Social Determinants of Alcohol and Marijuana Effects: A Systematic Theory

Based on the sociological perspective on recreational drug effects, three social determinants are propositionally related to the normal effects of alcohol and marijuana. Effects vary across drugs, users, and situations along an experiential-behavioral dimension termed “effect-orientation.” The content of normative expectations toward effects and the interactional characteristics of drug-using situations are conceptualized as direct determinants of effect-orientations. The relative clarity of normative expectations indirectly influences effect-orientations through its relationship to the other two social determinants. The theory stresses the importance of comparative research on the normal uses of alcohol and marijuana.     

DRUG OFFENDERS IN TAIWAN AND THE UNITED STATES: A CROSS-CULTURAL ANALYSIS

Using data collected from nationwide surveys of drug-using offenders in the United States and Taiwan, this article compares offender differences with respect to socio-demographic characteristics, childhood experiences, drug use and treatment patterns, and criminal histories. The results suggest that the experiences of U.S. drug-using offenders are more complex, with multiple routes and consequences of drug use, while the social constructionist view is more appropriate to explain the experience of Taiwanese drug-using offenders. Overall, U.S. drug-using offenders reported earlier drug and criminal involvement, experienced more prior arrests, and committed more non-drug-related crimes. Family problems were more prevalent among U.S. drug-using offenders than Taiwanese drug-using offenders. Drug-using offenders in the U.S. also reported using a variety of different drugs and participating in multiple treatment programs. The major agents supplying illicit drugs were known dealers, and friends or acquaintances of U.S. and Taiwanese drug-using offenders, respectively. The article concludes that to effectively eliminate the problem of drug misuse, the Taiwanese government should focus on treatment instead of imprisonment, while the U.S. should target troubled teens and families.     

Legal sanctions and information about drugs as influences upon the decision by adolescents whether to use illicit drugs

Although those Malaysian secondary schoolchildren who have never used drugs are consistent in their support for legal and social sanctions against drug use, it is argued that such sanctions are a relatively unimportant factor in the decision whether or not to use drugs. Non-drug users inhabit a social world separated from their drug-using contemporaries; they rely on information from public rather than direct social sources, and claim to have been little interested in information received. However, there is evidence that, for a minority of the drug-using sub-sample, public information campaigns have made them more rather than less interested in experimenting with drug substances.     

Drug offenders in Taiwan and the United States: a cross-cultural analysis.

Using data collected from nationwide surveys of drug-using offenders in the United States and Taiwan, this article compares offender differences with respect to socio-demographic characteristics, childhood experiences, drug use and treatment patterns, and criminal histories. The results suggest that the experiences of U.S. drug-using offenders are more complex, with multiple routes and consequences of drug use, while the social constructionist view is more appropriate to explain the experience of Taiwanese drug-using offenders. Overall, U.S. drug-using offenders reported earlier drug and criminal involvement, experienced more prior arrests, and committed more non-drug-related crimes. Family problems were more prevalent among U.S. drug-using offenders than Taiwanese drug-using offenders. Drug-using offenders in the U.S. also reported using a variety of different drugs and participating in multiple treatment programs. The major agents supplying illicit drugs were known dealers, and friends or acquaintances of U.S. and Taiwanese drug-using offenders, respectively. The article concludes that to effectively eliminate the problem of drug misuse, the Taiwanese government should focus on treatment instead of imprisonment, while the U.S. should target troubled teens and families.     

广东省公众用药安全意识与行为的调查分析

目的:了解广东省公众安全用药意识掌握情况以及安全用药行为现状,并为有针对性地开展公众安全用药健康教育提供参考。方法:采用现场填写、当场回收问卷的方法对珠三角、粤东、粤西、粤北地区的公众进行调查,了解其用药情况、用药意识及用药行为。结果:公众安全用药意识指标中清楚知道"饭前服药"定义的仅有27.4%;公众安全用药行为中,有"不按疗程服药、好转立即停药、频繁换药"的高达80.2%。公众安全用药意识及行为不良发生率普遍较高,安全用药知识相对缺乏,科学合理用药不尽人意。结论:公众安全用药意识淡薄,正确用药行为欠缺,公众自身要加强用药知识的学习;政府应加大安全用药知识普及力度;社会要承担起推广安全用药的责任,促进广东省公众安全用药。     

Depression in the barrio: An analysis of the risk and protective nature of cultural values among Mexican American substance users

Understanding the effect of cultural values on depression and how social networks influence these relationships may be important in the treatment of substance-using, Mexican American populations. Latino cultural values, familismo, personalismo, fatalismo, and machismo, may be associated with depression among Latinos. The current study identified the association of traditional Latino values on depressive symptomatology among a sample of Mexican American heroin injectors. A cross-sectional research design and field-intensive outreach methodology were utilized to recruit 227 Mexican American men. Participants were categorized into depressed and nondepressed groups. Relations among cultural values and depression were examined using logistic regression. Findings indicate that drug-using men with higher familismo and fatalismo scores are protected against depressive symptomatology. Relations between familismo and depression seem to be moderated by having a drug use network. In addition, findings reveal that age is inversely related to depressive symptomatology. Young Mexican American heroin users who do not ascribe to traditional Latino values may be highly associated with depression and therefore more vulnerable to riskier drug use behaviors. Moreover, drug-using social networks may affect the protective nature of certain cultural values. Further research is needed to identify whether culturally tailored treatments can cultivate these values while simultaneously undermining the effect of substance-using social networks in order to reduce depression symptoms among this group of high-risk substance users.     

Gender Differences in the Impact of Social Support on Crack Use Among African Americans

This article examines the influence of social support on crack use in a sample of 435 African American out-of-treatment crack users recruited through street outreach in Raleigh, North Carolina, between 2000 and 2002. Multivariate regression models indicated that social support was not a strong influence on crack use. For women, no social support variables predicted crack use, whereas for men, having a non-using partner was negatively associated with crack use. Findings indicate that existing social support is not strongly linked to drug use among African Americans, but African American men may be positively influenced by non-using sexual partners. Limitations of the sample and data are discussed. Further research is needed on the influence of social support for African American drug-using populations.     

A partner's drug-using status impacts women's drug treatment outcome

The role that male sexual partners play in the treatment outcome of drug dependent pregnant women deserves greater attention. Pregnant women enrolled in a comprehensive treatment program with drug-free (n=85) or drug-using (n=82) male sexual partners completed a relationship survey and were compared on partner and psychosocial variables. Compared with male drug-free partners, male drug-using partners had more unemployment and more current legal involvement, less education, were less likely to be supportive of the pregnant woman's recovery efforts and were more likely to give them money to buy drugs. Male drug-free partners also had fewer medical, dental, legal and transportation needs than male drug-using partners. Data from treatment retention suggests that women with male drug-using partners are retained in a comprehensive treatment for a shorter time than women with male drug-free partners. A male partner's drug-using status should be considered when treating pregnant drug dependent women.     

Gender differences in the impact of social support on crack use among African Americans

This article examines the influence of social support on crack use in a sample of 435 African American out-of-treatment crack users recruited through street outreach in Raleigh, North Carolina, between 2000 and 2002. Multivariate regression models indicated that social support was not a strong influence on crack use. For women, no social support variables predicted crack use, whereas for men, having a non-using partner was negatively associated with crack use. Findings indicate that existing social support is not strongly linked to drug use among African Americans, but African American men may be positively influenced by non-using sexual partners. Limitations of the sample and data are discussed. Further research is needed on the influence of social support for African American drug-using populations.     

The normalisation of drug supply: The social supply of drugs as the “other side” of the history of normalisation

Aims: Describes how the relative normalisation of recreational drug use in the UK has been productive of, and fused with, the relatively normalised and non-commercial social supply of recreational drugs. Methods: Semi-structured interviews with 60 social suppliers of recreational drugs in two studies (involving a student population n?=?30 and general population sample n?=?30). Respondents were recruited via purposive snowball sampling and local advertising. Findings: Both samples provided strong evidence of the normalised supply of recreational drugs in micro-sites of friendship and close social networks. Many social suppliers described “drift” into social supply and normalised use was suggested to be productive of supply relationships that both suppliers and consumers regard as something less than “real” dealing in order to reinforce their preconceptions of themselves as relatively non-deviant. Some evidence for a broader acceptance of social supply is also presented. Conclusions: The fairly recent context of relative normalisation of recreational drug use has coalesced with the social supply of recreational drugs in micro-sites of use and exchange whereby a range of “social” supply acts (sometimes even involving large amounts of drugs/money) have become accepted as something closer to gift-giving or friendship exchange dynamics within social networks rather than dealing proper. To some degree, there is increasing sensitivity to this within the criminal justice system.     

Perceiving Need for Drug Treatment: A Look at Eight Hypotheses

Data from the Drug Use Forecasting Program, sponsored by the National Institute of Justice, were used to examine eight hypotheses predicting the perceived need for drug treatment among drug-using arrestees. The findings support five of the eight hypotheses, including those related to drug severity, drug type, prior treatment experience, ethnicity, and the fear of AIDS. There was no support for the gender-related help-seeking or the social isolation hypotheses, and the findings contradict the maturing out hypothesis. The policy implications of our findings are discussed.     

Causes and correlates of adolescent drug abuse and implications for treatment

On the basis of the literature, the following risk factors for drug abuse by adolescents were identified: biological predisposition to drug abuse; personality traits that reflect a lack of social bonding; a history of low quality and consistency of family management, family communication, family relationships and parental role-modelling, a history of being abused or neglected; low socioeconomic status; emotional or psychiatric problems; significant stressors and/or inadequate coping skills and social supports; inadequate social skills; history of associating with drug-using peers, rejection by prosocial peers due to poor social skills; a history of low commitment to education, failure at school; a history of anti-social behaviour and delinquency and early initiation to drug use. Models for conceptualizing the aetiology of drug abuse are discussed, namely Jessor's problem behaviour syndrome and Rhodes & Jason's Social Stress Model. It is clear that the path to drug abuse is complex, so simple solutions to the problem are unlikely to be effective.     

Social relationships and intravenous drug use among methadone maintenance patients

This study examined the extent to which social relationships were associated with continued injection drug use and needle sharing among 252 methadone maintenance patients. Logistic regression analyses indicated that drug use was highest among persons who had a substance using live-in partner and among those with more drug-using social relationships. Among injectors, whites and those who had more people present during IV drug use were more likely to share needles, while those with more emotional support were less likely to do so. These findings suggest that personal relationships strongly influence continued injection drug use and that methadone programs should help patients develop social networks of non-users.     

The syndemic of HIV,HIV-related risk and multiple co-morbidities among women who use drugs in Malaysia: Important targets for intervention

BackgroundSubstance use and HIV are syndemic public health problems in Malaysia. Harm reduction efforts to reduce HIV transmission have primarily focused on men with substance use disorders.ObjectivesTo explore HIV risk behaviors, substance use, and social factors associated with poor health outcomes among women who use drugs in Malaysia.MethodsA cross-sectional survey of 103 drug-using women in Kuala Lumpur, Malaysia were recruited to assess their medical, psychiatric and social comorbidity as well as their engagement in nationally recommended HIV testing and monitoring activities.ResultsOne-third reported having ever injected drugs, with most (68.2%) having recently shared injection paraphernalia. Sex work (44.7%) and infrequent condom use (42.4%) were common as was underlying psychiatric illness and physical and sexual violence during childhood and adulthood. Most women (62.1%) had unstable living situations and suffered from an unmet need for social support and health services. HIV prevalence was high (20%) with only two thirds of women eligible for antiretroviral therapy having received it. Suboptimal HIV testing and/or monitoring was positively associated with interpersonal violence (AOR 2.73; 95% CI 1.04-7.14) and negatively associated with drug injection (AOR 0.28; 95% CI 0.10-0.77).Conclusions/ImportanceWomen who use drugs in Malaysia demonstrate considerable medical, psychiatric and social co-morbidity, which negatively contributes to optimal and crucial engagement in HIV treatment-as-prevention strategies. Mental health and social support may be key targets for future public health interventions aimed at drug-using women in Malaysia.     

A case-linkage study of the relationship between drug misuse,crime, and psychosocial problems in a total criminal justice population

This study was designed to inform the development of new Criminal Justice Intervention Programmes for drug-using offenders by examining the complex inter-relationships of drug problems, drug crime and generic crime together with psychological and social problems. The study combined total population datasets for police and probation agencies with all drug agencies in one geographical area. It first examined associations between greater frequency of crime, drug crime and drug problems. It then examined associations between each of these factors and a range of psychological and social problems. There is a relationship between drug crime and drug problems and both are associated with increased frequency of crime. However, drugs and crime variables are mediated by a range of other social and psychological factors, which strongly influence the probability of drug problems and crime, indicating a need for caution in identifying simple cause-and-effect relationships between crime and drugs.     

Ecstasy (MDMA): are the psychological problems associated with its use reversed by prolonged abstinence?

RATIONALE: Chronic, regular recreational use of ecstasy (MDMA) is associated with psychopathology, elevated behavioural impulsivity and persistent impairment of memory performance. OBJECTIVE: The aim of the present study was to investigate which of these sequelae persist after at least 6 months of abstinence from ecstasy. METHODS: Four groups of participants were compared: 18 current regular recreational ecstasy users, 15 ex-regular ecstasy users who had abstained from using the drug for an average of 2 years, 16 polydrug users who had never taken ecstasy and 15 drug-naive controls. RESULTS: There were no significant group differences in age, education level, or pre-morbid intelligence and, generally, the use of illicit drugs other than ecstasy was not significantly different among the three drug-using groups. Both current and ex-ecstasy users exhibited elevated psychopathology and behavioural impulsivity compared with polydrug users and drug-naive controls, but current ecstasy users exhibited a broader range of psychopathology than ex-users. Both groups of ecstasy users also exhibited impaired working memory and verbal recall performance compared with drug-naive controls, but only ex-users exhibited impaired verbal recall relative to polydrug users. Regression analysis indicated that psychopathology was primarily predicted by the extent of previous consumption of cannabis rather than ecstasy, whereas the majority of the cognitive deficits were only predicted by the extent of previous ecstasy use. CONCLUSIONS: Selective impairments of neuropsychological performance associated with regular ecstasy use are not reversed by prolonged abstinence. This is consistent with evidence that ecstasy has potent and selective neurotoxic effects on brain serotonergic systems in humans.     

Cannabis use in adolescents: the impact of risk and protective factors and social functioning

The study uses a school-based sample to test the social and familial risk and protective factors relating to cannabis use. Based on a self-completion survey of 2078 14-16-year-olds (mean age of 15 years) attending seven standard state-run secondary schools in south London, an assessment was made of rates and risk factors for cannabis use. Twenty-four per cent of the total sample had ever used cannabis, with 15% having done so in the month prior to assessment. In addition to greater likelihood of illicit drug use, lifetime cannabis users were less likely to spend time regularly with both their mothers and fathers, but more likely to spend free time with friends who smoked, drank alcohol and used illicit drugs, and with friends involved in criminal activities. Among those who had ever used cannabis, frequency of cannabis use was predicted (using linear regression) by two onset factors (earlier initiation of drinking and cannabis use were both linked to more frequent use) and two social factors (more time spent with drug-using friends and less time spent with the mother). Overall, the study showed that early onset, itself predicted by social networks, is linked to more frequent use of cannabis and that this appears to be sustained by less time spent with parents and more with drug-using peers. [Best D, Gross S, Manning V, Gossop M, Witton J, Strang J. Cannabis use in adolescents: the impact of risk and protective factors and social functioning. Drug Alcohol Rev 2005;24:483-488]     

Interpersonal Influences in Adolescent Drug Use—The Role of Older Siblings,Parents, and Peers

Drawing data from the first year of a longitudinal study of 508 families with focal adolescents aged 11 to 13 years and their older siblings (14 to 18 years), the investigators examined the influence of older siblings' drug-using attitudes and behaviors, in comparison with parental and peer drug-using attitudes and behaviors, on focal adolescents' nonuse and use of substances. Older siblings are frequently a source of drugs and use substances with their younger siblings, though peers remain the primary source and the most frequent cousers. For most substances, frequency of use was predicted by older sibling and peer substance use, each after controlling for the other. Parental drug use was found to be minimal in comparison to older siblings and peers. Findings relative to the potentially important role of older siblings in influencing their younger siblings' drug-using behavior are discussed.     

Rethinking indicators of problematic cannabis use in the era of medical cannabis legalization

IntroductionRecent rapid changes in medical cannabis policies and increases in medical use of cannabis have raised new research questions related to potential effects of medical cannabis legalization on cannabis use problems. In order to investigate such effects there is a need for screening tools that are sensitive to the fact that people may be using for medical and/or recreational purposes. This article critically assesses whether screening tools designed to measure cannabis use problems in recreational users are meaningful as measures of problems resulting from medical use.Results and conclusionsIt is possible that existing cannabis problem screening tools are not equally valid across medical and recreational users, since individual screening items have different implications for recreational and medical users. For instance, items that measure use that deviates from common patterns of recreational use (use before midday and use alone) reflect normative assumptions that non-problematic recreational use will occur in contexts of parties or social gatherings. However, use before midday and alone are how people typically take medication for chronic medical health problems. There is thus a need to develop and validate criteria for problematic use in medical cannabis patients.