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Floyd LJ. Perceived neighborhood disorder and frequency of marijuana use among emerging adult African American females. J Ethn Subst Abuse 2020; 21:570-584. [PMID: 32697628 DOI: 10.1080/15332640.2020.1793862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Emerging adult African American females are at increased risk for cannabis use disorders. Ecological models suggest that African Americans' increased risk for substance use disorders and associated adverse outcomes may result from chronic exposure to contextual disadvantages, such as living in economically deprived and disorganized communities. However levels of vulnerability for developing cannabis use disorders vary, even among residents of disadvantaged neighborhoods. Therefore, studies focused on within group differences are necessary. This study examined the relationship between frequency of marijuana use and perceived neighborhood disorder. The sample included 117 African American emerging adult females (Mage = 23.6 ± 3.4). After providing informed consent, participants completed a semi-structured interview that included the Neighborhood Environment Scale and a self-report measure of marijuana use. Additionally, participants provided a urine sample that was tested for the presence of psychoactive drugs. 46% tested positive for marijuana and 45% reported using marijuana in the past 30 days. 27% reported frequent/heavy use. Results from multinomial logistic regression analysis indicated a significant relationship between perceived neighborhood disorder and heavy marijuana use (AOR = 3.3; 95% CI = 1.06 - 10.29). Findings suggest African American emerging adult female residents of economically disadvantaged neighborhoods who appraise their environments as disorganized may be at heighten risk for problematic marijuana use and should be targeted for intervention. Moreover, the findings support the need for multi-systems interventions. As policy makers consider the legalization of marijuana, it is important that differences in marijuana use behaviors and negative outcomes across groups and contexts are taken into consideration.
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Novak P, Bloodworth R, Green K, Chen J. Local Health Department Activities to Reduce Emergency Department Visits for Substance Use Disorders. J Healthc Qual 2020; 41:134-145. [PMID: 31094946 PMCID: PMC6527127 DOI: 10.1097/jhq.0000000000000161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Affordable Care Act (ACA) provides financial incentives to prevent substance use disorders (SUDs). Local health departments (LHDs) can receive funds to establish care teams that partner with primary care providers and health systems. This study estimates the potential effect of LHDs on emergency visits for SUDs, using linked data sets from the Healthcare Cost and Utilization Project Emergency Department (ED) sample for the State of Maryland-2012, the National Association of County and City Health Officials Profiles Survey 2013, and Area Health Resource File 2013 to estimate potential effect of LHDs' provision of SUD preventive care and SUD-related policy implementation. Local health department involvement in SUD-related policy during the past 2 years and provision of preventive care for behavioral health in the past year significantly reduced the probability of having a SUD-related ED visit by 11% and 6%, respectively, after controlling for individual characteristics (odds ratio [OR] = 0.89, p < .001; OR = 0.93, p < .001). After adjusting for the individual and contextual factors, LHD involvement in policy was still associated with 14% reduction in SUD-related ED visits (OR = 0.86, p < .001). Results offer insights on the extent to which the LHD activities can possibly affect SUD-related ED visits and provide a foundation for future work to identify effective LHD interventions.
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Affiliation(s)
- Priscilla Novak
- Department of Health Services Administration , School of Public Health, University of Maryland, College Park, MD, Also Agency for Healthcare Research and Quality (employee), , Cell: (571) 201-5165
| | - Robin Bloodworth
- Department of Health Services Administration , School of Public Health, University of Maryland College Park, MD Also Patient Centered Outcomes Research Institute (employee)
| | - Kerry Green
- Department of Behavioral and Community Health , School of Public Health, University of Maryland, College Park, MD
| | - Jie Chen
- Department of Health Services Administration , School of Public Health, University of Maryland, College Park, MD
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Redmond ML, Smith S, Collins TC. Exploring African-American womens' experiences with substance use treatment: A review of the literature. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:337-350. [PMID: 31609461 PMCID: PMC7032990 DOI: 10.1002/jcop.22241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 06/11/2019] [Accepted: 08/20/2019] [Indexed: 06/10/2023]
Abstract
The aim of this systematic review is to synthesize evidence on treatment barriers among African-American women who seek treatment for substance use disorders. The authors reviewed articles from 1995 to 2018 on the topic of substance use disorders among African-American women. Based on the review of 13 articles, we found African-American women were more likely to encounter treatment readiness barriers compared to access barriers and system-related barriers. Personal and interpersonal barriers were more readily identified throughout the literature reviewed. However, African-American women did encounter other barriers such as access- and system-related barriers. In addition, the intersection of race, gender, and class was not addressed in the specific articles, but should be considered when working to remove treatment barriers for this population. While prevalence of alcohol and drug use is limited among African-American women, it is important to understand how treatment readiness barriers may limit successful completion of treatment and ongoing progress. Implications for treatment and future research in addressing barriers to treatment for African-American women are discussed.
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Affiliation(s)
- Michelle L Redmond
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, Kansas
| | - Sharla Smith
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, Kansas
| | - Tracie C Collins
- College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA
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Beverly HK, Castro Y, Opara I. Age of First Marijuana Use and Its Impact on Education Attainment and Employment Status. JOURNAL OF DRUG ISSUES 2019; 49:228-237. [PMID: 31341332 DOI: 10.1177/0022042618823007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
With the increased prevalence of marijuana use among youth, the increase in state legalization, and changing social norms in the United States, it is important to understand the long-term impact of marijuana use initiation. This study examined whether age of first marijuana use is associated with educational attainment and employment status. Data from 5,988 adults aged 26 to 49 years who participated in the 2015 National Survey on Drug Use and Health were used in the current study. Logistic regression analyses were used to examine the odds of graduating from high school and being employed. Controlling for demographics, persons with late-early first use had significantly higher odds of graduating from high school and being employed compared with persons with early first use. Results underscore the importance of early prevention for youth aged 15 and younger and have implications for intervention and policy development.
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Lewis B, Hoffman L, Garcia CC, Nixon SJ. Race and socioeconomic status in substance use progression and treatment entry. J Ethn Subst Abuse 2017; 17:150-166. [PMID: 28846065 DOI: 10.1080/15332640.2017.1336959] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined trajectories of progression from early substance use to treatment entry as a function of race, among inpatient treatment seekers (N = 945). Following primary race-contingent analyses of use progression, secondary analyses were conducted to investigate the effects of socioeconomic status (SES) on the observed differences. African Americans reported significant delays in treatment entry relative to Caucasians. Racial differences in alcohol, marijuana, and cocaine use trajectories were observed. Accounting for SES rendered observations of accelerated use among African Americans nonsignificant. However, inclusion of SES failed to mitigate the marked racial disparity in treatment entry.
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Affiliation(s)
- Ben Lewis
- a University of Florida , Gainesville , Florida
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Pittman DM, Cho Kim S, Hunter CD, Obasi EM. The role of minority stress in second-generation Black emerging adult college students' high-risk drinking behaviors. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:445-455. [PMID: 28206779 PMCID: PMC5491347 DOI: 10.1037/cdp0000135] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This study used a minority stress framework to investigate the relationships between multiple stressors (e.g., general life stress, race related stress, and acculturative stress) and high-risk drinking behaviors in a sample of second-generation Black emerging adult college students across the United States. METHOD Participants (n = 148) were recruited from U.S. colleges and universities as part of a large, multiwave cross-sectional study. RESULTS Findings from this study mirrored those in the extant literature: the positive relationship between race-related stress and high-risk drinking behaviors found in other marginalized groups. However, when all stressors were entered into the model, acculturative stress accounted for significant variance in high-risk drinking behaviors above and beyond general life and race-related stressors in second generation Black emerging adult college students. CONCLUSION Findings underscore the need to better understand the influence of acculturative stress on high-risk drinking behaviors among second-generation Black emerging adult college students: an understudied population in both the acculturation and alcohol use literatures. Implications for future research and clinical practice are discussed. (PsycINFO Database Record
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Affiliation(s)
| | - Sara Cho Kim
- Counseling and Human Development, The George Washington University
| | - Carla D Hunter
- Department of Psychology, University of Illinois at Urbana-Champaign
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Shorey RC, Fite PJ, Choi H, Cohen JR, Stuart GL, Temple JR. Dating Violence and Substance Use as Longitudinal Predictors of Adolescents' Risky Sexual Behavior. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 16:853-61. [PMID: 25797949 DOI: 10.1007/s11121-015-0556-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objectives of this study is to examine dating violence perpetration and victimization (physical, psychological, and sexual) and lifetime substance use (alcohol, marijuana, and hard drugs) as longitudinal predictors of adolescents' risky sexual behavior across 1 year and to determine whether predictors varied across adolescents' gender and ethnicity. A sample of Caucasian, African American, and Hispanic male and female adolescents from seven public high schools in Texas (N = 882) participated. Adolescents completed self-report measures of dating violence, lifetime substance use, and risky sexual behavior at baseline and, 1-year later, completed a second assessment of their risky sexual behavior. Path analysis demonstrated that greater physical dating violence victimization, lifetime alcohol use, lifetime marijuana use, and age (being older) were all significant predictors of risky sexual behavior at the 1-year follow-up. These results did not vary across gender or the three ethnic groups (Caucasian, African American, and Hispanic). Overall, substance use was a longitudinal predictor of risky sexual behavior across the three ethnic groups, with physical dating violence victimization being the only type of dating violence longitudinally predicting risky sexual behavior. Prevention efforts should consider the roles of physical dating violence and substance use in preventing risky sexual behavior.
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Affiliation(s)
- Ryan C Shorey
- Department of Psychology, Ohio University, 239 Porter Hall, Athens, OH, 45701, USA,
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Campbell LF, Wilmoth K, Mason M. Association of exposure to neighborhood drug activity, neurobehavioral traits, and marijuana use among at-risk African American females. Addict Behav 2015; 50:45-50. [PMID: 26101077 PMCID: PMC10176802 DOI: 10.1016/j.addbeh.2015.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/29/2015] [Accepted: 06/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Theories of relative deprivation suggest African Americans in disadvantaged communities are at increased risk for drug use. This increased risk may be due, in part, to exposure to drugs and drug subcultures. Given the significance of the prefrontal cortex (PFC) functioning in yielding behavior that is strategically guided rather than reactive to environmental demands, it is important to examine the relationship between PFC functioning, neighborhood drug activity and substance use among African Americans residing in high risk communities. METHODS A sample of 120 young adult African American females was recruited from high-risk neighborhoods. Each completed the modified version of the neighborhood environment scale, a neurobehavioral assessment designed to measure apathy, behavioral disinhibition and executive dysfunction, and provided a urine sample that was tested for the presence of psychoactive drugs. RESULTS Logistic regression analyses indicated that females with higher scores on behavioral disinhibition were 2.6 times more likely to test positive for marijuana (95%CI = 1.02, 6.57). Neither apathy nor executive dysfunction was related to marijuana use. No relationship emerged between neighborhood drug activity and marijuana use. CONCLUSIONS Among the neurobehavioral traits considered only behavioral disinhibition was associated with marijuana use, suggesting that different neurobehavioral domains may be uniquely related to marijuana use. For females living in high risk environments, the extent to which they are able to control impulses may provide some protection against marijuana use. Future studies focused on the moderating effects of behavioral disinhibition on the association of exposure to risk environments and marijuana use may prove beneficial. Further, the study adds to the small base of literature supporting the Frontal Systems Behavior Scale as a brief assessment to evaluate frontally-mediated neurobehavioral traits relevant to substance use. However, future studies aimed at examining the influence of neighborhood drug activity might benefit from more precise measures of exposure to neighborhood drug activity. More research to replicate and expand on the present findings is warranted.
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Affiliation(s)
- Leah Floyd Campbell
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States; Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, PO Box 980489, Richmond, VA 23298-0489, United States.
| | - Kristin Wilmoth
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9044, United States
| | - Michael Mason
- Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, PO Box 980489, Richmond, VA 23298-0489, United States
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Whitbeck LB, Armenta BE. Patterns of substance use initiation among Indigenous adolescents. Addict Behav 2015; 45:172-9. [PMID: 25679365 PMCID: PMC6014601 DOI: 10.1016/j.addbeh.2015.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 11/25/2014] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND The data for this study come from an eight-wave panel study of Indigenous (Canadian First Nations and American Indian) adolescents from three U.S. reservations and four Canadian reserves. OBJECTIVES Our objective was to investigate variations in patterns of substance use initiation from early adolescence through early adulthood using data collected annually for 8 years. METHOD At baseline the sample included 675 Indigenous adolescents (M age=11.10, SD=.83; 50.3% girls). First, we calculated cumulative rates of substance use initiation by age. We then examined whether the cumulative initiation rates were moderated by gender using logistic regression analyses. Second, we calculated hazard rates for substance use initiation by age. Third, we focused on the ordering of two substances, paired two substances, and three substance initiation sequences. RESULTS If one looks only at the cumulative rates of substance use initiation there appears to be support for a sequential progression of substance use during early adolescence. In contrast to the cumulative rates of substance use initiation, the hazard analyses showed a much more mixed, less progressive sequence. Among two substance pairings a nicotine to marijuana initiation sequence was most likely, followed by a nicotine to alcohol sequence. An alcohol to marijuana sequence was nearly twice as likely as a marijuana to alcohol sequence. Refined analyses to conform to those of many of the traditional gateway studies by introducing paired two substance orderings indicated that nicotine and/or alcohol prior to marijuana use was by far the most likely sequence. In two of the three most likely three substance sequences (nicotine to alcohol to marijuana and nicotine to marijuana to alcohol) nicotine was the first substance initiated. CONCLUSION This study refines the gateway hypothesis for Indigenous adolescents by providing an in-depth analysis of substance use initiation. The only evidence for a "gateway" substance that emerged in our analyses was for nicotine use which was likely to precede alcohol and marijuana use in both two-substance pairings and to a lesser extent in three-substance initiation sequences.
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Affiliation(s)
- Les B Whitbeck
- Department of Sociology, University of Nebraska-Lincoln, United States.
| | - Brian E Armenta
- Department of Sociology, University of Nebraska-Lincoln, United States
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Shorey RC, Fite PJ, Elkins SR, Frissell KC, Tortolero SR, Stuart GL, Temple JR. The association between problematic parental substance use and adolescent substance use in an ethnically diverse sample of 9th and 10th graders. J Prim Prev 2014; 34:381-93. [PMID: 24006209 DOI: 10.1007/s10935-013-0326-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Adolescents of parents who use substances are at an increased risk for substance use themselves. Both parental monitoring and closeness have been shown to mediate the relationship between parents' and their adolescents' substance use. However, we know little about whether these relationships vary across different substances used by adolescents. Using structural equation modeling, we examined these associations within a racially and ethnically diverse sample of 9th and 10th graders (N = 927). Path analyses indicated that maternal closeness partially mediated the association between maternal problematic substance use and adolescent alcohol use. Parental monitoring partially mediated the relationship between paternal problematic substance use and adolescent alcohol, cigarette, marijuana, inhalant, and illicit prescription drug use. These results were consistent across gender and race/ethnicity. These findings suggest that parental interventions designed to increase closeness and monitoring may help to reduce adolescent substance use.
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Whitesell NR, Kaufman CE, Keane EM, Crow CB, Shangreau C, Mitchell CM. Patterns of substance use initiation among young adolescents in a Northern Plains American Indian tribe. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2012; 38:383-8. [PMID: 22931070 PMCID: PMC10405741 DOI: 10.3109/00952990.2012.694525] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Substantial evidence documents problematic substance use in Northern Plains American Indian communities. Studies suggest that disparities can be traced to disproportionate rates of early substance use, but most evidence comes from the retrospective reports of adults or older adolescents. OBJECTIVE To use a prospective longitudinal design to examine substance use initiation patterns as they emerge among young American Indian adolescents. METHODS Four waves of data were collected across three consecutive school years from middle school students on a Northern Plains reservation (N = 450). Discrete-time survival analyses were used to estimate risks of initiation of cigarettes, alcohol, and marijuana from age 10 to 13. RESULTS Risk for cigarette initiation was relatively high at age 10 and stable until age 13. Marijuana risk was low at age 10 but increased sharply by age 12. Alcohol initiation lagged, not surpassing risk for cigarette initiation until age 13 and remaining below risk for marijuana initiation throughout middle school. Hazards for girls trended higher than those for boys across all substances, but differences did not reach significance. CONCLUSION Initiation patterns among these American Indian adolescents differed from patterns reported in other US groups, particularly with respect to deviation from the sequence characterized the initiation of marijuana before alcohol that is predicted by the gateway theory. SCIENTIFIC SIGNIFICANCE Findings suggest that prevention efforts with youth in this community should begin early with a primary focus on marijuana use. They also suggest the importance of examining sequences of substance initiation among youth in other American Indian communities.
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Affiliation(s)
- Nancy Rumbaugh Whitesell
- Department of Community and Behavioral Health, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus , Aurora, CO 80045, USA.
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Hser YI, Hunt SA, Evans E, Chang YJ, Messina NP. Hispanic parenting women in women-only versus mixed-gender drug treatment: a 10-year prospective study. Addict Behav 2012; 37:729-35. [PMID: 22398357 DOI: 10.1016/j.addbeh.2012.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 01/18/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
Abstract
The present study examined Hispanic substance-using parenting women treated in women-only (WO; n=126) versus mixed-gender (MG; n=853) programs and associated outcomes assessed 10 years after admission. Relative to other races/ethnicities of women admitted to the set of 40 California treatment programs in 2000-2002, Hispanic women were underrepresented in WO programs. Compared to those in MG programs, Hispanic women in WO programs demonstrated more severe treatment needs, indicated by their greater severity in drug and alcohol use, health and mental health problems, and criminal justice involvement at admission. They also had fewer economic resources (15% WO vs. 23% MG were employed, p<.05; 48% vs. 37% on public assistance, p<.05). Data based on administrative records covering 3 years pre-admission and 8 years post-admission showed that Hispanic women treated in WO programs had higher mental health service utilization over 8 years post-treatment admission, though no differences were found in trajectories of arrests and incarceration. In sum, long-term outcomes (in terms of criminal justice involvement) among Hispanic women in WO treatment were comparable to those in the MG treatment, despite greater service needs at admission. WO programs were able to engage more Hispanic women in use of mental health services. Future research should focus on factors limiting Hispanic women's participation in WO programs, which could suggest ways for improvement so as to benefit all Hispanic women in need of these special services.
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