Substance Abuse Prevention:

Recent advances in the field of substance abuse prevention have derived from a consideration of the etiology of substance use and have also been solidly grounded in psychological theory. Evaluation studies of psychosocial prevention interventions have become increasingly rigorous , and clearly demonstrate the there are effective approaches to prevention. The Life Skills Training Program is an example of a competence enhancement approach demonstrates its effectiveness at reducing substance use behavior, experience working with disadvantaged youth suggests the need to broaden the concept of competence enhancement. Specifically, recommendations are made for formalizing the concept of positive life options as a potentially important component of substance abuse prevention.     

Problematic Substance Use Among Hispanic Adolescents and Young Adults: Implications for Prevention Efforts

Using data collected between 2005 and 2012 from a longitudinal study of acculturation patterns and substance use among Hispanic youth in Southern California (N = 2722), we fit multivariate logistic regression models to estimate the association of type and frequency of drug use, friend and parent drug use, cultural orientation (measured by the ARSMA-II), and psychological distress (CES-D score) in 10th grade with problematic substance use (measured with the RAPI) in (i) 11th grade and (ii) young adulthood. We conclude that future intervention efforts with Hispanic adolescents and young adults should target polysubstance and problem users and emphasize inter-individual, structural, and cultural processes as they relate to problematic substance use.     

A Review on Attachment and Adolescent Substance Abuse: Empirical Evidence and Implications for Prevention and Treatment

Background: This paper reviews research on the relation of attachment and substance use disorders (SUD) in adolescence. Based on a theoretical introduction, we review evidence for a possible general link between SUD and insecure attachment, for links between specific forms of SUD and specific patterns of attachment, and for studies on family patterns of attachment in adolescence. Methods: Using medical and psychological databases, we identified 10 studies on adolescent SUD and another 13 studies on adult SUD. Results: Empirical evidence strongly supports the assumption of insecure attachment in SUD samples. With regard to specific patterns of attachment, results mainly point towards fearful and dismissing-avoidance, whereas single studies report preoccupied and unresolved patterns. Results indicate different patterns of attachment in different groups of substance abusers, that is, fearful-avoidant attachment in heroin addicts and more heterogeneous results in abusers of other substances. Explorative data suggest different types of insecure family attachment patterns, which might imply different functions of substance abuse and lead to different treatment recommendations. Methodological problems such as poor assessment of SUD and the use of different measures of attachment limit comparability. Conclusions: Although a lot of research is still needed to address the unknowns in the relation between attachment and SUD, there is strong evidence for a general link between SUD and insecure attachment. Data on connections between different patterns of attachment and different pathways towards SUD are less conclusive but mainly point to disorganized and externalizing pathways. Evidence suggests that fostering attachment security might improve the outcome of state-of-the-art approaches in both early interventional treatment and prevention. Implications for individual and family approaches are outlined.     

Community Asset Assessment and Substance Abuse Prevention:

A case study of substance abuse prevention asset (resiliency) assessment of a Puerto Rican community in New England demonstrates the importance of this approach towards the development of collaborative services between natural support systems and formal human service organizations. A series of recommendations will be provided to help substance abuse-related programs based in communities.     

Nonresponse Bias in Adolescent Substance Abuse Treatment Outcomes Research: Implications for Evaluating Care

ABSTRACT

Nonresponse bias was investigated in an outcomes study of adolescent substance abuse treatment. Treatment-related characteristics of respondents (n = 53) were compared with those of non respondents (n = 61). Statistical analysis showed that few differences were seen between respondents and nonrespondents. The results indicate that outcomes data can be collected in this treatment population that are relatively unaffected by nonresponse bias. Missing responses are shown to be very likely missing at random.     

Widening the Disparity Gap: Differences in Outcomes for Racial and Ethnic Groups in Youth Substance Abuse Prevention Programming

Abstract

This study examined racial and ethnic differences in the outcomes of a universal evidence-based program targeted to children and adolescents. Using data collected in 2015 and 2016 from the Alcohol: True Stories Hosted by Matt Damon program (N?=?925), the study found the outcome of perceptions on risk of harm from alcohol use significantly different between the group of White respondents and the group of non-White respondents, and between the group of Hispanic respondents and the group of non-Hispanic respondents. Program effectiveness was found only among White and non-Hispanic respondents, widening the already existing gap between these populations.     

Network Theory: A Model for Understanding Drug Abuse Among African-American and Hispanic Youth

No significant differences are found in the density or multiplexity of friendship networks of adolescent drug users and non-users. However, users are more likely than non-users to have friends from the same neighborhood, to have more intimate friendship networks, and to change friends over time. Users are less likely to have friends from the same school and to have parents involved in extracurricular activities. Networks of White users and non-users are more similar than those of Hispanics or African Americans.     

Stress, Mental Health and Substance Abuse Problems In a Sample of Diversion Program Youth: An Exploratory Latent Class Analysis

Reflective of interest in mental health and substance abuse issues among youths involved with the justice system, we performed a latent class analysis on baseline information collected on 100 youths involved in two diversion programs. Results identified two groups of youths: Group 1: a majority of the youths, who had high levels of delinquency, mental health and substance abuse issues, Group 2: youths with low levels of these problems. Comparison of these two groups on a variety of psychosocial measures and parent/guardian reports found differences between them that were consistent with their problem group classification. Follow-up analysis confirmed problem behavior that was consistent with the youths' latent class placement. Implications of the findings for research and practice will be presented.     

“Substance Abuse” Disorders among Runaway and Homeless Youth

This study used systematic sampling methods to recruit a sample of 432 homeless youth from both service and natural “hang-out” sampling sites. According to DSM-III criteria, the majority of respondents were classified as having an alcohol and/or illicit “drug abuse” disorder (71%). The results from multivariate logistic regression analyses indicate that cumulative length of time homeless is positively associated with risk for an “abuse” disorder. The implications of these findings and recommendations for service interventions are discussed. [Translations are provided in the International Abstracts Section of this issue.]     

A Pilot Project: Continuing Education for Pharmacists on Substance Abuse Prevention

The American Association of Colleges of Pharmacy advocates that pharmacists can have a significant impact on substance abuse prevention provided they receive adequate training. Continuing education programs are needed to enable practicing pharmacists to augment their limited education. This paper examines the process the Society of Teachers of Family Medicine (STFM) used to develop a pilot continuing education program for pharmacists. With limited literature and a small number of pharmacy teaching about substance abuse, input on topics and training methods was obtained from a convenience sample of practicing pharmacists to enhance the information from the pharmacist faculty regarded as content experts. Results of this pilot study revealed lack of agreement between faculty and practicing pharmacists regarding the prioritizing of content and educational methods. Consequently, input must be obtained from targeted audiences instead of relying solely on the advice of identified academic content experts when designing continuing educational programs. Other professions should consider this process when designing continuing education programs. Pharmacists are poised to play an important role in the prevention of substance abuse problems, but they need continuing education about substance abuse.     

Computer-Assisted HIV Prevention for Youth With Substance Use Disorders

We developed an interactive, customizable, Web-based program focused on the prevention of HIV, sexually transmitted infections, and hepatitis among youth. Results from a randomized, controlled trial with youth in treatment for substance use demonstrated that this Web-based tool, when provided as an adjunct to an educator-delivered prevention intervention, increased accurate prevention knowledge, increased intentions to carefully choose partners, and was perceived as significantly more useful relative to the educator-delivered intervention when provided alone. Results suggest this Web-based program may be effective and engaging and may increase the adoption of effective HIV and disease prevention science for youth. Limitations are discussed.     

Examining Gender Differences in Adolescent Substance Abuse Behavior: Comparisons and Implications for Treatment

ABSTRACT

This study investigates gender differences in adolescent substance abuse behavior, treatment effectiveness, and the associated relationships with pre-, during-, and post-treatment groups of variables. Analyses were performed using 6-month post-treatment follow-up data from over two thousand subjects. T- test analysis showed that females exhibited more psychological difficulties, family-related problems, and sexual abuse experiences, whereas males exhibited worse school and legal problems before treatment. Females also showed better attendance in aftercare or self-help groups and better treatment outcomes than males. Discriminant function analyses indicated that school problems, legal problems, lack of religious involvement, and substance abuse before treatment could discriminate abstinence status for females at 6-month follow-up. Substance abuse before treatment, length of stay, and parental participation in treatment could differentiate abstinence status for males at 6-month follow-up. Limitations in applying research findings and implications for adolescent substance abuse treatment are also discussed.     

Hispanic Substance Use:

No abstract available for this article.     

Effective Treatment for Substance Abuse:

No abstract available for this article.     

Substance Abuse Prevention Program for Children and Adolescents in a Community-Based Clinic

Abstract

This paper describes a community-based substance abuse prevention program utilizing a cognitive-behavioral curriculum to children and adolescents affected by a substance use disorder in a parent or caretaker.     

The California Substance Abuse Research Consortium: origins,history, and issues

When research results are passively presented in the policy world, especially when policy is tied to politics, researchers are often surprised and disappointed that officials do not attend to the obvious applications of their work. Active, timely, bidirectional exchange of information among parties is crucial. However, many contextual influences inhibit exchange efforts and must be recognized and understood in order to be overcome. Obstacles include "political entropy," bureaucratic "deference to hierarchy," media distortions, failure to reimburse provider staff in-service training, and comfort by all with the "way things are." Countering these contextual negative influences requires at least two "champions" (one from the government agency involved and one from academia), persuasion via reason, use of contemporary, politically correct rhetoric, building support through the most important constituencies, and, finally, pluck, persistence, and the ability to adapt to the inevitably changing context. This article discusses each of these aspects and describes examples of problems and solutions that have occurred throughout the history of substance abuse research and information exchange within the context of one key California effort, first known as the State Epidemiology Work Group, and later as the Substance Abuse Research Consortium.     

A Model for the Evaluation of Statewide Substance Abuse Prevention Programs

A recently completed study of the existing substance abuse prevention programs in Iowa is discussed. Content analyses were made of three sets of material: the prevention grants made to (1) community agencies and (2) community/parents' groups which were funded by the Iowa Department Substance Abuse, and (3) state agency documents. The findings revealed that there were articulation problems between the agencies and that the projects were vaguely conceived and evaluated.

Although the federal Community Mental Health Centers Acts of 1963-1965 and the “Hughes Act” of 1970, and various states, have provided funding for substance abuse prevention programs, the overall effectiveness and efficiency of statewide prevention programs have received little attention in publications. A computerized literature search failed to find any evaluations of an overall statewide system.

A number of states-for example, California (California State Plan, 1972) and South Carolina (Twentieth Annual Report, 1976)-have advocated the development of “model” prevention delivery systems, but followup evaluations of the “models” were not apparent. Programs in schools have been evaluated frequently (Kinder, Pape, and Walfish, 1980). However, except for Horman (1975), little has been published on the management of statewide substance abuse programs. Certainly, within the context of the present conservative political trend and federal-level budget problems, the need for statewide system level evaluations will increase.

This paper describes a study which examined the prevention delivery system in one U.S. state—Iowa. The project studied the Iowa Department of Substance Abuse (IDSA), the Department of Public Instruction (DPI), the district Area Education Agencies (AEA), and the 29 community agencies which received IDSA prevention grants in 1983. Also included are the 21 parent/community groups subsidized by the Iowa Department of Substance Abuse in 1981. First, the prevention delivery system is discussed; and the study methodology, findings, and recommendations then follow.     

Adolescent Substance Abuse:

Adolescent substance abuse remains a significant problem confronting the nation. This paper addressed the state of practice with regard to adolescent substance abuse prevention intervention. Data on the extent, nature, and consequences of adolescent substance use are presented and problems with the definition of substance abuse in this population are considered. Primary and secondary prevention programs are discussed, including programs targeting high risk youth, school and peer group, families, and communities. Tertiary prevention intervention efforts are outlines and the need for further treatment research highlighted. In addition, the importance of intervention across multiple populations and systems is emphasized.