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Background

A significant minority of Australians engage in concurrent drug use (using more than one drug in a given period). We examined clusters and correlates of concurrent drug use using the latest available nationally representative survey data on Australian young adults.

Sample

3836 participants aged 18–29 years (mean age 24 years) from the 2010 National Drug Strategy Household Survey (NDSHS).

Method

Clusters were distilled using latent class analysis of past year use of alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, ketamine, GHB, inhalants, steroids, barbiturates, meth/amphetamines, heroin, methadone/buprenorphine, other opiates, painkillers and tranquillisers/sleeping pills.

Results

Concurrent drug use in this sample was best described using a 4-class solution. The majority (87.5%) of young adults predominantly used alcohol only (50.9%) or alcohol and tobacco (36.6%). 10.2% reported using alcohol, tobacco, marijuana, and ecstasy, and 2.3% reported using an extensive range of drugs.

Conclusion

Most drug use clusters were robust in their profile and stable in their prevalence, indicating little meaningful change at the population level from 2007. The targeting of alcohol and tobacco use remains a priority, but openness to experiencing diverse drug-related effects remains a significant concern for 12.5% of young people in this age group.  相似文献   

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Objective

This study examined the relationship between two risk factors for substance misuse (self-control, substance using friends) and changes in jail inmates' substance misuse from pre-incarceration to post-release.

Method

Participants were 485 adult jail inmates held on a felony conviction, recruited from a metropolitan county-jail situated in the mid-Atlantic region of the U.S. During incarceration, participants completed self-report assessments of pre-incarceration substance misuse and self-control. At one-year post-release, participants reported their substance misuse and proportion of substance-using friends (n = 322 at follow-up).

Results

The relationship between self-control and changes in inmates' substance misuse was fully mediated by association with substance-using friends. Age moderated the relationship between friends' substance use and changes in inmates' own misuse of marijuana and cocaine. Friends' use was more strongly related to marijuana misuse for younger adults than for older adults. However, for cocaine misuse, this relationship was stronger for older adults than for younger adults. Self-control's relationships with other variables were not moderated by age.

Conclusions

This study underscores importance of self-control's indirect relationship (through substance-using friends) with changes in substance misuse: inmates with lower self-control were more likely to associate with substance-using friends and, in turn, had more symptoms of substance misuse 1-year post release. Results emphasize the importance of considering adult substance-users' friend-relationships. However, age and type of substance appear important when considering the relative importance of friends' influence.  相似文献   

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Introduction

Several cross-sectional studies have examined relationships between neighborhood characteristics and substance misuse. Using data from a sample of African-American adults relocating from US public housing complexes, we examined relationships between changes in exposure to local socioeconomic conditions and substance misuse over time. We tested the hypothesis that adults who experienced greater post-relocation improvements in local economic conditions and social disorder would have a lower probability of recent substance misuse.

Methods

Data were drawn from administrative sources to describe the census tracts where participants lived before and after relocating. Data on individual-level characteristics, including binge drinking, illicit drug use, and substance dependence, were gathered via survey before and after the relocations. Multilevel models were used to test hypotheses.

Results

Participants (N = 172) experienced improvements in tract-level economic conditions and, to a lesser degree, in social disorder after moving. A one standard-deviation improvement in tract-level economic conditions was associated with a decrease in recent binge drinking from 34% to 20% (p = 0.04) and with a decline in using illicit drugs weekly or more from 37% to 16% (p = 0.02). A reduction in tract-level alcohol outlet density of >3.0 outlets per square mile predicted a reduction in binge drinking from 32% to 18% at p = 0.05 significance level.

Discussion

We observed relationships between improvements in tract-level conditions and declines in substance misuse, providing further support for the importance of the local environment in shaping substance misuse. These findings have important implications for public housing policies and future research.  相似文献   

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Background

Media reporting on illicit issues has been frequently criticised for being sensationalised, biased and narrow. Yet, there have been few broad and systematic analyses of the nature of reporting. Using a large sample and methods commonly adopted in media communications analysis this paper sought to identify the dominant media portrayals used to denote illicit drugs in Australian newspapers and to compare and contrast portrayals across drug types.

Methods

A retrospective content analysis of Australian print media was carried out over the period 2003-2008 from a sample comprised of 11 newspapers. Articles that contained one or more mention of five different drugs (or derivatives) were identified: cannabis, amphetamines, ecstasy, cocaine and heroin. A sub-sample of 4397 articles was selected for media content analysis (with 2045 selected for full content analysis) and a large number of text elements coded for each. Key elements included topic, explicit or implicit messages about the consequences of drugs/use and three value dimensions: overall tone, whether drugs were portrayed as a crisis issue and moral evaluations of drugs/use.

Results

The dominant media portrayals depicted law enforcement or criminal justice action (55%), but most articles were reported in a neutral manner, in the absence of crisis framings. Portrayals differed between drugs, with some containing more narrow frames and more explicit moral evaluations than others. For example, heroin was disproportionately framed as a drug that will lead to legal problems. In contrast, ecstasy and cocaine were much more likely to emphasise health and social problems.

Conclusion

Media reporting on illicit drugs is heavily distorted towards crime and deviance framings, but may be less overtly sensationalised, biased and narrowly framed than previously suggested. This is not to suggest there is no sensationalism or imbalance, but this appears more associated with particular drug types and episodes of heightened public concern.  相似文献   

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Aims

To review and summarize existing prospective studies reporting on remission from dependence upon amphetamines, cannabis, cocaine or opioids.

Methods

Systematic searches of the peer-reviewed literature were conducted to identify prospective studies reporting on remission from amphetamines, cannabis, cocaine or opioid dependence. Searches were limited to publication between 1990 and 2009. Reference lists of review articles and important studies were searched to identify additional studies. Remission was defined as no longer meeting diagnostic criteria for drug dependence or abstinence from drug use; follow-up periods of at least three years were investigated. The remission rate was estimated for each drug type, allowing pooling across studies with varying follow-up times.

Results

There were few studies examining the course of psychostimulant dependence that met inclusion criteria (one for amphetamines and four for cocaine). There were ten studies of opioid and three for cannabis dependence. Definitions of remission varied and most did not clearly assess remission from dependence. Amphetamine dependence had the highest remission rate (0.4477; 95%CI 0.3991, 0.4945), followed by opioid (0.2235; 95%CI 0.2091, 0.2408) and cocaine dependence (0.1366; 95%CI 0.1244, 0.1498). Conservative estimates of remission rates followed the same pattern with cannabis dependence (0.1734; 95%CI 0.1430, 0.2078) followed by amphetamine (0.1637; 95%CI 0.1475, 0.1797), opioid (0.0917; 95%CI 0.0842, 0.0979) and cocaine dependence (0.0532; 95%CI 0.0502, 0.0597).

Conclusions

The limited prospective evidence suggests that “remission” from dependence may occur relatively frequently but rates may differ across drugs. There is very little research on remission from drug dependence; definitions used are often imprecise and inconsistent across studies and there remains considerable uncertainty about the longitudinal course of dependence upon these most commonly used illicit drugs.  相似文献   

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Background

This study investigated circumstances of initiating new-type drug use among adult new-type drug users and differences among those who first used methamphetamine, ecstasy and ketamine.

Methods

A total of 276 participants were recruited, using respondent-driven sampling (RDS) from nine seeds recruited through NGOs, social workers and outreach workers in Shanghai, China.

Results

Methamphetamine was the most frequently reported first new-type drug used (37.1%), followed by ecstasy (35.6%) and ketamine (20.0%). 38.7% of participants initiated new-type drug use before the age of 21 years. 47.8% knew at initiation that club drugs can be harmful. Most were introduced to new-type drug use by friends, spouses or boy/girlfriends. The three most common reasons for initiation were curiosity, peer influence, and wishing to dull one's emotions. Those first using methamphetamine were more likely to be female, have a monthly individual income less than 3000 Yuan (approx. $476), initiate use at 21 years or older and at private setting than those first using ecstasy and ketamine.

Conclusions

There is an urgent need for drug education efforts in China to raise awareness of the harms of new-type drugs, as well as to increase knowledge about the paradox of new-type drug effects. Drug prevention and intervention programs should be tailore to target populations and their social context.  相似文献   

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Objective

Although many adolescents use and abuse illicit drugs, few of those who could benefit from substance abuse treatment ever receive these services. The present study examines the prevalence of utilization of substance abuse treatment in national samples of adolescents over the past 22 years and identifies characteristics associated with receipt of these services.

Method

Monitoring the Future data on lifetime utilization of substance abuse treatment was available for 12th grade students who reported any lifetime illicit drug use from 1987 to 2008 (N = 25,537). After describing the prevalence of treatment utilization over this time period, logistic regression was used to examine potential predictors of treatment utilization.

Results

The overall prevalence of treatment utilization has remained relatively unchanged over the past 22 years. In multivariable models, adolescents reporting a greater frequency of lifetime use of marijuana or cocaine were more likely to receive substance abuse treatment. Additionally, substance abuse treatment utilization was more likely in those who received other mental health services.

Conclusion

Despite increased evidence for the effectiveness of substance abuse treatment, utilization of these services by adolescents has remained low and relatively stable over the past 22 years. Attempts to increase utilization of substance abuse treatment services would likely benefit from building on existing connections with mental health treatment.  相似文献   

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Rationale

Despite years of research and much controversy surrounding the effects of ecstasy use, findings are equivocal. Attempting to reduce methodological problems, such as concurrent use of other recreational drugs, could lead to a clearer picture of the effects of ecstasy use on cognitive function.

Objectives

The aim of this study is to investigate the effects of both prolonged abstention from ecstasy use and current use on cognitive function while controlling for the regular use of other recreational drugs used by ecstasy users (alcohol, cannabis, cocaine, amphetamines and lysergic acid diethylamide).

Materials and methods

A range of cognitive functions (including working memory, episodic memory, verbal learning and executive functions) was assessed in 109 participants: 25 current ecstasy users, 28 ex-ecstasy users (abstinent for at least 1 year), 29 polydrug-using controls (matched to both ecstasy-using groups for the use of other recreational drugs) and 27 drug-naïve controls.

Results

There was an overall tendency for impaired verbal learning and memory in both current ecstasy users and polydrug controls. There was also evidence of reduced response inhibition in the current ecstasy users and polydrug controls, which appeared to be related to recency of drug use. However, the majority of tests showed no group differences.

Conclusions

The results suggest that recreational drug use in general, rather than ecstasy use per se, can lead to subtle cognitive impairments and that recent drug use appears to impact strongest on cognitive performance. This study highlights the importance of controlling for the use of all recreational drugs and, in particular, recent drug use when investigating ‘effects of ecstasy’ on cognitive function.
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Background

Elevated depressive and anxiety symptoms during childhood and adolescence have been associated with greater risk of later ecstasy use. Ecstasy users have reported using ecstasy to reduce depression or worry, or to escape. While these findings suggest that some people use ecstasy as a form of self-medication, limited research has been conducted examining the relationship between affective symptoms, coping styles and drug use motives in ecstasy users. This cross-sectional study aimed to determine if coping style and/or ecstasy use motives are associated with current mood symptoms in ecstasy users.

Methods

A community sample (n = 184) of 18–35 year olds who had taken ecstasy at least once in the past 12 months completed self-report measures of depression, anxiety, ecstasy use motives and coping styles. Timeline followback methods were used to collect information on lifetime ecstasy, recent drug use and life stress. Trauma exposure was measured using the Composite International Diagnostic Interview—Trauma List.

Results

Coping motives for ecstasy use and an emotion-focused coping style were significantly associated with current depressive and anxiety symptoms. Emotion-focused coping mediated the relationship between a history of trauma and current anxiety symptoms and moderated the relationship between recent stressful life events and current depressive symptoms.

Conclusions

These findings highlight the importance of interventions targeting motives for ecstasy use, and providing coping skills training for managing stressful life events among people with co-occurring depressive/anxiety symptoms and ecstasy use.  相似文献   

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Objective

The aim of this study is to check the validity of the self-report of drug use by pregnant adolescents, by comparing their responses to a structured interview about their use of cocaine and marijuana during the pregnancy with an analysis of their hair.

Results

Hair analysis detected the use of cocaine and/or marijuana in the third trimester of pregnancy in 60 (6%) patients. 40 (4%) patients used only marijuana, 17 (1.7%) used only cocaine, and 3 (0.3%) used both drugs. None of the patients had reported the use of these substances in their interviews with healthcare professionals.

Conclusion

Although the prevalence of the use of drugs during pregnancy is significant despite consistent evidence about the compromise of the neurobehavioral development of the newborns that are exposed to drugs during the prenatal period, drug use is frequently not reported. Therefore, more sensitive methods of detection should be used so that appropriate medical and psychosocial interventions can be implemented for the mothers as well as for their children.  相似文献   

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Background

Illicit substances increase risk of morbidity and mortality and have significant consequences for society. Personality traits are associated with drug use; we test whether these associations vary by socioeconomic status.

Method

Participants (N = 412) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study completed the Revised NEO Personality Inventory and self-reported use of opiates and cocaine. 50% of participants were living below 125% of the federal poverty line. Mean-level personality differences across never, former, and current opiate/cocaine users were compared. Logistic regressions compared never versus current users and interactions between personality traits and poverty status tested whether these associations varied by socioeconomic status.

Results

High Neuroticism and low Agreeableness increased risk of drug use. The association between low Conscientiousness and drug use was moderated by poverty, such that low Conscientiousness was a stronger risk factor for illicit substance use among those with relatively higher SES. For every standard deviation decrease in Conscientiousness, there was a greater than 2-fold increase in risk of illicit substance use (OR = 2.15, 95% CI = 1.45–3.17). Conscientiousness was unrelated to drug use among participants living below 125% of the federal poverty line.

Conclusions

Under favorable economic conditions, the tendency to be organized, disciplined, and deliberate is protective against drug use. These tendencies, however, matter less when financial resources are scarce. In contrast, those prone to emotional distress and antagonism are at greater risk for current drug use, regardless of their economic situation.  相似文献   

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Background

Release from prison is associated with a markedly increased risk of both fatal and non-fatal drug overdose, yet the risk factors for overdose in recently released prisoners are poorly understood. The aim of this study was to identify risk and protective factors for non-fatal overdose (NFOD) among a cohort of illicit drug users in Vancouver, Canada, according to recent incarceration.

Methods

Prospective cohort of 2515 community-recruited illicit drug users in Vancouver, Canada, followed from 1996 to 2010. We examined factors associated with NFOD in the past six months separately among those who did and did not also report incarceration in the last six months.

Results

One third of participants (n = 829, 33.0%) reported at least one recent NFOD. Among those recently incarcerated, risk factors independently and positively associated with NFOD included daily use of heroin, benzodiazepines, cocaine or methamphetamine, binge drug use, public injecting and previous NFOD. Older age, methadone maintenance treatment and HIV seropositivity were protective against NFOD. A similar set of risk factors was identified among those who had not been incarcerated recently.

Conclusions

Among this cohort, and irrespective of recent incarceration, NFOD was associated with a range of modifiable risk factors including more frequent and riskier patterns of drug use. Not all ex-prisoners are at equal risk of overdose and there remains an urgent need to develop and implement evidence-based preventive interventions, targeting those with modifiable risk factors in this high risk group.  相似文献   

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