Alcohol and drug use in orthopaedic inpatients

A series of 109 adult orthopaedic inpatients was interviewed about alcohol and other drug use and alcohol-related problems in general in the week preceding admission to hospital. The most frequently used drugs were alcohol (reported by 75%), tobacco (53%), analgesics (28%) and cannabis (15%). Alcohol was used hazardously by 28% of patients. More patients scored as problem drinkers on the Trauma Scale (52%) than the Brief MAST (7%). The detection of alcohol-related problems at an early stage is important. It is suggested that trauma victims in hospital be routinely screened for this.     

Alcohol and marijuana use in pathways of risk for sexually transmitted infection in white and black adolescent females

Background: Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. The authors tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females. Methods: The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions. The 3 oldest cohorts (N = 1750; 56.8% black, 43.2% white) provided self-reports of substance use, depression and conduct problems, SRB, and STI at ages 16–18. A path model tested alcohol and marijuana use at age 17 as mechanisms that mediate the associations of depression and conduct problems at age 16 with SRB and STI at age 18. Results: Race was involved in 2 risk pathways. In one pathway, white females reported greater alcohol use, which was associated with greater SRB. In another pathway, black females reported earlier sexual onset, which was associated with subsequent SRB. Public assistance use was independently associated with early sexual onset and STI. SRB, but not substance use, mediated the association of depression and conduct problems with STI. Conclusions: Differences by race in pathways of risk for SRB and STI, involving, for example, alcohol use and early sexual onset, were identified for young white and black females, respectively. Depression and conduct problems may signal risk for SRB and STI in young females, and warrant attention to improve health outcomes.     

Alcohol use/abuse and help-seeking among U.S. adults: The role of racial-ethnic origin and foreign-born status

We used data from Wave 1 and Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions to examine racial-ethnic and nativity-based variations in alcohol use/abuse and treatment seeking while accounting for acculturation, stress, and social integration factors. The dependent variables included alcohol use, risky drinking, DSM-IV alcohol use disorder, and treatment seeking in the past 12 months. Racial-ethnic categories included African, European, Asian/Pacific Islander, Mexican, Puerto Rican, and other Hispanic/Latino. Acculturation, social stress, and social integration were assessed with previously validated, detailed measures. Bivariate probit models with sample selection were estimated for women and men. Immigrant status and origin associations with alcohol use/abuse and treatment seeking were strong and largely unaffected by other social factors. Europeans and men of Mexican origin had the highest while women of African, Asian/Pacific Islander, and Puerto Rican origins had the lowest rates of alcohol use/abuse. Years in the United States was associated with a higher risk of alcohol use/abuse for all immigrant groups. Foreign-born individuals were no less likely than U.S. natives to seek treatment if they were abusing or were dependent on alcohol. Further modeling of these relationships among specific immigrant groups is warranted. These findings inform alcohol rehabilitation and mental health services for racial-ethnic minorities and immigrants.     

Maternal and Paternal Alcohol Misuse and Alcohol-Related Outcomes Among College Students

Using a large college student sample (N = 1,095), the present study examined whether the relationship between parental alcohol abuse and offspring alcohol use varied as a function of parent and offspring gender, and whether the relationship to the non-substance-abusing mother or father buffered against the risk associated with being an adult child of an alcoholic (ACOA). Among women, maternal ACOAs (i.e., the mother only was suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption, whereas among men, both parent ACOAs (i.e., both parents were suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption. No support was found for the buffering hypothesis. We discuss implications of our findings and future directions.     

Alcohol consumption and use of health care services in people with severe mental illness and stressful childhood experiences

People who suffer from severe mental illness often present with histories of abuse during childhood. Alcohol use disorders is a common co-morbidity of survivors of childhood abuse and neglect. This study analyzes the effects of stressful childhood experiences, a proxy for trauma, on the frequency of alcohol consumption and the utilization of health care services in a population of people with severe mental illness. There were 111 men (mean age: 35 years) and 72 women (mean age: 40.0 years) with severe mental illness that were recruited from psychiatric outpatient clinics in New York City. The analysis focused on lifetime prevalence of stressful childhood experiences, alcohol consumption, and utilization of health care services over time. The longitudinal data were analyzed over 12 months with a level-2 model (multilevel modeling). Out of the participants, 41.5% reported a history of more than four types of abusive experiences. There were 33.3% that had a DSM-IV diagnosis of alcohol abuse and 27.3% qualified for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of alcohol dependence throughout their lives. Stressful childhood experiences predicted an increased frequency of alcohol consumption over time. People with histories of childhood abuse had more often been to outpatient clinics and 12-step programs, but at the same time showed lower frequency rates of psychiatrist visits and visits to outpatient clinics. Childhood abuse is prevalent in people with severe mental illness and is related to an increased alcohol consumption. Despite an increased need of health care services, affected persons might encounter more barriers to access them.     

Sexual Victimization in Female and Male College Students: Examining the Roles of Alcohol use,Alcohol Expectancies,and Sexual Sensation Seeking

Alcohol and alcohol expectancies relate to sexual victimization. The present study examined these links in a sample of 407 predominantly Hispanic male and female college students, along the Mexico–US border. The study also examined the independent contribution of sexual sensation seeking to the prediction of victimization. Results showed that victimization was associated with alcohol risk, alcohol consumption-related problems, and positive alcohol expectancies. Importantly, sexual sensation seeking independently predicted victimization and did so after controlling for alcohol risk and expectancies. Our results suggest that associations among victimization, alcohol risk, and expectancies generalize to Hispanic women and men. The study's limitations are noted.     

Recreational drug use in New Zealand

A general population sample of 5126 New Zealanders aged 15-45 was surveyed in late 1990 to determine their use of alcohol, tobacco, cannabis, and other illicit drugs. The results show that alcohol and tobacco are the most commonly used drugs. Cannabis had been tried by 43% of the sample, and this level of use appears similar to that in Australia and the United States. Hallucinogens were the next most common illicit drug and had been tried by 8% of the sample. Again the New Zealand rates appear similar to those for the United States or Australia. Much lower levels of use were reported for stimulants, opiates, tranquillizers and solvents than for other illicit drugs. The New Zealand prevalence rates for these substances are lower than those in the United States. The rates for these other classes of drugs are more similar to Australia, but may be slightly lower for stimulants, tranquillizers and solvents.     

Epidemiology of road accidents involving young adults: Alcohol,drugs and other factors

This paper reviews the magnitude and characteristics of the problem of road accidents involving young adults. The magnitude of the problem is considered from the perspective of the contribution of road accidents to mortality and morbidity among young people, relative to other causes. The over-representation of young adults in road accidents is examined to determine the extent to which it occurs as a result of their involvement as drivers, passengers, or as pedestrians. To determine the characteristics of collisions involving young adults, the potential contributory role of alcohol, drugs, and other factors in their collisions is evaluated on the basis of current epidemiological evidence, drawn particularly from studies conducted in Canada. The review examines factors that are related not only to the frequency of collision involvement, but also to the severity of the collision.Although the principal intention of the review is to identify what is known about factors that appear to contribute to accidents involving young adults, an additional purpose is to identify what is not known, and in this context, to suggest, given current methodological and practical limitations, what is capable of being determined in the near term.     

Alcohol use and the Traveller community in the west of Ireland

Introduction and Aims. The Traveller community as ethnic minority is vulnerable to problematic alcohol use, because of social exclusion, discrimination, lack of awareness and difficulties in engaging with addiction treatment protocols. Design and Methods. This research yielded an exploratory account of Travellers and alcohol use according to the perspectives of the Travellers and key service providers in the west of Ireland, within the context of a large‐scale study on Travellers and substance use. The research consisted of 12 peer‐accompanied focus groups of Traveller men and women (n = 57) and 45 semistructured interviews with a self‐selecting sample of key service agencies. The research themes related to Traveller culture and alcohol use, sex differences, reasons for consuming alcohol, attitude to alcohol use, problematic alcohol use, levels of alcohol harm‐related knowledge, perceptions of alcohol‐related risk and experiences of addiction services. A thematic analysis of the information garnered guided this comparative analysis. Results. The Traveller community, and in particular Traveller men, are presenting with increasingly problematic alcohol use, because of dissipation of their culture and their experiences of marginalisation, discrimination, depression, illiteracy and poverty. Difficulties engaging with law enforcement, community health and addiction services compromise their efforts to deal with this problem and home detoxification attempts are common. Discussion and Conclusions. Services must aim to take into consideration the cultural needs of Travellers and provide appropriate educational materials, peer education programs and flexible treatment approaches for those Travellers experiencing problematic alcohol use. [Van Hout MC. Alcohol use and the Traveller community in the west of Ireland. Drug Alcohol Rev 2009]     

Considerations in Sentencing the Drug Offender

Abstract

The purpose of this investigation was to determine if there were gender differences in 80 medical records (37 African-American men and 43 African-American women) from one drug treatment facility located in a midwest ern city. Using independent t-tests and chi square analyses to determine group differences, there were significant gender differences relative to childhood sexual abuse experiences and maternal alcohol and other drug abuse; however, there were no gender differences relative to most drug-related behaviors and to paternal alcohol or other drug abuse. Implications for further study are discussed.     

Alcohol and recreational drug use by HIV-seropositive homosexual men

The objectives of this study were to describe the patterns of alcohol and recreational drug use of HIV-seropositive homosexual men and to determine the effect of alcohol use on HIV risk-taking behaviour. Of particular interest was the effect of knowledge of HIV status on these behaviours. Information on alcohol and drug use was obtained from 485 HIV-seropositive homosexual and bisexual men presenting to a HIV-antibody testing and medical management clinic. Heavy alcohol use was common, with 46.2% reporting consumption of six or more standard drinks on one day recently. Men who knew that they were HIV infected drank significantly more than those men who had yet to learn of their HIV status at the time of interview. There was clear evidence in this study for a role of alcohol use in HIV risk-taking behaviour. Almost one-third (27%) of the HIV-seropositive men reported unprotected anal intercourse during the previous 3 months with approximately one-third of these (27/76, 35·5%) nominating alcohol as contributing to their high HIV-risk behaviour.     

Normalization as a barometer: Recreational drug use and the consumption of leisure by younger Britons

This article discusses the development of the normalization thesis in respect of monitoring sustained increases in young Britons’ consumption of illicit drugs and alcohol over the past decade. It describes five dimensions of normalization which have been applied in a cluster of studies undertaken by the author, highlighting results from the N.W. England Longitudinal Study showing easy accessibility, high rates of drug trying (76% at 22 years) and long-term recreational drugs careers involving both alcohol and illicit drugs. The social accommodation of ‘sensible’ substance use was apparent amongst most drug abstainers in the cohort who routinely had close friends who used drugs ‘recreationally’. Further cultural acceptance of recreational drug use is described. A sixth dimension – state or government responses to widespread recreational drug use – is introduced and illustrated. The article concludes by emphasizing the negative outcomes associated with recreational poly substance use in terms of personal and public health highlighting the ‘slippage’ from recreational to problem drug use as a growing phenomenon. It calls for a more integrative national strategy to address negative aspects of normalization.     

Youth alcohol and other drug use in the United States and Australia: a cross-national comparison of three state-wide samples

Although youth drug and alcohol harm minimization policies in Australia are often contrasted with the abstinence and zero tolerance policies adopted in the United States, there has been little research directly comparing youth substance use behaviour in the two countries. Three state representative samples in Victoria, Australia (n = 7898) and in the US states of Oregon (n = 15 224) and Maine (n = 16 245) completed a common cross-sectional student survey. Rates of alcohol use (lifetime alcohol use, recent use in the past 30 days), alcohol use exceeding recommended consumption limits (binge drinking: five or more drinks in a session), other licit drug use (tobacco use), and norm-violating substance use (substance use at school, use in the past 30 days of marijuana or other illicit drug use) were compared for males and females at ages 12-17. Rates were lower (odds ratios 0.5-0.8) for youth in Maine and Oregon compared to Victoria for lifetime and recent alcohol use, binge drinking and daily cigarette smoking. However, rates of recent marijuana use and recent use of other illicit drugs were higher in Maine and Oregon, as were reports of being drunk or high at school. In contradiction of harm minimization objectives, Victoria, relative to the US states of Oregon and Maine, demonstrated higher rates of alcohol use exceeding recommended consumption limits and daily tobacco use. However, findings suggested that aspects of norm-violating substance use (substance use at school, marijuana use and other illicit drug use) were higher in the US states compared to Victoria. [Toumbourou JW, Beyers JM, Catalano RF, Hawkins JD, Arthur MW, Evans-Whipp T, Bond L, Patton GC. Youth alcohol and other drug use in the United States and Australia: a cross-national comparison of three state-wide samples. Drug Alcohol Rev 2005;24:515-523]     

Bereavement through substance use: findings from an interview study with adults in England and Scotland

Background: Deaths associated with alcohol and/or drugs belong to a category of ‘special’ deaths due to three characteristics: traumatic circumstances of the death, stigma directed to both the bereaved and the deceased, and resulting disenfranchised grief experienced by the bereaved. These factors can impede those who are bereaved in this way from both grieving and accessing support. In response to a lack of research in this area this paper reports on an interview study that has aimed to better understand the experiences and needs of this neglected group of bereaved people.

Method: Interviews with 106 adults (parents, children, spouses, siblings, nieces and friends) bereaved through substance use in Scotland and England.

Results: Five themes describe interviewee experiences: possibility of death, official processes, stigma, grief and support. These findings suggest what is dominant or unique in this group of bereaved people; namely, that living with substance use (including anticipatory grief), experiencing the subsequent death (often traumatic and stigmatised) and the responses of professionals and others (more likely negative than positive) can disenfranchise grief and negatively impact bereavement and seeking support.

Conclusions: This article describes a large and unique sample, the largest in the world to be recruited from this population. Our study raises awareness of a hitherto largely ignored and marginalised group of bereaved people, highlighting what might be particular to their bereavement experience and how this may differ from other bereavements, thereby providing an evidence base for improving the availability, level and quality of support.