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Aas M, Etain B, Bellivier F, Henry C, Lagerberg T, Ringen A, Agartz I, Gard S, Kahn JP, Leboyer M, Andreassen OA, Melle I. Additive effects of childhood abuse and cannabis abuse on clinical expressions of bipolar disorders. Psychol Med 2014; 44:1653-1662. [PMID: 24028906 DOI: 10.1017/s0033291713002316] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Previous studies of bipolar disorders indicate that childhood abuse and substance abuse are associated with the disorder. Whether both influence the clinical picture, or if one is mediating the association of the other, has not previously been investigated. METHOD A total of 587 patients with bipolar disorders were recruited from Norway and France. A history of childhood abuse was obtained using the Childhood Trauma Questionnaire. Diagnosis and clinical variables, including substance abuse, were based on structured clinical interviews (Structured Clinical Interview for DSM-IV Axis I disorders or French version of the Diagnostic Interview for Genetic Studies). RESULTS Cannabis abuse was significantly associated with childhood abuse, specifically emotional and sexual abuse (χ 2 = 8.63, p = 0.003 and χ 2 = 7.55, p = 0.006, respectively). Cannabis abuse was significantly associated with earlier onset of the illness (z = -4.17, p < 0.001), lifetime history of at least one suicide attempt (χ 2 = 11.16, p = 0.001) and a trend for rapid cycling (χ 2 = 3.45, p = 0.06). Alcohol dependence was associated with suicide attempt (χ 2 = 10.28, p = 0.001), but not with age at onset or rapid cycling. After correcting for possible confounders and multiple testing, a trend was observed for an interaction between cannabis abuse and childhood abuse and suicide attempt (logistic regression: r 2 = 0.06, p = 0.039). Significant additive effects were also observed between cannabis abuse and childhood abuse on earlier age at onset (p < 0.001), increased rapid cycling and suicide attempt (logistic regression: r 2 = 0.03-0.04, p < 0.001). No mediation effects were observed; childhood abuse and cannabis abuse were independently associated with the disorder. CONCLUSIONS Our study is the first to demonstrate significant additive effects, but no mediation effects, between childhood abuse and cannabis abuse on increased clinical expressions of bipolar disorders.
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Affiliation(s)
- M Aas
- KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - B Etain
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatry, Créteil, France
| | | | - C Henry
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatry, Créteil, France
| | - T Lagerberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - A Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - I Agartz
- KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - S Gard
- Fondation Fondamental, Créteil, France
| | - J-P Kahn
- Fondation Fondamental, Créteil, France
| | - M Leboyer
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatry, Créteil, France
| | - O A Andreassen
- KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - I Melle
- KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway
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HAMMOND CHRISTOPHERJ, PILVER COREYE, RUGLE LOREEN, STEINBERG MARVINA, MAYES LINDAC, MALISON ROBERTT, KRISHNAN-SARIN SUCHITRA, HOFF RANIA, POTENZA MARCN. An exploratory examination of marijuana use, problem-gambling severity, and health correlates among adolescents. J Behav Addict 2014; 3:90-101. [PMID: 25215219 PMCID: PMC4117289 DOI: 10.1556/jba.3.2014.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/14/2014] [Accepted: 01/15/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS Gambling is common in adolescents and at-risk and problem/pathological gambling (ARPG) is associated with adverse measures of health and functioning in this population. Although ARPG commonly co-occurs with marijuana use, little is known how marijuana use influences the relationship between problem-gambling severity and health- and gambling-related measures. METHODS Survey data from 2,252 Connecticut high school students were analyzed using chi-square and logistic regression analyses. RESULTS ARPG was found more frequently in adolescents with lifetime marijuana use than in adolescents denying marijuana use. Marijuana use was associated with more severe and a higher frequency of gambling-related behaviors and different motivations for gambling. Multiple health/functioning impairments were differentially associated with problem-gambling severity amongst adolescents with and without marijuana use. Significant marijuana-use-by-problem-gambling-severity-group interactions were observed for low-average grades (OR = 0.39, 95% CI = [0.20, 0.77]), cigarette smoking (OR = 0.38, 95% CI = [0.17, 0.83]), current alcohol use (OR = 0.36, 95% CI = [0.14, 0.91]), and gambling with friends (OR = 0.47, 95% CI = [0.28, 0.77]). In all cases, weaker associations between problem-gambling severity and health/functioning correlates were observed in the marijuana-use group as compared to the marijuana-non-use group. CONCLUSIONS Some academic, substance use, and social factors related to problem-gambling severity may be partially accounted for by a relationship with marijuana use. Identifying specific factors that underlie the relationships between specific attitudes and behaviors with gambling problems and marijuana use may help improve intervention strategies.
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Affiliation(s)
- CHRISTOPHER J. HAMMOND
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, USA
| | - COREY E. PILVER
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, USA
| | | | | | - LINDA C. MAYES
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - ROBERT T. MALISON
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, USA
| | - SUCHITRA KRISHNAN-SARIN
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, USA
| | - RANI A. HOFF
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, USA
- Department of Epidemiology, Yale University School of Medicine, New Haven, CT, USA
| | - MARC N. POTENZA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA
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Chi FW, Weisner C, Grella CE, Hser YI, Moore C, Mertens J. Does age at first treatment episode make a difference in outcomes over 11 years? J Subst Abuse Treat 2014; 46:482-90. [PMID: 24462221 PMCID: PMC3940137 DOI: 10.1016/j.jsat.2013.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 11/26/2013] [Accepted: 12/09/2013] [Indexed: 12/29/2022]
Abstract
This study examines the associations between age at first substance use treatment entry and trajectory of outcomes over 11 years. We found significant differences in individual and treatment characteristics between adult intakes first treated during young adulthood (25 years or younger) and those first treated at an older age. Compared to their first treated older age counterparts matched on demographics and dependence type, those who entered first treatment during young adulthood had on average an earlier onset for substance use but a shorter duration between first substance use and first treatment entry; they also had worse alcohol and other drug outcomes 11 years post treatment entry. While subsequent substance use treatment and 12-step meeting attendance are important for both age groups in maintaining positive outcomes, relationships varied by age group. Findings underline the importance of different continuing care management strategies for those entering first treatment at different developmental stages.
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Affiliation(s)
- Felicia W Chi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612.
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612; Department of Psychiatry, University of California San Francisco, San Francisco, CA 94143
| | - Christine E Grella
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90025
| | - Yih-Ing Hser
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90025
| | - Charles Moore
- Kaiser Permanente Chemical Dependency Recovery Program, Sacramento, CA 95821-6237
| | - Jennifer Mertens
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612
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Use transition between illegal drugs among Brazilian university students. Soc Psychiatry Psychiatr Epidemiol 2014; 49:385-94. [PMID: 23918195 DOI: 10.1007/s00127-013-0748-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 07/24/2013] [Indexed: 01/28/2023]
Abstract
PURPOSE The aim of the present study was to test whether the first use of an illicit drug increases the chance of first use of other illicit drugs. METHOD The transitions from the first use of a drug to the first use of another drug were analyzed. Comparisons were made between first drug users and non-users. Survival analysis methods were used to compare the cumulative probability of second drug use after adjusting for socio-demographic covariates and the intermediate use of alcohol and/or tobacco. A total of 12,721 Brazilian university students participated in this study. RESULTS Inhalants and marijuana were used prior to the use of several other drugs, whereas the opposite pattern was not found. Ecstasy was used before other drugs in several instances. Other well-examined drugs, such as amphetamines, cocaine and hallucinogens, were used both before and after other illicit drugs without any marked predominance for either of the two roles. CONCLUSIONS This study supports the role of the use of marijuana and inhalants almost exclusively before the use of other illicit drugs, whereas the use of ecstasy has an opposite role. These roles could be linked to the prevalence of lifetime use and whether individuals were at an earlier or later age during experimentation.
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Roberts AL, Galea S, Austin SB, Corliss HL, Williams MA, Koenen KC. Women's experience of abuse in childhood and their children's smoking and overweight. Am J Prev Med 2014; 46:249-58. [PMID: 24512863 PMCID: PMC3962663 DOI: 10.1016/j.amepre.2013.11.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 10/28/2013] [Accepted: 11/01/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Smoking and overweight are principal determinants of poor health for which individual-level interventions are at best modestly effective. This limited effectiveness may be partly because these risk factors are patterned by parents' experiences preceding the individual's birth. PURPOSE To determine whether women's experience of abuse in childhood was associated with smoking and overweight in their children. METHODS In 2012, data were linked from two large longitudinal cohorts of women (Nurses' Health Study II [NHSII], n=12,666) and their children (Growing Up Today [GUTS] Study, n=16,774), 1989-2010. ORs of children following higher-risk smoking trajectories and risk ratios (RRs) of children's overweight and obesity by their mother's childhood experience of physical, emotional, and sexual abuse were calculated. The extent to which mother's smoking and overweight, socioeconomic indicators, family characteristics, and child's abuse exposure accounted for possible associations was ascertained. RESULTS Children of women who experienced severe childhood abuse had greater likelihood of higher-risk smoking trajectories (OR=1.40, 95% CI=1.21, 1.61), overweight (RR=1.21, 95% CI=1.11, 1.33), and obesity (RR=1.45, 95% CI=1.21, 1.74) across adolescence and early adulthood compared with children of women who reported no abuse. Mother's smoking and overweight and children's abuse exposure accounted for more than half of the elevated risk of following the highest-risk smoking trajectory and overweight in children of women abused. CONCLUSIONS These findings raise the possibility that childhood abuse may not only adversely affect the health of the direct victim but may also affect health risk factors in her children decades after the original traumatic events.
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Affiliation(s)
- Andrea L Roberts
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA.
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston
| | - Heather L Corliss
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston
| | - Michelle A Williams
- Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Karestan C Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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ter Bogt TF, de Looze M, Molcho M, Godeau E, Hublet A, Kokkevi A, Kuntsche E, Gabhainn SN, Franelic IP, Simons-Morton B, Sznitman S, Vieno A, Vollebergh W, Pickett W. Do societal wealth, family affluence and gender account for trends in adolescent cannabis use? A 30 country cross-national study. Addiction 2014; 109:273-83. [PMID: 24261614 PMCID: PMC3947129 DOI: 10.1111/add.12373] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 04/02/2013] [Accepted: 09/27/2013] [Indexed: 11/28/2022]
Abstract
AIMS To examine cross-national changes in frequent adolescent cannabis use (40+ times consumed over life-time at age 15) over time and relate these trends to societal wealth, family affluence and gender. DESIGN Data from three cycles (2002, 2006, 2010) of the Health Behaviour in School-aged Children (HBSC) Study were used for cross-sectional and trend analyses of adolescent cannabis use. SETTING Representative surveys in 30 European and North American countries. PARTICIPANTS A total of 160 606 15-year-old students. MEASUREMENTS Respondents' life-time cannabis use, demographics, family affluence (FAS) and frequency of peer contacts were measured individually. Indicators of wealth (gross domestic product per capita, GDP) and perceived availability of cannabis were obtained from national public data bases. FINDINGS The frequency of life-time cannabis use decreased over time among adolescents in Europe and North America, particularly in western European countries and the United States (relative risk (RR) = 0.86: confidence interval (CI) 0.79-0.93). This trend was not observed consistently in rapidly developing countries in eastern, central and southern Europe. Over time (2002-10), cannabis use became: (i) less characteristic of high GDP countries in contrast to lower GDP countries (RR = 0.74: CI 0.57-0.95); (ii) less characteristic of youth from high FAS families in contrast to youth from low FAS families (RR = 0.83: CI 0.72-0.96); and (iii) characterized by an increasing gender gap, i.e. consumption was higher among males (RR 1.26: CI 1.04-1.53). Perceived availability of cannabis and peer contacts remained strong predictors of frequent cannabis use. CONCLUSIONS Among 30 European and North American countries, cannabis use appears to have 'trickled down' over time, with developing countries taking on the former (heavier) use pattern of richer countries, and less affluent youth taking on the former (heavier) use pattern of more affluent youth. Cannabis use continues to be more common among adolescent males than females.
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Affiliation(s)
- Tom F.M. ter Bogt
- Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Margreet de Looze
- Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Michal Molcho
- Health Promotion, National University of Ireland, Galway, Ireland
| | - Emmanuelle Godeau
- UMR 1027, Inserm, Université de Toulouse, Toulouse, France ; Service médical du rectorat de Toulouse, Toulouse, France
| | - Anne Hublet
- Department of Public Health, Gent University, Gent, Belgium
| | - Anna Kokkevi
- University Mental Health Research Institute, Athens, Greece
| | - Emmanuel Kuntsche
- Sucht Schweiz Research Institute, Lausanne, Switzerland; Behavioural Science Institute; Radboud University, Nijmegen, the Netherlands
| | | | | | - Bruce Simons-Morton
- Prevention Research Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, United States
| | | | - Alessio Vieno
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Universita degli Studi di Padova, Padova, Italia
| | - Wilma Vollebergh
- Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - William Pickett
- Department of Public Health Sciences, Queen’s University, Kingston, Canada; Department of Emergency Medicine, Queen’s University, Kingston, Canada
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Dissabandara LO, Loxton NJ, Dias SR, Dodd PR, Daglish M, Stadlin A. Dependent heroin use and associated risky behaviour: the role of rash impulsiveness and reward sensitivity. Addict Behav 2014; 39:71-6. [PMID: 24112954 DOI: 10.1016/j.addbeh.2013.06.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 04/04/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
Abstract
Impulsive temperament has long been considered as a risk factor for substance use disorders (SUD). Considering the heterogeneity of impulsivity, a biologically-based 2-factor model incorporating reward sensitivity and rash impulsiveness facets, has been proposed. Here we report how these two facets of impulsiveness could be associated with different aspects of dependent heroin use and associated risky behaviour. Two hundred and ninety three dependent heroin users and 232 non-users were assessed on reward sensitivity, rash impulsivity, and the related trait of punishment sensitivity. After adjusting for multiple comparisons, heroin users were found to be more rash-impulsive and reward-sensitive than non-users (p<0.001). Within users, rash impulsivity was associated with high risk behaviour including escalating heroin consumption, injecting heroin use, hazardous drinking, low treatment-seeking and risky sexual behaviour. Reward sensitivity was uniquely associated with early onset of drug use. While greater impulsivity is a common trait in drug users compared with non-users, the use of a 2-factor model of impulsivity provides additional information regarding specific aspects of drug initiation and maintenance that can be targeted in the prevention and treatment of heroin dependence.
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108
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Icick R, Lauer S, Romo L, Dupuy G, Lépine JP, Vorspan F. Dysfunctional parental styles perceived during childhood in outpatients with substance use disorders. Psychiatry Res 2013; 210:522-8. [PMID: 23880480 DOI: 10.1016/j.psychres.2013.06.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 04/11/2013] [Accepted: 06/22/2013] [Indexed: 11/16/2022]
Abstract
People who suffer from substance use disorders (SUDs) frequently report to have undergone childhood adversity that is often associated with father or mother dysfunction, or both. Yet that issue has been barely addressed in opiate dependent patients. Therefore we sought to evaluate parent-specific dysfunctional styles perceived during childhood in a clinical sample from an outpatient addiction treatment program using the Measure Of Parental Styles (MOPS) questionnaire. DSM-IV diagnoses of substance use disorders and history of suicide attempts, family structure and changes of caregiver during childhood were obtained from 159 consecutive outpatients, along with their perception of parental bonding with the MOPS, in which mother and father scores are separate. Mother neglect dimension was significantly correlated with an earlier age at onset of several substances' use, the number of prior hospitalizations and of lifetime suicide attempts. Most of these associations remained significant in multivariate models. This was the first assessment of a representative sample of outpatients with SUDs by the MOPS questionnaire. Given its excellent acceptance and its association with several key correlates of SUDs, it should be used to design specific interventions targeted at attachment and familial management as well as in research models on gene × environment interactions.
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Affiliation(s)
- Romain Icick
- CSAPA Espace Murger, Service de Psychiatrie d'Adultes du Pr F Bellivier, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Assistance Publique - Hôpitaux de Paris, Paris, France; INSERM U 705, CNRS UMR 8206, Paris, France.
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109
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Galéra C, Pingault JB, Fombonne E, Michel G, Lagarde E, Bouvard MP, Melchior M. Attention problems in childhood and adult substance use. J Pediatr 2013; 163:1677-1683.e1. [PMID: 23972646 DOI: 10.1016/j.jpeds.2013.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/23/2013] [Accepted: 07/02/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the link between childhood attention problems (AP) and substance use 18 years later. STUDY DESIGN This cohort study was conducted in a community sample of 1103 French youths followed from 1991 to 2009. Exposures and covariates were childhood behavioral problems (based on parental report at baseline), early substance use, school difficulties, and family adversity. Outcome measures were regular tobacco smoking, alcohol problems, problematic cannabis use, and lifetime cocaine use (based on youth reports at follow-up). RESULTS Individuals with high levels of childhood AP had higher rates of substance use (regular tobacco smoking, alcohol problems, problematic cannabis use, and lifetime cocaine use). However, when taking into account other childhood behavioral problems, early substance use, school difficulties, and family adversity, childhood AP were related only to regular tobacco smoking and lifetime cocaine use. Early cannabis exposure was the strongest risk factor for all substance use problems. CONCLUSION This longitudinal community-based study shows that, except for tobacco and cocaine, the association between childhood AP and substance use is confounded by a range of early risk factors. Early cannabis exposure plays a central role in later substance use.
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Affiliation(s)
- Cédric Galéra
- Department of Child and Adolescent Psychiatry, Charles Perrens Hospital, University of Bordeaux, Bordeaux, France; INSERM U897, Center for Research in Epidemiology and Biostatistics, Prévention et Prise en Charge des Traumatismes, Bordeaux, France.
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DeBeck K, Kerr T, Marshall BDL, Simo A, Montaner J, Wood E. Risk factors for progression to regular injection drug use among street-involved youth in a Canadian setting. Drug Alcohol Depend 2013; 133:468-72. [PMID: 23910434 PMCID: PMC3818386 DOI: 10.1016/j.drugalcdep.2013.07.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 07/05/2013] [Accepted: 07/05/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Street-involved youth are at high risk for experimenting with injection drug use; however, little attention has been given to identifying the factors that predict progression to on-going injecting. METHODS Logistic regression was used to identify factors associated with progression to injecting weekly on a regular basis among a Canadian cohort of street-involved youth. RESULTS Among our sample of 405 youth who had initiated injecting at baseline or during study observation, the median age was 22 years (interquartile range [IQR]=21-24), and 72% (293) reported becoming a regular injector at some point after their first injection experience. Of these, the majority (n=186, 63%) reported doing so within a month of initiating injection drug use. In multivariate analysis, the drug used at the first injection initiation event (opiates vs. cocaine vs. methamphetamine vs. other; all p>0.05) was not associated with progression; however, younger age at first injection (adjusted odds ratio [AOR]=1.13), a history of childhood physical abuse (AOR=1.81), prior regular use of the drug first injected (AOR=1.77), and having a sexual partner present at the first injection event (AOR=2.65) independently predicted progression to regular injecting. CONCLUSION These data highlight how quickly youth progress to become regular injectors after experimentation. Findings indicate that addressing childhood trauma and interventions such as evidence-based youth focused addiction treatment that could prevent or delay regular non-injection drug use, may reduce progression to regular injection drug use among this population.
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Affiliation(s)
- Kora DeBeck
- British Columbia Centre for Excellence in HIV/AIDS,School of Public Policy, Simon Fraser University
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS,Division of AIDS, Department of Medicine, University of British Columbia
| | | | - Annick Simo
- British Columbia Centre for Excellence in HIV/AIDS
| | - Julio Montaner
- British Columbia Centre for Excellence in HIV/AIDS,Division of AIDS, Department of Medicine, University of British Columbia
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS,Division of AIDS, Department of Medicine, University of British Columbia
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Quek LH, Chan GCK, White A, Connor JP, Baker PJ, Saunders JB, Kelly AB. Concurrent and simultaneous polydrug use: latent class analysis of an Australian nationally representative sample of young adults. Front Public Health 2013; 1:61. [PMID: 24350230 PMCID: PMC3860005 DOI: 10.3389/fpubh.2013.00061] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 11/14/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol use and illicit drug use peak during young adulthood (around 18-29 years of age), but comparatively little is known about polydrug use in nationally representative samples of young adults. Drawing on a nationally representative cross-sectional survey (Australian National Drug Strategy Household Survey), this study examines polydrug use patterns and associated psychosocial risk factors among young adults (n = 3,333; age 19-29). METHOD The use of a broad range of licit and illicit drugs were examined, including alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, ketamine, GHB, inhalants, steroids, barbiturates, meth/amphetamines, heroin, methadone/buprenorphine, other opiates, painkillers, and tranquilizers/sleeping pills. Latent class analysis was employed to identify patterns of polydrug use. RESULTS Polydrug use in this sample was best described using a 5-class solution. The majority of young adults predominantly used alcohol only (52.3%), alcohol and tobacco (34.18%). The other classes were cannabis, ecstasy, and licit drug use (9.4%), cannabis, amphetamine derivative, and licit drug use (2.8%), and sedative and alcohol use (1.3%). Young adult males with low education and/or high income were most at risk of polydrug use. CONCLUSION Almost half of young adults reported polydrug use, highlighting the importance of post-high school screening for key risk factors and polydrug use profiles, and the delivery of early intervention strategies targeting illicit drugs.
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Affiliation(s)
- Lake-Hui Quek
- Faculty of Health Sciences, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | - Gary C. K. Chan
- Faculty of Health Sciences, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | - Angela White
- Faculty of Health Sciences, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | - Jason P. Connor
- Faculty of Health Sciences, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Peter J. Baker
- Faculty of Health Sciences, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
- Faculty of Health Sciences, School of Population Health, The University of Queensland, Brisbane, QLD, Australia
| | - John B. Saunders
- Faculty of Health Sciences, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | - Adrian B. Kelly
- Faculty of Health Sciences, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
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Walton MA, Bohnert K, Resko S, Barry KL, Chermack ST, Zucker RA, Zimmerman MA, Booth BM, Blow FC. Computer and therapist based brief interventions among cannabis-using adolescents presenting to primary care: one year outcomes. Drug Alcohol Depend 2013; 132:646-53. [PMID: 23711998 PMCID: PMC3770780 DOI: 10.1016/j.drugalcdep.2013.04.020] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 04/12/2013] [Accepted: 04/15/2013] [Indexed: 12/30/2022]
Abstract
AIMS This paper describes outcomes from a randomized controlled trial examining the efficacy of brief interventions delivered by a computer (CBI) or therapist (TBI) among adolescents in urban primary care clinics. METHODS Patients (ages 12-18) self-administered a computer survey. Adolescents reporting past year cannabis use completed a baseline survey and were randomized to control, CBI or TBI, with primary (cannabis use, cannabis related consequences - CC) and secondary outcomes [alcohol use, other drug use (illicit and non-medical prescription drugs), and driving under the influence of cannabis (DUI)] assessed at 3, 6, and 12 months. RESULTS 1416 adolescents were surveyed; 328 reported past year cannabis use and were randomized. Comparisons of the CBI relative to control showed that at 3 months the group by time interaction (G × T) was significant for other drug use and CC, but not for cannabis use, alcohol use, or DUI; at 6 months, the G × T interaction was significant for other drug use but not for cannabis use, alcohol use, or CC. For analyses comparing the TBI to control, at 3 months the G×T interaction was significant for DUI, but not significant for cannabis use, alcohol use, or CC; at 6 months, the G×T interaction was not significant for any variable. No significant intervention effects were observed at 12 months. CONCLUSION Among adolescent cannabis users presenting to primary care, a CBI decreased cannabis related problems and other drug use and a TBI decreased cannabis DUI in the short-term. Additional boosters may be necessary to enhance these reductions over time.
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Affiliation(s)
- Maureen A Walton
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA.
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113
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Yeoman K, Safranek T, Buss B, Cadwell BL, Mannino D. Adverse childhood experiences and adult smoking, Nebraska, 2011. Prev Chronic Dis 2013; 10:E159. [PMID: 24050529 PMCID: PMC3780713 DOI: 10.5888/pcd10.130009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Smoking is a public health risk; the prevalence of smoking among adults in Nebraska is 18.4%. Studies indicate that maltreatment of children alters their brain development, possibly increasing risk for tobacco use. Previous studies have documented associations between childhood maltreatment and adult health behaviors, demonstrating the influence of adverse experiences on tobacco use. We examined prevalence and associations between adverse childhood experiences and smoking among Nebraskans. METHODS We analyzed 2011 Nebraska Behavioral Risk Factor Surveillance System (Adverse Childhood Experience module) data, defining adverse childhood experience exposures as physical, sexual, and verbal abuse (ie, direct exposures), and household dysfunction associated with mental illness, substance abuse, divorce, domestic violence, and living with persons with incarceration histories (ie, environmental exposures). We estimated prevalence of exposures, taking into account the complex survey design. We used logistic regression with predicted margins to estimate adjusted relative risk for smoking by direct or environmental exposure. RESULTS Approximately 51% of Nebraskans experienced 1 or more adverse childhood events; 7% experienced 5 or more. Prevalence of environmental exposures (42%) was significantly higher than that of direct exposures (31%). Prevalence of individual exposures ranged from 6% (incarceration of a household member) to 25% (verbal abuse). Adjusted relative risks of smoking for direct and environmental exposures were 1.5 and 1.8, respectively. CONCLUSION We present a new method of evaluating adverse childhood experience data. Prevalence of adverse childhood experiences is high among Nebraskans, and these exposures are associated with smoking. State-specific strategies to monitor adverse events among children and provide interventions might help to decrease the smoking rate in this population.
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Affiliation(s)
- Kristin Yeoman
- Epidemic Intelligence Service Officer assigned to Nebraska Department of Health and Human Services, 301 Centennial Mall South, Lincoln, NE 68509, USA.
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114
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Draucker CB, Mazurczyk J. Relationships between childhood sexual abuse and substance use and sexual risk behaviors during adolescence: An integrative review. Nurs Outlook 2013; 61:291-310. [DOI: 10.1016/j.outlook.2012.12.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 12/17/2012] [Accepted: 12/19/2012] [Indexed: 11/29/2022]
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Onset of cocaine use: associated alcohol intoxication and psychosocial characteristics among adolescents in substance abuse treatment. J Addict Med 2013; 7:183-8. [PMID: 23519050 DOI: 10.1097/adm.0b013e318288daa2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cocaine abuse is widespread in Europe, and Ireland ranks among the leading countries for prevalence of cocaine use among adolescents. This study aimed to examine demographic and substance use correlates of lifetime cocaine use among adolescents with substance use disorder, and to explore the relationship between alcohol intoxication and cocaine initiation. METHODS Data from a cross-sectional study of 171 adolescents presenting to an outpatient substance abuse treatment program in the Dublin metropolitan area were analyzed. Bivariate and multivariate analyses were conducted. RESULTS Approximately 64% of the participants reported ever used cocaine: 70% reported the first use of cocaine was while alcohol intoxicated and 96% reported the onset of cocaine use was preceded by cannabis use. Later age at treatment entry, unstable accommodation, non engagement in educational/vocational functions, and greater frequency of alcohol and cannabis use had robust associations with lifetime cocaine use. Male gender was significantly associated with first use of cocaine while alcohol intoxicated. CONCLUSIONS Alcohol frequently plays a central role in cocaine initiation in Irish adolescents. Efforts to delay, avoid, or reduce adolescent drinking may yield benefits in terms of reducing cocaine use initiation in this population.
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116
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Hall W, Degenhardt L. The adverse health effects of chronic cannabis use. Drug Test Anal 2013; 6:39-45. [DOI: 10.1002/dta.1506] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/04/2013] [Accepted: 06/04/2013] [Indexed: 01/04/2023]
Affiliation(s)
- Wayne Hall
- The University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Site; Herston QLD 4029 Australia
- National Addiction Centre; Kings College London; London WC2R 2LS United Kingdom
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney NSW 2052 Australia
- Melbourne School of Population and Global Health; University of Melbourne; Melbourne VIC 3010 Australia
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Kristman-Valente A, Wells EA. The role of gender in the association between child maltreatment and substance use behavior: a systematic review of longitudinal research from 1995 to 2011. Subst Use Misuse 2013; 48:645-60. [PMID: 23750770 DOI: 10.3109/10826084.2013.800115] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This systematic review analyzes the role of gender in the association between childhood maltreatment and substance use outcomes, among longitudinal papers published between 1995 and 2011. Ten papers examined gender as a moderating variable. Results on gender differences were mixed. When studies that found no gender effects were compared with studies that did identify gender effects, differences in measurement, sample composition, and developmental timing of outcomes were identified. This review also examines how gender effects are assessed. Implications and limitations of these findings are discussed. Areas for future research are identified.
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Archie S, Boydell KM, Stasiulis E, Volpe T, Gladstone BM. Reflections of young people who have had a first episode of psychosis: what attracted them to use alcohol and illicit drugs? Early Interv Psychiatry 2013; 7:193-9. [PMID: 22404861 DOI: 10.1111/j.1751-7893.2012.00355.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To identify factors that contribute to the initiation of alcohol and street drug use from the perspective of people who were enrolled in early intervention programmes for a first episode of psychosis. METHOD Eight focus groups were conducted involving an average of four to six participants per group, with each group consisting of young people who met provincial inclusion criteria for early intervention programmes. Thematic analysis was used to systematically code transcripts from the focus groups for concepts, patterns and themes related to early use of illicit substances. RESULTS Participants included 45 young people diagnosed with affective psychosis or non-affective spectrum disorders. Seventy-three percent were male, with a median age of 23 years. In general, substance use was an important topic that emerged across all focus groups. Participants talked about three main factors attracting them to initiate use of substances, most predominantly cannabis: (i) using within a social context; (ii) using as a self-medication strategy; and (iii) using to alter their perceptions. CONCLUSIONS The need for social relationships, coping strategies and pleasurable experiences appear to be important reasons for initiating substance use. Additional research is needed to identify whether prodromal youth report the same factors that attract them to initiate use in order to develop more effective prevention strategies.
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Affiliation(s)
- Suzanne Archie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
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119
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Hall W, Carter A. Anticipating possible policy uses of addiction neuroscience research. DRUGS-EDUCATION PREVENTION AND POLICY 2013. [DOI: 10.3109/09687637.2013.779426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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120
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Rasic D, Weerasinghe S, Asbridge M, Langille DB. Longitudinal associations of cannabis and illicit drug use with depression, suicidal ideation and suicidal attempts among Nova Scotia high school students. Drug Alcohol Depend 2013; 129:49-53. [PMID: 23041136 DOI: 10.1016/j.drugalcdep.2012.09.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 09/12/2012] [Accepted: 09/13/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine associations of cannabis and other illicit drug use with depression, suicidal ideation and suicidal attempts over a two year period during adolescence. METHODS Nine hundred and seventy-six school students in four high schools in northern Nova Scotia, Canada, were surveyed in grade 10 and followed up in grade 12. Assessments of past 30 day cannabis and illicit drug use as well as mental health variables (risk of depression, suicidal ideation and suicide attempts) were obtained at baseline (2000 and 2001) and follow-up two years later (2002 and 2003). Generalized estimating equations modelled depression, suicidal ideation and attempts among illicit drug users and non-users. RESULTS Illicit drug use with or without cannabis use was significantly associated with higher odds of depression, suicidal ideation and suicide attempt. Heavy cannabis use alone predicted depression but not suicidal ideation or attempt. CONCLUSIONS Illicit drug use, with and without accompanying cannabis use, among high school students increases the risk of depression, suicidal ideation and suicidal attempts. Heavy cannabis use alone predicts depression but not suicidal ideation or attempts.
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Affiliation(s)
- Daniel Rasic
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, NS B3H 1V7, Canada
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121
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White A, Chan GCK, Quek LH, Connor JP, Saunders JB, Baker P, Brackenridge C, Kelly AB. The topography of multiple drug use among adolescent Australians: findings from the National Drug Strategy Household Survey. Addict Behav 2013; 38:2068-73. [PMID: 23403274 DOI: 10.1016/j.addbeh.2013.01.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 12/18/2012] [Accepted: 01/03/2013] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND AIMS Despite evidence that many Australian adolescents have considerable experience with various drug types, little is known about the extent to which adolescents use multiple substances. The aim of this study was to examine the degree of clustering of drug types within individuals, and the extent to which demographic and psychosocial predictors are related to cluster membership. DESIGN AND METHOD A sample of 1402 adolescents aged 12-17 years were extracted from the Australian 2007 National Drug Strategy Household Survey. Extracted data included lifetime use of 10 substances, gender, psychological distress, physical health, perceived peer substance use, socioeconomic disadvantage, and regionality. Latent class analysis was used to determine clusters, and multinomial logistic regression employed to examine predictors of cluster membership. RESULT There were 3 latent classes. The great majority (79.6%) of adolescents used alcohol only, 18.3% were limited range multidrug users (encompassing alcohol, tobacco, and marijuana), and 2% were extended range multidrug users. Perceived peer drug use and psychological distress predicted limited and extended multiple drug use. Psychological distress was a more significant predictor of extended multidrug use compared to limited multidrug use. DISCUSSION AND CONCLUSION In the Australian school-based prevention setting, a very strong focus on alcohol use and the linkages between alcohol, tobacco and marijuana are warranted. Psychological distress may be an important target for screening and early intervention for adolescents who use multiple drugs.
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Affiliation(s)
- Angela White
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia.
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Myers B, Kline TL, Browne FA, Carney T, Parry C, Johnson K, Wechsberg WM. Ethnic differences in alcohol and drug use and related sexual risks for HIV among vulnerable women in Cape Town, South Africa: implications for interventions. BMC Public Health 2013; 13:174. [PMID: 23442318 PMCID: PMC3598514 DOI: 10.1186/1471-2458-13-174] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Accepted: 02/23/2013] [Indexed: 11/17/2022] Open
Abstract
Background Alcohol and other drug (AOD) use among poor Black African and Coloured women in South Africa compounds their sexual risk for HIV. Given South Africa’s history of ethnic disparities, ethnic differences in sex risk profiles may exist that should be taken into account when planning HIV risk reduction interventions. This paper aims to describe ethnic differences in AOD use and AOD-related sexual risks for HIV among vulnerable women from Cape Town, South Africa. Method Cross-sectional data on 720 AOD-using women (324 Black African; 396 Coloured) recruited from poor communities in Cape Town were examined for ethnic differences in AOD use and AOD-related sexual risk behavior. Results Ethnic differences in patterns of AOD use were found; with self-reported drug problems, heavy episodic drinking and methamphetamine use being most prevalent among Coloured women and cannabis use being most likely among Black African women. However, more than half of Black African women reported drug-related problems and more than a third tested positive for recent methamphetamine use. More than a third of women reported being AOD-impaired and having unprotected sex during their last sexual encounter. Coloured women had four-fold greater odds of reporting that their last sexual episode was AOD-impaired and unprotected than Black African women. In addition, close to one in two women reported that their sexual partner was AOD-impaired at last sex, with Coloured women having three-fold greater odds of reporting that their partner was AOD-impaired at last sex than Black African women. Conclusions Findings support the need to develop and test AOD risk reduction interventions for women from both ethnic groups. In addition, findings point to the need for tailored interventions that target the distinct profiles of AOD use and AOD-related sex risks for HIV among Black African and Coloured women.
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Affiliation(s)
- Bronwyn Myers
- Alcohol and Drug Abuse Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg 7505, South Africa.
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123
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Gorka SM, Shankman SA, Seeley JR, Lewinsohn PM. The moderating effect of parental illicit substance use disorders on the relation between adolescent depression and subsequent illicit substance use disorders. Drug Alcohol Depend 2013; 128:1-7. [PMID: 22901413 PMCID: PMC3510318 DOI: 10.1016/j.drugalcdep.2012.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 05/25/2012] [Accepted: 07/21/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous research has demonstrated that depression and family history of illicit substance use disorders (ISUDs) are risk factors for the development of ISUDs. However, no study to date has examined whether these risk factors interact to predict onset. In addition, history of parental and sibling ISUDs have been identified as risk factors almost exclusively in healthy individuals and thus, it is unknown whether they confer unique risk among adolescents with a history of depression. METHODS The current study examined these questions using data from the Oregon Adolescent Depression Project (OADP). DSM diagnoses of probands were assessed during 4-waves, first in adolescence (ages 14-18) and subsequently up until age 30. Lifetime DSM diagnoses of ISUDs in biological mothers, fathers, and siblings were obtained. RESULTS Proportional hazards model analyses indicated that there was a significant depression by parental ISUDs interaction. Among probands with parental ISUDs (and not among those without parental ISUDs), depression in adolescence was significantly associated with a shorter time to develop an ISUD. Sibling ISUDs were not associated with onset and did not interact with adolescent depression. CONCLUSION Prevention and intervention efforts targeted at this particularly at-risk group may be effective.
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Affiliation(s)
- Stephanie M. Gorka
- University of Illinois at Chicago Department of Psychology 1007 West Harrison St. (M/C 285) Chicago, IL 60657
| | - Stewart A. Shankman
- University of Illinois at Chicago Department of Psychology 1007 West Harrison St. (M/C 285) Chicago, IL 60657
| | - John R. Seeley
- Oregon Research Institute 1715 Franklin Boulevard Eugene, OR 97403
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Abstract
OBJETIVOS: Analisar a influência do ambiente familiar no consumo de crack em usuários habituais ou dependentes. MÉTODOS: Pesquisa qualitativa, realizada com 15 familiares de usuários de crack em tratamento em um serviço especializado, por meio de entrevista semiestruturada. Os dados foram analisados de acordo com conteúdo temático e organizados em categorias. RESULTADOS: Dentre os fatores de influência, verificou-se a deficiência de suporte parental, a superproteção dos filhos, a presença de cultura implícita do uso de drogas, a existência de conflitos e violências, a desinformação e o desconhecimento sobre o uso de drogas. CONCLUSÃO: Constatou-se que as famílias apresentaram vários elementos considerados desfavoráveis no ambiente familiar, os quais atuaram como elemento facilitador ao uso crack.
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125
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Kaynak Ö, Meyers K, Caldeira KM, Vincent KB, Winters KC, Arria AM. Relationships among parental monitoring and sensation seeking on the development of substance use disorder among college students. Addict Behav 2013; 38:1457-63. [PMID: 23017733 DOI: 10.1016/j.addbeh.2012.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 08/08/2012] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
Abstract
Substance use disorder is a serious health problem that tends to manifest in late adolescence. Attempting to influence targetable risk and protective factors holds promise for prevention and treatment. Survey data from 1253 college students (48.5% male, 26.9% non-White) were used to investigate the independent and combined effects of two prominent factors, sensation seeking and parental monitoring, on the probability of alcohol and/or cannabis dependence during the first year of college. In multivariate analyses that controlled for high school use, gender, race, mother's education, and importance of religion, retrospective reports by the student of parental behavior during the last year of high school indicated that higher levels of parental monitoring had a direct effect on reducing risk for alcohol dependence during the first year of college, but not on cannabis dependence. High levels of sensation seeking were associated with increased risk for both alcohol and cannabis dependence. No interaction effects were found. The results extend prior findings by highlighting influences of pre-college parental monitoring and sensation seeking on the probability of alcohol and/or cannabis dependence during the first year of college. The findings also suggest that these two factors are useful in identifying college students at high risk for alcohol and/or cannabis dependence.
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Richardson GA, Larkby C, Goldschmidt L, Day NL. Adolescent initiation of drug use: effects of prenatal cocaine exposure. J Am Acad Child Adolesc Psychiatry 2013; 52:37-46. [PMID: 23265632 PMCID: PMC3530145 DOI: 10.1016/j.jaac.2012.10.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 10/10/2012] [Accepted: 10/18/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate the direct effects of prenatal cocaine exposure (PCE) on adolescent drug use, while controlling for other predictors of adolescent use. METHOD Data are from a longitudinal study of PCE in which women and their offspring were assessed throughout childhood. Adolescents were interviewed at 15 years about their age at initiation of alcohol, marijuana, and tobacco. The sample consisted of 214 adolescents and their caregivers: 50% was of white ethnicity, and 50% African American. RESULTS First trimester cocaine exposure significantly predicted earlier adolescent marijuana and alcohol initiation. The hazard of marijuana and alcohol initiation among exposed adolescents was almost two times greater than among nonexposed adolescents, adjusting for other significant factors. There were no differences in tobacco initiation. Other significant predictors of adolescent drug use were family history of alcohol problems, exposure to violence, and childhood maltreatment. CONCLUSIONS Cocaine exposure during early pregnancy was associated with initiation of marijuana and alcohol use. Exposure to violence, childhood maltreatment, and familial factors also predicted adolescent initiation, but did not mitigate the effects of PCE. The combination of these risk factors has significant implications for the development of later substance use, social, and psychiatric problems.
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Cannabis and depression: an integrative data analysis of four Australasian cohorts. Drug Alcohol Depend 2012; 126:369-78. [PMID: 22749560 DOI: 10.1016/j.drugalcdep.2012.06.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 05/29/2012] [Accepted: 06/02/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND This study presents an integrative data analysis of the association between frequency of cannabis use and severity of depressive symptoms using data from four Australasian cohort studies. The integrated data comprised observations on over 6900 individuals studied on up to seven occasions between adolescence and mature adulthood. METHODS Repeated measures data on frequency of cannabis use (not used/<monthly/≥monthly/≥weekly) and concurrently assessed depression scores were pooled over the four cohorts. Regression models were fitted to estimate the strength of association between cannabis use and depression. Fixed effects regression methods were used to control for confounding by non-observed fixed factors. RESULTS Increasing frequency of cannabis use was associated with increasing depressive symptoms (p<0.001). In the pooled data weekly users of cannabis had depression scores that were 0.32 (95%CI 0.27-0.37) SD higher than non-users. The association was reduced but remained significant (p<0.001) upon adjustment for confounding. After adjustment depression scores for weekly users were 0.24 (95%CI 0.18-0.30) SD higher than non-users. The adjusted associations were similar across cohorts. There was a weak age×cannabis use interaction (p<0.05) suggesting that the association was strongest in adolescence. Attempts to further test the direction of causality using SEM methods proved equivocal. CONCLUSIONS More frequent cannabis use was associated with modest increases in rates of depressive symptoms. This association was stronger in adolescence and declined thereafter. However, it was not possible from the available data to draw a definitive conclusion as to the likely direction of causality between cannabis use and depression.
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128
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Afifi TO, Henriksen CA, Asmundson GJG, Sareen J. Childhood maltreatment and substance use disorders among men and women in a nationally representative sample. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2012; 57:677-86. [PMID: 23149283 DOI: 10.1177/070674371205701105] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the association between a history of 5 types of childhood maltreatment (that is, physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect) and several substance use disorders (SUDs), including alcohol, sedatives, tranquilizers, opioids, amphetamines, cannabis, cocaine, hallucinogens, heroin, and nicotine, in a nationally representative US adult sex-stratified sample. METHOD Data were drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative US sample of adults aged 20 years and older (n = 34 653). Logistic regression models were conducted to understand the relations between 5 types of childhood maltreatment and SUDs separately among men and women after adjusting for sociodemographic variables and Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I and II mental disorders. RESULTS All 5 types of childhood maltreatment were associated with increased odds of all individual SUDs among men and women after adjusting for sociodemographic variables, with the exception of physical neglect and heroin abuse or dependence, emotional neglect, and amphetamines and cocaine abuse or dependence among men (adjusted odds ratio range 1.3 to 4.7). After further adjustment for other DSM Axis I and II mental disorders, the relations between childhood maltreatment and SUDs were attenuated, but many remained statistically significant. Differences in the patterns of findings were noted for men and women for sexual abuse and emotional neglect. CONCLUSIONS This research provides evidence of the robust nature of the relations between many types of childhood maltreatment and many individual SUDs. The prevention of childhood maltreatment may help to reduce SUDs in the general population.
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Affiliation(s)
- Tracie O Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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Neisewander J, Peartree N, Pentkowski N. Emotional valence and context of social influences on drug abuse-related behavior in animal models of social stress and prosocial interaction. Psychopharmacology (Berl) 2012; 224:33-56. [PMID: 22955569 PMCID: PMC4071609 DOI: 10.1007/s00213-012-2853-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 08/18/2012] [Indexed: 02/07/2023]
Abstract
RATIONALE Social factors are important determinants of drug dependence and relapse. OBJECTIVES We reviewed pre-clinical literature examining the role of social experiences from early life through the development of drug dependence and relapse, emphasizing two aspects of these experiences: (1) whether the social interaction is appetitive or aversive and (2) whether the social interaction occurs within or outside of the drug-taking context. METHODS The models reviewed include neonatal care, isolation, social defeat, chronic subordination, and prosocial interactions. We review results from these models in regard to effects on self-administration and conditioned place preference established with alcohol, psychostimulants, and opiates. RESULTS We suggest that in general, when the interactions occur outside of the drug-taking context, prosocial interactions are protective against drug abuse-related behaviors, whereas social stressors facilitate these behaviors. By contrast, positive or negative social interactions occurring within the drug-taking context may interact with other risk factors to enhance or inhibit these behaviors. CONCLUSIONS Despite differences in the nature and complexity of human social behavior compared to other species, the evolving animal literature provides useful models for understanding social influences on drug abuse-related behavior that will allow for research on the behavioral and biological mechanisms involved. The models have contributed to understanding social influences on initiation and maintenance of drug use, but more research is needed to understand social influences on drug relapse.
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Affiliation(s)
- J.L. Neisewander
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287-4501,Corresponding author: Janet Neisewander, Ph.D., School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287-4501, , Phone: 480-965-0209, Fax: 480-965-6899
| | - N.A. Peartree
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ 85287-1104
| | - N.S. Pentkowski
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287-4501
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Nomura Y, Hurd YL, Pilowsky DJ. Life-time risk for substance use among offspring of abusive family environment from the community. Subst Use Misuse 2012; 47:1281-92. [PMID: 22780838 PMCID: PMC5962519 DOI: 10.3109/10826084.2012.695420] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The current study examined the cumulative risk, age of initiation, and functional impairments among adults with substance use problems (N = 1748) by child abuse status. Child abuse was associated with earlier initiation of marijuana, cocaine, and heroin use, and had greater risks for all the drugs studied (hazard ratios, 1.7-3.2). Furthermore, child abuse was associated with increased medical and functional impairments, including ER visits, health problems, drug dealing, drug dependence, and drug cravings. Provision of social services and parenting education during the perinatal period may prevent the long-term impact of child abuse on substance use and related impairments. The study's limitations are noted.
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Affiliation(s)
- Yoko Nomura
- Department of Psychology, Queens College, CUNY, Flushing, New York 11367, USA.
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131
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McCart MR, Zajac K, Kofler MJ, Smith DW, Saunders BE, Kilpatrick DG. Longitudinal examination of PTSD symptoms and problematic alcohol use as risk factors for adolescent victimization. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2012; 41:822-36. [PMID: 22963207 DOI: 10.1080/15374416.2012.717872] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.
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Affiliation(s)
- Michael R McCart
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
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132
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Trenz RC, Harrell P, Scherer M, Mancha BE, Latimer WW. A model of school problems, academic failure, alcohol initiation, and the relationship to adult heroin injection. Subst Use Misuse 2012; 47:1159-71. [PMID: 22621313 PMCID: PMC6280666 DOI: 10.3109/10826084.2012.686142] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The current study uses structural equation modeling to investigate factors associated with alcohol initiation and injection heroin use. Baseline data from the NEURO-HIV Epidemiologic Study in Baltimore, Maryland, were used. Participants were 404 injection heroin users (M(age) = 32.72) with a history of regular injection in their lifetime. Latent variables were created for self-reported school problems and academic failure. The final model indicated that greater school problems were associated with earlier alcohol initiation (ß = -0.22, p < .001) and earlier alcohol initiation was associated with greater frequency of recent heroin use (ß = -0.12, p < .05). Academic failure was directly related to greater frequency of recent heroin injection (ß = 0.15, p < .01). The results expand research investigating the relationship between adolescent behavior and illicit drug use in adulthood.
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Affiliation(s)
- Rebecca C Trenz
- Department of Psychology and Social Work, School of Social and Behavioral Sciences, Mercy College, Dobbs Ferry, New York 10522, USA.
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133
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Lü X, Zhao C, Zhang L, Ma B, Lou Z, Sun Y, Chen J, Wu W, Beveridge TJR, Zhou W, Liu Y. The effects of rearing condition on methamphetamine self-administration and cue-induced drug seeking. Drug Alcohol Depend 2012; 124:288-98. [PMID: 22377091 DOI: 10.1016/j.drugalcdep.2012.01.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 01/29/2012] [Accepted: 01/29/2012] [Indexed: 01/07/2023]
Abstract
BACKGROUND Little is known about the effect of different rearing conditions on the effects of methamphetamine and whether the introduction of enriched rearing conditions at different stages of development could produce different behavioral outcomes. METHODS In Experiment 1, rats were reared in either enriched (EE) or isolated environments (IE) from PND 21 to 60. In Experiment 2, two groups of animals were handled in the same fashion as those in Experiment 1. Additional two groups were housed in IE during the first 20 or 30 days and then housed under EE for the remaining 20 or 10 days respectively. Locomotor activity and Morris Water Maze were tested. The effects of rearing conditions on methamphetamine (METH) self-administration were investigated. RESULTS IE animals exhibited higher levels of locomotion than EE animals, but EE animals showed enhanced Morris water maze performance. Animals reared in IE for 30 and 40 days more readily acquired METH self-administration, compared to those reared in IE for 20 and in EE for 40 days respectively. However, the effect of rearing conditions was only seen at the lowest dose tested under FR schedule and breakpoints obtained from PR schedule were not significantly affected. Those reared in IE for 20 and EE for 40 days animals produced significantly fewer responses during the extinction and cue-induced reinstatement of METH self-administration, compared with animals reared in IE for 30 and 40 days, respectively. CONCLUSION Rearing condition plays a significant role in locomotor activity, spatial memory and behavioral effects of METH.
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Affiliation(s)
- Xiuyi Lü
- Ningbo University School of Medicine, PR China
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134
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Karahalios A, Baglietto L, Carlin JB, English DR, Simpson JA. A review of the reporting and handling of missing data in cohort studies with repeated assessment of exposure measures. BMC Med Res Methodol 2012; 12:96. [PMID: 22784200 PMCID: PMC3464662 DOI: 10.1186/1471-2288-12-96] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 07/11/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Retaining participants in cohort studies with multiple follow-up waves is difficult. Commonly, researchers are faced with the problem of missing data, which may introduce biased results as well as a loss of statistical power and precision. The STROBE guidelines von Elm et al. (Lancet, 370:1453-1457, 2007); Vandenbroucke et al. (PLoS Med, 4:e297, 2007) and the guidelines proposed by Sterne et al. (BMJ, 338:b2393, 2009) recommend that cohort studies report on the amount of missing data, the reasons for non-participation and non-response, and the method used to handle missing data in the analyses. We have conducted a review of publications from cohort studies in order to document the reporting of missing data for exposure measures and to describe the statistical methods used to account for the missing data. METHODS A systematic search of English language papers published from January 2000 to December 2009 was carried out in PubMed. Prospective cohort studies with a sample size greater than 1,000 that analysed data using repeated measures of exposure were included. RESULTS Among the 82 papers meeting the inclusion criteria, only 35 (43%) reported the amount of missing data according to the suggested guidelines. Sixty-eight papers (83%) described how they dealt with missing data in the analysis. Most of the papers excluded participants with missing data and performed a complete-case analysis (n=54, 66%). Other papers used more sophisticated methods including multiple imputation (n=5) or fully Bayesian modeling (n=1). Methods known to produce biased results were also used, for example, Last Observation Carried Forward (n=7), the missing indicator method (n=1), and mean value substitution (n=3). For the remaining 14 papers, the method used to handle missing data in the analysis was not stated. CONCLUSIONS This review highlights the inconsistent reporting of missing data in cohort studies and the continuing use of inappropriate methods to handle missing data in the analysis. Epidemiological journals should invoke the STROBE guidelines as a framework for authors so that the amount of missing data and how this was accounted for in the analysis is transparent in the reporting of cohort studies.
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Affiliation(s)
- Amalia Karahalios
- Cancer Epidemiology Centre, Cancer Council Victoria, Carlton, VIC, Australia
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135
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Lown EA, Mertens AC, Korcha RA, Leisenring W, Hudson MM, Greenfield TK, Robison LL, Zeltzer LK. Prevalence and predictors of risky and heavy alcohol consumption among adult siblings of childhood cancer survivors. Psychooncology 2012; 22:1134-43. [PMID: 22736595 DOI: 10.1002/pon.3121] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 05/17/2012] [Accepted: 05/24/2012] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To describe alcohol consumption patterns and risk factors for risky and heavy alcohol use among siblings of childhood cancer survivors compared with survivors and national controls. METHODS Secondary analysis of prospectively collected data from two national surveys was performed including a cohort of 3034 adult siblings of childhood cancer survivors (age 18-56 years) and 10,398 adult childhood cancer survivors, both from the Childhood Cancer Survivor Study, plus 5712 adult participants from the population-based National Alcohol Survey. Cancer-related experiences, self-reported current health, and mental health were examined in relation to alcohol consumption patterns including heavy and risky drinking. RESULTS Adult siblings of childhood cancer survivors were more likely to be heavy drinkers (OR adj = 1.3; 1.0-1.6) and risky drinkers (OR adj = 1.3; 1.1-1.6) compared with controls from a national sample. Siblings were also more likely to drink at these two levels compared with survivors. Factors associated with heavy drinking among siblings included being 18-21 years old (OR adj = 2.9; 2.0-4.4), male (OR adj = 2.3; 1.7-3.0), having a high school education or less (OR adj = 2.4; 1.7-3.5), and drinking initiation at a young age (OR adj = 5.1; 2.5-10.3). Symptoms of depression, (OR adj = 2.1; 1.3-3.2), anxiety (OR adj = 1.9; 1.1-3.3), and global psychiatric distress (OR adj = 2.5; 1.5-4.3) were significantly associated with heavy alcohol use. CONCLUSIONS Siblings of children with cancer are more likely to be risky and heavy drinkers as adults compared with childhood cancer survivors or national controls. Early initiation of drinking and symptoms of psychological distress should be identified during early adolescence and effective sibling-specific interventions should be developed and made available for siblings of children with cancer.
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Affiliation(s)
- E Anne Lown
- Alcohol Research Group, Emeryville, CA 94608, USA.
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136
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Wei C, Anthony JC, Lu Q. Genome-environmental risk assessment of cocaine dependence. Front Genet 2012; 3:83. [PMID: 22629285 PMCID: PMC3355331 DOI: 10.3389/fgene.2012.00083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 04/26/2012] [Indexed: 01/22/2023] Open
Abstract
Cocaine-associated biomedical and psychosocial problems are substantial twenty-first century global burdens of disease. This burden is largely driven by a cocaine dependence process that becomes engaged with increasing occasions of cocaine product use. For this reason, the development of a risk-prediction model for cocaine dependence may be of special value. Ultimately, success in building such a risk-prediction model may help promote personalized cocaine dependence prediction, prevention, and treatment approaches not presently available. As an initial step toward this goal, we conducted a genome-environmental risk-prediction study for cocaine dependence, simultaneously considering 948,658 single nucleotide polymorphisms (SNPs), six potentially cocaine-related facets of environment, and three personal characteristics. In this study, a novel statistical approach was applied to 1045 case-control samples from the Family Study of Cocaine Dependence. The results identify 330 low- to medium-effect size SNPs (i.e., those with a single-locus p-value of less than 10−4) that made a substantial contribution to cocaine dependence risk prediction (AUC = 0.718). Inclusion of six facets of environment and three personal characteristics yielded greater accuracy (AUC = 0.809). Of special importance was the joint effect of childhood abuse (CA) among trauma experiences and the GBE1 gene in cocaine dependence risk prediction. Genome-environmental risk-prediction models may become more promising in future risk-prediction research, once a more substantial array of environmental facets are taken into account, sometimes with model improvement when gene-by-environment product terms are included as part of these risk predication models.
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Affiliation(s)
- Changshuai Wei
- Department of Epidemiology and Biostatistics, Michigan State University East Lansing, MI, USA
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137
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Cerdá M, DiGangi J, Galea S, Koenen K. Epidemiologic research on interpersonal violence and common psychiatric disorders: where do we go from here? Depress Anxiety 2012; 29:359-85. [PMID: 22553006 PMCID: PMC3375609 DOI: 10.1002/da.21947] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Magdalena Cerdá
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York,Correspondence to: Magdalena Cerdá, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W168th St., New York, NY 10032.
| | - Julia DiGangi
- Department of Clinical Psychology, DePaul University, Chicago, Illinois
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Karestan Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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138
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Abstract
Epidemiological studies of substance use and substance use disorders (SUDs) have provided an abundance of data on the patterns of substance use in nationally representative samples across the world (Degenhardt et al. in PLoS Med 5(7):e141, 2008; Johnston et al. in Monitoring the future national survey results on drug use, 1975-2010, vol I, secondary school students. Institute for Social Research, Ann Arbor, MI, 2011; SAMHSA in Results from the 2010 national survey on drug use and health: summary of national findings, vol NSDUH, series H-41, HHS Publication No. (SMA) 11-4658. Substance Abuse and Mental Health Services Administration, Rockville, 2011). This paper presents a summary of the goals, methods, and recent findings on the epidemiology of substance use and disorders in the general population of adults and adolescents and describes the methods and findings on the genetic epidemiology of drug use disorders. The high 12-month prevalence rates of substance dependence in US adults (about 12 % for alcohol and 2-3 % for illicit drugs) approximate those of other mental disorders as well as chronic physical disorders with major public health impact. New findings from the nationally representative samples of US youth reveal that the lifetime prevalence of alcohol use disorders is approximately 8 % and illicit drug use disorders is 2-3 % (Merikangas et al. in J Am Acad Child Adolesc Psychiatry 49(10):980-989, 2010; Swendsen et al. in Arch Gen Psychiatry 69(4):390-398, 2012; SAMHSA in Results from the 2010 national survey on drug use and health: summary of national findings, vol NSDUH, Series H-41, HHS Publication No. (SMA) 11-4658. Substance Abuse and Mental Health Services Administration, Rockville, 2011). The striking increase in prevalence rates from ages 13 to 18 highlight adolescence as the key period of development of SUDs. The application of genetic epidemiological studies has consistently demonstrated that genetic factors have a major influence on progression of substance use to dependence, whereas environmental factors unique to the individual play an important role in exposure and initial use of substances. Identification of specific susceptibility genes and environmental factors that influence exposure and progression of drug use may enhance our ability to prevent and treat SUDs.
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139
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Trenz RC, Scherer M, Harrell P, Zur J, Sinha A, Latimer W. Early onset of drug and polysubstance use as predictors of injection drug use among adult drug users. Addict Behav 2012; 37:367-72. [PMID: 22172686 PMCID: PMC3288417 DOI: 10.1016/j.addbeh.2011.11.011] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 09/12/2011] [Accepted: 11/08/2011] [Indexed: 12/28/2022]
Abstract
Early onset of alcohol, marijuana, and cigarette use is an indicator of later substance use problems in adulthood such as alcohol or other drug dependence. This paper seeks to address the association between early onset alcohol, marijuana, cigarette, and polysubstance use with injection drug use among recent illicit drug users. The current study used baseline data from the Baltimore site of the NEURO-HIV Epidemiologic Study, an investigation of neuropsychological and social-behavioral risk factors of HIV, hepatitis A, hepatitis B, and Hepatitis C among both injection and non-injection drug users in Baltimore, Maryland. The present study used a subset (N=651) of the larger parent study that identified as White or Black, and reported any drug use in the past 6 months. In the full sample slightly more than half (52.5%) of study participants were IDUs. IDUs differed from non-IDUs on age of initiation for cigarettes, marijuana, and alcohol, with IDUs initiating the use of all three substances significantly earlier than non-IDUs. IDUs also had significantly greater proportions of early onset of alcohol (χ(2)=19.71, p<.01), cigarette (χ(2)=11.05, p<.01), marijuana (χ(2)=10.83, p<.01), and polysubstance use (χ(2)=23.48, p<.01) than non-IDUs. After adjusting for age, gender, and race/ethnicity, only participants identified as early onset alcohol users (AOR=1.47, 95% CI: 1.00-2.18) and early onset polysubstance users (AOR=1.62, 95% CI: 1.10-2.38) were more likely to have IDU status than those who reported initiating substance use later. IDU status was then stratified by race/ethnicity. After controlling for age and gender, only early polysubstance use was a significant predictor of IDU status for Whites (AOR=2.06, 95% CI: 1.07-3.93). Consistent with literature on early substance initiation and later illicit substance use, early onset of alcohol and polysubstance use is an important risk factor for IDU in adulthood.
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Affiliation(s)
- Rebecca C Trenz
- Johns Hopkins University Bloomberg School of Public Health, United States.
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140
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Acri MC, Gogel LP, Pollock M, Wisdom JP. What Adolescents Need to Prevent Relapse after Treatment for Substance Abuse: A Comparison of Youth, Parent, and Staff Perspectives. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2012; 21:117-129. [PMID: 24723746 DOI: 10.1080/1067828x.2012.662111] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Little is known about what factors and supports youths identify as important for their sustained recovery after substance abuse treatment, and if their caregivers and treatment staff identify similar needs. The purpose of this study was to explore what youths, caregivers, and staff perceive as important to remain substance free after completing a residential treatment program. METHODS Semi-structured interviews were conducted with 28 adolescents, 30 parents, and 29 staff at 3 treatment agencies. Data were coded thematically and themes were organized by respondent type. RESULTS There was high frequency and concordance across respondents regarding the need for aftercare services, supportive relationships, and activities. Only one item, outpatient treatment, demonstrated significant differences across groups. CONCLUSIONS External supports and activities are important to recovery of adolescents from substances following treatment completion. Implications and potential areas of inquiry are discussed.
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Affiliation(s)
- Mary C Acri
- New York State Psychiatric Institute, New York, NY, USA
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141
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Brunnberg E, Boström ML, Berglund M. Sexual force at sexual debut. Swedish adolescents with disabilities at higher risk than adolescents without disabilities. CHILD ABUSE & NEGLECT 2012; 36:285-295. [PMID: 22571912 DOI: 10.1016/j.chiabu.2012.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 12/22/2011] [Accepted: 01/11/2012] [Indexed: 05/31/2023]
Abstract
UNLABELLED The aims of this study are first to compare the incidence of force on the first occasion of sexual intercourse reported by participants with disabilities to that of students without disabilities; second to determine whether there are significant differences in mental health, substance abuse, and school performance as reported by participants forced into their sexual debut as opposed to those who were not forced, analysed by gender; and finally to identify the significant variables that predict girls reporting force at sexual debut as opposed to girls not reporting force, as well as to identify similar variables within the male group. There were no data on sexual abuse prior to the first occasion of full sexual intercourse. METHOD This cross-sectional study is based on 2 surveys: Life and Health---Young People 2005 and 2007. All 17/18-year-old adolescents in upper-secondary schools in a county in Sweden were asked the same questions both years. A total of 2,254 students completed the survey in 2005 and 2,641 in 2007. RESULTS The main finding is that force at sexual debut (intercourse) is more common among adolescents with a disability (4.0%) than those not reporting any disability (1.6%), and is most common among those reporting multiple disabilities (10.4%). This was found both for girls and boys, even if the rates for girls were several times higher. Other findings are that girls and boys reporting force at sexual debut (disability and non-disability groups taken together) reported different profiles. For girls, their country of origin and who they live with are significant. This background data is not significant for boys. Boys report a strong psychosomatic reaction. CONCLUSION Culture-, functionality-, and gender-sensitive studies of adolescents' reactions to sexual abuse are needed to help determine relevant and effective interventions.
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Affiliation(s)
- Elinor Brunnberg
- School of Health, Care and Social Welfare, ICU CHILD, Mälardalen University, SE-631 05 Eskilstuna, Sweden
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142
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Social influences on morphine-conditioned place preference in adolescent BALB/cJ and C57BL/6J mice. Psychopharmacology (Berl) 2012; 219:923-32. [PMID: 21837434 PMCID: PMC3638792 DOI: 10.1007/s00213-011-2421-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 07/15/2011] [Indexed: 01/21/2023]
Abstract
RATIONALE Among human adolescents, drug use is substantially influenced by the attitudes and behaviors of peers. Social factors also affect the drug-seeking behaviors of laboratory animals. Conditioned place preference (CPP) experiments indicate that social context can influence the degree to which rodents derive a rewarding experience from drugs of abuse. However, the precise manner by which social factors alter drug reward in adolescent rodents remains unknown. OBJECTIVES We employed the relatively asocial BALB/cJ (BALB) mouse strain and the more prosocial C57BL/6J (B6) strain to explore whether "low" or "high" motivation to be with peers influences the effects of social context on morphine CPP (MCPP). METHODS Adolescent mice were conditioned by subcutaneous injections of morphine sulfate (0.25, 1.0, or 5.0 mg/kg). During the MCPP procedure, mice were housed in either isolation (Ih) or within a social group (Sh). Similarly, following injection, mice were conditioned either alone (Ic) or within a social group (Sc). RESULTS Adolescent B6 mice expressed a robust MCPP response except when subjected to Ih-Sc, which indicates that, following isolation, mice with high levels of social motivation are less susceptible to the rewarding properties of morphine when they are conditioned in a social group. By contrast, MCPP responses of BALB mice were most sensitive to morphine conditioning when subjects experienced a change in their social environment between housing and conditioning (Ih-Sc or Sh-Ic). CONCLUSIONS Our findings demonstrate that susceptibility to morphine-induced reward in adolescent mice is moderated by a complex interaction between social context and heritable differences in social motivation.
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143
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Pope HG, Kanayama G, Hudson JI. Risk factors for illicit anabolic-androgenic steroid use in male weightlifters: a cross-sectional cohort study. Biol Psychiatry 2012; 71:254-61. [PMID: 21839424 PMCID: PMC3218214 DOI: 10.1016/j.biopsych.2011.06.024] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 06/10/2011] [Accepted: 06/28/2011] [Indexed: 01/17/2023]
Abstract
BACKGROUND Illicit anabolic-androgenic steroid (AAS) abuse, though an important public health problem, remains inadequately studied. Almost all AAS abusers are male and lift weights, but the risk factors for AAS use among male weightlifters remain poorly understood. METHODS We recruited 233 experienced male weightlifters, of whom 102 (44%) reported lifetime AAS use, and assessed their childhood and adolescent attributes retrospectively, using structured clinical interviews and computerized questionnaires. This cross-sectional cohort approach-a design that we have formally presented in the recent methodological literature-utilizes a study cohort, not selected for outcomes of interest, and assesses exposures and outcomes retrospectively. We hypothesized that conduct disorder and body-image concerns would be major risk factors for subsequent AAS use among male weightlifters. RESULTS Within our study population, many attributes showed little association with AAS use, but conduct disorder and body-image concerns showed strong associations. For individuals with prior conduct disorder versus those without, the hazard ratio (95% confidence interval) for subsequent AAS use was 2.2 (1.5, 3.4). For individuals in the middle versus lowest tertile of scores on a retrospective adolescent muscle-dysmorphia scale, the hazard ratio was 1.5 (.84, 2.6); for the highest versus lowest tertile, the hazard ratio was 3.3 (2.0, 5.3); and for the linear trend of hazard ratios, p < .001. CONCLUSIONS Conduct disorder and body-image concerns represent important risk factors for AAS use among male weightlifters. Thus, assessment of these attributes may help to identify individuals most likely to require interventions to discourage this form of substance abuse.
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Affiliation(s)
- Harrison G Pope
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts 02478, USA.
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144
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Retention and ongoing participation in residential substance abuse treatment: perspectives from adolescents, parents and staff on the treatment process. J Behav Health Serv Res 2012; 38:488-96. [PMID: 20824359 DOI: 10.1007/s11414-010-9226-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Many adolescents entering substance abuse treatment do not stay for the full course of prescribed treatment. There have been few explorations into what facilitates the ongoing participation of adolescents while in treatment. This paper describes adolescent, parent, and treatment staff perceptions of the barriers and facilitators to retention and participation. Interviews were conducted with 87 adolescents, parents, and staff from three residential substance abuse treatment agencies in two states. Data were coded thematically and organized into themes by respondent type. Respondents reported barriers related to treatment population, program design, and communication and relationships, and reported facilitators related only to communication and relationships. Staff reported far more barriers than facilitators in comparison to either adolescents or parents. Findings suggest that parents and staff underestimate their contributions to the treatment process and practitioners might benefit from rethinking how to communicate the value of these stakeholders.
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145
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Abstract
This paper summarises data for the prevalence, correlates, and probable adverse health consequences of problem use of amphetamines, cannabis, cocaine, and opioids. We discuss findings from systematic reviews of the prevalence of illicit drug use and dependence, remission from dependence, and mortality in illicit drug users, and evidence for acute and chronic effects of illicit drug use. We outline the regional and global distribution of use and estimated health burden from illicit drugs. These distributions are likely to be underestimates because they have not included all adverse outcomes of drug use and exclude those of cannabis--the mostly widely used illicit drug. In high-income countries, illicit drug use contributes less to the burden of disease than does tobacco but a substantial proportion of that due to alcohol. The major adverse health effects of cannabis use are dependence and probably psychotic disorders and other mental disorders. The health-related harms of cannabis use differ from those of amphetamine, cocaine, and opioid use, in that cannabis contributes little to mortality. Intelligent policy responses to drug problems need better data for the prevalence of different types of illicit drug use and the harms that their use causes globally. This need is especially urgent in high-income countries with substantial rates of illicit drug use and in low-income and middle-income countries close to illicit drug production areas.
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Affiliation(s)
- Louisa Degenhardt
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
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Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med 2012; 9:e1001349. [PMID: 23209385 PMCID: PMC3507962 DOI: 10.1371/journal.pmed.1001349] [Citation(s) in RCA: 1677] [Impact Index Per Article: 139.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 10/17/2012] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Child sexual abuse is considered a modifiable risk factor for mental disorders across the life course. However the long-term consequences of other forms of child maltreatment have not yet been systematically examined. The aim of this study was to summarise the evidence relating to the possible relationship between child physical abuse, emotional abuse, and neglect, and subsequent mental and physical health outcomes. METHODS AND FINDINGS A systematic review was conducted using the Medline, EMBASE, and PsycINFO electronic databases up to 26 June 2012. Published cohort, cross-sectional, and case-control studies that examined non-sexual child maltreatment as a risk factor for loss of health were included. All meta-analyses were based on quality-effects models. Out of 285 articles assessed for eligibility, 124 studies satisfied the pre-determined inclusion criteria for meta-analysis. Statistically significant associations were observed between physical abuse, emotional abuse, and neglect and depressive disorders (physical abuse [odds ratio (OR) = 1.54; 95% CI 1.16-2.04], emotional abuse [OR = 3.06; 95% CI 2.43-3.85], and neglect [OR = 2.11; 95% CI 1.61-2.77]); drug use (physical abuse [OR = 1.92; 95% CI 1.67-2.20], emotional abuse [OR = 1.41; 95% CI 1.11-1.79], and neglect [OR = 1.36; 95% CI 1.21-1.54]); suicide attempts (physical abuse [OR = 3.40; 95% CI 2.17-5.32], emotional abuse [OR = 3.37; 95% CI 2.44-4.67], and neglect [OR = 1.95; 95% CI 1.13-3.37]); and sexually transmitted infections and risky sexual behaviour (physical abuse [OR = 1.78; 95% CI 1.50-2.10], emotional abuse [OR = 1.75; 95% CI 1.49-2.04], and neglect [OR = 1.57; 95% CI 1.39-1.78]). Evidence for causality was assessed using Bradford Hill criteria. While suggestive evidence exists for a relationship between maltreatment and chronic diseases and lifestyle risk factors, more research is required to confirm these relationships. CONCLUSIONS This overview of the evidence suggests a causal relationship between non-sexual child maltreatment and a range of mental disorders, drug use, suicide attempts, sexually transmitted infections, and risky sexual behaviour. All forms of child maltreatment should be considered important risks to health with a sizeable impact on major contributors to the burden of disease in all parts of the world. The awareness of the serious long-term consequences of child maltreatment should encourage better identification of those at risk and the development of effective interventions to protect children from violence.
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Affiliation(s)
- Rosana E Norman
- Queensland Children's Medical Research Institute, University of Queensland, Herston, Australia.
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147
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Homma Y, Chen W, Poon CS, Saewyc EM. Substance Use and Sexual Orientation Among East and Southeast Asian Adolescents in Canada. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2011; 21:32-50. [PMID: 22485070 DOI: 10.1080/1067828x.2012.636687] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The purpose of this study was to examine the relationship between substance use and sexual orientation among Asian adolescents in Canada. We analyzed an East and Southeast Asian subsample of a province-wide, school-based survey (weighted N = 51,349). Compared to heterosexual adolescents of the same gender, gay, lesbian, bisexual, and mostly heterosexual adolescents were more likely to use alcohol, marijuana, or other illicit drugs. Particularly, sexual minority girls were at increased risk for substance use. The findings suggest the need for substance use prevention interventions that are sensitive to gender, sexual orientation, and culture.
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148
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Perera-Diltz DM, Perry JC. Screening for Adolescent Substance-Related Disorders Using the SASSI-A2: Implications for Nonreporting Youth. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2011. [DOI: 10.1002/j.2161-1874.2011.tb00068.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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149
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Childhood abuse and harmful substance use among criminal offenders. Addict Behav 2011; 36:1205-12. [PMID: 21872997 DOI: 10.1016/j.addbeh.2011.07.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 05/14/2011] [Accepted: 07/20/2011] [Indexed: 01/09/2023]
Abstract
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.
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150
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Cerdá M, Tracy M, Sánchez BN, Galea S. Comorbidity among depression, conduct disorder, and drug use from adolescence to young adulthood: examining the role of violence exposures. J Trauma Stress 2011; 24:651-9. [PMID: 22147426 PMCID: PMC3268258 DOI: 10.1002/jts.20696] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We assessed relations among depression, conduct disorder, and drug use from adolescence to young adulthood, and evaluated whether exposure to violence contributed to disorder co-occurrence. We used data from the Project on Human Development in Chicago Neighborhoods. Respondents were 12-15 years old in 1995-1997 (N = 1,517), and were reinterviewed in 1997-2000 (n = 1,315), and 2000-2002 (n = 1,210). We examined exposure to violence at ages 12-15 and 14-17, and depression, conduct disorder, and drug use at ages 14-17 and 17-20. Multivariate transition models revealed an association between prior conduct disorder and drug use, as well as a relationship between prior depression and conduct disorder. Adolescent exposure to violence was associated with higher odds of conduct disorder and drug use but not depression. Comorbid relations between conduct disorder and drug use were independent of prior exposure to violence. Although preventing adolescent exposure to violence may reduce the risk of conduct disorder and drug use by young adulthood, future research needs to investigate alternative determinants of sequential comorbidity among depression, conduct disorder, and drug use in adolescence and young adulthood.
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Affiliation(s)
- Magdalena Cerdá
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168th St., New York, NY 10032, USA.
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