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A pilot study was conducted to develop a marijuana knowledge scale and test feasibility of an information literacy-focused intervention targeting college students. First, students recruited from four classes completed an online survey measuring knowledge, attitudes, and intention to use marijuana and the responses (n = 117) were used to create a 19-item knowledge scale. Subsequently, one-hour group intervention was delivered in two of the four classes and volunteers among them completed a post-test (n = 34). The results showed that the intervention increased knowledge and decreased peer approval. Knowledge gain was higher among those with lower initial confidence in their knowledge. No direct effects were found on risk or intention to use. Keywords: marijuana, cannabis, intervention, education, knowledge, injunctive norm, college students, Significance of college attendance as a risk factor for marijuana initiation escalated since Colorado and Washington legalized recreational use of marijuana in 2013 (Mlech, Patrick, O'Malley, & Johnston, 2017). In [...]

* Context.--Urine drug testing is frequently ordered by health care providers. Immunoassays are widely used for drug testing, yet have potential limitations, including variable cross-reactivity. The last decade has seen worsening of a prescription drug abuse epidemic. Objective.--To use data from a College of American Pathologists proficiency testing survey, Urine Drug Testing, Screening, to determine and summarize the characteristics, performance, and limitations of immunoassays. Design.--Seven years of proficiency surveys were reviewed (2011-2017). Results.--Rapid growth was seen in participant volumes for specific immunoassays for synthetic opioids (eg, buprenorphine, fentanyl, oxycodone) and 3,4-methylene-dioxymethamphetamine ('ecstasy'). Participant volumes remained high for immunoassays targeting less commonly abused drugs such as barbiturates and phencyclidine. For opiate immunoassays, the number of laboratories using a 2000 ng/mL positive cutoff remained stable, and an increasing number adopted a 100 ng/mL cutoff. Opiate and amphetamine immunoassays showed high variability in cross-reactivity for drugs other than the assay calibrator. Assays targeting a single drug or metabolite generally performed well on drug challenges. Conclusions.--Survey results indicate strong clinical interest in urine drug testing and some adoption of new assays. However, urine drug testing availability does not parallel prevailing patterns of drug prescribing and abuse patterns. In particular, specific immunoassays for synthetic opioids and a lower positive cutoff for opiate immunoassays may be underused, whereas immunoassays for barbiturates, methadone, propoxyphene, and phencyclidine may be overused. Laboratories are encouraged to review their test menu, cutoffs, and assay performance and adjust their test offerings based on clinical needs and technical capabilities. (Arch Pathol Lab Med. 2020;144:177-184; doi: 10.5858/ arpa.2018-0562-CP), Substance abuse continues to be a significant problem in the United States and other countries. (1,2) In the last 2 decades, nonmedical use of opioids and other prescription medications has [...]

Methamphetamine (also known as ice, crystal, meth or glass) abuse is an established public health concern in the United States as well as globally. It is estimated that there are [...]

Drug abuse is a significant problem affecting youth. According to the 2011 Youth Risk Behavior Surveillance (YRBS) data: 39.9% of students had used marijuana one or more times during their [...]

The Prescription Opioid Misuse Index (POMI) was developed and used in a larger study designed to assess correlates of OxyContin abuse in pain patients prescribed OxyContin, patients treated for OxyContin addiction, and individuals incarcerated for OxyContin-related charges. The POMI was administered to 40 subjects with addiction problems and 34 pain patients who had received OxyContin for pain. Receiver operating characteristic curve analysis indicated that endorsing two or more of six items reliably classified a person as at risk for misuse of their medication. When comparing drug abuse/dependence in subjects classified as misusers or users, significantly more misusers received a diagnosis for alcohol (p < .01), illicit drugs (p < .05), and other prescription medications (p < .05) and reported greater lifetime use of alcohol (p < .002) and illicit drugs (p < .01). No between-group differences were found regarding psychiatric problems. The POMI appears to be a sensitive and specific instrument for identifying patients who misuse opioid medications. Keywords: Screening instrument; Prescription drug abuse; Opioids; Pain

Literature indicates that drug courts produce lower recidivism rates, increased retention rates, and lower costs than traditional criminal justice case processing. As drug courts approach their second decade, there is a void in the literature regarding factors that influence the success of drug court programs. This work aimed to fill that void by equipping policy makers with meaningful information regarding (a) drug court success and (b) factors that facilitate and challenge the implementation of drug court programs. This study measured the perceptions of drug court judges and administrators in five states to examine factors identified by respondents as key to program success. Federal, state, and local factors (agencies and actors) influenced the success of drug court programs, with state and local factors consistently identified as most supportive and influential. Findings also indicated that perceived success was higher for drug court personnel (a) without graduate and professional degrees (law) and (b) with more experience guiding drug courts. Keywords: drug courts; implementation; public policy; drug offenders; drug treatment; crime control policy

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.12.002 Byline: Paiboon Daosodsai (a), Mark A. Bellis (b), Karen Hughes (b), Sara Hughes (b), Sopida Daosodsai (c), Qutub Syed (d) Keywords: Drug use; Methamphetamine; Alcohol; Schoolchildren; Thailand; Substance use Abstract: In 2003 the Thai government announced a radical shift in drug policy with the implementation of a War on Drugs. Although consequences of this controversial measure (e.g. drug dealer deaths) have received widespread attention relatively little work has evaluated changes in substance use. We used two anonymous representative samples of secondary school students to compare drug use in Northeast Thailand before (1998; n =4217) and after (2004/5; n =3489) the War on Drugs. Results indicate that reported levels of current illicit drug use reduced significantly between 1998 and 2004/5 (for methamphetamine from 4.2% to 0.9%). By examining trends in year of first methamphetamine use we identify that observed reductions in drug initiation are temporally consistent with the War on Drugs. However, while prevalence of alcohol use has also fallen, there was a three-fold increase in daily alcohol use. We suggest that this rise, combined with other negative impacts of 'wars' on drugs, means drug control requires a public health perspective that sees eliminating drug use as part of a wider strategy that has improvement in population health, not just drug prevention, as its core objective. Author Affiliation: (a) Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand (b) Centre for Public Health, Liverpool John Moores University, Castle House, North Street, Liverpool, L3 2AY, UK (c) Khon Kaen Drug Dependence Treatment Centre, Khon Kaen 40000, Thailand (d) Health Protection Agency North West, Rooms 103-112 DBH House, 105 Boundary Street, Liverpool, L5 9YJ, UK

Drug users are disproportionately affected by hepatitis C virus (HCV), yet they face barriers to health care that place them at risk for levels of HCV-related care that are lower than those of nondrug users. Substance abuse treatment physicians may treat more HCV-infected persons than other generalist physicians, yet little is known about how such physicians facilitate HCV-related care. We conducted a nationwide survey of American Society of Addiction Medicine physicians (n = 320) to determine substance abuse physicians' HCV-related management practices and to describe factors associated with these practices. We found that substance abuse treatment physicians promote several elements of HCV-related care, including screening for HCV antibodies, recommending vaccinations against hepatitis A and B, and referring patients to subspecialists for HCV treatment. Substance abuse physicians who also provide primary medical or HIV-related care were most likely to facilitate HCV-related care. A significant minority of physicians were either providing HCV antiviral treatment or willing to provide HCV antiviral treatment. Keywords: Hepatitis C virus; Chronic hepatitis C; Drug users; Substance abuse treatment physicians; Addiction medicine

OBJECTIVES. Our goals were to (l) determine adolescents&apos; motivations (reasons) for engaging in the nonmedical (illicit) use of 4 classes of prescription medications and (2) examine whether motivations were associated with a higher risk for substance abuse problems. RESPONDENTS. The 2005 sample (N = 1086) was derived from one ethnically diverse school district in southeastern Michigan and included 7th- through 12th-grade students. METHODS. Data were collected by using a self-administered, Web-based survey that included questions about drug use and the motivations to engage in nonmedical use of prescription medication. RESULTS. Twelve percent of the respondents had engaged in nonmedical use of opioid pain medications in the past year: 3% for sleeping, 2% as a sedative and/or for anxiety, and 2% as stimulants. The reasons for engaging in the nonmedical use of prescription medications varied by drug classification. For opioid analgesics, when the number of motives increased, so too did the likelihood of a positive Drug Abuse Screening Test score. For every additional motive endorsed, the Drug Abuse Screening Test increased by a factor of 1.8. Two groups of students were compared (at-risk versus self-treatment); those who endorsed multiple motivations for non-medical use of opioids (at-risk group) were significantly more likely to have elevated Drug Abuse Screening Test scores when compared with those who were in the self-treatment group. Those in the at-risk group also were significantly more likely to engage in marijuana and alcohol use. CONCLUSION. The findings from this exploratory study warrant additional research because several motivations for the nonmedical use of prescription medications seem associated with a greater likelihood of substance abuse problems. Key Words nonmedicat prescription drug use, adolescents&apos; prescription medication abuse, ACCORDING TO THE National Survey on Drug Use and Health 2004 data, (1) ~9% of adolescents aged 12 to 17 years used prescription drugs for nonmedical purposes in the past [...]

Poison Control Center (PCC) cases involving intentional ingestion, injection or inhalation of prescription opioids are a potentially valuable source of information on the abuse and misuse of these products. This study sought to validate PCC classifications of prescription opioid intentional exposure cases against clinical diagnostic criteria. 4,321 cases were reviewed. PCC-clinician concordance was good to excellent for Withdrawal, Abuse, and Suicide (kappa statistics: 0.73, 0.53, 0.48, respectively), but poor for Misuse and Intentional Unknown (Specific motive not known). Interrater reliability among clinicians was good (weighted kappa range: 0.56-0.68). Results demonstrate the degree of compatibility between PCC and standard nosologic classifications. Keywords: Abuse, interrater reliability, Poison Control Centers, prescription opioids, INTRODUCTION The nonmedical use of prescription opioids is a significant and growing public health concern in the United States (1, 2, 3, 4). According to the 2003 National Survey on [...]

Benzodiazepines are among the most commonly prescribed therapeutics. Women seem to be more likely than men to be prescribed a benzodiazepine and to use benzodiazepines for nonmedical reasons; they also appear to be at higher risk for benzodiazepine dependence. The aim of the present investigation was to assess the acute behavioral effects of a benzodiazepine in women and men. To accomplish this, 13 volunteers (6 women, 7 men) first learned to discriminate 0.375-mg triazolam, a triazolobenzodiazepine hypnotic. After acquiring the discrimination, (i.e., >80% correct responding on 4 consecutive sessions) a range of doses of triazolam (0, 0.0625, 0.125, 0.25, and 0.375 mg) were tested in each participant. Triazolam dose dependently increased drug-appropriate responding and subject ratings of sedation and impaired performance (i.e., significant effect of dose). The women and men did not differ significantly on any measure. The results of the present experiment suggest that women and men are not differentially sensitive to the behavioral effects of triazolam. Keywords: Benzodiazepines, drug discrimination, sex, gender, triazolam, INTRODUCTION Women and men differ with respect to drug-taking behavior (1-3). Recent epidemiological data from the 2002 National Survey on Drug Use and Health suggest that men are more likely [...]

In 'Drug Use,' Peter Reuter, a professor at the University of Maryland School of Public Affairs and Department of Criminology, examines substance abuse and addiction among welfare and low-income mothers. He describes the changing pattems of drug use in the general population. Reuter explains that drug use increased rapidly in the late 1970s, declined in the 1980s, and remained relatively flat in the 1990s. The patterns, however, are driven largely by changes in marijuana use. The pattern of frequent use of more dangerous drugs, such as cocaine, is somewhat different. The heavy use of cocaine--especially crack cocaine--peaked during the late 1980s. By the early 1990s, the number of new addicts had fallen dramatically, although not many heavy users discontinued their use. As a result, the stock of frequent users held constant through much of the 1990s and only recently began to decline as more users discontinued their use or died. His main data sources are the Arrestee Drug Abuse Monitoring (ADAM) program, the Drug Abuse Warning Network (DAWN), Monitoring the Future (MTF), and the National Household Survey of Drug Abuse (NHSDA).

Despite the utility of substance abuse treatment, large numbers of people with serious substance use problems do not get the treatment that is needed. Communities that participated in the Robert Wood Johnson Foundation's 'Fighting Back' program (see Saxe et al., this issue) developed a range of strategies to facilitate the provision of treatment to community members. As part of the national evaluation of Fighting Back, a general population survey conducted in 1995, 1997, and 1999 in 12 of the Fighting Back communities and 29 comparison communities assessed problem substance use, dependence, and treatment. These data were used to examine whether the gap between treatment need and treatment utilization was reduced in the Fighting Back communities. Results indicated that the discrepancy between treatment need and utilization of specialized treatment was unchanged, with as few as 6% to 7% identified as needing treatment actually receiving treatment. There were, however, a number of characteristics that distinguished those who received treatment from those who did not: (1) females were more than seven times less likely to receive treatment when needed than were males; (2) African Americans were four times less likely and Hispanics three times less likely than White respondents; (3) those 25 years and younger were four times less likely than those over 25; (4) unemployed and those living in poverty were three times more likely to receive treatment. The implications of these findings are that even within comprehensive approaches to substance abuse, more must be done to identify those in need of treatment, to understand the factors that explain the discrepancies between those in need of treatment who do and do not receive treatment, and to develop methods for getting those in need into treatment.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.05.005 Byline: Carol J. Boyd (a), Sean Esteban McCabe (a), Christian J. Teter (b)(c) Keywords: Asthma inhaler abuse and diversion; Drug abuse; Prescription drug abuse Abstract: To assess the relationship between prescription asthma inhaler misuse and other substance abuse. Author Affiliation: (a) Substance Abuse Research Center, 2025 Traverwood, Suite C, University of Michigan, Ann Arbor, MI 48105-2194, United States (b) Northeastern University School of Pharmacy, Boston, MA, United States (c) McLean Hospital Alcohol and Drug Abuse Treatment Program Belmont, USA Article Note: (footnote) [star] This work was supported in part by a grant from the University of Michigan.

A large body of research shows that youth with disabilities, who comprise about 13% of the country's school-aged population, report comparable to higher incidence rates of alcohol, tobacco, and other drug (ATOD) use than their peers. Furthermore, youth with disabilities who reported ATOD use or who engaged in binge drinking had significantly more negative educational outcomes and engaged in sexual activity at a younger age than nonusers. This study describes risk factors for substance use, personal characteristics, aspects of the attitudinal environment, and educational, employment, and social outcomes among youth across 6 categories of disability. Data came from the National Center for Education Statistics' National Education Longitudinal Study of 1988-2000 (NELS:88). The findings indicate that (a) youth with varying types of disabilities are relatively homogenous with respect to risk behaviors, personal characteristics, and outcomes; (b) youth with emotional, learning, or multiple disabilities may be at heightened risk for binge drinking and marijuana use; and (c) youth with emotional and multiple disabilities may be less likely to graduate from high school or its equivalent 8 years beyond the 12th grade. Based on these results and limitations of the NELS sampling strategy, appropriate interventions are discussed as well as the need for more definitive operational definitions for disabilities, specifically the biopsychosocial approach used by the International Classification of Functioning, Disability, and Health., A growing body of research suggests that youth with disabilities experience comparable, and in some cases higher, incidence rates of alcohol and other drug use than their peers. (1-10) Morgan [...]

This article explores the prevalence of drug and alcohol use and related risks by attendees at electronic music dance events (EMDEs) in club settings. From six events located on the East and West Coasts, anonymous data were collected via self-report questionnaires, drug bioassays, and alcohol breath tests prior to entry (N = 240) and upon exit from the venues (N = 219). EMDEs were locations for identifying young adults who were aged 18 to 25 (70%), not college students (54%), and at risk for substance use. Nearly half of the sample (45%) were positive for drug use, and 60% were positive for alcohol use at entrance. Slightly more than one third (38%) were positive for drug use, and 59% were positive for alcohol use at exit. Only a small percentage of the sample converted from no use to drug use on premises (5.4%). Future investigations need to explore targeted substance use prevention strategies within this context.

The estimation of tobacco-reporting validity in an epidemiological survey on drug use was carried out by comparing the responses to questions about tobacco use and passive exposure to smoking with biological tests for cotinine. The underreporting of tobacco was relatively rare but the estimates of the study state that it may be increasing over time.