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Population-based estimates of substance use patterns have been regularly reported now for several decades. Concerns with the quality of the survey methodologies employed to produce those estimates date back almost as far. Those concerns have led to a considerable body of research specifically focused on understanding the nature and consequences of survey-based errors in substance use epidemiology. This paper reviews and summarizes that empirical research by organizing it within a total survey error model framework that considers multiple types of representation and measurement errors. Gaps in our knowledge of error sources in substance use surveys and areas needing future research are also identified. [ABSTRACT FROM AUTHOR]

This paper reviews some of the potential sources of failure in surveys concerned with substance use. These failures are both conceptual and methodological in nature. Conceptual failures include nonuse and misuse of survey data, the inability of these data to detect emerging substance use trends and problems, and relevant ethical concerns. Methodological failures include sampling, coverage, nonresponse, and measurement and processing errors, which are indigenous at some level to all epidemiologic surveys. Consideration of these is necessary if survey data are to be appropriately used for their intended purposes. [ABSTRACT FROM AUTHOR]

Hair specimens were collected from 322 subjects and analyzed as part of an experimental study administering household surveys during 1997 to a high-risk community sample of adults from Chicago, Illinois. Toxicologic results were compared with survey responses about recent and lifetime drug use. About 35% of the sample tested positive for cocaine, and 4% tested positive for heroin. Sample prevalence estimates of cocaine use based on toxicologic results were nearly five times the survey-based estimates of past month use and nearly four times the survey-based estimates of past year use. With the hair test results as the standard, cocaine and heroin use were considerably underreported in the survey. Underreporting was more of a problem for cocaine than for heroin. Among those who tested positive, survey disclosure of cocaine use was associated with higher levels of cocaine detected in hair. In general, when recent drug use was reported, it was usually detected in hair. When a drug was detected in hair, use was usually not reported in the survey. When heroin was detected in hair, cocaine was almost always detected as well. Am J Epidemiol 1999; 149:955–62. [ABSTRACT FROM PUBLISHER]

This presentation discusses potential associations between dimensions of culture and patterns of substance use. Several well-known frameworks for organizing cultural values and orientations are presented. As an illustration, one framework (Hofstede, 2001) is examined for its relevance in understanding national-level variations in patterns of alcohol and illicit drug use. Two of four cultural dimensions examined, individualism-collectivism and uncertainty avoidance, are found to be independently associated with one or more substance use measures in a diverse sample of 64 nations. Future multi-level analyses that integrate cultural values and orientations into empirical studies will enable more systematic assessments of the role of socio-cultural contexts in substance use epidemiology. [ABSTRACT FROM AUTHOR]

Presents an introduction to the September 2005 issue of the journal "Substance Use and Misuse."

Although lesbians are believed to be at heightened risk for alcohol abuse and alcohol dependency, the reliability and validity of currently available screening measures have yet to be explored in this population group. In this paper, we report the psychometric properties of the CAGE in a diverse sample of 63 lesbians and comparisons with a control group of 57 heterosexual women. Data were collected in Chicago during 1997–1998 using face-to-face interviews. Findings suggest that the CAGE has good reliability and concurrent validity among lesbians. One CAGE item, concerned with drinking in the morning, however, was found to be only weakly associated with the other items among lesbians. Although this pilot study is limited by the nonprobability sample, we conclude that evaluating the appropriateness of other alcohol and drug abuse measures in high-risk populations, such as lesbians, should be a research priority. [ABSTRACT FROM AUTHOR]

To better understand the prevalence, correlates, risk factors and context of club drug use among US adults in the City of Chicago. An Audio Computer-Assisted Self Interview was administered to a household probability sample of adults, aged 18–40 years, from June 2001 to January 2002. Subjects were drawn from randomly selected households using a multi-stage area probability design. The data represent 627 randomly selected adult participants. Weighted prevalence estimates with design-effect adjusted confidence intervals of life-time, past 12 month and past 30 day use of any club drug and of specific club drugs; prevalence of rave attendance, other drug use, motivation for use among club drug users; χ2 tests of significance, logistic regression and adjusted odds ratios. Overall club drug prevalence rates were nearly twice those obtained for MDMA alone. Club drug users were more likely to use multiple illicit substances and to report having been in treatment for substance use. A majority of life-time club drug users never attended a rave although rave attendees were more likely to report frequent use of MDMA. Use was associated with gender, race and sexual orientation. Prevention research should be informed by further population-based research on club drug use. Research should not focus exclusively on rave attendees, as they are only a subset of club drug users. Research is needed on neurological and behavioral sequelae across different types of club drugs, gender differences in the impact of sexual orientation on club drug risk and on the effects of personality characteristics such as sensation seeking on club drug use behavior. [ABSTRACT FROM AUTHOR]

To examine whether neighborhood racial characteristics are associated with the under reporting of life time cocaine/crack use. A household survey of high-risk communities with above-average admissions to state-supported drug and alcohol treatment programs. Chicago, Illinois, USA. A total of 303 adults. Self-reported use of cocaine/crack during a respondent's life time, hair test assays for cocaine use and level of neighborhood diversity measured using the Simpson Index. Respondents from more segregated neighborhoods were more likely than those from diverse neighborhoods to under report life time cocaine/crack use. Neighborhood racial characteristics should be considered as an important factor in household surveys on illicit substance use. [ABSTRACT FROM AUTHOR]

We present an overview of the cross-cultural quality of survey reports of substance use behaviors in the United States. Empirical data from 36 published studies (1977 2003) are examined to evaluate the reliability and validity of substance use reports across cultural groups. In these studies, race/ethnicity are used as proxy indicators of respondent culture. In general, the available research suggests that, with a few exceptions, the quality of survey data on racial and ethnic disparities in substance use is often limited by differential measurement error. A conceptual paradigm is presented to consider a wide range of potential causes for these differences in measurement error that includes two dimensions: emphasis on negative vs. positive behavior patterns, and emphasis on internal vs. external causal factors. These two dimensions yield four potential models that arc useful in understanding variations in substance use measurement error: the cultural deficit model, the cultural conflict model, the mainstream conformity model, and the cultural distrust model. Future research should focus on the ability of each of these alternative models to account for cultural variability in the quality of substance use reporting. Key Words: Culture; Survey measurement error; Substance use; Risk; High risk populations; Proxy indicators; Recanting. [ABSTRACT FROM AUTHOR]

Introduces a series of articles relating to the relationship between homelessness and substance use.

PURPOSE: To investigate whether substance abuse is a direct factor in the explanation of homelessness or one that operates indirectly through disaffiliation and human capital processes to place individuals at greater risk of the condition.METHODS: Analyses were conducted using data on substance abuse and homeless experiences from a random probability sample of 481 homeless persons and those at risk of homelessness in Cook County, Illinois. Covariance structure models were used to assess substance abuse, human capital, and disaffiliation as potential precursors of homelessness, with particular attention paid to the direct and indirect role of substance abuse in the loss of domicile.RESULTS: Analysis of several nested models of homelessness links substance abuse only indirectly to loss of domicile, primarily through its impact on social and institutional affiliations. Contrary to expectations, substance abuse did not impact homelessness indirectly by diminishing the accumulation of human capital.CONCLUSIONS: The role of disaffiliation as a proximate cause of homelessness was confirmed. This locates the phenomenon within the context of society itself, as a direct result of a breakdown in the social bonds necessary for human community. Substance abuse plays a critical role in this breakdown, negatively influencing social as well as institutional relationships. [Copyright &y& Elsevier]

Representative data from the U.S. National Health Interview Survey are used to investigate the substance use patterns of immigrants and compare them to those of the native born populations. The information examined is from the 1991 supplementary Drug and Alcohol Use Data File, which examined the self-reported substance use behaviors of approximately 21,000 adults aged 18–44. Findings indicate that immigrants to the U.S. in the late twentieth century are less likely to use alcohol and other drugs than are native born citizens. Additional findings suggest assimilation processes by which exposure to mainstream American society leads to patterns of alcohol and illicit drug use among long term immigrants that approximates that of the native born population. The patterns of substance use observed among immigrants, however, are not consistent with acculturative stress mechanisms. These findings provide an important and representative profile of the substance use patterns of one of the largest international migration streams of the past one hundred years. [ABSTRACT FROM AUTHOR]

We examined the potential prevalence impact of differences in consent procedures, mode of administration, and editing protocols in the 1997 National Household Survey on Drug Abuse, the Monitoring the Future study, and the Youth Risk Behavior Survey, limiting analyses to 10th and 12th graders. NHSDA's high level of compliance with federal regulations regarding human subjects research, including thorough parental permission prior to adolescent participation, may in part be responsible for the relatively tow prevalence rates obtained in this study. Key mode effects which contribute to observed differences across surveys are survey setting and privacy. The two school-based surveys produce higher prevalence estimates than the NHSDA. Although NHSDA prevalence rates increase with increased interview privacy, the increase is not enough to account for discrepancies with the school surveys. The procedures used to handle inconsistent survey responses and to impute missing data are very different across the three surveys. These differences in editing procedures, however, are unlikely to be responsible for the observed differences in prevalence rates. Based on these analyses, we conclude that the field would benefit from a welt-designed experimental study evaluating school vs. household effects as well as the impact of variation in consent procedures. Increased methodological research on the validity of school based drug surveys is also needed. [ABSTRACT FROM AUTHOR]

Although a small number of studies are available that evaluate the effects of interviewer characteristics in substance use surveys conducted in person, none have done so using information collected via telephone interviews. We address this issue by examining the utility of social attribution and social desirability models for detecting the presence of interviewer effects in a large statewide telephone survey concerned with substance use. The specific outcome variables of interest were reports of lifetime and 18-month composite drug use. Analyses focus on the direct effects of individual interviewer characteristics (to assess social attribution) and a summary measure of interviewer-respondent similarity (to assess social distance) and employ random effects regression models to control for respondent clustering by interviewer. Results are most consistent with a social distance model and suggest that social distance between respondent and interviewer may decrease the probability of respondents reporting substance use behavior. [ABSTRACT FROM AUTHOR]

Few studies comparing telephone and in-person surveys have examined response differentials to sensitive questions. This paper examines responses to a series of substance use questions asked of samples of university students interviewed face to face and via telephone. Consistent differences are found to exist, with in-person respondents being more likely to report having used a number of substances, including tobacco and several illegal drugs. Analysis suggests that these differences are attributable to a method rather than a selection effect. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study examines the relationship between self-reported symptoms of substance dependence and risky sexual behavior among 187 HIV-negative men who have sex with men. Method: In a supplement to a Chicago household survey, using random probability sampling, men who reported consensual sex with other men or who identified as gay or bisexual were selected for interviews. Participants reported on sexual behavior, substance use, and symptoms of substance dependence related to past year use of alcohol, marijuana, cocaine, and sedatives, tranquilizers or pain relievers. Risky sexual behavior was defined as unprotected insertive or receptive anal intercourse plus having multiple partners, casual partners, or a partner who was HIV positive or of unknown serostatus. Results: Risky sexual behavior in the past six months was significantly and positively associated with alcohol dependence symptoms, cocaine dependence symptoms (receptive only), and prescription drug dependence symptoms (insertive only). Confirmatory factor analyses revealed that dependence symptoms loaded on separate factors by substance, which in turn loaded on an overarching dependence symptoms factor. In structural equation models, individual substance factors were not significantly associated with sexual risk behavior, however the higher order dependence symptoms factor was significantly and positively associated with both receptive and insertive risk behavior. Conclusions: MSM with symptoms of multiple substance use dependencies are more likely to be engaged in sexual behavior that places them at risk for acquiring HIV and other sexually transmitted infections. Alcohol and drug abuse treatment providers should be aware of the need for HIV testing and counseling in this population. [Copyright &y& Elsevier]

Objective: Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education- matched urban heterosexual women. Method: Data came from comparable face-to-face interviews with 405 self-identified Chicago-area lesbians and with 548 urban women from a U.S. national sample. Rates of hazardous drinking (heavy episodic drinking, intoxication, drinking- related problems, alcohol-dependence symptoms) were compared for exclusively heterosexual, mostly heterosexual, bisexual, mostly lesbian, and exclusively lesbian subgroups. Results: Exclusively heterosexual women had lower rates than did all other women on all measures of hazardous drinking. Exclusively heterosexual women also reported less childhood sexual abuse, early alcohol use, and depression. Bisexual women reported more hazardous drinking indicators and depression than did exclusively or mostly lesbian women. Conclusions: These results indicate that sexual minority women are likely to have elevated risks of hazardous drinking. The differences between lesbian and bisexual women suggest that more attention is needed to subgroup differences among sexual minority women. Health care providers need to know the sexual identity of their patients and how their sexual identity may affect their risks for hazardous drinking. Higher rates of childhood sexual abuse, early drinking, and depression among sexual minority women suggest that these experiences may be important in assessing and treating problems related to their drinking, and in developing prevention and early intervention strategies. [ABSTRACT FROM AUTHOR]

Since subjects are often uncomfortable disclosing sensitive information, questions gauging respondent reaction to survey questions about drug abuse may aid in the interpretation of responses. Such debriefing questions can be worded subjectively, i.e., asking subjects about their perceptions of the reactions of others to questions. Using data from a study employing both types of debriefing questions, we examined whether question wording made any difference. We evaluated the extent to which drug reporting was associated with respondent reaction to the survey and whether reactions varied by type of debriefing question. A factor analysis of debriefing questions appended to an experimental household survey on drug abuse yielded factors reflecting distinct subjective and projective dimensions. Analyses suggested that debriefing question wording does make a difference with respect to respondent reaction. Contrary to expectations, analyses suggested that those reporting drug use expressed less comfort on subjectively worded items and more comfort on projectively worded items. Subjects who self-administered their survey also reported lower levels of subjective comfort. The projective measures derived from analsyses were associated with three demographic variables: Younger subjects reported higher levels of projective ease than older subjects. Those with some college reported higher levels of projective ease than those with the least amount of formal education. African-Americans reported lower levels of projective ease than White/Other subjects. Implications for the design, interpretation, and analysis of drug use surveys are considered. [ABSTRACT FROM AUTHOR]