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Background and Objectives: This paper examines risk factors of gambling and problem gambling among racial subgroups in the U.S. population, namely Native Americans and blacks, for whom research data are lacking.Methods: Findings are based on a large representative general population survey (n = 3,474) of gambling in the U.S. with an oversample of Native Americans (n = 549). Multiple domains were assessed including sociodemographic factors; ecological factors (census-defined neighborhood disadvantage, geocoded density of casinos within 30 miles of respondents' homes, and perceived gambling convenience); impulsivity; and alcohol abuse.Results: After controlling for all variables in the study, neighborhood disadvantage has a significantly greater effect on overall gambling, frequent gambling, and problem gambling for Native Americans than for the rest of the U.S.Population: In addition, the relationship between frequent gambling and heavier drinking is much stronger for blacks than for the rest of the U.S.Population: Discussion and Conclusions: There is a lack of research on gambling involvement among minority groups in the U.S. Blacks and Native Americans are at a higher risk for problem gambling as compared with the rest of the population. Furthermore, social factors and alcohol abuse may show a stronger co-occurrence with gambling involvement among minority groups than among whites.Scientific Significance: This study is a large representative U.S. sample with sizeable numbers of Native Americans and blacks. Thus, prevalence rates and risk factors can be assessed for these important population subgroups. This will allow for targeted intervention programs for Native Americans and blacks with problem gambling and alcohol abuse. (Am J Addict 2017;26:713-721). [ABSTRACT FROM AUTHOR]

Background and Objectives: Homeless women have shown high rates of substance use disorders (SUD), but many studies are more than a decade old, limited in geographic location, or focus only on women living outdoors or in shelters. The purpose of this study was to obtain a more current and representative sample of homeless women and the prevalence and predictors of substance use disorders among women seeking primary care at Health Care for the Homeless clinics across the US.Methods: Eleven Health Care for the Homeless (HCH) clinics in nine states contributed proportionally to a sample of n = 780 female patients who completed a self-administered survey including demographics, housing history, health, mental health, and drug and alcohol use.Results: Compared to the general population of women, rates were four times higher for an alcohol use disorder, and 12 times higher for a drug use disorder.Discussion and Conclusions: The findings indicate a significant need for SUD services, with an equally high need for mental health services. In addition, high rates of victimization and use of tobacco, and overall poor health status, indicate overall health disparities.Scientific Significance: Addressing barriers to full integration of substance use and mental health services, such as improving screening, reimbursement, clinician training, and addressing biases about motivation of this population to engage in treatment, are necessary to improve the health of women seeking care in HCH settings. (Am J Addict 2017;26:680-688). [ABSTRACT FROM AUTHOR]

Background and Objectives: We conducted a review of the prevalence and co-occurrence of 12 types of addictions in US ethnic/racial groups and discuss the implications of the results for genetic research on addictions.Methods: We utilized MEDLINE and PsycINFO databases to review the literature on alcohol, tobacco, marijuana, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We present results for each addiction based on total US prevalence, prevalence within ethnic groups, and co-occurrence of addictions among ethnic groups when available.Results: This review indicates very little research has examined the interrelationships of addictive behaviors among US ethnic groups. The studies that exist have focused nearly exclusively on comorbidity of substances and gambling behaviors. Overall findings suggest differences among US ethnic groups in prevalence of addictions and in prevalence of addiction among those who use substances or engage in gambling. Almost no ethnic group comparisons of other addictive behaviors including eating/food, internet, love, sex, exercise, work, and shopping were identified in the literature.Conclusions: Despite large-scale research efforts to examine alcohol and substance use disorders in the United States, few studies have been published that examine these addictive behaviors among ethnic groups, and even fewer examine co-occurrence and comorbidity with other addictions.Scientific Significance: Even with the limited studies, these findings have implications for genetic research on addictive behaviors. We include a discussion of these implications, including issues of population stratification, disaggregation, admixture, and the interplay between genetic and environmental factors in understanding the etiology and treatment of addictions. (Am J Addict 2017;26:424-436). [ABSTRACT FROM AUTHOR]

Background and Objectives: Epidemiologic data on substance misuse prevalence among US Veterans are crucial to plan for Veterans' future healthcare needs. We estimated US Veterans' age-specific, overall, and age-adjusted prevalence of substance misuse, assessed whether prevalence differed between Veterans and civilians, and examined temporal trends in prevalence.Methods: Substance-related measures were obtained from the National Surveys on Drug Use and Health, 2002-2012 (N = 24,210 Veterans; 338,556 civilians).Results: Among women and men Veterans overall, past-month heavy episodic drinking and daily cigarette smoking were the most prevalent types of substance misuse. For Veteran women and men ages 18-25, the prevalence of past-year illicit drug use was 29% and 38%, which was comparable to the prevalence of past-month daily cigarette smoking, and the prevalence of past-year prescription drug misuse was 14% and 18%. For men ages 18-25, heavy episodic drinking, daily cigarette smoking, alcohol use disorder (AUD), and substance use disorder were more prevalent among Veterans than civilians. For women, the age-specific, overall, and age-adjusted prevalence of daily cigarette smoking was generally greater among Veterans than civilians. There was a decreasing temporal trend in overall AUD prevalence among Veteran men, reflecting a decreasing trend in age-specific prevalence among Veteran men ages 35-49.Discussion and Conclusions: Young Veterans' high prevalence of substance misuse, and the generally high prevalence of daily smoking among Veterans, underscore the need for evidence-based assessments and treatment options that are accessible and effective for Veterans.Scientific Significance: This study provides foundational information on the epidemiology of substance misuse among Veterans. (Am J Addict 2017;26:357-365). [ABSTRACT FROM AUTHOR]

Background: Substance use disorders (SUDs), which encompass alcohol and drug use disorders (AUDs, DUDs), constitute a major public health challenge among US veterans. SUDs are among the most common and costly of all health conditions among veterans.Objectives: This study sought to examine the epidemiology of SUDs among US veterans, compare the prevalence of SUDs in studies using diagnostic and administrative criteria assessment methods, and summarize trends in the prevalence of SUDs reported in studies sampling US veterans over time.Methods: Comprehensive electronic database searches were conducted. A total of 3,490 studies were identified. We analyzed studies sampling US veterans and reporting prevalence, distribution, and examining AUDs and DUDs.Results: Of the studies identified, 72 met inclusion criteria. The studies were published between 1995 and 2013. Studies using diagnostic criteria reported higher prevalence of AUDs (32% vs. 10%) and DUDs (20% vs. 5%) than administrative criteria, respectively. Regardless of assessment method, both the lifetime and past year prevalence of AUDs in studies sampling US veterans has declined gradually over time.Conclusion: The prevalence of SUDs reported in studies sampling US veterans are affected by assessment method. Given the significant public health problems of SUDs among US veterans, improved guidelines for clinical screening using validated diagnostic criteria to assess AUDs and DUDs in US veteran populations are needed.Scientific Significance: These findings may inform VA and other healthcare systems in prevention, diagnosis, and intervention for SUDs among US veterans. [ABSTRACT FROM AUTHOR]