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Metheny N, Tran NK, Scott D, Dastur Z, Lubensky ME, Lunn MR, Obedin-Maliver J, Flentje A. Intimate partner violence is related to future alcohol use among a nationwide sample of LGBTQIA+ people: Results from The PRIDE Study. Drug Alcohol Depend 2024; 260:111342. [PMID: 38820909 DOI: 10.1016/j.drugalcdep.2024.111342] [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: 11/15/2023] [Revised: 04/09/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer, intersex, aromantic and asexual (LGBTQIA+) communities in the United States experience higher rates of alcohol use than the general population. While experiencing intimate partner violence (IPV) is thought to lead to increased alcohol use in LGBTQIA+ people, little research has investigated the temporal relationship between IPV and alcohol use in this population. METHODS Data from two annual questionnaires of The Population Research in Identity and Disparities for Equality Study (The PRIDE Study) longitudinal cohort (n=3,783) were included. Overall IPV and three sub-types (physical, sexual, and emotional) - measured in 2021 using the extended Hurt, Insult, Threaten, Scream (E-HITS) screening tool - was examined as a predictor of Alcohol Use Disorders Identification Test (AUDIT) score in 2022 using multivariable linear regression to assess linear and quadratic associations. Models were adjusted for sociodemographic characteristics and history of alcohol use. RESULTS One-quarter (24.7%) of respondents reported experiencing past-year IPV in 2021. The mean AUDIT score in 2022 was 3.52 (SD = 4.13). In adjusted models, both linear (B: 0.26, 95% CI: 0.14, 0.38) and quadratic (B: -0.03, 95% CI: -0.04, -0.01) terms for overall IPV were significantly associated with next-year AUDIT score. These patterns were mirrored in each IPV sub-type, were not attenuated when accounting for relationship characteristics, and were heterogeneous across gender identity groups. CONCLUSIONS These results provide evidence of a temporal relationship between IPV and alcohol use in LGBTQIA+ communities, suggesting that efforts to prevent and mitigate IPV may help reduce alcohol use disparities in this population.
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Affiliation(s)
- Nicholas Metheny
- Nell Hodgson Woodruff School of Nursing Emory University, Atlanta, GA, USA.
| | - Nguyen Khai Tran
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Dalton Scott
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Zubin Dastur
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Micah E Lubensky
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA, USA; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Epidemiology and Public Health, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA; Department of Epidemiology and Public Health, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Annesa Flentje
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA; Department of Psychiatry, School of Medicine, University of California, San Francisco, CA, USA
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Forkus SR, Goldstein SC, Schick MR, Flanagan JC, Weiss NH. Hair cortisol and substance use among women currently experiencing intimate partner violence: The role of PTSD symptom severity. Drug Alcohol Depend 2024; 261:111378. [PMID: 38936182 DOI: 10.1016/j.drugalcdep.2024.111378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Substance use is highly prevalent among women experiencing intimate partner violence (IPV) and has been associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and resulting cortisol response. Posttraumatic stress disorder (PTSD) symptoms may play an important role in exacerbating the association between cortisol levels and substance use behaviors. PURPOSE This study examined the role of PTSD symptoms in the relation between cortisol and past month substance use behaviors. The current study used hair cortisol as an index of past 30-day HPA-axis functioning and ecological momentary assessment (EMA) to characterize substance use behaviors more accurately over a 30-day period. METHOD Participants were 90 community women who had experienced physical or sexual IPV in the past 30 days by their current male partner and used any amount of alcohol or drugs (M age = 40.71; 54.4 % white). Participants completed (a) a baseline interview, (b) EMA for 30-days, and (c) a follow up interview where they were asked to provide a hair sample for cortisol analyses. Data collection took place from 2018 to 2020. RESULTS PTSD severity moderated the relations between cortisol and days of drinking and binge drinking. In the context of high PTSD symptomology, women with high cortisol levels spent, on average, an additional 7.4 days drinking and 8.1 days binge drinking in the past 30 days compared to women with low cortisol levels, in a model adjusted for age. CONCLUSIONS Results highlight the prominent role of PTSD symptoms in the association between cortisol and alcohol use among women experiencing IPV.
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Affiliation(s)
- Shannon R Forkus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Silvi C Goldstein
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Nicole H Weiss
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Jarnecke AM, Saraiya TC. Identifying best practices for substance-related intimate partner violence screening and referral: a narrative review. Front Psychiatry 2024; 15:1380102. [PMID: 38957738 PMCID: PMC11217329 DOI: 10.3389/fpsyt.2024.1380102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/29/2024] [Indexed: 07/04/2024] Open
Abstract
Introduction Substance use is strongly associated with intimate partner violence (IPV) and is a modifiable risk factor for IPV. However, lack of comprehensive screening and referral for co-occurring IPV and substance use, along with their psychiatric sequalae, limits the identification and implementation of effective interventions for substance-related IPV. This narrative review (1) investigates the literature on screening and referral practices for IPV, and if these include screening for substance use or other psychiatric comorbidities, (2) provides recommendations for current best practices, and (3) suggests future directions for research and practice aimed at identifying and reducing substance-related IPV. Methods A narrative literature review examined studies investigating IPV screening and referral programs in clinics. Selected studies were reviewed for: (1) effectiveness, (2) barriers to implementation and sustainability, and (3) responsivity to psychiatric comorbidity, including substance use and substance use disorders (SUD). Results Findings suggest that effective IPV screening and referral programs have been developed, but disparities in IPV screening exist and many programs only screen for IPV victimization. Barriers to the implementation and sustainability of IPV screening programs include lack of ongoing provider training, funding or institutional support, and direct connection to referral services. Further, many IPV screening programs lack assessment of and referral for comorbid psychiatric conditions, including substance use, and tend not to be routinely implemented in SUD clinics. Discussion Additional systematic work is needed to develop universal and comprehensive screening and referral programs for substance-related IPV and address issues of long-term sustainability, particularly within SUD treatment settings.
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Affiliation(s)
- Amber M. Jarnecke
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Tanya C. Saraiya
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Center of Alcohol & Substance Use Studies, Rutgers University-New Brunswick, Piscataway, NJ, United States
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Anyango J, Renbarger KM. Thematic Synthesis of the Experiences of Intimate Partner Violence Among Mothers Who Use Substances. Nurs Womens Health 2024:S1751-4851(24)00084-9. [PMID: 38823784 DOI: 10.1016/j.nwh.2024.04.002] [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: 12/06/2023] [Revised: 03/29/2024] [Accepted: 04/08/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE To integrate the findings of qualitative research to describe the experiences of intimate partner violence (IPV) among mothers who use substances. DATA SOURCES A systematic search of the literature was conducted using the databases of the American Psychological Association PsycINFO, CINAHL, and PubMed along with a manual search of Google Scholar. STUDY SELECTION The Joanne Briggs Institute critical appraisal checklist for qualitative research criteria was used to assess the studies for selection. Inclusion criteria comprised (a) qualitative research, (b) available in English, (c) published in peer-reviewed journals, (d) inclusive of descriptions of IPV experienced by mothers who use substances, (e) conducted in the United States, and (f) published between January 2013 and October 2023. DATA EXTRACTION The researchers highlighted and extracted data from studies that met the inclusion criteria. Data describing IPV among mothers who use substances were extracted. DATA SYNTHESIS A thematic synthesis was used to integrate the findings using three stages and included (a) free line-by-line coding of the findings of the primary studies, (b) the development of the free codes into associated areas to construct descriptive subthemes, and (c) the development of overarching analytic themes. CONCLUSION Findings from 11 qualitative studies were synthesized. Four descriptive subthemes emerged to delineate the experiences of IPV in mothers who use substances: Experience of Various Types of IPV, Lack of Structures to Identify and Address IPV, Coping With Violence by Taking Substances, and Substance Use Influences Behaviors of IPV. Nurses who work with mothers who use substances should be knowledgeable about local resources for IPV, complete ongoing educational training for IPV screening, and be familiar with recommended guidelines for the routine assessment of IPV.
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Thompson RA, Johnson D, Ashworth M, Stott M. Establishing Quality and Outcome Measures for Recovery Housing: A Tiered Approach Supporting Service Evolution. Community Ment Health J 2024; 60:681-690. [PMID: 38270727 PMCID: PMC11001738 DOI: 10.1007/s10597-023-01219-6] [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: 08/22/2023] [Accepted: 12/15/2023] [Indexed: 01/26/2024]
Abstract
With over one-hundred thousand drug overdose deaths in 2021, substance use disorder (SUD) is a public health crisis in the United States. Medical stabilization has been the predominant focus of SUD interventions despite low levels of retention. Consequently, national quality measures for SUD care outside the clinical continuity of care are limited. The expansion of recovery support services addressing social drivers of health outside clinical settings is needed. The current SUD quality measures are not applicable nor feasible for recovery support service providers with limited resource capacities, like the estimated 17,900 recovery housing providers nationwide. Despite widespread support for recovery housing and its documented effectiveness, no universal set of measures has been developed for widespread adoption. In this brief, a matrix of quality measures are proposed to meet the needs of recovery housing providers with various capacities to support service evolution and improve equitable SUD treatment and recovery care.
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Affiliation(s)
- Robin A Thompson
- Fletcher Group, Inc., 601 Meyers Baker Road, Suite 238, London, KY, 40741, USA.
| | - David Johnson
- Fletcher Group, Inc., 601 Meyers Baker Road, Suite 238, London, KY, 40741, USA
| | - Madison Ashworth
- Fletcher Group, Inc., 601 Meyers Baker Road, Suite 238, London, KY, 40741, USA
| | - Milena Stott
- Fletcher Group, Inc., 601 Meyers Baker Road, Suite 238, London, KY, 40741, USA
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Nabayinda J, Witte SS, Kizito S, Nanteza F, Nsubuga E, Sensoy Bahar O, Nabunya P, Ssewamala FM. The impact of an economic empowerment intervention on intimate partner violence among women engaged in sex work in southern Uganda: A cluster randomized control trial. Soc Sci Med 2024; 348:116846. [PMID: 38581814 DOI: 10.1016/j.socscimed.2024.116846] [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] [Received: 09/18/2023] [Revised: 02/20/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
Women engaged in sex work (WESW) are at heightened risk of experiencing intimate partner violence (IPV) compared to women in the general population. This study examines the impact of an economic empowerment intervention on IPV among WESW in Southern Uganda. We used data from 542 WESW in Southern Uganda recruited from 19 HIV hotspots between June 2019 and March 2020. Eligible participants were 18+ years old, engaged in sex work-defined as vaginal or anal sexual intercourse in exchange for money, alcohol, or other goods, reported at least one episode of unprotected sexual intercourse in the past 30 days with a paying, casual, or regular sexual partner (spouse, main partner). We analyzed data collected at baseline, 6, and 12months of follow up. To examine the impact of the intervention on IPV, separate mixed-effects logistic regression models were run for each type of IPV (physical, emotional, and sexual) as experienced by participants in the last 90 days. Results show that the intervention was efficacious in reducing emotional and physical IPV as evidenced by a statistically significant intervention main effect for emotional IPV, χ2(1) = 5.96, p = 0.015, and a significant intervention-by-time interaction effect for physical IPV, χ2(2) = 13.19, p < 0.001. To qualify the intervention impact on physical IPV, pairwise comparisons showed that participants who received the intervention had significantly lower levels of physical IPV compared to those in the control group at six months (contrasts = -0.12 (95% CI: -0.22, -0.02), p = 0.011). The intervention, time, and intervention-by-time main effects for sexual IPV were not statistically significant. Our findings suggest economic empowerment interventions as viable strategies for reducing emotional IPV among WESW. However, it is also essential to understand the role of interventions in addressing other forms of IPV especially for key populations at high risk of violence, HIV, and STI. The study was registered at ClinicalTrials.gov, ID: NCT03583541.
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Affiliation(s)
- Josephine Nabayinda
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Susan S Witte
- Columbia University, School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Samuel Kizito
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Flavia Nanteza
- International Center for Child Health and Development (ICHAD), Masaka Office, Uganda
| | - Edward Nsubuga
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Ozge Sensoy Bahar
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Proscovia Nabunya
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Fred M Ssewamala
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA.
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Forkus SR, Giff ST, Tomko R, Gex K, Flanagan JC. An examination of cannabis use motives among couples with intimate partner violence and alcohol use disorder. Am J Addict 2024. [PMID: 38591739 DOI: 10.1111/ajad.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/26/2024] [Accepted: 03/30/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Cannabis use is highly prevalent among individuals with a history of intimate partner violence (IPV) and among people who drink alcohol. Motives for cannabis use are important correlates of consumption and problem severity. However, no research has examined cannabis use motives among couples with IPV. The goals of the study were to examine (1) the associations between a person and their partner's cannabis use motives; and (2) examine the extent to which each partners' cannabis use motives are related to their own and their partner's cannabis consumption. METHODS Participants were 100 couples (n = 92 different-sex couples, n = 8 same-sex couples) who reported physical IPV in their current relationship. RESULTS Certain cannabis motives (coping and conformity) and behaviors (cannabis use frequency, quantity and drug-related problems) were positively associated between intimate partners. One's own higher coping motives were associated with greater frequency of cannabis consumption; higher conformity motives were associated with less quantity of consumption; higher social motives were associated with greater quantity of cannabis consumption; and one's partner's social motives were associated with less quantity of cannabis consumption. DISCUSSION AND CONCLUSIONS: Findings suggest that couples report similar motives for cannabis use, and that one's own and their partner's motives may differentially influence frequency and quantity of use. SCIENTIFIC SIGNIFICANCE This study provides novel information on congruency between cannabis use motives and behaviors between intimate partners, as well as how both an individual and their partner's motives for use can influence an individual's cannabis use behaviors.
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Affiliation(s)
- Shannon R Forkus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sarah T Giff
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
| | - Rachel Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kathryn Gex
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
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Jiwatram-Negron T, Meinhart M, Ward M, Michalopoulos L, Zhan Q, Nikitin D, Gilbert L. Associations between different forms of intimate partner violence and posttraumatic stress among women who use drugs and alcohol in Kyrgyzstan. J Trauma Stress 2024; 37:318-327. [PMID: 38356327 DOI: 10.1002/jts.23017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 02/16/2024]
Abstract
Survivors of intimate partner violence (IPV) have an increased risk of experiencing posttraumatic stress, and the subsequently associated symptoms can vary by form of IPV exposure (i.e., physical, sexual, or psychological IPV). Related research among socially marginalized populations, however, is limited, including among women who use and misuse substances. Drawing on baseline data from a pilot study conducted among 213 women in Kyrgyzstan who reported using drugs or engaging in hazardous alcohol use, we examined the associations between different forms of IPV and severe posttraumatic stress symptoms (PTSS). The vast majority of participants reported lifetime (93.9%, n = 200) and past 3-month (65.3%, n = 139) IPV, and two thirds of participants (65.3%, n = 139) reported experiencing PTSS in the prior month. Multivariable logistic regression analyses indicated statistically significant associations between only some forms of IPV and PTSS, including physical IPV, adjusted odds ratio (aOR) = 3.24, 95% confidence interval (CI) [1.15, 9.14], and injurious IPV, aOR = 2.71, 95% CI [1.10, 6.65]. Additionally, experiencing any form of IPV was associated with 4.95 higher odds of reporting PTSS, 95% CI [1.16, 21.15]; no other results were significant. These results not only underscore the need for future research on the mechanisms that might explain the unique associations between different forms of IPV and posttraumatic stress, but also highlight an urgent need for trauma-informed mental health and psychosocial support interventions for women who use drugs and alcohol.
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Affiliation(s)
| | - Melissa Meinhart
- National Coalition of Independent Scholars, Battleboro, Vermont, USA
| | - Malorie Ward
- School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | | | - Qihao Zhan
- School of Social Work, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | | | - Louisa Gilbert
- School of Social Work, Columbia University, New York City, New York, USA
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Qeadan F, Ross S, Barbeau WA, Madden EF, Venner KL, English K. Psychostimulant Misuse Among American Indian, Alaskan Native, or Native Hawaiian College Students in the U.S. From 2015 to 2019. Subst Abuse 2023; 17:11782218231209667. [PMID: 38025909 PMCID: PMC10655647 DOI: 10.1177/11782218231209667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/04/2023] [Indexed: 12/01/2023]
Abstract
Introduction This study examines factors associated with psychostimulant misuse, including polysubstance use and social factors, among the understudied American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) college student population. Methods Data were from the 2015 to 2019 American College Health Association-National College Health Assessment IIc (ACHA-NCHA IIc) survey. Multivariable logistic regression models and odds ratios were used to estimate associations between psychostimulant misuse and potential risk and protective factors among AI/AN/NH college students, including licit and illicit substance use, social support, relationship factors, exposure to violence or abuse, mental health symptoms, drug and alcohol education, and sample demographics. Results Opioid misuse among AI/AN/NH college students significantly increased the odds of using psychostimulants. Specifically, for cocaine use, the adjusted odds ratio (aOR) was 3.17 with a 95% confidence interval (C.I.) of 2.17 to 4.63; for methamphetamine use, the aOR was 38.87 (95% C.I. 19.24-78.52). For amphetamine misuse among non-Tobacco users, the aOR was 5.47 (95% C.I. 3.49-8.55), while among Tobacco users, the aOR was 2.65 (95% C.I. 2.07-3.41). For cocaine and other stimulant misuse, the aOR was 3.64 (95% C.I. 2.30-5.67). Additionally, the use of other types of licit and illicit substances was associated with greater odds of psychostimulant use and misuse. Conversely, factors such as age, living on campus, and residing in parental/guardian housing were linked with lower odds of psychostimulant use and misuse. Conclusion Substance use prevention and treatment interventions targeting AI/AN/NH college students should address polysubstance use, including the combined use of opioids and psychostimulants. Substance use interventions should not be siloed to focus narrowly on single substances but rather should leverage potential protective factors against substance use, such as promoting supportive campus and family living conditions and other social support networks, in broad efforts to reduce multiple forms of substance use among AI/AN/NH students.
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Affiliation(s)
- Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Sydney Ross
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - William A Barbeau
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Erin F Madden
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Kamilla L Venner
- Department of Psychology, Center on Alcohol, Substance Use and Addictions (CASAA), University of New Mexico, Albuquerque, NM, USA
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
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Sedgewick AE, Wang CL, Levine EA, Greenfield SF, Sugarman DE. Recovering Safety: A Pilot Study of a Women's Empowerment Group for Survivors of Intimate Partner Violence with Substance Use Disorders. ALCOHOLISM TREATMENT QUARTERLY 2023; 42:62-75. [PMID: 38370979 PMCID: PMC10871666 DOI: 10.1080/07347324.2023.2272799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This pilot study examined the feasibility and satisfaction of the Recovering Safety group, an outpatient empowerment, psychoeducational skills group for women with substance use disorders (SUDs) who have experienced intimate partner violence (IPV). Patient satisfaction, empowerment, and safety were assessed at three time points. Participants (N=8) reported high satisfaction with the group and rated the IPV-informed content, women-only participants, and female therapist as important factors; empowerment increased from pre- to post group. These results support initial feasibility; further study of such treatments is needed to examine efficacy of this group intervention.
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Affiliation(s)
- Amanda E. Sedgewick
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Callie L. Wang
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
| | - Emily A. Levine
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
| | - Shelly F. Greenfield
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Dawn E. Sugarman
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Feld H, Elswick A, Goodin A, Fallin-Bennett A. Partnering with recovery community centers to build recovery capital by improving access to reproductive health. J Nurs Scholarsh 2023; 55:692-700. [PMID: 36345125 DOI: 10.1111/jnu.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/19/2022] [Accepted: 10/08/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND People with substance use disorders (SUD), especially opioid use disorder (OUD) have the highest rates of unintended pregnancies (80-95%) and report unmet reproductive health needs. Women of childbearing age have some of the highest death rates from opioids and are notably rising the most rapidly, and when pregnancy does occur overdose is one of the leading causes of maternal mortality. There are numerous gender-based health disparities and social determinants of health shaped by the distribution of power and privilege that influence the risk trajectories of people who can get pregnant or are pregnant with a substance use disorder (SUD). PURPOSE The purpose of this paper is to describe how reproductive health is essential to recovery and building recovery capital for people who can get pregnant, (1) introduce a pilot implementation science study working with trained peer support coaches to promote reproductive autonomy in the community, and (2) make policy and advocacy recommendations relevant to the new reproductive health landscape in the United States. We will also describe the adaptation and feasibility of the initial pilot study where we partnered with a recovery community center to train peer recovery coaches to provide low barrier resources (contraception, pregnancy tests and prenatal vitamins) and referrals to health care. METHODS This initiative is the merging of best practices in recovery and community-based global reproductive health, to empower people with SUD who can get pregnant in an implementation science framework. The pilot study will last 3 months in each city and aims to (1) assess and describe the effectiveness of the training of local peer recovery coaches on the link between recovery capital and reproductive health, and (2) assess the feasibility, acceptability, appropriateness, scalability, sustainability, and uptake and reach of low barrier reproductive health resources (pregnancy tests, prenatal vitamins, and emergency contraception). In this paper we are only reporting the initial findings regarding adaptation and feasibility. FINDINGS Informed by qualitative interviews with stakeholders and participants, the method of contraception was adapted from injectable to emergency to meet the needs and context of the community with SUD. Early outcomes such as uptake and acceptability indicate that this is a feasible model with peer recovery coaches and recovery community centers, with the greatest uptake of emergency contraception and pregnancy tests. CONCLUSION Considering recent policies limiting access to reproductive health, innovative community-based solutions are needed to engage and empower people who can get pregnant or are pregnant while in active drug use and in recovery. Providing low barrier reproductive health items by people with lived experience with SUD can serve as a valuable harm reduction model and improve recovery capital. CLINICAL RELEVANCE This is the first study to propose a methodology and context to implement a community-based study merging best practices in recovery with those in reproductive health with the potential to improve recovery capital and maternal/child health trajectories for people with SUD.
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Affiliation(s)
- Hartley Feld
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Alex Elswick
- Family Sciences, University of Kentucky, Lexington, Kentucky, USA
- Voices of Hope, Lexington, Kentucky, USA
| | - Amie Goodin
- Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, Florida, USA
| | - Amanda Fallin-Bennett
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
- Voices of Hope, Lexington, Kentucky, USA
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12
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Amaro H, Kong Y, Marsh JC, Khachikian T, Guerrero EG. Identifying gender differences in risk profiles and in opioid treatment outcomes in Los Angeles County. EVALUATION AND PROGRAM PLANNING 2023; 97:102240. [PMID: 36702006 PMCID: PMC10121834 DOI: 10.1016/j.evalprogplan.2023.102240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 06/17/2023]
Abstract
Policies and programs that aim to minimize wait time to enter opioid use disorder (OUD) treatment and maximize retention respond to potential differences in female and male clients' risk profiles. We conducted multigroup latent class analysis using significant individual risk factors. Our sample included 13,453 opioid treatment episodes from 135 unique substance use disorder treatment programs in Los Angeles County, California, in four waves: 2011 (66 programs, 1035 clients), 2013 (77 programs, 3671 clients), 2015 (75 programs, 4625 clients), and 2017 (69 programs, 4106 clients). Groups at risk of waiting longer included clients who were female, had mental health issues, received medication for OUD, had criminal justice involvement, received mandated referrals, had children in child protective services, and had caretaker responsibilities. All clients with children in protective services were likely to wait longer than those not in protective services, but women waited longer. Findings highlight that: (a) women and men in OUD treatment have significant health and social problems; (b) female and male clients have distinct risk profiles; and (c) targeted services responding to risk profiles may improve treatment access and engagement. Findings have implications for health policy and program evaluation and planning in the delivery of treatment services considering gendered risk factors.
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Affiliation(s)
- Hortensia Amaro
- Florida International University, Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, 11200 SW 8th St, AHC4, Miami, FL 33199, United States
| | - Yinfei Kong
- California State University, Fullerton College of Business and Economics, 800 N State College Blvd, Fullerton CA 92831, United States
| | - Jeanne C Marsh
- University of Chicago, School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States
| | - Tenie Khachikian
- University of Chicago, School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States
| | - Erick G Guerrero
- I-LEAD Institute, Research to End Healthcare Disparities Corp, 12300 Wilshire Blvd, Suite 210, Los Angeles, CA 90025, United States.
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13
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Mikhael V, Ghabi R, Belahmer A, Kadi R, Guirguis N, Gutzeit A, Froehlich JM, Ferreira E, Higgs T, Dufour MM, Theoret V, Hebert M, Turgeon J, Balcom MC, Khurana B, Matoori S. Intimate partner violence: Defining the pharmacist’s role. Can Pharm J (Ott) 2023; 156:63-70. [PMID: 36969310 PMCID: PMC10034523 DOI: 10.1177/17151635231152450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/28/2022] [Indexed: 02/19/2023]
Affiliation(s)
| | | | | | | | | | - Andreas Gutzeit
- Department of Health Sciences and Medicine, University of Lucerne, and the Institute of Radiology and Nuclear Medicine and Breast Center St. Anna
| | - Johannes M. Froehlich
- Hirslanden Klinik St. Anna, Lucerne, Switzerland; the Clinical Research Group, Klus Lab Zurich, Zurich, Switzerland
| | - Ema Ferreira
- Faculté de Pharmacie
- Département de pharmacie, CHU Ste-Justine, Montreal, Quebec
| | | | | | - Valerie Theoret
- Département de sexologie, Université du Québec à Montréal, Montréal, Quebec
| | - Martine Hebert
- Département de sexologie, Université du Québec à Montréal, Montréal, Quebec
| | - Joane Turgeon
- Faculté de l’éducation permanente, Université de Montréal, Montreal, Quebec
| | | | - Bharti Khurana
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
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14
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Mehr JB, Bennett ER, Price JL, de Souza NL, Buckman JF, Wilde EA, Tate DF, Marshall AD, Dams-O'Connor K, Esopenko C. Intimate partner violence, substance use, and health comorbidities among women: A narrative review. Front Psychol 2023; 13:1028375. [PMID: 36778165 PMCID: PMC9912846 DOI: 10.3389/fpsyg.2022.1028375] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/14/2022] [Indexed: 01/28/2023] Open
Abstract
Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.
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Affiliation(s)
- Jacqueline B. Mehr
- School of Environmental and Biological Sciences, Rutgers University – New Brunswick, New Brunswick, NJ, United States
| | - Esther R. Bennett
- School of Social Work, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Julianne L. Price
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States,Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Nicola L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jennifer F. Buckman
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States,Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Elisabeth A. Wilde
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States,George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - David F. Tate
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States,George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - Amy D. Marshall
- Department of Psychology, College of the Liberal Arts, The Pennsylvania State University, State College, PA, United States
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Carrie Esopenko
- Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States,*Correspondence: Carrie Esopenko,
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15
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Castro-Alves J, Bastos FI, Cobo B, De Boni RB. Physical violence against women in Brazil: Findings from the 3rd Brazilian household survey on substance use. Glob Public Health 2023; 18:2244032. [PMID: 37615170 DOI: 10.1080/17441692.2023.2244032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 07/30/2023] [Indexed: 08/25/2023]
Abstract
Brazil has a historical gap regarding information on violence against women. Herein we aimed to evaluate the association of socioeconomic and demographic characteristics with physical violence against women in Brazil, as well as the possible escalation of violence to severe patterns of violence. We analysed data from the 3rd Brazilian Household Survey on Substance Use, in 2015. The main outcomes were reporting any physical violence and being stabbed/shot in the last 12-months. Logistic regressions were fitted to assess the association between socioeconomic and demographic variables with the outcomes. We estimated 3.8 million women reported any physical violence (5.52%): 3.79% reported threats to beat/ push/kick, 1.87% threats with knife/gun, 2.49% were beaten/pushed/kicked, 0.63% were spanked/ choked, and 0.21% were stabbed/shot. The higher the severity of violence, the higher the number of types of violence experienced. The likelihood of reporting any violence was higher among women 18-24 years, without a stable partner, who were at an informal job or unemployed, and who live in urban areas. The sociodemographic characteristics associated with reporting any violence reinforce the importance of addressing gender inequalities. Evidence of escalation violence reinforces the need to protect and care for women who report any type of violence.
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Affiliation(s)
- Julio Castro-Alves
- Instituto Nacional de Infectologia Evandro Chagas (INI), FIOCRUZ, Rio de Janeiro, Brazil
| | - Francisco I Bastos
- Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
| | - Barbara Cobo
- Escola Nacional de Ciências Estatísticas (ENCE), IBGE, Rio de Janeiro, Brazil
| | - Raquel B De Boni
- Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
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16
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Puig-Amores I, Cuadrado-Gordillo I, Martín-Mora-Parra G. Suicidal Behaviour as an Emerging Factor in Female Victims of Gender-Based Violence within a Relationship: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15340. [PMID: 36430058 PMCID: PMC9690275 DOI: 10.3390/ijerph192215340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/08/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Intimate partner violence (IPV), in addition to being an important public health problem, is a risk factor for suicidal behaviour (SB). The objective of this study was to explore the risk of suicidal behaviour associated with the different forms of abuse and the consequences derived from it. This exploratory study was conducted on a sample of women who experienced IPV (N = 70) in the Extremadura Region (Spain). Demographic factors, abuse experience, suicidal ideation (SI), suicidal communication (SC), and suicide attempts (SAs) were analysed according to the type of abuse. We found that a very high prevalence of psychological violence (IPVp) was accompanied, in most cases, by some other type of abuse (IPVp+). Additionally, a significant relationship was found between IPV and SB. Logistic regression revealed a greater risk of SI and SA in the IPVp+ group. The results of this study could be useful to healthcare service professionals in preventing suicidal behaviour.
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