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Li J, He J, Wang P, Li J, Zhang Y, You J, Chongsuvivatwong V. Pathway of effects of adverse childhood experiences on the poly-drug use pattern among adults using drugs: A structural equation modeling. Front Public Health 2023; 11:1043222. [PMID: 37089499 PMCID: PMC10114543 DOI: 10.3389/fpubh.2023.1043222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/13/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionAdverse childhood experiences (ACEs) are associated with an increased risk of poly-substance use among drug-using adults. However, there is a paucity of literature on a direct or indirect relationship between ACEs and drug use patterns. We thus aimed to identify the pathway of effects of ACEs on drug use patterns in adults by the structural equation model (SEM).MethodsA cross-sectional study was conducted by respondent-driving sampling and consecutive sampling among adult drug users in Southwest China in 2021. Descriptive, univariate, and SEM analyses were performed by R software 4.2.1.ResultsOf 406 participants recruited from a drug abuse clinic, the average age was 34 years. The majority of the participants were male patients (98.3%) from ethnic minorities (79.6%), who were unmarried (71.6%) and employed (81.2%). Nearly 95.5% experienced ACEs with 46.6% of them reporting four or more ACEs. The median value of self-perception of drug abuse score, friend drug use score, and drug use score was 8.0 (3.0, 11.0), 1.0 (0.0, 1.0), and 1.0 (1.0, 2.0) respectively. In the confirmatory analysis part of SEM, the construct of latent variables fitted well with the data. Poly-drug use was significantly and directly affected by three predictors including monthly incomes (β = 0.09), friend drug use (β = 0.50), and ACEs (β = 0.11). The indirect effect of ACEs passing through self-perception of drugs (β = 0.09) was not significant.DiscussionACEs have an independent and direct effect on the drug user for poly-drug use apart from the effect of drug-using friends and family income.
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Affiliation(s)
- Jing Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- International Research Fellow, Prince of Songkla University, Hat Yai, Songkhla, Thailand
- *Correspondence: Jing Li
| | - Jianhui He
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Jiashuang Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yunjia Zhang
- Chenggong Campus, Yunnan University Secondary School, Kunming, Yunnan, China
| | - Jing You
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Virasakdi Chongsuvivatwong
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
- Virasakdi Chongsuvivatwong
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Kimong PJ, Erford BT, DeCino DA. Psychometric Synthesis of the Center for Epidemiologic Studies Depression Scale – Revised English and Translated/Adapted Versions. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1080/07481756.2022.2099900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Farooqui M, Shoaib S, Afaq H, Quadri S, Zaina F, Baig A, Liaquat A, Sarwar Z, Zafar A, Younus S. Bidirectionality of smoking and depression in adolescents: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 45:e20210429. [PMID: 35738567 PMCID: PMC10416256 DOI: 10.47626/2237-6089-2021-0429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/08/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recently, evidence has been accumulating that both smoking and mental health disorders are continuously increasing among adolescents. This systematic review elucidates the research into evidence of the direction of the association and risk factors influencing the relationship between smoking and depression. We also highlight recent studies on the effects of electronic cigarettes and developments on the association between depression and smoking. METHODS A literature search was conducted on databases including PubMed, Ovid Medline, EMBASE, and PsycINFO and in relevant neurology and psychiatry journals. Terms used for electronic searches included smoking, tobacco, cigarettes; depression; adolescent, youth; direction. Relevant information was then utilized to synthesize findings on the association between smoking and depression among adolescent population. RESULTS The initial database searches yielded 2,738 related articles. After screening and cross-referencing, duplicate articles, articles published in languages other than English, and studies on animals, social and lifestyle factors, mood disorders, and substance use were excluded. Of these, a total of 122 publications only focusing on smoking and depression in the adolescent population were selected for synthesis in this qualitative systemic review. These include 110 original research articles, eight meta-analyses and reviews, and four reports and websites. CONCLUSION The relationship between smoking and depression in the literature does not reflect the cause-effect relationship. The lack of evidence on the direction of the association may reflect futile study designs, confounding factors and/or use of indirect measures of depression and quantification of smoking. Future prospective randomized studies should target elucidation of the causal association.
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Affiliation(s)
- Mudassir Farooqui
- Department of NeurologyUniversity of IowaHospitals and ClinicsIowa CityIAUSA Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
| | - Samra Shoaib
- Department of PsychiatryNassau UniversityMedical CenterEast MeadowNYUSA Department of Psychiatry, Nassau University Medical Center, East Meadow, NY, USA.
| | - Humera Afaq
- Department of Public HealthNational UniversitySan DiegoCAUSA Department of Public Health, National University, San Diego, CA, USA.
| | - Syed Quadri
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Fatima Zaina
- Department of PulmonologyZiauddin University and HospitalKarachiPakistan Department of Pulmonology, Ziauddin University and Hospital, Karachi, Pakistan.
| | - Aqsa Baig
- Liaquat National HospitalMedical CollegeKarachiPakistan Liaquat National Hospital & Medical College, Karachi, Pakistan.
| | - Ayesha Liaquat
- Karachi Medical and Dental CollegeKarachiPakistan Karachi Medical and Dental College, Karachi, Pakistan.
| | - Zoona Sarwar
- Department of SurgeryUniversity of OklahomaOklahoma CityOKUSA Department of Surgery, University of Oklahoma, Oklahoma City, OK, USA.
| | - Atif Zafar
- Department of NeurologyUniversity of TorontoTorontoONCanada Department of Neurology, University of Toronto, Toronto, ON, Canada.
| | - Sana Younus
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTXUSA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Williams GC, Patte KA, Ferro MA, Leatherdale ST. Associations between Longitudinal Patterns of Substance Use and Anxiety and Depression Symptoms among a Sample of Canadian Secondary School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910468. [PMID: 34639768 PMCID: PMC8507734 DOI: 10.3390/ijerph181910468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/09/2021] [Accepted: 10/02/2021] [Indexed: 01/21/2023]
Abstract
The objective of this study is to examine the longitudinal associations between latent classes of substance use and anxiety and depression scores among youth who use substances. This study uses data from three waves (Wave 1: 2017/18, Wave 2: 2018/19, and Wave 3: 2019/20) of the COMPASS study. Students in grades 9 and 10 who reported substance use at baseline (n = 738) report their substance use (alcohol, cannabis, cigarettes, and e-cigarettes) and anxiety and depression symptoms at each wave. A Repeated Measures Latent Class Analysis (RMLCA) is used to determine substance use classes, and mixed models are used to examine the associations between substance use classes and anxiety and depression. We identify three classes of substance use: (1) occasional alcohol and e-cigarette use, (2) escalating poly-substance use, and (3) consistent poly-substance use. After controlling for relevant covariates, consistent poly-substance use is associated with depression (Female OR: 1.24 [95%CI: 0.46, 2.02]; Male OR 1.13 [95%CI: 0.38, 1.87]) but not anxiety. Escalating poly-substance use is associated with depression among males (OR 0.72 [95%CI: 0.10, 1.33]). These findings should be taken into consideration when creating prevention programming and treatment strategies for adolescents. Substance use programming should be comprehensive, consider multiple substances, and be cognizant of symptoms of mental illness, particularly depression.
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Affiliation(s)
- Gillian C. Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.F.); (S.T.L.)
- Correspondence:
| | - Karen A. Patte
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada;
| | - Mark A. Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.F.); (S.T.L.)
| | - Scott T. Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.F.); (S.T.L.)
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Kechter A, Barrington-Trimis JL, Cho J, Davis JP, Huh J, Black DS, Leventhal AM. Distress tolerance and subsequent substance use throughout high school. Addict Behav 2021; 120:106983. [PMID: 34010760 DOI: 10.1016/j.addbeh.2021.106983] [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: 12/21/2020] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine the association of perceived distress tolerance-one's ability to endure aversive experiences-with subsequent substance use frequency during adolescence. METHODS High school students (N = 3,203) were surveyed semiannually from 2013 to 2017. The Distress Tolerance Scale (DTS) was administered at baseline (9th grade) and self-reported past 30-day number of days used of alcohol, cigarettes, e-cigarettes, cannabis, and opioids (range: 0-30) were assessed at all timepoints. Self-reported baseline ever (vs. never) use of each substance and depressive/anxiety symptom status (clinical and subclinical vs. none) were tested as moderators. RESULTS Among baseline never substance users, a greater baseline mean DTS score was associated with fewer days of alcohol, cigarette, and opioid use in past-30 days over 4 years of follow-up (IRR range = 0.60-0.84); among ever-users, baseline mean DTS was not significantly associated with substance use across follow-up timepoints (p-interaction = 0.03). The association of DTS and frequency of substance use did not differ by baseline mental health status for any substance (all ps > 0.05). CONCLUSIONS Greater perceived distress tolerance at the start of high school may be a protective factor against substance use frequency prior to initial use. Interventions that build distress tolerance in early adolescence may be warranted to prevent higher frequency substance use throughout high school.
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Rodriguez AS, Robinson LD, Kelly PJ, Hudson S. Polysubstance use classes and health outcomes among women attending specialist substance use treatment services. Drug Alcohol Rev 2021; 41:488-500. [PMID: 34405938 DOI: 10.1111/dar.13375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 07/01/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Substance use is increasingly prevalent among women. Little research examines subgroups of women with substance use issues to identify their characteristics and thus enable treatment recommendations. The present study used latent class analysis to identify subgroups of substance use among women in substance-use treatment based on use in the 30 days prior to intake and examined changes in mental health and treatment outcomes following 60 days of treatment. METHODS Participants were women (N = 493) attending specialist non-government substance use treatment services in New South Wales, Australia. RESULTS Four distinct classes of substance users were identified: (i) Amphetamine Type Stimulants (ATS) Polysubstance (40.6%, n = 200); (ii) Alcohol Only (33.1%, n = 163); (iii) Cannabis and Alcohol (17.0%, n = 84) and (iv) Other Polysubstance (9.3%, n = 46). Women in the ATS Polysubstance class were the youngest and those in the Alcohol Only class were the oldest. DISCUSSION AND CONCLUSIONS Findings show that classes with high polysubstance use (ATS Polysubstance) differed from the single-substance use class (Alcohol Only). The ATS Polysubstance class had significantly greater improvements in health outcomes after 60 days compared to the Alcohol Only class. These findings suggest that although women with polysubstance use can benefit from substance use treatment, younger women (ATS Polysubstance) may benefit even more than older women (Alcohol Only). Future research should utilise a longitudinal design and examine additional psychosocial characteristics to extend on current findings.
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Affiliation(s)
| | - Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Medical and Health Institute, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Medical and Health Institute, University of Wollongong, Wollongong, Australia
| | - Suzie Hudson
- Network of Alcohol and Other Drugs Agencies, Sydney, Australia
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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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Agaku I, Odani S, Nelson J. Medical use and misuse of psychoactive prescription medications among US youth and young adults. Fam Med Community Health 2021; 9:e000374. [PMID: 33536180 PMCID: PMC7871219 DOI: 10.1136/fmch-2020-000374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate prevalence and correlates of medical use and misuse of psychoactive prescription medications among US youth and young adults. DESIGN Cross-sectional, self-reported surveys from the 2015-2018 National Survey of Drug Use and Health. Sampling was probabilistic and nationally representative. SETTING The target population included individuals from households, non-institutional group quarters (eg, college dormitories) and civilians living on military bases. Questionnaires were completed using computer-assisted self-interview methods. PARTICIPANTS Our analytical sample included youth and young adults aged 12-25 years (n=110 556). Psychoactive prescription medication misuse was a report by the respondent that they had used psychoactive prescription medications in the past year in any way not directed or prescribed for them. Medical use was defined as past-year use without a report of misuse. Because certain variables were assessed only among adults, our multivariable analysis to identify correlates of misuse was restricted to young adults aged 18-25 years (n=55 690). RESULTS Among US youth aged 12-17 years, 25.0% reported use of any psychoactive prescription medication assessed, and 5.7% reported past-year use of at least two psychoactive prescription medications. Among youth who used any psychoactive prescription medications, 20.9% (1.3 million) reported misuse; 3.4% were classified as having substance use disorder. Past-year use of each psychoactive prescription medication was: opioids (19.0%), stimulants (7.2%), tranquillisers (4.3%) and sedatives (2.2%). Among users of each psychoactive prescription medication, the estimated percentage reporting misuse was as follows: opioids (17.6%, 0.8 million), stimulants (24.2%, 0.4 million), tranquillisers (40.1%, 0.4 million) and sedatives (14.2%, 80 000). Among users of each psychoactive prescription medication, the estimated percentage having substance use disorder was as follows: opioids 2.6%, stimulants 3.0%, tranquillisers 7.0% and sedatives 3.6%. Analyses among young adults aged 18-25 years revealed that, compared with never users of non-prescription substances (including alcohol, tobacco, marijuana, cocaine, heroin), opioid misuse increased with: more recent use of non-prescription substances (adjusted prevalence ratios (APRs)=8.26, 2.75 and 2.41 for past ≤30-day, ≤12-month and >12-month use, respectively); and a higher number of substances used (APRs=1.69, 3.44, 6.82, 10.60 and 20.60 for 1, 2, 3, 4 and 5+ substances, respectively) (all p<0.05). Similar patterns were seen for stimulants, tranquillisers and sedatives. CONCLUSIONS It is important to monitor the diversity of medication misuse behaviours among youth and young adults, given their potential for abuse liability. Modifiable risk factors for prescription substance misuse, such as tobacco and other non-prescription substance use, underscore the need for comprehensive approaches towards health promotion among youth and young adults.
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Affiliation(s)
- Israel Agaku
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Satomi Odani
- Department of Social Medicine, University of Crete, Rethimno, Crete, Greece
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Peiper N, Aramburú C, Thompson K, Abadi M. Differential patterns of e-cigarette and tobacco marketing exposures among youth: Associations with substance use and tobacco prevention strategies. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 86:102925. [PMID: 33217687 PMCID: PMC8715723 DOI: 10.1016/j.drugpo.2020.102925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study identified patterns of tobacco marketing exposures among youth and examined their associations with substance use and tobacco prevention strategies. METHODS In Fall 2018, 2,058 middle and high school students (ages 11-18) in an Appalachian county completed a substance use and behavioral health surveillance survey. We conducted latent class analysis (LCA) to identify exposure classes based on responses to 14 tobacco marketing exposures. Multinomial logistic regression was then performed to determine associations between the latent classes with past 30-day substance use and tobacco prevention strategies (e.g., school policies, parental rules, prevention messages). RESULTS Four latent classes of marketing exposure were identified among middle school students: low exposure, television, social media, and high exposure. Multinomial logistic regression found significant associations between e-cigarette use with the social media and high exposure classes, while prescription drug use was associated with the social media class and alcohol use with the high exposure class. For high school students, five classes were identified: low exposure, social media, environmental, cigarettes, and high exposure. E-cigarette and prescription drug use were associated with the social media and high exposure classes. Cigarette use was associated with the social media class. School rules prohibiting e-cigarettes were associated with the television class for middle school students. Self-reported exposure to prevention messages about the harms of tobacco were associated with multiple exposure classes for both middle (television and social media) and high school (social media and cigarettes) students, suggesting that both pro- and anti-tobacco communications have become ubiquitous and may be saturating youth. CONCLUSION This study demonstrates the need for stricter tobacco marketing regulations and multi-level interventions beginning in early adolescence that focus on increasing media-based literacy for youth to better discern tobacco prevention messages from pro-tobacco communications.
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Affiliation(s)
- Nicholas Peiper
- Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA; Department of Epidemiology and Population Health, University of Louisville, 485 East Gray Street, Louisville 40202, KY, USA.
| | - Camila Aramburú
- Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA.
| | - Kirsten Thompson
- Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA.
| | - Melissa Abadi
- Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA.
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Evans BE, Kim Y, Hagquist C. A latent class analysis of changes in adolescent substance use between 1988 and 2011 in Sweden: associations with sex and psychosomatic problems. Addiction 2020; 115:1932-1941. [PMID: 32149444 DOI: 10.1111/add.15040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/19/2019] [Accepted: 03/02/2020] [Indexed: 11/26/2022]
Abstract
AIMS To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time. DESIGN Secondary analysis of repeated cross-sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988-91, 1995-98, 2002-05 and 2008-11). SETTING AND PARTICIPANTS The sample included all 15-16-year-olds in Värmland County, Sweden (n = 20 057). MEASUREMENTS Binary-coded substance use measures included life-time use of alcohol and tobacco, getting drunk and past school year use of inhalants. An eight-item scale was used to assess psychosomatic problems. FINDINGS A three-class model fitted the data best (i.e. non/low use, mainly alcohol use and polysubstance use). The patterns of substance use were different among cohorts; most notably, adolescents in the last cohort had lower odds of being included in the alcohol and polysubstance use classes rather than the non/low use class than in the earlier cohorts (all Ps < 0.001). Males had higher odds than females of being in the polysubstance use class rather than the non/low use class among the first three cohorts (all Ps < 0.001) but not the last. Sex was not associated with inclusion in the alcohol use class rather than the non/low use class. Adolescents who reported more psychosomatic problems had higher odds of being included in the alcohol and polysubstance use classes rather than the non/low use class (all Ps < 0.001). The associations of sex and psychosomatic problems with class inclusion did not change during the study period. CONCLUSIONS Between 1988 and 2011, patterns of substance use among adolescents in Sweden shifted away from polysubstance use and alcohol use to non-use or low use. Associations between patterns of substance use and sex and psychosomatic problems remained largely consistent across the study period.
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Affiliation(s)
- Brittany E Evans
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
| | - Yunhwan Kim
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
| | - Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
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Holmstedt A, Olsson M, Håkansson A. Clinical characteristics distinguishing tramadol-using adolescents from other substance-using adolescents in an out-patient treatment setting. Addict Behav Rep 2020; 11:100272. [PMID: 32322659 PMCID: PMC7160423 DOI: 10.1016/j.abrep.2020.100272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Non-medical Prescription Opioid Use (NMPOU) has increased worldwide during the last decades, and specifically, tramadol misuse may represent a novel pattern of substance use among adolescents. The present study aims to analyze characteristics distinguishing tramadol-using adolescents from other substance-using adolescents seeking out-patient treatment. METHODS This is a cross-sectional study of treatment-seeking patients between 13 and 24 years of age in an out-patient facility for substance use problems in Malmö, Sweden. A total of 526 treatment-seeking adolescents at an out-patient treatment center were included. Data on substance use, treatment history and socio-demographic variables were extracted through a semi-structured interview method aimed specifically for adolescents with alcohol or drug problems (Ung-DOK). Lifetime tramadol users were compared to non-users, and also, primary tramadol users were compared to remaining subjects. RESULTS Thirty-one percent (n = 162) were tramadol users (lifetime prevalence). In logistic regression, the tramadol group showed a significantly increased risk of tobacco use, problematic lifetime cocaine, benzodiazepine and amphetamine use, and were more likely to report contacts with the judicial system, and less likely to report contacts with child or adult psychiatry, and more likely to have parents born outside the Scandinavian countries. In logistic regression, primary tramadol use was negatively associated with frequent cannabis use. CONCLUSIONS Tramadol use appears to be a novel pattern among treatment-seeking adolescents. They showed a significantly increased risk of initiation of other illicit drugs and criminal behaviour, despite less contact with psychiatric care. More attention may be needed to this relatively novel pattern of opioid use.
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Affiliation(s)
- A. Holmstedt
- Lund University, Faculty of Medicine, Dept of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Malmö Addiction Center, Region Skåne, Malmö, Sweden
| | - M.O. Olsson
- Stockholm Center for Dependency Disorders, Region Stockholm, Centre for Psychiatric Research, Karolinska Institute, Stockholm, Sweden
| | - A. Håkansson
- Lund University, Faculty of Medicine, Dept of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Malmö Addiction Center, Region Skåne, Malmö, Sweden
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Karanikola M, Zisimou P, Nystazaki M, Koutrouba A, Severinsson E. Association between illegal use of substances and suicidal behavior in school students: An integrative review of empirical data. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2019; 32:80-101. [PMID: 30912247 DOI: 10.1111/jcap.12228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Investigation of the association between type of suicidal behavior and type and frequency of illegal use of substances (IUS) among school students (aged between 12 and 18 years), with a focus on gender differences. DESIGN AND METHODS A systematic review in PubMed, CINAHL, PsychINFO, and Scopus was performed. Identified articles were published between 2007 and 2018. RESULTS Twenty empirical studies confirmed the association between IUS and suicidality, strongly differentiated between males and females, highlighting the importance of gender-specific mediating factors. CONCLUSIONS Mental health nurses need to document gender factors, frequency, and motivation of IUS when screening adolescents experiencing suicidal behavior and IUS.
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Affiliation(s)
- Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Prodromoula Zisimou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Nystazaki
- Psychiatric Clinic of Ag. Anargiroi Hospital, Department of Nursing, National & Kapodistrian University of Athens, Athens, Greece
| | - Anna Koutrouba
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Elisabeth Severinsson
- Centre for Women's, Family and Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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Snenghi R, Pelletti G, Frigo AC, Forza G, Nalesso A, Montisci M, Favretto D. The Dangerous Pattern of Concurrent Use of Alcohol and Cocaine Among Drunk-Drivers of Northeast Italy. Alcohol Alcohol 2019; 53:735-741. [PMID: 30007323 DOI: 10.1093/alcalc/agy050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
Aim To estimate the prevalence of drug and polydrug use among drunk-drivers during the driving license regranting program, in order to assess the inclusion of toxicological tests on hair and urine samples in the systematic methodology in this category of subjects. Short summary A total of 2160 drunk-drivers were tested for alcohol and drugs during driving license regranting. Thirty-one subjects showed alcohol use, 212 illicit drug use and, among these, 131 were polydrug users. Nineteen different patterns of drug and polydrug use were found. Cocaine was detected in 165 subjects. Methods The study was performed on 2160 drunk-drivers examined at Legal Medicine and Toxicology Unit of the University of Padova, in a 3-year-period (2014-2017). The positivity for one or more illicit drugs in hair or urine samples was confirmed by LC/MS and GC/MS methods. Chi-square test, Fischer's exact test and Cochran-Armitage Trend test were used to study the correlation between general characteristics of the examined sample and the presence of drug/polydrug use. Results Thirty-one subjects showed alcohol use, 212 illicit drug use and, among these, 131 were polydrug users. Nineteen different patterns of drug and polydrug use were found. Cocaine was detected in 165 subjects in whom 122 showed a concurrent use of alcohol and cocaine, identified through the detection of cocaethylene in hair samples. No significant association and/or trends between drug/polydrug use and the general characteristics of the sample were detected. Conclusions The results show that drug and polydrug use among drunk-drivers should be subjected to toxicological as well as alcohological monitoring, especially in the regranting procedure. The implementation of this procedure could improve the knowledge of dimensions of the issue, providing a powerful means for the reduction of phenomenon of driving under the influence of alcohol and drugs.
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Affiliation(s)
- Rossella Snenghi
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
| | - Guido Pelletti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Bologna, Italy
| | - Anna Chiara Frigo
- Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Giovanni Forza
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
| | - Alessandro Nalesso
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
| | - Massimo Montisci
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
| | - Donata Favretto
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
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McKelvey K, Popova L, Kim M, Chaffee BW, Vijayaraghavan M, Ling P, Halpern-Felsher B. Heated tobacco products likely appeal to adolescents and young adults. Tob Control 2018; 27:s41-s47. [PMID: 30352843 PMCID: PMC6252490 DOI: 10.1136/tobaccocontrol-2018-054596] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/13/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Beginning in the 1960s in the USA and globally since 1998, tobacco companies have beenaggressively promoting heated tobacco products (HTP). In 2016, Philip Morris International (PMI) applied to the US Food and Drug Administration (FDA) seeking authorisation to market their IQOS HTP system and flavoured 'HeatSticks' in the USA as a modified-risk tobacco product (MRTP). METHODS We systematically evaluated the publicly available data PMI submitted to FDA in its MRTP application to determine whether PMI's IQOS product meets the US Tobacco Control Act's standard for MRTP claims. We examined whether PMI provided sufficient data showing tobacco users will not initiate with IQOS, that youth will not misperceive the MRTP-related claims being made concerning IQOS, and how youth perceive health risks associated with IQOS. RESULTS PMI's own studies failed to provide evidence that youth, including non-users and former users, will not find IQOS appealing, will not initiate use of IQOS and will not perceive these products as risk-free. Further, PMI did not refer to independent studies conducted among adolescents which could influence their conclusions. Finally, their studies suffered from design and implementation flaws and cannot be relied on to support the proffered claims. CONCLUSION PMI's own data and available evidence from scientific studies conducted independent of the tobacco industry regarding how novel tobacco products are currently being marketed suggest that introduction of IQOS will result in adolescent and young adult non-users initiating tobacco use with IQOS and could also increase poly-use of IQOS along with other tobacco products.
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Affiliation(s)
- Karma McKelvey
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Minji Kim
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
| | - Benjamin W Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California, San Francisco, California, USA
| | - Maya Vijayaraghavan
- General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, California, USA
| | - Pamela Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA
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Gonzálvez MT, Morales A, Orgilés M, Sussman S, Espada JP. Role of smoking intention in tobacco use reduction: A mediation analysis of an effective classroom-based prevention/cessation intervention for adolescents. Addict Behav 2018; 84:186-192. [PMID: 29723801 DOI: 10.1016/j.addbeh.2018.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Although some school-based tobacco cessation and prevention programs have been proven to be effective, there remains a lack of understanding of how these programs succeed. METHODS This longitudinal study aimed to test smoking intention as a mediator of Project EX's intervention efficacy to reduce tobacco use. Using a computerized random number generator, six high schools located in the Mediterranean coast were randomly selected to participate in the program condition (Spanish version of Project EX) or the waiting-list control group with baseline, immediate-posttest, and 12-month follow-up assessments. At baseline, 685 adolescents aged 14-20 years (mean age: 14.87; SD = 0.92; 47.4% were females) were evaluated using self-administered tests of tobacco, and smoking intention. A biomarker of smoke inhalation, a measurement of exhaled carbon monoxide (ECM), was used. Mediation analyses were conducted using the PROCESS v2.12 macro for Windows. RESULTS Project EX had a significant effect on smoking intention. Indirect effects indicated that Project EX reduced the ECM level, and number of cigarettes used. CONCLUSIONS This is the first Spanish study that explored intention as a mediator of the long-term efficacy of Project EX to reduce tobacco use in adolescents. Results suggested that interventions that reduce consumption intention at short-term are more likely to be successful in decreasing tobacco use in the long-term.
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Affiliation(s)
- María T Gonzálvez
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain.
| | - Alexandra Morales
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain
| | - Mireia Orgilés
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain
| | - Steve Sussman
- Preventive Medicine/Psychology, University of Southern California, United States
| | - José P Espada
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain
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Quiroga E, Pinto-Carral A, García I, Molina AJ, Fernández-Villa T, Martín V. The Influence of Adolescents' Social Networks on Alcohol Consumption: A Descriptive Study of Spanish Adolescents Using Social Network Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091795. [PMID: 30134531 PMCID: PMC6164789 DOI: 10.3390/ijerph15091795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 08/06/2018] [Accepted: 08/17/2018] [Indexed: 11/16/2022]
Abstract
In adolescence, friends are important due to their influence on the acquisition of habits such as alcohol consumption. However, there is a lack of studies that describe the structural context of adolescents, which would be useful to implement prevention strategies. Therefore, our research question was how adolescent friendship networks influence alcohol consumption. Our goal was to determine the structural profile of adolescent at-risk alcohol users and their relational context in the classroom. We designed a descriptive cross-sectional study based on social network analysis to analyze structural patterns. We recruited 195 students. Social-network and alcohol-consumption variables were analyzed using the UCINET and STATA programs. Some 86.67% of participants had consumed alcohol at some time in their lives and the prevalence of at-risk alcohol use was higher in females (50.48% vs. 49.52%; OR: 1.84; CI 95%: 0.99⁻3.43%; p = 0.036). The lower the intensity of friendship, the more contacts adolescent at-risk alcohol users had within the network, and the easier it was for them to access their peers. Consequently, we conclude that the structure of a class is a key factor that merits further research.
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Affiliation(s)
- Enedina Quiroga
- SALBIS Research Group, Faculty of Health Sciences, University of León, Campus of Ponferrada s/n, Ponferrada, 24401 León, Spain.
| | - Arrate Pinto-Carral
- SALBIS Research Group, Faculty of Health Sciences, University of León, Campus of Ponferrada s/n, Ponferrada, 24401 León, Spain.
| | - Isaías García
- SECOMUCI Research Groups, Escuela de Ingenierías Industrial e Informática, University of León, Campus de Vegazana s/n, C.P. 24071 León, Spain.
| | - Antonio J Molina
- GIIGAS Research Group, Instituto de Biomedicina (IBIOMED), University of León, Campus de Vegazana s/n, C.P. 24071 León, Spain.
| | - Tania Fernández-Villa
- GIIGAS Research Group, Instituto de Biomedicina (IBIOMED), University of León, Campus de Vegazana s/n, C.P. 24071 León, Spain.
| | - Vicente Martín
- GIIGAS Research Group, Instituto de Biomedicina (IBIOMED), Ciber de Epidemiologia y Salud Pública (CIBERSP), University of León, Campus de Vegazana s/n, C.P. 24071 León, Spain.
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