Adolescent drug use, health and personality.

Four factors have confounded the association between drug use and morbidity: (a) known drug users may be less healthy than unknown drug users; (b) drug users are rarely compared to control subjects; (c) the socio-economic status of drug users predisposes them to ill-health; (d) the personality of drug users predisposes them to ill-health. Here, controlling for these confounds, in a study of 210 adolescent drug users it was found that subjective ill-health was more strongly related to drug use than was objective ill-health. Drug use was related to neuroticism and psychopathic deviance. Controlling for personality, drug use accounted for little additional variance in health. It is concluded that drug use and health are not strongly related amongst adolescent drug users, although, because of their personalities, drug users tend not to feel well. Implications are discussed for the self-treatment explanation of drug use and for the design of preventative programmes.     

Tobacco, alcohol, cannabis and other illegal drug use among young adults: the socioeconomic context

Background

Low socioeconomic position predicts risk of substance abuse, yet few studies tested the role of preexisting familial and individual characteristics.

Methods

Data come from the TEMPO (Trajectoires Epidémiologiques en Population) study (community sample in France, 1991–2009, n = 1103, 22–35 years in 2009) set up among offspring of participants of an epidemiological study (GAZEL). Past 12-month substance use was assessed in 2009 by self-completed mail survey: regular tobacco smoking, alcohol abuse (AUDIT), cannabis use, problematic cannabis use (CAST), other illegal drug use. Socioeconomic position was defined by educational attainment, occupational grade, employment stability and unemployment. Covariates included demographics (age, sex, relationship status, parenthood), family background (parental income, parental tobacco smoking, parental alcohol use), and juvenile characteristics (psychological problems, academic difficulties) measured longitudinally.

Results

35.8% of study participants were regular smokers, 14.3% abused alcohol, 22.6% used cannabis (6.3% had problematic cannabis use) and 4.1% used other illegal drugs. Except for alcohol abuse, substance use rates were systematically higher in individuals with low, rather than intermediate/high, socioeconomic position (age and sex-adjusted ORs from 1.75 for cannabis use to 2.11 for tobacco smoking and 2.44 for problematic cannabis use). In multivariate analyses these socioeconomic disparities were decreased, but remained statistically significant (except for illegal drugs other than cannabis).

Conclusions

Tobacco smoking, alcohol, cannabis and polysubstance use are common behaviors among young adults, particularly those experiencing socioeconomic disadvantage. Interventions aiming to decrease substance abuse and reduce socioeconomic inequalities in this area should be implemented early in life.     

Adolescent drug use and adult drug problems in women: direct, interactive, and mediational effects.

The authors studied effects of variables assessed in adolescence on problems from drug use in adulthood in a community sample of women. One focus of this 13-year longitudinal study was moderators, which were hypothesized to exacerbate, or attenuate, the effects of early drug consumption on later drug problems. Potential moderators were sensation seeking, social conformity, academic orientation, parental support, depression, and drug problems in parents. Direct and mediating effects of these variables, as well as of drug consumption, were also evaluated. Results showed that most of the significant effects involved sensation seeking and social conformity. In addition, adolescent drug use significantly predicted adult polydrug problems. The effects of sensation seeking are consistent with the view that this variable reflects a sensitivity to drug use, which makes it more likely that drug use gets translated into drug abuse.     

Polysubstance use in rural West Virginia: Associations between latent classes of drug use,overdose, and take-home naloxone

BackgroundRural communities in the United States have been disproportionately affected by the opioid crisis. Little research has explored the relationship between polysubstance use and overdose experiences among people who inject drugs (PWID) in rural communities. We sought to identify classes of polysubstance drug use among rural PWID and evaluate the associations between polysubstance drug use classes, recent overdose experiences, and receipt of take-home naloxone (THN).MethodsWe surveyed 420 PWID (June-July 2018) who had injected drugs in the previous 6 months in Cabell County, West Virginia. Participants were recruited from the local syringe services program and through street-based recruitment. We conducted a latent class analysis using 9 measures of injection and non-injection drug use and tested for associations with having experienced an overdose in the past 6 months and having received THN in the past 6 months.ResultsWe identified four substance use classes in our sample: polydrug/polyroute use (35.0% of the sample), polyroute stimulant/injection opioid use (33.3%), polyroute stimulant use (20.3%), and injection opioid use (11.3%). Overall, 42.6% of the sample had experienced an overdose in the past 6 months. The classes differed in terms of overdose (χ=91.53, p<0.001), with the polydrug/polyroute use class having the highest probability of overdose and the polyroute stimulants class having the lowest. Only 46.5% of participants had received THN, and probabilities differed between classes (χ=21.93, p<0.001). The polyroute stimulants/injection opioid use and polydrug/polyroute use classes had the highest levels of THN receipt while the polyroute stimulants use class had the least.ConclusionAmong rural PWID in West Virginia, polysubstance use was prevalent and associated with overdose and THN acquisition. These analyses demonstrate the importance of scaling up naloxone distribution in rural settings. Overdose prevention initiatives are reaching persons at high risk of overdose, but expansion of services is needed.     

Adolescent Internet use and its relationship to cigarette smoking and alcohol use: A prospective cohort study

The present study aims to investigate the longitudinal impact of situational Internet use on future cigarette smoking and alcohol use among male and female adolescents. A Northern Taiwanese cohort sample of adolescents with no prior use of cigarettes (n = 1445) or alcohol (n = 1468) was surveyed at age 16 and again 4 years later. Information regarding where, why, and length of time spent using the Internet was gathered from the 16-year-old participants. Outcome information regarding cigarette/alcohol use was gathered via a follow-up questionnaire at age 20. Multivariate regressions were used to incorporate peer, individual and family characteristics as measured at age 16 and create models of future cigarette and alcohol use at age 20. The analyses demonstrated that adolescent Internet use, particularly where such use took place, has a significant impact on future cigarette smoking and alcohol use, adjusted for conventional factors, and its relationship differs significantly by gender. Female adolescents with Internet café use appear to be especially likely to develop these two risky behaviors. The why of Internet use is also a predictor of future cigarette smoking. Finally, time spent using the Internet is significantly related to alcohol use; greater use of the Internet is associated with higher levels of drinking. The results revealed that different risky behaviors are differentially influenced by separate components of adolescent Internet use. These findings suggest that programs aimed at promoting adolescent health could potentially benefit Taiwanese adolescents by including components related to situational Internet use and taking gender into consideration.     

Adolescent addictive internet use and drug abuse in Wuhan,China

Background: Drug use (DU) and addictive internet use (AIU) are two increasing risk behaviors among youth in China. However, little information is available on the relationship between addictive internet use and DU. Therefore, we investigate the role of AIU on DU behavior and its impact on the variables such as pro-drug attitude (PDA), anti-drug attitude (ADA), social norm of drugs and intentions on DU.

Method: A total of 3018 students (47% boys, 53% girls), who were from 15 secondary schools (five middle schools, five academic high schools, and five vocational high schools) and one university in Wuhan, China, completed paper-and-pencil questionnaires during class-time. A conceptual model was developed based on Reasoned Behavior Theory. Structural equation modeling (SEM) was used to test the proposed model.

Results: The prevalence rate of internet addiction and DU are 5 and 4%, respectively. In the SEM model (GFI = 0.920, AGFI = 0.907, RMSEA = 0.047), adolescent DU and intention of DU were significantly predicted by AIU, which is mediated by PDA, ADA, and perceived social norm of DU.

Conclusions: These findings contribute to the theoretical and managerial understanding of the role of AIU behaviors on adolescent DU. It suggests that prevention education of DU should be strengthened among young internet users.     

Adolescent alcohol and cannabis use in relation to peer and school factors. Results of multilevel analyses

The present study used a multilevel approach with multiple informants to determine whether, at individual level, association with substance-using peer groups, and, at class level, incidences of intoxicated students in school premises, are related to students' own substance use. Additionally, it tested the hypothesis that such school incidences affect the closeness of the relation between association with substance-using peers and students' own substance use. Multilevel regression models were estimated separately for drunkenness and cannabis use on the basis of cross-sectional data from 3,925 students of eighth and ninth grades in Switzerland (mean age 15.3, S.D. 0.9) and their teachers (N=220). For both drunkenness and cannabis use, the results confirmed that association with substance-using peers is strongly related to individual substance-use. A higher level of students' own cannabis use and a closer relation between association with cannabis-using peers and the students' own cannabis use were found in classes where students saw others coming cannabis-intoxicated to school or taking cannabis in school premises. Such relations were not found for alcohol. It appears that cannabis use at school or shortly before arriving at school creates an atmosphere that favors cannabis use whether or not students are associated with cannabis-using peers. Establishing an overarching environment of disapproval appears to be an effective means of preventing cannabis use by adolescents.     

Adolescent stigma towards drug addiction: Effects of age and drug use behaviour

The objective of this study was to examine adolescent age and experience with drug use on stigmatizing attitudes toward drug addiction. Data were derived from the  2005 cycle of the Ontario Student Drug Use Survey. In total, 4078, 7- to 12-graders completed self-administered questionnaires that included a measure of drug abuse stigma. Results indicated that stigma scores were higher among younger than older adolescents, and the decline across age was robust, occurring among both males and females and those from rural and non-rural areas. The decline, however, was stronger among non-drug users and among those who had no close friends that use drugs. Despite the age-related decline, the level of stigma in general suggested that drug abuse stigma may continue into adulthood. Findings highlight that individual attitudes toward drug use and drug abusers are salient factors for personal drug use. Given that stigma is a barrier to treatment, but reduced stigma may encourage greater adolescent use, this study highlights the need for more in-depth studies of drug stigma.     

Adolescent ecstasy and other drug use in the National Survey of Parents and Youth: the role of sensation-seeking, parental monitoring and peer's drug use

The association between high sensation-seeking, close friends' drug use and low parental monitoring with ecstasy (MDMA) use in adolescence was examined in a sample of US household-dwelling adolescents aged 12-18 years (N=5049). We also tested whether associations were of stronger magnitude than associations between these correlates and marijuana or alcohol/tobacco use in adolescence. Data from Round 2 of the National Survey of Parents and Youth (NSPY) Restricted Use Files (RUF) was analyzed via Jackknife weighted multinomial logistic regression models. High sensation-seekers were more likely to be ecstasy, marijuana, and alcohol/tobacco users, respectively, as compared to low sensation-seekers. High sensation-seeking and close friends' drug use were more strongly associated with ecstasy as compared to marijuana and alcohol/tobacco use. Low parental monitoring was associated with marijuana use and alcohol/tobacco use and there was a trend for it to be associated with ecstasy use. Ecstasy use is strongly associated with peer drug use and more modestly associated with high sensation-seeking. School prevention programs should target high-sensation-seeking adolescents and also encourage them to affiliate with non-drug using peers.     

Stress, escapism and patterns of alcohol and drug use

Stress-related misuse of alcohol or drugs appears to be impulsive and may reflect conflict, learned helplessness or an attempt to reduce cognitive dissonance.     

Studies of factors in relapse to alcohol, drug and nicotine use: a critical review of methodologies and findings.

OBJECTIVE: To critically review the methodologies used to study relapse in substance abusers and compare some of the findings these methodologies have produced. METHOD: Representative studies that have used retrospective, prospective, or near real time methodologies to study antecedents or consequences of relapse are presented and the strengths and weaknesses of each methodology are reviewed. Limitations in the ability of substance abusers to accurately report internal states are considered. Degree of convergence in findings across methodologies is examined. RESULTS: Retrospective reports can provide perhaps the most detailed accounts of circumstances and experiences leading up to relapse, but are also more likely to be inaccurate due to the limitations of memory. Prospective studies are less likely to be affected by memory problems, but may not capture factors that immediately precede relapse. The near real time methodology, which uses palm-top computers to gather data, has many advantages over other methodologies, but a number of limitations as well. The two studies in which retrospective reports were directly compared to either prospective or near real time reports yielded mixed results regarding degree of agreement. Findings from several areas of research suggest that some substance abusers may have difficulty recognizing and reporting internal states. CONCLUSIONS: Despite memory problems and other limitations of self-report, all three methodologies have produced findings that implicate negative affect states, increased craving, cognitive factors, interpersonal problems, and lack of coping as factors in relapse. Future relapse studies should make use of all three methodologies to obtain data on relapse and consequences, and steps should be taken to enhance the accuracy of the self-reports that are gathered with each method.     

Adolescent personality profiles, neighborhood income, and young adult alcohol use: a longitudinal study

Personality traits and socioeconomic factors such as neighborhood income have been identified as risk factors for future alcohol abuse, but findings have been inconsistent possibly due to interactions between risk and protective factors. The present study examined the prediction of drinking behavior using empirically derived multi-trait patterns and tested for moderation by average neighborhood income. Using latent profile analysis (LPA) in a sample of 863 Dutch adolescents, four empirical personality profiles based on 6 traits were observed: Extraverted, Dysregulated, Neurotic, and Regulated. Dysregulated and Extraverted youth drank higher quantities of alcohol more frequently in young adulthood relative to the Regulated group, above and beyond the effects of baseline adolescent drinking, age, and sex. Profile levels of neuroticism did not appear to affect drinking behavior. Average neighborhood income did not moderate adolescent personality and young adult drinking. These findings suggest that future alcohol research should consider individual trait patterns to inform prevention and intervention efforts, and theories implicating both positive and negative emotionality traits as risk factors for drinking are preferable to those emphasizing the importance of the latter.     

Tobacco, alcohol, and marijuana use among first-year U.S. college students: a time series analysis

The present study sought to evaluate the day-to-day patterns of tobacco, alcohol, and marijuana use among first-year college students in the United States. Using 210 days of weekly time-line follow-back diary data collected in 2002 to 2003, the authors examined within-person patterns of use. The sample was 48% female and 90% Caucasian. Sixty-eight percent of the participants were permanent residents of Indiana. Univariate time series analysis was employed to evaluate behavioral trends for each substance across the academic year and to determine the predictive value of day-to-day substance use. Some of the most common trends included higher levels of substance use at the beginning or end of the academic year. Use on any given day could be predicted best from the amount of corresponding substance use 1 day prior. Conclusions: Although universal intervention might best be focused in the earliest weeks on campus and at the end of the year when substance use is at its highest, the diversity of substance use trajectories suggests the need for more targeted approaches to intervention. Study limitations are noted.     

From first drug use to drug dependence; developmental periods of risk for dependence upon marijuana, cocaine, and alcohol.

The focal point of this paper is the transition from drug use to drug dependence. We present new evidence on risk for starting to use marijuana, cocaine, and alcohol, as well as risks for progression from first drug use to the onset of drug dependence, separately for each of these drugs. Data from the National Comorbidity Survey (NCS) were analyzed. The NCS had a representative sample of the United States population ages 15-54 years (n = 8,098). Survival analysis techniques were used to provide age- and time-specific risk estimates of initiating use of marijuana, cocaine, and alcohol, as well as of becoming dependent on each drug. With respect to risk of initiating use, estimated peak values for alcohol and marijuana were found at age 18, about two years earlier than the later peak in risk of initiating cocaine use. With respect to risk of meeting criteria for the clinical dependence syndrome, estimated peak values for alcohol and marijuana were found at age 17-18. Peak values for cocaine dependence were found at age 23-25. Once use began, cocaine dependence emerged early and more explosively, with an estimated 5-6% of cocaine users becoming cocaine dependent in the first year of use. Most of the observed cases of cocaine dependence met criteria for dependence within three years after initial cocaine use. Whereas some 15-16% of cocaine users had developed cocaine dependence within 10 years of first cocaine use, the corresponding values were about 8% for marijuana users, and 12-13% for alcohol users. The most novel findings of this study document a noteworthy risk for quickly developing cocaine dependence after initial cocaine use, with about one in 16 to 20 cocaine users becoming dependent within the first year of cocaine use. For marijuana and alcohol, there is a more insidious onset of the drug dependence syndrome.     

Comorbidity for alcohol use disorders and drug use in mexican-origin groups: comparison of data from national alcohol surveys in the U.S. And Mexico

The comorbidity, separately, of alcohol dependence and consequences of drinking with illicit drug use is compared between Mexicans and Mexicans Americans, using data from the 1995 and 2000 U.S. National Alcohol Surveys (n = 830) and the 1998 Mexico National Household Survey on Addictions (n = 3313). Among drinkers, comorbidity was significantly more prevalent among Mexican Americans than among Mexicans and was positively associated with level of acculturation among Mexican Americans. Although data may not be generalizable, they are important for a better understanding of cultural influences on the development of comorbid substance abuse* conditions among Mexicans immigrating to the United States and their substance abuse treatment needs.     

Health beliefs relating to alcohol and other drug use in the Australian population

This study uses data from a nationally representative population survey conducted in March and April 1993 to examine alcohol and other drug-related health beliefs within the Australian population. The results show widespread ignorance about the causes of drug-related mortality, with 43 percent of respondents believing that alcohol is the major cause of drug-related premature death. Only 32 percent of the respondents mentioned tobacco as the major cause of death. Those who identified tobacco as the drug causing the greatest number of deaths were more likely to be male, young, Australian or British-born, and better educated. Women were more accurate in their assessment of the risk levels associated with alcohol consumption than men, as were the young and the better educated. There is widespread public knowledge about the risks that are associated with passive smoking. Overall, the results point to the need to focus health promotion and awareness campaigns on the groups that have so far proved most immune to health messages, namely, heavy drinkers and smokers.     

Daydreaming,drug and alcohol use in college students: A factor analytic study

This investigation, one of a series examining patterns of drug and alcohol use or non-use in young adults, explored personality and daydreaming patterns of 579 male and female college students by means of multivariate analyses and factor analysis. Students from a Northeastern and border state rural college filled out surveys of drug and alcohol use and also were administered the Jackson Personality Research Form, the Singer-Antrobus Imaginal Processes Inventory, the Rotter Locus of Control Scale, and the Zuckerman Sensation-Seeking Scales. Data indicated patterns of widespread but moderate drug and alcohol use even in the rural college group. Daydreaming patterns replicated those of earlier studies but were not especially related to drug or alcohol indulgence.