Factors Related to Injection Drug Use Among Female Prisoners

Female inmates (N == 655) of a large prison facility in the southeastern United States were surveyed about their substance use, social histories, and demographics. Multinomial logistic regression was used to identify predictors of injection drug use. The sample was primarily young (M == 34 ± 9 years), and evenly split on race (45.3%% White and 44.6%% Black). Four predictors were identified as significant risk factors for injection drug use: being White, having a prior history of substance user treatment, having a prior drug-related charge, and being a problem drinker. Implications, limitations, and future directions are discussed.     

Illicit Drug Use From Adolescence to Young Adulthood Among Child Welfare-Involved Youths

This study examined illicit substance use among 1,004 adolescents, ages 11–21, involved with the Child Welfare System (CWS) and followed from 1999 to 2007. By the time they reached transition age, more than 60% of the sample had used an illicit substance in their lifetime. Predictors of regular use during adolescence were having a prior CWS report, externalizing behavior problems, delinquency, and any sexual experience. Exposure to physical abuse was predictive of escalating substance use trajectories. Protective factors included having a child at any point during the study, parental monitoring, and being placed in kinship care.     

Estimating the Prevalence of Illicit Drug Use Among Students Using the Crosswise Model

Objective: The aim of our study is to compare the prevalence of illicit drug use estimated through a technique referred to as the “crosswise model” (CM) with the results from conventional direct questioning (DQ). Method: About 1,500 students from Tehran University of Medical Sciences 2009–2010 were first interviewed by DQ and, then three months later, by the CM. Result: The CM yielded significantly higher estimates than DQ for lifetime prevalence of use of any illicit drug (CM = 20.2%,DQ = 3.0%, p < .001) and for lifetime prevalence of use of opium or its residue (CM = 13.6%, DQ = 1.0%, p < .001). Also, for use of any illicit drug in the last month and use of opium or its residue in the last month, the CM yielded higher point estimates than DQ, although these differences were not significant (any drug: CM = 1.5%, DQ = 0.2%, p = .66; opium: CM = 3.8%, DQ = 0.0%, p = .21). Conclusion: Our findings suggest that the CM is a fruitful data collection method for sensitive topics such as substance abuse.     

Drug Use Among Prisoners: By Any Definition,It's a Big Problem

According to several studies, the prevalence of drug use among prisoners is manyfold compared to general population. However, comparisons across studies are hampered by the use of a variety of mutually noncomparable methodologies. We report substance use among Finnish prisoners using three methods and analyze these differences. The material consisted of 610 Finnish prisoners in 2006 and represents all Finnish prisoners. The subjects participated in a comprehensive field study including a standardized psychiatric interview (SCID-I). Alcohol abuse/dependence was diagnosed in 68% (SCID-I) and 72% (ICD-10) among men and 70% (both SCID-I and ICD-10) among women. Drug abuse/dependence was diagnosed in 62% (SCID-I) and 69% (ICD-10) among men and 64% (SCID-I) and 70% (ICD-10) among women prisoners. Interview data revealed that the majority had at least tried most substances. Both alcohol and drug abuse/dependence were vastly more common among Finnish prisoners than reported elsewhere. The DSM-IV-based SCID-I produced slightly lower prevalence estimates than an ICD-10 clinical examination, but overall SCID/ICD agreement was very good. It seems that physicians use information other than that captured by standardized structured clinical interview when placing a diagnosis. Nonclinical interview-based prevalence figures may overestimate harmful use of drugs unless known risk patterns of use (e.g., intravenous use) are specifically addressed.     

Conduct Disorder Symptoms and Illicit Drug Use in Juvenile Justice Involved Youth: The Reciprocal Relationship Between Positive Illicit Drug-Use Attitudes and Illicit Drug Use

Conduct disorder (CD) symptoms cooccur at high rates with illicit drug use in juvenile justice involved youth, which results in poorer outcomes; however, research has not identified where best to intervene in this relationship, limiting the identification of modifiable risk factors to reduce negative effects of CD symptoms. Two mediation models were examined to investigate the potential for CD symptoms to influence a reciprocal relationship between illicit drug use and positive drug attitudes, controlling for age, gender, and race. Data were examined for 245 juvenile justice involved youth (mean age = 15.46, SD = 1.30, range 12–18, 64.9% Black, 80.4% male) who completed court-ordered psychological assessments. Findings indicate: (1) Positive attitudes toward illicit drug use significantly mediated the relationship between CD symptoms and illicit drug use (β = 0.16, CI 0.09–0.27; test for indirect effect z = 4.17, p < .001) and (2) illicit drug use significantly mediated the relationship between CD symptoms and positive attitudes toward illicit drug use (β = 0.20, CI 0.12–0.32; test for indirect effect z = 4.87, p < .001). Overall, the present study suggests that CD symptoms impart risk for illicit drug use both indirectly, through more positive attitudes toward illicit drug use, and directly, which further strengthens positive attitudes toward illicit drug use.     

Non Drug Use- and Drug Use-Specific Spirituality as One-Year Predictors of Drug Use Among High-Risk Youth

The present article explored two different dimensions of spirituality that might tap negative and positive relations with adolescent drug use over a 1-year period. Non-drug-use–specific spirituality measured how spiritual the person believes he or she is, participation in spiritual groups, and engagement in spiritual practices such as prayer, whereas drug-use–specific spirituality measured using drugs as a spiritual practice. Self-report questionnaire data were collected during 1997–1999 from a sample of 501 adolescents in 18 continuation high schools across southern California. Participants ranged in age from 14 to 19 and were 57% male, with an ethnic distribution of 34% White, 49% Latino, 5% African American, 7% Asian, and 5% other. A series of general linear model analyses were conducted to identify whether or not two different spirituality variables predict drug use (cigarettes, alcohol, marijuana, hallucinogens, and stimulants) at 1-year follow-up. After controlling for baseline drug use, non-drug-use–specific spirituality was negatively predictive of alcohol, marijuana, and stimulant use, whereas drug-use–specific spirituality failed to be found predictive of these variables one year later. Conversely, drug-use–specific spirituality was positively predictive of cigarette smoking and hallucinogen use, whereas non-drug-use spirituality failed to be found predictive of these variables. Our results provide new evidence that suggests that spirituality may have an effect on drug use among adolescents. The drug-use-specific measure of spirituality showed “risk effects” on drug use, whereas the other measure resulted in “protective effects,” as found in previous research. Knowledge of the risk and protective patterns and mechanisms of spirituality may be translated into future drug use prevention intervention programs.     

Patterns of Drug Use Among Drug Misusers in Sweden. Gender Differences

The goal of the article is to provide information about polydrug abuse and drug misuse patterns in Sweden among women and men. The data has been taken from a 1998 national survey of “Heavy”/severe drug misuse in Sweden, project “MAX-98” (). The drug misusers were reported by various government agencies, including health services, social services, police, and correctional treatment facilities on a special form. One of the significant gender differences that emerged was that a greater percent of the women in the survey used and injected amphetamines, injected opiates, and used tranquilizers/sedatives, while a greater percent of the men smoked cannabis, smoked heroin, and misused alcohol. Furthermore, the most common combinations for both genders was amphetamines + cannabis, followed by amphetamines + heroin + cannabis. Alcohol played a large role for the narcotics users. Heroin as a primary drug has grown in the age groups under 35. The trends document that the use of ecstasy as well as chemical CNS-stimulating/hallucinogenic drugs has grown, that polydrug use has increased compared with earlier surveys, and that the methods of ingestion have changed. It is therefore more precise today to speak of different types of polydrug users than about users of exclusively one drug.     

Illicit Drug Use in a Community-Based Sample of Heterosexually Identified Emerging Adults

In this study we assess lifetime and recent drug use patterns among 261 heterosexually identified 18- to 25-year-olds through brief street intercept surveys conducted in New York City. Marijuana, hallucinogens, powder cocaine, and ecstasy were the most frequently reported drugs for both lifetime and recent use. Findings further suggest significant differences in lifetime use along the lines of gender, race/ethnicity, and school enrollment for various drugs. Males reported using significantly greater numbers of different drugs compared to females, as did those not enrolled in school compared to school enrollees. These data suggest that illicit drug use in emergent adulthood does not develop in a monolithic manner and synergies must be considered in relation to gender, school enrollment, and employment that first surface in the child and adolescent developmental stages. In addition, primary prevention efforts targeting child and adolescent drug use may mitigate the emerging adult and lifetime substance use.     

Illegal Drug Use Among Asian American Youths in Dallas

Abstract

Asian Americans have often been perceived as the “model minority” that is relatively immune to the problem of illegal drug use. This paper examines the patterns and determinants of illegal drug use among first and second-generation Asian American youths in Dallas-an area with rapid Asian population growth. Through a targeted survey, we have found a very high rate of cumulative drug use and a significant rate of current drug use. We have also detected some intra-Asian differences in drug abuse among major Asian groups. The results of our statistical analysis identify several possible correlates of current Asian drug abuse, including gender, differential association, parental warning, GPA, type of neighborhood, and high-school quality.     

Correspondence between Oral Fluid Drug Test Results and Self-Reported Illicit Drug Use among Music Festival Attendees

Background: Use of illicit substances is often under-reported. Testing positive in oral fluid provides an objective confirmation of recent intake. Objectives: To examine the agreement between oral fluid test results and self-reported substance use among music festival attendees, and factors associated with reporting past 48?h drug use among users identified by drug testing. Methods: One thousand three hundred nine participants were recruited from six music festivals in Norway (June–August 2016). They completed a questionnaire and provided oral fluid samples analyzed for amphetamines, MDMA, tetrahydrocannabinol (cannabis), and cocaine. Additionally, their blood alcohol levels were measured. Results: Overall, 5.5% reported use of amphetamines, cannabis, cocaine, and/or MDMA during past 48?h in the questionnaire, whereas 10.8% tested positive in oral fluid. Only 16.7% of identified cocaine users and 31.1% of identified MDMA users reported past 48?h cocaine or MDMA use, respectively. Higher proportions of identified cannabis and amphetamine users reported past 48?h use (53.8% and 55.6%, respectively). Multivariable logistic regression analysis showed that among participants who tested positive, those reporting weekly illicit substance use (Adjusted Odds Ratio [AOR] 30.6; 95% Confidence Interval [CI] 6.3–147.9), and using such substances when younger than 18?years (AOR 5.0; 95% CI 1.9–13.4) were more likely to report past 48?h use. Conclusions/Importance: Oral fluid testing appears to be an important tool when studying illicit substance use among music festival attendees, as significant under-reporting was observed. Among those testing positive, regular, and experienced users were more likely to report recent use, compared to less regular and experienced users.     

New Drug Use Among Agricultural Workers

Research on drug use onset rarely examines the spatial dimensions of onset, owing to a literature that is overwhelming from urban areas of an industrialized country (United States). Narrative interviews from drug-using agricultural workers in contrast reveal another side of drug use onset, where influence of familiarity with place becomes evident, despite the expectation that the novelty and/or adventure within a lifestyle of seasonal employment and migratory labor that requires overnight accommodations on-the-season is likely to push/pull one into the first use of a new drug or the first drug that an individual has ever used.     

Psychotropic Drug Use Among the Elderly: Risk Factors Involved in Long-Term Use

This study explores the environmental, clinical, and personality factors that are associated with increased chronic psychotropic drug consumption in elderly patients. We collected data from 88 elderly individuals living in nursing homes, home-dwellings, and residential homes between December 2003 and June 2004. We assessed each subject's (1) current (previous four weeks) and chronic (>90 days) psychotropic drug consumption, (2) mood and anxiety (GHQ), and (3) personality (Temperament and Character Inventory). We found that 63% of the elderly subjects studied had used psychotropic drugs at least once and that one out of three elderly chronically consumed psychotropic drugs. Personality factors like harm avoidance and low level of persistence seem to be associated with chronic consumption.     

Illicit Drug Use and Social Victimization among Thai Sexual and Gender Minority Adolescents

Objectives: We examined the prevalence of lifetime illicit drug use and social victimization, and their association, among sexual and gender minority (SGM) and non-SGM Thai adolescents. Methods: In 2013, we conducted a school-based national survey among students grades 7–12 (aged 13–20?years) from 15 secondary schools (n?=?2,070) around Thailand. We classified adolescents with same-sex attraction, sexual or gender non-conforming identities as SGM. Generalized estimating equations were used to estimate the odds of illicit drug use by SGM and non-SGM status. Results: Prevalence of lifetime illicit drug use was significantly higher among SGM adolescents than non-SGM adolescents (10.3 vs. 5.3%), but did not differ between those with same-sex attraction and SGM identity (10.3 vs. 10.8%). Among non-SGM adolescents, general social victimization, sexual experience and any school truancy were associated with lifetime illicit drug use (OR = 2.59, 95% CI: 1.53, 4.38; OR = 6.59, 95% CI: 4.90, 8.86; and OR = 4.93, 95% CI: 3.13, 7.75, respectively). Among SGM adolescents, SGM-based social victimization, depressive symptomology and suicidal ideation were associated with lifetime illicit drug use (OR = 3.17, 95% CI: 2.03, 4.95; OR = 5.03, 95% CI: 2.32, 10.90; and OR = 5.03, 95% CI: 2.76, 9.16, respectively). Conclusions: SGM adolescents have higher burden of illicit drug use. Moreover, illicit drug use among SGM adolescents is indicative of depressive symptomology and suicidal ideation. Tailored and comprehensive programs are needed to reduce the gap in burden of illicit drug use between SGM and non-SGM adolescents.     

Age Cohort Differences in Illicit Drug Use and Hepatitis C Among African American Substance Users

Identifying prognostic indicators for undiagnosed Hepatitis C is crucial to attenuate the negative impact of this disease. This study explored the influence of recent and more distal injection drug use on biologically confirmed Hepatitis C infection among a sample (N = 260) of older and younger African Americans. Data from the baseline assessment of the NEURO-HIV epidemiologic study was analyzed using confounder adjusted regression techniques. Older adults were more likely to test positive for Hepatitis C (OR = 2.80, 95% CI = 1.53–5.11) due to lifetime injection drug use (AOR = 5.37, 95% CI = 3.10–9.28). Clinical implications are discussed.     

Initiation to the First Drug Use Among Substance-Dependent Persons in Iran

In the present study, we report the initiation to the first drug in a representative sample of drug dependents in Iran. This is a cross-sectional study with a sample size of 7,743. The participants were characterized as drug dependents according to the Diagnostic and Statistical Manual–Fourth Edition and were sampled from the medical centers, prisons, and streets of the capitals of 29 provinces in the Islamic Republic of Iran. The mean age at first drug use in the sample was 21.1 (6.5), which differed for various first drugs of abuse. Opium was the first drug of use among 46.4% of the sample, and cannabis was the first drug only among 23.5%. The most frequent place of initiation was at a friend's house (n = 2,476, 33.2%). The same-gender friend out of school (the highest rate) was the most frequent person who suggested the first use. A total of 43.5% of the participants started drug use with friends and 18.8% at a friend's party. Policymakers may benefit from considering the information provided here in designing programs with the purpose of prevention.     

The Use of the Case-Crossover Design in Studying Illicit Drug Use

The case-crossover design was developed to study time-varying exposures that cause transient excess risk of acute health events. It is a variant of case-control and subject-as-own-control research designs, involving use of information about exposure history of each case to estimate the transient effect. This kind of self-control design can help to reduce sampling bias otherwise introduced in the selection of controls, as well as confounding bias that might be derived from enduring individual characteristics, especially personality traits and other long-standing inherited or acquired vulnerabilities. When the subject is used as his or her own control, these personal vulnerabilities are matched. In this paper we discuss strengths and weaknesses of the case-crossover design and suggest applications of the case-crossover design in epidemiologic studies on suspected hazards of illicit drug use, and in studies of drug use and co-occurring psychiatric disturbances. We conclude that the case-crossover design can play a useful role, but it discloses a need to secure fine-grained measurements in epidemiologic research on psychiatric comorbidity. As explained in the paper, we also believe the case-crossover method may be of use to criminologists who study the drugs-crime nexus, to services researchers and clinicians who seek to understand treatment entry and compliance behavior, and to etiologists interested in polydrug use. [Translations are provided in the International Abstracts Section of this issue.]     

Getting Higher: Co-Occurring Drug Use Among Marijuana-Using Emerging Adults

The most widely used illicit drug in the United States continues to be marijuana, and its use among emerging adults continues to increase. Marijuana use can result in a range of negative consequences and has been associated with other drug use in adolescents and emerging adults. This study examined the relationship between marijuana use frequency and the use of six other drug classes (opiates, cocaine, stimulants, hallucinogens, inhalants, and sleep medications) among emerging adults. A cross-sectional interview design was used with a community sample of 1,075 emerging adults in the northeastern United States. Using logistic regression analysis controlling for age, ethnicity, gender, and frequency of binge alcohol, daily marijuana use was found to be associated with a significant increase in the expected odds of opiate, cocaine, stimulant, hallucinogen, inhalant, and tobacco use. The findings identify a subgroup of emerging adult marijuana users—those who use daily—that may be vulnerable to additional negative consequences associated with polysubstance use.     

Binge Drug Use Independently Predicts HIV Seroconversion Among Injection Drug Users: Implications for Public Health Strategies

Several studies have highlighted risk factors that cause HIV vulnerability among injection drug users (IDUs); these studies in turn have prompted public health officials to take action to minimize these risks. We sought to evaluate the potential association between binge drug use and HIV seroconversion and, subsequently, risk factors associated with binge drug use among a cohort of IDUs. To do this, we performed analyses of (1) associations with HIV seroconversion and (2) associations with binge drug use among participants enrolled in the Vancouver Injection Drug Users Study (VIDUS), a prospective cohort of IDU. Because serial measures for each individual were available, we undertook a time-updated Cox regression analysis to detect associations with HIV incidence and variables potentially associated with binge drug use were evaluated by using generalized estimating equations (GEE). Overall, 1548 IDU were enrolled into the VIDUS cohort between May 1996 and May 2003. There were 1013 individuals who were HIV seronegative at enrollment and had at least one follow-up visit; 125 (12%) became HIV positive during the study period for a cumulative incidence rate of 14% at 64 months after enrollment. In the final multivariate model, binge drug use [Adjusted Hazards Ratio: 1.61 (CI: 1.12, 2.31)] was independently associated with HIV seroconversion. In subanalyses, when we evaluated associations with binge drug use in GEE analyses, borrowing [Odds Ratio (OR): 153 (CI: 1.33–1.76)] and lending [OR: 1.73 (CI: 1.50–1.98)] syringes, sex trade work [OR: 1.14 (CI: 1.01–1.29)], frequent cocaine [OR: 2.34 (CI: 2.11–2.60)] and heroin [OR: 1.29 (CI: 1.17–1.43)] injection were independently associated with binge drug use and methadone [OR: 0.80 (CI: 0.71–0.89)] was protective against binge drug use. Our study identified an independent association between binge drug use and HIV incidence and demonstrated several high-risk drug practices associated with bingeing. Given the unaddressed public health risks associated with bingeing, a public health response protocol must be developed to minimize the personal and public health risks associated with the binge use of drugs.     

Alcohol and Drug Use and Aberrant Drug-Related Behavior Among Patients on Chronic Opioid Therapy

Objective: To better identify individuals on chronic opioid therapy (COT) at high risk for aberrant-drug related behavior (ADRB). We examine whether patients with low level alcohol and drug use have similar characteristics to those with alcohol and drug disorders. We then examined the relationship of alcohol and drug use to ADRBs among COT patients. Methods: The sample was 972 randomly selected COT patients (age 21–80 years old) from a large health system in Northern California, USA, and interviewed in 2009. Logistic regression models were used to model the dependent variables of: alcohol use, illicit drug use, alcohol disorders, illicit drug disorders, and ADRBs. Results: The odds of daily/weekly alcohol use were lower for those with a high daily opioid dose (120+ mg/day vs. <20 mg/day) (OR = 0.32, p < 0.010). Illicit drug disorders were associated with depression (OR = 2.31, p < .001) and being on a high daily opioid dose (OR = 5.51, p < .01). Participants with illicit drug use had higher odds of giving (OR = 2.57, p < 0.01) and receiving opioids from friends or family (OR = 3.25, p < 0.001), but disorder diagnoses were not associated with ADRBs. Conclusions: Findings reinforce that illicit drug use should be of high concern to clinicians prescribing opioids, and suggest it should be considered separately from alcohol use and alcohol disorders in the evaluation of ADRBs. Frequent alcohol use is low, but not uncommon, and suggests a need to discuss specific issues regarding safe use of opioids among persons who use alcohol that may differ from their risk of drug use.     

基本药物制度下的合理用药探讨

目的：探讨基本药物制度下的合理用药情况。方法：通过对基本药物制度的分析,目前不合理用药的原因的分析．提出促进合理用药的相应意见。结果与结论：建立并完善基本药物制度．促进合理用药。