51
|
Borders TF, Stewart KE, Wright PB, Leukefeld C, Falck RS, Carlson RG, Booth BM. Risky sex in rural America: longitudinal changes in a community-based cohort of methamphetamine and cocaine users. Am J Addict 2013; 22:535-42. [PMID: 24131160 DOI: 10.1111/j.1521-0391.2013.12028.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 02/17/2012] [Accepted: 10/02/2012] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study examined the longitudinal associations between stimulant use and sexual behaviors. METHODS Data are from a 3-year community-based study of 710 rural stimulant users. Past 30-day crack cocaine, powder cocaine, and methamphetamine use and sexual behaviors (any sex, inconsistent condom use, and multiple sexual partners) were assessed through in-person interviews every 6 months. RESULTS GEE analyses revealed that the odds of having sex remained steady over time, with crack cocaine and methamphetamine use positively associated with having sex. The odds of multiple sexual partners declined, but the odds of inconsistent condom use remained steady over time. Crack cocaine use was positively associated with multiple sexual partners, whereas powder cocaine use was negatively associated with inconsistent condom use. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Many rural stimulant users could potentially benefit from safe sex educational programs. Such efforts could reduce the incidence of HIV and other STIs in rural America.
Collapse
|
52
|
Borders TF, Booth BM. Stimulant use, religiosity, and the odds of developing or maintaining an alcohol use disorder over time. J Stud Alcohol Drugs 2013; 74:369-377. [PMID: 23490565 PMCID: PMC3602357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 11/07/2012] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Little is known about whether cocaine or methamphetamine use, particularly among stimulant users residing in rural areas, is associated with increased odds of developing or maintaining an alcohol use disorder (AUD) over time. One factor that may help to protect some users against the development of an AUD is religiosity. This study examined how stimulant use and religiosity are associated longitudinally with the odds of an AUD among a rural population-based cohort of stimulant users. METHOD Recent stimulant users (N = 710) were recruited via respondent-driven sampling and were interviewed every 6 months over a 3-year period. Concurrent and lagged generalized estimating equations analyses were conducted to estimate how past-30- day crack cocaine, powder cocaine, and methamphetamine use; religiosity; and other covariates were associated with the odds of an AUD. RESULTS At baseline, 56% of the participants met AUD criteria. The odds of an AUD declined significantly over time in the concurrent, but not the lagged, model. Crack cocaine use was associated with increased odds of an AUD in both models, although the strength of the concurrent association between an AUD and crack cocaine use declined over time. Powder cocaine use and more frequent church attendance also were concurrently associated with decreased odds of an AUD. CONCLUSIONS Rural stimulant users, especially those using cocaine, could potentially benefit from treatment for both alcohol use and stimulant use. In addition, our findings suggest that greater frequency of church attendance may be related to lower odds of the development or maintenance of an AUD.
Collapse
|
53
|
Wright PB, Curran GM, Stewart KE, Booth BM. A qualitative analysis of provider barriers and solutions to HIV testing for substance users in a small, largely rural southern state. J Rural Health 2013; 29:420-31. [PMID: 24088216 DOI: 10.1111/jrh.12021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Integrating HIV testing programs into substance use treatment is a promising avenue to help increase access to HIV testing for rural drug users. Yet few outpatient substance abuse treatment facilities in the United States provide HIV testing. The purpose of this study was to identify barriers to incorporating HIV testing with substance use treatment from the perspectives of treatment and testing providers in Arkansas. METHODS We used purposive sampling from state directories to recruit providers at state, organization, and individual levels to participate in this exploratory study. Using an interview guide, the first and second authors conducted semistructured individual interviews in each provider's office or by telephone. All interviews were recorded, transcribed verbatim, and entered into ATLAS.ti software (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany). We used constant comparison and content analysis techniques to identify codes, categories, and primary patterns in the data. FINDINGS The sample consisted of 28 providers throughout the state, 18 from the substance use system and 10 from the public/ community health system. We identified 7 categories of barriers: environmental constraints, policy constraints, funding constraints, organizational structure, limited inter- and intra-agency communication, burden of responsibility, and client fragility. CONCLUSIONS This study presents the practice-based realities of barriers to integrating HIV testing with substance use treatment in a small, largely rural state. Some system and/or organization leaders were either unaware of or not actively pursuing external funds available to them specifically for engaging substance users in HIV testing. However, funding does not address the system-level need for coordination of resources and services at the state level.
Collapse
|
54
|
Wright PB, Stewart KE, Curran GM, Booth BM. A Qualitative Study of Barriers to the Utilization of HIV Testing Services Among Rural African American Cocaine Users. JOURNAL OF DRUG ISSUES 2013; 43:314-334. [PMID: 24039279 DOI: 10.1177/0022042613476260] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative study is about barriers to the utilization of HIV testing as perceived by African Americans who have recently used cocaine and who live in the rural Delta region of Arkansas. Affordability, physical accessibility, and geographic availability were not perceived as barriers to HIV testing in this sample, yet acceptability was still perceived as poor. Acceptability due to social mores and norms was a major barrier. Many said testing was unacceptable because of fear of social costs. Many were confident of being HIV-negative based on risky assumptions about testing and the notification process. Small-town social and sexual networks added to concerns about reputation and risk. System approaches may fail if they focus solely on improving access to HIV services but do not take into consideration deeply internalized experiences of rural African Americans as well as involvement of the community in developing programs and services.
Collapse
|
55
|
Forman-Hoffman VL, Mengeling M, Booth BM, Torner J, Sadler AG. Eating Disorders, Post-Traumatic Stress, and Sexual Trauma in Women Veterans. Mil Med 2012; 177:1161-8. [DOI: 10.7205/milmed-d-12-00041] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
56
|
Edlund MJ, Booth BM, Han X. Who seeks care where? Utilization of mental health and substance use disorder treatment in two national samples of individuals with alcohol use disorders. J Stud Alcohol Drugs 2012; 73:635-46. [PMID: 22630802 DOI: 10.15288/jsad.2012.73.635] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Only a fraction of individuals with alcohol use disorders (AUDs) receive any AUD treatment during a given year. If a substantial proportion of individuals with unmet need for AUD treatment are receiving mental health treatment, accessibility of AUD treatment could potentially be improved by implementing strategies to ensure that individuals receiving mental health care are referred to the AUD sector or by increasing rates of AUD treatment in individuals receiving mental health treatment. METHOD We assessed patterns and predictors of mental health treatment and AUD treatment among individuals with 12-month AUDs, using secondary data analyses from two national surveys, the National Survey on Drug Use and Health (NSDUH; n = 4,545 individuals with AUDs) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 3,327 individuals with AUDs). RESULTS In both NSDUH and NESARC, 8% of individuals with AUDs reported past-year AUD treatment. Among individuals with AUDs, mental health treatment was more common than AUD treatment, with 20% of NSDUH respondents and 11% of NESARC respondents reporting receiving mental health treatment. Greater mental health morbidity increased the odds of mental health treatment, and AUD severity increased the odds of AUD treatment. Mental health morbidity also increased the odds of AUD treatment, mainly by increasing the odds of receiving the category of both AUD and mental health treatment. CONCLUSIONS Because individuals with AUDs are more likely to receive mental health treatment than AUD treatment, a key opportunity to improve the overall accessibility of treatment for AUDs may be to focus on improving AUD treatment among individuals receiving mental health treatment.
Collapse
|
57
|
Booth BM, Curran GM, Han X, Edlund MJ. Criminal justice and alcohol treatment: results from a national sample. J Subst Abuse Treat 2012; 44:249-55. [PMID: 22954511 DOI: 10.1016/j.jsat.2012.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 06/09/2012] [Accepted: 07/03/2012] [Indexed: 10/27/2022]
Abstract
This study investigates the associations of recent criminal justice involvement with perceived need for alcohol treatment and alcohol treatment utilization, adjusting for demographic and clinical characteristics. We examined a national sample of adults with alcohol use disorders (N=4390) from the 2006 National Survey on Drug Use and Health. Almost 15% reported criminal justice involvement in the past year. Generalized logit models regressed perceived need for alcohol or drug treatment and past year treatment utilization (versus neither) on past year legal involvement, demographic, and clinical information. In general, results found stronger associations between frequency of criminal justice involvement for treatment utilization compared to perceived need for treatment alone. Treatment utilization was also associated with being on probation, arrests for drug possession/sale and driving under the influence but perceived need was not. Study results suggest opportunities for interventions to increase treatment rates or treatment need, a major correlate of treatment utilization.
Collapse
|
58
|
Small J, Ounpraseuth S, Curran GM, Booth BM. Motivation to change as a mediator for the longitudinal relationships of gender and alcohol severity with one-year drinking outcome. J Stud Alcohol Drugs 2012; 73:504-13. [PMID: 22456256 DOI: 10.15288/jsad.2012.73.504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We examined whether motivation to change mediated the relationships between gender and baseline alcohol severity with drinking outcome at 12-month follow-up in a longitudinal community sample. METHOD Data were from baseline and 12-month interviews from the Rural Alcohol Study, a probability sample of rural and urban at-risk drinkers (N = 733) from six southern states. At-risk drinkers were identified through a telephone-screening interview. Measures of motivation (problem recognition and taking action) were the resultant two factors derived from the Stages of Change Readiness and Treatment Eagerness Scale. Items on social consequences of drinking measured alcohol severity. Structural equation models examined relationships between baseline alcohol severity and motivation with drinks per drinking day at 12 months. RESULTS We identified significant, direct paths between drinking at 12 months and alcohol severity and taking action with an unstandardized estimate of 0.116 (p < .05), alcohol severity and problem recognition (0.423, p < .01), and each of the two "motivation" latent constructs-problem recognition (1.846, p < .01) and taking action (-0.660, p < .01). Finally, the combined direct and negative effect of gender on alcohol consumption at 12-month follow-up was statistically significant, with an unstandardized estimate of -0.970 (p < .01). CONCLUSIONS The current study offers evidence for motivation to change as a viable mechanism through which alcohol severity is associated with subsequent drinking outcomes. More research is needed to further explore the persistence of motivation to change on drinking outcomes over time.
Collapse
|
59
|
Bradley CS, Nygaard IE, Mengeling MA, Torner JC, Stockdale CK, Booth BM, Sadler AG. Urinary incontinence, depression and posttraumatic stress disorder in women veterans. Am J Obstet Gynecol 2012; 206:502.e1-8. [PMID: 22631867 PMCID: PMC3381607 DOI: 10.1016/j.ajog.2012.04.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 03/03/2012] [Accepted: 04/10/2012] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To study associations between urinary incontinence (UI) symptoms, depression, and posttraumatic stress disorder in women veterans. STUDY DESIGN This cross-sectional study enrolled women 20 to 52 years of age registered at 2 midwestern US Veterans Affairs Medical Centers or outlying clinics within 5 years preceding study interview. Participants completed a computer-assisted telephone interview assessing urogynecologic, medical, and mental health. Multivariable analyses studied independent associations between stress and urgency UI and depression and posttraumatic stress disorder. RESULTS Nine hundred sixty-eight women mean aged 38.7 ± 8.7 years were included. Of these, 191 (19.7%) reported urgency/mixed UI and 183 (18.9%) stress UI. Posttraumatic stress disorder (odds ratio, 1.8; 95% confidence interval, 1.0-3.1) but not depression (odds ratio, 1.2; 95% confidence interval, 0.73-2.0) was associated with urgency/mixed UI. Stress UI was not associated with posttraumatic stress disorder or depression. CONCLUSION In women veterans, urgency/mixed UI was associated with posttraumatic stress disorder but not depression.
Collapse
|
60
|
Burnett-Zeigler I, Walton MA, Ilgen M, Barry KL, Chermack ST, Zucker RA, Zimmerman MA, Booth BM, Blow FC. Prevalence and correlates of mental health problems and treatment among adolescents seen in primary care. J Adolesc Health 2012; 50:559-64. [PMID: 22626481 DOI: 10.1016/j.jadohealth.2011.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 10/06/2011] [Accepted: 10/08/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE In this study, we describe the characteristics of adolescents with mental health problems among those presenting to primary care clinics in urban areas. METHODS The sample included 1,076 adolescents aged 12-18 years who presented to federally qualified community health clinics in urban cities in the Midwest. Bivariate and multivariate logistic regression analyses were conducted to examine the associations between having a mental health problem with demographic characteristics, health-related variables, and other risk and promotive factors. We also examined the use of health services and involvement in activities among those with mental health problems. RESULTS Approximately 14% of adolescents screened positive for a mental health problem; among those with a mental health problem, 42.8% received mental health services in the past 3 months. In the multivariate logistic regression analysis, adolescents who were female, with poorer grades, fair to poor self-reported health, using drugs, and lower parental monitoring were more likely to have a mental health problem. In bivariate analyses, adolescents with mental health problems were less likely to participate in school activities and community activities and more likely to use emergency room services. CONCLUSIONS Adolescents with mental health problems were more likely to have several other difficulties including poor grades, poor self-rated health, drug/alcohol use, and sexual activity. This study highlights the importance of screening youth with multidimensional needs and referring them to the appropriate services.
Collapse
|
61
|
Kramer TL, Han X, Booth BM. Young adult, rural, African American stimulant users: antecedents and vulnerabilities. J Ethn Subst Abuse 2012; 8:378-99. [PMID: 20098663 DOI: 10.1080/15332640903327393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Early initiation of substance use appears to be an alarming trend among rural minorities. This study focuses on 18- to 21-year-old African American stimulant users in the Arkansas Mississippi Delta. Most participants had no high school diploma and were unemployed; 74.5% had already been arrested. Substance use was initiated early and nearly all of the men and three-quarters of the women already met criteria for lifetime abuse or dependence. Only 18% reported that they had ever received substance abuse treatment. The results suggest that substance use interventions in rural communities will require multi-faceted strategies addressing economic, educational and healthcare disparities.
Collapse
|
62
|
Borders TF, Booth BM. Stimulant use trajectories and the longitudinal risk of heavy drinking: findings from a rural population-based study. Addict Behav 2012; 37:269-72. [PMID: 22112423 DOI: 10.1016/j.addbeh.2011.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 08/04/2011] [Accepted: 11/01/2011] [Indexed: 11/17/2022]
Abstract
The extant literature offers little information about the longitudinal course of alcohol use among stimulant users, particularly those in rural areas, but it is plausible that reductions in stimulant use are accompanied by increases in heavy drinking. The objective of this study was to examine the longitudinal relationships between heavy drinking days and latent trajectories of powder cocaine, crack cocaine, and methamphetamine use. Participants (n=710) were identified via Respondent-Driven Sampling in 3 rural communities in each of 3 states, with interviews conducted every 6 months over 3 years. Latent trajectory classes for powder cocaine, crack cocaine, and methamphetamine use were identified by conducting latent class growth analysis (LCGA). Generalized linear models (GLM) were conducted to examine how these latent classes were associated with the number of heavy drinking days in the past 30 days. Heavy drinking days did not significantly change over time when adjusting for covariates. Compared to those with a "fast low" trajectory of crack use, those with "steady high" and "declining" trajectories had more heavy drinking days. Compared to those with a "fast low" trajectory of powder cocaine use, those with a "steady moderate" trajectory had more heavy drinking days. Trajectories of methamphetamine use were not significantly associated with heavy drinking days. In conclusion, heavy alcohol use changes little over time among rural stimulant users. Many rural cocaine users could potentially benefit from interventions aimed at curtailing heavy drinking.
Collapse
|
63
|
Sadler AG, Mengeling MA, Torner JC, Syrop CH, Booth BM. The Authors Reply. J Womens Health (Larchmt) 2012. [DOI: 10.1089/jwh.2012.3515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
64
|
Kramer TL, Borders TF, Tripathi S, Lynch C, Leukefeld C, Falck RS, Carlson RG, Booth BM. Physical victimization of rural methamphetamine and cocaine users. VIOLENCE AND VICTIMS 2012; 27:109-124. [PMID: 22455188 PMCID: PMC3343718 DOI: 10.1891/0886-6708.27.1.109] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Substance use and physical violence often coincide, but little has been published on the correlates associated with receipt of partner versus nonpartner physical violence for rural users of methamphetamine and/or cocaine. In this study, participants' substance use, depression and past-year physical victimization were assessed. In separate logistic regression models, received partner violence in females was associated with age; alcohol, cocaine, and methamphetamine abuse/dependence; and number of drugs used in the past 6 months. In males, received nonpartner violence was associated with age, cocaine abuse/dependence, and being Caucasian. Findings suggest a relationship between stimulant use and received violence among rural substance users and a need for victimization screenings in settings where such individuals seek health care.
Collapse
|
65
|
Montgomery BEE, Stewart KE, Wright PB, McSweeney J, Booth BM. "We as drug addicts need that program": Insight from rural African American cocaine users on designing a sexual risk reduction intervention for their community. Subst Use Misuse 2012; 47:44-55. [PMID: 22216991 PMCID: PMC3655713 DOI: 10.3109/10826084.2011.628734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This focused ethnographic study examines data collected in 2007 from four gender- and age-specific focus groups (FGs) (N = 31) to inform the development of a sexual risk reduction intervention for African American cocaine users in rural Arkansas. A semi-structured protocol was used to guide audio-recorded FGs. Data were entered into Ethnograph and analyzed using constant comparison and content analysis. Four codes with accompanying factors emerged from the data and revealed recommendations for sexual risk reduction interventions with similar populations. Intervention design implications and challenges, study limitations, and future research are discussed. The study was supported by funds from the National Institute of Nursing Research (P20 NR009006-01) and the National Institute on Drug Abuse (1R01DA024575-01 and F31 DA026286-01).
Collapse
|
66
|
Sadler AG, Mengeling MA, Syrop CH, Torner JC, Booth BM. Lifetime Sexual Assault and Cervical Cytologic Abnormalities Among Military Women. J Womens Health (Larchmt) 2011; 20:1693-701. [DOI: 10.1089/jwh.2010.2399] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
67
|
Abstract
Many e-health technologies are available to promote virtual patient-provider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital "encounterless" utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access.
Collapse
|
68
|
Curran GM, Ounpraseuth ST, Allee E, Small J, Booth BM. Trajectories in use of substance abuse and mental health services among stimulant users in rural areas. Psychiatr Serv 2011; 62:1230-2. [PMID: 21969653 PMCID: PMC3374953 DOI: 10.1176/ps.62.10.pss6210_1230] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study examined substance abuse and mental health service utilization during a three-year period among stimulant users living in rural areas. METHODS Participants (N=710) were interviewed at baseline and every six months for 36 months. One-step transition probabilities were constructed between the two types of service use for each consecutive pair of interviews to examine the resulting steady-state probabilities among multiple one-step transition matrices. RESULTS Most participants received no substance abuse or mental health services. On average, the probabilities of reporting use of the same types of services during the 36-month follow-up were 82% for receiving neither service, 9% for receiving only mental health treatment, 6% for receiving only substance abuse treatment, and 2% for receiving both services. CONCLUSIONS Further study is needed to determine factors that affect the decision to seek mental health or substance abuse treatment among residents of rural communities.
Collapse
|
69
|
Sexton RL, Carlson RG, Leukefeld CG, Booth BM. Methamphetamine Use and Adverse Consequences in the Rural Southern United States: An Ethnographic Overview. J Psychoactive Drugs 2011; Suppl 3:393-404. [PMID: 17357531 DOI: 10.1080/02791072.2006.10400603] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Research on methamphetamine use and related issues often uses data from in-treatment and post-treatment populations in urban areas. Rural ethnographic studies are less common, particularly self-assessments by active methamphetamine users that explore use patterns and their adverse consequences. Such work is especially rare in the rural South, where illicit methamphetamine manufacture and use have recently been increasing. This article presents an ethnographic overview of methamphetamine use in rural Kentucky and Arkansas based on qualitative interviews conducted with 34 active, not-in-treatment, primary methamphetamine users. Methamphetamine supply, distribution, and prevalence of methamphetamine use are described. Pathways and motivations for methamphetamine use and use patterns are outlined as well. A discussion of the adverse consequences and potential risks of methamphetamine use follows. The findings indicate that informed drug treatment outreach and reduction of potential adverse consequences among methamphetamine users in rural areas are important issues for public health and for interventions.
Collapse
|
70
|
Pope SK, Falck RS, Carlson RG, Leukefeld C, Booth BM. Characteristics of rural crack and powder cocaine use: gender and other correlates. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2011; 37:491-6. [PMID: 21851207 DOI: 10.3109/00952990.2011.600380] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Little is known about the relationship of gender with cocaine use in rural areas. This study describes these relationships among stimulant users residing in rural areas of Arkansas, Kentucky, and Ohio. OBJECTIVES Understanding the characteristics of crack and powder cocaine users in rural areas may help inform prevention, education, and treatment efforts to address rural stimulant use. METHODS Participants were 690 stimulant users, including 274 (38.6%) females, residing in nine rural counties. Cocaine use was measured by self-report of cocaine use, frequency of use, age of first use, and cocaine abuse/dependence. Powder cocaine use was reported by 49% of this sample of stimulant users and 59% reported using crack cocaine. FINDINGS Differing use patterns emerged for female and male cocaine users in this rural sample; females began using alcohol, marijuana, and cocaine at later ages than males but there were no gender differences in current powder cocaine use. Females reported more frequent use of crack cocaine and more cocaine abuse/dependence than males, and in regression analyses, female crack cocaine users had 1.8 times greater odds of reporting frequent crack use than male crack users. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE These findings suggest differing profiles and patterns of cocaine use for male and female users in rural areas, supporting previous findings in urban areas of gender-based vulnerability to negative consequences of cocaine use. Further research on cocaine use in rural areas can provide insights into gender differences that can inform development and refinement of effective interventions in rural communities.
Collapse
|
71
|
Blow FC, Walton MA, Barry KL, Murray RL, Cunningham RM, Massey LS, Chermack ST, Booth BM. Alcohol and drug use among patients presenting to an inner-city emergency department: a latent class analysis. Addict Behav 2011; 36:793-800. [PMID: 21514734 DOI: 10.1016/j.addbeh.2010.12.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 11/19/2010] [Accepted: 12/17/2010] [Indexed: 11/18/2022]
Abstract
The inner city Emergency Department (ED) provides a window of opportunity for screening for alcohol and other drug misuse and substance use disorders (SUDs), in order to facilitate linkage for individuals who are in need of services targeting such issues. The majority of prior work in this area has focused on alcohol use. This study used latent class analyses to characterize substance use/SUDs among adults presenting to the ED for medical complaints or injuries. Participants (n=14,557; 77% participation; 45% male; 54% African-American) completed a computerized survey assessing demographics, health functioning, and substance use/SUDs. Although injured patients were significantly more likely to use tobacco, alcohol, and marijuana, and were more likely to have an alcohol use disorder, presenting complaint was not related to other drug use/diagnoses. Five latent classes were identified: (1) low users/SUDs (65.9%) (2) binge drinkers (24.3%), (3) marijuana users/SUD (3.5%), (4) cocaine users/SUD (2.9%), and (5) poly-drug users (3.3%). Compared to class 1, participants in the other classes were younger, male, without health insurance, with poor mental health functioning, tobacco users, and had prior substance use treatment. African-Americans were most likely to be in classes 3 or 4 and employed participants were most likely to be in class 2. In comparison to class 1, classes 2 and 3 reported better physical health; class 2 was more likely to present for injury whereas class 5 was more likely to present for a medical complaint. ED-based screening and interventions approaches need to address the co-occurrence of alcohol, illicit drug, and psychoactive prescription drug use.
Collapse
|
72
|
Mengeling MA, Sadler AG, Torner J, Booth BM. Evolving Comprehensive VA Women’s Health Care: Patient Characteristics, Needs, and Preferences. Womens Health Issues 2011; 21:S120-9. [DOI: 10.1016/j.whi.2011.04.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 04/19/2011] [Accepted: 04/20/2011] [Indexed: 10/28/2022]
|
73
|
Booth BM, Walton MA, Barry KL, Cunningham RM, Chermack ST, Blow FC. Substance use, depression, and mental health functioning in patients seeking acute medical care in an inner-city ED. J Behav Health Serv Res 2011; 38:358-72. [PMID: 21086057 PMCID: PMC3320727 DOI: 10.1007/s11414-010-9227-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The study investigated the behavioral health of a consecutive sample of 5,641 adult emergency department (ED) patients aged 19 through 60 presenting for medical care in a large, inner-city hospital ED. Twenty-three percent met the criteria for major depression; average mental health functioning, as measured by the mental health component of the SF-12, was half of a standard deviation lower than in the general population; 15% met the criteria for alcohol or drug abuse/dependence in the past year. Comorbidity was high. These behavioral health disorders may complicate treatment and diagnosis of the chief presenting complaint. These findings, coupled with the high rates of these disorders, suggest the importance of screening and either beginning appropriate treatment or offering appropriate referral for such disorders in ED settings.
Collapse
|
74
|
Booth BM, Mengeling M, Torner J, Sadler AG. Rape, sex partnership, and substance use consequences in women veterans. J Trauma Stress 2011; 24:287-94. [PMID: 21567476 DOI: 10.1002/jts.20643] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The association of rape history and sexual partnership with alcohol and drug use consequences in women veterans is unknown. Midwestern women veterans (N = 1,004) completed a retrospective telephone interview assessing demographics, rape history, substance abuse and dependence, depression, and posttraumatic stress disorder (PTSD). One third met lifetime criteria for substance use disorder (SUD), half reported lifetime completed rape, a third childhood rape, one quarter in-military rape, 11% sex with women. Lifetime SUD was higher for women with rape history (64% vs. 44%). Women with women as sex partners had significantly higher rates of all measures of rape, and also lifetime substance use disorder. Postmilitary rape, sex partnership, and current depression were significantly associated with lifetime SUD in multivariate models (odds ratio = 2.3, 3.6, 2.1, respectively). Many women veterans have a high need for comprehensive mental health services.
Collapse
|
75
|
Oser CB, Leukefeld CG, Tindall MS, Garrity TF, Carlson RG, Falck R, Wang J, Booth BM. Rural drug users: factors associated with substance abuse treatment utilization. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2011; 55:567-86. [PMID: 20463206 PMCID: PMC2923294 DOI: 10.1177/0306624x10366012] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The purpose of this study is to use a modified version of Andersen's Behavioral Model of Health Services Use to identify the correlates of the number of substance abuse treatment episodes received by rural drug users. Data were collected from face-to-face interviews with 711 drug users in rural areas of Ohio, Arkansas, and Kentucky. Descriptive analyses examine rural drug users' substance use histories and retrospective substance abuse treatment service utilization patterns. A negative binomial regression model indicated that selected predisposing, historical health, and enabling factors were significantly associated with the utilization of substance abuse treatment among rural drug users. Despite high levels of recent and lifetime self-reported substance use among these rural drug users, treatment services were underutilized. Future studies are needed to examine the impact of the health care system and characteristics of the external environment associated with rural substance abuse treatment in order to increase utilization among drug users.
Collapse
|