Inhalant use among incarcerated adolescents in the United States: prevalence, characteristics, and correlates of use

OBJECTIVE: To characterize patterns and correlates of inhalant use among incarcerated youth. METHOD: Residents (N=723) of 27 Missouri Division of Youth Services facilities completed interviews assessing substance use, psychiatric symptoms, antisocial traits, trauma, suicidality, and criminality. RESULTS: Participants averaged 15.5 (S.D.=1.2) years of age, were ethnically diverse, and predominantly male. More than one-third (36.9%) reported lifetime inhalant use; 47.9% of users had tried four or more inhalant products. Comparatively high rates of use were observed for Hispanic and small town/rural youth. Commonly abused agents included gasoline (22%), permanent markers (15%), computer "air duster," (15%) and spray paint (12%). Inhalant users evidenced significantly higher levels of criminal behavior, antisocial attitudes, current psychiatric symptoms, earlier onset of offending and substance use, and more extensive histories of head injury, kidney disease, hormonal problems, mental illness, suicidality, trauma, and substance-related problems than nonusers. In multiple logistic regression models, race/ethnicity, geographic area of residence, fearlessness, suicidality, and polydrug use distinguished inhalant users and nonusers. Measures of cognitive impairment, impulsivity, fearlessness, blame externalization, polydrug use, and substance-related problems were positively associated with lifetime frequency of inhalant use. CONCLUSIONS: Inhalant use was widespread in this sample and associated with serious physical and mental health impairments.     

Co-morbid post-traumatic stress disorder in a substance misusing clinical population

BACKGROUND: USA studies have reported high rates of co-morbid post-traumatic stress disorder (PTSD) and substance (drugs and alcohol) dependence/misuse. Avoidance of trauma reminders and associated distress may be achieved by the use of drugs and alcohol, alternatively a substance abusing lifestyle might predispose such individuals to experience traumatic events. This may have implications for treatment and management of patients with co-morbid substance misuse and PTSD. There have been no British studies looking at the extent of traumatic life events and post-traumatic stress disorder amongst substance misusers, although high rates of reported sexual and physical abuse have been reported in two recent UK studies with drug- and alcohol-dependent patients in clinical settings. AIMS: (i) To investigate the prevalence of co-morbid PTSD in a UK substance use disorder (SUD) inpatient clinical population; (ii) to identify the characteristics, severity and types of trauma experienced; (iii) to compare SUD patients with and without co-morbid PTSD on substance use and history, psychological/psychiatric and social variables METHOD: This is a cross-sectional study involving interviews with patients and case note review. SUD inpatients were interviewed about traumatic experiences, PTSD, and addiction. RESULTS: Ninety-four percentage reported experiencing one or more PTSD criterion A traumatic experiences. 38.5% met criteria for current PTSD and 51.9% for lifetime PTSD. Significant differences between the PTSD and non-PTSD groups were found in PTSD and trauma-related variables, notably social variables and distress associated with traumatic experiences, but few differences were found in addiction severity (medical and psychiatric composite scores of the ASI) and psychiatric symptomatology. CONCLUSIONS: This study highlights not only the importance of assessment of trauma and PTSD amongst substance misusers but, conversely the need for the assessment of substance abuse among victims of PTSD. Co-morbid psychopathology is common, so trauma histories and PTSD symptoms may become embedded in other co-morbid psychopathology.     

Inhalant use among antisocial youth: prevalence and correlates

The current (2.9%), annual (19.6%), and lifetime (34.3%) prevalence of inhalant use among 475 youth (M age = 15.5; SD = 1.5; 87.4% male) on probation in a western state of the United States was assessed. Inhalant users reported significantly less family support and cohesiveness and lower self-esteem, and significantly more lifetime thoughts of suicide and suicide attempts, neighborhood gang activity, peer and parental substance abuse, intentions to engage in illegal behavior, substance-related criminality, and substance abuse than did nonusers. Ethnicity, self-esteem, suicidality, number of substance-using peers, and extent of substance-related criminality significantly discriminated inhalant users from nonusers in a logistic regression analysis. Multiple linear regression analyses indicated that age, perceived school ability, age at initiation of alcohol use, self-esteem, and substance-related criminality significantly predicted age at onset of inhalant use (R2 = .30). Age at initiation of inhalant use, gang membership, truancy, and substance-related criminality significantly predicted lifetime frequency of inhalant use (R2 = .20). Study findings indicate that inhalant-using delinquents evidence significantly greater antisocial attitudes, personal and familial dysfunction, and substance abuse, than do their non-inhalant-using counterparts.     

Illicit peyote use among American Indian adolescents in substance abuse treatment: a preliminary investigation

Few studies to date have addressed illicit (i.e., nonceremonial) peyote use among American Indians (AIs). Participants were 89 AI adolescents admitted to a tribally operated residential substance abuse treatment program (RSATP) between 1998 and 2001. The RSATP is designed to provide specialized treatment of patients with substance use and other comorbid psychiatric disorders and is infused with a culturally sensitive approach to treatment. The participants completed a series of interviews that collected information on psychiatric diagnostic status, history of substance use, and ethnic identity. The majority of participants were male (65%), did not come from a two-parent household (75%), reported a mean use of 5.4 substances, and met full criteria for a median of 2.9 substance use disorders. Of 89 clients, 10 (11.2%) reported illicit use of peyote. The vast majority of these youth (n = 8) reported using peyote only once or twice in their lifetime. Illicit peyote users did not differ from nonusers in terms of age, gender, other substance use, prevalence of either other substance abuse/dependence or other nonsubstance use psychiatric disorders. However, illicit peyote users were more likely to report low levels of social support, low levels of self-esteem, and low identification with AI culture yet comparable involvement in AI traditional practices. The results of this exploratory study suggest that illicit peyote use is uncommon among AI adolescents with serious substance abuse problems.     

Preliminary survey of illegal drug misuse among Japanese high school students]

For several years, amphetamine misuse by high school students has been increasing in Japan. The Japanese National Police Agency announced that the third widespread use of amphetamines has started, especially among adolescents. However, there are few data on misuse of amphetamines or other substance abuse among high school students except for solvent inhalation. This is a preliminary survey report concerning substance abuse and substance-related problems among high school students. We surveyed 3393 high school students from 8 high schools in Kanagawa Prefecture and Kyushu Area on drinking and smoking status, and experience of illegal substance use. The results showed that 5.1% of the high school students had experiences of solvents inhalation, 1.1% of marijuana use, and 0.8% of amphetamine use. Around these illegal drug misusers, there were many reserves, such as students who experienced temptation to use solvents (13.6%), marijuana (2.4%), and amphetamines (2.5%), and those who responded that they wanted to use solvents (3.7%), marijuana (3.5%), and amphetamines (2.4%) if they were tempted. The prevalence of illegal drug misusers and reserves was not significantly different between male and female students, and they were concentrated among problem drinkers by the QF Scale and among current smokers. Prevalence of illegal drug misuse among Japanese high school students can not be estimated from the results of the survey because the subjects were limited to two areas and a small number of schools.     

Psychiatric disorders in inhalant users: results from The National Epidemiologic Survey on Alcohol and Related Conditions

OBJECTIVE: To examine the prevalence and correlates of mood, anxiety, and personality disorders among lifetime inhalant users. METHODS: Statistical analyses were based on data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of adults in the United States. RESULTS: Inhalant users (N=664) had high lifetime prevalences of DSM-IV mood (48%), anxiety (36%), and personality (45%) disorders. Of all inhalant users, 70% met criteria for at least one lifetime mood, anxiety, or personality disorder and 38% experienced a mood or anxiety disorder in the past year. Prevalences of comorbid psychiatric disorders varied by gender. Compared with male inhalant users, female inhalant users had higher prevalences of lifetime dysthymia (24% versus 16%), any anxiety disorder (53% versus 30%), panic disorder without agoraphobia (25% versus 11%), and specific phobia (28% versus 14%), but a lower prevalence of antisocial personality disorder (22% versus 36%). Female inhalant users also were more likely than male inhalant users to meet criteria for three or more mood or anxiety disorders (15% versus 8%) in the past year. Among inhalant users with comorbid disorders, those who developed social or specific phobia typically experienced onset of these disorders prior to initiation of inhalant use; all other mood and anxiety disorders usually developed following the onset of inhalant use. Inhalant users who were women, poor, less educated, with early onset of inhalant use, family histories of psychopathology, and personal histories of substance abuse treatment had increased odds of psychiatric disorders. CONCLUSIONS: Psychiatric disorders are highly prevalent among inhalant users nationally and female inhalant users are more likely than male inhalant users to experience multiple psychiatric disorders. Inhalant use and its consequences among females warrant greater research attention.     

Adolescent psychological health problems and delinquency among volatile substance users in a school sample in South London

The study assessed prevalence of volatile substance abuse (VSA), and its link to other forms of psychoactive substance use and to other problem behaviours among 14-15 year olds recruited from sixteen secondary schools in south-west London. Lifetime use of volatile substances was reported by 126 young people (6% of the sample) whose mean age of first use was 12.6 years. Using logistic regression analysis, lifetime use of volatile substances was found to be associated with more frequent cigarette smoking and more frequent drinking in the previous month, with higher levels of anxiety, greater involvement in delinquent acts, and lower levels of educational aspirations. Among volatile substance abusers, more frequent use was associated with higher levels of psychological distress and greater delinquent activity. Volatile substance abuse may be a marker for other forms of substance use and for other behaviour problems. This issue remains inadequately explored by researchers and clinicians.     

Adolescent psychological health problems and delinquency among volatile substance users in a school sample in South London

The study assessed prevalence of volatile substance abuse (VSA), and its link to other forms of psychoactive substance use and to other problem behaviours among 14–15 year olds recruited from sixteen secondary schools in south-west London. Lifetime use of volatile substances was reported by 126 young people (6% of the sample) whose mean age of first use was 12.6 years. Using logistic regression analysis, lifetime use of volatile substances was found to be associated with more frequent cigarette smoking and more frequent drinking in the previous month, with higher levels of anxiety, greater involvement in delinquent acts, and lower levels of educational aspirations. Among volatile substance abusers, more frequent use was associated with higher levels of psychological distress and greater delinquent activity. Volatile substance abuse may be a marker for other forms of substance use and for other behaviour problems. This issue remains inadequately explored by researchers and clinicians.     

Illicit Peyote Use Among American Indian Adolescents in Substance Abuse Treatment: A Preliminary Investigation

Few studies to date have addressed illicit (i.e., nonceremonial) peyote use among American Indians (AIs). Participants were 89 AI adolescents admitted to a tribally operated residential substance abuse treatment program (RSATP) between 1998 and 2001. The RSATP is designed to provide specialized treatment of patients with substance use and other comorbid psychiatric disorders and is infused with a culturally sensitive approach to treatment. The participants completed a series of interviews that collected information on psychiatric diagnostic status, history of substance use, and ethnic identity. The majority of participants were male (65%), did not come from a two-parent household (75%), reported a mean use of 5.4 substances, and met full criteria for a median of 2.9 substance use disorders. Of 89 clients, 10 (11.2%) reported illicit use of peyote. The vast majority of these youth (n = 8) reported using peyote only once or twice in their lifetime. Illicit peyote users did not differ from nonusers in terms of age, gender, other substance use, prevalence of either other substance abuse/dependence or other nonsubstance use psychiatric disorders. However, illicit peyote users were more likely to report low levels of social support, low levels of self-esteem, and low identification with AI culture yet comparable involvement in AI traditional practices. The results of this exploratory study suggest that illicit peyote use is uncommon among AI adolescents with serious substance abuse problems.     

Influence of Spirituality and Religiousness on Substance Misuse in Patients with Schizophrenia or Schizo-Affective Disorder

Substance misuse represents a major issue in the treatment of schizophrenia patients. Spirituality and religiousness have been shown to reduce substance misuse and to foster recovery among substance misusers in the general population. One hundred and fifteen stabilized outpatients with schizophrenia (mean age 39; 70% male) were selected in 2004 for an interview about religious coping. Religious involvement was significantly inversely correlated to substance use and abuse. A content analysis showed that religion may play a protective role toward substance misuse in 14% of the total sample, especially for patients who had stopped substance misuse (42%). It played a negative role in 3% of cases. Religion may play a role in the recovery of schizophrenia patients with substance misuse comorbidity.     

肺内吸入给药治疗哮喘和慢性阻塞性肺病研究进展

哮喘和慢性阻塞性肺疾病(COPD)是最常见的呼吸道疾病之一,全球分别有3 亿和2.1 亿患者。肺部吸入给药是治疗和管理哮喘、COPD 等呼吸道疾病的首选给药方式,而患者的依从性与该类制剂的疗效优劣有密切关系。综述现在已经上市的肺部吸入给药治疗哮喘和慢性阻塞性肺疾病的主要剂型和药品,以及雾化吸入剂、定量吸入剂和干粉吸入剂对患者依从性的影响,并认为提高患者依从性需要反复提供给患者个性化用药和正确使用给药装置的指导。     

Treatment outcomes of stimulant misusers: one year follow-up results from the national treatment outcome research study (NTORS)

There are substantial gaps in knowledge about treatment outcomes for stimulant misuse. This paper investigates patterns of stimulant use and outcomes of stimulant misusers one year after starting treatment at 54 agencies within United Kingdom national services. In a prospective, longitudinal cohort study of 1,075 drug misusers, 637 were current users of stimulant drugs at intake to treatment. Most of the clients were multiple drug users. Stimulants were the main problem drug for 13% of the sample. The two most frequently used drugs were crack cocaine and amphetamine sulphate. The most frequently reported pattern of stimulant use was among heroin dependent clients who also used stimulants. The clients for whom stimulants were the main problem drug were most likely to approach residential rehabilitation programs for treatment. Overall, the stimulant users showed satisfactory outcomes with marked reductions in substance use and other problem behaviors at follow-up. Many clients with stimulant misuse problems were able to achieve substantial improvements after treatment within existing services.     

Problem Severity and Symptomatology among Substance Misusers: Differences between African-Americans and Caucasians

Using data collected on 348 patients presenting to a hospital-based substance misuse treatment program, the present study compares psychiatric symptomatology and severity of substance misuse among African-American and Caucasian alcohol and drug misusers. African-Americans had a higher overall severity of substance misuse and reported using more substances than Caucasians. African-Americans also had higher levels of somatization, interpersonal problems, depression, hostility, obsessive/compulsive behavior, phobia, paranoia, and psychoticism than Caucasians. African-Americans exhibited higher levels of psychosocial stress and lower levels of global functioning than did Caucasians. The implications of the findings are discussed     

Lifetime physical and sexual abuse and substance use treatment outcomes in men

Although lifetime physical and sexual abuse are common among substance use disorder (SUD) patients, few studies have examined the impact of abuse on treatment outcomes, particularly for men. Men with lifetime physical (n = 49), sexual (n = 49), or no abuse (n = 117) history were assessed at entry to outpatient SUD treatment and at 6 and 12 months postintake. Men with a history of physical or sexual abuse had more severe drug problems at intake, but by 6 months, there were no group differences in drug use. However, relative to men without an abuse history, men with a sexual abuse history had more severe psychiatric problems at all three time points and were more likely to report significant suicidality at intake and 6 months. Findings suggest that men with a history of sexual abuse benefit from SUD treatment, but additional intervention may be warranted to remedy persisting psychiatric distress.