Cognitive motivations for drug use among adolescents: Longitudinal tests of gender differences and predictors of change in drug use.

Four factors were found to reflect 15 reasons for drug use, Enhance Positive Affect and Creativity, Reduce Negative Affect, Social Cohesion, and Addiction. These factors were found to reflect second-order latent factors of Alcohol Motivations as well as Cannabis Motivations and to be invariant by sex. All Alcohol and Cannabis Motivation scales were significantly correlated with actual use of alcohol, cannabis, cocaine, and hard drugs. In both bivariate and latent variable longitudinal analyses over a 1-yr period, motivations for alcohol use increased actual use of alcohol, whereas motivations for cannabis use increased all types of drug use. Very similar patterns of effects were noted for boys and girls. We conclude that self-acknowledged cognitive motivations or reasons for drug use are important etiological factors in understanding actual drug-use behavior and discuss the counseling and prevention implications of these results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns and correlates of initial and subsequent drug use among adolescents.

Studied survey data collected in 1978–1981 examining prior and current drug use in 8th, 10th, and 12th graders in Maryland public schools. A 6-variable model (legal drugs, cannabis, pills, psychedelics, cocaine, and heroin) was used to examine the sequential and cumulative nature of drug use in a sample of 2,036 students drawn from a total sample of 34,479 males and females. Guttman scaling, using current use data for both the original and a cross-validational sample, found a stable, sequential, and cumulative hierarchy of drug use in all grades. Regression analysis of psychosocial variables found that age at first use; frequency of use of marihuana, alcohol, and cigarettes; and amount of available spending money emerged as significant predictors of use, but with little difference in predictors between the 6 drug categories. For individuals who go on to hard drug use, the data indicate that initiation into the sequence begins with a legal substance such as alcohol or tobacco and proceeds through use of marihuana. The relationship between prevalence, as well as intensity of drug use, and several psychosocial variables (e.g., academic goals, grades, spending money) emphasizes the need for further causal modeling. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple protective and risk factors for drug use and abuse: Cross-sectional and prospective findings.

A conceptual elaboration was developed that incorporates many risk and protective factors, and both direct and moderating (buffering) influences on drug involvement were tested. From prospective data, 14 factors related to drug use were selected and assigned empirically to either a multiple protective index (PFI) or a risk factor index (RFI). Analyses examined the relationship of the RFI, PFI, and their interaction on measures of cigarette, alcohol, cannabis, cocaine, and hard drug use cross-sectionally in late adolescence and later in young adulthood. These same variables were used to predict alcohol, cannabis, and cocaine abuse 8 yrs later. Vulnerability as measured by the RFI, PFI, and their interaction was highly associated with drug use in adolescence, moderately associated with certain types of drug use in young adulthood, and strongly associated with heightened drug problems in adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs about the harmfulness of drug use in adults who use different drugs.

255 college students in different categories of drug use (abstainers, low alcohol users, high alcohol users, cigarette users, marijuana users, and cocaine users) rated the harmfulness of several factors of drug use, including type of drug (cigarettes, alcohol, marijuana, and cocaine), frequency of use (weekly vs daily), location of use (never at work vs sometimes at work), SES of the user (custodial worker vs CPA), and the pregnancy status of the user. Results show that Ss with greater drug experience had lowered concerns about harmfulness and more differentiated beliefs, not only for the drug or drugs that they were using but also for drugs that they were not using. Heavier use of alcohol was associated with lowered concern about the harmfulness of as-yet-untried drugs. Intervention may need to be aimed at changing systems of beliefs people have about drug use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cannabis versus other illicit drug use among methadone maintenance patients.

Few data exist on the prevalence and consequences of cannabis use among methadone maintenance patients. Weekly urine toxicology data from 70 patients in a methadone program were analyzed for evidence of cannabis as well as cocaine and benzodiazepines, and the relationship between use of these drugs and opiate use was examined. Patients who were positive for both cocaine and benzodiazepine, but not those positive for cannabis, were more likely also to test positive for opiates. Related literature is reviewed, and the issue of illicit drug use among such patients is discussed in the context of harm reduction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concurrent use of cocaine and alcohol is more potent and potentially more toxic than use of either alone--a multiple-dose study

BACKGROUND: Simultaneous abuse of cocaine and alcohol is widespread and increasingly detected in patients seeking emergent care. This double-blind, randomized, within-subjects study used a paradigm more closely approximating practices of drug abusers to better understand the pathogenesis of cocaine-alcohol abuse. METHODS: Subjects meeting DSM-IV criteria for cocaine dependence and alcohol abuse participated in three drug administration sessions: four doses of intranasal cocaine (1 mg/kg every 30 min) with oral alcohol (1 g/kg) administered following the initial cocaine dose and a second dose (120 mg/kg) at 60 min calculated to maintain plasma alcohol concentration at approximately 100 mg/dL during cocaine administration; four doses of cocaine/placebo alcohol; four doses of cocaine placebo/alcohol. Pharmacokinetic, physiological, and behavioral effects were followed over 8 hours. RESULTS: Cocaine-alcohol produced greater euphoria and increased perception of well-being relative to cocaine. Heart rate significantly increased following cocaine-alcohol administration relative to either drug alone. Cocaine concentrations were greater following cocaine-alcohol administration. Cocaethylene had a longer halflife with increasing concentrations relative to cocaine at later time points. CONCLUSIONS: Enhanced psychological effects during cocaine-alcohol abuse may encourage ingestion of larger amounts of these substances over time placing users at heightened risk for greater toxicity than with either drug alone.     

Substance use diagnosis within a community sample of adults: Distinction, comorbidity, and progression over time.

Practicing psychologists conceptualize, assess, and treat clients who use substances in different ways. Using longitudinal data from a multiethnic community sample of 470 adults, the authors examine patterns of abuse and dependence on alcohol, marijuana, and cocaine. Men were significantly more abusive, dependent, and polysubstance dependent on all drugs than women. A large percentage of drug abusers, and over 1/3 with drug dependence, remitted without formal treatment. However, early severe problems with cocaine increased later alcohol problems. Traditional disease progression and drug use acquisition models are not supported. Psychologists should incorporate the natural course of substance use into treatment and prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance use and abuse among children and teenagers.

During the past several years, there has been a renewed national concern about drug abuse, culminating in the current "war on drugs." In this review, we emphasize that even though child or teenage drug use is an individual behavior, it is embedded in a sociocultural context that strongly determines its character and manifestations. Our focus is on psychoactive substances both licit (cigarettes and alcohol) and illicit (e.g., cannabis and cocaine). We feel that it is critical to draw a distinction between use and abuse of drugs and to do so from a multidimensional perspective that includes aspects of the stimulus (drug), organism (individual), response, and consequences. Our selective review of substance use and abuse among children and adolescents covers epidemiology (patterns and extent of drug use), etiology (what generates substance use), prevention (how to limit drug use), treatment (interventions with drug users), and consequences (effects and outcomes of youthful drug use). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-generated drug outcomes in high-risk adolescents.

The perceived outcomes of drug use were studied in a sample of high-risk adolescents. Participants' self-generated responses provided the actual words they used to describe drug outcomes as well as associative frequency norms valuable for future research. The authors also compared outcomes in terms of class of outcome (positive vs. negative) and class of drug (alcohol, marijuana, cigarettes, cocaine, speed, and LSD). Although the studied drugs have divergent pharmacological effects. participants self-generated some of the same outcomes (e.g., relaxation) across some of the drugs. In addition, outcomes self-generated as positive outcomes were very rarely also self-generated as negative outcomes. Finally, regressions revealed that self-generated responses were not predicted by ethnicity, gender, or previous drug use. Many drug use outcomes thus appeared to be available in memory regardless of previous drug use or other characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in neuropsychological functioning over 10 years following adolescent substance abuse treatment.

Previously, Anderson, Ramo, Cummins, and Brown (2010) described six distinct patterns of alcohol and other drug (AOD) use during the decade following adolescents' treatment for alcohol and other substance use disorders (A/SUD). This time period represents a phase of significant neurodevelopment, and the influence of substance use on the brain is a concern. In the present study, we examined patterns of neuropsychological function over these 10 years in relation to the AOD trajectories identified for youth as they transition into their twenties. Participants were part of a longitudinal research project following adolescents with and without A/SUD who received neuropsychological examinations at baseline and up to 7 times thereafter spanning 10 years (N = 213; 46% female at baseline). Neuropsychological trajectories were significantly related to substance involvement patterns over time on measures of verbal learning and memory (ps = .011 to p = .0002), and verbal attention/working memory (p = .020), with heavier use patterns generally followed by poorer cognition. Heavy use of alcohol alone was independently associated with poorer verbal memory over time. Furthermore, substance withdrawal symptoms during each follow-up time point were related to poorer verbal learning and memory scores (ps     

Psychometric Evaluation of Self- and Collateral Timeline Follow-Back Reports of Drug and Alcohol Use in a Sample of Drug-Abusing and Conduct-Disordered Adolescents and Their Parents.

One hundred eighty-eight drug-abusing and conduct-disordered adolescents and their parents provided retrospective reports of the youths' frequency of alcohol and illicit drug use for each of the 6 months preceding their initial session in an outpatient treatment program. Youths' and parent reports of youths' drug and alcohol use for each month were similar. For marijuana and alcohol, frequency reports were related for each month, whereas hard drug reports were related only for the 4 months preceding intake. Relationships among alcohol and hard drug reports were strong during Months 1, 2, and 4 preceding intake, whereas strength of relationship among marijuana reports was similar throughout the 6 months. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recent-onset ecstasy use: Association with deviant behaviors and psychiatric comorbidity.

Background: Despite increases in ecstasy (MDMA) use in the United States, little is known about characteristics linked with recent-onset ecstasy use, especially psychiatric symptoms and deviant behaviors. Aims: To test whether individuals with high levels of other drug use are more likely to be recent-onset ecstasy users; to test whether psychiatric symptoms in adults are associated with recent-onset ecstasy use; to explore the association between recent-onset ecstasy use and concomitant deviant behaviors in adolescents and adults. Methods: Data from the 2001 National Survey on Drug Use and Health. Findings: Recent-onset ecstasy use was significantly more likely to occur among adolescents and adults (18-34 years old) who engaged in deviant behaviors during the past year as compared with those who did not engage in deviant behaviors during the past year. Higher levels of deviancy indicated a higher likelihood of being a recent-onset ecstasy user, and associations were strongest with nonviolent deviant behaviors such as selling illegal drugs and stealing. Associations between deviant behaviors and recent-onset ecstasy use were similar in strength to associations between deviant behaviors and recent-onset cocaine and marijuana use, respectively. Adults who had past-year psychiatric symptoms (both depressive and panic symptoms) were twice as likely to be recent-onset ecstasy users as compared with those without past-year psychiatric symptoms. Greater levels of drug involvement increased the odds of being a recent-onset ecstasy user. Conclusion: Recent-onset ecstasy use seems to be associated with a range of other behavioral problems and may reflect one aspect of a larger problem behavior syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Advances in the assessment of adolescent chemical dependency: Development of a chemical use problem severity scale.

Developed the Personal Involvement with Chemicals Scale (PICS) to measure the extent of psychological involvement in alcohol and drug use by adolescents. The PICS was tested on various adolescent populations including 646 12–18 yr olds receiving chemical dependency evaluation or treatment. Scale development and initial reliability and validity evidence are summarized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug use and validity of substance use self-reports in veterans seeking help for posttraumatic stress disorder.

The present study assessed drug use and the validity of self–reports of substance use among help–seeking veterans referred to a specialty clinic for the assessment of posttraumatic stress disorder (PTSD). Patients (n?=?341) were asked to provide a urine sample for use in drug screening as part of an evaluation of PTSD. Self–reports of substance use were compared with same–day supervised urine samples for 317 patients who volunteered to participate in a drug screening. Results suggested that self–reports were generally quite valid. Only 8% of the cases involved patients not reporting substance use detected by urine screens. A total of 42% of the participants were identified as using drugs of abuse (excluding alcohol) through self–report and urine drug screens. Among participants using drugs, PTSD diagnosis was significantly associated with greater marijuana and depressant use as compared with stimulant (cocaine and amphetamines) use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between adolescent alcohol use and peer alcohol use: A longitudinal random coefficients model.

Longitudinal latent growth models were used to examine the relation between changes in adolescent alcohol use and changes in peer alcohol use over a 3-year period in a community-based sample of 363 Hispanic and Caucasian adolescents. Both adolescent alcohol use and peer alcohol use were characterized by positive linear growth over time. Not only were changes in adolescent alcohol use closely related to changes in peer alcohol use, but the initial status on peer alcohol use was predictive of later increases in adolescent alcohol use and the initial status on adolescent alcohol use was predictive of later increases in peer alcohol use. These results are inconsistent with models positing solely unidirectional effects between adolescent alcohol use and peer alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric comorbidity with problematic alcohol use in high school students

OBJECTIVE: To delineate the degree to which various levels of problematic alcohol use are associated with psychiatric disorders in adolescents. METHOD: The lifetime occurrence of psychiatric disorders was examined in a community sample of 1,507 older adolescents (aged 14 through 18 years) who were categorized according to their alcohol use (i.e., abstainers, experimenters, social drinkers, problem drinkers, and abuse/dependence group). RESULTS: Increased alcohol use was associated with the increased lifetime occurrence of depressive disorders, disruptive behavior disorders, drug use disorders, and daily tobacco use. There was a trend for increased alcohol use in girls to be associated with anxiety disorders. More than 80% of adolescents with alcohol abuse/dependence had some other form of psychopathology. Alcohol disorders, in general, followed rather than preceded the onset of other psychiatric disorders. Comorbidity was associated with an earlier age of alcohol disorder onset and with greater likelihood of mental health treatment utilization. CONCLUSIONS: Rates of psychiatric comorbidity with problematic alcohol use in adolescents are striking and represent an important therapeutic challenge.     

Relationship between self-efficacy perceptions and in-treatment drug use among regular cocaine users

The perceived ability to engage in situation-specific behaviors (self-efficacy) to overcome nicotine dependence and alcohol abuse has been shown to correlate significantly with and be predictive of the actual ability to engage in such behaviors. Self-efficacy is also related to subsequent behavior change during treatment and maintenance of this change after treatment termination. In this study, part of national outcome study, the relationship between self-efficacy and drug use was investigated in a subsample of regular cocaine users (n = 294) who completed at least three months of treatment in community-based outpatient treatment programs. Frequency of cocaine and other drug use was reported for the period of 1 year before treatment and a 1 month and 3 months in treatment. Self-efficacy regarding resisting drug use was measured at 1 and 3 months in treatment. Self-efficacy at 1 month was correlated with cocaine use at 1 month and self-efficacy contributed to the prediction of self-reported drug use at 1 month over and above pretreatment and demographic variables. Similarly, self-efficacy at 3 months was correlated with cocaine use at 3 months and contributed to the prediction of self-reported drug use at 3 months. These outcomes were obtained even though over 75% of subjects reported no drug use during treatment. The results supported previous findings suggesting that increased self-efficacy regarding resisting drug use is associated with lower rates of drug use during treatment, and that self-efficacy enhancement may be an important intervention in the treatment of cocaine use.     

Dependent opioid users assessed for methadone treatment in Otago: patterns of drug use

AIMS: To provide detailed information about the types of drugs used and the patterns of drug use for injecting drug users presenting for methadone treatment. METHODS: A retrospective case note review was carried out for 126 consecutive clients who were assessed for methadone treatment in the Otago province over a 2 year period. Patterns of drug use in the three months prior to presentation were recorded. RESULTS: Over 60% of those presenting were using three or more opioid drugs, with the most common being homebake (63%), sustained release morphine sulphate tablets (62%), buprenorphine (52%), opium poppies (50%) and methadone (41%). Use of diacetylmorphine (heroin) was reported primarily by those returning from recent overseas travel. Most clients reported the regular use of multiple other of clients using benzodiazepines daily. Almost 80% of the group were regular tobacco smokers and 11% showed evidence of alcohol disorders (abuse or dependence). Low levels of use were reported for cocaine, amphetamines, and hallucinogens. CONCLUSION: These patterns of drug use have important implications for the planning of methadone treatment programmes.