Male and Female Stimulant Use Among Rural Kentuckians: The Contribution of Spirituality and Religiosity

The importance of shared language in rural behavioral health interventions: An exploratory linguistic analysis

A focus on the use of shared language to enhance congruence in interventionist-client dialogue is missing from traditional research on evidence-based practices and rural behavioral health. This study incorporates qualitative interactional sociolinguistics, which includes discourse analysis (typically written or audio recordings of face-to-face encounters with 11 clients and a study interventionist), to describe those speech patterns in a broad sense (dialect), as well as more specific use of communicative strategies to increase parity in the interaction between a rural interventionist delivering an evidence-based practice in the context of a research study with rural women opioid users in a non-therapeutic context. Study findings indicated that in the context of delivering the intervention, use of a shared language, language pattern congruence, and communication styles can greatly augment the intent of the approach with vulnerable populations. In addition, other communicative strategies connected with traditional Appalachian values - such as religion, home, and family - were also important. This study makes an important contribution to behavioral health research and practice by understanding critical factors that may influence evidence-based practice delivery, particularly in real-world settings with vulnerable populations. These findings have important implications for the utilization of creative approaches to understand critical components of the clinical interaction as indicators of fidelity.

Gender Differences in the Association Between Religion/Spirituality and Simultaneous Polysubstance Use (SPU)

While religion/spirituality strongly protects against drug use (Cheney et al. in J Drug Issues 44(1):94-113, 2014), little is known about gender differences in the association of religion/spirituality on simultaneous polysubstance use (SPU) among those who use prescription opioids. Data come from a community-based study that recruited community members from the St Louis area (N = 632). Participants were asked whether they used prescription opioids when not prescribed for them or in ways other than prescribed in the past 12 months. Religion/spirituality was categorized as high, medium, or low based on personal views on the importance of religion and spirituality, attendance at religious services, and advice seeking from religious leaders. SPU was defined as non-medical use of opioids simultaneously with use of cocaine, alcohol, ecstasy, or marijuana. Multivariate logistic regression determined the association between religion/spirituality, demographic variables, and SPU. Men with high levels of religion/spirituality had 63 % decreased odds of SPU compared with men with low levels. Other variables associated with SPU in men were four or more arrests (AOR 2.21), multiple sex partners (AOR 2.11), and opioid use without a prescription (AOR 3.04). Women with high or medium levels of religion/spirituality had 58 and 62 % decreased odds of SPU compared with women with low levels. Variables that predicted SPU in women also included 4+ arrests (AOR 5.00) and never being married (AOR 2.13). Being African-American was associated with decreased odds of SPU in women (AOR 0.32). Overall, a high level of religion/spirituality was associated with lower odds of SPU. Gender differences in this association were evident, whereas women with even a medium level of religion/spirituality had significantly decreased odds of SPU. Future drug prevention and interventions should consider the relevance of religion/spirituality in SPU.

Relationship power as a mediator of intimate partner violence and mental health issues among incarcerated, substance-using women

The purpose of this study was to examine perceived relationship power as a mediator of the relationship between intimate partner violence (IPV) and mental health issues among incarcerated women with a history of substance use. Cross-sectional data from 304 women as part of the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) were used to evaluate this hypothesis. Regression analyses examined the mediation relationship of perceived relationship power in the association between a history of IPV and mental health issues. Results supported the hypothesis, suggesting that perceived relationship power helps to explain the association between IPV and mental health issues. Implications of the findings for the provision of services to address the needs of these women are discussed, including assessment of perceived relationship power and focusing counseling interventions on women's experiences with power in intimate relationships.

The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women from one southern state

This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n = 206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included.

Young African American perceptions of substance use in rural eastern Arkansas communities

This study examined barriers to substance abuse treatment through focus group interviews of African American youth in three rural, eastern Arkansas counties in the Mississippi Delta region. Participants in the study included adolescents with a current or prior history of substance use, non-substance using adolescents acquainted with other substance users, and adolescents who initiated substance use during adolescence (N = 41). Grand tour and subsequent probe questions elicited multiple themes regarding rural adolescent substance use, treatment decisions, and preferences. Adolescents' perceptions of substance use indicate that treatment or prevention programs will need to address multiple dimensions, ranging from individual to community-wide factors.

What's Faith Got to Do with It? Religiosity Among Women Who Use Methamphetamine

Religiosity is not found to be consistently protective in mental health and substance use outcomes among illicit drug users. This study examines the association between religiosity, mental health and drug use among a community-recruited sample of women who use methamphetamine. The majority of the sample (74%) had high scores of religious faith. In multivariate analysis, those with high scores had higher odds of self-reporting a mental health diagnosis and of being psychologically dependent upon methamphetamine, and were less likely to report injection risk. Further examination of the role of religiosity in the lives of women who use methamphetamine is advised.

Reflections on the Meaning of Drug Epidemics

Fluctuations in the use of many drugs at one time or another have been characterized as drug epidemics. The depiction of drug use as an epidemic, as in the recent cases of methamphetamine and crack use, is a proven mechanism for communicating that a problem exists, but such depictions are not without risk. When the public characterization of drug use as an epidemic represents more than its epidemiological meaning of “unusually elevated occurrence,” panic is often substituted for reasoned action. Such declarations are likely to truncate objective investigation, generate fear rather than understanding, and stimulate reactive measures that exacerbate drug misuse. This article discusses the epidemiological origin and meaning of epidemic, documents how media headlines have sensationally depicted methamphetamine use, and recommends that alternative strategies for describing an increase in the incidence and prevalence of use may be more successful in directing researchers and policy makers toward effective strategies for reducing misuse.