bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistence in Turning to Faith as a Predictor of Drug Use and Criminality among Drug Court Clients
Authors: Duvall Jamieson L. , Staton-Tindall Michele , Oser Carrie , Leukefeld Carl
Published: March 2012

Faith-based beliefs are associated with and considered to be a vital component in enhancing the efficacy of substance abuse treatment and recovery. However, relatively little empirical information has been accumulated on the temporal stability of individuals' use of faith and its importance before and following initiation of the therapeutic process. The current study examined persistence in turning to faith across time as a predictor of substance use, criminal behavior, and perceived addiction severity in a sample of 500 Kentucky Drug Court participants. Results suggest that when modeling variance in faith, which persists across the two-year span of Drug Court involvement as a latent construct, greater persistence in one's faith predicts decreases in substance use frequency measured at the final 24-month interview. The latent faith construct was marginally related to differences in 24-month criminal behavior and was not associated with perceptions of addiction severity. Results are discussed for substance abuse treatment needs and recovery.
Reflections on the Early History of National Institute on Drug Abuse (NIDA): Implications for Today
Authors: DuPont Robert L.
Published: March 2012

The National Institute on Drug Abuse (NIDA) was formed in September, 1973 from a Division of the National Institute on Mental Health (NIMH), from the three-decade old Addiction Research Center (ARC) in Lexington Kentucky, and from the two year old Special Action Office for Drug Abuse Prevention (SAODAP), the original White House drug office. The legislation authorizing NIDA was passed by both Houses of Congress and signed by the president with bipartisan unanimity in response to the drug abuse epidemic, which had begun in the late 1960s. NIDA was the embodiment of the new Federal drug abuse strategy that, for the first time, balanced the traditional focus on law enforcement (supply reduction) with a new focus on treatment, prevention, and research (what became known as demand reduction). The current article offers a review of the early history of NIDA and its implications for future research.
Reflections of an Academic Clinical Researcher on the past 40 Years of Addiction Development
Authors: Schnoll Sidney H.
Published: March 2012

This paper reflects on three areas of addiction: prescription drug abuse, perinatal addiction, and the clinical fields of addiction medicine and addiction psychiatry. The concerns about the abuse and misuse of prescription drugs date back over a century with numerous laws passed to address these problems. Despite these laws, there has been increasing concern over the past decade about the increases in the nonmedical use and abuse of prescription drugs. This begs the question of whether the passing of laws addressing the supply side of the problem is the correct approach. Abuse of licit and illicit drugs by pregnant women creates concern because of the effects of drugs and alcohol on the fetus and future development of the child. Most of the studies have addressed newborn development without adequate studies of the effects of the drugs and withdrawal on pregnancy and the fetus. In addition, studies of long-term effects on the development of the child are needed. The only way to adequately address these important clinical issues will be to have well-trained clinicians and clinical investigators in addiction medicine and addiction psychiatry.
Reflections on the Meaning of Drug Epidemics
Authors: Chitwood Dale D. , Murphy Sheigla , Rosenbaum Marsha
Published: March 2012

Fluctuations in the use of many drugs at one time or another have been characterized as drug epidemics. The depiction of drug use as an epidemic, as in the recent cases of methamphetamine and crack use, is a proven mechanism for communicating that a problem exists, but such depictions are not without risk. When the public characterization of drug use as an epidemic represents more than its epidemiological meaning of “unusually elevated occurrence,” panic is often substituted for reasoned action. Such declarations are likely to truncate objective investigation, generate fear rather than understanding, and stimulate reactive measures that exacerbate drug misuse. This article discusses the epidemiological origin and meaning of epidemic, documents how media headlines have sensationally depicted methamphetamine use, and recommends that alternative strategies for describing an increase in the incidence and prevalence of use may be more successful in directing researchers and policy makers toward effective strategies for reducing misuse.
Reflections on 40 Years of Ethnographic Drug Abuse Research: Implications for the Future
Authors: Carlson Robert G. , Singer Merrill , Stephens Richard C. , Sterk Claire E.
Published: March 2012

This paper focuses on past, present, and potential future contributions of ethnographic research to describing and understanding “street cultures” of drug use and the implications these have for informing various interventions. The first section provides an overview of ethnography and drug abuse research. This is followed by a historical perspective on the ethnography of street cultures. Next, the significance of ethnographic drug abuse research is highlighted, with a focus on its methodology. Ethnographic contributions to the development, implementation, and evaluation of interventions are discussed, including ethical issues. Subsequently, the interdisciplinary nature of ethnographic drug abuse research is described. Methodological challenges emerged over time as the definition of street cultures and drug trends shifted. These are illustrated with examples, including the use of prescription drugs, new heroin users, and rural drug and methamphetamine use. The final sections focus on career opportunities for ethnographers and opportunities and barriers for the future. We address training needs for interdisciplinary inquiry, the potential role of ethnographers in prevention and treatment research, and the link to studies on the brain and genetics. The future of ethnographic research on drug use will be influenced by the funding structure. We conclude with a summary of reflections on the past and aspirations for the future.
Reflections on Drug Policy
Authors: McBride Duane C. , Terry-McElrath Yvonne , Harwood Henrick , Inciardi James A. , Leukefeld Carl
Published: March 2012

The history of United States drug policy is complex, ranging from laissez-faire to strict prohibition. In recent years, there has been little federal interest in drug policy reform and a continuing focus on a prohibitionist deterrence approach. During this period, state initiatives have been in the forefront of drug policy experimentation via ballot initiatives, legislative actions, or judicial and administrative policy decisions. The resulting state-level drug policy landscape includes continued prohibition as well as harm reduction, medicalization, and decriminalization. In addition, there has been considerable state-level policy focus on substance abuse treatment quality. With a new presidential administration, there is some indication that drug policy reform may be a national issue as part of the federal health reform agenda. The authors hope that the results of state policy experiments that provide evidence for the viability of harm reduction, quality treatment, and related approaches can be a viable part of the national policy discussion.
The Neurobiology of Addiction: Where We Have Been and Where We Are Going
Authors: Koob George F. , Simon Eric J.
Published: March 2012

A number of dramatic breakthroughs in the neurobiology of addiction have occurred in the past 40 years. Two domains will be highlighted: the neurocircuitry of addiction and the molecular biology of addiction targets. The neurobiological substrates for the reinforcing effects of drugs of abuse have been largely identified both at the initial site of action and in the circuitry involved. In human imaging studies, decreases in dopaminergic function have been identified as a key element of addiction, lending support for research on the role of dopamine in addiction. Three novel areas currently are emerging: the role of deficits in frontal cortex functioning, changes in the brain neurocircuitry that convey long-term vulnerability to relapse, and the role of nondopaminergic systems in the neuroadaptations associated with the development of drug dependence. Parallel to these functional changes have been major advances in our understanding of the molecular biology of addiction; the greatest contribution has been in the understanding of the molecular mechanisms of opioid action. This paper reviews the major developments in our understanding of the molecular biology of the endogenous opioid system and the use of genomics to advance our knowledge of the function and regulation of opioid receptors and endorphins.
Reflections on the past 40 Years of Behavioral Pharmacology Research on Problems of Drug Abuse
Authors: Balster Robert L. , Walsh Sharon L. , Bigelow George E.
Published: March 2012

Behavioral pharmacology research has made important contributions to the conceptualization of addictions and to the treatment and prevention of substance abuse. It has its intellectual roots in the experimental analysis of behavior and close ties with experimental and clinical pharmacology. Because substance abusers self-administer drugs repeatedly, this presents the opportunity for learning to occur. The application of learning theory to the laboratory study of drug effects in both animals and humans has been a major contribution of behavioral pharmacology research. Principles derived from over 40 years of behavioral pharmacology research are now widely accepted in the addiction field and have contributed to the development of both pharmacological and behavioral treatments. Drug abuse prevention through the assessment of the abuse liability of new medications has also been an important applied area of research in the field. Personal reflections of three behavioral pharmacologists provide examples of important influences in the field.
Treatment Research: Accomplishments and Challenges
Authors: Hubbard Robert , Simpson D. Dwayne , Woody George
Published: March 2012

This article reviews the history of substance abuse treatment and its evaluation. The authors comment on key aspects of this history and its implications for the future. Research has been a key factor in the support of substance abuse treatment and the expansion and improvement of treatment options. Despite the progress in the field, organizational structure and functioning, ambivalence on the moral/medical basis of addiction, and narrow perspectives on evidence-based practice have presented barriers for advancement. Future improvement of treatment is seen as dependent on the partnership of researchers and real world providers, studies of evidence- based practice in a wide variety of community based settings and the consideration of complex and changing real-world environments, particularly for rural, uninsured and under-served populations.
The Therapeutic Community for Addictions: An Evolving Knowledge Base
Authors: De Leon George , Wexler Harry
Published: March 2012

The therapeutic community (TC) has become an established treatment approach serving thousands of substance abusers in community, institutional, and other settings. This article summarizes the research that contributed to the acceptance and growth of TCs and laid the groundwork for the establishment of TCs for substance abusers in correctional settings. The TC knowledge base has contributed to the revival of a rehabilitation philosophy in correctional policy, which is described in the second section. The reflections of the authors who have collaborated for about 40 years are provided at the end of the paper.
Health Services Research for Drug and Alcohol Treatment and Prevention
Authors: McCarty Dennis , Roman Paul M. , Sorensen James L. , Weisner Constance
Published: March 2012

Health services research is a multidisciplinary field that examines ways to organize, manage, finance, and deliver high-quality care. This specialty within substance abuse research developed from policy analyses and needs assessments that shaped federal policy and promoted system development in the 1970s. After the authorization of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), patient information systems supported studies of treatment processes and outcomes. Health services research grew substantially in the 1990s when NIAAA and NIDA moved into the National Institutes of Health, and legislation allocated 15% of their research portfolio to services research. The next decade will emphasize research on quality of care, adoption and use of evidence-based practices (including medication), financing reforms, and integration of substance abuse treatment with primary care and mental health services.
Reflections on 25 Years of HIV and AIDS Research among Drug Abusers
Authors: Booth Robert E. , Des Jarlais Don C. , Friedman Samuel R.
Published: March 2012

Booth: Since early in the HIV epidemic, street outreach workers, often indigenous to the target population, have served both to recruit drug injectors for interventions and to conduct interventions. The typically unstructured nature of outreach interventions present challenges in determining the nature of services actually delivered. It is recommended that both qualitative and quantitative methods be utilized to monitor intervention service delivery. Des Jarlais: The threat of AIDS has led to profound behavioral changes among drug users. These changes need to be seen primarily not as responses to public health interventions, but in terms of the competencies of drug users themselves. A Drug User Competency Model of HIV Prevention would include: 1. Competency in understanding HIV transmission, 2. Competency in reducing HIV risk behavior, and 3. The competency of altruism. Friedman: Twenty years of work on HIV among drug users highlight that we need to incorporate large-scale social dynamics in research and interventions, understand drug users' sexual behavior and networks, and view drug users as multifaceted human beings, not just “walking addictions.” Crucially, drug users can be highly competent at many things, so non-users can learn from their ideas and their practices. Drug users can be partners and sometimes leaders, not just “disabled addicts.”
Drug Abuse Research: Today and Tomorrow
Authors: Guydish Joseph R.
Published: March 2012

Many of the papers in this theme issue originated as presentations at a conference entitled “Reflections on 40 Years of Drug Abuse Research.” At the conference, leaders in the drug abuse field presented their work, as well as their visions and concerns for the future of drug abuse research, and many of those presentations are included as papers in this issue of the Journal of Drug Issues. At the end of the conference, and after hearing presentations from senior researchers in the field, several mid-career investigators were invited to reflect on the conference and on the field of drug abuse research at this time in its history. This brief article offers reactions to the conference, in terms of its meaning for the future of drug abuse research.
Smoking Cessation Services in Adolescent Substance Abuse Treatment: Opportunities Missed?
Authors: Knudsen Hannah K.
Published: March 2012

The majority of adolescents receiving substance abuse treatment also use tobacco, yet there are few data regarding the adoption of tobacco use assessment and smoking cessation services by adolescent treatment programs. Using data from a national sample of adolescent-only treatment programs (n = 154), this research measures the adoption of aspects of assessment and treatment from the Public Health Service's (2000) guideline, Treating Tobacco Use and Dependence. When adoption of four intake/assessment practices was measured, adoption appeared high, but only 45% of programs had adopted all four practices. About 43% of programs offered some type of smoking cessation services. However, there was no association between adoption of intake procedures and the odds of availability of smoking cessation services, suggesting a lack of connection between the identification of treatment needs and the availability of services. The lack of smoking cessation services may represent a missed opportunity for early intervention with this population.
Effects of Smoking Cessation on Illicit Drug Use among Opioid Maintenance Patients: A Pilot Study
Authors: Dunn Kelly E. , Sigmon Stacey C. , Reimann Edward , Heil Sarah H. , Higgins Stephen T.
Published: March 2012

Opioid treatment program patients and staff often have concerns that smoking cessation may jeopardize abstinence from illicit drug use. In this study, we evaluated whether smoking abstinence produced with a two-week contingency-management (CM) intervention was associated with relapse to illicit drug use among patients enrolled in opioid maintenance. Opioid-maintenance patients who were stable in treatment and abstinent from illicit drugs were enrolled in a 14-day smoking-cessation study. Participants were dichotomized into Abstainers (> 90% smoking-negative samples, n=12) and Smokers (< 10% smoking-negative samples, n=16). Illicit drug assays included opioids, oxycodone, propoxyphene, cannabis, amphetamines, cocaine, and benzodiazepines. There were no differences between the Abstainers and Smokers, with 99% and 96% of samples testing negative for all illicit drugs in each group, respectively. Data from this study provide no evidence that smoking cessation among stable opioid-maintained patients undermines drug abstinence and lend support for programs that encourage smoking cessation during drug abuse treatment.
Gender Differences in Quit Support by Partners of Health-Compromised Smokers
Authors: Rohrbaugh Michael J. , Shoham Varda , Dempsey Catherine L.
Published: March 2012

In a study of spousal support for smoking cessation, 34 couples in which one partner continued to smoke despite having a heart or lung problem used an adaptation of Cohen & Lichtenstein's (1990) Partner Interaction Questionnaire to describe the spouse's attempts to help the primary (ill) smoker quit. Female smokers received less support for quitting from their spouse or partner than male smokers did, regardless of whether the support was positive or negative, whether the partner also smoked, or whether the smoker or partner rated the partner's support behavior. Female patients in a treatment sub-sample were also less likely than men to achieve stable 1-year cessation if the couple had rated partner support at baseline as coercive or unhelpful. Given known gender differences in relapse risk, cessation interventions for health-compromised female smokers might profitably include partners in addition to the smokers themselves.
Staff Knowledge, Attitudes, and Practices regarding Nicotine Dependence Differ by Setting
Authors: Tajima Barbara , Guydish Joseph , Delucchi Kevin , Passalacqua Emma , Chan Mable , Moore Matt
Published: March 2012

This study examined smoking-related knowledge, beliefs, self-efficacy, smoking cessation practices, and barriers to providing smoking cessation services in a workforce sample. The 11 participating clinics (N=335 staff) included substance abuse treatment and HIV care clinics categorized into three types: Veterans Affairs Medical Center (VAMC) clinics, hospital-based clinics, and community-based clinics. Staff in both VAMC and hospital-based settings shared characteristics that may predict smoking-related knowledge, beliefs, and practices (higher education level, low smoking rates, fewer staff in recovery, and location in hospital-affiliated environments where there was greater emphasis on physical health). However, staff in VAMC settings outperformed those in both hospital-based and community-based clinic settings on measures of smoking-related knowledge, beliefs, self-efficacy, and practices. Well-developed procedures to support VAMC clinicians in addressing smoking may account for these findings. Findings suggest that both reductions in staff smoking, and development and implementation of smoking policy are needed to support staff in better addressing nicotine dependence in community-based treatment settings.
Does the Presence of a Smoking Cessation Clinical Trial Affect Staff Practices Related to Smoking?
Authors: Chun JongSerl , Guydish Joseph R. , Delucchi Kevin
Published: March 2012

This study investigated whether organizational changes occurred when nicotine treatments were tested in specialty care clinics. Two intervention clinics (one drug treatment and one HIV-care) participated in clinical trials for nicotine treatment. Three clinics (two drug and one HIV-care) were control clinics. Staff in the intervention clinics (n=57) and in the control clinics (n=62) were surveyed at baseline and 18 months later. Staff surveys concerned nicotine-related knowledge, beliefs about treating smoking, self-efficacy in delivering such treatment, nicotine related practices, and barriers to providing nicotine treatment. Mean scale scores at 18 months were no different in clinics participating in the clinical trials from the control group for any of the five scales (knowledge, practices, barriers, efficacy and beliefs). The presence of a smoking cessation clinical trial did not influence staff knowledge, attitudes, or practices related to smoking in these clinics. More specific organizational intervention may influence staff practices related to addressing smoking among clients in drug treatment and HIV-care clinics.
Assessing Non-Injecting Heroin Use in Birmingham, UK: A Comparison of Characteristics and Reasons for Non-Injecting in Samples of Never-Injected and Formerly-Injecting Heroin Users in Contact with Adult Drug Treatment
Authors: Smith Alison C. , Best David , Day Ed
Published: March 2012

Aims: To explore reasons why individuals who prefer to use heroin by routes other than injection have abstained from injecting despite entrenched heroin use. Methods: A cross-sectional interview using structured and semi-structured questions was carried out with 40 non-injecting heroin users (20 former injectors and 20 who had never injected) recruited at two Community Drug Team sites in Birmingham, UK. Results: The most endorsed reason for non-injection was worry about appearance. Additional reasons included identity issues and stigmatized status of injecting. ‘Never injectors’ were younger (p<0.05), more likely to have an educational qualification (OR: 4.89; 95% CI: 1.20, 19.94), had higher measured heroin dependence (p=0.05) and lower prior exposure to injecting (p<0.001) than former injectors. There was no difference between the groups in estimated prevalence of injection among peers. Conclusions: This study points to continuity between injecting and non-injecting cultures, challenges the concept of injection as a natural progression from non-injecting heroin use, and highlights personal addiction career factors in injection transitions.
Combining Different Substances in the Dance Scene: Enhancing Pleasure, Managing Risk and Timing Effects
Authors: Hunt Geoffrey , Evans Kristin , Moloney Molly , Bailey Noelani
Published: March 2012

Combining mind-altering substances, whether illegal or legal, has provoked calls of alarm and concern among drug researchers for over thirty years. Since then numerous studies have been conducted to trace the different prevalent combinations and emphasize the serious consequences for individuals who use two or more drugs at any given time. Recently, this concern has been heightened as a result of the evidence that polydrug use among young people is increasing, especially among those who attend electronic music dance parties. The aim of this paper is to explore the different drug combinations used by a group of young people who attend raves, clubs and dance parties in the San Francisco Bay Area. Based on in-depth interviews with 300 young people we explore not only the different substances combined, but the meanings given as to why such combinations are chosen. In exploring our respondents' accounts, we hope to highlight both the thinking behind their drug using practices and the range of procedures adopted by young people to enhance the pleasures they hope to achieve in taking different substances, and control any potential problems.
Community Characteristics and Methamphetamine Use: A Social Disorganization Perspective
Authors: Hayes-Smith Justin , Whaley Rachel Bridges
Published: March 2012

The current study applied the first macro-level analysis of methamphetamine use. The extant literature on macro-level drug use has suggested that areas with high levels of social disorganization experience high rates of drug use. In this study it was expected that school districts with low SES and high rates of ethnic heterogeneity, residential instability and family disruption will experience high rates of methamphetamine use. In addition, it was expected that rural and suburban school districts would show higher rates than urban school districts. Social disorganization hypotheses were partially supported as low economic status and residential instability are associated with methamphetamine use. Interestingly, a high percentage of white population is positively associated with methamphetamine use. Further, school districts in the southwest region of Michigan were significantly more likely to have higher percentages of methamphetamine users.
Losing All the Pieces: A Qualitative Study of HIV Risk Perception and Risk Reduction among Rural African American Women Who Use Cocaine
Authors: Wright Patricia B. , McSweeney Jean C. , Frith Sarah E. , Stewart Katharine E. , Booth Brenda M.
Published: March 2012

The purpose of this study was to examine HIV-related beliefs of rural African American women who use stimulant drugs and their perceived risk for acquiring HIV. Qualitative interviews were conducted with 15 African American women living in the Mississippi Delta region of rural Arkansas. All women in the study were active users of crack and/or powder cocaine. We used the qualitative methods of content analysis and constant comparison to analyze the transcribed interviews. Four major themes emerged from the analysis: 1) Knowledge and Beliefs, 2) Don't Ask, Don't Tell, 3) Staying Safe, and 4) Surviving in the Community. Based on participants' responses, we discuss implications for framing new risk-reduction interventions tailored to the specific needs of this high-risk population at both the individual and community levels.
Access to Licensed Cannabis Supply and the Separation of Markets Policy in the Netherlands
Authors: Wouters Marije , Korf Dirk J.
Published: March 2012

In the Netherlands, small amounts of cannabis can be lawfully sold to consumers in so-called coffee shops. Many communities in the country do not have coffee shops, and users under 18 years of age are not allowed to enter coffee shops. A field sample of 773 current cannabis users were interviewed in seven Dutch cities, two without any coffee shop, five varying in coffee shop density. The vast majority (n = 665; 86.0%) buy their own cannabis, and more than 70% of the cannabis is bought in licensed coffee shops. In logistic regression analyses, three variables were significantly and independently associated with buying from unlicensed suppliers: coffee shop density, age, and sex. With higher coffee shop density it was less likely to buy outside of coffee shops. Under-age buyers were more than twice as likely to buy their cannabis from unlicensed dealers. Males were more likely to buy their cannabis from unlicensed sellers than females. A substantial proportion of unlicensed suppliers sell other drugs as well, thereby increasing the risk of being offered hard drugs when buying soft drugs. This risk is greater for minors than for adults, since a higher proportion of minors use unlicensed selling points.
Social Capital and Beyond: A Qualitative Analysis of Social Contextual and Structural Influences on Drug-Use Related Health Behaviors
Authors: Kirst Maritt J.
Published: March 2012

Using a social capital framework, this study explores how aspects of social relationships within the social networks of injection drug users (IDUs) and crack smokers (CSs) influence their drug use-related risk and protective health behaviors. Interviews were conducted with a quota sample of 80 socioeconomically marginalized drug users in Toronto, Canada, and qualitative data were extracted from 77 of these interviews. Analysis of the interview transcripts revealed themes indicating that social capital, in the form of collective norms, trust, and exchange of safer drug use information, within users' drug networks encouraged risk and/or protective behaviors within particular contexts. The analysis also highlighted the influence of social structural factors, such as harm reduction and health service delivery on the users' health behaviors. The implications of these findings for harm-reduction services are discussed.
Reasons for Drug Use among American Youth by Consumption Level, Gender, and Race/Ethnicity: 1976–2005
Authors: Terry-McElrath Yvonne M. , O'Malley Patrick M. , Johnston Lloyd D.
Published: March 2012

This study examined self-reported reasons for the use of nine substances among nationally representative samples of U.S. high school seniors participating in the Monitoring the Future study from 1976 through 2005. In general, social/recreational reasons were the most commonly reported reasons for the use of most drugs. However, for psychotherapeutic drugs, coping with negative affect and physical needs were reasons most commonly mentioned. Results indicated that the proportion of students reporting various reasons has shifted significantly over time. Further, we found significant differences by gender and race/ethnicity in reported reasons for use. Prevention and intervention efforts must address the facts that (1) while social usage reasons do predominate, it is essential to consider coping and drug-effect reasons for use as well; and (2) there are appreciable differences by gender and race/ethnicity in reasons for drug use.
Making a Difference: The Impact of Traditional Male Role Models on Drug Sale Activity and Violence Involving Black Urban Youth
Authors: Parker Karen F. , Maggard Scott R.
Published: March 2012

Elijah Anderson's Code of the Street provides an ethnographic account of a disadvantaged urban environment where residents face poverty and racial residential isolation. For Anderson, joblessness among African-American men deprive youth of positive male role models, creating a context for the “street code” to govern behavior, leading youth to violence. Similarly, a disadvantaged urban setting in which opportunities in legitimate labor markets are lacking fosters an environment where youth may seek illicit markets for a means of economic support. Drawing on Anderson's work, we assess the availability of male role models (older, employed black males) and the concentration of urban disadvantage on black juvenile drug sales and violent arrests across multiple cities in 2000. We find Anderson's concerns over the removal of traditional role models as a result of rising disadvantage in a Philadelphia community to be generalized to large urban areas. Specifically, we find that the presence of traditional role models reduces aggravated assaults by youth, but male role models are unable to reduce the economic lure of drug sales for black urban youth in disadvantaged environments.
Profiling Violent Incidents in a Drug Treatment Sample: A Tripartite Model Approach
Authors: Erickson Patricia G. , Macdonald Scott , Hathaway Andrew D.
Published: March 2012

This research focuses on the qualitatively descriptive accounts of drug-related violent incidents drawn from a treatment sample of 571 substance abuse clients in Ontario. Nearly half (n = 269) had experienced at least one violent incident in the past year, and 91% had used one or more substances prior to the most recent episode. The classification of the explicitly drug-related violent events (n = 176), based on Goldstein's tripartite model, is its first application in an adult drug treatment sample. Although respondents were not criminal offenders, and interpersonal violence related to psychopharmacological effects predominated, economic or systemic linkages related to drug scarcity and the drug market were implicated in one fifth of all occurrences. Alcohol and cocaine were the substances most implicated in all three aspects of the model. Since a drug treatment sample is a high-risk group for violence, interventions that raise awareness of potential for violence linked to not only intoxication but also scarcity conflicts and illicit drug market involvement are warranted. Since most violence occurs in the community, such initiatives may benefit those in treatment and serve as an important public health strategy.
Peer-Driven Interventions in Vietnam and China to Prevent HIV: A Pilot Study Targeting Injection Drug Users
Authors: Broadhead Robert S. , Hammett Theodore M. , Kling Ryan , Ngu Doan , Liu Wei , Chen Yi , Quyen Hoang Ngoc , Binh Kieu Thanh , Van Tren Hoang , Borch Casey , Gauchat Gordon , Des Jarlais Don C.
Published: March 2012

The HIV epidemic in China and Vietnam is on the increase among injection drug users (IDUs). We report on the results of a pilot outreach study in northern Vietnam and southern China to test the feasibility of a peer-driven intervention (PDI) to prevent HIV among IDUs. In the PDI, recruitment relies on a “chain-referral” model in which IDUs carry-out the core outreach activities that salaried outreach-workers/peer-educators traditionally provide. A 6-month follow-up was built into the study design to measure possible changes in IDUs' risk behaviors. The impact results of the pilot study are reported bearing on several different measures, such as changes in IDUs' rates of lending or borrowing used syringes, willingness to enter into drug treatment, baseline and follow-up recruitment success, and effectiveness of serving as peer-educators in the community. The evidence suggests the PDI is highly feasible and deserving of greater research in both China and Vietnam.
Substance Use and Social Stability among At-Risk HIV-Infected Persons
Authors: Rebholz Casey , Drainoni Mari-Lynn , Cabral Howard
Published: March 2012

Little is known about how substance use patterns affect social stability among persons living with HIV/AIDS (PLWH). This manuscript examines associations, using survey data collected between 2003–2004, between substance use and social stability measures in 1,133 at-risk PLWH enrolled in 10 outreach programs across the US funded by the Health Resources and Services Administration. Substance use patterns were found to impact the social stability indicators of housing status, need for food, and income level. Effect varied by types and numbers of drugs used. These findings have important implications for policy and for planning effective program interventions for HIV-infected substance users.
The Deconstruction of a Drug Crisis: Media Coverage of Drug Issues during the 1996 Presidential Campaign
Authors: Deseran Travis A. , Orcutt James D.
Published: March 2012

The 1996 U.S. presidential campaign represents an unusual and important case for research on the social construction of drug problems. Presidential candidate Robert Dole and other prominent politicians made dramatic claims about a growing teenage “drug crisis” based on supportive evidence from several national surveys. However, these claims were often ignored and even criticized by the news media. This paper examines how and why journalists responded so differently to this putative crisis than they did to earlier drug crises, such as the media “feeding frenzy” about crack cocaine in the 1980s. An analysis of news stories, political statements, and editorial commentary that appeared in major news outlets during 1995 and 1996 reveals a number of tactics that media workers employed to deconstruct politicians' claims and to frame the drug issue as an election-year strategy rather than as an authentic crisis.
Prevalence and Correlates of Hepatitis C among Injection Drug Users: The Significance of Duration of Use, Incarceration, and Race/Ethnicity
Authors: Latimer William W. , Hedden Sarra L. , Moleko Anne-Gloria , Floyd Leah , Lawson April , Melnikov Alexander , Severtson S. Geoffrey , Cole Kristin
Published: March 2012

The study examined associations between hepatitis C (HCV) seropositivity and a lifetime history of jail or correctional facility incarceration among injection drug users. The sample consisted of 351 injection drug users recruited in inner-city neighborhoods of Baltimore. Multiple logistic regressions were fit to assess associations between HCV seropositivity and a lifetime history of incarceration for the total sample and stratified by race. Analyses demonstrated HCV nearly two times greater for whites than African Americans. In addition, HCV was 2.6 times greater in participants incarcerated in correctional facilities and HCV was 7.4 times greater in participants reporting more than 5 years of injection drug use compared to participants reporting less than 1 year of injection drug use. The study findings suggest that incorporating systematic HCV screening, prevention, and treatment programs within correctional systems represents a vital yet under-utilized strategy to reduce HCV transmission in society as a whole.
Social Estrangement: Factors Associated with Alcohol or Drug Dependency among Homeless, Street-Involved Young Adults
Authors: Thompson Sanna J. , Rew Lynn , Barczyk Amanda , McCoy Pepper , Mi-Sedhi Ada
Published: March 2012

Substance use is highly prevalent among homeless, street-involved young people. Societal estrangement is often associated with substance use, particularly among this population. The current study utilized a descriptive correlational design to identify four domains of social estrangement: disaffiliation, human capital, identification with homeless culture, and psychological dysfunction. These domains were tested to determine their association with alcohol or drug dependence. Interviews utilizing self-report instruments were conducted with 185 young adults aged 18–23 years of age who were receiving homeless services from a community drop-in center. In this sample, the vast majority reported high levels of alcohol and drug use with more than half being identified as dependent on alcohol and/or drugs. Polysubstance use was highly prevalent and most reported marijuana as their drug of choice. Findings indicate that identification with homeless culture was the most highly predictive domain of social estrangement for both alcohol and drug dependency. Implications for services to this population are discussed.
Confirmatory Factor Analysis and Test-Retest Reliability of the Alcohol and Drug Confrontation Scale (ADCS)
Authors: Polcin Douglas L. , Galloway Gantt P. , Bond Jason , Korcha Rachael , Greenfield Thomas K.
Published: March 2012

The addiction field lacks an accepted definition and reliable measure of confrontation. The Alcohol and Drug Confrontation Scale (ADCS) defines confrontation as warnings about the potential consequences of substance use. To assess psychometric properties, 323 individuals entering recovery houses in U.S. urban and suburban areas were interviewed between 2003 and 2005 (20% women, 68% white). Analyses included test-retest reliability, confirmatory factor analysis, and measures of internal consistency. Findings support the ADCS as a reliable way of assessing two factors: internal support and external intensity. Confrontation was experienced as supportive, accurate and helpful. Additional studies should assess confrontation in different contexts.
Nonsocial Reinforcement of the Nonmedical Use of Prescription Drugs: A Partial Test of Social Learning and Self-Control Theories
Authors: Higgins George E. , Mahoney Margaret , Ricketts Melissa L.
Published: March 2012

In this study, we examine the explanation of the nonmedical use of prescription drugs. We test the comparative utility of two theories of drug use (i.e., social learning theory and self-control theory) on the nonmedical use of prescription drug use. Our contribution to social learning theory is the use of an understudied part of the theory—nonsocial reinforcement. We expect the two theories to explain the nonmedical use of prescription drugs. Using data from the 2006 Monitoring the Future Survey (MTF), we showed both theories have a link with the nonmedical use of prescription drugs. A consistent theme was that social learning theory had a consistent link with the nonmedical use of prescription drugs. However, self-control and nonsocial reinforcement have inconsistent links with the nonmedical use of prescription drugs. We discuss the policy implications of these findings.
Toronto Drug Treatment Court: Participant Intake Characteristics as Predictors of “Successful” Program Completion
Authors: Newton-Taylor Brenda , Patra Jayadeep , Gliksman Louis
Published: March 2012

Through descriptive and multivariate analyses, program outcomes for three groups of Toronto Drug Treatment Court participants (TDTC) were compared focusing on their substance use, legal, and socioeconomic differences at entry into the program, and their compliance behaviors during the first month of the program. Multivariate analyses demonstrated that graduate and expelled non-engaged participants were significantly different from the moment they started the program. At the time of application to the program expelled non-engaged participants used crack/cocaine on more days in the prior 90-day period, were in custody at their first TDTC appearance, had more criminal convictions over their lifetime, reported more recent substance use, and committed more breaches of their bail conditions than the other two participant groups. However, differences between graduate and expelled-engaged participants were not as clear, indicating important program outcome similarities between the two groups and how drug treatment court success should be conceptualized and measured.
Medical Conditions of Hazardous Drinkers and Drug Users in Primary Care Clinics in Cape Town, South Africa
Authors: Mertens Jennifer R. , Flisher Alan J. , Ward Catherine L. , Bresick Graham F. , Sterling Stacy A. , Weisner Constance M.
Published: March 2012

Research has identified a wide range of health conditions related to alcohol and drug use in studies conducted primarily in developed countries and in populations with severe alcohol and drug problems. Little is known about medical conditions in those with less severe alcohol and drug use in developing countries. We used WHO AUDIT and ASSIST screeners to identify hazardous drinking or drug use in public health clinics in Cape Town, South Africa, and included questions about doctor-diagnosed medical conditions. Using logistic regression we examined the relationship of medical conditions to hazardous alcohol, drug and tobacco use. Those with hazardous substance use had higher prevalence of many health conditions including tuberculosis, Hepatitis B, migraine, chronic bronchitis, and liver cirrhosis. Optimal treatment for some medical conditions may include treatment of underlying hazardous substance use, particularly use of drugs other than alcohol. In these populations, access to substance use treatment is limited and even brief interventions or advice may be useful.
Research Note: The Security of Urine Drug Testing
Authors: Johnston Roger G. , Michaud Eric C. , Warner Jon S.
Published: March 2012

We studied 23 different commercial products for collecting, storing, securing, and mailing urine samples analyzed for illicit drug use. Despite their tamper-indicating features, all of these products can be quickly and easily tampered with, either before or after sample collection, while leaving little or (usually) no evidence to be detected. Either false-positive or false-negative drug test results could then occur. A brief review of other security practices and standards associated with urine drug testing suggests there may often be additional serious security problems. Given the importance of drug testing and the fact that illicit drug tests have a huge impact on people's careers, livelihoods, and reputations, better security, especially better tamper detection features, would seem warranted.
Are There Gender Differences in Arrest Trajectories among Adult Drug Abuse Treatment Participants?
Authors: Prendergast Michael , Huang David , Evans Elizabeth , Hser Yih-Ing
Published: March 2012

This paper examines the arrest trajectories of adult men and women, drawn from a sample of clients admitted to substance abuse treatment. Growth mixture modeling was used to identify distinctive trajectories in arrests for men and women between ages 18 and 45. In addition, the characteristics of men and women in each of the trajectory groups were compared by gender, arrest trajectory, and the interaction of gender and arrest trajectory. Findings indicated that while the shape of the five trajectories was similar for men and women, higher percentages of men than women were in the High trajectory group (12.5% vs. 8.5%), the Moderate group (27.9% vs. 20.9%), and Slow Increase group (25.5% vs. 20.6%), with more women than men being in the Low group (34.1% vs. 27.1%). Although arrests declined as men and women aged, there did not appear to be many individuals who had terminated their criminal career by age 45. Overall, more similarities than differences were observed in the characteristics of men and women across trajectories. Additional research should examine whether the causal factors influencing arrest trajectories differ by gender.
Evaluation of Longitudinal Intervention Effects: An Example of Latent Growth Mixture Models for Ordinal Drug-Use Outcomes
Authors: Liu Li C. , Hedeker Donald , Segawa Eisuke , Flay Brian R.
Published: March 2012

Heterogeneity often exists among behavioral growth trajectories in a study population. In the evaluation of intervention effects for longitudinal randomized trials, it is informative to examine the impact of an intervention on subgroups characterized by different types of growth trajectories. This paper presents an application of growth mixture modeling to an ordinal-scale substance-use behavior outcome from the Aban Aya Youth Project (AAYP), a longitudinal preventive intervention trial targeting health-compromising behaviors among adolescents. Results suggested two classes of adolescent substance use growth trajectories: Class 1 (44.7% of the sample) started at a higher level and had a relatively shallow increase over time; Class 2 had a lower baseline level and a rapid increase over time. The intervention effectively reduced the rapid increase of substance use for the adolescents in the second class.
Using the Group-Based Dual Trajectory Model to Analyze Two Related Longitudinal Outcomes
Authors: Xie Haiyi , McHugo Gregory J. , He Xiaofei , Drake Robert E.
Published: March 2012

The group-based latent trajectory model allows investigators to identify distinctive trajectory groups based on relevant outcomes. Dual trajectory analysis enables examination of the interrelationship between two outcomes simultaneously. This paper describes the application of the group-based dual trajectory model in mental health and substance abuse research. We analyzed two related recovery outcomes: 1) social contact with non-substance abusing friends and 2) stage of substance abuse treatment. We identified four groups for social contact and four groups for substance abuse treatment. We then examined the interrelationship between the two outcomes across the trajectory groups over 10 years. The two outcomes are positively associated longitudinally and evolve in the same direction, although for specific groups, the two outcomes do not covary. By examining dynamic linkages across all trajectory groups between two longitudinal outcomes, the dual model provides a more comprehensive and realistic understanding of the underlying relationships between the two outcomes under investigation.