Journal of substance abuse最新文献

Purpose: A common criticism of designated driver programs (DDPs) is that they promote excessive drinking among companions of the designated driver (DD). Methods: Data were collected from two representative samples of drinkers using computer-assisted telephone interviews (CATIs), and questionnaires administered to customers in barrooms. Results: Most respondents drank moderately—had usual estimated blood alcohol concentrations (BACs) of less than 0.10 when they used DDs. Differences between respondents' estimated BACs when they used a DD and when they drank outside their homes were very small: 0.017 in both samples. Additional analyses examined shifts between lower and higher categories of risk defined as a BAC of less than 0.10 and a BAC of 0.10 or greater. A minority, 15% of CATI and 30% of barroom respondents, switched to the higher risk category when using a DD. These CATI and barroom respondents increased their BACs by an average of 0.089 and 0.11, respectively. Risk associated with this increase was mitigated, however, by respondents' infrequent use of DDs. Implications: Use of DDs was not generally associated with excessive alcohol consumption. Since a minority of respondents did drink heavily when using a DD, programs promoting DD use should caution drinkers that the availability of a DD is not an excuse for excessive consumption, and remind hosts and servers that they should not overserve their guests or customers even when they have a DD.

Purpose: This study examines the validity of selected items from the Substance Abuse Subtle Screening Inventory-Adolescent (SASSI-A) version in predicting Diagnostic Interview Schedule for Children (DISC version 2.3) Substance abuse and dependency (SA/D) for Native Hawaiian (i.e., indigenous people of the Hawaiian Islands) and non-Hawaiian adolescents (youth without any Native Hawaiian indigenous ancestry). Methods: 542 students were randomly selected from the larger sample to participate in the DISC administration. Demographic information, SASSI-A scores, and DISC diagnoses were obtained for each student. Univariate and multiple logistic regressions were performed in the prediction of DISC SA/D. Results: SASSI-A Factor 1, consisting of three items measuring substance use, was found to have the best utility, accounting for 18.1% of the variance, in predicting DISC SA/D. Implications: These results support selected SASSI-A items in screening for SA/D for Native Hawaiian and non-Hawaiian adolescents in Hawaiı̀ as compared to other community-based screening instruments for other populations.

Peer pressure is consistently implicated in the excessive drinking of college students. However, both theory and empirical findings suggest that peer pressure is a combination of three distinct influences: overt offers of alcohol, modeling, and social norms. Overt offers of alcohol can range from polite gestures to intense goading or commands to drink. Modeling occurs when the student's behavior corresponds to another student's concurrent drinking behavior. Perceived social norms can serve to make excessive alcohol use appear common and acceptable to the student. This review critically examines the literature on each form of peer influence and provides suggestions for future research.

Purpose: An important question for alcohol abuse prevention and treatment is whether individuals with high needs for social approval, or those who drink heavily in social contexts, are particularly vulnerable to modeling effects in alcohol consumption. Methods: Male and female heavy social drinkers (N=202), as distinguished by these cognitive and situational variables, participated in a multisession dyadic modeling effects study along with a same-sex confederate model who exhibited alternating patterns of heavy and light consumption in an experimental barroom. Results: Subjects with high needs for social approval, and those who tend to drink heavily in social contexts, were particularly vulnerable to imitating directional changes in modeled drinking levels across heavy and light consumption experimental sessions. Additionally, modeling effects were revealed, including reductions in drinking levels, regardless of individual characteristics such as demographics or levels of intoxication achieved on “usual drinking occasions.” Implications: Findings suggest that individuals exhibiting high needs for social approval, and those who tend to drink heavily in social contexts, may benefit from (1) befriending lower risk models and (2) prevention and/or intervention efforts to reduce risk for substance use by reducing excessive needs for social approval and/or reducing exposure to social contexts where heavy drinking and related risk behavior is normative.

Purpose: The purpose of this study was to examine the relationship between age at drinking onset and the development of DSM-IV alcohol abuse and dependence in a 12-year prospective study of youth in the United States. Methods: Logistic regression analyses were used to quantify the relationship between age at drinking onset and the development of alcohol abuse and dependence controlling for sociodemographic factors and problem indicators. Results: The odds of alcohol dependence decreased by 5% in 1989 and 9.0% in 1994 for each year drinking onset was delayed. In 1994, the odds of alcohol abuse increased by 7.0% with each decreasing year of age at drinking onset, while age at drinking onset was not related to alcohol abuse in 1989. Several other risk factors were found to be strong and consistent predictors of abuse and dependence in 1989 and 1994, including being male, divorced, separated or never married, younger, and having an early history antisocial behaviors and marijuana use. Implications: Implications of the results of this study are discussed in terms of other factors that may impact on the onset-abuse and onset-dependence relationship and the need to focus future prevention efforts.

Purpose: Rates of smoking are much higher among persons with alcohol problems and a history of depressive illness than persons without those disorders. Drug use in general may be motivated by outcome expectancies such as negative affective reduction and relaxation. Persons with a history of depression may smoke as a means of mood management. The role of outcome expectancies and major depression in maintaining smoking behavior in a high-risk group of smokers, such as recovering alcoholics, has not been thoroughly examined. Methods: Using a cross-sectional design, 161 abstinent alcohol-dependent men and women who smoked were administered the Inventory to Diagnose Depression (IDD), a self-report instrument for assessing current and lifetime depression according to DSM-IV criteria, and measures of alcohol dependence, nicotine dependence, smoking motives, and situation-defined temptations to smoke. Results: As expected, smoking motives and temptations were moderated by history of depression. Alcoholics with a history of depression were more likely to smoke with the expectancy of negative affect reduction than those with no prior major depression. Using multiple regression, negative affective reduction, addiction, and severity of past depression were the strongest predictors of current temptations to smoke. Implications: These results suggest that individuals with a combined history of alcoholism and major depression are at a high risk to use smoking as a means of mood enhancement.

Purpose: To explore the associations between violent and other crimes, and alcohol intoxication and recent use of cocaine, marijuana, and other drugs among men and women arrestees and examine gender differences in these relationships. Methods: We conducted a secondary analysis of 1998 using Arrestee Drug Abuse Monitoring (ADAM) system data using a sample of 9242 male and 2594 women arrested for violent and property offenses in 35 cities. Logistic regression was used to predict arrest for a violent offense (rather than a property crime) from drug- and alcohol-related, and other variables. Results: Both gender and alcohol intoxication are significantly related to arrest for a violent offense. However, the intoxication effects (in the absence of cocaine) are more than three times as great for female (Exp(β)=5.59) as male arrestees (Exp(β)=1.74), while the combined effects of alcohol and cocaine predict a property offense for women but are insignificant for men. Implications: To achieve further reductions in violent crime, intervention strategies need to focus on reducing alcohol intoxication as well as illicit drug use. Research on the role of alcohol on women's aggression and violence also is suggested.