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Faith-based beliefs are associated with and considered to be a vital component in enhancing the efficacy of substance abuse treatment and recovery. However, relatively little empirical information has been accumulated on the temporal stability of individuals' use of faith and its importance before and following initiation of the therapeutic process. The current study examined persistence in turning to faith across time as a predictor of substance use, criminal behavior, and perceived addiction severity in a sample of 500 Kentucky Drug Court participants. Results suggest that when modeling variance in faith, which persists across the two-year span of Drug Court involvement as a latent construct, greater persistence in one's faith predicts decreases in substance use frequency measured at the final 24-month interview. The latent faith construct was marginally related to differences in 24-month criminal behavior and was not associated with perceptions of addiction severity. Results are discussed for substance abuse treatment needs and recovery.

Extensive research suggests that marijuana use tends to precede the use of other illicit substances among adolescents. At the same time, there remain two viable interpretations of such research. First, marijuana use may cause an increase in one's probability of using other drugs. Second, the correlation between marijuana use and other drug use may be spurious, reflecting the influence of one or more 'third variables' that simultaneously cause both behaviors. The present paper provides an empirical assessment of each view using panel data from three waves of the National Youth Survey. Even after adjusting for the influence of variables derived from strain theory, social bonding theory, and differential association theory, a series of longitudinal logistic regression analyses fail to disconfirm the hypothesis that marijuana use exerts a causal influence on one's probability of using other illicit substances. A three-wave panel model adjusting for the influence of unmeasured variables yields similar results.

We tested a theoretical model that posited direct and interactive relationships between personality and environment as predictive of problem drug use. Hierarchical regression analyses were performed on data from a nonclinical sample of males and females first tested in adolescence and followed into young adulthood. In main effects analyses, cross-sectional models for marijuana and a composite of 'harder' drugs strongly supported our theoretical perspective: several environmental and personality variables significantly predicted concurrent problem use. Longitudinal analyses produced mixed results, with either smaller numbers of significant personality/environment predictors or personality predictors dropping out completely. Peer drug use and depression best predicted problem 'hard' drug use, while motivations to use with others and disinhibition best predicted problem marijuana use. Personality/peer group interactions were significant both cross-sectionally and longitudinally, indicating that membership in a problem-using social network enhanced the predictive ability of, or helped bring to fruition, several personality predisposers.

Our study targets an understanding of the drug-related identity change process, which may offer important sociological insights into the etiology of drug abuse. Our work is grounded in symbolic interactionism, cultural studies, and an extant drug-identity model (Anderson 1994). We use a quantitative survey instrument and retrospective accounts to test our model with a representative sample of white and black females and males seeking treatment for drug abuse in mid-Michigan. Our data show that for many drug-related identity change began in childhood and early adolescence with marginalizing experiences that helped create ego identity discomfort and lost control in defining an identity before drug use Identification with a drug subculture offered alternative identities to resolve such predicaments. Additionally, we found that identification with a drag subculture significantly reduced ego identity discomfort during drug use; which, thereby, substantiates the claim that subcultures can act as solutions to individual problems and predicaments.

We used data from the screening phase and first two waves of a panel study to compare the home environments of families with a substance-abusing parent, families with a depressed parent, and families in a comparison group. We diagnosed substance use disorder and affective disorder by administering the Structural Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) to each participating parent. The data suggest that families in which parents display a substance use disorder are very similar to those in which parents suffer from affective disorder, in terms of negative life events and lower family cohesion. The results of structural equation modeling indicate that parental substance use disorder and parental affective disorder influence adolescent substance use and depressive symptoms. In addition, parental substance use disorder has a direct influence on adolescent substance use at the time the first-wave data were collected, but this effect does not persist over time.

This paper applies the risk factor approach to assess the influence of protection and risk on five measures of substance use: overall involvement in drugs, frequent alcohol use, frequent illegal drug use, frequent drug abuse, and quantity of daily cigarette consumption. For each measure, it was hypothesized that an index of risk factors would serve to increase the likelihood of the occurrence of problem behavior and that an index of protection would result in a reduction. It was also hypothesized that under conditions of high risk the effect of protection would moderate the influence of risk factors more forcefully than under conditions of low risk. Data were obtained from a self-report questionnaire containing over 60 risk and protective measures administered to nearly 400 grade 9 students in 7 high schools located in Toronto, Canada. Measures were tested in a series of regression equations to construct indices of risk and protective factors for each substance measure. Results supported the hypothesis of separate risk and protective factor main effects for all categories of substances. Evidence of moderate to strong interaction effects (i.e., a moderating influence of protection) were also noted. Implications are discussed for methods of identifying high risk youth as well as programs designed to prevent/reduce problem behaviors among this group.

In order to understand the nature and intensity of the debate over the reform of 'drug' legislation, it is necessary to appreciate the aesthetic forces which influence attitudes to this question, and the symbolic meaning which is attached to the imagery of drugs. The 'war on drugs' is a war about emotional imagery and contested symbols, and in particular about the idea of the boundary - a matter crucial to the metaphysics and social organization of Western society. At the same time, it will be argued, it is the failure to recognize that we are dealing with the symbolic realm which bedevils both drug users and legislative policy. The reification of symbols causes and perpetuates the very problems that are intended to be solved. In their fetishization of the objects of drug use, the law and the addict are far more alike than one might think.

The psychopathology of drug addiction is reviewed. Empirical research data on a time span of more than twelve years are presented. The data support a four-type-based classification of drug abusers, and the family structure underlining such personality types is analyzed. Clinical cases are presented. Type A addicts (adjustment disorders) present an evident relation between the external event, psychic trauma, and drug-abusing behavior. Type B (neurotic disorders) have a tendency to reduce internal anxiety by drug abuse, and their personal problems may be covered by drug use. Type C (psychosis and borderline) are a heterogeneous group, where often drug use can create an intense experience of inner freedom. Type D (sociopathic personality disorders) often express their psychic conflicts by means of serious acting-out, and come from families were 'nonexistent' marriages were established. Intervention in public health services is examined, as well as the evolution of the addiction depending on the typology. The special cases of information on HIV infection prevention and overdose risk are also evaluated. It is concluded that the typology of drug addicts may shed light on prevention and therapy, whereas more specific therapeutic programs are needed.

Although a causal connection between self-esteem and drug use might make intuitive sense, a critical evaluation of the research calls this relationship into question. The most fatal flaw in the 'low self-esteem causes drug use' argument is the fact that only a very small proportion of the variance in drug use is associated with self-esteem across a variety of definitions of self-esteem. In addition, the literature is fraught with methodological and statistical problems that severely limit the conclusions that can be drawn. Methodological problems examined in the article include: measurement of self-esteem, measurement of drug use and abuse, inclusion of confounding variables, and tendency to infer causality from correlational data. Statistical problems explored are: differences between the results of studies employing multivariate and bivariate statistics, failure to report strength of association indices, inflated experimentwise error rate when conducting numerous statistical analyses, failure to collapse several highly correlated variables into fewer factors, tendency to misinterpret statistical data, and reporting insufficient statistical information to allow readers to draw their own conclusions. We conclude that the scientific evidence relating self-esteem and drug use is insufficient to justify making self-esteem enhancement the cornerstone of drug prevention efforts.

The current debate over the disease model of addictive behaviors is briefly reviewed, and the ill-will between some advocates and opponents of disease conceptions is noted. The recognition that language distinguishes humans from other living beings is introduced, in which one's reality is generated linguistically. This is fundamentally divergent from the rationalistic view that there is an objective world, free of observer bias, that language seeks to describe. Consequently, diseases are seen as interpretations, or attempts to ascribe meaning to a set of observations. Since meaning happens only in language, diseases are necessarily linguistic distinctions, and not physical entities. The author recommends efforts be directed toward developing innovative treatment approaches, rather than quarreling over the veracity of addiction as disease. Listening for the explicit and implicit rules that patients live by and assisting them to invent new realities and practices in language that permit more productive moves is advocated.

The concept of addiction has been misused and misunderstood probably more than any other term relating to alcohol and drug use. Addiction is a troublesome concept not only in the arena of public discourse, but recently even in the professional and research literature. The traditional concept emphasized physical dependence as the central component of the concept, but never definitions have broadened the concept to include any hard-to-stop habit and any drug use that one want to condemn. I suggest that the newer concepts have an ideological component to them which tends to reduce precision in the interest of getting on the right side of the war on drugs. The clearest example of this is what happended in the 1980's in the redefinition of cocaine from a non-addictive drug to an addictive drug, even though the most recent research evidence on cocaine continues to find that it does not produce physical dependence. I propose a definition of addiction for theoretical and research purposes that is basically a reiteration of the traditional concept.

Although many psychoactive substances have been associated with violent behavior, only a subgroup manifests excessively aggressive behavior when sober or intoxicated. Theories to explain addictive behaviors in general may directly relate to the specific proclivity to exhibit excessive aggression in this subset of users. Certain personality traits and cognitive deficits coexist in individuals prone to both drug abuse and violence, suggesting a common origin. Because these excessive and compulsive behaviors have been linked with aberrations in the metabolism and activity of the neurotransmitters dopamine and serotonin, their origins may be partly genetic or biological. Alterations in neurotransmitter function influence activities within the brain's reward center to perturb nervous system arousal levels, thereby increasing stimulation-seeking behaviors. Manifestations of these neurobiological aberrations can be measured in physiological and biochemical processes that serve to mediate these behavioral and psychological outcomes.

We investigated the relationship between the drug use norms of young adults' peers (recalled from age 15) and subject's drug use in the past 12 months. Subjects included two samples of 18-24 year olds from a low income, minority neighborhood in New York City: A probabilistically selected household sample, and a targeted sample of users of cocaine, heroin, crack or injected drugs. Norms varied by drug, and were least negative for marijuana, and increasingly negative for cocaine, heroin, crack, and injected drugs. We found a strong relationship between recalled norms and current use both for individual drugs and for a hierarchically defined level of drug use; this relationship remained significant after controlling for sociodemographics and parental and sibling drug use. Intervention programs for young teens that influence peer selection and norms of groups of adolescents should be developed and tested. Research is needed on the social, economic, political, and other determinants of norms in their neighborhood contexts.

We evaluated the importance of interviewer and subject effects on cocaine and marijuana use disclosure in a sample of over 3,000 male juvenile arrestees. Analyses evaluated the viability of Social Attribution and Conditional Social Attribution models of interviewer effects. The viability of alternative models was investigated in the context of comparative analyses excluding and including statistical adjustments for the clustering of responses by interviewers. Interviewer effects were more salient in models predicting marijuana disclosure than in models predicting cocaine disclosure. Logistic regression analyses provided support for Social Attribution and Conditional Social Attribution models of interviewer effects. Models suggested large interviewer cluster effects. Cluster adjustment altered interpretation of effects for both cocaine and marijuana. Subject race/ethnicity effects were salient in models predicting disclosure for both drugs, but were especially large in models predicting cocaine disclosure.

Ephemeral stages in the use of licit and illicit substances have been documented for several decades. Sophisticated analyses have repeatedly demonstrated that 'gateway' substances, such as alcohol and tobacco, emphasize early roles in a drug-using pathway. Adolescents are unlikely to use marijuana without first using alcohol and tobacco, and will not use more serious drugs, such as cocaine and heroin, without first using marijuana. To date, however, most research has focused on non-deviant populations. In the current analysis, non-recursive path models are estimated on a population of 1,252 adult Philadelphia arrestees surveyed through the Arrestee Drug Abuse Monitoring (ADAM) Program. Analyses confirm patterns of drug escalation among arrestees with 'soft,' 'alternative,' and 'hard' central nervous system (CNS) modifying drugs. Generalizability and intervention strategies are discussed.

Much of the research literature on the validity of self-reported drug use, primarily drawn from studies of males in criminal justice and drug treatment populations, has focused on whether subjects positive for drug use by an objective measure such as urinalysis actually report recent drug use. Few studies have investigated correlates of underreporting in these populations. Using a sample of 437 female arrestees, we examined correlates of underreporting previously identified in the research literature. Findings suggest that female arrestees without prior treatment experience or charged with a nondrug offense were less likely to report recent cocaine use than their counterparts who had previously been in treatment or were charged with a drug offense. These correlates did not apply to recent heroin use. Some support was found for race as a correlate of underreporting. Implications of the findings for the measurement of drug use in arrestees are discussed.