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Black N, Noghrehchi F, Yuen WS, Aiken A, Clare PJ, Chan G, Kypri K, McBride N, Bruno R, Slade T, Boland V, Mattick R, Peacock A. Transitions to polysubstance use: Prospective cohort study of adolescents in Australia. Addiction 2024; 119:1100-1110. [PMID: 38499496 DOI: 10.1111/add.16468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/23/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND AND AIMS Adolescent polysubstance use has been associated with adverse social and health outcomes. Our aim was to measure rates and transitions to polysubstance use during adolescence and identify factors associated with initiation and discontinuation of polysubstance use. DESIGN Prospective cohort study. Multistate Markov modelling was used to estimate rates and identify correlates of transitions between substance use states. SETTING AND PARTICIPANTS Adolescent-parent dyads (n = 1927; adolescents in grade 7, age ≈13 years) were recruited from Australian schools during 2010/11 (Wave 1). Adolescents were surveyed annually until 2016/17 (n = 1503; age ≈19 years; Wave 7) and parents were surveyed annually until 2014/15 (Wave 5). MEASUREMENTS Alcohol, tobacco, cannabis and 3,4-methylenedioxymethamphetamine (MDMA) use outcomes were collected at Waves 3-7. Potential confounders were collected at Waves 1-6 and consisted of sex, anxiety and depression symptoms and externalizing problems, parental monitoring, family conflict and cohesion, parental substance use and peer substance use. Covariates were age and family socioeconomic status. FINDINGS Few adolescents engaged in polysubstance use at earlier waves (Wave 3: 5%; Wave 4: 8%), but proportions increased sharply across adolescence (Waves 5-7: 17%, 24%, 36%). Rates of transitioning to polysubstance use increased with age, with few (<9%) adolescents transitioning out. More externalizing problems (odds ratio [OR] = 1.10; 99.6% confidence interval [CI] = 1.07-1.14), parental heavy episodic drinking (OR = 1.22; 99.6% CI = 1.07-1.40), parental illicit substance use (OR = 3.56; 99.6% CI = 1.43-8.86), peer alcohol use (OR = 5.68; 99.6% CI = 1.59-20.50) and peer smoking (OR = 4.18; 99.6% CI = 1.95-8.81) were associated with transitioning to polysubstance use. CONCLUSIONS Polysubstance use in Australia appears to be rare during early adolescence but more common in later adolescence with low rates of transitioning out. Externalizing problems and greater parental and peer substance use are risk factors for adolescent polysubstance use that may be suitable intervention targets.
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Affiliation(s)
- Nicola Black
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Firouzeh Noghrehchi
- Biomedical Informatics and Digital Health, The University of Sydney, Camperdown, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
- Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Shenton Park, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
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Kelly AB, Munnings A, Zhao X, Rowland B, Laurens KR, Campbell M, Williams J, Bailey JA, Killingly C, Abimanyi-Ochom J, Kremer P, Toumbourou JW. Polydrug use in Australian 12-14 year olds from 2006 to 2017: an examination of drug use profiles, emotional control problems, and family relationship characteristics. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2023. [DOI: 10.1080/00049530.2023.2174705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- Adrian B. Kelly
- Centre for Inclusive Education, Queensland University of Technology, Brisbane, Australia
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
- Centre for Child Health and Well-being (Childhood Adversity, Mental Health, and Resilience Theme), Queensland University of Technology, Brisbane, Australia
| | - Andrew Munnings
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Xiang Zhao
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Bosco Rowland
- School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Melbourne, Australia
- Faculty of Medicine and the Eastern Health Clinical School, Monash University Melbourne, Australia
| | - Kristin R. Laurens
- Centre for Inclusive Education, Queensland University of Technology, Brisbane, Australia
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
- Centre for Child Health and Well-being (Childhood Adversity, Mental Health, and Resilience Theme), Queensland University of Technology, Brisbane, Australia
| | - Marilyn Campbell
- Centre for Inclusive Education, Queensland University of Technology, Brisbane, Australia
- School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, Australia
| | - Joanne Williams
- School of Health, Swinburne University of Technology, Melbourne, Australia
| | - Jen A. Bailey
- Social Developmental Research Group, University of Washington, Seattle, WA, USA
| | - Callula Killingly
- Centre for Inclusive Education, Queensland University of Technology, Brisbane, Australia
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Julie Abimanyi-Ochom
- School of Health and Social Development, Deakin University, Melbourne, Australia
| | - Peter Kremer
- School of Exercise and Nutrition Sciences and Centre for Sport Research, Deakin University, Melbourne, Australia
| | - John W. Toumbourou
- School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Melbourne, Australia
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Schaefer JD, Nelson KM, Wilson S. The Effects of Adolescent Cannabis Use on Psychosocial Functioning: A Critical Review of the Evidence. Psychiatr Clin North Am 2023; 46:677-689. [PMID: 37879831 PMCID: PMC11113564 DOI: 10.1016/j.psc.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adult socioeconomic status, and legal consequences, mechanisms underlying these associations remain largely unclear. Cannabis use may have a deleterious causal effect on functioning, but it is also possible the association may be due to reverse causation or confounding by shared vulnerability factors that account for both cannabis use in adolescence and concurrent and subsequent psychosocial impairment. Causally informative studies that delineate these possibilities, including research using epidemiologic samples and quasi-experimental designs, are critical to move the field forward.
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Affiliation(s)
- Jonathan D Schaefer
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@JonSchaeferPhD
| | - Kayla M Nelson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@KaylaNeIson
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA.
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Ford JA, McCabe SE, Schepis TS. Prescription Drug Misuse with Alcohol Coingestion among US Adolescents: Youth Experiences, Health-related Factors, and Other Substance Use Behaviors. J Addict Med 2023; 17:379-386. [PMID: 37579092 PMCID: PMC10354210 DOI: 10.1097/adm.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND While alcohol use and prescription drug misuse (PDM) are common among adolescents, there is relatively little research on coingestion. This is disquieting as polysubstance use has become a major contributing factor in drug overdose deaths among young people in the United States. METHODS The current research uses multiple years of data from the National Survey on Drug Use and Health (2015-2019) to assess characteristics associated with coingestion among adolescents aged 12 to 17 years ( N = 57,352). Multinomial logistic regression analysis is used to identify characteristics associated with past 30-day PDM with and without alcohol coingestion. The primary objective is to determine how youth experiences with parents, involvement in conventional activities, religiosity, social support, and school status are associated with coingestion. RESULTS Among adolescents who report past 30-day PDM, 18.6% coingest with alcohol and 77.5% of adolescents who coingest report at least one substance use disorder. Several youth experiences were significantly associated with opioid coingestion including increased conflict with parents (relative risk ratio [RRR], 1.27; 95% confidence interval [CI], 1.07-1.48), lower levels of religiosity (RRR, 0.72; 95% CI, 0.52-0.98), less social support (RRR, 0.36; 95% CI, 0.18-0.69), and not being in school (RRR, 3.86; 95% CI, 1.33-11.17). In addition, emergency department visits, depression, and other substance use behaviors were also significantly associated with coingestion. CONCLUSIONS Findings demonstrate a strong connection between coingestion and substance use disorder among US adolescents. The findings from the current study can inform prevention and intervention efforts by identifying youth experiences and health-related factors that are associated with coingestion.
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Affiliation(s)
- Jason A Ford
- From the Department of Sociology, University of Central Florida, Orlando, FL (JAF); Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI (JAF, SEMC, TSS); Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI (SEMC); Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI (SEMC); Institute for Social Research, University of Michigan, Ann Arbor, MI (SEMC); Department of Psychology, Texas State University, San Marcos, TX (TSS)
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Rodríguez-Cano R, Kypriotakis G, Cortés-García L, Bakken A, von Soest T. Polysubstance use and its correlation with psychosocial and health risk behaviours among more than 95,000 Norwegian adolescents during the COVID-19 pandemic (January to May 2021): a latent profile analysis. Lancet Reg Health Eur 2023; 28:100603. [PMID: 37131865 PMCID: PMC9996359 DOI: 10.1016/j.lanepe.2023.100603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
Background Polysubstance use represents an adolescent health risk; however, large-scale studies investigating this issue during the COVID-19 pandemic are scarce. We aim to (i) characterise substance use profiles among adolescents and (ii) identify correlates of such substance use profiles. Methods Norwegian nationwide survey data from 2021 were analysed using latent profile analysis. Participants were 97,429 adolescents aged 13–18. We assessed cigarette, e-cigarette and snus use, alcohol consumption, and cannabis and other illicit drug use. Correlates included psychosocial variables, health risk behaviours, and COVID-19-related problems. Findings We identified three adolescent profiles; those who use no substances (n = 88,890; 91%); those who use snus and alcohol (n = 6546; 7%); and those who use multiple substances (i.e., polysubstance profile; n = 1993; 2%). Boys, older adolescents, adolescents with lower socio-economic status, and those reporting low levels of parental control, and higher parental alcohol use, mental health problems, pain-related variables, and other health risk behaviours were most likely to be in the polysubstance profile. Adolescents with social and mental health issues related to COVID-19 were more at risk of being in the polysubstance profile. Adolescents who use snus and alcohol showed similar patterns of risk factors, but on a somewhat lower level than those in the polysubstance profile. Interpretation Adolescents who use multiple substances have an unhealthier lifestyle, are at a higher risk of experiencing psychosocial impairments, and report more problems related to the COVID-19 pandemic. Preventative strategies to reduce polysubstance use might help promote psychosocial well-being in adolescents across various life domains. Funding This study was funded by two grants from the 10.13039/501100005416Research Council of Norway (project #: 288083 and 300816). The 10.13039/501100014232Norwegian Directorate of Health has funded the data collection. The Research Council of Norway and the Norwegian Directorate of Health have not had any role in study design, data collection, data analysis, interpretation, and writing of the report.
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Affiliation(s)
- Rubén Rodríguez-Cano
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway,Corresponding author. PROMENTA Research Center, Department of Psychology, University of Oslo, Psykologisk institutt Postboks-1094 Blindern, 0317, Oslo, Norway
| | - George Kypriotakis
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laura Cortés-García
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anders Bakken
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | - Tilmann von Soest
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway,Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
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Pavlov RO, Andreescu V. Gender-based differences in abstention and desistance from drug use among American Indian adolescents. J Ethn Subst Abuse 2023:1-39. [PMID: 36877014 DOI: 10.1080/15332640.2023.2185335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Informed by the social control theoretical perspective, this study intends to identify the factors more likely to differentiate American Indian (AI) adolescents who never used illicit drugs (abstainers) and those who used drugs in the past but did not report recent drug usage (desisters) from their peers who reported lifetime and recent drug usage (persisters). This secondary analysis is based on data from a multi-site study conducted between 2009 and 2013. It is based on a gender-balanced sample (N = 3,380) of AI adolescents (50.50% male; Mean age = 14.75; SD = 1.69) representing the major AI languages and cultural groups in the U.S. Half of the AI adolescents reported lifetime drug use (50.40%), 37.50% never used drugs, and 12.10% stopped using drugs. When controlling for the variables included in the analysis, AI boys were significantly more likely than AI girls to desist from drug use. Both boys and girls who never used drugs tended to be younger, were less likely to have delinquent friends and a lower level of self-control, had stronger bonds to school, but lower levels of family attachment, and reported increased parental supervision. Compared to drug users, desisters associated significantly less with delinquent peers. While school attachment, self-control, and parental monitoring did not differentiate female desisters from female drug users, adolescent boys who desisted from drug use were more likely to report higher levels of school attachment and parental monitoring and their level of self-control was less likely to be low.
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Affiliation(s)
- Ruben O Pavlov
- Department of Criminal Justice, University of Louisville, Louisville, Kentucky
| | - Viviana Andreescu
- Department of Criminal Justice, University of Louisville, Louisville, Kentucky
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Schaefer JD, Nelson KM, Wilson S. The Effects of Adolescent Cannabis Use on Psychosocial Functioning: A Critical Review of the Evidence. Child Adolesc Psychiatr Clin N Am 2023; 32:43-55. [PMID: 36410905 DOI: 10.1016/j.chc.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adult socioeconomic status, and legal consequences, mechanisms underlying these associations remain largely unclear. Cannabis use may have a deleterious causal effect on functioning, but it is also possible the association may be due to reverse causation or confounding by shared vulnerability factors that account for both cannabis use in adolescence and concurrent and subsequent psychosocial impairment. Causally informative studies that delineate these possibilities, including research using epidemiologic samples and quasi-experimental designs, are critical to move the field forward.
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Affiliation(s)
- Jonathan D Schaefer
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@JonSchaeferPhD
| | - Kayla M Nelson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@KaylaNeIson
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA.
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8
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Kaner E, Islam S, Lipperman-Kreda S. Adolescent alcohol initiation: Context of close friendships and the role of trust. Drug Alcohol Depend 2022; 237:109515. [PMID: 35660334 PMCID: PMC9462552 DOI: 10.1016/j.drugalcdep.2022.109515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/14/2022] [Accepted: 05/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Adolescent initiation of drinking and intoxication is associated with concurrent and later problems among adolescents. This study explores the mechanisms by which the context of close friendships is important to adolescents' decisions to initiate drinking and heavy alcohol use. METHODS In-depth face-to-face qualitative interviews were conducted online with 50 adolescents (12-16 years) who reported lifetime drinking. These semi-structured interviews allowed adolescents to describe their first experiences with drinking, reflecting on their social and environmental contexts, decision-making process, and expectations. We conducted a thematic analysis of the narratives, which revealed the nuances of social relationships and trusting peers and their impacts on alcohol use initiation patterns. RESULTS In contrast to common perceptions of peer pressure, youth described decision-making about alcohol that was influenced by feelings of safety and security produced by close relationships. Specifically, social relationships, especially the presence of close friends, influenced decisions to initiate alcohol use. CONCLUSION Results of this study suggest that close peer relationships enhanced feelings of safety even while engaging in risky behaviors. These results suggest the importance of understanding the complex relationships between social contexts, close friendships, and perceived trust and can inform future research and interventions on alcohol prevention or delayed initiation among adolescents.
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Affiliation(s)
- Emily Kaner
- Prevention Research Center, Pacific Institute of Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, California 94704, USA.
| | - Sabrina Islam
- Prevention Research Center, Pacific Institute of Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, California 94704, USA; School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Berkeley, California 94704, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute of Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, California 94704, USA
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The Mediating Role of Contextual Problems and Sensation Seeking in the Association between Substance Use and Mental Health in Adolescents from Northern Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042262. [PMID: 35206450 PMCID: PMC8871919 DOI: 10.3390/ijerph19042262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/05/2022] [Accepted: 02/09/2022] [Indexed: 02/06/2023]
Abstract
Substance use is a risk behavior that has been associated with adverse mental health outcomes in adolescence. The aim of this study was to determine the relation between behavioral problems, emotional problems, and substance use as well as the mediating role of contextual problems and sensation seeking in this relation. A cross-sectional study of 2277 adolescents from Northern Chile was conducted. The System for the Evaluation of Children and Adolescents (SENA) was used to assess substance use, contextual problems, sensation seeking, and emotional and behavioral problems. Through a mediational model, it was observed that substance use has a positive indirect effect on emotional and behavioral problems when both contextual problems and sensation seeking act as mediating variables. An indirect effect of substance use on contextual problems with sensation seeking as a mediator was also observed. The results suggests that context and sensation seeking are a relevant source of information in understanding adolescents and their propensity to use drugs. Interventions based on addressing contextual problems (problems with school, peers, and family) and enhancing personal resources should be implemented in order to reduce substance use in adolescents as well as the consequences it can generate in the short, medium, and long term.
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Does parental permissiveness toward cigarette smoking and alcohol use influence illicit drug use among adolescents? A longitudinal study in seven European countries. Soc Psychiatry Psychiatr Epidemiol 2022; 57:173-181. [PMID: 34120221 PMCID: PMC8761139 DOI: 10.1007/s00127-021-02118-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/02/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Adolescents' perceptions of parental norms may influence their substance use. The relationship between parental norms toward cigarette and alcohol use, and the use of illicit substances among their adolescent children is not sufficiently investigated. The purpose of this study was to analyze this relationship, including gender differences, using longitudinal data from a large population-based study. METHODS The present study analyzed longitudinal data from 3171 12- to 14-year-old students in 7 European countries allocated to the control arm of the European Drug Addiction Prevention trial. The impact of parental permissiveness toward cigarettes and alcohol use reported by the students at baseline on illicit drug use at 6-month follow-up was analyzed through multilevel logistic regression models, stratified by gender. Whether adolescents' own use of cigarette and alcohol mediated the association between parental norms and illicit drug use was tested through mediation models. RESULTS Parental permissive norms toward cigarette smoking and alcohol use at baseline predicted adolescents' illicit drug use at follow-up. The association was stronger among boys than among girls and was mediated by adolescents' own cigarette and alcohol use. CONCLUSION Perceived parental permissiveness toward the use of legal drugs predicted adolescents' use of illicit drugs, especially among boys. Parents should be made aware of the importance of norm setting, and supported in conveying clear messages of disapproval of all substances.
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Abraham O, Rosenberger CA, Birstler J, Tierney K. Examining adolescents' opioid knowledge and likelihood to Utilize an educational game to promote medication safety. Res Social Adm Pharm 2021; 18:3191-3198. [PMID: 34561172 DOI: 10.1016/j.sapharm.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Adolescents' knowledge on opioids is seldom studied, despite the fact young people are one of the groups most affected by the opioid crisis within the United States. There is a need to understand adolescents' perceptions about opioid misuse and safety to create the necessary tools to educate adolescents on safe opioid use. OBJECTIVE This study sought to understand adolescents' knowledge and perceptions of opioid use and safety as well as their receptiveness to using an educational game for improving medication safety knowledge. METHODS A 67-item survey was developed to assess adolescents' opioid perceptions, knowledge, and the likelihood of an educational game to enhance their opioid medication safety. A nationally representative sample of US adolescents aged 12 to 18 were recruited via a Qualtrics participant panel to complete the online survey from October through November 2020. Survey questions were grouped into 10 categories to represent key concepts and summarized into concept scores. Concepts were described through means, median, and range as well as percent correct for individual questions. Differences between groups were assessed using Kruskal-Wallis tests. Concept scores and their relation to the participant's age were described by the Pearson's correlation coefficient and the linear model coefficient. RESULTS A total of 592 responses were analyzed. Male and older participants reported greater perceived opioid knowledge than females. White participants reported higher rates of perceived opioid knowledge, behavioral intent, and knowledge of safe medication disposal than any other racial group. About 80% of participants were receptive to the use of an educational game to increase their opioid safety knowledge. CONCLUSIONS There are discrepancies in adolescents' knowledge on opioid safety and harm amongst genders, race, and age. Study findings support the use of an educational game to increase adolescents' opioid knowledge. Future studies should design an educational game intended for a diverse audience.
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Affiliation(s)
- Olufunmilola Abraham
- University of Wisconsin-Madison, School of Pharmacy, Social and Administrative Sciences Division, Madison, WI 53705, USA.
| | - Claire A Rosenberger
- University of Wisconsin-Madison, School of Pharmacy, Social and Administrative Sciences Division, Madison, WI 53705, USA
| | - Jen Birstler
- University of Wisconsin- Madison, School of Medicine and Public Health, Department of Biostatistics & Medical Informatics, Madison, WI 53726, USA
| | - Kathleen Tierney
- University of Wisconsin-Madison, School of Pharmacy, Social and Administrative Sciences Division, Madison, WI 53705, USA
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Ladis B, Trucco EM, Huang H, Thomlison B, Fava NM. Longitudinal Effects of Peer, School, and Parenting Contexts on Substance Use Initiation in Middle Adolescence. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:566-584. [PMID: 34096482 PMCID: PMC8649054 DOI: 10.1080/26408066.2021.1932660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Purpose: Preventing substance use initiation (SUI) can reduce negative consequences associated with adult substance use disorder. The role of involvement with deviant peers, school connectedness, and parenting quality on SUI was investigated among a community sample (N = 387).Method: PROCESS tested whether three parenting quality factors (Parental Knowledge and Affective Relationships, Parental Control, and Parental Communication and Involvement) served as moderators of two different mediation pathways (involvement with deviant peers and school connectedness) on three SUI outcomes (alcohol, cigarettes, and marijuana).Results: Involvement with deviant peers mediated the relation between school connectedness and substance use. Low school connectedness predicted high deviant peer affiliation, which, in turn, predicted high SUI. School connectedness did not mediate involvement with deviant peers and substance use. Parenting quality factors were not significant moderators.Conclusion: Supporting adolescents who lack strong school connections may help prevent involvement with deviant peers, which, in turn, may prevent SUI.
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Affiliation(s)
- Barry Ladis
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
| | - Elisa M Trucco
- Department of Psychology, Florida International University, Miami, United States
- Center for Children and Families, Florida International University, Miami, United States
- Department of Psychiatry, University of Michigan, United States
| | - Hui Huang
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
| | - Barbara Thomlison
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
| | - Nicole M Fava
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
- Center for Children and Families, Florida International University, Miami, United States
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Frazer I, Thielking M, Orr C. Perspectives of Australian family support professionals on the causes and consequences of maladaptive parent-adolescent conflict. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1948796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Imogen Frazer
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Monica Thielking
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Catherine Orr
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
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Luke JN, Thorpe A, Black C, Thorpe L, Thomas D, Eades S, Rowley K. Collaborative Social-Epidemiology: A Co-analysis of the Cultural and Structural Determinants of Health for Aboriginal Youth in Victorian Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8674. [PMID: 34444421 PMCID: PMC8393666 DOI: 10.3390/ijerph18168674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, interpret data, and contextualize findings. Using this participatory co-analysis approach, we selected "cultural" and "structural" determinants identified by Aboriginal organizations as important and modelled these using principal component analysis. Resulting components were then modelled using logistic regression to investigate associations with "likely being well" (Kessler-10 score < 20) for 88 Aboriginal adolescents aged 11-17 years. Principal component analysis grouped 11 structural variables into four components and 11 cultural variables into three components. Of these, "grew up in Aboriginal family/community and connected" associated with significantly higher odds of "likely being well" (OR = 2.26 (1.01-5.06), p = 0.046). Conversely, "institutionally imposed family displacement" had significantly lower odds (OR = 0.49 (0.24-0.97), p = 0.040) and "negative police contact and poverty" non-significantly lower odds (OR = 0.53 (0.26-1.06), p = 0.073) for "likely being well". Using a co-analysis participatory approach, the voices of Aboriginal researchers and Aboriginal organizations were able to construct a social world that aligned with their ways of knowing, doing, and being. Findings highlighted institutionally imposed family displacement, policing, and poverty as social sites for health intervention and emphasized the importance of strong Aboriginal families for adolescents.
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Affiliation(s)
- Joanne Nicole Luke
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
| | - Alister Thorpe
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
| | - Carlina Black
- The Victorian Aboriginal Child Care Agency, Preston 3072, Australia;
| | - Lisa Thorpe
- Bubup Wilam-Aboriginal Child and Family Centre, Thomastown 3074, Australia;
| | - David Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia;
| | - Sandra Eades
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
- Curtin Medical School, Curtin University, Bentley 6102, Australia
| | - Kevin Rowley
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
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15
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Neuroimaging evidence for structural correlates in adolescents resilient to polysubstance use: A five-year follow-up study. Eur Neuropsychopharmacol 2021; 49:11-22. [PMID: 33770525 DOI: 10.1016/j.euroneuro.2021.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 12/13/2022]
Abstract
Early initiation of polysubstance use (PSU) is a strong predictor of subsequent addiction, however scarce individuals present resilience capacity. This neuroimaging study aimed to investigate structural correlates associated with cessation or reduction of PSU and determine the extent to which brain structural features accounted for this resilient outcome. Participants from a European community-based cohort self-reported their alcohol, tobacco and cannabis use frequency at ages 14, 16 and 19 and had neuroimaging sessions at ages 14 and 19. We included three groups in the study: the resilient-to-PSU participants showed PSU at 16 and/or 14 but no more at 19 (n = 18), the enduring polysubstance users at 19 displayed PSU continuation from 14 or 16 (n = 193) and the controls were abstinent or low drinking participants (n = 460). We conducted between-group comparisons of grey matter volumes on whole brain using voxel-based morphometry and regional fractional anisotropy using tract-based spatial statistics. Random-forests machine-learning approach generated individual-level PSU-behavior predictions based on personality and neuroimaging features. Adolescents resilient to PSU showed significant larger grey matter volumes in the bilateral cingulate gyrus compared with enduring polysubstance users and controls at ages 19 and 14 (p<0.05 corrected) but no difference in fractional anisotropy. The larger cingulate volumes and personality trait "openness to experience" were the best precursors of resilience to PSU. Early in adolescence, a larger cingulate gyrus differentiated adolescents resilient to PSU, and this feature was critical in predicting this outcome. This study encourages further research into the neurobiological bases of resilience to addictive behaviors.
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16
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Busse A, Kashino W, Suhartono S, Narotama N, Pelupessy D, Irwanto, Essau CA. An open trial investigation of Treatnet Family among adolescents with substance use problems. Addict Behav Rep 2021; 14:100358. [PMID: 34141858 PMCID: PMC8185142 DOI: 10.1016/j.abrep.2021.100358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/23/2021] [Accepted: 05/20/2021] [Indexed: 11/21/2022] Open
Abstract
Treatnet Family (TF) had a positive significant impact in reducing alcohol use. After participating in the TF, the adolescents were engaged with significantly fewer friends who consumed substances and participated in antisocial behaviours. The two most reported life events (i.e., “got in a lot of arguments or fights” and “had problems with drugs or alcohol”) before the intervention were significantly decreased at the follow-up assessment. Based on parent’s/family member’s reports, there was a significant decrease in mental health problems across time.
Introduction Studies that used evidence-based family therapies have demonstrated significant effects in reducing adolescent drug use and delinquent behaviours, and in reducing comorbid mental health problems. However, almost all these studies were conducted in high-income countries. The overall aim of the present study was to explore the effect of United Nations Office on Drugs and Crime’s (UNODC) Treatnet Family (TF) in reducing substance consumption, drug-related activities, reducing mental health problems, and in improving family interaction among adolescents with substance-use problems. Method Nineteen adolescents who had been referred to a community counselling clinic because of substance-use problems and their parents/family members participated in TF. They completed a set of questionnaires to measure substance use, family functioning, mental health problems, and life events at pre-, post-intervention as well as at a one month-follow-up assessment. Results TF had a positive significant impact in reducing alcohol use among adolescents with substance-use problems. The number of adolescents who smoked cigarettes and marijuana, and used amphetamines reduced across time. After participating in TF, the adolescents were involved with significantly fewer friends who consumed substances and participated in antisocial behaviours. Furthermore, parent/family member reported a significant decrease in mental health problems, and positive changes in adolescent’s behaviours. Conclusion The TF had a positive impact in reducing alcohol consumption and problems related to substance consumption among adolescents with substance-use problems when delivered by practitioners in routine community settings.
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Affiliation(s)
- Anja Busse
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Wataru Kashino
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Sanita Suhartono
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Narendra Narotama
- United Nations Office on Drugs and Crime, Country Office Indonesia, Indonesia
| | - Dicky Pelupessy
- Faculty of Psychology, Universitas Indonesia, Jakarta, Indonesia
| | - Irwanto
- Center on Social Innovation and Public Health Policy, Atma Jaya Indonesian Catholic University, Jakarta, Indonesia
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17
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Chan GCK, Becker D, Butterworth P, Hines L, Coffey C, Hall W, Patton G. Young-adult compared to adolescent onset of regular cannabis use: A 20-year prospective cohort study of later consequences. Drug Alcohol Rev 2021; 40:627-636. [PMID: 33497516 DOI: 10.1111/dar.13239] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 08/20/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This paper compares consequences of cannabis use initiated after high school with those of cannabis initiation in adolescence, with estimates of the proportion of adverse consequences accounted for by adult-onset and adolescent-onset cannabis users. METHODS A state-representative sample in Victoria, Australia (n = 1792) participated in a 10-wave longitudinal study and was followed from age 15 to 35 years. Exposure variable: Patterns of cannabis use across 20 years. Outcomes at age 35: Alcohol use, smoking, illicit drug use, relationship status, financial hardship, depression, anxiety and employment status. RESULTS Substantially more participants (13.6%) initiated regular use after high school (young-adult onset) than in adolescence (7.7%, adolescent onset). By the mid-30s, both young-adult and adolescent-onset regular users were more likely than minimal/non-users (63.5%) to have used other illicit drugs (odds ratio [OR] > 20.4), be a high-risk alcohol drinker (OR > 3.7), smoked daily (OR > 7.2) and less likely to be in relationships (OR < 0.4). As the prevalence of the young-adult-onset group was nearly double of the adolescent-onset group, it accounted for a higher proportion of adverse consequences than the adolescent-onset group. DISCUSSION AND CONCLUSIONS Cannabis users who began regular use in their teens had poorer later life outcomes than non-using peers. The larger group who began regular cannabis use after leaving high school accounted for most cannabis-related harms in adulthood. Given the legalisation of cannabis use in an increasing number of jurisdictions, we should increasingly expect harms from cannabis use to lie in those commencing use in young adulthood.
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Affiliation(s)
- Gary C K Chan
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia
| | - Denise Becker
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Peter Butterworth
- Research School of Population Health, Australian National University, Canberra, Australia.,Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia
| | - Lindsey Hines
- Population Health Sciences Institute, University of Bristol, Bristol, UK
| | - Carolyn Coffey
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia
| | - George Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
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18
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Franzese AT, Blalock DV, Blalock KM, Wilson SM, Medenblik A, Costanzo PR, Strauman TJ. Regulatory Focus and Substance Use in Adolescents: Protective Effects of Prevention Orientation. Subst Use Misuse 2021; 56:33-38. [PMID: 33078977 PMCID: PMC8320403 DOI: 10.1080/10826084.2020.1833926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Substance use is a major risk factor for negative health and functioning outcomes among middle schoolers. The purpose of this study was to assess whether individual differences in the adolescents' goal orientation are associated with elevated or attenuated risk for substance use. Regulatory focus theory stipulates that individuals vary in their strength of orientation toward promotion goals ("making good things happen") and prevention goals ("keeping bad things from happening"). Objectives: We sought to examine the association between individual differences in regulatory focus and adolescents' reports of their own and their friends' substance use. Methods: Participants were 241 seventh grade students who completed measures of regulatory focus (promotion and prevention orientation), self-reported substance use, perceived substance use habits of peers, and demographics. Logistic regression models were used to examine adjusted odds of lifetime tobacco use, alcohol use, and marijuana use for both participants' own use and their reports of friends' use. Results: Prevention orientation was associated with lower odds of all self-reported lifetime substance use outcomes (tobacco, alcohol, and marijuana). Prevention orientation was also associated with lower odds of reporting all types of substance use among friends. Promotion orientation was not associated with any self-reported substance use outcome, and was only associated with higher odds of reporting lifetime alcohol use among friends. Conclusions: These findings underscore the importance of regulatory focus as it relates to adolescent substance use. Future research may seek to incorporate regulatory focus within interventions intended to prevent or delay initiation of substance use in adolescents.
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Affiliation(s)
| | - Dan V Blalock
- Center to Advance Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Kyla M Blalock
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Sarah M Wilson
- Center to Advance Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Alyssa Medenblik
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Philip R Costanzo
- Department of Psychology and Neuroscience, Duke University, Durham, NC
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19
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Finan LJ, Lipperman-Kreda S. Changes in Drinking Contexts over the Night Course: Concurrent and Lagged Associations with Adolescents' Nightly Alcohol Use. Alcohol Clin Exp Res 2020; 44:2611-2617. [PMID: 33067817 PMCID: PMC7725854 DOI: 10.1111/acer.14486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Examining underage drinking contexts can advance the field of adolescent substance use prevention by supporting and informing interventions that can target adolescents in specific contexts. The current study examines how concurrent and lagged situational (i.e., alcohol availability and adult supervision), social (i.e., the number of people and presence of friends), and location (i.e., home vs other location) context characteristics change risks for alcohol use over the night course. METHODS Text messages with links to online surveys were used to collect ecological momentary assessment (EMA) data over 2 weekends from adolescents in California. Data were collected using adolescents' personal cell phones early and late in the evening and the following morning. Analyses were limited to adolescents with at least 1 drinking occasion during EMA (N = 58; Mage = 16.64, SD = 0.74; 48% female; 83% White). RESULTS Drinking earlier in the evening was positively associated with continued drinking over the night course. Context characteristics were found to play important concurrent and lagged roles in increasing the likelihood of alcohol use over evening hours. CONCLUSIONS Findings indicated substantive concurrent and lagged social, situational, and location-based contextual effects on adolescent alcohol use over the course of an evening. Importantly, context characteristics were differentially associated with alcohol use over the course of the evening. The fact that these contextual factors are modifiable suggests that the use of prevention strategies delivered to adolescents throughout the evening may reduce adolescents' drinking and related problems over the evening hours.
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Affiliation(s)
- Laura J Finan
- From the, Department of Psychology, (LJF), Illinois State University, Normal, Illinois, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, (SL-K), Pacific Institute for Research and Evaluation, Berkeley, California, USA
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20
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Sahed I, Jourdain A. Families and Relationships with Friends in the Genesis of Addiction in Adolescents. Essay on Life Course Analysis of 15–18 Year-Olds Enrolled in School, in Paris and the Surrounding Area (Ile-de-France). JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2020. [DOI: 10.1080/1067828x.2020.1805837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Imaine Sahed
- Université Paris-Saclay, UVSQ, CNRS, Versailles, France
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21
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Serdarevic M, Elliott A, Striley CW, Cottler LB, Osborne V. If kids ruled the world, how would they stop non-medical use of prescription drugs? JOURNAL OF HEALTH RESEARCH 2020; 34:283-294. [PMID: 34296069 PMCID: PMC8293975 DOI: 10.1108/jhr-02-2019-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We examined ideas about how youth would mitigate non-medical use of prescription medications among their peers. DESIGN/METHODOLOGY/APPROACH The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) interviewed 11,048 youth10-18 years of age between 2008 and 2011 from entertainment venues of 10 US urban, suburban, and rural areas. Using a mixed-methods approach, participants completed a survey culminating in open ended questions asking: 1) How should kids your age be told about prescription drugs and their effects?; 2) If you ran the world, how would you stop kids from taking other people's prescription medicines?; 3)Why do people use prescription stimulants without a prescription? Responses from a random sample of 900 children were analyzed using qualitative thematic analyses. FINDINGS The random sample of 900 youth (52% female, 40% white, with a mean age was 15.1 years) believed they should be educated about prescription drugs and their negative effects at schools, at home by parents, through the media, and health professionals. Youth would stop kids from using other people's prescription drugs through more stringent laws that restricted use, and education about negative consequences of use. Peer pressure was the most common reason youth gave for using other's pills, though some reported using for curiosity. ORIGINALITY/VALUE This analysis shows the importance of considering youth's opinions on non-medical use of prescription medications, which are often overlooked. Studies should disseminate this data from youth to stop the illicit use of prescription drugs among teens and youth.
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Affiliation(s)
| | - Amy Elliott
- University of Florida, Gainesville, Florida, United States
| | | | | | - Vicki Osborne
- Drug Safety Research Unit, Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
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22
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Prevalence and correlates of youth poly-substance use in the COMPASS study. Addict Behav 2020; 107:106400. [PMID: 32222564 DOI: 10.1016/j.addbeh.2020.106400] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/03/2020] [Accepted: 03/16/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Youth poly-substance use, associated with long-term negative health and social outcomes, is of increasing concern following the rise of e-cigarette vaping and cannabis legalization in Canada. This work aimed to investigate current evidence on correlates of this behaviour to inform effective prevention and harm reduction programming. DESIGN Cross-sectional sample taking part in a cohort study. SETTING Canadian high schools (AB, BC, ON, QC) PARTICIPANTS: 74,501 Canadian high school students who completed the COMPASS student questionnaire in 2018/2019. MEASUREMENTS Self-report data on use of five substances (alcohol, cigarettes, e-cigarettes, cannabis, and opioids) alongside demographic factors, social and school support, and mental health-related measures. RESULTS Of the 39% of youth who reported current substance use, 53% reported using two or more. E-cigarette vaping was most prevalent (28%) and most often combined with other substances. Feeling supported by friends and having no problem with seeking help at school were associated with higher levels of poly-substance use. Family support, school connectedness, and school support to resist drugs decreased the risk of substance co-use. CONCLUSIONS The evidence presented here suggests that interventions for youth poly-substance use should rely on joint efforts between parents, schools, and communities to focus on structural factors rather than problematizing the individual.
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23
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Egan KL, Gregory E, Osborne VL, Cottler LB. Power of the Peer and Parent: Gender Differences, Norms, and Nonmedical Prescription Opioid Use Among Adolescents in South Central Kentucky. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:665-673. [PMID: 30637670 DOI: 10.1007/s11121-019-0982-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined risk factors of nonmedical prescription opioid use (NMPOU) among adolescents and how risk factors differ by gender. In the fall of 2017, adolescents attending 6th through 12th grades across 44 schools in 10 south central Kentucky counties were invited to participate in an anonymous, school-based survey. A total of 11,761 adolescents completed the survey. Logistic regression was conducted to examine the association between NMPOU and constructs of the Theory of Reasoned Action (i.e., attitudes and subjective norms), descriptive norms (i.e., peer use), and parental control of prescription medications in the home. There were 297 (2.7%) adolescents who reported NMPOU in the past 12 months. In the adjusted multivariate logistic regression model, for both males and females, the adolescents who perceived that more of their peers engaged in NMPOU were significantly more likely to endorse NMPOU, whereas male and female adolescents who perceived their peers disapproved of use were significantly less likely to report NMPOU. Parent disapproval was significantly associated with decreased NMPOU for females only. Moderated regression analyses revealed that gender moderated the relationship between parental disapproval and NMPOU. We found that during adolescence, NMPOU is influenced by peer norms for both genders and parental norms for females. These results indicate that prevention efforts should focus on changing adolescents' peer and parental norms related to NMPOU.
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Affiliation(s)
- Kathleen L Egan
- Department of Heath Education and Promotion, East Carolina University, 3105 Carol G. Belk Building, Greenville, NC, 27858, USA.
| | - Eric Gregory
- Community Survey Solutions, LLC, Bowling Green, KY, USA
| | - Vicki L Osborne
- Drug Safety Research Unit, Southampton, UK.,Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Linda B Cottler
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
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24
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Osborne V, Striley CW, Nixon SJ, Winterstein AG, Cottler LB. Sex differences in peer and parental risk factors for non-medical use of prescription opioids in youth. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 46:203-215. [PMID: 31603348 DOI: 10.1080/00952990.2019.1671436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Prescription opioid non-medical use (NMU) and its associated consequences have been of concern in the US in recent years.Objective: We examined peer influence and parental guidance, in addition to peer and parental sources of alcohol, on patterns of prescription opioid use, including NMU, among males and females separately. We hypothesized that peer influence and parental guidance would have a differential influence for males and females.Methods: The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) recruited youth 10-18 years from 10 US cities between 2008 and 2011 (n = 11,048). The cross-sectional survey included questions on past 30-day prescription opioid use (10,965 provided responses), with NMU defined as non-oral use and/or use of someone else's opioids. Multinomial logistic regression was conducted, examining medical use only and NMU in the past 30 days.Results: Among the 10,965 youth, 3.1% (n = 345) reported past 30-day NMU. Obtaining alcohol from parents was associated with increased odds of past 30-day NMU among males (OR = 2.49, 95%CI: 1.54,4.03) only. For each additional close friend who used other substances, odds of past 30-day NMU increased among males (OR = 1.23, 95%CI: 1.11,1.37) and females (OR = 1.15, 95%CI: 1.04,1.27). Increased number of close friends was associated with decreased odds of past 30-day NMU among males (OR = 0.87, 95%CI: 0.78,0.97) and females (OR = 0.86, 95%CI: 0.77,0.96).Conclusions: Peer and parental risk factors for prescription opioid NMU were identified among youth, although not all differed by sex. An increased number of close friends was a protective factor against prescription opioid NMU for both males and females.
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Affiliation(s)
- Vicki Osborne
- Department of Epidemiology, University of Florida, Gainesville, FL, USA.,Drug Safety Research Unit, Southampton, UK
| | | | - Sara J Nixon
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Almut G Winterstein
- Department of Epidemiology, University of Florida, Gainesville, FL, USA.,Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, FL, USA
| | - Linda B Cottler
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
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25
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Kiedrowski L, Selya A. Patterns of Polysubstance Use Among Non-Hispanic White and American Indian/Alaska Native Adolescents: An Exploratory Analysis. Prev Chronic Dis 2019; 16:E40. [PMID: 30950789 PMCID: PMC6464047 DOI: 10.5888/pcd16.180108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The prevalence of polysubstance use is well described, but less is known about correlates and patterns of polysubstance use. Previous research characterized latent subgroups of substance users by the type substance used. Racial disparities in the prevalence of polysubstance use exist, particularly for American Indian/Alaska Native (AI/AN) populations. The objective of our study was to describe differences in patterns of polysubstance use between non-Hispanic white and AI/AN adolescents. METHODS We obtained data from the 2013 Youth Risk Behavior Survey (YRBS). We analyzed substance use patterns (cigarettes, alcohol, marijuana, cocaine, inhalants, heroin, methamphetamines, ecstasy, steroids, and injected drugs) separately among 375 AI/AN and 15,633 non-Hispanic white adolescents. We calculated pairwise correlations. Exploratory factor analysis identified latent factors of polysubstance use patterns. RESULTS The use of all substances by AI/AN adolescents was the same or higher than use by non-Hispanic white adolescents, particularly for cocaine, heroin, and steroids. We found strong correlations between use of heroin and injected drugs and between use of cocaine and ecstasy among both populations. We found a latent factor for cigarettes, alcohol, and marijuana and another factor for broad polysubstance use among both populations. We found a factor for steroids and injected drugs among AI/AN adolescents, a factor for cocaine and ecstasy among non-Hispanic white adolescents, and a unique factor for methamphetamines. CONCLUSION Differences in substance use patterns exist between AI/AN and non-Hispanic white adolescents, particularly for illegal drug use. If validated in future research, information on these differences could be used to inform tailored intervention programs aimed at preventing substance use.
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Affiliation(s)
- Lee Kiedrowski
- University of North Dakota School of Medicine & Health Sciences, Grand Forks, North Dakota
- 1301 N Columbia Rd, Grand Forks, ND 58203-2898.
| | - Arielle Selya
- Department of Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
- Behavioral Sciences Group, Sanford Research, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
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26
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Chan GCK, Leung J, Hall W. Non-medical use of pharmaceutical opioids with and without other illicit substances in Australia: Prevalence and correlates. Drug Alcohol Rev 2019; 38:151-158. [PMID: 30652366 DOI: 10.1111/dar.12893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 12/08/2018] [Accepted: 12/10/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION AND AIMS To estimate the prevalence of non-medical use of pharmaceutical opioids and examine the socio-demographic, psychological, health and behavioural correlates and type of opioids used. DESIGN AND METHODS Data from the Australian National Drug Strategy Household Survey 2016 was used. The sample consisted of. 23 448 participants aged over 14 years (54% female). The key measure was opioid use status in the past year. Based on participants' responses to questions about their substance use in the past 12 months, they were grouped into four opioid use status: (i) No illicit substance use (ISU) and no non-medical use of pharmaceutical opioids (NMUPO); (ii) ISU but no NMUPO; (iii) NMUPO but no ISU; and (iv) NMUPO and ISU. RESULTS The prevalence non-medical pharmaceutical opioid use was 3.56%. Two-thirds of them engaged in NMUPO but no ISU; one-third engaged in NMUPO and ISU. Younger people were more likely to use pharmaceutical opioids in addition to other illicit drugs, while older people were more likely to only use pharmaceutical opioids. Alcohol risk and daily smoking were associated with using pharmaceutical opioids and other illicit drugs, but not with pharmaceutical opioids only. Those who reported only using pharmaceutical opioids were more likely to use over-the-counter codeine products. DISCUSSION AND CONCLUSIONS Over 700 000 Australian used pharmaceutical opioids for non-medical purpose. Among users, two-thirds used only opioids and one-third used opioids in addition to other illicit drugs. Profile of these two types of users were substantially different. Future prevention efforts targeting different type of opioids users may need to be optimised based on their profiles.
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Affiliation(s)
- Gary Chung Kai Chan
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia
| | - Janni Leung
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia
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Banks DE, Hershberger AR, Pemberton T, Clifton RL, Aalsma MC, Zapolski TCB. Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:313-322. [PMID: 30620228 DOI: 10.1080/00952990.2018.1558450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Adolescent cannabis use is associated with increased risk for psychological problems, with evidence for more severe problems among youth who use cannabis in combination with other substances (i.e., polysubstance use). Juvenile offenders engage in both cannabis use and polysubstance use at higher rates than the general adolescent population. Yet, limited research has examined the relationship between cannabis poly-use (e.g., cannabis and alcohol use) and functional or psychological problems among juvenile offenders. OBJECTIVES The current study addresses this gap by examining the association of polysubstance use of cannabis compared to cannabis only use with cognitive functioning, psychological distress, and substance-related problems among juvenile detainees. METHODS Participants were 238 detained youth ages 12-18 (80.4 % male, 77.3% non-White) who completed assessments of substance use, intellectual functioning, psychological symptoms, and substance-related problems. Youth were also assessed by a clinical psychologist for substance use disorder. RESULTS Four cannabis-use typologies were identified; cannabis and alcohol use was the largest class, followed by cannabis only use, cannabis, alcohol and other drug use, then cannabis and other drug use. Polysubstance use was associated with lower scores on measures of intellectual functioning, more externalizing and internalizing symptomology, and more substance-related problems relative to cannabis only use. However, the relationship between polysubstance use and problems varied by typology. CONCLUSIONS Findings suggest that justice-involved youth engaged in polysubstance use may be at greater need for concurrent academic, affective, and behavioral support in their rehabilitation and transition back to the community.
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Affiliation(s)
- Devin E Banks
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
| | | | - Taylor Pemberton
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
| | - Richelle L Clifton
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
| | - Matthew C Aalsma
- b Department of Pediatrics , Indiana University School of Medicine , Indianapolis , IN , USA
| | - Tamika C B Zapolski
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
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Longitudinal patterns of amphetamine use from adolescence to adulthood: A latent class analysis of a 20-year prospective study of Australians. Drug Alcohol Depend 2019; 194:121-127. [PMID: 30419406 DOI: 10.1016/j.drugalcdep.2018.08.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 08/22/2018] [Accepted: 08/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND To examine the longitudinal patterns of amphetamine use over twenty years from adolescence to the mid-thirties; and identify adolescent antecedents of future problematic patterns of use. DESIGN Ten-wave longitudinal study following participants from age 15 to age 35 in Victoria, Australia. Participants (N = 1755; 47% males) first enrolled in the Victoria Adolescent Health Cohort Study in 1992. MEASUREMENTS Outcome: Self-reported frequency of amphetamine use. PREDICTORS Gender, depression and anxiety, peer alcohol and tobacco use; self-reported alcohol, tobacco and cannabis use, self-reported adolescent antisocial behavior. FINDINGS Three different longitudinal patterns were identified: Non-user (83.7%); Occasional user (14.5%); Regular user (1.8%). Among the two user patterns, amphetamine use was commonly initiated in late teenage years or early 20s, peaked at mid-20s, and declined substantially by mid-30s. Participants who used cannabis and had smoking peers during adolescence were at significantly more likely to become an occasional or regular user (p < .05). CONCLUSION Regular cannabis use and peer tobacco use during adolescence were the two strongest predictors of a longitudinal pattern of regular amphetamine use in the mid-30s. This suggests that prevention programs could be implemented around or before mid-adolescence and interventions to reduce amphetamine harms focus on high-risk individuals in their 20s when amphetamine use was at its peak.
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El Kazdouh H, El-Ammari A, Bouftini S, El Fakir S, El Achhab Y. Potential risk and protective factors of substance use among school adolescents in Morocco: A cross-sectional study. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1535003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Hicham El Kazdouh
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Abdelghaffar El-Ammari
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Siham Bouftini
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Samira El Fakir
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Youness El Achhab
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
- Regional Centre for Careers Education and Training of Fez-Meknes, Fez, Morocco
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Mehus CJ, Doty J, Chan G, Kelly AB, Hemphill S, Toumbourou J, McMorris BJ. Testing the Social Interaction Learning Model's Applicability to Adolescent Substance Misuse in an Australian Context. Subst Use Misuse 2018; 53:1859-1868. [PMID: 29509085 PMCID: PMC6133245 DOI: 10.1080/10826084.2018.1441307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Parents and peers both influence the development of adolescent substance misuse, and the Social Interaction Learning (SIL) model provides a theoretical explanation of the paths through which this occurs. OBJECTIVE The SIL model has primarily been tested with conduct outcomes and in US samples. This study adds to the literature by testing the SIL model with four substance use outcomes in a sample of Australian youth. METHOD We used structural equation modeling to test the fit of the SIL model to a longitudinal sample (n = 907) of students recruited in grade 5 in Victoria, Australia participating in the International Youth Development Study, who were resurveyed in grades 6 and 10. RESULTS The model fit was good (χ2(95) = 248.52, p < .001; RMSEA = .04 [90% CI: .036 - .049]; CFI = .94; SRMR = .04). Path estimates from parenting to antisocial behavior and from antisocial behavior to antisocial peers were significant. In turn, having antisocial peers was significantly related to alcohol use, binge drinking, tobacco use, and marijuana use. From parenting, only the direct path to marijuana use was significant, but indirect effects were significant. CONCLUSIONS The SIL model illustrates that parenting plays an early role in the formation of adolescent peer relations that influence substance misuse and identifies etiological pathways that can guide the targets of prevention. The SIL pathways appear robust to the Australian social and policy context.
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Affiliation(s)
- Christopher J. Mehus
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota
| | - Jennifer Doty
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota
| | - Gary Chan
- Centre for Youth Substance Abuse Research, University of Queensland
| | - Adrian B. Kelly
- Centre for Youth Substance Abuse Research, University of Queensland
| | - Sheryl Hemphill
- School of Psychology, Australian Catholic University, Centre for Adolescent Health, Department of Paediatrics, The University of Melbourne, Royal Children’s Hospital, & Murdoch Childrens Research Institute
| | - John Toumbourou
- School of Psychology, Deakin University and, Murdoch Children’s Research Institute
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Family, personal, and social factors associated with the non-use of contraceptive methods during the first sexual experience in adolescent women. J Public Health Policy 2017; 39:100-110. [DOI: 10.1057/s41271-017-0094-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Lipperman-Kreda S, Gruenewald PJ, Grube JW, Bersamin M. Adolescents, alcohol, and marijuana: Context characteristics and problems associated with simultaneous use. Drug Alcohol Depend 2017; 179:55-60. [PMID: 28755540 PMCID: PMC5599344 DOI: 10.1016/j.drugalcdep.2017.06.023] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/16/2017] [Accepted: 06/18/2017] [Indexed: 11/17/2022]
Abstract
We investigated contexts of simultaneous use of alcohol and marijuana and the impact of simultaneous use on problems among adolescents. Ecological momentary assessment data were obtained over two weekends from 150 adolescents in California (47% female, M age=16.36years), using smartphone surveys administered early and late in the evening and again the following morning. We assessed whether, in what context, and with whom adolescents drank alcohol and used other substances over 3 evening hours. We assessed problems they experienced each evening on the following morning. Results showed that greater adult supervision in every context was associated with a 55% lower risk of simultaneous use (RRR=0.45, p≤.05). Contexts with no other underage drinkers were associated with 99% lower risk of simultaneous use (RRR=0.01, p≤.005). Each occasion of simultaneous use was related to 110% increase in the number of problems (IRR=2.10, p≤.005), with 83%, 221% and 311% greater odds of violence (OR=1.83, p≤.05), driving under the influence or riding with a drunk driver (OR=3.21, p≤.05), or being drunk (OR=4.11, p≤.005). Additional analyses showed that these problems may be attributed largely to the alcohol consumed in each context. Results demonstrate that it is essential to consider situational and social characteristics of substance use contexts to better understand adolescent simultaneous use of alcohol and drugs and problems.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612, United States.
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612, United States
| | - Joel W Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612, United States
| | - Melina Bersamin
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612, United States
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