Cultural values associated with substance use among Hispanic adolescents in southern California

Cultural values can shape people's attitudes toward substance use and influence their risk of experimentation with drugs. This article examines the relationships between cultural values (familism, respeto, and machismo), fatalism (a culturally encouraged personality disposition), and substance use among Hispanic adolescents. In 2005, cross-sectional data were collected from 1,616 Hispanic ninth grade students in Los Angeles. Each cultural value was associated with lifetime substance use; however, these relationships depended on the type of substance and gender. Our findings suggest that it might be useful to incorporate the cultural values and address the personality trait of fatalism in prevention programs for Hispanic adolescents. The study's limitations are noted.     

Drug use and associated factors among rural adolescents in Costa Rica

The objectives of this study, carried out in 1995, were to assess both licit and illicit substance use among rural male and female Costa Rican adolescents, and associated health, psychological, and psychosocial problems. A sample of 304 students from rural schools was randomly selected. The mean age for females was 14.7 years (S.D. = 1.71), and for males was 14.4 years (S.D. = 1.62). The data were collected using the Latin-American version of Drug Use Screening Inventory (DUSI). Results showed a high prevalence of past-year alcohol use for both males and females (56.6% and 47.4%, respectively), and a lower prevalence of past-year tobacco use (44.0% and 7.7%). There results also showed a low level of use of solvent inhalants and benzodiazepines. In terms of illicit drugs, males preferred cocaine and marijuana, while females only reported amphetamine use. An analysis of adolescent functioning showed differences among alcohol users and nonusers in behavior patterns and peer relationships. However, no significant differences were found regarding rebellion, depression, and social isolation. The implications of these results are discussed, along with the importance of enhancing prevention, as well as early detection and intervention.     

Childhood abuse and harmful substance use among criminal offenders

Childhood abuse is a serious problem that has been linked to harmful alcohol and drug use in non-offender samples. In a sample of 219 criminal offenders, we examined the associations between childhood physical and sexual abuse and three indices of harmful substance use. Results indicate that physical abuse was associated with symptoms of alcohol use disorder and sexual abuse was associated with symptoms of drug use disorder among offenders. Both forms of childhood abuse were associated with substance use consequences, even after taking into account substance type and frequency of use. No gender by childhood abuse interactions were found. Symptoms of depression and generalized anxiety partially mediated relationships between childhood abuse and substance use consequences. Findings underscore the importance of assessing childhood abuse and treating anxiety and depression among offenders who exhibit harmful substance use.     

Social influences as explanations for substance use differences among Asian-American and European-American adolescents

The present study examines the social influences in the Asian-American and European-American adolescent environment to provide a greater understanding of effect of ethnic differences on the prevalence of substance abuse. Participants were 957 Asian-American and 3705 European-American seventh grade adolescents. It was found that Asian-American students were less likely to use alcohol and cigarettes, and had a more abstinence-promoting environment than European-American adolescents. This difference in Asian-American adolescents appeared to be the result of less adult and peer influence to use alcohol or cigarettes, less offers of alcohol, and an increased likelihood of having an intact family when compared to European-American adolescents. Additionally, Asian-American adolescents reported having fewer friends and spending less time with their friends than European-American adolescents. It was concluded that social influences play an important role in explaining why Asian-American adolescents have lower rates of substance use.     

Cultural protective factors for community risks and substance use among rural African American adolescents

Relatively little attention has been afforded to protective factors for community-level risks among non-urban populations. This study examined the extent to which traditional cultural attitudes and behaviors of 137 African American adolescents (ages 12-17) from a rural community moderated the relationship between perceived community disorganization and substance use behaviors. Results from hierarchical linear regression revealed that traditional cultural attitudes and behaviors were differentially related to community disorganization and adolescent substance use. In terms of protective influences, religious beliefs and practices and traditional family practices moderated the effect of community disorganization on substance use. Specifically, religious beliefs and practices demonstrated a protective-stabilizing effect as community disorganization increased; traditional family practices demonstrated a protective but reactive effect. Attitudes of cultural mistrust increased youth's susceptibility to substance use as community disorganization worsened--vulnerable and reactive. The findings underscore the importance of examining the link between cultural and contextual factors in an attempt to understand the etiology of substance use among rural African American adolescents.     

Comparison between Dutch and Norwegian parents regarding their perceptions on parental measures to prevent substance use among adolescents

This study investigated whether Dutch and Norwegian parents differ in their perceptions on parental measures and how parents view governmental responsibility to prevent adolescents from substance use. Data were derived from a cross-sectional internet survey conducted in the Netherlands and Norway. A subsample of Dutch (n?=?2017) and Norwegian parents (n?=?844) was selected. Parents were asked about their perceptions on different parental measures in relation to substance use, e.g. setting the right example, setting rules, parental behavior in the presence of adolescents, and how they view governmental responsibility compared with parental responsibility in relation to substance use among adolescents. The parental responsibility for taking parental measures against adolescents’ substance use was emphasized by both the Dutch and Norwegian parents. Compared to Dutch parents, Norwegian parents were slightly more positive about taking parental measures. Dutch frequent and heavy drinkers and Norwegian men were the most negative about parental perceptions on alcohol measures. Regarding perceptions on parental measures on drug use, Dutch and Norwegian lifetime cannabis users and current cannabis users supported parental measures to a lesser extent. Overall, the results suggest that both Dutch and Norwegian parents feel the responsibility to provide measures to prevent children from alcohol and drug use, irrespective of the alcohol and drug policy in their own country. Both the Dutch and Norwegian supported parental measures to prevent adolescents from substance use.     

Relations among parental substance use, violence exposure and mental health: the national survey of adolescents

OBJECTIVE: To study the relations among parental substance use, violence exposure and psychopathology in a nationally representative sample of adolescents. METHOD: Random digit dialing methodology was used to obtain a nationally representative sample of 4023 adolescents, ages 12-17. Telephone surveys, conducted in 1995, assessed demographics, parental substance use, violence exposure, and three psychiatric disorders: major depressive disorder (MDE), posttraumatic stress disorder (PTSD), and substance abuse/dependence (SA/D). RESULTS: Obtained prevalence rates included: 8.2% for sexual assault, 22.5% for physical assault, and 39.7% for witnessing violence at home or in the community. Substance use by a family member was reported by 18.4% (n=721) of adolescents, with 50.6% reporting parental alcohol use and 19.1% (n=138) reporting parental drug use. Consistent with hypotheses, violence exposure and parental substance use, particularly parental alcohol abuse, were independently associated with outcomes. Additionally, parental substance use emerged as a moderator for MDE, PTSD, and SA/D; however, the moderating relations varied according to the outcome variable investigated. CONCLUSIONS: Violence-exposed adolescents reporting parental alcohol or drug use had the highest rates of psychiatric diagnoses.     

Interpersonal conflict tactics and substance use among high-risk adolescents

Adolescents who use aggressive tactics to handle interpersonal conflicts may be at high risk for substance use, while adolescents who possess coping strategies to avoid or manage interpersonal conflict may be at lower risk for substance use. This study examined the association between interpersonal conflict tactics and substance use among 631 continuation high school students. Items from a modified Conflict Tactics Scale formed three factors: Physical Aggression, Nonphysical Aggression, and Nonaggression. Logistic regression analyses revealed that adolescents' ways of responding to interpersonal conflicts were associated with their substance use. Use of physical aggression was associated with a higher risk of cigarette, alcohol, marijuana, and other drug use. Use of nonphysical aggression was associated with a higher risk of cigarette and alcohol use. Use of nonaggressive conflict tactics was associated with a lower risk of cigarette use. Adolescents who respond to interpersonal conflicts in an aggressive manner, whether physical or verbal/psychological, may be at increased risk for substance use, while nonaggressive conflict management skills may be protective. Possibly, teaching adolescents nonaggressive techniques for handling interpersonal conflict may be a useful strategy for preventing both interpersonal violence and substance use.     

Gender differences in psychiatric comorbidity among adolescents with substance use disorders

The authors examined gender differences in rates of comorbid psychiatric disorders among adolescents with I or more psychoactive substance use disorders. Baseline diagnostic data were obtained from 135 adolescents, ages 12 to 19, and their parents-guardians, who participated in a study to develop and efficacy test Integrated Family and Cognitive-Behavioral Therapy. Rates of attention-deficit/hyperactivity disorder and conduct disorder were higher among drug-abusing male adolescents compared with drug-abusing female adolescents. However, high rates of disruptive behavior disorders also characterized drug-abusing female adolescents. Similarly, drug-abusing female adolescents exhibited a higher rate of major depression compared with drug-abusing male adolescents. However, rates of dysthymia, double depression (i.e., major depression and dysthymia), and bipolar disorder were equivalent between genders.     

Religiosity, refusal efficacy, and substance use among African-American adolescents and young adults

Research points toward multiple pathways (i.e., psychosocial domains) through which religiosity influences substance use behaviors. This study examined whether refusal efficacy mediated the relationship between religiosity and substance use in African-American adolescents and young adults. Four hundred thirty-five urban and rural African-Americans, aged between 12 and 25, completed measures of private and public religiosity, refusal efficacy, and substance use (i.e., tobacco, alcohol, marijuana, and other illicit drug use). Tests for mediation were computed with private and public religiosity as independent variables, drug refusal efficacy as mediator, and substance use as the criterion. Results show that drug refusal efficacy mediated the relationship between private religiosity and tobacco, marijuana, and other illicit drug use, but not for alcohol use. Refusal efficacy also mediated the relationship between public religiosity and alcohol use, but not for other licit and illicit substances. The findings provide support for the unique impact of public religiosity when considering its role in preventive intervention. Future research should consider examining other psychosocial domains which may mediate the effect of religiosity on substance use behaviors among African-American adolescents.     

Cannabis dependence,withdrawal, and reinforcing effects among adolescents with conduct symptoms and substance use disorders

The prevalence of cannabis use is rising among adolescents, many of whom perceive little risk from cannabis. However, clinicians who treat adolescent substance users hear frequent reports of serious cannabis-use disorders and problems. This study asked whether cannabis produced dependence and withdrawal among such patients, and whether patients' reports supported previous laboratory findings of reinforcing effects from cannabis. This was a screening and diagnostic study of serial treatment admissions. The diagnostic standard was the DSM-III-R dependence criteria, and the setting was a university-based adolescent substance treatment program with male residential and female outpatient services. The patients were 165 males and 64 females from consecutive samples of 255 male and 85 female 13–19-year-olds referred for substance and conduct problems (usually from social service or criminal justice agencies). Eighty-seven patients were not evaluated, usually due to early elopement. Twenty-four others did not meet study admission criteria: ≥one dependence diagnoses and ≥three lifetime conduct-disorder symptoms. The main measures were items from diagnostic interview instruments for substance dependence, psychiatric disorders, and patterns of substance use. Diagnoses were substance dependence, 100%; current conduct disorder, 82.1%; major depression, 17.5%; attention-deficit/hyperactivity disorder, 14.8%. The results show that most patients claimed serious problems from cannabis, and 78.6% met standard adult criteria for cannabis dependence. Two-thirds of cannabis-dependent patients reported withdrawal. Progression from first to regular cannabis use was as rapid as tobacco progression, and more rapid than that of alcohol, suggesting that cannabis is a reinforcer. The data indicate that for adolescents with conduct problems cannabis use is not benign, and that the drug potently reinforces cannabis-taking, producing both dependence and withdrawal. However, findings from this severely affected clinical population should not be generalized broadly to all other adolescents.     

The intersection between response inhibition and substance use among adolescents

Problems related to the capacity to successfully engage response inhibition are considered a risk factor for the development of substance use disorders (SUDs), but the evidence has been predominantly cross-sectional. In this commentary, we argue that recent longitudinal studies with multi-modal measures of response inhibition can improve understanding of how response inhibition may intersect with substance use among adolescents. Most Stop-Signal studies suggest that slower response inhibition predicts substance use progressions, with one multi-site study showing greater fronto-parietal activity indicative of risk. Most Go-NoGo studies suggest that blunted activation of prefrontal cortical areas during response inhibition predicts substance use progressions, while commission errors are less effective in identifying adolescents at risk. Studies differ in subject populations, outcome measures, statistical methods, and BOLD response contrasts, which challenge the capacity to compare and generalize findings. We encourage research teams throughout the globe to undertake multi-modal, longitudinal studies to assess brain functioning with large sample sizes, and when possible, before significant substance use potentially obscures interpretation of findings. Systematic review and meta-analysis of this growing literature are also important goals for future research.     

Factors associated with former smokers among female adolescents in rural Virginia

We examined multiple ecological factors (individual, family, peer, school, and community) associated with female adolescent former smokers (FS), current smokers (CS), and never smokers (NS) in a sample of 2029 seventh to twelfth grade girls living in a rural area of Virginia. We were particularly interesting in examining variables related to FS. Compared to CS, FS reported lower levels of delinquency, less coping by taking drugs, less availability of cigarettes, and less alcohol and marijuana use. They also reported less depression, fewer suicidal thoughts, and fewer suicide attempts than CS. FS reported spending more time in community clubs, had higher self-esteem, obtained higher grades, had more parental monitoring, more parent attachment, and more school attachment than CS. Logistical regression analysis predicting current or former smoking status revealed significant effects on coping by taking drugs, alcohol use, depression, grades, parental monitoring, and perceived availability of cigarettes. The findings have implications for smoking intervention programs with adolescent girls in rural areas.     

The association of current stimulant use with demographic, substance use, violence-related, social and intrapersonal variables among high risk youth

This paper reports the association of current stimulant use with demographic, other substance use, violence-related, social and intrapersonal variables among a large sample of high risk adolescents. A total of 21.4% of the sample reported using stimulants in the last 30 days. In a final, multivariable model, nonredundant concurrent predictors of current stimulant use were reports that friends use stimulants, reports that stimulants were likely to be used again in the next 12 months, use of alcohol, hallucinogens, or cocaine in the last 30 days, use of alcohol or other drugs to feel more safe, and reports of depression in the last week. Being above the median on 0 to all 7 of these correlates predicted from 0% to 85% of those who were above the median on current stimulant use. One may speculate that programming for these stimulant-using youth should include treatment of multiple substances, depression, and correction of social-cognitive misperceptions.     

High prevalence of substance use disorders among adolescents who use marijuana and inhalants

BACKGROUND: We examined the association between the use of inhalants, marijuana, and other drugs and recent DSM-IV substance use disorders among adolescents aged 12-17 years. METHODS: Data were drawn from 2000 to 2001 National Household Surveys on Drug Abuse. Adolescents aged 12-17 years who reported having ever used an illicit drug in their lifetime were categorized into four mutually exclusive groups: inhalant users (16%), marijuana users (53%), inhalant and marijuana users (16%), and other drug users (15%). Logistic regression models were used to estimate associations with recent substance use diagnoses among lifetime adolescent drug users (N=10,180). RESULTS: We found that 31% of lifetime drug users reported having never used marijuana. One half of these atypical drug users were predominantly nonmedical users of pain relievers. Adolescents who used inhalants or other drugs but not marijuana were least likely to report multidrug use. Adolescents who reported using both inhalants and marijuana were most likely to use three or more classes of drugs (73%) and to receive a diagnosis of past year alcohol (35%) and drug (39%) abuse or dependence. CONCLUSIONS: Our study findings suggest that among lifetime adolescent drug users, those who use both inhalants and marijuana are at very high risk for alcohol and drug use disorders.     

Flavored tobacco use is associated with dual and poly tobacco use among adolescents

ObjectivesThis study examines the relationships between flavored tobacco use and single, dual, and poly tobacco product use, among adolescents. Given the increased use of flavored tobacco products, it is vital to understand if flavored products are associated with dual and poly tobacco product use.MethodsData were obtained from the 2017 National Youth Tobacco Survey. Participants were 2042 adolescent past 30-day tobacco users. Multivariable multinomial logistic regression models were used to assess the relationship between flavored tobacco use and past 30-day single, dual, and poly (three or more) tobacco product use. Two analyses were conducted using different categories as referent groups to allow for a comprehensive examination of the relationship between all groups. Covariates included sex, grade level, race/ethnicity and exposure to tobacco marketing.ResultsApproximately half of all adolescent tobacco users (45.7%) reported use of more than one product. The majority of adolescent tobacco users reported using flavors (69.4%). Flavored tobacco use was significantly correlated with a greater risk of dual (RRR: 2.09) and poly (RRR: 5.54) tobacco use, relative to single product use, controlling for covariates. Similarly, flavored tobacco use was significantly correlated with a greater risk of poly (RRR: 2.66) tobacco use, relative to dual tobacco use, controlling for covariates.ConclusionsA positive relationship was observed for flavored tobacco use and multiple tobacco product use. Findings suggest the need to consider stronger regulations of flavored tobacco products. Similarly, as most adolescent tobacco users reported using flavors, findings suggest the need to emphasize flavored tobacco use in prevention and education programs.     

Tobacco use and psychiatric comorbidity among adolescents in substance abuse treatment

Adolescents in substance abuse treatment have approximately four times higher rates of tobacco use compared with adolescents in the general population, yet many substance abuse treatment programs do not provide tobacco cessation interventions. This study examined change in tobacco use among 151 adolescents in state-funded substance abuse treatment from intake to 12-month follow-up in relation to psychiatric comorbidity and substance use. Most adolescents (67.5%) used tobacco at intake and follow-up. Having a diagnosis of a mood, anxiety, or behavioral disorder was significantly associated with change in tobacco use. Individuals with a psychiatric disorder were less likely to be nonusers of tobacco than to be individuals who continued tobacco use (adjusted odds ratio [OR] = 0.153, 95% confidence interval [CI] = 0.040-0.587, p < .01), and they were less likely to have initiated tobacco use at follow-up than individuals who continued tobacco use (adjusted OR = 0.320, 95% CI = 0.105-0.970, p < .05). Contrary to the hypothesis, alcohol use and drug use during the 12-month follow-up was not significantly related to change in tobacco use. Adolescents in substance abuse treatment with comorbid psychiatric disorders may be particularly vulnerable to continuing tobacco use.