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Emergency department (ED) settings have gained interest as venues for illegal drug misuse prevention and intervention, with researchers and practitioners attempting to capitalize on the intersection of need and opportunity within these settings. This study of 686 adult patients visiting two EDs for various reasons who admitted drug use compared daily cannabis-only users, nondaily cannabis-only users, and other drug users on sociodemographic and drug-related severity outcomes. The three drug use groups did not differ on most sociodemographic factors or medical problem severity scores. Forty-five percent of the sample was identified as having a drug use problem. ED patients who used drugs other than cannabis were at particular risk for high drug use severity indicators and concomitant problems such as psychiatric problems and alcohol use severity. However, 19-29% of cannabis-only users were identified as having problematic drug use. Furthermore, daily cannabis-only users fared less well than nondaily cannabis users with regard to drug use severity indicators and self-efficacy for avoiding drug use. Results may assist emergency medicine providers and medical social workers in matching patients to appropriate intervention. For example, users of drugs other than cannabis (and perhaps heavy, daily cannabis-only users) may need referral to specialty services for further assessment. Enhancement of motivation and self-efficacy beliefs could be an important target of prevention and treatment for cannabis-only users screened in the ED.

BackgroundAlthough screening, brief intervention, and referral to treatment (SBIRT) has shown promise for alcohol use, relatively little is known about its effectiveness for adult illicit drug use. This randomized controlled trial assessed the effectiveness of the SBIRT approach for outcomes related to drug use among patients visiting trauma and emergency departments (EDs) at two large, urban hospitals.MethodsA total of 700 ED patients who admitted using illegal drugs in the past 30 days were recruited, consented, provided baseline measures of substance use and related problems measured with the Addiction Severity Index-Lite (ASI-Lite), and then randomized to the Life Shift SBIRT intervention or to an attention-placebo control group focusing on driving and traffic safety (Shift Gears). Both groups received a level of motivational intervention matched to their condition and risk level by trained paraprofessional health educators. Separate measurement technicians conducted face-to-face follow-ups at 6 months post-intervention and collected hair samples to confirm reports of abstinence from drug use. The primary outcome measure of the study was past 30-day drug abstinence at 6 months post-intervention, as self-reported on the ASI-Lite.ResultsOf 700 participants, 292 (42%) completed follow-up. There were no significant differences in self-reported abstinence (12.5% vs. 12.0% , p = 0.88) for Life Shift and Shift Gears groups, respectively. When results of hair analyses were applied, the abstinence rate was 7 percent for Life Shift and 2 percent for Shift Gears (p = .074). In an analysis in which results were imputed (n = 694), there was no significant difference in the ASI-Lite drug use composite scores (Life Shift +0.005 vs. Shift Gears +0.017, p = 0.12).ConclusionsIn this randomized controlled trial, there was no evidence of effectiveness of SBIRT on the primary drug use outcome.Trial registrationClinicalTrials.gov NCT01683227.

Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. The determination of how well national and local policy and intervention efforts address teen substance use depends largely on the collection of valid and accurate data. Assessments of substance use rely heavily on retrospective self-report measures, but the reliability and validity, however, may be limited by various sources of measurement error. This study utilizes four waves of data from the National Longitudinal Survey of Youth spanning eight years. Results from multiple linear regression analyses showed that the single most consistent variable associated with telescoping was the number of years since the substance was first reported. Time since first report was the single consistent variable and was strongly associated with telescoping in each wave-to-wave comparison for all three substances under study. Implications for policy and research are discussed. (Contains 7 tables.)

Services for homeless youth traditionally provided shelter and nourishment but do little to break the cycle of homelessness. A more comprehensive approach to serve homeless youth is the drop-in center model that provides safe and easy-to-find facilities within communities to bridge the gap between the streets and transitional/permanent housing. Research describing homeless youth who utilize drop-in centers is lacking. This study examines characteristics/preferences of 96 homeless adolescents attending one of two drop-in centers in Southern California. Homeless youth reported high prevalence of risk behaviors regardless of the center of attendance. Furthermore, our analyses revealed significant differences related to demographics, sexual risk behaviors, and substance use between homeless youth at the two drop-in centers. These findings illuminate the specific characteristics and preferences of homeless youth who attend drop-in centers and can be used to inform providers, advocates, and policy makers. (Contains 3 tables.)

This study examined teen marijuana report stability over 8 years. The stability of self-reports refers to the consistency of self-reported use across several years. This study used fives waves of data across 8 years from the National Longitudinal Survey of Youth. Analyses were conducted to examine the internal or within-wave consistency as well as external or across-waves consistency for self-reported marijuana use. Further tests were conducted to identify if there were any differences for age, ethnicity, and sex for report consistency. Report stability was higher for lifetime use reports than the age of onset reports. Wave-by-wave differences revealed stability remained at acceptable levels in nearly all comparisons at agreement being about 75%. Overall, report agreement was higher for females, older adolescents, and non-Hispanic/non-black youths in bivariate analyses. However, only older chronological age remained consistently significantly associated with better report stability in multiple logistic regression models. Implications regarding misclassification of users for prevention programs and measurement issues are discussed. (Contains 7 tables.)

This study analyzed six waves of panel data from the National Longitudinal Survey of Youth (NLSY). These analyses were conducted to test the stability of self-reported lifetime use and age of onset. Intraclass correlation coefficients (ICCs) indicated that the stability of age of onset reports decreased with longer time frames between follow-ups. The percentage of youths who had discrepancies in self-reported ever use of alcohol at two-year follow-up ranged from 15% to 35%. Higher discrepancy rates were found for males and younger respondents. Differences in report stability as a function of race/ethnicity were minimal. Questions related to lifetime use and age of onset have implications for the study of lifetime trajectories of use and the timing of prevention programs. (Contains 7 tables.)

This study is the first to examine adolescent cigarette report stability over 10 years. Six waves of data were utilized from the National Longitudinal Survey of Youth. This study examined internal/logical consistency and external consistency. Report stability was higher for lifetime use reports than the age of onset reports. Wave-by-wave differences revealed stability increased across time, with one-third denying use in the first two wave comparisons but dropping to 20% by the last comparison. Overall, report agreement was higher for females, older adolescents, and non-Hispanic/non-black youths. Implications regarding misclassification of users for prevention programs and measurement issues are discussed. (Contains 5 tables.)

Objective: To test and compare 2 predictive models of weapon carrying in youth (n=308) recruited from 4 drop-in centers in San Diego and Imperial counties. Methods: Both models were based on the Behavioral Ecological Model (BEM). Results: The first and second models significantly explained 39% and 53% of the variance in weapon carrying, respectively, and both full models shared the significant predictors of being black(-), being Hispanic (-), peer modeling of weapon carrying/jail time(+), and school suspensions(+). Conclusions: Results suggest that the BEM offers a generalizable conceptual model that may inform prevention strategies for youth at greatest risk of weapon carrying.

This study compared two groups of adolescents seeking help at HIV prevention drop-in agencies. The first group attended agencies in low-income Hispanic neighborhoods which recruited within the locale. The second group of youth attended agencies that recruited based upon a specific population--they targeted homeless and LGBQ youth. We explored the characteristics of adolescents who sought initial services, the types of services requested, and attitudes toward the centers. Results indicated that those who utilized the population-based agencies were more likely to be homeless, have higher depression scores, and be older. They reported coming to the agency to find a safe place, whereas those who utilized the neighborhood-based agencies came specifically for concrete services. Implications are discussed. (Contains 5 tables.)

This study examines the risk for alcohol and other drug (AOD) problems resulting from alcohol plus marijuana use compared to alcohol-only use. Data are from telephone interviews with 1113 randomly selected college students attending two large urban universities in the southwestern United States. Alcohol and marijuana users (dual users) were more likely to be younger and report a higher mean number of drinks per occasion and experiencing all AOD problems studied compared to alcohol-only users. Multivariate logistic regression analysis findings reveal the relationship between dual-substance use and increased risk for AOD problems remained after controlling for demographics and alcohol use behaviors. Such problems include greater odds of legal problems and riding with or being an intoxicated driver. College students using alcohol and marijuana are at much higher risk for AOD problems than are students who use alcohol only, even when heavy drinking is taken into account. (Contains 3 tables.)

Adolescence is a developmental period during which many youth experiment with risk practices. This paper examined the association of parental monitoring with a range of alcohol and other drug (AOD) use behaviors among high-risk youth, while controlling for other demographic and environmental variables previously found to be associated with AOD use. Participants were recruited as part of a longitudinal evaluation study of four youth drop-in centers located in Southern California. These centers served at-risk youth, including Hispanic, Lesbian/Gay/Bisexual/Questioning (LGBQ), and homeless and runaway youth. Participants were aged 14 to 24 and were new attendees at the drop-in centers. Results from logistic regression analyses revealed that while controlling for demographic and environmental variables, adolescents who reported less parental monitoring were more likely to report lifetime use of cigarettes, marijuana, and methamphetamine, and in the past three months, use of alcohol and binge drinking. The findings thus indicate that, even among high-risk youth, those who reported low parental monitoring were significantly more likely to use a variety of substances. Implications of these findings are discussed as they pertain to AOD prevention and interventions for children and their families.

Analyses of study on adolescents in publicly funded treatment programs present sex and ethnic differences. Among some of the findings: females were more likely to report methamphetamine use, males reported marijuana use; Hispanics and African Americans were referred to treatment from criminal justice; reported marijuana as primary drug; mandated to treatment, and released unsatisfactorily, compared to White adolescents. (Contains 35 references and 6 tables.) (ADT)

Explored the impact of caregiver alcohol and other drugs (AOD) use on child protective services (CPS) case substantiation: cases with indications of AOD use were more likely to be substantiated than those without. Compared CPS-involved and non- involved women in AOD treatment; increasing numbers of children and younger maternal ages are risk factors for CPS involvement among AOD-using women. (JPB)

Paper presents public health model of alcohol intensity and attendant consequences. Analyses examined influence of agent (beverage of choice), host (individual characteristics), and environment (contexts of drinking) on indexes of alcohol intensity and alcohol-related consequences. Analyses suggest males, adolescents who begin drinking at a younger age, and older adolescents drink with more intensity. Implications for prevention and research are offered. (Contains 39 references, 2 tables, and 3 figures.) (Author)

Examined students' perceptions of alcohol promotion at a large public university. Student surveys of how they perceived alcohol promotion both in terms of their drinking behavior and the extent to which they perceived it occurred on campus indicated that abstainers and nonbinge drinkers believed alcohol was promoted to a greater extent than did binge drinkers. (SM)

Public Health Model was used to examine relationships between smoking severity (never smokers, former smokers, continued smokers) and host and environmental variables. Results indicate former smokers are more like never smokers on most risk and protective variables. Final analyses indicated continued smokers are more likely to be Non-Black and Hispanic, be older, and have a more distant maternal relationship. (Contains 49 references and 6 tables.) (Author)

This article describes a middle level teacher preparation program, Teaching Early Adolescents in Middle Schools (TEAMS). This collaborative program provides field experiences that utilize mentors and interdisciplinary teams to help preservice teachers develop the instructional and interpersonal skills needed to work effectively with early adolescents. (IAH)

Objective: To identify predictors of error in estimated blood alcohol concentration (eBAC) in a sample of bar patrons. Method: Six hundred sixty-six patrons (43.6% female) were randomly sampled from 32 bars. Patrons were asked to provide a breath sample into a handheld breath alcohol concentration test unit upon entrance and exit from the bar. Patrons also completed a brief survey at entrance and exit. For analyses, this sample was stratified by whether patrons consumed alcohol before attending the bar. Estimates of BAC were calculated using Matthews and Miller's formula (1979). A three-category dependent variable was created based on the estimation accuracy of eBAC relative to breath alcohol concentration: accurate (within .02), underestimate of BAC, and overestimate of BAC. Results: Of those that drank before arriving at the bar, 29% of eBACs were accurate, 32.3% were underestimates, and 38.8% were overestimates. For those who drank only at the bar, 42.0% were accurate, 20.8% were underestimates, and 37.7% were overestimates. Among those who drank before attending the bar, the number of drinks consumed before attending the bar was significantly related to eBAC underestimate. Among those who drank only at the bar, predictors of overestimate included being female, drinking more, and drinking longer. Conclusions: The accuracy of eBAC is poor at best. In an earlier study of parties, eBACs were often underestimated; in the bar setting, eBACs were often overestimated. More research is needed to understand the role of setting on eBAC calculations., THE BULK OF THE EPIDEMIOLOGICAL literature on alcohol consumption is based on self-reports of drinking quantity, frequency, variability, or heavy episodic drinking (Gruenewald and Nephew, 1994; Wechsler et al., 2002). [...]

Objective: Seasonality in alcohol consumption has implications for epidemiology and prevention. In this research we examined seasonal, temporal, and contextual variation in drinking among college students at a large West Coast university. Method: We used a field survey (across a 3-year period) to collect anonymous breath alcohol concentrations from students sampled randomly as they walked on and near the campus on weekend nights. Results: After controlling for student demographics, we found that the breath alcohol concentration samples we collected during the spring and winter were significantly higher than those collected during the fall. Subsequent analyses indicated that this difference could be attributed to fewer students drinking in the fall rather than to students consuming smaller quantities of alcohol. Conclusions: Seasonal trends in college student drinking mirror seasonal trends demonstrated in the general population. This research may help guide future intervention or prevention efforts. (J Stud. Alcohol Drugs 69: 323-331, 2008), UNDERSTANDING SEASONAL, temporal, and contextual variations in risky drinking behavior may have important implications for epidemiology and prevention. This may be particularly true for college populations relative to the working [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.05.016 Byline: Mark B. Reed (a), Rong Wang (a), Audrey M. Shillington (b), John D. Clapp (b), James E. Lange (a) Keywords: Smoking; Alcohol consumption; Smoking initiation; College students Abstract: During the decade of the 1990s, smoking prevalence increased nearly 30% in the college student population. Although most college students initiate smoking before the age of 18, recent evidence suggests a sizable minority of undergraduates report starting smoking while in college. This study examined the concurrent use of alcohol and tobacco as well as the relationship between alcohol use and smoking initiation among a sample of undergraduate students attending a large public university in the southwestern United States. We defined three categories of smoking status for this study: never smokers (n =777), experimenters (n =158), and smokers (n =178). Both experimenters and smokers reported consuming significantly more drinks per occasion in the past 28 days and more drinks on one occasion in the past 2 weeks compared to never smokers; however, there was no significant difference between experimenters and smokers on either of these measures of consumption. The results of two multinomial logistic regression models showed that measures of alcohol consumption and drinking frequency were significantly associated with being an experimenter or smoker after controlling for demographic and other drug use covariates. Results of a logistic regression analysis revealed a significant relationship between past year drinking frequency and smoking initiation among respondents who reported that they were not smoking at all 12 months prior to their survey participation. The influence of alcohol consumption on smoking initiation among college students is discussed. Author Affiliation: (a) AOD Initiatives Research, San Diego State University, 6386 Alvarado Court, Suite 224, San Diego, CA 92120, USA (b) San Diego State University, Center for Alcohol and other Drug Studies and Services, 6386 Alvarado Court, Suite 224, San Diego, CA 92120, USA

During the past five years, a few studies have reported that college students are using stimulants such as Ritalin without a prescription. To date, studies on college Ritalin/Adderall use have been from samples in the eastern or midwestern U.S. This study was designed to examine risk and protective factors associated with Ritalin/Adderall use among a college sample in Southern California. Our findings indicate that 11.2% of students reported past year and over 4% reported past 30 day use of Ritalin/Adderall. In our final analysis, students with lower GPAs, in a fraternity/sorority, not in a committed relationship, and who smoke and use other drugs were more likely to report past year and past 30 day Ritalin/Adderall use. Implications for prevention programming of these findings are discussed.

Objective: Using self-report survey data and measures of breath alcohol concentration (BrAC), this study examined the validity of an estimate of blood alcohol concentration (eBAC). Differences between eBAC and BrAC were modeled to identify sources of error related to survey-derived eBAC. Further, using hierarchical multilevel analyses, environmental event characteristics were examined as sources of eBAC error. Method: College students were interviewed and provided breath samples at randomly selected parties on Friday and Saturday nights. Interviews included items assessing the total number of drinks consumed, duration of drinking event, gender, and weight, which allowed for the calculation of eBAC. Results: Overall, eBACs were in accurate. Total number of drinks consumed was associated with underestimates of eBAC, whereas time drinking was associated with over-estimates of eBAC. Environmental variables, including party size, rowdy behavior, having food present, and observing many intoxicated partygoers, were also associated with eBAC errors. Conclusions: Current self-report survey methodology to calculate eBAC may be insufficient to estimate BAC with any accuracy. Environmental factors associated with the last drinking event for which BAC is being estimated should be considered when calculating eBAC., THE HIGH COST OF BIOLOGICAL MEASURES of blood alcohol concentrations (BACs) has resulted in few studies (see Lange and Voas [2001] and Thombs et al. [2003]) of college student drinking [...]

A study is conducted that examines the frequency of substance use among 14 to 24 year old homeless youth. Results suggest that homeless adolescent drug use exists at high levels and is related to parental monitoring and peer modeling of other risk behaviors.

Objective: The purpose of this study was to describe the demographic, substance use, and treatment variables of alcohol and other drag (AOD) treatment seeking pregnant women. This study also compared women on these variables based on Child Protective Service (CPS) status. Method: Secondary data of all pregnant women with at least one child entering all publicly funded AOD treatment programs (N = 678), in a southwest county, over a 3-year period were analyzed to examine the differences between pregnant women also involved with CPS and those not involved with CPS. Results: Pregnant women reporting CPS involvement were similar to non-CPS women on demographic variables but differed on drug use and treatment variables. CPS women were more likely to report marijuana use as their primary problem drug, be mandated to treatment, attend day treatment and be released from treatment unsatisfactorily compared to the non-CPS pregnant women. Those without CPS involvement were more likely to report cocaine or crack as their primary drag, attend outpatient treatment and be found to have a satisfactory release from treatment compared to those with CPS involvement. Results from the multiple logistic regression analysis found that the significant predictors of CPS involvement were mandated status and unsatisfactory treatment release. Conclusions: Differences in treatment outcomes may be based on AOD agencies' difficulty in working with mandated clients and/or with the multiple demands placed by CPS on clients as part of their treatment plans. Further research is needed to determine reasons for CPS clients' high failure rates in AOD treatment. Keywords: Drug treatment; Pregnancy; Child welfare

Alcohol and other drug problems experienced by adolescents who use only alcohol compared to those who use both alcohol and marijuana (A + M) is studied. Using the national longitudinal survey of youth 1994 data, forward multiple regression analyses revealed that impulsivity, A + M use (compared to alcohol-only use), age, sex, religiosity, frequency of substance use were associated with a higher number of behavioral problems. Youth with more alcohol problems were found to be binge drinkers, impulsive, more frequent alcohol users, and nonHispanic. Implications and future research needs are discussed. Key Words: Adolescence; Alcohol and drug problems; Marijuana use; Alcohol use; Co-morbid substance use, BACKGROUND Alcohol and marijuana (A + M) continue to be important public health problems in this country. Use of alcohol and other drugs (AOD) has a negative impact on adolescents [...]

This study examined the relationship between environmental characteristics and heavy episodic drinking by examining college students'last drinking events. For this study, 409 undergraduate students attending a large public university were randomly selected. Students were asked to report on their last drinking event within the 30-day period prior to being surveyed. There were 274 drinking events analyzed. Bivariate analyses and multiple logistic regression analysis were used to identify contextual factors predictive of heavy episodic drinking in specific drinking events. Drinking with friends, drinking beer and hard liquor, and having many people intoxicated at an event were predictive of heavy episodic drinking events. Dating events were protective of heavy episodic drinking. Implications for future research and prevention are discussed. Key Words: College students; Drinking contexts; Heavy episodic alcohol consumption., Alcohol use by college students has long been a concern in the United States (1). Several recent large, national epidemiological studies have examined heavy episodic drinking (i.e., 5 or more [...]

College students have an elevated risk for self‐injurious thoughts and behaviours (SITBs), and there are robust differences in prevalence rates for SITBs across gender identities. Although numerous constructs have been implicated as risk factors, researchers have not significantly improved at predicting SITBs, possibly owing to constraints of confirmatory analyses. Classification trees are exploratory, person‐centred analyses that enable joint examination of numerous correlates and their interactions. Thus, classification trees may discern previously unstudied risk factors and identify distinct subpopulations with elevated risk for SITBs. We tested classification trees that evaluated 298 potential correlates of nonsuicidal self‐injury and suicidal ideation across self‐identified women and men. Data came from 5,131 college students who completed the National College Health Assessment, which assesses a wide range of health‐related constructs. Models produced parsimonious decision trees that accounted for a substantial amount of outcome variability (38.3–51.5%). Psychopathology, poorer psychological well‐being, and other SITBs emerged as important correlates for all participants. Trauma, disordered eating, and heavy alcohol use were salient among women, whereas alcohol use norms were important correlates among men. Importantly, models identified several constructs that may be amenable to intervention. Results support the use of exploratory analyses to explicate heterogeneity among individuals who engage in SITBs and suggest that gender identity is an important moderator for certain risk factors. [ABSTRACT FROM AUTHOR]

Background: Many states in the U.S. have changed how they regulated medicinal and/or recreational marijuana. Understanding the impact of these policy changes on marijuana use and perceptions of acceptability and safety of use is needed. The current study examined perceptions and patterns of marijuana use among college students, a population at increased risk for initiation and heavy use. Method: Data include Colorado university students and national sample averages. We used repeated cross-sectional analyses to examine responses to the American College Health Association National College Health Assessment and added marijuana measures. We examined differences in use and norms pre- to post-legalization among Colorado college students. Colorado data were also compared to national summary statistics. Results: Social norms, use initiation, and use recency and frequency in Colorado increased significantly across changes in recreational legislation. Descriptive norms and rates of ever users in Colorado increased faster than national averages. Conclusions: Results suggest recreational legalization increases how quickly social norms become more approving. As marijuana policy continues to change, implementing social norms interventions alongside legislative changes may offset increases in risk for use initiation and frequency by countering increased social norms favorable to use. [ABSTRACT FROM AUTHOR]

This paper examines the contextual characteristics common to binge drinking occasions reported by college students. In addition, the study examines the influence of such contextual characteristics on alcohol-related problems experienced by students. Using random sampling and telephone interview methodology, 401 college students attending a large southern California university were surveyed by trained research staff. The interview protocol was based on the Core Survey and included context of use questions from the College Risk Assessment Guide. Results of stepwise multiple logistic regressions indicate that drinking with friends and events with food available protect against alcohol problems, while drinking events in which illicit drugs are available present higher risk for problems. Implications for future research and prevention are discussed. Key Words. Binge drinking; College students; Contexts of use; Problems, INTRODUCTION Binge drinking among college students is a major public health concern. Recent studies indicate that the prevalence of binge drinking among college students in the United States is moderately [...]