Monitoring Substance Use in Adolescents: school survey or household survey?

The methodologies of school and household surveys for monitoring substance use among adolescents are compared, their respective strengths and weaknesses described and directions for improvement indicated. This work is in part based on our experience with the ongoing Dutch National School Survey, which is a monitor on substance use and its putative risk factors. It is held every 4 years among samples of 10 000 students. Starting in 1984 we now have five waves of data. Our experiences are placed in the broader context of the literature and several conclusions are drawn. The school survey offers a number of benefits: participation rates are high, costs per respondent are low, and substance use among minority groups can be monitored well. The school survey generates relevant contextual information on fellow-students, classes and schools. It can also generate contextual information on the students' households and the communities in which they live. Further, aetiological inference is enhanced when the school survey is designed as a cohort study. This, however, is only a viable option when data collecting is carried out at least every 2 years and depends on information needs.     

Volatile substance misuse among youth in Israel: results of a national school survey

Volatile substance misuse (VSM) among Israeli youth has been identified as widespread and growing. Using data from the 2009 National School Survey of 12-18 year olds (N = 7,166), this study describes VSM prevalence among Jews and Arabs, examining relationships between past-month VSM and sociodemographic, behavioral, psychological, and interpersonal characteristics. Past-month VSM, reported by 7.5% of respondents, was significantly associated with other risky behaviors including past-month illicit drug use (Adjusted odds ratios (AOR) = 5.41, 95% CI: 3.5-8.1), Internet gambling (AOR = 2.12, 95% CI: 1.5-3.1), smoking, binge drinking, and truancy. National drug policy must address VSM and develop strategies to reduce demand and supply. Potential study limitations are noted.     

Alcohol and drug problems in the schools: results of a national survey of school administrators

A mail survey of public high-school administrators in the United States was conducted to gather information about the nature and extent of school problems with student alcohol and drug use. Of the 728 schools selected for the national metropolitan probability sample, 543 (75%) returned a completed questionnaire. The results indicated that from 1980 to 1985, about one in six students attended schools that reported a serious problem with student alcohol use. In contrast, the proportion of students attending schools with a serious drug problem decreased from about one in four in 1980-81 to about one in seven in 1984-85. The most common explanation provided for a decreasing student alcohol or drug problem was changes in the school's discipline policy or increased enforcement of the existing policy. Few respondents attributed a reduction in student alcohol or drug problems to prevention or treatment programs. Limitations of the survey data are discussed as well as directions for future research.     

Consequences of Teenage Drug Use:

Despite the fairly well-established literature on theories and empirical studies to predict the initiation of teenage drug using behaviors, very little theory development, and even less research, has been directed toward understanding the adult consequences and outcomes of adolescent drug use. This paucity of well-articulated theories, lack of theoretical development, and few empirical analyses is addressed in this paper. Various theories and mechanisms available to explain the impact of drug use on aspects of the individual and society are reviewed. Although several theories touch on the notion of drug use consequences, for most of them, their explicit aim is to determine the antecedents of drug use. Several areas are discussed including the type of consequences, methodological concerns, currently available theoretical frameworks, presentation of a new theory to explain consequences of teenage drug use, and a selected review of empirical studies on drug use consequences. Emprical research is reviewed in regard to consequences of teenage drug use on physical health, educational pursuits, mental health, deviance, family formation, sexual behavior, livelihood, and social integration.     

Drug dependence units in England and Wales. The results of a national survey

Drug dependence units (DDUs) form the cornerstone of government policy response to problem drug taking. Yet we know surprisingly little about the facilities that they can provide and what treatment policies they adopt. This paper constitutes a modest attempt to fill some of the gaps in our knowledge and points to the need to base future policy recommendations on detailed empirical research.     

Drug and alcohol consumption and sexual risk behaviour among young adults: results from a national survey.

To study the association of the consumption of alcohol and other psychoactive drugs with sexual risk behaviour for HIV infection, data from a representative sample of the Spanish population aged 18-39 years were analysed. A national household survey was carried out in 1996 using a combination of face-to-face interviews and self-administered questionnaires. The survey included 5253 subjects aged 18-39 years who provided information on alcohol and drug consumption, number of sexual partners and condom use with the steady partner and with casual partners in the 12 months before the survey. Of those surveyed, 27.4% had been drunk at least once and 20.5% had consumed drugs. Both behaviours were associated with male sex, younger age, higher educational level, being single and having had more than one sexual partner. In the logistic regression analysis adjusting for the sociodemographic variables, the greater frequency of drunkenness and cannabis use were associated with having more than one sexual partner. Regular condom use was significantly less frequent among cocaine users and more frequent among opiate users, but was not associated with the use of other drugs. Sexual risk behaviour (i.e. more than one partner and failure to use a condom regularly) was more frequent among persons who had been drunk or used cannabis or cocaine. Excessive consumption of alcohol, and cannabis and cocaine use are independently associated with sexual behaviour involving greater risk of HIV infection or transmission.     

Youthful Drug Use and Drug Subcultures

Drug involvement is such an intensely social behavior that it lends itself to the notion of a subcultural existence. The social aspects of drug involvement generate a value system that is different from the dominant order. Using a longitudinal sample of college students, the findings indicate two distinctively different types of drug use, marijuana-only versus illicit drug involvement, that correspond to a subcultural or contracul-tural phenomenon. The elements of a subculture or contraculture are amenable to empirical measurement and can be differentiated from the dominant value system. Marijuana use reflects a type of subculture activity that maintains ties to the conventional order. Illicit drug use, on the other hand, is a contracultural activity, representing a pronounced break with the dominant culture.     

探讨合理用药之对策

目地:探讨如何进一步提高合理用药的水平。方法:参考有关文献和资料,结合工作实际,进行汇总,分析并加以阐述。结果:合理用药可以提高治疗水平,减少不良反应和药源性疾病的发生。结论:合理用药意义重大,呼吁医务人员要自觉规范用药行为。     

Alternatives to Drug Use: An Alternative Approach to Drug Education

The Alcohol and Drug Education Course, a secondary prevention program for drug-abusing adolescents, was evaluated. The program provided some drug information, but primarily emphasized alternatives to drug and alcohol use for achieving altered states of consciousness. Students were found to be relatively knowledgeable about the effects of drugs, but were also misinformed on some issues. The program was successful in increasing the students' awareness of alternatives to drug use and the hazards of drug abuse, and in decreasing their reported reliance on drugs for achievement of altered states of consciousness.     

College Students' Use of Cocaine

After experiencing a period of rapid decline between 1986 and 1994, cocaine use is once again on the rise in the United States. The increased prevalence of use among college students is particularly troubling because of its potential impact on human capital acquisition and long-term labor market success. Merging information on the price of cocaine and marijuana from the U.S. Drug Enforcement Agency with data on cocaine use from the College Alcohol Study, we investigate the demand for cocaine in the college population. We find evidence that participation in cocaine use by college students is responsive to changes in the price of cocaine and marijuana and that cocaine and marijuana are economic complements for this population. Further investigation revealed significant differences in the demand for cocaine by those less than age 21 and those at least age 21, years, with the younger age group being more responsive to changes in the price of cocaine. No difference is found, however, in the demand for cocaine across gender.     

Drug Use Among Teenagers: Patterns of Present and Anticipated Use

All the students in four elective classes in one high school re-ponded to a questionnaire concerning drug use, selected attitudes, and selected behaviors. There were few differences between drug users and nonusers in terms of the attitudes and behaviors measured. However, there were striking differences between the high school sample and youth who frequented a free clinic. The “hang-loose” ethic was much more apparent at the clinic. Implications are briefly discussed.     

Drug Use Research: Drug Users as Subjects or Agents of Change

Background: Reviews have commented on rising clandestine manufacture of opiate drug solutions for injecting, and to a lesser extent for oral use. Very little is known about user attempts to culture poppy seeds, widely available on the internet for manufacture of long acting medium-high potency oral solutions, both as poppy seed tea or as opium tincture (laudanum). Objectives: A netnographic research methodology aimed to provide online consumer insight into user sourcing and decision influences, experiences of home manufacture of laudanum, utilization of opium tincture recipes, and consumptive patterns. Methods: A systematic internet search was conducted using the terms: “Laudanum,” “Opium tincture,” and “Tincture of Opium” in combination with “forum.” Following screening of 810 forum threads with exclusion criteria and removal of duplicates, 75 fora threads on 6 online drug fora were analyzed using the empirical phenomenological psychological method. Four themes were generated. Results: Findings illustrated the underpinning of user reminiscing about Victorian use of standardized laudanum, long duration shelf life, and medicinal use for opiate withdrawals with intentions to prepare. Preparation of famous recipes and use of authentic storage bottles boosted nostalgia. Participants appeared well versed in kitchen chemistry processes. Discussions centered on type and amount of alcohol used, use of additives to promote palatability and intoxication effect, homogenization of poppy seeds, and double extraction using opium tincture. Lack of detail available on intoxication experiences, with tentative dosage advised. Conclusions: Development of targeted and credible “counterpublic” harm reduction initiatives situated within online consumerism of communal drug knowledge is warranted.     

Drug identification: a survey of poison control centers

OBJECTIVE: The objective of this study was to determine current practices and opinions of poison center staff and directors regarding drug identification (ID) calls. METHODS: Surveys were developed and mailed to 911 poison center staff members and 69 managing directors at 69 poison control centers in the United States in December 2001. RESULTS: Responses were received from 317 staff members and 33 directors from 49 centers. Nearly half of the staff respondents stated that they had not received drug ID training beyond how to look up the identity of an oral medication. About one-half of staff and director respondents stated that their centers had only informal (unwritten) drug ID policies, while one-fourth each responded they had formal written policies or had no policy at all. A majority of respondents indicated that their centers either allow or require specialists to provide ID for non-ingestion-related cases. Nearly all staff and director respondents routinely provide ID services to law enforcement officers and health care professionals regardless of whether ingestion was involved. Slightly more than one-half of staff respondents inquire about possible ingestion with almost every request, while one-third only inquire when the caller gives some indication that ingestion may have occurred. Case-based questions reveal that different practices are utilized depending on the type of medication for which ID is being requested. Factors such as risk of liability, patient confidentiality, guardianship, and the person's best interest appear to contribute to decisions regarding the provision of medication ID. CONCLUSION: Drug identification practices vary from center to center throughout the United States. Though the service is greatly utilized, few centers have written policies. In addition, training for the provision of this service appears to be inadequate in many centers. The development of drug identification guidelines to be utilized throughout poison centers would provide much needed consistency and guidance.     

Reasons for Drug Abstention: A Study of Drug Use and Resilience

Abstract

Despite extensive prevention efforts, recent years have seen an increase in illicit drug use among young people. However, many people choose to not use drugs while they are growing up. This study sought to uncover reasons why some individuals seem to have more resilience when faced with drug use than others. Fear of the physical damage drugs caused, parental disapproval of drug use, and a belief that drugs would interfere with goals were cited most often as reasons for not using. Furthermore, students who had never used drugs had more positive relationships with family and peers compared to those who had used them.