Substance use in rural adolescents: The impact of social capital, anti-social capital, and social capital deprivation

Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community

BACKGROUND

Rural areas in the United States (US) are ravaged by the opioid overdose epidemic. Oconee County, an entirely rural county in northwest South Carolina, is likewise severely affected. Lack of harm reduction and recovery resources (e.g., social capital) that could mitigate the worst outcomes may be exacerbating the problem. We aimed to identify demographic and other factors associated with support for harm reduction and recovery services in the community.

METHODS

The Oconee County Opioid Response Taskforce conducted a 46-item survey targeting a general population between May and June in 2022, which was mainly distributed through social media networks. The survey included demographic factors and assessed attitudes and beliefs toward individuals with opioid use disorder (OUD) and medications for OUD, and support for harm reduction and recovery services, such as syringe services programs and safe consumption sites. We developed a Harm Reduction and Recovery Support Score (HRRSS), a composite score of nine items ranging from 0 to 9 to measure level of support for placement of naloxone in public places and harm reduction and recovery service sites. Primary statistical analysis using general linear regression models tested significance of differences in HRRSS between groups defined by item responses adjusting for demographic factors.

RESULTS

There were 338 survey responses: 67.5% were females, 52.1% were 55 years old or older, 87.3% were Whites, 83.1% were non-Hispanic, 53.0% were employed, and 53.8% had household income greater than US$50,000. The overall HRRSS was relatively low at a mean of 4.1 (SD = 2.3). Younger and employed respondents had significantly greater HRRSS. Among nine significant factors associated with HRRSS after adjusting for demographic factors, agreement that OUD is a disease had the greatest adjusted mean difference in HRSSS (adjusted diff = 1.22, 95% CI=(0.64, 1.80), p < 0.001), followed by effectiveness of medications for OUD (adjusted diff = 1.11, 95%CI=(0.50, 1.71), p < 0.001).

CONCLUSIONS

Low HRRSS indicates low levels of acceptance of harm reduction potentially impacting both intangible and tangible social capital as it relates to mitigation of the opioid overdose epidemic. Increasing community awareness of the disease model of OUD and the effectiveness of medications for OUD, especially among older and unemployed populations, could be a step toward improving community uptake of the harm reduction and recovery service resources critical to individual recovery efforts.

Civic Development within the Peer Context: Associations between Early Adolescent Social Connectedness and Civic Engagement

Social connectedness is theorized to contribute to civic development and in turn, civic engagement is thought to cultivate social connectedness. Little research has examined how social connectedness is linked with early adolescent civic engagement. The current study used a social network research design to examine associations between early adolescent social connectedness via their position within their peer network and their civic engagement. Middle-school students (N = 213) aged 11-15 years (M = 12.5; 57% female) were recruited from a remote US community and provided nominations for peer connections and reported on multiple aspects of civic engagement. Early adolescents who had identified more peer nominations had higher civic efficacy. Youth who had fewer connections with different peer groups and fewer connections with popular peers were more engaged in political behavior. Greater popularity was associated with higher political engagement for boys, but not girls. Greater connections with different peer groups was associated with greater environmentalism for younger but not older teens. These findings highlight the need to consider adolescent civic development within the peer context.

Associations between ethnic-racial identity and alcohol problems among diverse emerging adults

Excessive alcohol use and problems during college is a major public health concern, and there are health disparities in patterns of drinking and alcohol-related illnesses based on ethnicity and race. Given the prevalence and disparities in excessive alcohol use and problems and associated negative impacts, it is important to examine potential protective factors such as dimensions of ethnic-racial identity (ERI). Thus, the current study examined how multiple dimensions of ERI were associated with alcohol use and alcohol use disorder (AUD) symptoms, and how these relations varied by individuals' ethnic-racial group among 1850 diverse emerging adults (M = 18.46, SD = .38). Findings indicated that there were significant differences by race/ethnicity. ERI affirmation was negatively associated with AUD symptoms for Asian individuals and African American individuals, while ERI exploration was positively associated with AUD symptoms among African American individuals. ERI resolution was negatively associated with alcohol use for Latinx individuals and positively associated with alcohol use for Multiracial individuals. Among White individuals, ERI exploration was negatively associated with alcohol use and ERI affirmation was negatively associated with AUD symptoms. Overall, the current study builds on our understanding of nuanced ways in which ethnic-racial identity impacts alcohol problems among emerging adults and highlights areas for future research.

The relationship between internet addiction and psychosomatic disorders in Iranian undergraduate nursing students: a cross-sectional study

Internet addiction has an important impact on individuals, families, and communities. The effects of internet addiction are cumulative, significantly contributing to costly physical, mental, social, and public health problems. Thus, this study sought to examine relationships between internet addiction and psychosomatic disorders in Iranian undergraduate nursing students. This cross-sectional study was conducted on 300 undergraduate nursing students in the city of Hamadan in Iran, in 2018. Data collection tools included socio-demographic, the internet addiction test (IAT), and the psychosomatic complaints questionnaire. Data were analyzed by a Pearson's and independent t-tests using SPSS-18.0. The mean age of the students were 22.3 ± 3.02. The findings showed that 78.7% of nursing students reported mild, 20% moderate and 1.3% severe internet addiction, and there was a significant positive correlation between internet addiction and psychosomatic disorders (P < 0.05, r = 0.132). Internet addiction and psychosomatic disorders in nursing students can jeopardize their mental and physical health, and affect their future academic and professional activities. Therefore, providing educational and counseling interventions and reducing the negative effects of the internet can help to improve student health.

Parenting Practices and Adjustment Profiles among Latino Youth in Rural Areas of the United States

On average, Latino adolescents in the United States (U.S.) are at an elevated risk for developing internalizing symptoms, externalizing behaviors, and engaging in binge drinking. Latino youth in rural U.S. contexts may be particularly at risk. Parent–adolescent relationships may be associated with each of these indicators of maladjustment, as well as the co-occurrence of these issues. In the current study, adjustment profiles based on internalizing symptoms, externalizing behaviors, and binge drinking among 198 Latino adolescents (Mage = 15.90, SD = 1.47) living in rural areas of the United States were examined. Further, the association of adjustment profiles with parental behavioral involvement, parental monitoring, and familial ethnic socialization was tested. Four adjustment profiles emerged from a cluster analysis (i.e., low risk, internalizing risk, externalizing risk, co-occurring risk). Results indicated that adolescents in the co-occurring risk profile reported the lowest levels of parental monitoring compared to the other three profiles, lower familial ethnic socialization compared to the low risk and internalizing risk profiles, and lower parental behavioral involvement compared to the internalizing risk profile. The findings have implications for family-based, culturally informed interventions to encourage positive adjustment among Latino adolescents in rural areas of the United States.

Polysubstance Use Among Adolescents in a Low Income, Rural Community: Latent Classes for Middle- and High-School Students

PURPOSE

Rural communities are currently being impacted by a nationwide epidemic of prescription opioid misuse. Rural adolescent substance users may be at substantial risk for later addiction to these and other drugs.

METHODS

This study uses Latent Class Analysis to identify subtypes of polysubstance users among a sample of 7,074 rural adolescents. Separate models were estimated for middle- and high-school youth. Predictive validity was estimated using cumulative ordinal logistic regression of the classes on a set of youth and family characteristics.

FINDINGS

We identified a 4-class solution for both middle- and high-school students marked by initiation of an increasing number of substances used at greater frequency. These classes included Substance Nonusers, Primarily Alcohol Users, Initiators-Low Frequency Users, and Initiators-Moderate-to-High Lifetime Frequency Users. About 6%-10% of youth reported using prescription drugs at least once, and in the moderate-to-high frequency class, middle-school youth were more likely to use prescription drugs and inhalants compared to high-school youth in the same class. The 4 classes were associated with race/ethnicity, and in high school with receiving free/reduced price lunch.

CONCLUSION

In general, younger adolescents have lower overall use rates, but within certain classes identified by this analysis, the observed pattern suggests that younger cohorts are turning to prescription drugs and inhalants. These findings support the implementation of universal substance use prevention programs, targeted programs for youth experiencing risk factors associated with substance use, and improved rural substance abuse treatment options.