Substance Use Among a Sample of Foreign- and U.S.-Born Southeast Asians in an Urban Setting

Abstract

Asian Americans (AA) are thought to have the lowest rates of substance use. This study examined substance use prevalence among 494 urban-dwelling Southeast Asians using snowball techniques. Prevalence estimates were age-adjusted proportionate to the U.S. Asian population. Findings show beer and alcohol consumption approximated the national percentage among 25-44 year olds. U.S.-born were about three times likelier to have past month substance use. Foreign-born Vietnamese were likelier than U.S.-born to use all substances except for beer. U.S. and foreign-born beer consumption rates were similar. Future research is needed to delineate substance use determinants and patterns in foreign-and U.S.-born AA sub-groups.     

A Study of Multiple Behavioral Addictions in a Substance Abuse Sample

Behavioral addictions (BAs) are underrecognized, even in addiction programs. We assessed BAs in a substance abuse sample (n = 51; data collection 2011–2012). A self-report Behavioral Addictions Screen, assessing eight BAs, was administered using an automated telephone system. Most endorsed at least one BA, with the most common shopping/spending; eating; work; computer/internet; and sex/pornography. Lowest were gambling, self-harm, and exercise. Some BAs were correlated with others. Gender, ethnicity, age, and positive depression and posttraumatic stress disorder screens were associated with specific BAs. Future research could address interpretation of “addiction,” comparison to diagnostic interviews, relationship to substance use disorders, and larger samples.     

Prevalence and Sociodemographic Correlates of Lifetime Substance Use Among a Rural and Diverse Sample of Adolescents

ABSTRACT

Background: Data are limited regarding the prevalence of substance use among adolescents in rural and ethnically diverse communities. This study examined rates and sociodemographic correlates of lifetime substance use among adolescents in Mississippi, a rural state that is the poorest in the country (21.3% poverty rate) and has the largest proportion of African Americans per capita (36.3%). Methods: Participants in this cross-sectional study were 6349 adolescents (6th through 12th grade) who reported on lifetime tobacco, alcohol, marijuana, cocaine, inhalant, hallucinogen, and methamphetamine use. Results: Lifetime smoking (10.2% to 44.5%), alcohol (23.2% to 72.0%), and marijuana use (7.9% to 39.2%) increased steadily when comparing students in 6th to 12th grade. Substances with more serious abuse potential (cocaine [6.7% to 11.1%], inhalants [12.2% to 17.9%], hallucinogens [4.4% to 12.1%], and methamphetamine [3.0% to 6.7%]) displayed more modest increases across grade. Adolescents who classified their race/ethnicity as “Other” (i.e., not white, black/African American, Asian, or Hispanic/Latino/Latina) demonstrated more than 2-fold increased likelihood of methamphetamine use (odds ratio [OR] = 2.42), and increased risk for use of any illicit substance (OR = 1.49). In general, males demonstrated an increased risk for use across substances (OR = 1.15–1.94), and higher income was associated with a decreased likelihood of illicit substance use (OR = 0.51–0.67). Living in a more populated area was associated with an increased likelihood of alcohol (OR = 1.43), marijuana (OR = 2.11), and cocaine use (OR = 2.06), and use of any illicit substance (OR = 1.54). Conclusions: Mississippi adolescents reported higher rates of lifetime cocaine, inhalant, hallucinogen, and methamphetamine use across all grade levels compared with national surveys. Male gender, low income, and residence in more populated areas were associated with increased use of several substances. Findings demonstrate the need for prevention and intervention programs targeting impoverished rural and ethnically diverse communities.     

“Substance Abuse” Disorders among Runaway and Homeless Youth

This study used systematic sampling methods to recruit a sample of 432 homeless youth from both service and natural “hang-out” sampling sites. According to DSM-III criteria, the majority of respondents were classified as having an alcohol and/or illicit “drug abuse” disorder (71%). The results from multivariate logistic regression analyses indicate that cumulative length of time homeless is positively associated with risk for an “abuse” disorder. The implications of these findings and recommendations for service interventions are discussed. [Translations are provided in the International Abstracts Section of this issue.]     

Screening for Substance Abuse Among Adolescents Validity of the CAGE-AID in Youth Mental Health Care

Objective: To examine the diagnostic accuracy of the four-item self-report and parent-report versions of the CAGE-AID as a screen for substance-use disorders (SUD) among adolescents in mental health care. Method: Patients were 190 Dutch treatment-seeking adolescents (12–18 years old, mean age 15.5 years, 53% boys) and their parents who completed the CAGE-AID questionnaire during intake. DSM-IV clinical diagnoses were used as gold standard in receiver operating characteristic analyses to determine psychometric properties. Results: Psychometric properties for both the self-report and the parent-report versions showed the CAGE-AID's excellent diagnostic accuracy in predicting SUD. Conclusions: The CAGE-AID seems to be a brief and valid instrument for detecting SUD among adolescents in mental health care. However, denial may play a role in both the CAGE-AID and the clinical interviews. More research is needed to further establish the CAGE-AID's usefulness in other settings. The study's limitations have been noted.     

Factors Associated with Substance Use Among Homeless Young Adults

ABSTRACT

The purpose of this study was to investigate factors associated with substance use among homeless young adults. Multinomial logistic regression analyses examined the influence of social networks and economic factors among a group of homeless young adults with differing levels of alcohol and drug use. In addition, for those with an alcohol use disorder, the role of future time expectancies was examined. A sample (n = 185) of homeless young adults aged 18 to 23 were recruited from a community drop-in center and interviewed utilizing self-report instruments. Findings suggest that social networks, economic factors, and future expectancies are significant predictors of the level of substance use among homeless young adults. Being able to identify those areas that place homeless young adults at risk for substance abuse and dependence has implications for effective intervention.     

Substance Use Coping as a Mediator of the Relationship Between Trauma Symptoms and Substance Use Consequences Among Incarcerated Females With Childhood Sexual Abuse Histories

Rates of substance use and maltreatment are alarmingly high among incarcerated women. Although the direct link between trauma and substance use has been established, less is known about potential mediators. Thus, we examined substance use coping as a mediator between trauma symptoms and substance use consequences among a sample of incarcerated females (N = 111) who were survivors of childhood sexual abuse. Trauma symptoms predicted the severity of substance use consequences, with this relationship being mediated fully by avoidance coping (e.g., using substances to cope). Overall, trauma histories are important in predicting outcomes but must be examined in the context of current coping behaviors and substance use. Findings (data collected in 2007/2008) may help promote interventions that target patterns of coping and/or emotional avoidance among trauma survivors with substance use problems in incarcerated populations. The study's limitations are noted.     

Differences by Gender in Predictors of Motivation Among Substance Abuse Treatment Participants

Background: Substance-involved females tend to have different clinical profiles than men (Adams, Leukefeld, &; Peden, 2008 Adams, S., Leukefeld, C. G., &; Peden, A. R. (2008). Substance abuse treatment for women offenders: A research review. Journal of Addictions Nursing, 19(2), 61–75. [Google Scholar]); yet they do not appear to have worse treatment outcomes (Green, 2006 Green, C. A. (2006). Gender and use of substance abuse treatment services. Alcohol Research and Health, 29(1), 55–62. [Google Scholar]; Hser, Huang, Teruya, &; Anglin, 2003 Hser, Y.-I., Huang, D., Teruya, C., &; Anglin, M. D. (2003). Gender comparisons of drug abuse treatment outcomes and predictors. Drug and Alcohol Dependence, 72(3), 255–264. [Google Scholar]). As motivation for treatment is considered essential in the substance abuse treatment context (Cahill, Adinoff, Hosig, Muller, &; Pulliam, 2003 Cahill, M. A., Adinoff, B., Hosig, H., Muller, K., &; Pulliam, C. (2003). Motivation for treatment preceding and following a substance abuse program. Addictive Behaviors, 28(1), 67–79. [Google Scholar]; Longshore &; Teruya, 2006 Longshore, D., &; Teruya, C. (2006). Treatment motivation in drug users: A theory-based analysis. Drug and Alcohol Dependence, 81(2), 179–188. [Google Scholar]), it is possible that higher motivation among females could potentially counteract the negative effect of more risk factors. Objective: The purpose of the current study was to examine if females differ from males in their motivation for treatment using the Texas Christian University Motivation Form scales: desire for help, problem recognition, treatment readiness, pressure for treatment, and treatment needs; and whether factors predicting motivation for treatment differed between male and female participants of substance abuse treatment. Methods: The sample included 2,989 substance-involved males and 982 substance-involved females who were referred to substance abuse treatment through a case management program. Linear regression models predicting each motivation scale were analyzed, followed by gender-specific models. Results: Overall, the results did not demonstrate a significant gender difference in the motivation scales. However, among male participants, the findings did show that Hispanic significantly predicted desire for help and alcohol as a primary drug of choice predicted treatment readiness. Conclusion: Findings suggest that motivation for treatment may be a gender-neutral construct, and that there is a need to better understand sociodemographic predictors of motivation.     

Substance Abuse and Relationship Violence Among Men Court-Referred to Batterers' Intervention Programs

There is extensive theoretical and empirical evidence linking substance abuse and marital violence. However in batterer populations, researchers have not compared hazardous and nonhazardous drinkers' substance use characteristics, marital aggression, extramarital violence (i.e., general violence), depressive symptomatology, marital satisfaction, and other relevant variables. In addition, much of the previous research on substance use and abuse in batterer populations employed a single, nonstandardized measure of substance use, and no previous research has examined substance use in court-mandated batterers' relationship partners. We recruited 150 men who were arrested for violence and court-referred to batterer intervention programs. We administered multiple measures of substance use and abuse and assessed the batterers' marital aggression, relationship satisfaction, depressive symptomatology, use of general violence, and their relationship partners' substance use. We also divided the sample into groups of Hazardous Drinkers (HD) and Nonhazardous Drinkers (NHD). Across the entire sample, half of the batterers had an alcohol-related diagnosis and approximately one third reported symptoms consistent with a drug-related diagnosis. Over one third of the total sample reported that their relationship partners were hazardous drinkers. Relative to the NHD group, the HD group scored significantly higher on measures of general violence, depressive symptomatology, alcohol use, alcohol problems, and drug problems. The HD group also reported significantly higher partner alcohol and drug use and abuse scores, relative to the NHD group. The results of the study suggest that substance use and abuse should routinely be assessed as part of batterer interventions and that batterer programs would be improved by offering adjunct or integrated alcohol treatment.     

Correlates of Risky Alcohol and Methamphetamine Use Among Currently Homeless Male Parolees

Homeless men on parole are a hard-to-reach population with significant community reintegration challenges. This cross-sectional study describes sociodemographic, cognitive, psychosocial, and drug-related correlates of alcohol and methamphetamine use in 157 homeless male parolees (age range 18–60) enrolled in a substance abuse treatment center in Los Angeles, California. Logistic regression results revealed that being African American and older were negatively related to methamphetamine use, whereas being older and more hostile were related to riskier alcohol abuse. Findings from this study provide a greater understanding of correlates of methamphetamine and alcohol—-two of the most detrimental forms of substances abused among currently homeless parolees.     

Associations Between Proactive and Reactive Subtypes of Aggression and Lifetime Substance Use in a Sample of Predominantly Hispanic Adolescents

The current study evaluated the link between proactive (goal-oriented) and reactive (behavior in response to a perceived threat) aggression and lifetime alcohol, tobacco, and marijuana use in a sample of 152 predominantly Hispanic (94.7%) high school students. Furthermore, the impact of neighborhood violence and gender invariance on these associations were examined. Findings suggested unique associations between proactive, not reactive, aggression and use of all three substances. No significant interactions between the aggression subtypes and neighborhood violence were evident, and no gender differences emerged. Findings suggest targeting proactive aggression for the prevention of substance use for both males and females.     

Availability and Use of Substance Abuse Treatment Programs Among Substance-Using Men Who Have Sex With Men Worldwide

Background: Substance use is common among men who have sex with men (MSM) worldwide, and epidemiologic data suggest that alcohol/substance-using MSM are at greater risk for HIV. However, there are scarce data on substance abuse treatment programs (SATPs) for substance-using MSM. Objectives: We examined proportions of substance use as well as SATP availability and use. We used multivariable regression models, controlling for potential confounders, to examine behavioral and demographic correlates of SATP availability and use. Methods: This is a cross-sectional study of a multi-region, online sample of substance-using MSM. Results: In this sample, 75% were substance-using MSM of whom 36% reported at-least-weekly use. Substance use was most prevalent among respondents from Eastern Europe/Central Asia (86%) and Latin America (79%). Among substance-using MSM, 96% and 33% reported alcohol intoxication and other substance use, respectively; 11% reported having high SATP availability; and 5% reported using SATPs. Controlling for global region of origin and age, high SATP availability was associated with high access to HIV risk-reduction education (aOR = 3.19; CI = 1.48–6.89), mental health services (aOR = 2.53; CI = 1.32–4.83), and medical care (aOR = 2.32; CI = 1.12–4.80); less than college-level education (aOR = 0.32; CI = 0.18–0.54); and higher comfort levels with providers (aOR = 1.75; CI = 1.30–2.37). Controlling for substance use frequency and personal income additionally, using SATPs was associated with higher levels of connection to the gay community (aOR = 2.76; CI = 1.22–6.22). Conclusion: In this global sample of MSM, we found high alcohol intoxication and other substance use proportions. Few substance-using MSM report SATP availability, highlighting the need to develop novel substance use programs outside traditional treatment settings.     

Substance Use and Parent Characteristics Among High School Students: Edirne Sample in Turkey

ABSTRACT

The current study on substance use and family characteristics of adolescents is a part of the extensive research on substance use characteristics among high school students in Edirne, Turkey. This cross-sectional study was conducted with 8,483 high school students within the 2010–2011 academic year. Self-administered questionnaires were completed anonymously by the participants. The lifetime prevalence of alcohol use was 24.6% and tobacco use was 21.4%. The most commonly used illicit substance was cannabis (1%), followed by inhalants (0.5%) and ecstasy (0.4%). The use of alcohol, tobacco, and nearly all the illegal substances was significantly higher among males compared to females. The rates of lifetime substance use varied by family-related factors such as family structure, perceived parental attitudes and intrafamilial relationships, parental socioeconomic status, and parental substance use. The limitations and implications of these findings are discussed.     

Lifetime Substance Use and HIV Sexual Risk Behaviors Predict Treatment Response to Contingency Management Among Homeless,Substance-Dependent MSM

Abstract

Homeless, substance-dependent men who have sex with men (MSM) continue to suffer health disparities, including high rates of HIV. One-hundred and thirty one homeless, substance- dependent MSM were randomized into a contingency management (CM) intervention to increase substance abstinence and health-promoting behaviors. Participants were recruited from a community-based, health education/risk reduction HIV prevention program and the research activities were also conducted at the community site. Secondary analyses were conducted to identify and characterize treatment responders (defined as participants in a contingency management intervention who scored at or above the median on three primary outcomes). Treatment responders were more likely to be Caucasian/White (p < .05), report fewer years of lifetime methamphetamine, cocaine, and polysubstance use (p ≤ .05), and report more recent sexual partners and high-risk sexual behaviors than nonresponders (p < .05). The application of evidence-based interventions continues to be a public health priority, especially in the effort to implement effective interventions for use in community settings. The identification of both treatment responders and nonresponders is important for intervention development tailored to specific populations, both in service programs and research studies, to optimize outcomes among highly impacted populations.     

Risk/Protective Factors Associated with Substance Use Among Runaway/Homeless Youth Utilizing Emergency Shelter Services Nationwide

Abstract

Rates of alcohol, tobacco, and marijuana use among runaway/homeless youth are substantially higher than found among American high school students. To understand the risk and protective factors associated with substance use, this study (1) assessed cigarette, alcohol, and marijuana use among a national sample of runaway/homeless youth, (2) identified risk/protective factors associated with lifetime substance use, and (3) examined risk/protective factors associated with six month frequency of substance use. Unduplicated cases (n = 11,841) from the 1997 Runaway/Homeless Youth Management Information System (RHY MIS) were analyzed. Results showed that substance use levels are greater than previously reported for this population. Predictors of cigarette, alcohol, and marijuana use and frequency were predominately individual youth risk factors and demographics rather than family risk factors. Providers in emergency youth shelters are in a prime position to assess substance use behaviors, as well as the associated risk factors. Provision of appropriate screening and referral to other services is essential to meet the needs of these youth.     

Trauma and Substance Misuse: Critical Considerations in Understanding the Maelstrom

Research has established that a relationship between trauma and substance use disorders (SUDs) exists. The nature of the relationship and its dimensions are not well understood. Nevertheless, it is important to consider either problem when the other is present. Given the spate of traumatic events occurring globally in recent years, it is critical for the planning group for the development of the “For Whom Is It Permitted, for Whom Is It Forbidden” museum exhibit to consider the complex relationship between trauma and SUDs and ways of representing it in the exhibit. This article briefly discusses what is posited and known about trauma and SUDs in relation to one another. Key points to consider in developing representations of the relationship between trauma and SUDs are raised.     

Childhood Abuse,Religious Involvement,and Lifetime Substance Use Disorders among Latinas Nationwide

Background: Childhood abuse is a major behavioral health concern and imposes lasting sequelae on mental and physical health, including lifetime substance use disorders (LT-SUD). Yet, gender-specific research examining this early trauma and substance use in Latina-Americans (Latinas) is scarce. No study has explored the relationship between collectivist cultural factors and LT-SUD in this largest minority-female subgroup of the United States’ population. Objectives: Based on coping theory, this study investigated the association between childhood abuse, cultural factors, and LT-SUD among Latinas nationwide. Methods: Using the National Latino and Asian American Study we performed three-step logistic regressions to investigate LT-SUD for 1,427 Latinas, following three preplanned steps: (1) childhood physical and sexual abuse (CPA and CSA) with LT-SUD; (2) known correlates as controls; and (3) cultural strength factors. Results: The prevalence rates of CPA and CSA were 28.0% and 18.4%, and that of LT-SUD was 4.8%. Religious attendance at a weekly level was negatively related to LT-SUD. Alongside English proficiency, discrimination, and social support, however, CPA and religious coping were positively associated with LT-SUD. Conclusion/Importance: Childhood physical abuse is an early risk factor for long-term substance use, viewed as a negative coping strategy. Religious attendance may have potential protection for Latinas. The victimization history may lead to coexisting positive (e.g., pursing social support, religious coping) and negative (e.g., SUD) coping behaviors within Latino communities.