bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Substance use during the Transition to Adulthood: A Comparison of College Students and Their Noncollege Age Peers
Authors: White Helene R. , Labouvie Erich W. , Papadaratsakis Vasiliki
Published: March 2012

This study examines transitions in alcohol, cigarette, and marijuana use and alcohol- and marijuana-related problems from late adolescence through young adulthood. Men and women who attend college are compared to their peers who do not to determine if the situational/socialization effects of college are unique during this developmental period. Prospective data from a community sample were collected at ages 18, 21, and 30 years. ANOVAs revealed that 18 year olds who transition out of high school, regardless of college status, reported higher levels of substance use than their peers who were still in high school. In addition, nonstudents compared to college students reported higher levels of cigarette and marijuana use in adolescence, emerging adulthood, and young adulthood and higher levels of alcohol- and marijuana-related problems in adolescence and young adulthood. Latent growth curve analyses revealed that college status was related to lower levels of alcohol and marijuana problems at age 18, greater increases from ages 18 to 21, and greater decreases from ages 21 to 30 even after controlling for level and growth in use. Overall, the findings suggest that nonstudents may be a more important target group than college students for drug use prevention efforts during emerging adulthood.
Substance use Trajectories from Early Adolescence to Emerging Adulthood: A Comparison of Smoking, Binge Drinking, and Marijuana use
Authors: Tucker Joan S. , Ellickson Phyllis L. , Orlando Maria , Martino Steven C. , Klein David J.
Published: March 2012

Over the past several years, there has been growing interest in identifying distinct developmental trajectories of substance use. Using data from the RAND Adolescent/Young Adult Panel Study (N = 6,527), we synthesize our prior findings on patterns of smoking, binge drinking, and marijuana use from early adolescence (age 13) to emerging adulthood (age 23). We also present new data on how these trajectory classes compare on key psychosocial and behavioral outcomes during emerging adulthood. For each type of substance use, we found two periods of vulnerability: early adolescence and the transition to emerging adulthood. As expected, early users were at relatively high risk for poor outcomes at age 23 compared to consistent low-level users and abstainers, even if they reduced their use during adolescence. However, youths who were not early users, but steadily increased their use over time, also tended to be at relatively high risk. Results suggest that multiple prevention approaches might be needed to successfully reach at-risk youths.
Tobacco, Alcohol, and other Drug use among High-Risk Young People: A Five-Year Longitudinal Study from Adolescence to Emerging Adulthood
Authors: Rohrbach Louise A. , Sussman Steve , Dent Clyde W. , Sun Ping
Published: March 2012

The present study described the prevalence of adult role taking and substance use among individuals attending alternative high schools, who were followed for five years to early emerging adulthood (n = 848). Psychosocial factors at baseline and adult role taking at the follow-up were examined as correlates of substance use during emerging adulthood. At this stage of life, 74% of subjects were employed, 30% were married or engaged, and 43% had at least one child. One third of subjects were daily cigarette smokers, and 24% had used marijuana in the past 30 days. Forty-seven percent had experienced negative consequences of alcohol or drug use in the last year. The most consistent positive predictors of substance use in emerging adulthood were male gender and previous drug use. Addiction concern was a consistent negative predictor. After controlling for baseline psychosocial variables, attending school and being married at the five-year follow-up were negative correlates of both personal consequences and problems related to alcohol or drug use.
Changes in Marijuana use over the Transition into Marriage
Authors: Leonard Kenneth E. , Homish Gregory G.
Published: March 2012

Reductions in substance use tend to coincide with marriage, as both may occur during emerging adulthood. During the transition to marriage, it is possible that one's spouse may be the influence that causes the reduction in substance use. Data on participants (N = 471 couples) for this report are taken from a longitudinal study of early marriage. The objective of the current analysis is to determine if having a spouse who uses marijuana is associated with a greater likelihood of one's own use. Additionally, we are interested in spousal influence and cessation. The findings support spousal influence. Husbands are more likely to start using marijuana if their wives use marijuana, but the reverse is not true. Husbands also are more likely to stop using if their spouses do not use. During the transition into marriage, the drug use of one spouse does affect the other. However, this influence appears to be unidirectional, with wives influencing their husbands more often.
How Can Research-Based Findings Be Used to Improve Practice? Perspectives from Participants in a Statewide Outcomes Monitoring Study
Authors: Grella Christine E. , Hser Yih-Ing , Teruya Cheryl , Evans Elizabeth
Published: March 2012

This paper reports on the perspectives of substance abuse treatment providers and administrators who participated in a collaborative project to implement a statewide outcome monitoring system, the California Treatment Outcome Project (CalTOP). Program providers and county administrators were invited to discuss their perceptions regarding the relationship of research to treatment practice following completion of the project. Themes identified from this research-practice meeting were augmented by observations from program site visits and focus groups conducted with project participants during start-up. Participants articulated a range of actual and potential applications for using outcome data to improve treatment practice and to inform policy development, stressed several ways in which they could build upon the data-collection infrastructure developed for the project, and identified potential areas for continued program and staff development based on outcome findings. Future steps include identifying the organizational and workforce characteristics related to a program's readiness to incorporate research-based practices.
Instruments of Policy and Administration for Improving Substance Abuse Treatment Practice and Program Outcomes
Authors: Heinrich Carolyn J. , Fournier Elizabeth
Published: March 2012

The call for practice improvement in substance abuse treatment is motivated by the ultimate goal of achieving consistently positive post-treatment outcomes. A central hypothesis of the empirical investigation in this study is that consumer-level outcomes are affected either directly or indirectly through clinical practice, by factors originating at the policy and organizational level. Four broad categories of policy and program administration (funding, service technology and delivery, organizational structure, and leadership) that facilitate or hinder the implementation of practice improvements are investigated. Models hypothesizing that the effects of policy and program administration will vary according to the treatment goals and corresponding measurement of outcomes are tested. Using newly available data that link program- and consumer-level measures, the empirical analysis shows statistically significant direct effects of program and policy factors on outcomes as well as effects of these variables on treatment practices that have significant implications for treatment outcomes.
Prescription Drug Use, Health Services Utilization, and Health Problems in Rural Appalachian Kentucky
Authors: Leukefeld Carl , McDonald Hope Smiley , Mateyoke-Scrivner Allison , Roberto Heather , Walker Robert , Webster Matthew , Garrity Thomas
Published: March 2012

Rural states like Kentucky now lead the nation in the illicit diversion of narcotic prescription drugs. In order to understand this phenomenon, we examine the currently popularly abused prescription drug OxyContin® by comparing differences in drug use, health services use, and criminality among a nontreatment group of rural Appalachian probationers who reported using OxyContin® (n = 101) with nonusers of OxyContin® (n = 194). Although OxyContin® users were younger, a number of differences emerged. OxyContin® users exhibited higher levels of use for 15 illicit drugs examined; used more detoxification services; attended more AA/NA meetings; reported more depression, anxiety, trouble concentrating, and violence; and reported more crime for 16 crimes. We discuss the implications of OxyContin® use including the possibility that it may be a marker for other illicit rural drug use.
Examining the Impact of Individual, Community, and Market Factors on Methamphetamine Use: A Tale of Two Cities
Authors: Rodriguez Nancy , Katz Charles , Webb Vincent J. , Schaefer David R.
Published: March 2012

Although prior studies have monitored the trends in methamphetamine use and reported its increase over the years, few studies have considered how community-level characteristics affect the use of methamphetamine. In this study, we utilize data from the Arrestee Drug Abuse Monitoring (ADAM) program from two cities to examine how individual-level, community-level, and drug market factors influence methamphetamine use. Results indicate that both individual and community-level data significantly influence methamphetamine use. Also, findings show that predictors of methamphetamine use (at the individual and community-level) differ significantly from marijuana, cocaine, and opiate use. Policy implications regarding law enforcement suppression and the treatment of methamphetamine users are discussed.
They Do Things Differently over There: Doctors, Drugs, and the “British System” of Treating Opiate Addiction
Authors: Witton John , Keaney Francis , Strang John
Published: March 2012

The “British System” for treating opiate problems developed in the early part of the 20th century. Marked by an absence of a centrally coordinated policy, the system allowed doctors freedom and flexibility in prescribing to patients with opiate-related problems. These core features of the system have been retained despite buffetings from heroin epidemics among the young in the 1960s and 1980s and the challenge of HIV/AIDS among injecting drug users. Crime reduction became the focus of British drug policy in the 1990s, but nevertheless, treatment is still recognized as a key component of integrated UK drug policy in the early 21st century. Independence and diversity have thrived over this time. So what does the British System comprise today? And where is it going for tomorrow?
Mexican American Youth and Adult Prison Gangs in a Changing Heroin Market
Authors: Valdez Avelardo
Published: March 2012

This article focuses on the interaction between the larger community's drug markets and youth and adult prison gangs, and the process that leads to specific adverse consequences both to the youth gangs as organizations, and to individual members. Described is the emergence of a restructured heroin market dominated by an adult prison gang. A major consequence of this was the increasing use of heroin among Mexican American gang members and their transformation from autonomous youth gangs to extensions of the adult prison gangs or their demise. Data was collected from 160 members of 26 Mexican American youth gangs and key informants in San Antonio. Findings focus on organizational rules, drug market transformations, consequences on members, and the impact of heroin on the gang's organization. Discussed is how the dominance of prison gangs is related to the increased incarceration and recidivism rates of Mexican Americans and declining economic opportunities for urban minorities.
The Relative Contributions of Parental and Sibling Substance Use to Adolescent Tobacco, Alcohol, and other Drug Use
Authors: Fagan Abigail A. , Najman Jake M.
Published: March 2012

While research demonstrates that parental tobacco and alcohol use increases the likelihood of children's substance use, it is unclear whether or not sibling use has a greater, weaker, or similar effect. Based upon self-reported information from Australian adolescents, their siblings and parents, this investigation examines the association between siblings' tobacco and alcohol use. The relationship is consistent, moderately strong, and remains significant when controlling for a number of family-related factors, indicating that the shared environment cannot fully explain the extent of similarity in siblings' behaviors. In addition, sibling substance use has a greater effect on adolescent substance use than does smoking or drinking by parents. These findings indicate the need to include siblings and information regarding sibling relationships in prevention and intervention programs.
The Variation in Arrestees' Disclosure of Recent Drug Use across Locations, Drugs, and Demographic Characteristics
Authors: Golub Andrew , Liberty Hilary James , Johnson Bruce D.
Published: March 2012

This study provides a comprehensive multivariate analysis of drug use disclosure among arrestees interviewed between 2000 and 2001 at 37 sites across the U.S. served by the Arrestee Drug Abuse Monitoring (ADAM) Program. Rates varied widely by drug and across sites. The marijuana disclosure rate varied from 68% in Fort Lauderdale to 93% in Spokane. The cocaine/crack disclosure rate varied from 28% in Chicago to 70% in Kansas City. Moreover, covariates of disclosure differed across drugs. This wide variation in disclosure suggests extreme caution be used when comparing self-reports of prevalence across drugs, locations, and individual characteristics – certainly at least for arrestees.
Rapid Assessment of Drug Abuse Prevention Needs for Youth in Small Spanish Municipalities: Coping with Resource Limitations
Authors: Valderrama Juan Carlos , Tortajada Silvia , Alapont Lourdes , Vidal Antonio , Pérez José , Castellano Miguel , Gómez Josefa , Aleixandre Rafael , Trotter Robert T.
Published: March 2012

This study evaluates the drug abuse prevention needs for Spanish youth in municipalities with a population below 7,000 inhabitants in the province of Valencia, Spain. The primary goal of the project was to generate policy and to identify possible courses of drug prevention in these towns. The project utilized the basic RARE model. Grounded Theory was used to frame the qualitative analysis. Interviews with local cultural experts provided strong evidence that many specifically mandated prevention needs are not adequately covered in small municipalities. The data emphasizes the ways in which young people are critical of the prevention actions directed at them. The recommended programs emphasize (1) joint actions using youth networks, (2) educating parents to take an active role in the prevention chain, (3) extending the range and availability of leisure activities, and (4) making sure that the information campaigns are adapted to the interests of young people.
Methamphetamine use and Violence
Authors: Sommers Ira , Baskin Deborah
Published: March 2012

The current research analyzed the relationship between methamphetamine use and violence. Interviews were conducted with a sample of 205 respondents. The research was based on life history interviews with individuals who used methamphetamine for a minimum of three months and who resided in Los Angeles County. Of the 205 respondents, 55 (26.8%) had committed violence while under the influence of methamphetamine. Males comprised two thirds of the 55 respondents (N=36). Of the total sample, 30% of males and 23% of females committed methamphetamine-related violence, respectively. Overall, the 55 respondents reported 80 separate violent events while using methamphetamine. Of these 80 events, 41 (51.4%) acts of violence involved domestic relationships, 28.6% (N=23) of the violent events were drug related, 8.6% (N=7) were gang related, and 11.3% (N=9) involved random acts of violence (e.g., road rage, stranger assault). The study findings suggest that methamphetamine use heightens the risk for violence. Everyone interviewed agreed that methamphetamine has clear abuse and violence potential. Having said this, it is crucial to state that there was no evidence of a single, uniform career path that all chronic methamphetamine users follow. Progression from controlled use to addiction is not inexorable. Furthermore, a significant number of sample members experienced limited or no serious social, psychological, or physical dysfunction as a result of their methamphetamine use. Most germane to this study, we found that violence is not an inevitable outcome of even chronic methamphetamine use.
Sanctions and Rewards in Drug Court Programs: Implementation, Perceived Efficacy, and Decision Making
Authors: Lindquist Christine H. , Krebs Christopher P. , Lattimore Pamela K.
Published: March 2012

A key component of drug courts is the use of graduated sanctions and rewards to encourage compliance; however, little is known about how such systems are actually implemented. The current paper documents the specific behaviors that are sanctioned and rewarded and the sanctions and rewards used, perceptions of the efficacy of sanctions, the level of standardization in the application of sanctions and rewards, participants' understanding of the sanctioning system, and the decision-making process regarding sanctioning in five judicial circuits in Florida. Using qualitative data gathered from interviews with 86 key stakeholders and analyzed using NUD*IST software, we conducted comparisons between drug courts and traditional courts, as well as by respondent role (staff vs. offender). Our main findings are that (1) many more sanctions were used and more behaviors were identified as being likely to result in a sanction in drug courts compared to traditional courts, (2) the sanctions used in drug courts were more treatment oriented than in traditional courts, and (3) the drug courts appeared to emphasize tailoring the sanction to the individual participant rather than applying sanctions in a standardized manner.
Influences of Personal, Injunctive, and Descriptive Norms on Early Adolescent Substance use
Authors: Elek Elvira , Miller-Day Michelle , Hecht Michael L.
Published: March 2012

Social norms play an important role in adolescent substance use. Norm focus theory (Cialdini, Reno, & Kallgren, 1990) distinguishes three types of norms: injunctive, descriptive, and personal. This study examines the relative influences of these three norms, as well as the moderating effects of gender and ethnicity, on the concurrent substance use of 2,245 Mexican or Mexican-American students, 676 students of other Latino or multiethnic Latino origin, 756 non-Hispanic White students, and 353 African- American students. Personal norms appear to be the strongest significant predictor of substance use. Descriptive, parental injunctive, and friend injunctive norms also demonstrate significant, though weaker influences. Controlling for intentions reduces the predictive ability of each type of norm, especially personal norms. Gender moderates the relationship between norms and substance use with the relationships generally stronger for males. Personal norms act as stronger predictors of some types of substance use for Mexican/Mexican Americans.
Young Adult Ecstasy use Patterns: Quantities and Combinations
Authors: Sterk Claire E. , Theall Katherine P. , Elifson Kirk W.
Published: March 2012

The objectives of this paper are to describe ecstasy use patterns among young adult (18–25 years) users and to compare use patterns and self-reported effects according to the frequency (number of days used in the last 90 days) and intensity (typical number of pills taken per sitting) of ecstasy use. Computer-assisted structured interviews were conducted with 261 young adult active ecstasy users in Atlanta, Georgia. A typical dose of ecstasy intake was two pills, often followed by a booster dose. In addition, binging on ecstasy was reported. Ecstasy was mentioned as the primary drug of choice by one fifth of respondents. Poly-drug use dominated, and a substantial proportion of the respondents reported symptoms of ecstasy dependence. Differences in sociodemographic characteristics, poly-drug use, and reported effects of ecstasy use were found according to frequency and intensity of ecstasy use. Findings from this paper are important for the development of effective prevention efforts, including drug treatment and policy.
Community-Based Prevention Programs in the War on Drugs: Findings from the “Fighting Back” Demonstration
Authors: Saxe Leonard , Kadushin Charles , Tighe Elizabeth , Beveridge Andrew A. , Livert David , Brodsky Archie , Rindskopf David
Published: March 2012

Illegal drug use remains one of the United States' most serious health problems, and the “War on Drugs” continues without an end in sight. Antidrug programs, which offer the potential to reduce substance abuse problems, are a component of efforts to deal with the problem, but they operate absent adequate scientific analysis. Although policy has shifted from a focus on supply control to one that includes prevention and treatment, research and theory lag behind program implementation. Thus, for example, community-based programs designed to change norms and systems of substance use have been widely promoted despite the lack of data to support their use. The present paper summarizes findings from an evaluation of a large national demonstration program, “Fighting Back.” Results of the evaluation of broad-based community initiatives in a dozen communities show that the programs failed to reduce rates of substance use and associated harms. These findings, along with other evidence, place reliance on community-based programs at odds with public rhetoric. To deal more effectively with substance abuse, there is a need to move from “grading” programs to understanding why and how interventions function.
Community-Based Substance Abuse Reduction and the Gap between Treatment Need and Treatment Utilization: Analysis of Data from the “Fighting Back” General Population Survey
Authors: Tighe Elizabeth , Saxe Leonard
Published: March 2012

Despite the utility of substance abuse treatment, large numbers of people with serious substance use problems do not get the treatment that is needed. Communities that participated in the Robert Wood Johnson Foundation's “Fighting Back” program (see Saxe et al., this issue) developed a range of strategies to facilitate the provision of treatment to community members. As part of the national evaluation of Fighting Back, a general population survey conducted in 1995, 1997, and 1999 in 12 of the Fighting Back communities and 29 comparison communities assessed problem substance use, dependence, and treatment. These data were used to examine whether the gap between treatment need and treatment utilization was reduced in the Fighting Back communities. Results indicated that the discrepancy between treatment need and utilization of specialized treatment was unchanged, with as few as 6% to 7% identified as needing treatment actually receiving treatment. There were, however, a number of characteristics that distinguished those who received treatment from those who did not: (1) females were more than seven times less likely to receive treatment when needed than were males; (2) African Americans were four times less likely and Hispanics three times less likely than White respondents; (3) those 25 years and younger were four times less likely than those over 25; (4) unemployed and those living in poverty were three times more likely to receive treatment. The implications of these findings are that even within comprehensive approaches to substance abuse, more must be done to identify those in need of treatment, to understand the factors that explain the discrepancies between those in need of treatment who do and do not receive treatment, and to develop methods for getting those in need into treatment.
Establishing Program Legitimacy in Multiethnic Settings: The Robert Wood Johnson Foundation's “Fighting Back” Program
Authors: Lindholm Matthew Luther
Published: March 2012

While there is a plethora of literature on program models, evaluation strategies, evaluation outcomes, and lessons learned regarding anti-alcohol and drug community coalitions, case studies of implementation are rare. This paper analyzes multiple case histories of implementation of the Robert Wood Johnson Foundation's (RWJF) “Fighting Back” (FB) program with particular attention to issues in multiethnic sites. A common theme in the case histories was minority challenge to the legitimacy of local grantees' (lead agency) leadership in addressing local alcohol and other drug (AOD) problems facing minorities. The local projects adopted a range of strategies to increase their legitimacy with minorities: sharing policy making with or turning it over to minority leadership, recruiting minorities for positions on staff and committees, and subcontracting or making grants to minority-run organizations to implement project activities. These responses reduced challenges to the local projects' legitimacy but also produced unanticipated consequences; most significantly, the nature of project activity expanded well beyond the original scope of FB's mission to reduce demand for AOD. The discussion addresses the implications of legitimacy issues related to political control of FB, allocation of the grant's resources, and how AOD problems and solutions were framed in the context of urban multiethnic U.S. settings.
Can Social Psychological Delinquency Theory Explain the Link between Marijuana and other Illicit Drug Use? A Longitudinal Analysis of the Gateway Hypothesis
Authors: Rebellon Cesar J. , Van Gundy Karen
Published: March 2012

Extensive research suggests that marijuana use tends to precede the use of other illicit substances among adolescents. At the same time, there remain two viable interpretations of such research. First, marijuana use may cause an increase in one's probability of using other drugs. Second, the correlation between marijuana use and other drug use may be spurious, reflecting the influence of one or more “third variables” that simultaneously cause both behaviors. The present paper provides an empirical assessment of each view using panel data from three waves of the National Youth Survey. Even after adjusting for the influence of variables derived from strain theory, social bonding theory, and differential association theory, a series of longitudinal logistic regression analyses fail to disconfirm the hypothesis that marijuana use exerts a causal influence on one's probability of using other illicit substances. A three-wave panel model adjusting for the influence of unmeasured variables yields similar results.
The Risk Avoidance Partnership: Training Active Drug Users as Peer Health Advocates
Authors: Weeks Margaret R. , Dickson-Gómez Julia , Mosack Katie E. , Convey Mark , Martinez Maria , Clair Scott
Published: March 2012

Efforts have expanded to create AIDS prevention programs for drug users that consider the social context and interpersonal relationships within which risky practices take place. The Risk Avoidance Partnership (RAP) project is designed to train active drug users as peer/public health advocates (PHAs) to bring a structured, peer-led intervention into the sites where they and their drug-using social networks use illicit drugs. The RAP peer health advocacy training curriculum and peer-led intervention promote harm reduction among drug users and support drug-user organization to reduce infectious disease and other harm in the context of injection drug use, crack cocaine use, and sexual activity. Initial findings suggest that RAP PHAs perceive a significant positive role change in themselves while conducting health advocacy work and willingly and successfully carry the peer-led intervention into locations of high-risk drug activity to deliver it to their peers even in the absence of project staff support.
State Drug Policy Reform Movement: The Use of Ballot Initiatives and Legislation to Promote Diversion to Drug Treatment
Authors: VanderWaal Curtis J. , Chriqui Jamie F. , Bishop Rachel M. , McBride Duane C. , Longshore Douglas Y.
Published: March 2012

For most of the past 25 years, the federal government and many states have adopted a tough, punitive approach to drug offenses. In recent years, changes in public perception and state budget shortfalls have spurred a policy reform movement across the political spectrum that advocates diverting low-level, nonviolent drug offenders into treatment rather than incarcerating them. In nine of the 24 states where ballot initiatives are permitted, citizens have attempted or have successfully placed initiatives on the ballot since 1996. In an additional 12 states, drug policy reformers have successfully passed legislation that allows for diversion. In this paper we briefly trace the history of the diversion-to-treatment policy reform movement, identify the successful diversion-related ballot initiatives and enacted laws from each state, and, using a qualitative content analysis approach, describe the nature and extent of those laws. Finally, we discuss the implications of these differences for state criminal justice policies.
Long-Term Predictors of HIV Risk Behaviors among IDUs
Authors: Corsi Karen F. , Kwiatkowski Carol F. , Booth Robert E.
Published: March 2012

Drug users are at high risk for disease due to injection and sex behaviors. Longitudinal research with drug users can help researchers understand reasons for continued high-risk behaviors among this vulnerable population. Data are from a follow-up study conducted from 1999 to 2003, which attempted to relocate clients who were initially recruited through street outreach in Denver, Colorado from 1990 to 1995. A total of 773 subjects were located (82% relocation rate), 578 of whom were interviewed at follow-up. Statistical analysis revealed significant improvement in most high-risk injection and sex behaviors. However, over half the sample reported having sex without a condom at follow-up. Further analysis revealed that having sex without a condom at baseline, not having previously participated in drug treatment, being of an ethnicity other than African American, smoking crack, and having sex with a drug injector were all significantly related to having sex without a condom at follow-up. These findings are discussed with regards to developing interventions in order to increase condom use in this high risk population.
Providers' Perceptions of Gender-Specific Drug Treatment
Authors: Fendrich Michael , Hubbell Amy , Lurigio Arthur J.
Published: March 2012

This study examined substance abuse treatment providers' perceptions of the gender-specific service needs of women in treatment as well as the obstacles that impede the delivery of services to meet those needs. Surveys were administered to more than 100 staff members of five treatment agencies that were participating in the Chicago Practice Improvement Collaborative. These surveys were followed up with focus group discussions. Most participants reported that their treatment agencies delivered gender-specific services but also described the numerous barriers to addressing women's specific needs, such as limited resources and the psychosocial challenges experienced by women in treatment (e.g., depression, child care, and family responsibilities). We discuss these findings in light of previous studies, the strengths and limitations of our research design, and the value of collaborations between researchers and practitioners.
Protecting Alabama Students from Alcohol and Drugs: A Multi-Level Modeling Approach
Authors: Lo Celia C. , Anderson Anita S. , Minugh P. Allison , Lomuto Nicoletta
Published: March 2012

This research examines both risk and protective factors in the frequency of drug and alcohol use by Alabama public school students in grades six through 12. Factors are measured at the individual and county level. The data on both levels were obtained by the Substance Abuse Services Division of the Alabama Department of Mental Health and Mental Retardation. The results of data analysis—comprising hierarchical linear modeling techniques (HLM)—show that, overall, the individual protective factors do reduce student use of alcohol and drugs, controlling for certain risk factors. The county-level structural-disadvantage factor, however, operates in direction opposite to expectations. According to the results, structural disadvantage reduces rather than increases student use of all drugs. The implications of the important role structural variables play in individual drug use are discussed.
The Prevalence and Distribution of Employee Substance-Related Problems and Programs in the Israeli Workplace
Authors: Bamberger Peter , Biron Michal
Published: March 2012

We used a national sample of 100 Israeli enterprises to examine the prevalence and distribution of employee substance-related workplace problems, as well as the prevalence and distribution of alternative programs/policies aimed at addressing such problems among Israeli workplaces. Although 29% of the responding firms reported having handled one or more cases involving employee workplace substance use or impairment, across these firms, only 53 actual cases were reported. Given an average enterprise size of 325 employees, this suggests a workforce prevalence rate for such problems of 0.16%. Only 10% of the enterprises studied offered any type of substance-related employee assistance, and only 12% included a specific reference to substance use in their discipline policy. The social policy and workplace implications of these findings are discussed.
Initiation to Pharmaceutical Opioids and Patterns of Misuse: Preliminary Qualitative Findings Obtained by the Ohio Substance Abuse Monitoring Network
Authors: Daniulaityte Raminta , Carlson Robert G. , Kenne Deric R.
Published: March 2012

Pharmaceutical opioid misuse has been recognized as a growing public health problem across the nation. To develop appropriate treatment and prevention programs, the population of pharmaceutical opioid abusers has to be well understood. This exploratory study is based on qualitative interviews with 24 people in the Dayton/Columbus, Ohio, area. Interviews were conducted for the Ohio Substance Abuse Monitoring Network, a statewide epidemiological surveillance system. Participants ranged in age from 18 to 48 years; the majority was White and male. To explain initiation and continued use of pharmaceutical opioids, participants discussed a number of different reasons, including self-medication of emotional and physical pain, legitimate medical prescriptions related to chronic pain management, social influences, recreation, and easy access to pharmaceutical opioids. On the basis of participant age and lifetime experiences with pharmaceutical opioid and other drug misuse, six user groups were identified that faced unique risks and prevention/treatment challenges. Research implications are discussed.
Waiting Time as a Barrier to Treatment Entry: Perceptions of Substance Users
Authors: Redko Cristina , Rapp Richard C. , Carlson Robert G.
Published: March 2012

Many substance users report that they experience multiple barriers that produce significant challenges to linking with treatment services. Being on a waiting list is frequently mentioned as a barrier, leading some people to give up on treatment and to continue using, while prompting others to view sobriety during the waiting period as proof they do not need treatment. This ethnographic study examines the views that 52 substance users have of the waiting time before treatment and the strategies they created to overcome it. Understanding how substance users react to waiting time itself and in relation to other barriers can lead to services that are effective in encouraging treatment linkage.
Practicing Risk Control in a Socially Disapproved Area: Swedish Socially Integrated Drug Users and Their Perception of Risks
Authors: Rödner Sharon
Published: March 2012

Based on socio-cultural theories of risk and through individual conversational interviews with socially integrated drug users in Stockholm, Sweden, this article examines the informants' perception of drug-related risk and risk management. The analysis further examines these perceptions in relation to core Swedish cultural ideals of conscientiousness. The research shows that the informants have a sophisticated system of controlling their drug use and that this is based on a modified form of core Swedish cultural ideals. The article proposes that this has bearing for prevention policies which often neglect the cultural and social context connected to drug related risks perception and management.
College Undergraduate Ritalin Abusers in Southwestern California: Protective and Risk Factors
Authors: Shillington Audrey M. , Reed Mark B. , Lange James E. , Clapp John D. , Henry Susan
Published: March 2012

During the past five years, a few studies have reported that college students are using stimulants such as Ritalin without a prescription. To date, studies on college Ritalin/Adderall use have been from samples in the eastern or midwestern U.S. This study was designed to examine risk and protective factors associated with Ritalin/Adderall use among a college sample in Southern California. Our findings indicate that 11.2% of students reported past year and over 4% reported past 30 day use of Ritalin/Adderall. In our final analysis, students with lower GPAs, in a fraternity/sorority, not in a committed relationship, and who smoke and use other drugs were more likely to report past year and past 30 day Ritalin/Adderall use. Implications for prevention programming of these findings are discussed.
Rhetoric versus Practice in Czech Drug Policy
Authors: Radimecký Josef
Published: March 2012

Modern official Czech drug policies were initiated in 1993 when the government approved its first national drug policy program for 1993 to 1996. The current policy was defined in the National Drug Policy Strategy 2005–2009, a document that calls for an evidence-based drug policy and a balanced and interdisciplinary approach to the problem of drug use. In order to assess the existence of possible discrepancies between these official statements and their practical implementation, the author provides an analysis of Czech drug policy based on a review of official and other documents as well as interviews with representatives and key players in the Czech drug policy arena. The main finding is that several conflicts exist between the official policy and its practical application and that these disparities serve as obstacles to its effectiveness. These differences exist because of the wide variety of ways in which key players have conceptualized drug use per se and the manner in which they have constructed particular reform measures to implement and mirror their main interests and priorities. Particular areas of concern that have been especially impacted by these phenomena are illustrated and discussed below. In order to assure the effectiveness of future Czech drug policy, further research, especially regarding its practical application, needs to occur.
Substance Use among Czech Adolescents: An Overview of Trends in the International Context
Authors: Csemy Ladislav , Lejčková Pavla , Sadílek Petr
Published: March 2012

The rapid dissemination of drug use among adolescents in the Czech Republic and other Central and Eastern European countries during the 1990s had a significant impact on health care and social services for this population group. This paper describes the current situation related to drug use among adolescents in the Czech Republic and in other European countries and discusses several attitudinal and behavioral correlates of drug use among young people. The results presented here have been extracted from a database of the European School Survey on Alcohol and Other Drugs (ESPAD) from 1995, 1999, and 2003. At the time of data collection, the average age of respondents in the sample was 15.4 years. Marijuana was the most common illicit substance used by European adolescents. The results also showed a marked increase in the number of adolescents who use substances repeatedly between 1995 and 2003. A marked increase in the popularity of ecstasy occurred in the same period. Between 1999 and 2003, the use of opiates and amphetamines in the Czech Republic decreased slightly. Attitudinal variables indicate that Czech adolescents tend to be more tolerant towards selected forms of drug using behavior than are their peers in Europe. The policy by which society tries to confront drug related health and social issues includes an expansion of the network of specialized facilities for treatment and resocialization and long-term programs in the field of prevention. In the future, the significance of programs that focus on early detection and intervention will increase.
Economic Stressors, Social Integration, and Drug Use among Women in an Inner City Community
Authors: Hatch Stephani L.
Published: March 2012

This article uses data from a study of 122 adult women drug users residing in the Atlanta, Georgia metropolitan area to identify associations between economic stressors related to occupying disadvantaged statuses, institutional integration, and drug use. The data stem from targeted sampling and ethnographic mapping procedures. The findings suggest that experiencing stressors related to economic circumstance and daily subsistence increased the likelihood of drug use. Results also indicate religious involvement and kinship networks are independently and negatively associated with drug use, but fail to reduce the negative effects of economic stressors on drug use. The author suggests that institutional integration, however limited, may be a formidable deterrent to drug use. Continued identification of multi-level integration sources may inform drug treatment approaches in community programs.
Differences in HIV Sexual Risk Behaviors between Heterosexual and Nonheterosexual Male Users of Methamphetamine
Authors: Dew Brian J. , Elifson Kirk W. , Sterk Claire E.
Published: March 2012

Previous studies examining HIV sexual risk behaviors among male methamphetamine users have primarily focused on men who have sex with men (MSM) while ignoring heterosexual methamphetamine users. In this study, active male users of methamphetamine are differentiated based on sexual orientation. Targeted sampling guided the recruitment, and face-to-face survey interviews were conducted with 108 active male methamphetamine users. Participants were classified into heterosexual (n = 69) and non-heterosexual (n = 39) users. Between-group differences were found based on socio-demographics, drug use histories, and HIV sexual risk behavior. Heterosexual males were more likely than their nonheterosexual peers to be younger, less educated, unemployed, and less likely to be tested for HIV. Nonheterosexual males were more likely than heterosexual males to identify methamphetamine as their primary drug of choice, commence poly-drug use at a later age, and report more sexual partners in the past year. Findings from this study may lead to the development and/or refinement of successful prevention and intervention strategies that are more culturally sensitive to heterosexual and nonheterosexual male users of methamphetamine.
Consumer Perspectives on Co-Occurring Disorders Treatment
Authors: Brooks Audrey J. , Malfait A. Jason , Brooke Denali , Gallagher Sandra M. , Penn Patricia E.
Published: March 2012

A series of four focus groups were conducted with 35 clients with a co-occurring diagnosis of mental illness and substance abuse to obtain their perspectives on treatment. Four content areas emerged. System barriers, such as poor therapeutic environment, difficulties navigating complex systems, and poor integration of services were most frequently mentioned. Factors facilitating recovery included consumer strengths, a positive therapeutic environment, and helpful recovery tools. Consumer challenges refer to obstacles in the client's life including the long-term chronic nature of their illness, self-medication of psychiatric symptoms, and limited personal resources and options. Specific treatment needs, such as treatment from “similar others,” one-on-one counseling, and time management were identified. The results demonstrate that a client-centered approach is preferred. Limited system resources continue to be a barrier. Improved coordination of services and cross-training on co-occurring diagnosis are needed. Consumers recognize the long-term nature of their problems and have strengths for dealing with them.
The Multidimensional Structure of Internal Barriers to Substance Abuse Treatment and Its Invariance across Gender, Ethnicity, and Age
Authors: Xu Jiangmin , Wang Jichuan , Rapp Richard C. , Carlson Robert G.
Published: March 2012

The goal of the present study was to identify the dimensions present in items representing internal barriers to substance abuse treatment and to test their invariance across gender, ethnic, and age groups. Twenty items from the Barriers to Treatment Inventory (BTI) were used to assess the structure and nature of the internal treatment barriers of 518 clients presenting to a central intake unit for a substance abuse assessment. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) revealed that a five factor model provided the best fit to the data. Internal treatment barriers were best described by five dimensions: absence of problem, negative social support, fear of treatment, privacy concerns, and committed lifestyle. Extending the confirmatory factor analysis to test multi-group invariance, there were some differences in measurement and structural relations among the internal barrier dimensions across gender, ethnic, and age groups. However, the lack of invariance was small and practically insubstantial. The findings led to the conclusion that the theoretical constructs measured by the five internal barrier dimensions are equivalent across important characteristics in this population.
Club Drug Use and Risk Management among “Bridge and Tunnel” Youth
Authors: Kelly Brian C.
Published: March 2012

Club drugs present a range of risks similar to the range of psychoactive effects resulting from the use of the substances in this classification. These drugs remain in wide use amongst those in rave and club subcultures. This paper explores a range of risk management practices used by youth who utilize club drugs within rave and club subcultures. Through the use of ethnographic methods during a two-year period of fieldwork, the author collected data on club drug use and risk taking among “Bridge and Tunnel” youth. The resulting paper provides a descriptive typology of a series of risk management practices and explores how these practices are strategically deployed in an effort to maximize enjoyment and minimize danger.