"...you would probably want to do it. Cause that's what made them popular": Exploring perceptions of inhalant utility among young adolescent nonusers and occasional users

Associations between discrimination and substance use among college students in the United States from 2015 to 2019

Discrimination has been associated with adverse health behaviors and outcomes, including substance use. Higher rates of substance use are reported among some marginalized groups, such as lesbian, gay, and bisexual populations, and have been partially attributed to discrimination. This study uses 2015-2019 National College Health Assessment data to determine whether college students reporting discrimination due to sexual orientation, race/ethnicity, gender, or age report greater substance use than their peers who do not report such experiences. Additionally, we assess exploratory questions regarding whether substance choices differ among students who reported facing discrimination. Over time, about 8.0% of students reported experiencing discrimination in the past year. After applying inverse probability treatment weights (IPTWs), exposure to discrimination was associated with an excess of 44 cases of marijuana use per 1000 students, an excess of 39 cases of alcohol use per 1000 students, and an excess of 11 cases of prescription painkiller use per 1000 students. Multivariable logistic regression models with IPTW demonstrated that students who experienced discrimination were more than twice as likely to use inhalants and methamphetamine. These students were also significantly more likely to use other drugs, including opiates, non-prescribed painkillers, marijuana, alcohol, hallucinogens, cocaine, and cigarettes; however, the differences with peers were smaller in magnitude. Students who experienced discrimination did not differ from peers who reported non-prescribed antidepressants use and were significantly less likely to use e-cigarettes and smokeless tobacco. Associations between discrimination and substance use vary by race, gender, sexual orientation, and age. These findings indicate that discrimination has significant associations with many kinds of substance use; however, the magnitude varies by substance type. More institutional efforts to address sources of discrimination affecting college students are needed.

Reducing inhalant use in Latino adolescents through synchronized parent-adolescent interventions

This article presents the effects of a synchronized Latino youth/parent intervention on adolescent inhalant use. The analytic sample included only Latino adolescents (n = 487) between the ages of 12 and 14. Randomized at the school-level, the design included three possible conditions: (1) child and parent received the prevention interventions, (2) only the parent received the prevention intervention, (3) neither child or parent received the prevention interventions. Drawing from the eco-developmental perspective, the overall hypothesis was that youth randomly assigned to the condition with both interventions will report the strongest inhalant use prevention outcomes. Descriptive statistics and regression tests of significant group differences by treatment condition confirmed the overall hypothesis. Children receiving the youth intervention and whose parents received the synchronized parenting intervention reported the strongest desired inhalant prevention effects. The findings are interpreted from an eco-developmental perspective and implications for practice, policy, and future research are discussed.

Adolescent inhalant use and psychosis risk - a prospective longitudinal study

BACKGROUND

Cross-sectional studies have suggested inhalant use is associated with psychosis. This association was examined in a longitudinal study accounting for other substance use and potential confounders.

METHODS

We used a prospective sample (N = 6542) from the Northern Finland Birth Cohort 1986. Self-report questionnaires on substance use and psychotic experiences were completed when the cohort members were 15-16 years old. Inhalant use was categorized into four groups (never, once, 2-4 times, 5 times or more). Subsequent psychosis diagnoses (ICD-10) until age 30 years were obtained from national registers. Cox regression analysis was used to examine the association between adolescent inhalant use and risk of psychosis.

RESULTS

During the observation period 124 individuals were diagnosed with incident psychosis. Overall, there were 225 (3.4%) subjects with any inhalant use, 18 (8.0%) of whom were diagnosed with psychosis during the follow up. Of non-inhalant users (n = 6317) 106 (1.7%) were diagnosed with psychosis. Compared to non-users, those using inhalants had increased risk of incident psychosis with most frequent inhalant use associated with the greatest risk (unadjusted HR = 9.46; 3.86-23.20). After adjusting for baseline psychotic experiences, other substance use, comorbid mental disorder and parental substance abuse, the increased risk of psychosis persisted (HR = 3.06; 1.05-8.95). Furthermore, a dose-response effect between inhalant use and risk of psychosis was identified (OR = 2.34; 1.83-2.99).

CONCLUSIONS

Inhalant use in adolescence was independently associated with incident psychosis. The adverse health outcomes associated with adolescent inhalant use provide compelling reasons for implementation of policies to reduce the use of volatile substances in adolescents.

Inhalant Abuse and Dextromethorphan

Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.

Adolescent inhalant use prevention, assessment, and treatment: A literature synthesis

Inhalant use refers to the use of substances such as gases, glues, and aerosols in order to achieve intoxication, while inhalant use disorder (IUD) encompasses both DSM-IV-TR criteria for inhalant abuse and dependence. Inhalant use among adolescents is an international public health concern considering the severe medical and cognitive consequences and biopsychosocial correlates. In this paper, we summarize the current state of the literature on inhalant use among adolescents focusing on social context, prevention, assessment, and treatment strategies. Psychoeducation, skills training, and environmental supply reduction are helpful strategies for preventing adolescent inhalant use, while parent and adolescent self-report as well as physician report of medical signs and symptoms can aid in assessment and diagnosis. Although research has only begun to explore the treatment of inhalant use, preliminary findings suggest that a multimodal approach involving individual counselling (i.e., CBT brief intervention), family therapy, and activity and engagement programs is the first-line treatment, with residential treatment programs indicated for more severe presentations. The limited nature of treatments developed specifically for inhalant use combined with high prevalence rates and potential for significant impairment within the adolescent population indicate the need for further research. Research should focus on understanding the social context of use, establishing the efficacy of current adolescent substance use treatments adapted for inhalant use, and exploring long-term outcomes.

Patterns of substance use, delinquency, and risk factors among adolescent inhalant users

BACKGROUND

Despite insidious effects, use of inhalant substances by adolescents remains an understudied phenomenon.

OBJECTIVE

This research was designed to identify patterns of past year substance use and delinquency among adolescent inhalant users.

METHOD

The study used a sample of adolescent inhalant users (ages ranged from 12-17 years, n = 7,476) taken from a pooled sample of the 2002 through 2012 National Survey of Drug Use and Health (NSDUH). Three-step latent class analyses were conducted with past year substance use and delinquency behaviors as class indicators. Demographic and social covariates were included in the analyses.

RESULTS

Analyses yielded a six-class solution comprised of classes of users characterized by low substance use/low delinquency, high substance use/low delinquency, low substance use/fighting, cigarettes/alcohol/marijuana, high substance use/high delinquency, and cigarettes/alcohol/ marijuana/opioids/moderate delinquency.

CONCLUSIONS

Findings provide insight into the taxonomy of adolescent inhalant user heterogeneity, and may inform future efforts at detection and prevention of inhalant use by suggesting warning signs of co-occurring externalizing behaviors and possible indications of underlying internalized issues.

Attitude ambivalence, friend norms, and adolescent drug use

This study assessed the moderating effects of attitudinal ambivalence on adolescent marijuana use in the context of the theory of planned behavior (TPB). With data from the National Survey of Parents and Youth (N = 1,604), two hierarchical multiple regression models were developed to examine the association of ambivalent attitudes, intentions, and later marijuana use. The first model explored the moderating effect of ambivalence on intentions to use marijuana; the second tested the moderation of ambivalence on actual marijuana use 1 year later. Results across both analyses suggest that ambivalence moderated the association of friend norms and subsequent adolescent marijuana use: friend norms were better predictors of marijuana intentions (β = 0.151, t = 2.29, p = 0.02) and subsequent use when adolescents were attitudinally ambivalent about marijuana use (β = 0.071, t = 2.76, p = 0.006). These results suggest that preventive programs that affect the certainty with which adolescents holds pro- or antimarijuana attitudes may influence the likelihood of their resistance to, initiation, or continuance of marijuana use.

Parent-child drug communication: pathway from parents' ad exposure to youth's marijuana use intention

The authors combined the 2-step flow of communication model and the theory of planned behavior to create a framework to evaluate the effectiveness of a set of advertisements from the National Youth Anti-Drug Media Campaign promoting parent-child drug communication. The sample consisted of 1,349 pairs of parents and children who responded to the first and second annual rounds of the National Survey of Parents and Youth, and 1,276 pairs from Rounds 3 and 4. Parents' exposure to the campaign reported at Round 1 was indirectly associated with youth's lowered intentions to use marijuana at Round 2. Ad exposure was associated with positive changes in parental attitudes toward drug communication and perceived social approval of antidrug communications. These two beliefs, along with perceived behavioral control, predicted parents' intentions to discuss drugs with their children. Parental intentions to discuss drugs reported at Round 1 were associated with youth's report of actual drug communication with their parents at Round 2. Frequency and breadth of the topics in parent-child drug communication were associated with less positive attitudes toward marijuana use among youth who spoke with their parents. Together, the child's attitudes toward marijuana use and perceived ability to refuse marijuana use predicted youth's intentions to use marijuana. The proposed model fit well with the data and was replicated in a parallel analysis of the data from Rounds 3 and 4. Implications for future antidrug media campaign efforts are discussed.

Factors mediating the association of the recency of parent's marijuana use and their adolescent children's subsequent initiation

This study was designed to determine whether the relation between parents' recency of (lifetime) marijuana use (RMU) and their adolescent children's subsequent marijuana initiation was mediated by the adolescents' expectancies regarding the consequences of usage, their anticipated severity of punishment for use, and their evaluative attitudes toward marijuana. Parents and their initially marijuana-abstinent adolescent children drawn from the National Survey of Parents and Youth were studied (N = 1,399). A bootstrapped multiple mediation analysis tested whether adolescents' expectations, anticipated punishment, and attitudes toward marijuana collected in the first year of the longitudinal study mediated the relationship between parents' RMU and their adolescent children's marijuana initiation 1 year later. Analysis revealed a statistically significant association between the parental measure and youths' subsequent initiation (p < .001). The three mediators were related significantly to parents' RMU and adolescents' usage. Individually, each variable mediated the association of the parental measure and that of their initially abstinent adolescents when usage was assessed 1 year later. The results offer insight into the positive association of parents' RMU with their child's marijuana use and provide insights that may be useful in future prevention efforts.

Understanding early-onset drug and alcohol outcomes among youth: the role of family structure, social factors, and interpersonal perceptions of use

Research on adolescents focuses increasingly on features of the family in predicting and preventing illicit substance use. Multivariate analyses of data from the National Survey of Parents and Youth (N=4173) revealed numerous significant differences on risk variables associated with family structure on adolescent drug-related perceptions and substance use. Youth from dual-parent households were least likely to use drugs and were monitored more closely than single-parent youth (p<0.001). A path analytic model estimated to illuminate linkages among theoretically implicated variables revealed that family income and child's gender (p<0.001), along with family structure (p<0.05), affected parental monitoring, but not parental warmth. Monitoring and warmth, in turn, predicted adolescents' social and interpersonal perceptions of drug use (p<0.001), and both variables anticipated adolescents' actual drug use one year later (p<0.001). Results reconfirm the importance of parental monitoring and warmth and demonstrate the link between these variables, adolescents' social and intrapersonal beliefs, and their use of illicit substances.

Family structure and adolescent drug use: an exploration of single-parent families

Data from the 2004 Monitoring the Future survey examined a nationally representative cross-sectional sample of 8th to 12th grade adolescents in rural and urban schools from across the United States (N = 37,507). Results found that drug use among daughters living with single fathers significantly exceeded that of daughters living with single mothers, while gender of parent was not associated with sons' usage. This distinction in adolescent drug use between mother-only versus father-only households is largely overlooked in contemporary studies. Factors responsible for variations in sons' and daughters' usage in single-parent families have important implications for future drug prevention efforts.

Influencing inhalant intentions by changing socio-personal expectations

This study investigates an approach for reducing inhalant initiation among younger adolescents: altering Socio-Personal Expectations (SPEs), a term referring to perceived linkages between behavior and personally relevant social outcomes. The study focuses specifically on SPEs regarding outcomes associated with increased social status and popularity. An anti-inhalant message was embedded within a short anti-bullying education video. Young adolescents (N=893) were assigned randomly to receive a message focused on the physical or the social harms of inhalant use. The objectives of this study were to test: (1) the malleability of SPEs, (2) SPEs' predictive validity for future inhalant use, and (3) whether being exposed to a socio-personal threat, rather than a physical threat, led to different variables affecting drug-relevant decision-making processes. Analysis of variance suggested the malleability of SPEs (p< .001). Multiple regression analysis revealed that SPEs were predictive of future inhalant use. SPEs accounted for a significant portion of variance in future intentions over and above demographic variables, prior use, psychosocial variables, and perceived physical harm (R(2)= .26, p< .01). Moreover, being exposed to a social, rather than a physical threat, message resulted in different variables being predictive of future intentions to use inhalants.