Young adult, rural, African American stimulant users: antecedents and vulnerabilities

A comparison of African American and Caucasian stimulant users in 12-step facilitation treatment

Engagement in 12-step meetings and activities has been shown to be a powerful aid to recovery from substance use disorders. However, only limited attention has been given to ethnic and racial differences in attitudes toward 12-step and involvement. This study utilized data from a large multisite trial testing the effectiveness of a 12-step facilitation therapy with stimulant-dependent treatment seekers. We compared baseline differences and treatment outcomes between African American and Caucasian participants. A select few baseline differences were found (i.e., African Americans reported higher levels of spirituality than Caucasians; African American participants indicated more perceived benefits of 12-step involvement; Caucasians were more likely to endorse future involvement in 12-step). There were no outcome differences (e.g., substance use outcomes, 12-step meeting attendance). The tested intervention produced similar outcomes for both groups, indicating that it may be useful across racial categories.

Stimulant use by young adult African Americans in a rural community: a pipeline to prison?

The association between stimulant use and legal outcomes was examined in rural adults aged 18-21 years (n = 98) in the Mississippi River Delta of Arkansas from 2003 through 2008. Participants were interviewed at baseline and every 6 months for 2 years, using the Substance Abuse Outcomes Module, Addiction Severity Index, Short-Form 8 Health Survey, Brief Symptom Inventory, Patient Health Questionnaire depression screen, and an abbreviated antisocial personality disorder measure. More than three quarters were arrested before baseline; 47 were arrested over the next 2 years. Early arrest but not substance use was related to subsequent arrest. Limitations and implications for interventions are discussed.

Two-year trajectory of stimulant use in 18- to 21-year-old rural African Americans

Little is known about stimulant use trajectories of rural African American youth. The purpose of the present study is to explore substance use over 24 months in 98 African Americans, ages 18 to 21, who used cocaine or methamphetamine 30 days prior to baseline. The majority was male, unemployed, and had not graduated from high school. At baseline, almost half of the participants met criteria for abuse/dependence of cocaine--the primary stimulant used--which decreased to 25% by the final follow-up. Similar decreases were noted in rates of alcohol and marijuana abuse/dependence, although monthly use remained high. Participants reported minimal utilization of mental health or substance abuse services, but demonstrated significant improvements on physical and mental health measures. In summary, cocaine use declined, but other substances were used at high rates, suggesting a significant need for intervention services that address multisubstance use in rural areas.