Showing papers in "Substance Abuse in 2015"
TL;DR: Existing research suggests that people who are at risk for overdose and other bystanders are willing and able to be trained to prevent overdoses and administer naloxone, and an emerging clinical practice that may reduce fatalities from overdose while enhancing the safe prescribing of opioids.
Abstract: . Background: As physicians have increased opioid prescribing, overdose deaths from pharmaceutical opioids have substantially increased in the United States. Naloxone hydrochloride (naloxone), an opioid antagonist, is the standard of care for treatment of opioid induced respiratory depression. Since 1996, community-based programs have offered overdose prevention education and distributed naloxone for bystander administration to people who use opioids, particularly heroin. There is growing interest in translating overdose education and naloxone distribution (OEND) into conventional medical settings for patients who are prescribed pharmaceutical opioids. For this review, we summarized and classified existing publications on overdose education and naloxone distribution to identify evidence of effectiveness and opportunities for translation into conventional medical settings. Methods: For this review, we searched English language PubMed for articles on naloxone based on primary data collection from hu...
153 citations
TL;DR: A unique suggestion for successful implementation of the Substance Abuse and Mental Health Services Administration screening, brief intervention, and referral to treatment approach in the organization is to utilize existing primary care clinic-based psychologists to conduct brief intervention and facilitate referrals to treatment.
Abstract: Background: Substance abuse in the United States is a serious public health concern impacting morbidity and mortality. However, systematic screening and intervention has not been widely adopted into routine practice by health care organizations and routine screening and intervention is not currently in place for primary care at Kaiser Permanente Colorado. Therefore, a formative evaluation was conducted to explore and enhance implementation of the Substance Abuse and Mental Health Services Administration (SAMHSA) screening, brief intervention, and referral to treatment (SBIRT) approach in the organization. Methods: Key clinical stakeholders, including internal and family medicine physicians, primary care nurses, mental health therapists, chemical dependency clinicians, and clinic-based psychologists provided feedback. Two focus groups were also conducted with patient stakeholders: one in English and one in Spanish. Results: All clinical stakeholders promoted clinic-based psychologists to conduct br...
110 citations
TL;DR: These findings are unique, as they target urban adolescents with a mobile health format and add to the growing literature on the efficacy of text-delivered interventions.
Abstract: Background: This paper describes the development of an urban adolescent text messaging tobacco cessation intervention and preliminary findings from a randomized, controlled trial. The authors successfully adapted a face-to-face intervention into a personalized, automated, and interactive 5-day texting protocol. Methods: Respondent-driven sampling was used beginning at a community substance abuse facility. Seventy-two tobacco-dependent adolescents were randomized into an automated computer texting program that delivered either the experimental condition of 30 motivational interviewing– and social network counseling–based personalized messages or the attention control condition consisting of a texting program covering general (non–smoking-related) health habits. All teens were provided smartphones for the study and were assessed at baseline and at 1, 3, and 6 months post intervention. Analyses examined condition × time interactions. Results: At 6 months, the experimental condition decreased the numb...
80 citations
TL;DR: Synthetic cannabinoids use was common in the past month and often overlaps with other drug use, particularly marijuana use, and should be asked about during clinical encounters with young adults.
Abstract: Background: Synthetic cannabinoids (SCs) are a class of drugs of abuse with deleterious consequences. Despite governmental regulations related to distribution and sale, SC variants are still available online. More research is needed to determine SC use prevalence and factors associated with SC use, especially among young adults. Methods: One thousand eighty individuals, 18–25 years old, were surveyed, between January 2012 and July 2013, during recruitment for a randomized controlled trial investigating health behaviors in young adults. Advertisements were placed online and in community locations seeking individuals “who had recently used marijuana or alcohol.” Respondents were queried about their use of alcohol and drugs, including SCs, in the last month. Results: Participants averaged 21.4 years old and were 53.4% male. Nearly 59% were non-Hispanic white, 15% were African American, 15% were Hispanic, and 11% identified as other. Approximately 9% reported SC use in the last month, a level higher t...
77 citations
TL;DR: The current weight of evidence supports the hypothesis that early initiation of cannabis use increases the risk of early onset psychotic disorder, especially for those with a preexisting vulnerability and who have greater severity of use.
Abstract: Background: It is important to evaluate the impact of cannabis use on onset and course of psychotic illness, as the increasing number of novice cannabis users may translate into a greater public health burden. This study aims to examine the relationship between adolescent onset of regular marijuana use and age of onset of prodromal symptoms, or first episode psychosis, and the manifestation of psychotic symptoms in those adolescents who use cannabis regularly. Methods: A review was conducted of the current literature for youth who initiated cannabis use prior to the age of 18 and experienced psychotic symptoms at, or prior to, the age of 25. Seventeen studies met eligibility criteria and were included in this review. Results: The current weight of evidence supports the hypothesis that early initiation of cannabis use increases the risk of early onset psychotic disorder, especially for those with a preexisting vulnerability and who have greater severity of use. There is also a dose-response associa...
76 citations
TL;DR: These results provide insight regarding individual feelings of social support and abstinence-specific self-efficacy by showing that one's social network-level characteristics are related to one's perceptions of socialSupport.
Abstract: Background: Social support and characteristics of one's social network have been shown to be beneficial for abstinence and substance use disorder recovery. The current study explores how specific sources of social support relate to general feelings of social support and abstinence-specific self-efficacy. Methods: Data were collected from 31 of 33 individuals residing in 5 recovery houses. Participants were asked to complete social support and social network measures, along with measures assessing abstinence from substance use, abstinence self-efficacy, and involvement in 12-step groups. Results: A significant positive relationship was found between general social support and abstinence-specific self-efficacy. General social support was also significantly associated with the specific social support measures of sense of community and Alcoholics Anonymous (AA) affiliation. Social network size predicted abstinence-related factors such as AA affiliation and perceived stress. Conclusions: These results ...
71 citations
TL;DR: There is strong evidence for a general link between SUD and insecure attachment, and evidence suggests that fostering attachment security might improve the outcome of state-of-the-art approaches in both early interventional treatment and prevention.
Abstract: Background: This paper reviews research on the relation of attachment and substance use disorders (SUD) in adolescence. Based on a theoretical introduction, we review evidence for a possible general link between SUD and insecure attachment, for links between specific forms of SUD and specific patterns of attachment, and for studies on family patterns of attachment in adolescence. Methods: Using medical and psychological databases, we identified 10 studies on adolescent SUD and another 13 studies on adult SUD. Results: Empirical evidence strongly supports the assumption of insecure attachment in SUD samples. With regard to specific patterns of attachment, results mainly point towards fearful and dismissing-avoidance, whereas single studies report preoccupied and unresolved patterns. Results indicate different patterns of attachment in different groups of substance abusers, that is, fearful-avoidant attachment in heroin addicts and more heterogeneous results in abusers of other substances. Explorati...
68 citations
TL;DR: Results demonstrate the feasibility of using smartphones for recovery monitoring and support with adolescents, with potential to reduce use.
Abstract: Background: Smartphone applications can potentially provide recovery monitoring and support in real-time, real-life contexts. Study aims included determining feasibility of (a) adolescents completing ecological momentary assessments (EMAs) and utilizing phone-based ecological momentary interventions (EMIs); and (b) using EMA and EMI data to predict substance use in the subsequent week. Methods: Twenty-nine adolescents were recruited at discharge from residential treatment, regardless of their discharge status or length of stay. During the 6-week pilot, youth were prompted to complete an EMA at 6 random times per day and were provided access to a suite of recovery support EMI. Youth completed 87% of the 5580 EMAs. Based on use in the next 7 days, EMA observations were classified into 3 risk groups: “Current Use” in the past 30 minutes (3% of observations), “Unrecognized Risk” (42%), or “Recognized Risk” (55%). All youth had observations in 2 or more risk groups and 38% in all 3. Youth accessed an E...
63 citations
TL;DR: Preliminary data from this study provide preliminary data that can be used by schools of nursing and health care employers to improve early identification of nurses' substance use and mental illness treatment needs.
Abstract: Background: Although some studies have examined the prevalence of substance use among nurses, few have assessed substance use in the workplace or early cues for identifying these health conditions. Primary data collected as part of a larger program evaluation were examined with the purpose of better understanding (a) the context and perceived consequences of substance use and mental illness among nurses and (b) barriers and opportunities for earlier identification and treatment of these issues among nurses, their colleagues, and employers. Methods: Anonymous surveys were mailed to 441 active and recent participants of a peer health assistance program in the summer of 2010. The survey examined drug-related behaviors in the workplace; behavioral cues that may permit earlier identification of substance use and mental illness; perceptions of barriers to seeking assistance; and strategies for preventing problems and overcoming barriers to seeking assistance. Results: Responses were received from 302 nu...
60 citations
TL;DR: Interventions to increase the prevalence of breastfeeding among women taking methadone should address identified logistical, educational, and psychological barriers and consider inclusion of women themselves, partners, peers, and clinicians.
Abstract: Background: Despite evidence of low transfer of methadone into breast milk and the potential physical and psychological benefits that breastfeeding offers for methadone-exposed mothers and infants, the rate of breastfeeding initiation in this population is about half that reported nationally. This study describes the perceptions surrounding breastfeeding decisions and management among pregnant and postpartum women taking methadone. Methods: Seven pregnant women and 4 postpartum women enrolled in methadone maintenance programs participated in semistructured, audiotaped interviews and focus groups, respectively, about their breastfeeding experiences. Transcripts were analyzed and coded using qualitative content analysis. Results: Three major content categories were identified: (1) fears, barriers, and misconceptions about breastfeeding while taking methadone; (2) motivation and perceived benefits of breastfeeding; and (3) sources of information, support, and anxiety about general breastfeeding manag...
47 citations
TL;DR: Support groups for families of people who use opioids are promising venues to conduct overdose prevention trainings because attendees are motivated to receive training and will use naloxone to rescue people when witnessing an overdose.
Abstract: Background: In response to the overdose epidemic, a network of support groups for family members in Massachusetts has been providing overdose education and naloxone rescue kits (OEN). The aims of this study were to describe the characteristics, motivations, and benefits of family members who receive OEN and to describe the frequency of naloxone used during an overdose rescue. Methods: This cross-sectional, multisite study surveyed attendees of community support groups for family members of opioid users where OEN training was offered using a 42-item self-administered survey that included demographics, relationship to the individual using opioids, experience with overdose, motivations to receive OEN, and naloxone rescue kit use. Results: Of 126 attendees who completed surveys at 8 sites, most attendees were white (95%), female (78%), married or partnered (74%), parents of an individual using opioids (85%), and providing financial support for the individual using opioids (52%). The OEN trainees (79%)...
TL;DR: Initial data suggest that therapist and computer BIs are promising, increasing perceived importance of reducing drinking, and findings provide clues to potentially beneficial components of BIs.
Abstract: Background: Alcohol brief interventions (BIs) delivered by therapists are promising among underage drinkers in the emergency department (ED); however, integration into routine ED care is lacking. Harnessing technology for identification of at-risk drinkers and delivery of interventions could have tremendous public health impact by addressing practical barriers to implementation. The paper presents baseline, within BI session, and posttest data from an ongoing randomized controlled trial (RCT) of youth in the ED. Methods: Patients (ages 14–20) who screened positive for risky drinking were randomized to computer BI (CBI), therapist BI (TBI), or control. Measures included demographics, alcohol consumption (Alcohol Use Disorders Identification Test—Consumption [AUDIT-C]), process questions, BI components (e.g., strengths, tools), and psychological constructs (i.e., importance of cutting down, likelihood of cutting down, readiness to stop, and wanting help). Results: Among 4389 youth surveyed (13.7% re...
TL;DR: Results from this study suggest that the relationship between the onset of substance use and later substance abuse may be substance specific.
Abstract: Background: Early onset of alcohol use has been linked to later alcohol problems in adulthood. Currently, it is not clear whether early onset of marijuana and tobacco use similarly predicts alcohol problems. Moreover, most studies examining the effect of early substance use onset on later problems only have followed youth into their early 20s. Therefore, the primary goal of this study was to examine whether early onset of alcohol, marijuana, and tobacco use predicts alcohol problems beyond the transition to adulthood. Methods: The sample included 225 15–19-year-old youth (60% girls; 62% Caucasian) who were surveyed in three time periods: 1993–1998 (Time 1), 1998–2003 (Time 2), and 2003–2007 (Time 3). Participants reported their age of onset for regular drinking, tobacco use, and marijuana use. At each time of measurement, they also completed surveys relating to their alcohol use and abuse. Results: Participants with an earlier age of onset of drinking regularly scored higher on the Michigan Alcoho...
TL;DR: Examination of prevalence, policies, and treatment systems of comorbid substance misuse and psychotic illness in Europe illustrated differences and similarities with US findings, suggesting integrated models implemented following US example might perform differently within the context of well-established EU community mental health services.
Abstract: Background: Most evidence about comorbid addiction and major mental illness comes from the USA, since this literature remains relatively limited in many European countries The purpose of this review was to examine prevalence, policies, and treatment systems of comorbid substance misuse and psychotic illness in Europe, illustrating differences and similarities with US findings Methods: Based on computerized main databases searches, a narrative review was performed Results: The availability of substances but also the social contexts in terms of individual and local issues are factors likely to explain different dual diagnosis prevalence rates in Europe as compared with the USA Conclusions: Integrated models implemented following US example might perform differently within the context of well-established European Union (EU) community mental health services Such programs would require additional resources and radical redesign of service delivery systems
TL;DR: A systematic review of publications that defined and measured N MPO within health insurance claims databases in order to describe definitions of NMPO and identify areas for improvement is conducted.
Abstract: Background: Health insurance claims data may play an important role for health care systems and payers in monitoring the nonmedical use of prescription opioids (NMPO) among patients. However, these systems require valid methods for identifying NMPO if they are to target individuals for intervention. Limited efforts have been made to define NMPO using administrative data available to health systems and payers. We conducted a systematic review of publications that defined and measured NMPO within health insurance claims databases in order to describe definitions of NMPO and identify areas for improvement. Methods: We searched 8 electronic databases for articles that included terms related to NMPO and health insurance claims. A total of 2613 articles were identified in our search. Titles, abstracts, and article full texts were assessed according to predetermined inclusion/exclusion criteria. Following article selection, we extracted general information, conceptual and operational definitions of NMPO,...
TL;DR: This is a version of an unedited manuscript that has been accepted for publication and all legal disclaimers that apply to the journal relate to this version also.
Abstract: While marijuana remains the most widely used illicit drug in the United States1 and is the subject of countless medical, psychological, and sociological studies,2 its potential harms are not fully
TL;DR: The continual need to advocate for education and development of substance abuse practitioners across professions is discussed, and directions for future research are described.
Abstract: Background: Counseling and social work programs educate future practitioners who are likely to be engaged in direct practice with individuals impacted by substance use disorders. Recent changes to policy and practice, including the Affordable Health Care Act and DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), contribute to the ongoing need to develop substance abuse competencies among mental health professionals at all educational levels and across multiple disciplines. Methods: The authors reviewed programs of study and course catalogs identified and accessed online for counselor education, Bachelor of Social Work, and Master of Social Work programs to identify offered and required courses focused on substance abuse, as determined by course title and description. Results: Of the 97 master's-level counseling programs reviewed, 67 required at least 1 course in substance abuse and 12 offered at least 1 elective in substance abuse. Of the 89 Bachelor of Social Work program...
TL;DR: XR-NTX is a cost-effective medication for treating opioid dependence if state addiction treatment payers are willing to pay at least $72 per opioid-free day.
Abstract: . Background: The aim of this study was to estimate the cost-effectiveness of injectable extended-release naltrexone (XR-NTX) compared with methadone maintenance and buprenorphine maintenance treatment (MMT and BMT, respectively) for adult males enrolled in treatment for opioid dependence in the United States from the perspective of state-level addiction treatment payers. Methods: A Markov model with daily time cycles was used to estimate the incremental cost per opioid-free day in a simulated cohort of adult males aged 18–65 over a 6-month period from the state health program perspective. Results: XR-NTX is predicted to be more effective and more costly than methadone or buprenorphine in our target population, with an incremental cost per opioid-free day gained relative to the next-most effective treatment (MMT) of $72. The cost-effectiveness of XR-NTX relative to MMT was driven by its effectiveness in deterring opioid use while receiving treatment. Conclusions: XR-NTX is a cost-effective medicat...
TL;DR: Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving, is safe and effective for active drinkers, and may thereby support harm reduction goal setting.
Abstract: Background: Abstinence-based alcohol interventions are minimally desirable to and effective for chronically homeless individuals with alcohol dependence who have multimorbidity and high publicly funded service utilization and associated costs. Lower-barrier, patient-centered combined pharmacobehavioral interventions may more effectively treat this population. Harm reduction counseling involves a nonjudgmental, empathic style and patient-driven goal setting that requires neither abstinence nor use reduction. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving, is safe and effective for active drinkers, and may thereby support harm reduction goal setting. The aims of this 12-week, single-arm pilot were to initially document some aspects of feasibility, acceptability, and alcohol outcomes following XR-NTX administration and harm reduction counseling for chronically homeless individuals with alcohol dependence. Methods: Participants ...
TL;DR: Social support predicted perceived improvement in all of the areas examined (e.g., health, family/social relationships) and abstinence; however, attachment style did not predict improvement or with readiness to change.
Abstract: Background: A basic principle within the addictions treatment field is that social support is a vital ingredient in the recovery process. This study examines the nature of social support in a sample of opioid-dependent men and women who are currently being treated in a medication-assisted treatment program (methadone). This research examines the types of social support behaviors that the opioid-dependent individuals consider helpful and explores whether attachment style (i.e., secure, ambivalent, or anxious attachment) was a determining factor in whether social support was perceived as helpful. The dependent variables included readiness to change addictive behaviors and abstinence from other mood-altering drugs. Methods: Participants (N = 159) completed a demographic questionnaire, the Significant Others Scale, the Experiences in Close Relationships Scale, the Multidimensional Scale of Perceived Social Support Assessment, the Readiness to Change Scale, and an Attachment Style Questionnaire. The de...
TL;DR: Recovery was seen as a process rather than a fixed goal, confirming that there is a need for services to negotiate individualized recovery goals, spanning harm minimization and abstinence-oriented treatment approaches.
Abstract: Background: This study aimed to explore the client experience of long-term opiate substitution treatment (OST). Methods: A qualitative grounded theory study set in a UK rural community drug treatment service. Results: Continuous OST enabled stability and a sense of “normality.” Participants expressed relief at moving away from previous chaotic lifestyles and freedom from the persistent fear of opiate withdrawal. However, for some, being on a script made them feel withdrawn, lethargic, and unable to fully participate in mainstream society. Intrapersonal barriers (motivation and fear) were perceived as key barriers to abstinence. Conclusions: Participants experienced long-term OST as a transition between illicit drug use and recovery. Recovery was seen as a process rather than a fixed goal, confirming that there is a need for services to negotiate individualized recovery goals, spanning harm minimization and abstinence-oriented treatment approaches.
TL;DR: Results suggest a significantly lower rate of hospitalizations among navigation participants, although the rate of emergency department/urgent care visits was not improved and follow-up was limited by rearrests.
Abstract: Background: Former prison inmates experience high rates of hospitalizations and death during the transition from prison to the community, particularly from drug-related causes and early after release. The authors designed a randomized controlled trial (RCT) of patient navigation to reduce barriers to health care and hospitalizations for former prison inmates. Methods: Forty former prison inmates with a history of drug involvement were recruited and randomized within 15 days after prison release. Participants were randomized to receive 3 months of patient navigation (PN) with facilitated enrollment into an indigent care discount program (intervention) or facilitated enrollment into an indigent care discount program alone (control). Structured interviews were conducted at baseline, 3 months, and 6 months. Outcomes were measured as a change in self-reported barriers to care and as the rate of health service use per 100 person-days. Results: The mean number of reported barriers to care was reduced at ...
TL;DR: The high toll in human suffering and economic costs due to morbidity and mortality from opioid misuse and opioid use disorders is well documented as discussed by the authors, and well-known statistics have captured the nation's a...
Abstract: The high toll in human suffering and economic costs due to morbidity and mortality from opioid misuse and opioid use disorders is well documented. Well-known statistics have captured the nation's a...
TL;DR: Research staff perceive that cell phones, Internet searches, and social networking sites were effective tools to achieve high follow-up rates in drug abuse research.
Abstract: Background: The growing use of newer communication and Internet technologies, even among low-income and transient populations, require research staff to update their outreach strategies to ensure high follow-up and participant retention rates. This paper presents the views of research assistants on the use of cell phones and the Internet to track participants in a multisite randomized trial of substance use disorder treatment. Methods: Preinterview questionnaires exploring tracking and other study-related activities were collected from 21 research staff across the 10 participating US sites. Data were then used to construct a semistructured interview guide that, in turn, was used to interview 12 of the same staff members. The questionnaires and interview data were entered in Atlas.ti and analyzed for emergent themes related to the use of technology for participant-tracking purposes. Results: Study staff reported that most participants had cell phones, despite having unstable physical addresses and ...
TL;DR: Greater attention is needed on the development, evaluation, and implementation of 3 preventive strategies aimed at fully informing adults prescribed opioids about the risks of opioids to family members and others and educating parents on safe disposal options.
Abstract: Pharmaceutical opioid prescribing, opioid use disorders, and related poisonings have increased substantially in the last decade. In particular, pharmaceutical opioid deaths among youth have markedly increased. One area that has received relatively little attention is the role of home safety, given that parents are an important source of opioids for youth. Parents may intentionally share opioids with youth, due to low perceived risks or limited knowledge, and youth may divert opioids from parents’ medicine cabinets. Safe medication storage has long been mandated by treatment programs that provide pharmacologically supported treatment of opioid use disorders, but it is not generally encouraged or required for pharmaceutical opioids prescribed for pain. Greater attention is needed on the development, evaluation, and implementation of 3 preventive strategies. These 3 strategies can be delivered in or supported by adult medical practices: (1) fully informing adults prescribed opioids about the risks of...
TL;DR: Evidence of training satisfaction, increased confidence in talking to adolescents about substance use, and widespread use of recommended practices immediately following training is found.
Abstract: Background: Screening, brief intervention, and referral to treatment (SBIRT) is recommended as part of routine health care for adolescents as well as adults. In an effort to promote universal SBIRT, the Substance Abuse and Mental Health Services Administration awarded funding to residency programs to develop and implement SBIRT education and training. Our project focused on creating scientifically based, developmentally appropriate strategies and teaching materials for the adolescent age range. This paper describes curriculum development and implementation and presents evaluation data. Methods: Pediatric and child psychiatry residents were trained. The training consisted of 4 activities: (1) case-based teaching modules, (2) role-play of motivational interviewing and brief interventions, (3) mock interviews with trained adolescents, and (4) supervised “hands-on” screening and brief interventions. Main outcome measures included trainee satisfaction, and SBIRT knowledge, perceived self-efficacy, and ...
TL;DR: The potential to initiate BMT at harm reduction agencies is highly favorable among harm reduction clients, especially among those experiencing barriers to BMT.
Abstract: . Background: Harm reduction agencies complement addiction treatment by providing diverse services that improve the health of people who use drugs. Buprenorphine maintenance treatment (BMT) is an effective opioid addiction treatment that may be provided from flexible settings, potentially including harm reduction agencies. This study investigated attitudes toward different potential sites for BMT (harm reduction agencies, general medical clinics, and drug treatment programs) among harm reduction clients. Methods: Using computer-based interviews, participants indicated preferred potential site for BMT (harm reduction agency, drug treatment program, or general medical clinic), interest in BMT by potential site, motivation for treatment, and barriers to BMT. Multivariable logistic regression was used to determine factors associated with harm reduction agency preference. Results: Of 102 opioid users, the most preferred potential site for BMT was a harm reduction agency (51%), whereas fewer preferred g...
TL;DR: College students who reported engaging in NMUPD while driving were significantly more likely to report the use of alcohol, marijuana, ecstasy, cocaine, methamphetamine, ketamine, GHB (γ-hydroxybutyric acid), rohypnol, and mephedrone.
Abstract: Background: Over the past 20 years, there has been a dramatic increase in the nonmedical use of prescription drugs (NMUPD). However, minimal attention has been given to driving under the influence of prescription drugs used nonmedically. Methods: This study examines attitudes and characteristics that might be associated with driving while engaging in NMUPD. College students (N = 763) aged 18–25 years completed online surveys assessing demographic information, NMUPD, recreational use of other drugs, psychological variables, attitudes towards NMUPD and driving, and driving behavior. Results: Overall, 28.0% of participants reported lifetime NMUPD; 12.2% reported ever driving while engaging in NMUPD; and 7.9% reported this behavior in the past 3 months. Participants who reported engaging in NMUPD while driving were significantly more likely to report the use of alcohol, marijuana, ecstasy, cocaine, methamphetamine, ketamine, GHB (γ-hydroxybutyric acid), rohypnol, and mephedrone. These participants als...
TL;DR: This paper conducted interviews with Latino day laborers and 13 interviews with mental health and substance use providers that serve Latino immigrant men to identify sources of mismatch between traditional screening and brief intervention in their target population.
Abstract: Background: Brief intervention is known to reduce drinking in primary care; however, because health care access is limited for Latino immigrants, traditional brief interventions are unlikely to reach this population. Methods: Using Barrera and Castro's framework, our study aims to culturally adapt a screening and brief intervention program to reduce unhealthy alcohol use among Latino day laborers, a particularly vulnerable group of Latino immigrant men. We conducted 18 interviews with Latino day laborers and 13 interviews with mental health and substance use providers that serve Latino immigrant men. Interviews were conducted until saturation of themes was reached. Themes from interviews were used to identify sources of mismatch between traditional screening and brief intervention in our target population. Results: Unhealthy alcohol use was common, culturally accepted, and helped relieve immigration-related stressors. Men had limited knowledge about how to change their behavior. Men preferred to r...
TL;DR: Personal motivation to abstain and abstinence goal predicted motivation to reduce contact with substance-using peers, and network structure predicted perceived difficulty of network change, highlight the potential utility of addressing motivation and perceived difficulty to change the peer network as part of youth network-based interventions.
Abstract: Background: Among youth in substance use treatment, peer substance use consistently predicts worse treatment outcomes. This study characterized personal (egocentric) networks of treated youth and examined predictors of adolescents’ motivation and perceived difficulty in making changes in the peer network to support recovery. Methods: Adolescents (aged 14–18; N = 155) recruited from substance use treatment reported on substance use severity, motivation to abstain from substance use, abstinence goals such as “temporary abstinence,” motivation and perceived difficulty in reducing contact with substance-using peers, and personal network characteristics. Personal network variables included composition (proportion of abstinent peers) and structure (number of network members, extent of ties among members) for household and nonhousehold (peer) members. Results: Although a majority of peer network members were perceived as using alcohol or marijuana, youth in treatment had relatively high motivation to abs...