Trends in Alcohol‐Related Traffic Risk Behaviors Among College Students

Background: Alcohol‐impaired driving is a major public health problem. National studies indicate that about 25% of college students have driven while intoxicated in the past month and an even greater percentage drive after drinking any alcohol and/or ride with an intoxicated driver. The purpose of this investigation was to examine the change in these various alcohol‐related traffic risk behaviors as students progressed through their college experience. Methods: A cohort of 1,253 first‐time first‐year students attending a large, mid‐Atlantic university were interviewed annually for 4 years. Repeated measures analyses were performed using generalized estimating equations to evaluate age‐related changes in prevalence and frequency of each behavior (i.e., ages 19 to 22). Results: At age 19, 17%_wt of students drove while intoxicated, 42%_wt drove after drinking any alcohol, and 38%_wt rode with an intoxicated driver. For all 3 driving behaviors, prevalence and frequency increased significantly at age 21. Males were more likely to engage in these behaviors than females. To understand the possible relationship of these behaviors to changes in drinking patterns, a post hoc analysis was conducted and revealed that while drinking frequency increased every year, frequency of drunkenness was stable for females, but increased for males. Conclusions: Alcohol‐related traffic risk behaviors are quite common among college students and take a significant upturn when students reach the age of 21. Prevention strategies targeted to the college population are needed to prevent serious consequences of these alcohol‐related traffic risk behaviors.     

Energy drink consumption and increased risk for alcohol dependence

Background: Energy drinks are highly caffeinated beverages that are increasingly consumed by young adults. Prior research has established associations between energy drink use and heavier drinking and alcohol‐related problems among college students. This study investigated the extent to which energy drink use might pose additional risk for alcohol dependence over and above that from known risk factors. Methods: Data were collected via personal interview from 1,097 fourth‐year college students sampled from 1 large public university as part of an ongoing longitudinal study. Alcohol dependence was assessed according to DSM‐IV criteria. Results: After adjustment for the sampling design, 51.3%_wt of students were classified as “low‐frequency” energy drink users (1 to 51 days in the past year) and 10.1%_wt as “high‐frequency” users (≥52 days). Typical caffeine consumption varied widely depending on the brand consumed. Compared to the low‐frequency group, high‐frequency users drank alcohol more frequently (141.6 vs. 103.1 days) and in higher quantities (6.15 vs. 4.64 drinks/typical drinking day). High‐frequency users were at significantly greater risk for alcohol dependence relative to both nonusers (AOR = 2.40, 95% CI = 1.27 to 4.56, p = 0.007) and low‐frequency users (AOR = 1.86, 95% CI = 1.10, 3.14, p = 0.020), even after holding constant demographics, typical alcohol consumption, fraternity/sorority involvement, depressive symptoms, parental history of alcohol/drug problems, and childhood conduct problems. Low‐frequency energy drink users did not differ from nonusers on their risk for alcohol dependence. Conclusions: Weekly or daily energy drink consumption is strongly associated with alcohol dependence. Further research is warranted to understand the possible mechanisms underlying this association. College students who frequently consume energy drinks represent an important target population for alcohol prevention.     

Predictors of Drug Use in Prison among Incarcerated Black Men

Background: Black men currently comprise a substantial percentage of prisoners in the United States. Drug dependence is common among prison populations, and US prisons are high-risk environments for drug use. Prison drug use exacerbates health problems disproportionately prevalent among Black men and prisoners. Objectives: The goal of this research was to examine predictors of prison drug use among incarcerated Black men. Methods: This study examined drug use within the prison environment in a random sample of 134 Black men incarcerated in maximum-security correctional institution. The Addiction Severity Index (ASI) was used to measure illicit drug use history and the extent to which drug use occurred within the prison environment. Results: Seventy-five percent of the participants reported a history of illicit drug use. Overall, 20% (n 25) of the participants, or 25% of those with a history of drug use, reported using drugs during a time frame consistent with incarceration. Participants with lengthier histories of drug use (OR: 1.1, 95% CI 1.0–1.2) and those who were incarcerated longer (OR: 1.1, 95% CI 1.0–1.2) were more likely to use drugs in prison. Drug use in prison was associated with history of injection drug use and with probation/parole status when arrested. Conclusions: Prisoners are engaging in illicit drug use while incarcerated, suggesting that they could benefit from harm reduction and drug treatment services offered during incarceration. Scientific significance: Drug treatment programs that address long-standing addictions and coping mechanisms for lengthy prison stays, specifically, would be especially useful for this population.     

Differences in Self-Reported Discrimination by Primary Type of Drug Used among New York City Drug Users

Background: Illicit drug users experience various forms of discrimination which may vary by type of drug used, as there are different levels of stigma associated with different types of drugs. Objectives: This study investigated self-report of perceived discrimination by primary type of drug used. Methods: This analysis used data from “Social Ties Associated with Risk of Transition into Injection Drug Use” (START), a cross-sectional study of recently initiated injection drug users (IDUs) and prospective study of heroin/crack/cocaine-using non-IDUs (n = 652). Using log binomial regression, the relationship between primary drug used (i.e., single drug used most often) with discrimination due to drug use was examined. Results: Heroin users were significantly more likely (Prevalence ratio (PR): 1.52 (95% Confidence interval (CI): 1.15?2.07)) to report discrimination due to drug use compared to cocaine users. Conclusion and Scientific Significance: More research is needed to understand the mechanism through which discrimination affects heroin users, and its potential relation with other discrimination-related outcomes, namely depression and drug treatment.     

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

ABSTRACT

Background: While drug use is associated with HIV risk in Southeast Asia, little is known about substance use behaviors among women, including drug injection. Objectives: To describe patterns of substance use among women using alcohol and drugs in Malaysia and identify correlates of lifetime and active drug injection, a risk factor for HIV transmission. Methods: A survey of 103 women who used drugs in the last 12 months assessed drug use history and frequency, including drug injection and drug use during pregnancy, self-reported HIV-status, childhood and adulthood physical and sexual abuse, and access to and utilization of harm reduction services, including needle-syringe exchange programs (NSEP) and opioid agonist maintenance therapy (OAT). Principal component analyses (PCA) were conducted to assess drug use grouping. Results: Amphetamine-type substances (ATS; 82.5%), alcohol (75.7%) and heroin (71.8%) were the most commonly used drugs across the lifetime. Drug injection was reported by 32.0% (n = 33) of participants with 21.4% (n = 22) having injected in the last 30 days. PCA identified two groups of drug users: opioids/benzodiazepines and club drugs. Lifetime drug injection was significantly associated with lower education, homelessness, prior criminal justice involvement, opioid use, polysubstance use, childhood physical and sexual abuse, and being HIV-infected, but not with prior OAT. Conclusion: Women who use drugs in Malaysia report high levels of polysubstance use and injection-related risk behaviors, including sharing of injection equipment and being injected by others. Low OAT utilization suggests the need for improved access to OAT services and other harm reduction measures that prioritize women.     

Use of Salvia divinorum in a Nationally Representative Sample

Background: Salvia divinorum has known hallucinogenic effects and is legal in most parts of the United States. Given that this psychoactive substance has a potential of misuse and abuse, further data regarding the clinical and psychosocial factors associated with use are needed. Objectives: To examine the clinical and psychosocial characteristics associated with use of salvia. Methods: The study uses data from the National Survey on Drug Use and Health, 2008 (N = 55,623). Results: The results of this study suggest that salvia use is most common among young adults aged 18–25 years as well as individuals who had engaged in risk-taking behaviors (selling illicit drugs, stealing) or illicit drug use (especially other hallucinogens/ecstasy). Self-reported depression and anxiety were also associated with salvia use. Conclusions/Scientific Significance: The results provide evidence that salvia use is part of a broader constellation of psychosocial and behavioral problems among youth and young adults. The accessibility, legal status, and psychoactive effects of salvia can be a potentially complicating health risk to young people, especially among those with existing substance use problems.