bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term Impacts of the Swiss Heroin Prescription Trials on Crime of Treated Heroin Users
Authors: Ribeaud Denis
Published: March 2012

During the Swiss heroin prescription trials (PROVE, 1994–1996), over 1,000 heavily addicted heroin users were recruited into the program. While short- and medium-term effects of the program had been thoroughly assessed earlier, only a small body of data on the long-term effects on treated subjects was available. Data on program dropouts were particularly scarce. In order to partially fill that gap, police records of all participants were collected in summer 2000. Based on these data, the present paper focuses on the long-term effects (up to 48 months after admission) of heroin maintenance on criminal involvement and, to some extent, on addictive behavior. Results suggest that heroin prescription causes a strong and stable decrease in criminal involvement of most patients. Similar patterns of desistance are observed for a broad range of offenses and across different subpopulations of patients. Although the most pronounced decrease in criminal involvement is observed in the group of those treated permanently, treatment effects seem to hold in the post-treatment period. In particular, post-treatment rates of records related to use/possession of heroin remain comparatively stable, indicating that most program dropouts do not reengage in (public) use of illegal heroin. Additional data suggest that such stabilization is mainly related to the ability of the program to redirect the majority of patients towards alternative treatments once they left the treatment program.
Characteristics of Hidden Status among Users of Crack, Powder Cocaine, and Heroin in Central Harlem
Authors: Davis W. Rees , Johnson Bruce D. , Liberty Hilary James , Randolph Doris D.
Published: March 2012

This article analyzes hidden status among crack, powder cocaine, and heroin users and sellers, in contrast to more accessible users/sellers. Several sampling strategies acquired 657 users (N=559) and sellers (N=98). Indicators of hidden status were those who (1) paid rent in full in the last 30 days, (2) used nonstreet drug procurement, (3) had legal jobs, and (4) earned $1,000 or more in legal income in the last 30 days. Nearly half had at least one indicator; approximately 16% of users/sellers had two to four indicators. In logistic regression analyses, those who had not panhandled in the last 30 days, those who had used powder cocaine in the last 30 days, and those never arrested were the most likely to have hidden status, whether the analysis predicted those having any indicators or those having two to four indicators. The four indicators begin to operationally define hidden status among users of cocaine and heroin.
The Health Benefits of Secondary Syringe Exchange
Authors: Murphy Sheigla , Kelley Margaret S. , Lune Howard
Published: March 2012

From a process evaluation, participants in San Francisco's syringe exchange program (SEP) are described. Three groups, primary, secondary, and nonexchangers, were interviewed for a total of 244 study participants recruited from eight needle exchange sessions. Fifty percent of all primary exchangers exchanged for one or more injecting drug user(s) (IDUs). Three general routes of syringe distribution were identified between primary and secondary exchangers: between close friends and lovers; for people who lived in close proximity to them; and with customers who bought drugs from them. Focusing on why some go to SEPs and why some rely on others to go for them, findings are summarized primarily as the barriers for not attending SEPs, including exposure, legal status, illness, drug lifestyle, and conflicts with service provision. The secondary exchangers had similar risk reduction profiles to the SEP users that overall were better than the nonexchangers. For example, they shared syringes and cookers significantly fewer times than nonexchangers. The results demonstrate that these client-provided exchanges enable the SEP to overcome injection drug users' obstacles to program attendance, thereby reaching even hard to access members of IDU populations. We found the effects of these client-provided services to be positive for the larger IDU population.
Factors Associated with Criminal Severity among Adolescents Entering Substance Abuse Treatment
Authors: Kinlock Timothy W. , Battjes Robert J. , Gordon Michael S.
Published: March 2012

Adolescent substance abuse treatment has been increasingly emphasized as an intervention that could interrupt progression to adult criminal careers. However, information about the pretreatment criminal behavior of adolescent treatment clients has rarely been reported. This study examined the factors associated with the severity of self-reported pretreatment offending of 178 adolescents entering outpatient substance abuse treatment in Baltimore County, Maryland. Results indicated that increased severity of crime was related to male gender, use of drugs other than alcohol and marijuana, bullying and being physically cruel to people, higher levels of deviant behavior among peers, school problems, and having sex without a barrier. Given the rather low level of criminal involvement even among the more serious offenders, the degree to which study findings replicate those on other samples of adolescents is especially noteworthy.
Crack Cocaine Injection Practices and HIV Risk: Findings from New York and Bridgeport
Authors: Lankenau Stephen E. , Clatts Michael C. , Goldsamt Lloyd A. , Welle Dorinda
Published: March 2012

This article examines the behavioral practices and health risks associated with preparing crack cocaine for injection. Using an ethno-epidemiological approach, injection drug users (n=38) were recruited between 1999 and 2000 from public settings in New York City and Bridgeport, Connecticut and responded to a semistructured interview focusing on crack injection initiation and their most recent crack injection. Study findings indicate that methods of preparing crack for injection were impacted by a transforming agent, heat applied to the “cooker,” heroin use, age of the injector, and geographic location of the injector. The findings suggest that crack injectors use a variety of methods to prepare crack, which may carry different risks for the transmission of bloodborne pathogens. In particular, crack injection may be an important factor in the current HIV epidemic.
Trends in Alcohol use, Cocaine use, and Crime: 1989–1998
Authors: Martin Susan E. , Maxwell Christopher D. , White Helene R. , Zhang Yan
Published: March 2012

The widespread belief that illicit drugs are closely associated with crime has contributed to America's “War on Drugs” and attendant increases in arrests, convictions, and prison populations. However, the links between alcohol and crime have received less attention from policy makers and the public despite consistent evidence that alcohol is more likely than other drugs to be associated with violence. This study explores the relationship between alcohol and cocaine use and crime from 1989–1998, based on findings from the Drug Use Forecasting/Arrestee Drug and Alcohol Monitoring Program and the Uniform Crime Reports Program. We examine correlations among cocaine use, alcohol use, property crime, and violent crime at the city level to determine if there is a consistent pattern across cities over time. The analyses show a wide variation across cities in the links between both alcohol and cocaine use and violent and property crime rates over the 10-year period. However, the association between the annual rates of alcohol use and violent crime is stronger than that of alcohol use and property crime. These associations for alcohol remain in multivariate analyses, including statistical controls for temporal autocorrelation, SES, and heroin use. Cocaine use, in contrast, is not closely associated with either property or violent crime rates in the multivariate analyses. The findings suggest that to reduce violent crime rates, policy makers need to focus on addressing the contribution of alcohol. Furthermore, given the variation found across sites, efforts to reduce the drug/alcohol-crime links need to be tailored to local patterns and problems.
Research Note — Prescribing Diamorphine for Medical Conditions: A Very British Practice
Authors: Gossop Michael , Keaney Francis
Published: March 2012

Diamorphine, with a 129-year history, is one of the longest established medications. In British medicine, diamorphine is sometimes used as a maintenance treatment for opiate addiction but is also routinely used in clinical practice to treat a number of general medical conditions. These ways of using diamorphine are very different but are often confused by observers of the British system. Although the routine clinical use of diamorphine in medicine is unique to the United Kingdom (UK), in other countries there is little awareness of this very British practice. Diamorphine is used in hospitals, primary care settings, and hospices. It may be administered by different routes, including oral, intramuscular, intravenous, subcutaneous, inhaled, epidural, and intrathecal routes. Among its most important medicinal uses is the treatment of severe and/or intractable pain. Discussion of the medical uses of diamorphine is often confused by entanglement of medical practice and illicit drug abuse problems. This article summarizes the history, regulation, and uses of diamorphine in the UK.
The Origins and Future of the Dutch Approach towards Drugs
Authors: Uitermark Justus
Published: March 2012

This paper considers the roots of the Dutch approach towards drugs. It argues that the idiosyncratic nature of Dutch drug policies can be explained by taking into account the peculiar evolution of the Netherlands' political institutions. The distinctive character of Dutch policies is explained through the concept of gedogen. Gedogen refers to the practice of discriminatory enforcement. Gedogen can be defined as a regulatory system of organized toleration and targeted repression. Only those illegalities that are actually considered to cause social problems are targeted for repression. As such, the policy differs markedly from orthodox prohibitionist policy approaches. Policies towards ecstasy and cannabis are discussed to illustrate how gedogen works in practice. While it is argued that gedogen has functioned well for a number of years, doubts are expressed about the extent to which the Netherlands can be expected to continue to play the role of pioneer with respect to drug policies. After a revival of conservative politics, the country now seems ill equipped to develop alternative drug policies.
UK Policing of Drug Traffickers and Users: Policy Implementation in the Contexts of National Law, European Traditions, International Drug Conventions, and Security after 2001
Authors: Dorn Nicholas
Published: March 2012

This paper examines the day-to-day implementation of drug legislation in the United Kingdom (UK) by enforcement agencies, prosecution authorities, and courts within the broader contexts of national law on drug trafficking and possession, international drug conventions (especially the 1988 United Nations Convention), and issues concerning security and transnational organized crime. The situation in the UK is described, with some European comparison points. Increasingly, both in terms of the letter of the law and in everyday practice, police action against drug users in relation to simple possession is being deemphasized, especially with regard to cannabis. Government prioritizes its anti-trafficking action, especially in relation to “the drugs that do most harm.” The ways in which this strategy fits with the international drug conventions is outlined. In conclusion, this paper speculates how, in the light of the current climate surrounding international security, UK and other European drug policies might develop in future.
The Evolution of Swedish Drug Policy
Authors: Goldberg Ted
Published: March 2012

In order to understand any drug policy one must take into consideration its various components: assumptions about human nature, cultural and political traditions, the activities of different interest groups, theoretical framework, and the like. This paper discusses these aspects of Swedish drug policy as a means of shedding light on why Sweden, widely renowned as a humanitarian and rational country, has been one of the staunchest proponents of what some people consider to be inhumane and irrational drug policies. The author argues that Sweden's drug policy is basically logical, given the nation's cultural understanding and assumptions about alcohol (assumptions that have been transferred to other drugs as well). However, due to changes both within and outside of the country, alternative paradigms are gradually gaining ground, and there are indications that change in Swedish drug policy may be forthcoming.
Czech Drug Laws as an Arena of Drug Policy Battle
Authors: Zábranský Tomáš
Published: March 2012

This paper begins with a brief overview Czech drug policy and drug-related issues. The second section concentrates on how that policy has evolved since the fall of communism, identifies the main players in these events, and provides some details about the legislative procedure that eventually led to the reintroduction of punishments for the possession of illegal drugs. The paper describes in broad terms a major scientific evaluation of the impacts of recent legislative changes and subsequent government reactions to that report. Recent developments in the Czech drug policy debate are addressed in the third section of the paper. This account focuses on the ongoing legislative debate over whether the possession of drugs for personal use should be a criminal offense (this issue has been contested for nearly 10 years). Finally, a controversial legislative proposal that was only recently issued by the Ministry of Justice will be described.
Gender Differences in the Rehospitalization of Substance Abusers among Homeless Military Veterans
Authors: Benda Brent B.
Published: March 2012

This two-year follow-up study of military veterans treated in an inpatient drug treatment program was designed to examine any gender differences in predictors of rehospitalization for substance abuse or other psychiatric disorders. A survey was administered to 310 women and 315 men, involving several ecological predictors that rarely if ever had been investigated. For example, Cox's proportional hazard model indicated that childhood and current sexual and physical abuses were stronger predictors among women, whereas degree of substance abuse, cognitive disorders, aggression, and disadvantageous peer associations were stronger predictors among men. Social service implications of those findings were presented.
Rolling beyond Raves: Ecstasy use outside the Rave Setting
Authors: Boeri Miriam Williams , Sterk Claire E. , Elifson Kirk W.
Published: March 2012

In this paper, we explore settings of ecstasy use other than those that are part of the rave scene. Little is known about its use in other settings. Data from young adult (18–25 years old) active ecstasy users were collected using surveys (N = 158) and qualitative in-depth interviews (N = 66). Recruitment involved targeted and theoretical sampling. Data analysis was guided by the constant comparison method, common in grounded theory. Our findings indicate that ecstasy use has extended to social settings beyond raves, including dance/music venues, bars in inner-city neighborhoods, neighborhood cruising sites, and private residences. Users may attend multiple settings, and it is common for use practices to be transmitted across settings. An understanding of emerging social settings of ecstasy use and the associated use patterns provides baseline information for the development of effective and appropriate prevention and intervention programs, including drug treatment, as well as for policy makers.
Drug Treatment Programs as Sites of Opportunity for the Delivery of Hepatitis C Prevention Education: Client and Staff Perspectives
Authors: Munoz-Plaza Corrine E. , Strauss Shiela M. , Astone Janetta M. , Des Jarlais Don C. , Hagan Holly
Published: March 2012

This paper uses qualitative methods to examine both staff and clients' perceptions about the delivery of hepatitis C prevention education services at their respective residential drug treatment programs. Through in-depth discussion with participants, as well as program observation, we elicited clients' and staff attitudes about the role that drug treatment programs can play in providing prevention education services for hepatitis C, their evaluation of existing hepatitis C prevention education services, and recommendations for enhancing future services. Although participants identified limitations to services, most perceive that treatment programs can play an important role in hepatitis C prevention education service delivery. Participants view clients' misconceptions about hepatitis C, increased disease stigma, and diminished service utilization as potential consequences of limited hepatitis C prevention education services. Recommendations for improving services include more detailed and frequent opportunities for hepatitis C education, formalizing services, offering education in multiple formats, and providing additional staff training.
Drug Treatment Needs of Hispanic Drug Users in Long Beach, California
Authors: Fisher Dennis G. , Reynolds Grace L. , Moreno-Branson Catherine M. , Jaffe Adi , Wood Michele M. , Klahn Jennifer A. , Muñiz Juan F.
Published: March 2012

The objective of this study is to investigate differences between Hispanic and non-Hispanic drug users in Long Beach, CA, with respect to drug use, HIV risk behaviors, and drug treatment experience and to explore the dissimilarities between Hispanic drug users who identify their family origin as Mexican American compared to those who identify their family origin as Mexican. We recruited 1,728 drug users into an HIV risk reduction intervention; of these, 404 were Hispanic. The Risk Behavior Assessment (RBA) was used to collect information on demographics, drug and sex risk behaviors, and drug treatment experience. Hispanic drug users are significantly more likely to inject drugs than non-Hispanic drug users and were found to have a higher mean number of injections in the last 30 days. Hispanic drug users were more likely to have taken part in drug treatment programs, specifically methadone detoxification and maintenance programs. Self-identified Mexican drug users were less likely to have ever attended a drug treatment program than were Mexican-American drug users. Greater availability of drug treatment programs for monolingual and bilingual Hispanic injectors is needed.
Reciprocity and Exploitation: Social Dynamics in Private Drug use Sites
Authors: Dickson-Gómez Julia , Weeks Margaret R. , Martinez Maria , Radda Kim
Published: March 2012

The Study of High Risk Drug Use Settings for HIV Prevention was designed to increase knowledge of urban social contexts in which drugs are consumed. In this article, we use ethnographic methods to focus on one subtype of drug use setting in Hartford, Connecticut, private sites with gatekeepers. We analyze the social interactions of drug users who use these sites to explore the contradictory social processes that sometimes facilitate and at other times impede intervention efforts. Gatekeepers are often interested in attracting customers to their “business” and therefore may be willing to provide ongoing site-based HIV prevention education and materials. On the other hand, exploitative business exchanges contradict ideals of reciprocity and may undermine trust between gatekeepers and drug users impeding harm reduction efforts. Further, being the gatekeeper of a drug use site often accelerates gatekeepers' addictions, making it difficult for them to implement harm reduction strategies.
Research Note: Ethics of Drug Treatment Research with Court-Supervised Subjects
Authors: DuVal Gordon , Salmon Christina
Published: March 2012

The last two decades have seen an acceleration of clinical research on, and treatment advances in, addictive illness. Much important research in this area requires the participation of subjects who themselves suffer from drug dependence and have a strong likelihood of becoming involved in the criminal justice system at some point. However, using court-supervised persons with addictive disorders in drug research raises a number of significant ethical issues. These include, among others, worries about the individual's ability to provide capable, voluntary, informed consent and the obligation of researchers to safeguard sensitive clinical information. A variety of potentially coercive factors can influence court-supervised persons in their decision whether to enter research and can compromise their ability to provide informed consent. In this paper, we explore the ethical issues arising in this research and offer some suggestions for approaches to address these concerns.
Strategies for Controlling the Drug Supply: Policy Recommendations to Deal with Illicit Crops and Alternative Development Programs
Authors: Vargas Ricardo
Published: March 2012

Measuring the success of Alternative Development (AD) programs by the number of illicit crop hectares eradicated puts AD in an undesirable competition with aerial fumigation, which can reduce these areas in a much shorter time. Whereas AD can only obtain results over the long term, the political push to demonstrate immediate successful results has led to an imbalance in United States anti-drug aid, which is strongly weighted towards aerial fumigation. Despite the short-term success of aerial spraying, the key question of the political, social, and economic sustainability of the results obtained through the use of forceful eradication remains open. AD policies have suffered from changes in their focus over time. Today they are fixated on the idea that the sole purpose of illicit crops is to finance terrorist groups. This conception of the policy issue results in the use of force – specifically, aerial fumigations using chemicals – as the foundation for decision making. This single criterion, therefore, affects programs that once recognized the social and economic roots of the problem of illicit crops. This paper seeks to examine and question those aspects of the current strategy and to explore alternative strategies of eradication that take into account who makes decisions in this matter and on whose behalf said alternatives establish oversight for the ongoing advancement in drug policy.
The Ambiguity of Violence, Secrecy, and Trust among Colombian Drug Entrepreneurs
Authors: Zaitch Damián
Published: March 2012

Drug entrepreneurs are frequently portrayed as being violent, secretive, and only willing to work with trusted “equals.” However, these images often contrast with the social reality of drug dealing and dealers, which is more mundane, consensual, and public than imagined. Moreover, Colombian drug traffickers are either pushed to perform in accordance with such perceptions or simply to exploit their violent or secretive reputations. In addition to the actual use of violence, secrecy, and trust, drug entrepreneurs often use these resources strategically as a form of manipulation to either defend themselves, to gain power, or to construct their social or ethnic identities. While these resources serve as essential tools for business performance, they also constitute obstacles for success.

The time is past for guns and killings and massacres. We have to be cunning like the business people, there's more money in it and it's better for our children and grandchildren.

Mario Puzo, The Godfather
The Developmental Context of Substance use in Emerging Adulthood
Authors: Arnett Jeffrey Jensen
Published: March 2012

The theory of emerging adulthood has been proposed as a way of conceptualizing the developmental characteristics of young people between the ages of 18 and 25. Here, the theory is applied to explaining the high rates of substance use in this age group. Specifically, five developmentally distinctive features of emerging adulthood are proposed: the age of identity explorations, the age of instability, the age of self-focus, the age of feeling in-between, and the age of possibilities. Then, each of these features is applied to an explanation of drug use in emerging adulthood.
Emerging Adults' Substance use and Risky Behaviors in Club Settings
Authors: Miller Brenda A. , Furr-Holden C. Debra , Voas Robert B. , Bright Kristin
Published: March 2012

This article explores the prevalence of drug and alcohol use and related risks by attendees at electronic music dance events (EMDEs) in club settings. From six events located on the East and West Coasts, anonymous data were collected via self-report questionnaires, drug bioassays, and alcohol breath tests prior to entry (N = 240) and upon exit from the venues (N = 219). EMDEs were locations for identifying young adults who were aged 18 to 25 (70%), not college students (54%), and at risk for substance use. Nearly half of the sample (45%) were positive for drug use, and 60% were positive for alcohol use at entrance. Slightly more than one third (38%) were positive for drug use, and 59% were positive for alcohol use at exit. Only a small percentage of the sample converted from no use to drug use on premises (5.4%). Future investigations need to explore targeted substance use prevention strategies within this context.
Vulnerability, Social Networks, Sites, and Selling as Predictors of Drug use among Urban African American and Puerto Rican Emerging Adults
Authors: Schensul Jean J. , Burkholder Gary J.
Published: March 2012

This paper reviews the results of research conducted with African American and Puerto Rican emerging adults between the ages of 18 and 25 whose life experiences increase vulnerability to drug use and pose some significant challenges in achieving milestones widely recognized as important in achieving adult status. Literature on drug use in adolescence suggests that personal vulnerability accounts for most experimental and problem drug use. Included in the vulnerability construct are religiosity, perceived risk, social influence, drug access, social norms, and social risk defined primarily as exposure to various forms of violence. This study shows that personal vulnerability explains only some of the variance in use and predicts variance differently with respect to different specific drugs and polydrug use. Further, it argues that additional contextual factors including social networks, party and club attendance, and drug selling activities, all typical of emerging adulthood and urban lifestyle, are also important factors in enhancing potential for accelerated drug use during this developmental period. Finally, it notes that the consequences of these activities have implications for further economic and social marginalization of urban, multiethnic low income emerging adults.
College Student Drug Prevention: A Review of Individually-Oriented Prevention Strategies
Authors: Larimer Mary E. , Kilmer Jason R. , Lee Christine M.
Published: March 2012

The current paper highlights the college years as a risk period for development, continuation, and escalation of illicit substance use and substance use disorders and reviews the literature related to the prevention and treatment of these disorders in college populations. Despite widespread implementation of college drug prevention programs, a review of the literature reveals few controlled trials targeting this population. However, alcohol prevention has been extensively studied, and many efficacious interventions for college drinking share theoretical and methodological underpinnings with interventions shown to be efficacious in drug prevention and treatment with other populations (i.e., school-based prevention, adolescent and adult drug treatment). These interventions could be adapted to target drug prevention on college campuses. Barriers to implementation and evaluation of these interventions on campus are discussed, and suggestions are made for future research and programmatic directions.
Applying a Public Health Approach to Drug Abuse Research
Authors: Compton Wilson M.
Published: March 2012

Applying a public health perspective to drug abuse research has far-reaching implications. First, the health of the entire community is of concern, not just the individual patient. Because of the social impact of drug abuse, these problems become the responsibility of all citizens to address. Second, the perspective requires treating drug abuse as a health issue, not as a criminal justice, moral, or social issue. Third, as in other branches of medicine, applying this perspective to drug abuse research will encourage development of the most effective ways to enhance drug abuse prevention and treatment interventions through cross-disciplinary approaches. The public health approach requires studies that (1) determine need for intervention; (2) provide clues about etiology; (3) determine effective approaches, systems, and financing strategies; and (4) measure the impact of interventions and services on the health of a population. Overall, attending to the public health implications of research will help to assure the maximum impact of scientific findings.
Managed Care's Dual Impact on Outpatient Substance Abuse Treatment: Methadone Maintenance vs. Drug Free
Authors: Sindelar Jody L. , Olmstead Todd A.
Published: March 2012

The number and type of services offered at substance abuse treatment (SAT) facilities are important aspects of the quality of care. Managed care (MC) is a growing presence in SAT and has been shown to affect the provision of treatment. We expand on earlier work and examine the impact of managed care on the number and type of services offered by methadone maintenance (MM) and drug-free (DF) outpatient treatment facilities. We use the econometric technique of instrumental variables to address the issue of endogeneity of MC and service offerings, thereby allowing a causal interpretation of results. Using data from the 2000 National Survey of Substance Abuse Treatment Services, we find that MC significantly increases the total number of services offered in MM outpatient facilities by four, yet decreases the number by two in DF outpatient facilities. We also show how the impact on specific services differs by modality and provide explanations for our findings.
Multi-Level Assessment Protocol (MAP) for Adoption in Multisite Clinical Trials
Authors: Guydish Joseph , Manser Sarah Turcotte , Jessup Martha , Tajima Barbara , Sears Clare , Montini Theresa
Published: March 2012

The National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) is intended to test promising drug abuse treatment models in multisite clinical trials and to support adoption of new interventions into clinical practice. Using qualitative research methods we asked the following question: how might the technology of multisite clinical trials be modified to better support adoption of tested interventions? A total of 42 participants, representing eight organizational levels ranging from clinic staff to clinical trial leaders, were interviewed about their role in the clinical trial, its interactions with clinics, and intervention adoption. Among eight clinics participating in the clinical trial, we found adoption of the tested intervention in one clinic only. Analysis of interview data revealed four conceptual themes likely to affect adoption and may be informative in future multisite clinical trials. Planning for adoption in the early stages of protocol development will better serve the aim of integrating new interventions into practice.
Clinicians' Beliefs and Awareness of Substance Abuse Treatments in Research- and Nonresearch-Affiliated Programs
Authors: Arfken Cynthia L. , Agius Elizabeth , Dickson Marcus W. , Anderson Heidi L. , Hegedus Andrea M.
Published: March 2012

Clinicians' beliefs and awareness of treatment techniques may influence what innovations are perceived as needed and adoption of them. Clinicians at research-affiliated programs, however, may differ from clinicians at programs without research affiliation. We surveyed 162 clinicians at 15 substance abuse treatment programs (five research-affiliated programs and 10 matched nonresearch-affiliated programs) on addiction treatment belief items and awareness of Clinical Trials Network treatment innovations currently being tested. The research-affiliated clinicians had a higher percentage of clinicians with advanced degrees. In bivariate analyses, three differences in beliefs and four differences in awareness by research affiliation were found. Most of these differences disappeared during multivariate analyses. The results suggest that beliefs and awareness toward addiction treatment of research-affiliated clinicians, when controlling for demographic and professional characteristics, may be similar to those of other clinicians. This similarity should help in wider dissemination for those innovations found acceptable to clinicians at research-affiliated programs.
Organizational Predictors of Pharmacological Innovation Adoption: The Case of Disulfiram
Authors: Knudsen Hannah K. , Roman Paul M. , Ducharme Lori J. , Johnson J. Aaron
Published: March 2012

The research-to-practice gap in substance abuse treatment, particularly with regard to pharmacological innovations, necessitates the consideration of organizational characteristics that facilitate the adoption of innovations. Using data from a nationally representative sample of 394 privately funded substance abuse treatment centers, this study examines variation in the adoption of disulfiram in terms of organizational structure, workforce professionalism, and treatment philosophy. Logistic regression results indicated that hospital-based centers were significantly more likely to use disulfiram than freestanding treatment programs. In addition, the percentage of counselors with master's degrees and the percentage of certified/licensed counselors were positively associated with the likelihood of disulfiram utilization. Treatment centers that emphasized confrontational group therapy and spirituality were less likely to use disulfiram, while the adoption of disulfiram was more likely in centers that emphasized a medical model of addiction.
The Role of Organizational Characteristics in Determining Patterns of Utilization of Services for Substance Abuse, Mental Health, and Shelter by Homeless People
Authors: North Carol S. , Pollio David E. , Perron Brian , Eyrich Karin M. , Spitznagel Edward L.
Published: March 2012

This study aims to advance understanding of service provision to the homeless population through investigation of the effects of organizational characteristics. A longitudinal study of homelessness obtained structured psychiatric interview data from 400 participants and these individuals' service use and organizational data from 23 organizations over the next 12 months. Substance abuse service use was associated with organizational funding diversity, professionalism, and focus of services on substance abuse service provision. Other mental health service use was associated with small organizational size, professionalism, and simplicity of organizational funding diversity. Shelter service use was associated with complexity of services and small organizational size and inversely related to professionalism of staff. Results suggest relevance of organizational characteristics to understanding service access and use, controlling for individual need factors. Only by examining interactions among individual and organizational characteristics across sectors of care can the complexity of service provision to this multifaceted population be approached.
Screening for Co-Occurring Mental Disorders in Drug Treatment Populations
Authors: Magruder Kathryn M. , Sonne Susan C. , Brady Kathleen T. , Quello Susan , Martin Renée Hebert
Published: March 2012

Substance abuse treatment organizations are universally faced with the problem of co-occurring psychiatric disorders among the clients they serve. A first step is assessment of such comorbid conditions; however, the time constraints in front-line substance abuse treatment organizations make extensive clinical assessments almost impossible. The development and validation of a brief screening tool for psychiatric disorders in individuals with substance use disorders (SUDs) could have enormous implications for clinical practice. We assessed the performance characteristics of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and the Conners' Adult ADHD Rating Scale (CAARS) against the Structured Clinical Interview for DSM-IV (SCID-IV) in 120 patients admitted to SUD treatment. Patients were randomly assigned to receive either the SCID or PDSQ. In general, the PDSQ and CAARS performed well. There were no statistically significant performance differences by order of administration, gender, or drug use in past month. For the GAD subscale, Caucasian patients had higher levels of agreement than non-Caucasian patients.
“I'm a Health Nut!” Street Drug Users' Accounts of Self-Care Strategies
Authors: Drumm Rene‘ D. , McBride Duane , Metsch Lisa , Neufeld Melodie , Sawatsky Alex
Published: March 2012

This qualitative study analyzes data from in-depth interviews to describe self-care strategies among chronic and injecting drug users. While the types of strategies varied from participant to participant, the theme of proactive self-care remained strong throughout the data. Researchers identified five self-care domains discussed by the study participants. The self-care domains include strategies to improve nutrition, increase physical activity, address medical concerns, regulate substance use, and reduce sexual risk. Overall, these data indicate that chronic drug users are actively involved in managing and improving their health and attempt to take self-protective actions, even while continuing to engage in active drug use. These findings are particularly relevant for primary care providers, walk-in clinics, drug treatment programs, outreach workers and those engaged in harm reduction efforts. Recognizing that drug users are actively involved in taking care of their health can be an important strategy to build into any intervention or risk reduction program.
Race, Self-Control, and Drug Problems among Jail Inmates
Authors: De Li Spencer
Published: March 2012

The main objectives of this study are to test racial differences in self-control and race-specific effects of self-control on drug-related problems. On the basis of prior research, it is hypothesized that both self-control and its effect on drug-related behavioral problems vary by race. Data collected from White, Black, and Hispanic inmates incarcerated in five local jails in the greater Philadelphia area were used to test these hypotheses. The results indicate significant racial differences in levels of self-control. However, the impact of self-control on drug problems did not differ significantly among the three racial groups. Overall, the findings support the argument of the general theory of crime that self-control maintains a constant and positive effect on deviant and criminal behavior across racial groups.
Asian American Youth, the Dance Scene, and Club Drugs
Authors: Hunt Geoffrey , Evans Kristin , Wu Eileen , Reyes Alicia
Published: March 2012

The available research data on young Asian American drug use is relatively limited compared to the availability of research on other major ethnic groups. Today more published data have highlighted the extent to which drug use is significant and rising in Asian American communities. From our ongoing research on the social context of ecstasy and other club drug use in the San Francisco Bay Area, we analyze data from a total of 56 face-to-face interviews with young Asian American club and rave attendees. We explore the development of a distinctive Asian American experience, in order to understand the attraction of club drugs and the dance scene. We examine the specific social groupings in which they operate, the types of social events they attend, and the nature of their club drug use. We highlight some of the ways in which they construct and express their identities around these social groupings, in terms of ethnic and socio-cultural distinctions as well as other cultural commodities.
Risks of Arrest across Drug Markets: A Capture-Recapture Analysis of “Hidden” Dealer and User Populations
Authors: Bouchard Martin , Tremblay Pierre
Published: March 2012

Capture-recapture methodologies have been used to estimate the size of the hidden population of active offenders on the basis of the observed properties of the truncated distribution of arrested offenders. We use this approach to estimate the odds of arrest of marijuana, cocaine, crack, and heroin dealers and users in one Canadian province (Quebec). Findings indicate that risks of being arrested are much higher for sellers than for consumers and that this gap widens for the more harmful drugs. Findings also show, however, that vulnerability to arrest was significantly higher for marijuana users than for others users and that dealers in the smaller but more harmful drug markets (crack and heroin) manage to experience lower aggregate risks of arrest than cocaine or marijuana dealers.
Are You Positive? The Relationship of Minority Composition to Workplace Drug and Alcohol Testing
Authors: Gee Gilbert C. , Curbow Barbara , Ensminger Margaret E. , Griffin Joan , Laflamme David J. , McDonnell Karen , LeGrande David , Agnew Jacqueline
Published: March 2012

Although testing for alcohol and drug use is common in the U.S. workplace, relatively little is known about the characteristics of workplaces that test and about the consequences to persons tested. This paper describes the link between drug and alcohol testing and the minority composition of worksites. The data come from a 1999 survey of 264 union officials in the telecommunications industry. These preliminary data suggest minority worksites were more likely to perform pre-employment and just-cause testing and less likely to perform random drug testing, even after considering workplace characteristics such as normative use of drugs. A similar but weaker association was found for alcohol testing.
Substance Abuse Disorders among Homeless and Runaway Adolescents
Authors: Johnson Kurt D. , Whitbeck Les B. , Hoyt Dan R.
Published: March 2012

This paper presents lifetime and 12-month prevalence rates and comorbidity data for substance abuse disorders among homeless and runaway adolescents. Data are from baseline interviews of a longitudinal diagnostic study of 428 (187 males and 241 females) homeless and runaway adolescents aged 16 to 19 years (mean age = 17.4 year, SD = 1.05). The data were collected by full-time interviewers on the streets and in shelters in eight Midwestern cities of various populations. About two thirds (60.5%) of the runaways met lifetime criteria for at least one of three substance disorders (alcohol abuse, alcohol dependence, drug abuse), and nearly one half (48.1%) met 12-month criteria for at least one of the disorders. Nearly all of the adolescents (93%) who met criteria for a substance disorder met criteria for at least one other mental disorder. Those factors most predictive of meeting lifetime criteria include parenting practices, experience of abuse, and association with deviant peers.
White Chicks on Dope: Heroin and Identity Dynamics in New York in the 1990s
Authors: McCoy Kate , McGuire Judy , Curtis Ric , Spunt Barry
Published: March 2012

We examined heroin use among 15 White middle-class women using data from in-depth qualitative interviews and ethnographic observation between May 1996 and April 1999. These women represent a subsample of a diverse group of 550 in an ethnographic study of heroin use and dealing in New York City. Our analysis is organized into four sections: (1) a demographic sketch, (2) the first time, (3) mode of administration and patterns of use, and (4) heroin in the medicine cabinet. Heroin use among these women was not related to poverty or lack of opportunity, social disenfranchisement, defective or addictive personalities, childhood trauma, or seeking membership into deviant subcultures. While some of these discourses of adversity and thrill seeking may have surfaced in individual stories, the dominant theme that emerged from the data was that of active struggles around identity, struggles over who and how one does and does not want to be.
Urine Collection Jars versus Video Games: Perceptions of Three Stakeholder Groups toward Drug and Impairment Testing Programs
Authors: Seijts Gerard H. , O'Farrell Grace
Published: March 2012

The use of drug testing in the workplace is a controversial practice. Scholars, practitioners, unions, and organizations have therefore begun to explore whether there are alternative approaches to reduce counterproductive behaviors at work. We investigated the perceptions of labor relations experts, drivers of transportation vehicles, and users of public transportation services toward drug and impairment testing programs in the workplace. Impairment testing was viewed as more favorable in terms of combating and controlling counterproductive behaviors at work than drug testing. Perceptions of fairness, effectiveness in detecting impaired performance, and the potential to enhance a safer working environment were higher in the impairment testing condition as compared to the drug testing condition. Perceived invasiveness was lower in the impairment testing condition relative to the drug testing condition. Labor relations experts showed the least enthusiasm for both drug testing and impairment testing programs.
Inaccuracies in Self-Reports and Urinalysis Tests: Impacts on Monitoring Marijuana Use Trends among Arrestees
Authors: Golub Andrew , Liberty Hilary James , Johnson Bruce D.
Published: March 2012

Measured trends in drug use can potentially reflect changes in drug use, changes in the accuracy of the measurement instrument, or both. This paper compares marijuana use trends from 1987 to 2001 using self-report and urinalysis data from arrestees interviewed at 23 sites served by the Arrestee Drug Abuse Monitoring (ADAM) Program. Overall, 60% of the variation in reported use reflected changes in detected use. Most notably, reported and detected use suggested different dynamics to the increase in marijuana use during the 1990s. The growth in detected use started later, increased more, and lasted longer. Several factors appear to have clearly contributed to this divergence between the measures: the percentage of marijuana users that disclosed their activity changed over time, the accuracy of ADAM's urinalysis test increased with time, and the percentage of infrequent users changed over time (urinalysis tests are less likely to detect infrequent users). The paper concludes with recommendations for the careful analysis of marijuana use trends using self-report data, biological data, or both. Trends in cocaine, crack, heroin, and methamphetamine are also considered.
Intergenerational Roots of Early Onset Substance use
Authors: Thornberry Terence P. , Krohn Marvin D. , Freeman-Gallant Adrienne
Published: March 2012

This study examines intergenerational continuity in drug use across three generations of respondents in the same family. The data are from the Rochester Intergenerational Study, an ongoing, prospective, multi-generational investigation using a community-based sample. Our findings indicate that there is intergenerational continuity in drug use for Generation 2, or G2 daughters, but not sons, of G1 mothers. Use by G3 is significantly influenced by both G2 mothers and G1 grandmothers. However, for children of G2 fathers, neither prior generation's substance use is significantly related to G3 use. There is some indication that the absence of an effect from G2 fathers to G3 drug use is due to the number of nonresident fathers in the sample.