Prevalence and distribution of illicit drug use in the workforce and in the workplace: Findings and implications from a U.S. National survey.

This U.S. national study explored the overall prevalence, frequency, and distribution of illicit drug use in the workforce and in the workplace during the preceding 12 months. Illicit drug use in the workforce involved an estimated 14.1% of employed adults (17.7 million workers). Illicit drug use in the workplace involved an estimated 3.1% of employed adults (3.9 million workers). Illicit drug use in the workforce and in the workplace is not distributed uniformly in the employed population. At-risk, though circumscribed, segments of the U.S. workforce were identified with prevalence rates up to 55.8% for any use of illicit drugs and up to 28.0% for illicit drug use in the workplace. The implications of these data for future theoretical research and for management policy and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonproblem drinking outcomes in adolescents treated for alcohol use disorders.

Change to nonproblem drinking was studied in 159 adolescents (70% male) presenting for alcohol use disorders (AUDs) treatment. A community sample (n=148, 47% male) also was assessed. Clinical participants had a current AUD at baseline; 1 year later, 17% remained abstinent, 60% had at least 1 AUD symptom (problem drinkers), and 23% were drinking but had no AUD symptoms (nonproblem drinkers). Drinking among the nonproblem drinkers decreased and was lower than in the problem drinkers. Nonproblem drinkers increased in psychosocial functioning and decreased in the number of illicit drugs used relative to problem drinkers and generally did not differ from the abstainers. The results suggest alternative views of treatment goals, relapse, and treatment outcome in adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work-related risk factors and employee substance use: Insights from a sample of Israeli blue-collar workers.

Although studies have found evidence that certain workplace conditions in North American enterprises may serve as risk factors for alcohol and illicit drug use, little is known regarding the generalizability of these findings to enterprises in other countries. To address this gap, we collected data from a random sample of 569 blue-collar workers employed in nine different facilities of one of Israel's largest manufacturing firms. The results of zero-inflated Poisson and ordered probit regressions partly confirmed earlier findings reported in North America, with a heightened rate of a substance use among those perceiving (a) more permissive drinking norms, (b) lower supervisor ability to handle substance use problems, (c) greater exposure to job hazards, and (d) lower levels of coworker interactions. Permissive drinking norms were also found to moderate the associations between the other risk factors and substance use. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Clinical outcomes of an integrated treatment for depression and substance use disorders.

The authors compared longitudinal treatment outcomes for depressed substance-dependent veterans (N = 206) assigned to integrated cognitive–behavioral therapy plus standard pharmacotherapy (ICBT + P) or 12-step facilitation therapy plus standard pharmacotherapy (TSF + P). Drug and alcohol involvement and depressive symptomology were measured at intake and at 3-month intervals during treatment and up to 1 year posttreatment. Participants in both treatment conditions showed decreased depression and substance use from intake. ICBT + P participants maintained improvements in substance involvement over time, whereas TSF + P participants had more rapid increases in use in the months following treatment. Decreases in depressive symptoms were more pronounced for TSF + P than ICBT + P in the 6 months posttreatment. Within both treatment groups, higher attendance was associated with improved substance use and depression outcomes over time. Initial levels of depressive symptomology had a complex predictive relationship with long-term depression outcomes. Early treatment response predicted long-term substance use outcomes for a portion of the sample. Although both treatments were associated with improvements in substance use and depression, ICBT + P may lead to more stable substance use reductions compared with TSF + P. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

PTSD treatment and 5-year remission among patients with substance use and posttraumatic stress disorders.

Given the high prevalence of comorbid substance use and posttraumatic stress disorders (SUD-PTSD), how to best treat these patients is a pressing concern for SUD providers. PTSD treatment may play an important role in patients' recovery. One hundred male SUD-PTSD patients who attended SUD treatment completed 1-, 2-, and 5-year follow-ups. Outpatient treatment information was gathered from Veterans Affairs databases. PTSD treatment and 12-Step group attendance in the 1st year predicted 5-year SUD remission. Patients who received PTSD treatment in the first 3 months following discharge and those who received treatment for a longer duration in Year 1 were more likely to be remitted in Year 5. The receipt of PTSD-focused treatment immediately after SUD treatment may enhance long-term remission. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Binge drinking among female veterans affairs patients: Prevalence and associated risks.

This study evaluated the prevalence and associated risks of binge drinking, defined as having ≥4 drinks on an occasion in the past year, in a female patient population. Of 1,259 female Veterans Affairs patients surveyed, 780 reported drinking alcohol in the past year, and 305 (24% of respondents, 39% of drinkers) reported binge drinking in the past year; 84 (11% of drinkers) had done so monthly or more often. Age-adjusted logistic regression analyses indicated that women who reported past-year binge drinking monthly or more often reported significantly increased odds of morning drinking (odds ratio [OR]?=?40.3), others worrying about their drinking (OR?=?38.6), arguments after drinking (OR?=?13.5), hepatitis or cirrhosis (OR?=?3. 1), frequent injuries (OR?=?2.6), smoking (OR?=?3.7), drug use (OR?=?22.2), and multiple sexual partners (OR?=?4.6). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability of self-reported age of substance involvement onset.

The authors investigated the reliability of self-reported age of onset (AO) for alcohol, tobacco (cigarette), and illicit drug involvement. Participants were 410 young adults taking part in an 11-year longitudinal study. A moderate degree of reliability was found for the 3 substances. Despite this level of stability, results illustrate a tendency for reported AOs to increase over time. The trend is more salient for participants who reported younger AOs at the initial assessment. Findings also indicate that, for alcohol and tobacco, more individuals were classified as early onset based on Year 1 compared with Year 11 reports. Despite these systematic changes, at least for alcohol and illicit drugs, age at which onset was assessed did not moderate the association between AO and substance-related outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are work stressors related to employee substance use? The importance of temporal context assessments of alcohol and illicit drug use.

In this study, the author explored the relations of 2 work stressors (work overload and job insecurity) to employee alcohol use and illicit drug use. The primary goal was to explore the importance of temporal context (before work, during the workday, and after work) in the assessment of substance use compared with context-free (overall) assessments. Data were collected from a national sample of U.S. workers (N = 2,790) who took part in a broad cross-sectional survey on workplace health and safety. Consistent with past research, the results fail to support a relation between work stressors and overall measures of alcohol and illicit drug use. However, the results support the relation of work stressors to alcohol and illicit drug use before work, during the workday, and after work. These results provide support for both the stress-induced substance use and stress response dampening propositions of the tension-reduction hypothesis. When exploring the work environment as a potential cause of employee substance use, these results underscore the importance of measures that assess alcohol and illicit drug use in terms of their temporal relation to the workday. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ecological momentary assessment (EMA) in studies of substance use.

Ecological momentary assessment (EMA) is particularly suitable for studying substance use, because use is episodic and thought to be related to mood and context. This article reviews EMA methods in substance use research, focusing on tobacco and alcohol use and relapse, where EMA has been most applied. Common EMA designs combine event-based reports of substance use with time-based assessments. Approaches to data organization and analysis have been very diverse, particularly regarding their treatment of time. Compliance with signaled assessments is often high. Compliance with recording of substance use appears good but is harder to validate. Treatment applications of EMA are emerging. EMA captures substance use patterns not measured by questionnaires or retrospective data and holds promise for substance use research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of PTSD, depression, and substance use disorders on disease burden and health care utilization among OEF/OIF veterans.

Growing evidence suggests that posttraumatic stress disorder (PTSD) is associated with poorer health status (e.g., more medical disease, physical symptoms, and sick visits to health care professionals) among veterans who served in Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq. We investigated whether PTSD, depression, and substance use disorders independently predicted health status over time among OEF/OIF veterans. Information regarding psychiatric and medical conditions and health care utilization was culled for 4,463 OEF/OIF veterans enrolled in Veterans Administration primary care for a period of 6 years. Data were analyzed using multilevel modeling and generalized estimating equations. Results suggest that PTSD, depression, and substance use disorders are independently associated with increased medical disease burden and mental health care utilization but not increased medical health care utilization. The association between PTSD and medical disease burden strengthened over time. These data suggest that OEF/OIF veterans with PTSD may be at risk for increasingly poorer physical health in terms of medical disease burden over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol, Tobacco, and Drug Use Disorders and Personality Disorder Symptoms.

In a nonclinical sample of 395 young adults, the authors evaluated the relations between major personality traits, Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) personality disorder symptoms, and DSM-IV alcohol use disorders (AUDs). Consistent with previous findings, traits related to disinhibition and negative affectivity were consistently associated with AUDs, as were Cluster B personality disorder symptoms (especially antisocial and borderline disorder symptoms). Multivariate analyses revealed that Cluster B symptoms were significantly associated with AUDs above and beyond what was accounted for by personality traits. Further, the authors found differential patterns of relations between other substance use disorders (SUDs; i.e., tobacco dependence and drug use diagnoses) and personality disorder symptoms. Overall, these results suggest that personality disorder symptoms predict unique variance in SUDs that reflect maladaptive aspects of personality traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parents and families as contexts for the development of substance use and substance use disorders.

Parenting and familial influences on substance use and substance use disorders (SUDs) are important areas of study both for theories of etiology and for the development of preventive and treatment interventions. The articles in this special section illustrate both the value and the challenges of studying parenting and familial influences. Noteworthy issues include the need for mediational and moderational models examining the processes by which familial influences operate in a longitudinal framework to consider outcomes in a developmental context. Future directions include a multidisciplinary expansion of these studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in tobacco use among adolescent smokers in substance abuse treatment.

Adolescents with substance use disorders (SUDs) smoke cigarettes more than youth in the general population. Little is known about changes in smoking patterns during and after outpatient SUD treatment. We examined whether receiving SUD treatment had a differential impact on cigarette smoking behaviors of mild (     

Gender differences in psychiatric comorbidity among adolescents with substance use disorders.

The authors examined gender differences in rates of comorbid psychiatric disorders among adolescents with 1 or more psychoactive substance use disorders. Baseline diagnostic data were obtained from 135 adolescents, ages 12 to 19, and their parents-guardians, who participated in a study to develop and efficacy test Integrated Family and Cognitive-Behavioral Therapy. Rates of attention-deficit/hyperactivity disorder and conduct disorder were higher among drug-abusing male adolescents compared with drug-abusing female adolescents. However, high rates of disruptive behavior disorders also characterized drug-abusing female adolescents. Similarly, drug-abusing female adolescents exhibited a higher rate of major depression compared with drug-abusing male adolescents. However, rates of dysthymia, double depression (i.e., major depression and dysthymia), and bipolar disorder were equivalent between genders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping strategy use following computerized cognitive-behavioral therapy for substance use disorders.

Coping strategies are emerging as a predictor of treatment outcome for substance users and may be particularly important among computerized and self-change approaches. We used data from a randomized clinical trial of a computer-based version of cognitive–behavioral therapy (CBT4CBT) to: (1) examine the association between observer ratings of coping skills and self-reported coping strategies; (2) evaluate whether participants assigned to the CBT4CBT program reported greater use of coping strategies compared with those not exposed to the program; and (3) examine the differential effect of coping strategies by treatment group on drug-related outcomes. Individuals (N = 77) seeking treatment for substance dependence at a community-based outpatient substance abuse treatment facility were recruited and randomized to receive treatment-as-usual (TAU), or TAU plus CBT4CBT, with the Coping Strategies Scale administered at baseline and posttreatment. Self-reported coping strategy use was strongly correlated with observer ratings on a role-play assessment of coping skills. Although no significant group differences were found across time for coping strategy use, results suggested that as coping strategy use increased, drug use decreased, and this relationship was stronger for participants who received CBT4CBT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intelligence and substance use.

Why do some individuals choose to drink alcohol, smoke cigarettes, and use illegal drugs while others do not? The origin of individual preferences and values is one of the remaining theoretical questions in social and behavioral sciences. The Savanna-IQ Interaction Hypothesis suggests that more intelligent individuals may be more likely to acquire and espouse evolutionarily novel values than less intelligent individuals. Consumption of alcohol, tobacco, and drugs is evolutionarily novel, so the Savanna-IQ Interaction Hypothesis would predict that more intelligent individuals are more likely to consume these substances. Analyses of two large, nationally representative, and prospectively longitudinal data from the United Kingdom and the United States partly support the prediction. More intelligent children, both in the United Kingdom and the United States, are more likely to grow up to consume more alcohol. More intelligent American children are more likely to grow up to consume more tobacco, while more intelligent British children are more likely to grow up to consume more illegal drugs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: Predictors and substance abuse outcomes.

This study describes binge drinking trajectories from adolescence to emerging adulthood in 238 children of alcoholics and 208 controls. Mixture modeling identified three trajectory groups: early-heavy (early onset, high frequency), late moderate (later onset, moderate frequency), and infrequent (early onset, low frequency). Nonbingers were defined a priori. The early-heavy group was characterized by parental alcoholism and antisociality, peer drinking, drug use, and (for boys) high levels of externalizing behavior, but low depression. The infrequent group was elevated in parent alcoholism and (for girls) adolescent depression, whereas the nonbinger and late-moderate groups showed the most favorable adolescent psychosocial variables. All 3 drinking trajectory groups raised risk for later substance abuse or dependence compared with the nonbingers, with the early-heavy group at highest risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial functioning of adults who experienced substance use disorders as adolescents.

The authors examined whether substance use disorder (SUD) before age 19 was associated with functioning at age 30. Participants (N = 773) were assessed twice during adolescence and at ages 24 and 30. Eight of 14 adult measures were associated with adolescent SUD: education, unemployment, income, risky sexual behavior, suicide attempt, coping, stressful life events, and global adjustment. After adolescent comorbidity and functioning and adult SUD were controlled for, education and unemployment remained associated, and three variables emerged as significant: being a parent (significant only for participants without adult SUD), being currently married, and having decreased life satisfaction (significant only for participants with adult SUD). Adolescent SUD is associated with numerous functioning difficulties at age 30, some of which appear to be related to recurrent SUD, comorbid adolescent disorders, or functioning problems already evident in adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)