Showing papers in "American Journal of Drug and Alcohol Abuse in 2005"
TL;DR: This protocol enhanced treatment retention, variables of attention, and abstinence rates one year following treatment.
Abstract: This study examined whether an EEG biofeedback protocol could improve outcome measures for a mixed substance abusing inpatient population. Method. One hundred twenty-one volunteers undergoing an inpatient substance abuse program were randomly assigned to the EEG biofeedback or control group. EEG biofeedback included training in Beta and SMR to address attentional variables, followed by an alpha-theta protocol. Subjects received a total of 40 to 50 biofeedback sessions. The control group received additional time in treatment equivalent to experimental procedure time. The Test of Variables of Attention (TOVA), and MMPI, were administered with both tester and subject blind as to group placement to obtain unbiased baseline data. Treatment retention and abstinence rates as well as psychometric and cognitive measures were compared. Results. Experimental subjects remained in treatment significantly longer than the control group
188 citations
TL;DR: Examination of the association between interpersonal discrimination and the mental and physical health of illicit drug users in New York City found discrimination was significantly associated with poor mental health, depression, and the number of self-reported chronic physical health conditions.
Abstract: Although discrimination has been shown to adversely affect the health of marginalized populations, there is a paucity of research on the health impacts of discrimination experienced by illicit drug users. The purpose of this study was to examine the association between interpersonal discrimination and the mental and physical health of illicit drug users taking into account several potential confounding factors. A sample of 1,008 active illicit substance users (defined as having used cocaine, crack, or heroin in the previous 2 months) were recruited in three New York City neighborhoods between August 2000 and January 2001 using street-outreach techniques. Discrimination due to illicit drug use was the most common form of interpersonal discrimination experienced and more than one-half the study participants reported experiencing discrimination due to more than one attribute. Discrimination was significantly associated with poor mental health (measured by the SF-36 mental health score), depression (measured by the CES-D), and the number of self-reported chronic physical health conditions. The presence of multiple stigmatizing characteristics was associated with poorer mental and physical health. Discrimination may contribute to poor mental and physical health in this marginalized population, potentially complicating the provision of substance abuse treatment.
104 citations
TL;DR: Assessment of the role of alcohol use and depression in intimate partner violence (IPV) victimization and perpetration among Blacks and Hispanics in an underserved urban emergency department population found depression predicted IPV victimization, but not substance use.
Abstract: Objectives: The primary objective of this study was to assess the role of alcohol use and depression in intimate partner violence (IPV) victimization and perpetration among Blacks and Hispanics in an underserved urban emergency department population. Methods: This cross-sectional study surveyed male and female patients presenting to an urban emergency department. The outcome measures were physical or sexual IPV victimization and perpetration in the previous 12 months. The independent predictors included demographic variables, alcohol and drug use, and depressive symptoms. Logistic regression analyses calculated the adjusted odds ratio (AOR) and 95% confidence interval (CI) for predictors of IPV victimization and perpetration in separate models. Results: The prevalence of IPV victimization among Blacks and Hispanics were similar (14% and 10%, respectively) but blacks were nearly twice as likely to report IPV perpetration (17% vs. 9%, respectively).Predictors of IPV perpetration were Black race, married or ...
100 citations
TL;DR: Using, logistic regression techniques, individuals who were employed at the time of their enrollment into the drug court program were more likely to successfully complete the treatment program and individuals with a history of illicit intravenous drug use were less likely to complete the program.
Abstract: Drug courts are popular for dealing with drug-abusing offenders. However, relatively little is known about participant characteristics that reliably predict either success or failure in these treatment settings. In this article, we report on 99 individuals who were enrolled in a drug court program (approximately one-half of whom successfully completed the program). Using, logistic regression techniques we identified 2 significant predictors of outcome. First, individuals who were employed at the time of their enrollment into the drug court program were more likely to successfully complete the treatment program. Second, individuals with a history of illicit intravenous drug use were less likely to complete the program.
83 citations
TL;DR: Outcomes among 216 women enrolled in the Washington State Parent-Child Assistance Program are examined, suggesting that this community-based intervention model is effective over time and across venues.
Abstract: Home visitation interventions show promise for helping at-risk mothers, yet few programs have been developed and evaluated specifically for alcohol and drug-abusing pregnant women. This study examines outcomes among 216 women enrolled in the Washington State Parent-Child Assistance Program, a three-year intervention program for women who abuse alcohol and drugs during an index pregnancy. Pretest-posttest comparison was made across three sites: the original demonstration (1991-1995), and the Seattle and Tacoma replications (1996-2003). In the original demonstration, the client group performed significantly better than controls. Compared to the original demonstration, outcomes at replication sites were maintained (for regular use of contraception and use of reliable method; and number of subsequent deliveries), or improved (for alcohol/drug treatment completed; alcohol/ drug abstinence; subsequent delivery unexposed to alcohol/drugs). Improved outcomes at replication sites are not attributable to enrolling lower-risk women. Public policies and programs initiated over the study period may have had a positive effect on outcomes. Study findings suggest that this community-based intervention model is effective over time and across venues.
83 citations
TL;DR: In this article, the authors examined patterns of psychiatric dual and multiple diagnosis among a sample (N=226) of treatment-engaged substance-abusing youth (ages 13 to 17) who were residing at a runaway shelter.
Abstract: Although research on runaway and homeless youth is increasing, relatively little is known about the diagnostic profile of runaway adolescents. The current study examined patterns of psychiatric dual and multiple diagnosis among a sample (N=226) of treatment-engaged substance-abusing youth (ages 13 to 17) who were residing at a runaway shelter. As part of a larger treatment outcome study, the youths' psychiatric status was assessed using the DSM-IV based computerized diagnostic interview schedule for children [CDISC; (1)]. The majority of the youth in our sample met criteria for dual or multiple diagnosis (60%) with many having more than one substance-use diagnosis (56%). The severity of mental-health and substance-use problems in this sample of substance-abusing runaways suggests the need for continued development of comprehensive services. The range and intensity of diagnoses seen indicates a need for greater focus on treatment development and strategies to address their multiple areas of risk.
82 citations
TL;DR: There is a functional relation between posttraumatic stress symptoms and alcohol consumption among Red Cross workers who responded to the 9/11/2001 attacks, indicating that efforts to cope with traumatic stress symptoms may manifest in either increases or decreases in alcohol consumption.
Abstract: Objective: This study examined associations between alcohol use and PTSD symptoms among Red Cross workers who responded to the 9/11/2001 attacks. Method: Participants were 779 Red Cross paid and volunteer staff that responded during the first three months to the September 11, 2001, attacks against the United States. Women made up 64% of the sample. The American Red Cross provided a mailing list of all paid and volunteer staff (N = 6055 with valid addresses) that participated in the disaster relief operations in response to the September 11, 2001, attacks. Participants were randomly assigned to receive one of four questionnaire packets. The present study is based on the fourth group, which received the alcohol questionnaires. Results: Overall, traumatic stress symptoms and alcohol use were low. Hyperarousal and intrusion symptoms on the Impact of Events Scale-Revised (IES-R) were associated with alcohol consumption, hazardous alcohol consumption, and change in alcohol consumption when controlling for age, ...
80 citations
TL;DR: Key predictors of abstinence (CHAID) varied by follow-up and dependence disorder, except for doing service in AA and/or Narcotics Anonymous, which was the only specific 12-step activity that was a best predictor of abstinence in all three categories one year following treatment.
Abstract: Previous studies that have examined the effects of specific aspects of 12-step participation and social network composition on abstinence have focused mostly on alcohol-related outcomes and have screened out drug dependent persons. This article explores whether these predictors differentially affect abstinence based on DSM-III-R substance dependence disorder (alcohol dependence, drug dependence, and both alcohol and drug dependence). A heterogeneous community sample of treatment seekers (N=302) randomized to day treatment programs were followed at 6 and 12 months. Bivariate and multivariate regression models were used to test whether engagement in 12-step practices and social network influences to drink or use drugs predicted total abstinence from alcohol and drugs differentially by dependence disorder. Chi-square automatic interaction detector (CHAID) segmentation analyses were then conducted to identify the specific 12-step activities and social network thresholds that best distinguished higher rates of abstinence in each dependence category. Results showed that the number of 12-step meetings attended and number of prescribed 12-step activities engaged in similarly predicted abstinence for alcoholics, drug addicts, and those dependent on both alcohol and drugs. However, specific activities were associated with abstinence differentially by dependence disorder. While many activities differentiated abstinence for drug addicts and those dependent on both alcohol and drugs, for alcoholics only two Alcoholics Anonymous (AA) activities distinguished abstinence (having a sponsor and doing service). Key predictors of abstinence (CHAID) varied by follow-up and dependence disorder, except for doing service in AA and/or Narcotics Anonymous, which was the only specific 12-step activity that was a best predictor of abstinence in all three categories one year following treatment. Thus, "giving back" to one's peer community through service work, an important 12-step belief, seems to be universally valuable later in recovery. As for social network influences, a multivariate regression model showed that having a higher proportion of abstinent individuals in the network was associated with abstinence for alcoholics at 6 months only and for drug dependent persons at 12 months only. CHAID models supported these results and provided specific thresholds for 12-step measures (e.g., >20 meetings for alcoholics, 2 or more nondrinkers in the social network, 3 or more persons supporting reduction for those dependent on both alcohol and drugs, and having 2 or more nondrinkers for those dependent on drugs only). These results support the value of treatment providers prioritizing certain 12-step-related practices and social network changes based on their client dependence profiles. Early on, those with an alcohol diagnosis need to make a commitment to meetings and obtain a sponsor; also, they need to place themselves in a network that encourages sobriety. Early on, those who are drug-dependent-only especially need to become connected with 12-step programs to the extent that they consider themselves a member, and, later, saturate themselves in a highly supportive and predominantly nondrinking environment. Alcohol and drug dependent clients need more intense ongoing 12-step involvement (sponsor and meetings) as well as having nondrinking individuals and people supportive of abstinence in their network. For all clients, doing service is especially important at the longer 12-month posttreatment timeframe.
75 citations
TL;DR: It is suggested that low levels of acculturation may protect some Latino youth withpoor body image from coping via substance use and that poor body image among some Latinos may result less from adoption of American thinness ideals but rather from attitudes and behaviors that devalue the characteristics of Latino appearance.
Abstract: This study explored body image as measured by perceptions of weight and appearance and its impact on adolescent drug use among predominately Mexican American middle school students in the southwest. Outcomes analyzed included lifetime and recent alcohol, cigarette, and marijuana use and antidrug norms. Disliking one's looks was more of a risk factor for boys, whereas negative weight perceptions were more of a risk factor for girls. Relative to more acculturated (English-dominant) Latinos (N = 903), non-Latino Whites (N = 121), and other non-Latino youth (N = 107), less acculturated (Spanish-dominant) Latino youth (N = 212) reported the poorest body image. However, more acculturated Latino youth with poor body image had the greatest risk of substance use. More acculturated Latino boys who disliked their looks reported relatively greater amounts of recent alcohol use, and those who rated their bodies as too thin reported higher lifetime cigarette use, a greater amount and frequency of recent cigarette use, ...
67 citations
TL;DR: Despite the many similarities in SUD among those with and without ASPD, the morbidity in the ASPD as measured by number and types of substance-related problems and by all treatment variables is considerably greater.
Abstract: Objectives: The aims were to determine among patients with substance use disorder (SUD) whether those with antisocial personality disorder (ASPD) manifest less, the same, or more of the following: 1) temporal course of substance use, 2) severity of substance-related symptoms and problems, 3) familial SUD, 4) number and type of SUD diagnoses, and 5) extent of SUD treatment, as compared to patients without ASPD. Design and Definition: Scheduled interviews using Diagnostic and Statistical Manual (DSM) criteria were used to determine ASPD, which required childhood conduct disorder plus adult antisocial behavior. Clinicians blind to the ASPD assessment collected the remainder of the data. Settings: Alcohol-drug treatment programs were located in two university medical centers. Subjects: Six hundred and six voluntary patients aged 18 and older met diagnostic criteria for SUD. Results: SUD patients with ASPD reported more substance-related problems in seven out of eight areas of the interview-based Minnesota-Sub...
61 citations
TL;DR: Alcohol involvement is important in the early delinquent career whereas illicit drug use delays maturing out of delinquency, and alcohol dependence and drug consequences were associated with a faster increase.
Abstract: The current study investigated the influence of substance involvement on the trajectory of delinquency. Data were from 625 Buffalo, NY males aged 16-19, interviewed three times at 18-month intervals. Hierarchical linear models were fit separately for respondents with increasing and declining delinquency. In the increasing group, aIcohol involvment was associated with a higher starting point (intercept), and alcohol dependence and drug consequences were associated with a faster increase. In the declining group, alcohol dependence and drug consequences were associated with a higher starting point, and frequency of drug use was associated with a slower decline. Alcohol involvement is important in the early delinquent career whereas illicit drug use delays maturing out of delinquency. In a further analysis, substance involvement variables were time-varying covariates in the within-subjects model and controls in the between-subjects model. Respondents' alcohol and other drug use varied across time in sync with their criminal offending.
TL;DR: This analysis uses natural history interview data from 350 clients treated for MA use in Los Angeles County to examine clients' self-reported CJS/CPS pressure to enter treatment, comparing background and treatment characteristics and selected treatment outcomes across groups defined by existence of such perceived pressure and source of pressure.
Abstract: Policymakers have responded to the increase in the prevalence of methamphetamine (MA) use and the associated social costs (such as crime and child abuse and neglect) by mandating a growing number of MA users to substance abuse treatment via the criminal justice system (CJS) and/or child protective service (CPS) agencies. However, empirical evidence remains sparse about treatment outcomes specifically for MA users who report that their treatment admission occurred under such pressures. This analysis uses natural history interview data from 350 clients treated for MA use in Los Angeles County to examine clients' self-reported CJS/CPS pressure to enter treatment, comparing background and treatment characteristics and selected treatment outcomes across groups defined by existence of such perceived pressure and source of pressure. Approximately half the clients reported legal pressure to enter the index (used for sampling) treatment episode. Those reporting pressure were younger, less likely to have received residential treatment, and had longer treatment episodes than those not reporting pressure. Outcomes (treatment completion, relapse within 6 months, time to relapse, and percentage of days with MA use in 24 months following treatment) did not differ significantly in simple comparisons between the pressured and nonpressured groups; however, when client and treatment characteristics were controlled, the short term outcome of relapse within 6 months was worse for those reporting legal pressure. Outcomes did not differ by source of pressure.
TL;DR: Results indicate the use of assessing specific patient attributes to better inform treatment recommendations and predicted that alexithymia, antisocial personality disorder (ASPD), and network support for alcohol and drug use would be associated with less substance use for CBT subjects.
Abstract: Patient treatment matching hypotheses were tested for substance users randomly assigned to a group cognitive behavioral therapy (CBT; n= 114) or a group motivational intervention (GMI; n= 116). Treatment was scheduled twice weekly for 10 weeks. Using a patient attribute by treatment interaction design with a 15-week follow-up, the study predicted that alexithymia, antisocial personality disorder (ASPD), and network support for alcohol and drug use would be associated with less substance use for CBT subjects and that hostility and lower treatment motivation would be associated with less substance use for GMI subjects. Three of the hypothesized moderators were empirically supported: alexithymia, network support for alcohol, and ASPD. Results indicate the use of assessing specific patient attributes to better inform treatment recommendations.
TL;DR: Analysis of parenting status by gender indicated that, although a greater proportion of women were the parent of at least one biological child, there were actually more fathers than mothers within the cohort.
Abstract: This survey of individuals seeking methadone maintenance treatment was pursued to document the parenting status of drug-dependent men and clarify ways their status as parents differs from that of drug-dependent women. Data concerning demographic characteristics, drug abuse history, and parenting status were systematically coded from the medical records of 362 men and 162 women seeking methadone maintenance treatment during a 12-month period. Analysis of parenting status by gender indicated that, although a greater proportion of women were the parent of at least one biological child, there were actually more fathers than mothers within the cohort. Among the parents, fathers were more likely to have been abusing opioids when they first became a parent, and they were more likely to be living away from their children. There were no significant gender differences in the number of children or the average age of children. The results suggested that fathering may be an important, but largely neglected, treatment issue for drug-abusing men.
TL;DR: Examination of relationships between dissociative experiences, implicit processes, and sensation seeking in models of drug use and problem experiences revealed that implicit cognition independently predicted alcohol and marijuana use and mediated the predictive effects of sensation seeking on drug use.
Abstract: The present study evaluated the mediating role of implicit cognitive processes in the prediction of alcohol and marijuana use and examined the relationships between dissociative experiences, implicit processes, and sensation seeking in models of drug use and problem experiences. Participants were 467 diverse at-risk adolescents in California. Results from latent variable models revealed that implicit cognition independently predicted alcohol and marijuana use and mediated the predictive effects of sensation seeking on drug use. Dissociative experiences did not predict implicit cognition or drug use in this sample, though this factor was a significant predictor of problem experiences and was positively correlated with sensation seeking. This research provides further evidence suggesting that implicit, associative memory processes are influential in drug-use motivation.
TL;DR: Analysis of data on 167 incarcerated drug-abusing mothers from Baltimore City who had volunteered for a parenting program offered at a Maryland correctional facility revealed significant relationships between higher risk levels and less favorable current adjustment.
Abstract: Although the number of mothers with histories of drug addiction who are incarcerated has grown substantially in recent years, there is little information on their unique characteristics and vulnerability. Undertaken to address this issue, this study examined data on 167 incarcerated drug-abusing mothers from Baltimore City who had volunteered for a parenting program offered at a Maryland correctional facility. Prior to entering this program, mothers who consented to participate completed a battery of assessment measures, which included an extensive interview covering their early developmental and current experiences, along with standardized instruments measuring psychological adjustment and parenting satisfaction. Analyses of these data focused on the link between risk/protective factor information drawn from the early development experiences of the mothers and their current adjustment status. Results revealed significant relationships between higher risk levels and less favorable current adjustment. Implications of the findings of the study for both prevention and clinical intervention efforts targeting both mothers and their children are discussed.
TL;DR: Robust findings regarding treatment attendance suggest that this intervention is highly promising, and differences in heroin use and criminal involvement between experimental participants and each of the other two groups, while not consistently statistically significant, uniformly favored the experimental group.
Abstract: Because prisoners with preincarceration heroin dependence typically relapse following release, a pilot study examined a novel opioid agonist maintenance program whereby consenting males initiated levo-alpha-acetylmethadol (LAAM) treatment shortly before release from prison with opportunity to continue maintenance in the community. Treated prisoners (experimental group) were compared with controls who received community treatment referral information only and prisoners who withdrew from treatment prior to medication regarding treatment participation and community adjustment during nine months post-release. Nineteen of 20 (95%) prisoners who initiated maintenance in prison entered community treatment, compared with 3 of 31 (10%) controls, and 1 of 13 (8%) who withdrew. Moreover, 53% of experimental participants remained in community treatment at least six months, while no other participants did so. Differences in heroin use and criminal involvement between experimental participants and each of the other two groups, while not consistently statistically significant, uniformly favored the experimental group. Despite study limitations, robust findings regarding treatment attendance suggest that this intervention is highly promising.
TL;DR: In this article, the authors explored the utility of using existing measures of TI developed on adult populations to examine the correlates of therapeutic involvement among adolescents in drug treatment and found evidence that there may be important subgroup differences associated with gender and ethnicity.
Abstract: The current study addresses the critical need for research on the therapeutic involvement among adolescent substance users in treatment. Although therapeutic involvement (TI) and the services that clients receive during treatment are among the best predictors of treatment retention and through retention associated with better posttreatment outcomes, there are relatively few empirical studies of therapeutic involvement among adolescents in drug treatment. Using data on N=185 adolescent clients in five adolescent residential drug-treatment programs in New Jersey, factor analyses used maximum likelihood extraction and oblique rotation. Pearson's correlation coefficients and multivariate linear regression were used to explore the utility of using existing measures of TI developed on adult populations to examine the correlates of therapeutic involvement among adolescents. The majority of subjects (85%) were between 16 and 18 years of age, with an average age of 17 years. Seventy-nine percent were male, 20% were Hispanic, 36% were African-American, and 46% were Caucasian. Working alliance, self-esteem, spirituality, deviance, and substance use problem severity were associated with therapeutic involvement and there is evidence that there may be important subgroup differences associated with gender and ethnicity. Further research on the interplay between these factors, therapeutic involvement, and recovery among adolescents can inform the development of strategies to enhance the engagement and retention of adolescents in drug treatment.
TL;DR: Environmental factors may be particularly relevant to the understanding of SUDs and certain PDs, and were significantly positively related to proportion of friends who use alcohol and drugs regularly and drug use among romantic partners.
Abstract: Substance use disorders (SUDs) and Cluster B personality disorders (PDs) are both marked by impulsivity and poor behavioral control and may result in part from shared neurobiological or executive c...
TL;DR: It is argued that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement.
Abstract: Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of “spiritual transformation” in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and...
TL;DR: Analysis of social support and its association with employment, income, and drug use in a sample of 534 low-income women suggests that the perceived quality of support received is an important factor in achieving positive employment outcomes.
Abstract: This study examined social support and its association with employment, income, and drug use in a sample of 534 low-income women. Functional support was defined as the perceived quality of one's interactions with others. Structural support was defined as the number of individuals within five particular types of networks: social, employment, drug, close, and emergency. Over the two-year study period, significant increases were observed in hours worked, income from work, income from other sources, and total income. There was also a significant decrease in welfare income. Results suggest that the perceived quality of support received is an important factor in achieving positive employment outcomes.
TL;DR: The substance abuse and mental health problems group had the most serious health problems profiles and reported significantly greater use of the emergency room and more hospital stays both for their lifetime and in the year prior to their current incarceration.
Abstract: Individuals with substance abuse and mental health problems are common in prisons and jails, but relatively little is known about the health or health services utilization of inmates with these types of problems. This study, therefore, focuses on prisoners who self-reported receiving a prior diagnosis from a physician or a psychologist who indicated they had 1) substance abuse problems only, 2) mental health problems only, and 3) substance abuse and mental health problems. A fourth group of prisoners who reported no diagnoses were included as the "no problems" group. Comparisons were made on reports of lifetime health problems, use of preventive health services, and use of medical services. Findings showed the substance abuse and mental health problems group had the most serious health problems profiles. Use of preventive health services was similar across all four groups, but the substance abuse and mental health problems group reported significantly greater use of the emergency room and more hospital stays both for their lifetime and in the year prior to their current incarceration. The policy and practical relevance of the findings are discussed.
TL;DR: It is suggested that abstinence can unmask cognitive deficits induced by chronic cocaine use and circadian factors may mediate their severity.
Abstract: Five cocaine-dependent individuals completed a 22-day inpatient study of sleep and cognition. Following 3 days of drug-free baseline, participants underwent 3 days of twice-daily smoked cocaine base self-administration (6 50-mg doses, 14 minutes apart), followed by 15 days of abstinence. Each morning and afternoon, the CDR repeatable, multiple-version, computerized cognitive battery (whose stability following practice has been documented) was administered. During abstinence, performance deteriorated on vigilance tasks (especially reaction time) as well as on immediate and delayed verbal recognition tasks but not on working memory tasks. Declines were most evident in the afternoon. Data suggest that abstinence can unmask cognitive deficits induced by chronic cocaine use and circadian factors may mediate their severity.
TL;DR: It is suggested that supportive living environments may facilitate entry into treatment and may be helpful in devising appropriate and targeted interventions to encourage drug treatment entry.
Abstract: We tested hypotheses that social living arrangement and drug use in one's network are independently associated with entry into opiate agonist treatment modalities. Injection drug users (IDUs) attending the Baltimore Needle Exchange Program who received a referral for drug abuse treatment were studied. Baseline interviews, HIV testing, and the Addiction Severity Index (ASI) were administered. Agency records were used to confirm entry into a treatment program offering opiate agonist maintenance therapy within 30 days of the baseline interview. Logistic regression was used to identify predictors of treatment entry. To date, of 245 IDUs, 39% entered such a program. Multivariate logistic regression models controlling for age and intervention status revealed that compared to individuals who lived alone, in a controlled, or nonstable environment (e.g., streets, abandoned house, transitional housing program, or boarding house), individuals who lived with a sexual partner were 3 times more likely to enter treatment (adjusted Odds Ratio [aOR]=3.04; p=0.013) and those who lived with family or friends were almost 3 times more likely to enter treatment (aOR=2.72; p=0.016). In the bivariate analyses, a marginal association was observed between being responsible for children or others and entry into treatment (p=0.066); however, this association was not significant in the multivariate model. Findings from this study suggest that supportive living environments may facilitate entry into treatment and may be helpful in devising appropriate and targeted interventions to encourage drug treatment entry.
TL;DR: Results indicate that clients with higher cognitive ability may present with a greater capacity to engage in treatment than individuals with lower cognitive ability.
Abstract: This study examined correlates of high (HCA) and low (LCA) cognitive ability among substance dependent individuals who participated in an ongoing study of early engagement strategies. Participants (55% male; 98% African American), were administered the ASI, Shipley Institute of Living Scale, Beck Hopelessness scale, and TCU Motivation Scales at intake. Analyses were limited to 416 participants whose IQs fell within the upper and lower thirds of the sample. HCA participants reported more prior treatment episodes and longer durations of voluntary abstinence than LCA participants. There were no differences in retention, although HCA participants expressed significantly greater motivation and hopefulness at intake than LCA participants. Results indicate that clients with higher cognitive ability may present with a greater capacity to engage in treatment than individuals with lower cognitive ability.
TL;DR: A gender-specific, computerized intervention for preventing substance abuse among adolescent girls delivered on CD-ROM by computer showed GSI girls compared to girls receiving conventional intervention to possess a larger repertoire of stress-reduction methods.
Abstract: This study developed and tested a gender-specific intervention for preventing substance abuse among adolescent girls. Delivered on CD-ROM by computer, the program was compared with a conventional substance abuse prevention program delivered live in a group setting. Seventh-grade girls in New York City middle schools completed pretests, and, by school, were randomly assigned to receive either gender-specific computer intervention (GSI) or conventional intervention, and were posttested. Analyses of pretest to posttest gain scores showed GSI girls compared to girls receiving conventional intervention to possess a larger repertoire of stress-reduction methods, to report lower approval of cigarettes, alcohol, and drugs, to identify more unhealthy ways to deal with stress, to report lower likelihood of cigarette use or alcohol consumption if asked to do so by best friends, and to hold stronger plans to avoid cigarettes, alcohol, and drugs in the next year. These modest findings lend credence to the promise of gender-specific, computerized interventions for substance abuse prevention among adolescent girls.
TL;DR: Programs that incorporated at least 4 out of 5 effective intervention characteristics identified in the study significantly reduced use for both males and females relative to comparison youth, attest to the value of MSE designs as a source of applicable knowledge about prevention interventions.
Abstract: The National Cross-Site Evaluation is a large multisite evaluation (MSE) of 48 substance abuse prevention programs, 5,934 youth participating in programs, and 4,539 comparison youth programs. Data included a self-report questionnaire administered at 4 points in time, detailed dosage data on over 217,000 program contacts, and detailed site visit information. In a pooled analysis, the programs did not demonstrate significant positive effects on a composite outcome measure of tobacco, alcohol, and marijuana use in the previous 30 days. However, disaggregated analyses indicated that 1) sites in which comparison groups had strong opportunity to participate in prevention programs suppressed observed effects; 2) youth who had already started using before they entered programs reduced use significantly more than comparison youth who had started using; and 3) both males and females who participated in programs significantly reduced use relative to comparisons, but in very different patterns. Combining these patterns produced an apparent null effect. Finally, programs that incorporated at least 4 out of 5 effective intervention characteristics identified in the study significantly reduced use for both males and females relative to comparison youth. The lessons produced by this study attest to the value of MSE designs as a source of applicable knowledge about prevention interventions.
TL;DR: This study examined the relationship of relationship quality and partner's drug use on treatment outcomes for women in outpatient drug treatment and found that a higher proportion of women whose partners reported higher relationship quality failed to complete treatment.
Abstract: This study examined the relationship of relationship quality and partner's drug use on treatment outcomes for women in outpatient drug treatment. The sample consisted of predominately heterosexual couples where the female partner was in drug treatment. Both the partners' perception of relationship quality and the interaction of female client and her partner's perception of relationship quality were significant predictors of one of the outcome variables-the client's posttest report of days of drug use during the previous 30 days. Interestingly, clients reported more days of drug use when their partners reported higher relationship quality. A similar pattern was found with the ASI Drug composite score as the dependent variable except that the interaction term was not significant in that analysis. In addition, partners' relationship quality scores were associated with female clients' treatment completion. A higher proportion of women whose partners reported higher relationship quality failed to complete treatment. Partners' reports of pretest and posttest drug use were not related to women's treatment outcomes.
TL;DR: Supporting an association with each substance, odds ratios consistently strengthened as use increased and the associations for inhalant and steroid use argue for their inclusion in future research.
Abstract: This cross-sectional study examined the association between self-reported nonfatal occupational injuries among high school students in South Texas and their self-reported general use of substances. Data were collected using a self-administered, anonymous questionnaire (n = 3365). The independent variables included alcohol, marijuana, cocaine, inhalant, and steroid use. The dependent variable was occupational injury. Adjusting for grade, sex, ethnicity, and work intensity, odds ratios were calculated using logistic regression. Supporting an association with each substance, odds ratios consistently strengthened as use increased. Additional research is merited given the scant number of previous studies. The associations for inhalant (OR, 5.61) and steroid (OR, 7.63) use argue for their inclusion in future research.
TL;DR: People who reported having driven back roads in the past to avoid confrontation with the police after drinking had significantly higher estimated BAC levels than those who said they had never done so.
Abstract: Drinking and driving are still a serious concern on the roads, even though the last twenty years has seen an increase in exposure to various designated driver programs. Even though a majority of people have either been one or used one, most designated drivers have still consumed some alcohol. Another option is that of an outside driver, such as a safe ride program in which a safe ride is offered for free by taxis or volunteers. One such program under study, offers a ride home for both the driver as well as their vehicle. To examine the population who utilizes such a program two studies were conducted which included 1,985 participants (1206 male, 744 female) from two major California cities. The volunteer drivers gathered data during their rounds between January 2002 and September 2002. If the current safe ride program not been in place 632 Participants (44%) reported that they would have driven themselves home. 582 participants (40%) have used back roads in the past to evade being stopped by the police; on average they used back roads 3.4 times in the past month. When questioned about having control over not drinking and driving 455 (32%) participants didn't feel they had control over their choice to avoid drinking and driving. Participants who reported having driven back roads in the past to avoid confrontation with the police after drinking had significantly higher estimated BAC levels than those who said they had never done so. This sample reflected similar populations.