Journal of substance abuse最新文献

Purpose: Offering drinkers free safe rides (SRs) home can prevent DWI, but some suggest that it may also promote excessive drinking. Methods: Forty-two respondents to surveys completed by 472 drinkers in barrooms reported that they used a SR during the first 9 months they were offered. Results: Their usual estimated blood alcohol concentration (BAC) was significantly greater when they used a SR than on all occasions when they drank outside their homes. However, only 24% of respondents increased their usual BAC from a “low risk” category (BAC<0.10) when drinking outside the home, to a “high risk” category (BAC≥0.10) when using a SR. The majority (72%) of respondents did not change their BAC categories. One decreased his/her BAC from ≥0.10 when drinking outside the home to <0.10 when using a SR. Implications: These findings, coupled with data showing that respondents tended to use SRs infrequently (3.69 times per year), reduce concerns about the mean increase in their BACs when using SRs. Findings do not, however, resolve the issue of whether respondents whose drinking increased when they used a SR did so because a SR was available, or decided not to drive because they drank more. Recommendations for improving SR programs are discussed.

Objectives: To elaborate a state-of-the-art list of alcohol-related fatal medical conditions for future social-cost studies in Western societies. Methods: Three major social-cost studies were compared with regard to their respective section on fatal health effects attributable to long-term as well as short-term use of alcohol. On discordant conditions, a systematic literature search was conducted in the Medline and ETOH databases. Results: There is no consensus between social-cost studies with respect to alcohol-related causes of mortality. Based on the recent epidemiological evidence on alcohol and health, this paper suggests an up-to-date list of fatal medical conditions for which the causal relationship has been established with sufficient scientific evidence. A further investigation is needed, however, to reestimate relative risks by meta-analysis. Conclusions: Evaluating new epidemiological evidence regularly is necessary for the purpose of up-to-date social-cost studies

Purpose: This study describes the course of alcohol abuse among a nationally representative sample of young adults over a 5-year time period for the purpose of examining the validity of the DSM-IV alcohol abuse category. Methods: DSM-IV diagnoses of alcohol abuse at baseline and follow-up were examined using logistic regression analyses. Results: Alcohol abuse and dependence were shown to have different courses. Very few abusers at Time 1 became dependent at Time 2, suggesting that abuse is not merely prodromal to dependence. Females, Blacks, and high school dropouts were less likely to receive an abuse diagnosis at baseline. Marital status, family history, earlier onset of drinking, and heavy drinking were also related to abuse at baseline. Alcohol abuse at baseline, in addition to gender, marital status, family history, early onset drinking, and heavy drinking, predicted abuse at follow-up. Exclusion of the hazardous criterion item “driving after drinking too much” from the abuse diagnosis yielded similar results. Discussion: The DSM-IV alcohol abuse category was shown to have some diagnostic utility.

Purpose: While many youths residing at homeless shelters will return home, many are placed in group or foster homes. Few researchers have examined the experiences of adolescents with a history of these out-of-home placements. This study examined shelter residents and compared the experiences of system and non-system youth. Methods: Information regarding youths' family functioning, substance use, depression and related problem behaviors was obtained from substance abusing system (n=62) and non-system (n=82) adolescents staying at local runaway shelters. Results: System males engaged in significantly more delinquent behaviors than did non-system males and system females. Alcohol and drug problem consequences were positively associated with longevity in the system, while having ever attempted suicide was negatively associated with system longevity. System youth reported: 1) taking more prescribed psychotropic medications 2) experiencing more sexual abuse, and 3) less parental overprotection, as compared to non-system youth. Gender differences were found in which females reported more conflictual problem solving interactions with their parents than did males, as well as more comorbid diagnoses. Implications: Although longitudinal research is needed, findings argue that without intervention efforts targeted at identified problem behaviors, youth are at risk to continue their system involvement into adulthood.

Purpose: While sexual harassment and generalized workplace abuse (GWA) have been linked with alcohol use and abuse, active problem-focused coping has been shown to lessen vulnerability to deleterious mental health consequences of varied social stressors. At the same time, active coping is relatively more efficacious in response to stressors, which are amenable to change by personal actions. However, the moderating role that coping plays in relation to harassment and drinking is unknown. Method: Using data from a two-wave survey of university employees (N=2038), we addressed the extent to which (1) active coping was utilized by harassed and abused employees, (2) whether coping impacted on the continuation or cessation of harassment and abuse, and (3) the extent to which nonsuccessful coping was predictive of alcohol use and abuse. Results: Active coping had no significant impact on the ability to end harassing or abusive experiences. Moreover, the use of problem-focused coping that was unsuccessful predicted some drinking outcomes for both men and women, controlling for Wave 1 drinking and sociodemographic characteristics. Implications: The data suggest that increased institutional attention to the prevention of workplace harassment and abuse might impact on decreasing alcohol use and abuse.

Purpose: To investigate among children of opiate addicts a potential protective effect of religiousness (broadly defined in the literature to include religious beliefs, practice, and tradition) against onset of substance use. Methods: Subjects were 161 opiate-addicted biological parents recruited from methadone maintenance programs in the New York metropolitan area, their 279 children, and 63 non-opiate-addicted parents with whom the child had daily contact. Childhood onset of substance use was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS); parental DSM-III-R diagnosis of opiate addiction was assessed using the SADS—Lifetime Version (SADS-L). Results: Religiousness in children of opiate addicts was associated with a substantially decreased likelihood of onset of substance use. Parent–child concordance of religiousness showed additional protective qualities with respect to religious denomination in opiate-addicted parent and with respect to the personal importance of religion and frequent attendance of religious services in non-opiate-addicted parents. Conclusion: Religiousness protects against substance use among children of opiate addicts.

Purpose: To examine heroin use and associated morbidity in young adults undergoing drug detoxification. Methods: A retrospective chart review of all persons (ages 18–25) admitted to either of the two state-funded detoxification facilities in Rhode Island was conducted between June 1998 and June 1999. Only those reporting heroin as a primary drug were included in this study (N=201). Results: Clients were largely male (64%), and white (79%), with a mean age of 22. Of those that reported heroin as their primary drug, 62% used primarily by injection. Mean age of initiation for heroin use was 18.3 years. Twenty-two percent reported a psychiatric diagnosis, and 80% reported a substance-abusing family member. Injection, previous overdose, and a mother with a history of substance use were associated with early initiation of heroin use. Conclusions: The majority of young adults with heroin addiction undergoing detoxification began using heroin during late adolescence. Cooccurrence of psychiatric and medical diagnoses with heroin addiction was common, and may contribute to the severity of drug use. Efforts to identify risk factors for heroin and other injection drug use in adolescents and young adults will be critical for the design of effective interventions to prevent injection drug use and its associated morbidities.

Purpose: Recently we found that the early onset of regular tobacco use is as predictive of lifetime drug use and depressive disorders as it is of alcohol use disorders [Alcohol.: Clin. Exp. Res. 23 (1999) 513.]. This finding, which paralleled findings regarding early onset of alcohol use [J. Subst. Abuse 10 (1998) 59.], suggested that early regular use of any drug might simply be an indicator of risk for a constellation of problem behaviors. The purpose of the present study is to test this hypothesis as well as to study the strength and patterns of associations among these problem behaviors already present among youth. The results will permit description of more precise profiles to identify groups of children at risk. Methods: Using data for respondents aged 12–16 from the Third National Health and Nutrition Examination Survey (NHANES III), descriptive statistics were calculated and logistic regression models were estimated. Results: Descriptive analyses indicated that in comparison with those who never smoked, or who simply experimented, early-onset regular smokers, both those who began at age 13 or younger and those who did so between 14 and 16, were those most likely to use alcohol and other drugs as well as have school problems and early sexual experiences culminating in pregnancy. Multivariate logistic regression analyses were conducted to assess the associations among these high-risk behaviors. Implications: These results support the hypothesis that early onset of smoking is but an indicator of a syndrome of problem behaviors already in place during childhood. They also suggest that the significance of an age onset variable may differ depending on the age of the sample used. As follow-up data are collected, we expect to learn much about the natural course of the distinct risk groups identified in the analyses by studying longitudinally this nationally representative group of early adolescents.

Purpose: Nearly all prison-based substance abuse treatment programs have been designed with male prisoners in mind. Administering these male-oriented programs to women prisoners has been the standard correctional practice. Recently, this practice has received considerable criticism. Critics argue that female prisoners have special needs that are not met by programs originally designed for male prisoners. However, most of the empirical support for the existence of such special needs rely on two inappropriate samples: prisoners who are not in treatment and treatment participants who are not incarcerated. Findings from these two different groups may not be generalizable to the population of prisoners in treatment. Methods: This paper directly addresses this generalizability problem with an examination of gender differences among 1326 male and 318 female federal prisoners who were enrolled in a substance abuse treatment program. Results: Women used drugs more frequently, used harder drugs, and used them for different reasons than men. Women also confronted more difficulties than men in areas linked to substance abuse such as educational background, childhood family environment, adult social environment, mental health, and physical health. Conclusion: We find support for the argument that substance abuse treatment programs which were originally designed for men may be inappropriate for the treatment of women.

Purpose: The purpose of the present investigation was to examine the relationship between victimization from and perpetration of workplace aggression between coworkers and frequency of alcohol use during the last year. Methods: Civilian employees (N=300) selected from the US population were interviewed over the telephone with psychometrically sound measures of workplace aggression and alcohol use frequency during the last year. Hierarchical regression analyses were used to examine the relationship between alcohol use and workplace aggression, after controlling for sociodemographic variables. Results: Both percentage of days of any drinking and percentage of days of heavy drinking during the last year were positively related to (a) victimization from verbal and physical aggression at work and (b) perpetration of verbal and physical aggression at work. Implications: Consistent with research studies spanning the sociobehavioral literature, the present investigation found alcohol use was associated with perpetration of and victimization from verbal and physical workplace aggression. Although the study established an association exists between alcohol use and workplace aggression, future investigations should attempt to understand employee alcohol use in the context of a multifaceted model that includes other likely factors that contribute to the incidence of aggressive behavior on the job.