Differential contributions of family and peer factors to the etiology of narcotic addiction

Personal Social Networks and Relapses in Women With Substance Dependence: Application of the Theory of Planned Behavior

OBJECTIVE

Establishing positive network resources and rebuilding drug free networks are key components of recovery process for women with substance use disorder (SUDs). Theory of planned behavior (TPB) posits that behaviors are determined by behavioral intentions, which are determined by three factors: attitude toward the behavior, perceived behavioral control, and subjective norms. The current study applied TPB to examine whether women's personal social network characteristics (as subjective norms) were related to intentions towards, and/or a substance use relapse using prospective research design.

METHODS

Longitudinal data from 300 American women with SUD who received treatment at three county-funded, women-only intensive treatment programs was utilized for the current study.

RESULTS

Bayesian estimation path analyses indicated that attitude and abstinence self-efficacy at intake were not related to intention at the 6-month follow-up, but abstinence self-efficacy was directly related to substance use relapse by 12 months. Personal social network characteristics, number of treatment related persons in personal social network and sobriety support were significantly associated with intention at 6 months. The interaction between the numbers of treatment related persons and density was found on intention, suggesting that density strengthens the relationship between treatment related persons in network and intention. Intention to use substance was associated with relapse to substance use behavior.

CONCLUSION

Our findings support that personal social network characteristics can be considered as subjective norms in the TPB model. Personal social network interventions focusing on rebuilding consistent social norms against drug-using behaviors may decrease intention to use substance, which will lead to abstinence.

The self-serving benefits of being a good host: A role for our micro-inhabitants in shaping opioids' function

Opioids are highly efficacious in their ability to relieve pain, but they are liable for abuse, dependence, and addiction. Risk factors to develop opioid use disorders (OUD) include chronic stress, socio-environment, and preexisting major depressive disorders (MDD) and posttraumatic stress disorders (PTSD). Additionally, opioids reduce gut motility, induce loss of gut barrier function, and alter the composition of the trillions of microbes hosted in the gastrointestinal tract, known as the gut microbiota. The microbiota are significant contributors to the reciprocal communication between the central nervous system (CNS) and the gut, termed the gut-brain axis. They have strong influences on their host behaviors, including the ability to cope with stress, sociability, affect, mood, and anxiety. Thus, they are implicated in the etiology of MDD and PTSD. Here we review the latest studies demonstrating that intestinal flora can, directly and indirectly, by affecting sociability levels, responses to stress, and mental state, alter the responses to opioids. It suggests that microbiota can potentially be used to increase the resilience to develop analgesic tolerance and OUD.

The role of the vasopressin system and dopamine D1 receptors in the effects of social housing condition on morphine reward

BACKGROUND

The association with opioid-abusing individuals or even the perception of opioid abuse by peers are risk factors for the initiation and escalation of abuse. Similarly, we demonstrated that morphine-treated animals housed with only morphine-treated animals (referred to as morphine only) acquire morphine conditioned place-preference (CPP) more readily than morphine-treated animals housed with drug-naïve animals (referred to as morphine cage-mates). However, the molecular mechanisms underlying these effects are still elusive.

METHODS

Mice received repeated morphine or saline while housed as saline only, morphine only, or cage-mates. Then, they were examined for the expression levels of D1 dopamine receptor (D1DR), D2 dopamine receptor (D2DR), dopamine transporter (DAT), oxytocin, and Arginine-vasopressin (AVP) in the striatum using qPCR. Additionally, we examined the effects of the AVP-V1b receptor antagonist, SSR149415, on the acquisition of morphine conditioned place-preference (CPP).

RESULTS

Increased striatal expression of D1DR and AVP was observed in morphine only animals, but not morphine cage-mates. No significant effects were observed on the striatal expression of D2DR, DAT, or oxytocin. Antagonizing the AVP-V1b receptors decreased the acquisition of morphine CPP in the morphine only mice, but did not alter the acquisition of morphine CPP in the morphine cage-mate mice.

CONCLUSIONS

Housing with drug-naïve animals protects against the increase in striatal expression of D1DR and AVP elicited by morphine exposure. Moreover, our studies suggest that the protective effect of housing with drug-naïve animals on the acquisition of morphine reward might be, at least partially, mediated by AVP.

Family Risk Factors Among Women With Addiction-Related Problems: An Integrative Review

CONTEXT

Recent years have produced many articles about women's addiction and its risk factors and the consequences of substance use and misuse in the emotional, social, psychological, and economic domains of life. Family vulnerabilities are one of the most important variables contributing to addiction among women. Thus, the purpose of this article is to investigate areas of family life that lead to women's taking up and maintaining drug and alcohol abuse.

EVIDENCE ACQUISITION

A database search of PubMed, ScienceDirect, Springer, and Google Scholar was conducted using the following keywords: "women and addiction", "women addiction and family", "addiction", "substance abuse" and "family". For the first step, we chose studies that were conducted between 2000 and 2015, and for the second step, studies conducted before 2000. We categorized all search results into three main groups: processes related to family disturbances, factors related to parenting styles, and variables related to partners.

RESULTS

Partners, parenting styles, and family disturbances are three main factors affecting children growing up in a family and their inclination toward addiction. Some of these pathways are complicated and indirect, and some are straightforward.

CONCLUSIONS

Future research should pay more attention to the mechanisms and pathways mediating or moderating the relationship between family risk factors and addiction in women. Clinicians and researchers should keep in mind these vulnerabilities and take into consideration factors special to processes related to addiction in women.

Consumo de drogas en los jóvenes de la ciudad de Guayaquil, Ecuador

El objetivo de esta investigación fue conocer las causas predominantes y el tipo de droga que más consumen los jóvenes de 10 a 18 años que ingresaron en una institución que acoge niños infractores de una ciudad del Ecuador. Se trata de un estudio descriptivo y cualitativo, cuya recolección de datos ocurrió mediante entrevista semiestructurada e individual. Participaron diez jóvenes, con edades entre 10 y 16 años. El análisis de contenido resultó en tres temas: la carencia del apoyo familiar; las influencias del entorno en que se desarrollan los jóvenes y el desconocimiento del efecto que causan las drogas y los planes para el futuro. Se identificó que la droga más consumida fue la marihuana, seguida del alcohol e inhalantes. Explorar las causas que llevaron a estos jóvenes a consumir drogas contribuyó para la identificación de sus necesidades y de los espacios importantes para el cuidado en salud, con énfasis en la promoción de la salud.

The added risk of opioid problem use among treatment-seeking youth with marijuana and/or alcohol problem use

OBJECTIVES

To determine the added risk of opioid problem use (OPU) in youth with marijuana/alcohol problem use (MAPU).

METHODS

A total of 475 youth (ages 14-21 years) with OPU + MAPU were compared to a weighted sample of 475 youth with MAPU only (i.e. no OPU) before and after propensity score matching on gender, age, race, level of care and weekly use of marijuana/alcohol. Youth were recruited from 88 drug treatment sites participating in eight Center for Substance Abuse Treatment-funded grants. At treatment intake, participants were administered the Global Appraisal of Individual Need to elicit information on demographic, social, substance, mental health, human immunodeficiency virus (HIV), physical and legal characteristics. Odds ratios with confidence intervals were calculated.

RESULTS

The added risk of OPU among MAPU youth was associated with greater comorbidity; higher rates of psychiatric symptoms and trauma/victimization; greater needle use and sex-related HIV risk behaviours; and greater physical distress. The OPU + MAPU group was less likely to be African American or other race and more likely to be aged 15-17 years, Caucasian; report weekly drug use at home and among peers; engage in illegal behaviors and be confined longer; have greater substance abuse severity and polydrug use; and use mental health and substance abuse treatment services.

CONCLUSIONS

These findings expand upon the existing literature and highlight the substantial incremental risk of OPU on multiple comorbid areas among treatment-seeking youth. Further evaluation is needed to assess their outcomes following standard drug treatment and to evaluate specialized interventions for this subgroup of severely impaired youth.

Ambiente familiar e consumo de álcool e tabaco entre adolescentes

OBJETIVO: Analisar a influência do ambiente familiar em relação ao uso de álcool e tabaco pelos adolescentes. MÉTODOS: Trata-se de estudo descritivo, elaborado a partir da análise e aprofundamento da categoria referente ao uso de drogas lícitas e a influência familiar, presente em um questionário semiestruturado, contendo ao todo 25 questões sobre o uso álcool e tabaco, realizado junto a 1.533 adolescentes de ambos os sexos, tendo por critérios de inclusão: adolescentes entre dez e 20 anos de idade, matriculados e frequentando regularmente a sexta, a sétima ou a oitava séries do ensino fundamental e o primeiro, o segundo ou o terceiro anos do ensino médio das escolas estaduais situadas nas regiões de Santo Eduardo e Santa Emília, no município de Embu, no período matutino, e que aceitaram participar das oficinas de prevenção e promoção da saúde realizadas pelo Projeto Corporalidade e Promoção da Saúde. A análise estatística foi aplicada por meio do teste do qui-quadrado, ao nível de significância p<0,05, tendo como medida de risco a aplicação do Odds Ratio, com intervalo de confiança de 95%. RESULTADOS: Os dados demonstraram que 66% dos adolescentes que não experimentaram bebidas alcoólicas não possuem familiares que bebem frequentemente (p<0,001) e 84% dos que são fumantes apresentam familiares que fumam (p<0,001). CONCLUSÕES: O ambiente familiar induz e facilita o uso de álcool e tabaco por adolescentes, tornando-se fundamental a utilização deste conhecimento na elaboração de projetos de prevenção e educação em saúde.

Pathways to adult marijuana and cocaine use: a prospective study of African Americans from age 6 to 42

This study examines pathways to adult marijuana and cocaine use in a cohort of African Americans from Woodlawn, an inner city community in Chicago. Assessments were conducted in first grade (age 6), adolescence (age 16), early adulthood (age 32), and in mid-adulthood (age 42). The "social adaptation life course "framework guided the focus on social adaptation, social bonds, and economic resources as predictors of adult drug use. Results indicate that more frequent substance use in adolescence and lower-income and less-frequent church attendance in early adulthood increase the risk of mid-life drug use. Shyness in first grade related inversely to later cocaine use and marijuana use (marginally significant). Indirect pathways to drug use also were identified. Gender differences were not significant. The findings show continuities in social maladaptation over time and the importance of social integration and economic resources in the early adult years.

Impacts of age of onset of substance use disorders on risk of adult incarceration among disadvantaged urban youth: a propensity score matching approach

BACKGROUND

Age of onset of substance use disorders in adolescence and early adulthood could be associated with higher rates of adult criminal incarceration in the U.S., but evidence of these associations is scarce.

METHODS

Propensity score matching was used to estimate the association between adolescent-onset substance use disorders and the rate of incarceration, as well as incarceration costs and self-reported criminal arrests and convictions, of young men predominantly from African American, lower income, urban households. Age of onset was differentiated by whether onset of the first disorder occurred by age 16.

RESULTS

Onset of a substance use disorder by age 16, but not later onset, was associated with a fourfold greater risk of adult incarceration for substance related offenses as compared to no disorder (0.35 vs. 0.09, P=0.044). Onset by age 16 and later onset were both positively associated with incarceration costs and risk of arrest and conviction, though associations with crime outcomes were more consistent with respect to onset by age 16. Results were robust to propensity score adjustment for observable predictors of substance use in adolescence and involvement in crime as an adult.

CONCLUSION

Among young men in this high risk minority sample, having a substance use disorder by age 16 was associated with higher risk of incarceration for substance related offenses in early adulthood and with more extensive criminal justice system involvement as compared to having no disorder or having a disorder beginning at a later age.

Drug dependent parents: childcare responsibilities, involvement with treatment services, and treatment outcomes

Relatively little is known about the treatment of drug dependent parents. This study of drug misusers (n=1075) investigates the involvement of parents with treatment services, childcare arrangements before and during treatment, and outcomes at 1-year follow up. Almost half the sample (46%) were parents. Women were more likely to be responsible for the care of children. Parents, and especially women, who looked after children, were less likely to receive residential treatment. Illicit drug use and psychiatric symptoms were reduced at 1 year. Outcomes did not differ by gender or parenting status, but there was an interaction effect for psychiatric symptoms: for women, looking after children during treatment was associated with less improvement in psychiatric symptoms at follow up. Such women face special difficulties in access to services and would benefit if treatment services were able to offer improved access and childcare support.

Childhood and adolescent antecedents of drug and alcohol problems: A longitudinal study

Despite the serious health and economic consequences of drug and alcohol abuse and dependence, few studies have prospectively examined the etiology of this problem in non-clinical populations. This longitudinal study examines childhood and adolescent antecedents of drug and alcohol problems in adulthood among an African American cohort (n = 1242; 51% female) from Woodlawn, a neighborhood in Chicago. The participants were followed from age 6 to 32 years, and data were collected in first grade, adolescence, and adulthood. Structural equation modeling showed that, for both males and females, educational attainment was directly associated with a reduced risk for substance use problems. For males, first grade shyness was directly associated with a reduced risk of substance use problems, and adolescent substance use was directly associated with an increased risk. First grade aggression, low family socioeconomic status (SES), and low school bonds were indirectly associated with substance use problems for both males and females. For males, first grade underachievement had an indirect effect, and, for females, first grade shyness and strong parental supervision had indirect effects. This study is among the first to identify life course trajectories to substance use problems among an African American, community-based population. These results help to identify the targets and timing of interventions that may help to reduce the risk of drug and alcohol problems in adulthood.

La familia y los factores de riesgo relacionados con el consumo de alcohol y tabaco en los niños y adolescentes (Guayaquil-Ecuador)

La presente investigación tienen como objetivo el de identificar en un ambiente familiar los posibles factores de riesgo relacionados con el uso de alcohol y tabaco en los niños y adolescentes. Es importante destacar que estudio de esta naturaleza dentro de una perspectiva socio-cultural expresa la tentativa de comprender los factores de riesgo para el uso de bebidas alcohólicas y tabaco y enfrentar las influencias ambientales en el entorno familiar con vistas a prevenir futuros casos de dependencia. El estudio se utilizo una muestra de cien familia, a las que se les aplico un instrumento preestablecido con los responsables de las respectivas familias. Como resultado se obtuvo que 51% del nivel de escolaridad es bajo, el 54% tiene salario inferior al básico, el 61% ingieren bebidas alcohólicas. Vale destacar que incuestionablemente la reducción de la casuística de alcoholismo y/o tabaquismo repercute significativamente en le calidad de vida de los individuos.

Factors associated with heroin addiction among male adults in Lahore, Pakistan

The objective of this matched case control study was to evaluate the factors associated with heroin addiction among male heroin addicts of age 15 to 35 years in Lahore. A total of 233 heroin addicts, matched on neighborhood controls, were enrolled at a case control ratio of 1:2. Multivariate conditional logistic regression analysis was carried out to study the independent relationship of hypothesized factors with heroin addiction. The factors associated with heroin addiction were parental disharmony (i.e. occasional fights versus no fights: adjusted matched odds ratio (adj. mOR) = 4.3, 95% CI: 2.4-7.8; frequent fights versus no fights: adj. mOR = 6.0, 95% CI: 2.8-16.6), drug using peers (adj. mOR = 5.6, 95% CI, 2.6-12.1), alcohol use (adj. mOR = 4.2, 95% CI, 2.3-7.6). use of over the counter available drugs (adj. mOR = 4.1, 95% CI, 1.8-10.6), father's absence (adj. mOR = 2.9, 95% CI, 1.6-5.5), non-formal schooling of the mother (adj. mOR = 2.8, 95% CI, 1.7-4.7), non-formal schooling of the respondent (adj. mOR = 2.4, 95% CI, 1.5-3.8), and the presence of a drug user among similar age group family members (adj. mOR = 2.4, 95% CI, 1.3-4.8). It is recommended that public health strategies be formulated based on various facets of the problem revealed by this and previous research to prevent illicit drug use.

European adolescent substance use: the roles of family structure, function and gender

OBJECTIVES

The aim of this study was, first, to explore family structure and measures of family functioning in relation to adolescent substance use and secondly, to establish if these relationships differed according to gender or according to the city of origin of the sample.

DESIGN, SETTING, PARTICIPANTS

The study surveyed pupils aged 14-15 years in representative samples drawn from five European cities: Newcastle upon Tyne, Dublin, Rome, Bremen and Groningen. Data were obtained on 3984 participants in relation to their substance use, living with both biological parents, confiding in parents and grandparents. and supervision, as well as other variables representing delinquency, social class and drug availability.

RESULTS

Living with both parents was associated with reduced levels of drug use in four cities but not in Dublin, due perhaps to the high availability from peers in that city. It was not associated with reduced levels of regular drinking. The effect of confiding in mother was evident in all cities and in relation to substance use in general. However, when a delinquency variable was added to the logistic regressions, its significance in relation to polydrug use disappeared. Supervision was somewhat more important in relation to male than female drug use.

CONCLUSION

Living with both parents is a less robust barrier to substance use than qualitative aspects of family life, particularly attachment to mothers. The latter is a robust inhibitor of substance use irrespective of regional differences in drug availability, weakening only in the face of more generally problematic behaviour. Perhaps because of their greater tendency to risk-taking or rule breaking, supervision appears more important for male than female drug use. These findings underscore the role of families, but especially that of mothers, in regulating the substance-related behaviour of young people.

[Prevalence and risk factors associated with drug use among school students, Brazil]

OBJECTIVE

To assess prevalence and risk factors associated with drug abuse among public elementary and high school students in the southern city of Florianópolis, Brazil.

METHODS

A descriptive cross-sectional study was carried out using a standardized questionnaire created during the 4th National Survey on Drug Abuse. Four hundred and seventy-eight students were interviewed by trained college students. Of the interviewees, 43% aged 13 - 15 years and 32% aged 16 - 18 years and they had a higher socioeconomic status than the national average.

RESULTS

Ever use prevalence for alcohol, marijuana, solvent drugs and amphetamines was 86.8%, 19.9%, 18.2% and 8.4%, respectively. Regular use (6 or more times per month) of alcohol, marijuana, solvent drugs and amphetamines was found in 24.2%, 4.9%, 2.5% and 2.3% of students, respectively, a higher percentage when compared to other southern states' capitals and the national average. Age, sex, social status and living with both parents were significantly associated with drug abuse. Girls were twice as likely to consume weight loss drugs and stimulants, and almost three times more likely to use tranquilizers without medical prescription. Boys were almost twice as likely to use solvent drugs. Higher social students were twice as likely to consume alcohol than those of lower social status. Cigarette and marijuana smoking, respectively, were 84% and 67% more likely among students whose parents were separated.

CONCLUSIONS

There is a high prevalence of drug use among elementary and high school students in Florianópolis.

Die Bedeutung der Familie für den Konsum psychotroper Substanzen bei Jugendlichen

Zusammenfassung. Es wird die Frage untersucht, wie familiäre Variablen den Substanzkonsum (Alkohol, Nikotin, Haschisch, Medikamente) von Jugendlichen vorhersagen. Als Prädiktoren seitens der Familie werden die Zufriedenheit der Jugendlichen mit ihrer Familie, das familiäre Funktionsniveau mit den Dimensionen Kohäsion und Adaptabilität, die gemeinsam im Kreise der Familie verbrachte Zeit sowie die familiäre Unterstützung des Jugendlichen berücksichtigt. Die multivariaten Zusammenhänge werden bei 381 Jugendlichen im Alter zwischen zwölf und 16 Jahren analysiert. Die Ergebnisse zeigen, daß zur Vorhersage des Konsums psychotroper Substanzen die familiären Bedingungen von Bedeutung sind und insgesamt im Durchschnitt rund 10 % der Varianz des Substanzgebrauchs aufklären. Als zentral erweisen sich die familiäre Kohäsion, die Zufriedenheit der Jugendlichen mit der Familie und die Unterstützung durch die Eltern. Bei männlichen Jugendlichen ist zudem ein Moderatoreffekt des familiären Klimas bezüglich des Zusammenhangs von Streß und Substanzgebrauch nachweisbar.