). With the MINI diagnoses, DEP‐ADO had a sensitivity of 95.1% and a specificity of 68.9%.

Conclusion: DEP‐ADO appears to have higher diagnostic utility for identifying substance use than CRAFFT in regard to sensitivity and specificity. However, the CRAFFT has the advantage of considering substance use over a lifetime period. Further studies should be targeting younger subjects and more diverse substance‐use patterns.     

Multiple risk factors: prevalence and correlates of alcohol,tobacco and other drug (ATOD) use among university students in Egypt

Abstract

There is a lack of research on Alcohol, Tobacco and Other Drug (ATOD) use in the Eastern Mediterranean region (EMR). We assessed four ATOD behaviors (risk factors; smoking, alcohol consumption behavior, one’s own illicit drug/s use, friend’s illicit drug/s use), two mental health indicators (depressive symptoms, perceived stress), two socio-demographic features (gender, age) and two policy variables (agree with smoking and alcohol bans at university). A self-administered questionnaire was completed by 3258 students at 11 faculties of Assiut University in Egypt (2009–2010). As for ATOD individual risk factors, about 8.8% of the participants smoked cigarettes (occasionally or daily), 3.8% reported “high frequency” alcohol use (a few times each week, every day and a few times each day), 4.5% had ever used illicit drugs, and 15.3% had a friend who used illicit drug/s. For ATOD multiple risk factors, 28.5% of the sample reported any ATOD risk factor, and 8.7% of the sample reported ≥2 risk factors, and the frequencies were significantly higher among males. Depressive symptoms were positively associated with illicit drug/s use and with having a friend/s who use illicit drug/s. Smoking was positively associated with one’s illicit drug/s use, but negatively associated with having a friend who use illicit drug/s. Higher frequency of alcohol use was positively associated with illicit drug/s use. Age and perceived stress were not associated with any of ATOD variables. These findings contribute to lack of research on ATOD use across the EMR, and provide a platform for planning prevention/intervention policies.     

Prevalence and Factors Associated with the Use of Illicit Substances among Male University Students in Kuwait

Objectives

To estimate the prevalence of illicit use of substances and identify the factors associated with illicit drug use among male students in the state-run Kuwait University and private universities in Kuwait.

Subjects and Methods

The study was a cross-sectional survey with a sample of 1,587 male students from both private universities (n = 869) and the public (n = 718) Kuwait University in Kuwait. A self-administered questionnaire was used to collect data. Overall lifetime prevalence of substance use was computed with 95% confidence interval. Logistic regression was used to identify the factors influencing substance use, which was adjusted for potential confounders.

Results

The total lifetime prevalence of illicit drug use was 14.4% and the most frequently used illicit substance was marijuana (11%). The substance use in general varied significantly (p ≤ 0.001) between private (18%) and public (10%) universities. Multivariate logistic regression model revealed that drug use was positively associated with age, poor academic performance, high family income, being an only child, divorced parents, and graduation from a private high school.

Conclusion

Drug use among male university students in Kuwait was high and requires attention and appropriate intervention. The factors identified with drug use in this study could be utilized to develop appropriate public health policies and preventive measures that may improve the health status of the student population.Key Words: Prevalence, Illicit stimulants, Substance abuse, College students     

An examination of alcohol and drug use among urban college students

This study examines factors associated with alcohol and recreational drug use among urban college students. Undergraduate students at an urban college (n = 372) in New York City completed questionnaires assessing alcohol and drug use, depression and anxiety symptoms, and delinquent behaviors. Forty-two per cent of the respondents were Hispanic, 25.3% were African-American and 18.8% were Caucasian. Alcohol and drug users were found to have higher levels of delinquency than non-users. There was no relationship between ethnicity, the number of substances used and depression, anxiety, or delinquency. These findings are discussed as they pertain to prevention and intervention programs tailored to address the unique needs of this growing population.     

Reviews

Objective and design: To survey NHS staff in one NHS Region to determine (i) the extent of substance use and related problems, (ii) therapeutic attitudes towards people with substance misuse problems. A single phase cross‐sectional survey of health care professionals across six health authorities in the Yorkshire and Humberside region of England. Fifteen service areas were randomly selected from general psychiatry, accident and emergency, general medicine, including liver and obstetric units. Data were collected by means of an anonymous self‐completion questionnaire.

Results and conclusion: Forty‐two per cent of questionnaires were returned. NHS staff reported similar rates of drinking, smoking and illicit drug use to those of the same age and sex in the general population. Doctors smoke less and use fewer illicit drugs, health care assistants smoke more and nurses use more illicit drugs. In contrast to surveys in primary care, this survey found that specialists scored low on role legitimacy of working with substance misusers. There is a logic as to why this might be the case, however, there needs to be a review of how best to deliver the government strategies for alcohol misuse, smoking and illicit drug use. In secondary care there is a case for substance misuse interventions by professionals who are not integral to the specialist team.     

Perceived availability of substances,substance use and substance‐related problems: a cross national study among French and Dutch adolescents

Aim. A cross‐national comparison of perceived availability of alcoholic beverages and cannabis, and of the influence of availability on consumption of and problems due to alcohol and cannabis.

Method. National surveys of school‐going adolescents (14–18 years) in France and the Netherlands were used. The questionnaire was comparable for all measures used in this study. We distinguished between problems with peers, with socializing agents and adverse events (e.g. fights). Cross‐tabulations and logistic regression were used for data analysis.

Results. Compared with the French, Dutch adolescents perceive alcoholic beverages and cannabis as more easily available. Among the youngest (up to 17 years) the country difference is very small (3–4%). Perceived availability is of influence on alcohol and cannabis consumption, and on problems attributed to alcohol or cannabis consumption. In the Netherlands, the influence of perceived availability on alcohol consumption is stronger. When controlling for other variables, French adolescents are more likely to report problems due to cannabis use.

Conclusions. The difference in cannabis policy between the two countries has a limited influence on perceived availability. Perceiving a substance as difficult to get prevents (frequent) use of alcohol and cannabis and prevents cannabis‐related problems. A stronger enforcement of existing alcohol laws is recommended for the Netherlands. There are differences between France and the Netherlands in problems attributed to alcohol and cannabis which cannot be interpreted in the context of differences in policy     

Recent national trends in Salvia divinorum use and substance-use disorders among recent and former Salvia divinorum users compared with nonusers

CONTEXT: Media and scientific reports have indicated an increase in recreational use of Salvia divinorum. Epidemiological data are lacking on the trends, prevalence, and correlates of S. divinorum use in large representative samples, as well as the extent of substance use and mental health problems among S. divinorum users. OBJECTIVE: To examine the national trend in prevalence of S. divinorum use and to identify sociodemographic, behavioral, mental health, and substance-use profiles of recent (past-year) and former users of S. divinorum. DESIGN: Analyses of public-use data files from the 2006-2008 United States National Surveys on Drug Use and Health (N = 166,453). SETTING: Noninstitutionalized individuals aged 12 years or older were interviewed in their places of residence. MAIN MEASURES: Substance use, S. divinorum, self-reported substance use disorders, criminality, depression, and mental health treatment were assessed by standardized survey questions administered by the audio computer-assisted self-interviewing method. RESULTS: Among survey respondents, lifetime prevalence of S. divinorum use had increased from 0.7% in 2006 to 1.3% in 2008 (an 83% increase). S. divinorum use was associated with ages 18-25 years, male gender, white or multiple race, residence of large metropolitan areas, arrests for criminal activities, and depression. S. divinorum use was particularly common among recent drug users, including users of lysergic acid diethylamide (53.7%), ecstasy (30.1%), heroin (24.2%), phencyclidine (22.4%), and cocaine (17.5%). Adjusted multinomial logistic analyses indicated polydrug use as the strongest determinant for recent and former S. divinorum use. An estimated 43.0% of past-year S. divinorum users and 28.9% of former S. divinorum users had an illicit or nonmedical drug-use disorder compared with 2.5% of nonusers. Adjusted logistic regression analyses showed that recent and former S. divinorum users had greater odds of having past-year depression and a substance-use disorder (alcohol or drugs) than past-year alcohol or drug users who did not use S. divinorum. CONCLUSION: S. divinorum use is prevalent among recent or active drug users who have used other hallucinogens or stimulants. The high prevalence of substance use disorders among recent S. divinorum users emphasizes the need to study health risks of drug interactions.     

Licit and illicit drug use and social change among Bedouin Arabs in southern Israel

This study examines the levels of licit and illicit drug use among the urbanized and non-urbanized Negev Bedouin Arabs in Israel. In addition, issues of social relationships, environment and change, and socio-cultural values toward substance use were explored. The sample included 312 respondents, 150 from the urbanized settlements and 162 from the non-urbanized settlements. The results revealed that 64% of Bedouin reported using cigarettes, 90% of whom reported smoking daily. Cigarette use was significantly higher among non-urbanized (74%) than urbanized (55%) Bedouin. Thirty-one per cent of urbanized Bedouin and 30% of non-urbanized Bedouin reported ever using alcohol. Fifteen per cent of urban and non-urban Bedouin reported ever using illegal drugs, mainly cannabis. The majority of Bedouin substance users were under the age of 35. This strongly suggests that substance use, and in particular alcohol and drug use, represents a new phenomenon in this society. The Bedouin are in a transitional phase, which exposes them extensively to new and conflicting sets of social values, norms and behavioural patterns.     

Gearing up for the millennium

Abstract

Objective: The objective of this study was to estimate the prevalence of current alcohol use and its association with cigarette and drug use among 13–15-year-olds in Africa and the Americas.

Method: Cross-sectional data of the WHO Global School-based Student Health Survey from nine countries in the WHO African Region and seven countries/territories in the WHO Region of the Americas were analysed. Single and joint prevalence rates, and prevalence odds ratios were computed.

Results: In the majority of countries, alcohol was the most often consumed psychoactive substance, with the prevalence of current alcohol use outweighing the prevalence of current cigarette and lifetime drug use. Gender differences for alcohol were not marked. The use of alcohol was strongly associated with cigarette or drug use, indicating clustering.

Conclusions: For the bulk of countries in the Americas and for single countries in Africa, current alcohol use is as high as prevalence rates occurring in other parts of the world. It is imperative to monitor psychoactive substance use among adolescents in these countries to be able to prevent future health and social harm with the information gained.     

Associations of age at cannabis first use and later substance abuse with mental health and depression in young men

Purpose: This study aimed to determine if the associations between age at cannabis first use and mental health and depression persist after controlling for the misuse of cannabis, other illicit drugs, alcohol and cigarettes.

Methods: Baseline data from an ongoing cohort study on substance use risk factors were used (N?=?5521). The association between age at cannabis first use and the frequency of cannabis use was assessed using a Cox proportional hazard model. Associations with other illicit drug use, alcohol dependence, nicotine dependence, mental health and depression were tested using linear regressions and logistic regressions.

Results: Participants using cannabis “almost every day” were on an average two years younger at cannabis first use than those using cannabis “once a month or less”. Age at cannabis first use was also associated with other illicit drug use, alcohol dependence and nicotine dependence. Associations with mental health and depression were substantially attenuated after adjustment for the misuse of cannabis and other substances.

Conclusions: These findings show that early cannabis onset is associated with later impairments in mental health and depression; however, these are largely explained by later substance abuse. Effective preventive measures are needed to delay cannabis onset and to avoid the progression from cannabis to using other drugs.