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ABSTRACT This case study examines not only the prevalence of substance abuse in one rural Canadian high school but also how teachers understand teaching and learning in relation to substance [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2009.05.006 Byline: Jiang Yu (a), Lucia Perfetti Clark (a), Lalita Chandra (a), Agnelo Dias (b), Ting-Fun May Lai (c) Keywords: Asian American; Substance abuse; Cultural competency; Early intervention model Abstract: This article addresses the issue of underutilization of treatment services by Asian Americans. Although Asian Americans continue to be the fastest growing ethnic minority in New York City, they are reported to underutilize substance abuse treatment services. However, much of the underutilization may be attributed to cultural and language barriers hindering them from seeking help and support. Past literature indicates that when culturally appropriate services are available, service utilization tends to increase among Asian Americans. This study tested strategies to enhance the continuum of care in the Asian community by adapting a well-documented generic early intervention model in a culture-specific setting. The results of this study indicate that these models may be successfully adapted to culturally specific settings such as Asian American communities. When culturally competent services combined with case management and motivational interviewing are provided, there tends to be an increase in Asian clients' chance of accomplishing treatment goals. Author Affiliation: (a) New York State Office of Alcoholism and Substance Abuse, Albany, NY 12203, USA (b) Asian Outreach Program, Child Center of New York, Elmhurst, NY 11373, USA (c) Behavioral Health Services, Hamilton Madison House, New York, NY 10002, USA Article History: Received 31 December 2008; Revised 21 May 2009; Accepted 21 May 2009

Objectives. We examined the prevalence of depressive, anxiety, and substance use disorders among Latinos residing in the United States. Methods. We used data from the National Latino and Asian American Study, which included a nationally representative sample of Latinos. We calculated weighted prevalence rates of lifetime and past-year psychiatric disorders across different sociodemographic, ethnic, and immigration groups. Results. Lifetime psychiatric disorder prevalence estimates were 28.1% for men and 30.2% for women. Puerto Ricans had the highest overall prevalence rate among the Latino ethnic groups assessed. Increased rates of psychiatric disorders were observed among US-born, English-language-proficient, and third-generation Latinos. Conclusions. Our results provide important information about potential correlates of psychiatric problems among Latinos that can inform clinical practice and guide program development. Stressors associated with cultural transmutation may exert particular pressure on Latino men. Continued attention to environmental influences, especially among third-generation Latinos, is an important area for substance abuse program development. (doi: 10.2105/AJ PH.2006.087205)

Cet article aborde les changements que les femmes violentees ont apportes a leur consommation de drogues et qui ont eu recours a l'aide des maisons d'hebergement rurales et urbaines. Elles [...]

Over the past several years, there has been growing interest in identifying distinct developmental trajectories of substance use. Using data from the RAND Adolescent/ Young Adult Panel Study (N = 6, 527), we synthesize our prior findings on patterns of smoking, binge drinking, and marijuana use from early adolescence (age 13) to emerging adulthood (age 23). We also present new data on how these trajectory classes compare on key psychosocial and behavioral outcomes during emerging adulthood. For each type of substance use, we found two periods of vulnerability: early adolescence and the transition to emerging adulthood. As expected, early users were at relatively high risk for poor outcomes at age 23 compared to consistent low-level users and abstainers, even if they reduced their use during adolescence. However, youths who were not early users, but steadily increased their use over time, also tended to be at relatively high risk. Results suggest that multiple prevention approaches might be needed to successfully reach at-risk youths.

The theory of emerging adulthood has been proposed as a way of conceptualizing the developmental characteristics of young people between the ages of 18 and 25. Here, the theory is applied to explaining the high rates of substance use in this age group. Specifically, five developmentally distinctive features of emerging adulthood are proposed: the age of identity explorations, the age of instability, the age of self-focus, the age of feeling in-between, and the age of possibilities. Then, each of these features is applied to an explanation of drug use in emerging adulthood.

The present study described the prevalence of adult role taking and substance use among individuals attending alternative high schools, who were followed for five years to early emerging adulthood (n = 848). Psychosocial factors at baseline and adult role taking at the follow-up were examined as correlates of substance use during emerging adulthood. At this stage of fife, 74% of subjects were employed, 30% were married or engaged, and 43% had at least one child. One third of subjects were daily cigarette smokers, and 24% had used marijuana in the past 30 days. Forty-seven percent had experienced negative consequences of alcohol or drug use in the last year. The most consistent positive predictors of substance use in emerging adulthood were male gender and previous drug use. Addiction concern was a consistent negative predictor. After controlling for baseline psychosocial variables, attending school and being married at the five-year follow-up were negative correlates of both personal consequences and problems related to alcohol or drug use.

This study examines transitions in alcohol, cigarette, and marijuana use and alcohol- and marijuana-related problems from late adolescence through young adulthood. Men and women who attend college are compared to their peers who do not to determine if the situational/socialization effects of college are unique during this developmental period. Prospective data from a community sample were collected at ages 18, 21, and 30 years. ANOVAs revealed that 18 year olds who transition out of high school, regardless of college status, reported higher levels of substance use than their peers who were still in high school. In addition, nonstudents compared to college students reported higher levels of cigarette and marijuana use in adolescence, emerging adulthood, and young adulthood and higher levels of alcohol- and marijuana-related problems in adolescence and young adulthood. Latent growth curve analyses revealed that college status was related to lower levels of alcohol and marijuana problems at age 18, greater increases from ages 18 to 21, and greater decreases from ages 21 to 30 even after controlling for level and growth in use. Overall, the findings suggest that nonstudents may be a more important target group than college students for drug use prevention efforts during emerging adulthood.

This study examines the effects of 2 brief family-focused interventions on the trajectories of substance initiation over a period of 6 years following a baseline assessment. The 2 interventions, designed for general-population families of adolescents, were the 7-session Iowa Strengthening Families Program (ISFP) (Molgaard & Spoth, 2001) and the 5-session Preparing for the Drug Free Years Program (PDFY) (Catalano, Kosterman, Haggerty, Hawkins, & Spoth, 1999). Thirty-three rural public schools were randomly assigned to the ISFP, the PDFY, or a minimal-contact control condition. The authors evaluated the curvilinear growth observed in school-level measures of initiation using a logistic growth curve analysis. Alcohol and tobacco composite use indices--as well as lifetime use of alcohol, cigarettes, and marijuana--and lifetime drunkenness, were examined. Significant intervention-control differences were observed, indicating favorable delays in initiation in the intervention groups.

Objective: The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality. Method: Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence. Results: The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant. Conclusion: This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem. Keywords: Substance abuse; Sexual assault; South Africa

Abstract This study reports on findings from the first two years of a study to compare a standard Life Skill Training (LST) program with an infused (I-LST) approach. Nine small, [...]

Objective: The aim of this study was to investigate associations between four categories of maltreatment and substance use among adolescents. Method: All 10th through 12th graders (n = 2,187) at six public high schools in a rural Oregon county filled out an anonymous survey that included questions about their experience of emotional, sexual, and physical abuse and their use of a variety of substances. Substance use was subsequently categorized as: (1) tobacco use, (2) alcohol use, and (3) illicit drug use. Experience of maltreatment was subsequently categorized as: (1) no type of maltreatment, (2) emotional abuse, (3) physical abuse, (4) sexual abuse, and (5) sexual and physical abuse. Results: Results showed that all four categories of maltreatment were associated with increased levels of all three categories of substance use. Statistical comparisons of the magnitude effects of different types of maltreatment on substance use indicated a linear trend with the effects of emotional abuse being significantly lower than those of physical or sexual abuse, and the effects of the combination of physical and sexual abuse being significantly higher than the other types. Conclusion: Results suggested that all types of maltreatment, including emotional abuse, are related to significantly higher levels of substance use and should be considered serious risk factors for substance use during adolescence. Results also indicated that the strength of association between maltreatment and substance use varies by type of maltreatment. Youth who have experienced both physical and sexual abuse are at especially high risk of substance use. Keywords: Adolescent; Maltreatment types; Drug use

In this article, we report on our work at St. Ann's Corner of Harm Reduction, a multi-service agency committed to implementing effective public health strategies in disenfranchised communities from a harm reduction perspective. Based on our experiences, we hope to contribute to the ongoing dialogue about the definition of harm reduction, while proposing to integrate harm reduction and abstinence-oriented treatment modalities into a model of comprehensive drug prevention and care. The five components of our harm reduction service provision are discussed, and a vignette is provided. We conclude with a plea for close collaborations between innovative researchers and harm reduction agencies, and a call for the full integration of harm reduction approaches into the substance abuse field at large. Keywords: Harm reduction; Community based addiction treatment

Many psychiatric professionals are unfamiliar with gamma-hydroxybutyrate (GHB), an increasingly popular drug of abuse. GHB withdrawal can lead to psychosis and agitation, and patients may present to psychiatric facilities for treatment. Withdrawal may progress to delirium, with the potential for severe or even fatal medical complications. Therefore, it is imperative for psychiatric professionals to understand how to treat these patients. In this article, we describe two cases of severe GHB withdrawal syndrome that were treated in our inpatient psychiatric unit. These are among the most severe cases reported. Pertinent literature is reviewed and suggestions for treatment are discussed., PROBLEM STATEMENT Gamma-hydroxybutyrate (GHB), an increasingly popular drug to abuse (1-3), is unfamiliar to many psychiatric professionals. Recent cases of severe GHB withdrawal delirium have occurred in psychiatric settings, making [...]

Objective: This study, using latent variable methodology, explores simultaneously the relative effects of childhood abuse and early parental substance abuse on later chronic homelessness, depression, and substance abuse problems in a sample of homeless women. We also examine whether self-esteem and recent violence can serve as mediators between the childhood predictors and the dysfunctional outcomes. Method: The sample consists of 581 homeless women residing in shelters or sober living centers in Los Angeles (54% African-American, 23% Latina, 22% White, mean age = 33.5 years). Multiple-indicator latent variables served as predictors and outcomes in structural models. Childhood abuse was indicated by sexual, physical, and verbal abuse. Results: Childhood abuse directly predicted later physical abuse, chronic homelessness, depression, and less self-esteem. Parent substance use directly predicted later substance use problems among the women. Recent physical abuse predicted chronic homelessness, depression, and substance use problems. Greater self-esteem predicted less depression and fewer substance use problems. Childhood abuse also had significant indirect effects on depression, chronic homelessness, and drug and alcohol problems mediated through later physical abuse and self-esteem. Conclusions: Although there was a strong relationship between childhood abuse and parent drug use, childhood abuse was the more pervasive and devastating predictor of dysfunctional outcomes. Childhood abuse predicted a wider range of problems including lower self-esteem, more victimization, more depression, and chronic homelessness, and indirectly predicted drug and alcohol problems. The mediating roles of recent physical abuse and self-esteem suggest salient leverage points for change through empowerment training and self-esteem enhancement in homeless women. Keywords: Childhood abuse; Substance abuse; Homeless women; Depression

This study examines substance use between 10th and 12th grades in a predominantly African American sample of 785 adolescents from an urban environment. Psychological distress, academic factors, and perceptions of parents and peers are used to explain 10th-grade substance use and changes in use using hierarchical linear modeling. Results indicate that low achievement and motivation, high truancy, and perceptions of peer substance use are associated with higher 10th-grade substance use. Growth curve analyses reveal that adolescents who perceive negative school attitudes among peers are more likely to increase their cigarette and marijuana use. Among high-achieving students, low motivation is a risk factor for increased cigarette use. Implications focused on enhancing motivation, reducing truancy, and understanding adolescents' perceptions of their peers.

This study examined the prevalence of substance use and mental disorder profiles in a sample of mental health self-help attendees. Findings demonstrate that the rates of these disorders are equivalent to or exceed those found in clinical and community samples. Implications for the role that self-help agencies play in the lives of vulnerable individuals, as well as the justification for increased funding from drug and alcohol treatment sources, are discussed.

The comorbidity of bulimia and substance abuse is significant. The substance that is abused may vary and the abuse potential for nonillicit substances may be overlooked. This paper presents the first case reported of dextromethorphan abuse and bulimia. It demonstrates the complexity of assessment and treatment of bulimia and substance abuse of over-the-counter medications. Keywords - bulimia; substance abuse; dextromethorphan: over-the-counter medications: adolescent.

Over the last twenty years we have seen an increased effort to understand and solve the adolescent drug abuse problem. Researchers have developed a number of models to explain why [...]

The syndrome of factitious disorders with physical symptoms was named 'Munchausen's syndrome' by Richard Asher (1951). The present article contains an interesting case report of a patient who has a history of Munchausen's syndrome, substance abuse, and genuine physical illness. A review of the literature supports a strong association of substance abuse in patients with Munchausen's syndrome. Also important for clinicians to remember is that patients with Munchausen's syndrome often have true physical illnesses which need appropriate treatment. The patient described here has successfully begun treatment with methadone maintenance, but further study will be needed regarding methadone maintenance's role in the management of Munchausen's syndrome.

A study traced the correlation between conduct disorders, depression and drug abuse in New Zealand's youths. A group of 752 youths were studied once at the age of 11 and again at the age of 15. Males who exhibited conduct disorders and depression at the age of 11 exhibited multiple drug use at the age of 15. There was no such correlation for females. A strong correlation existed between conduct and depressive disorders and concurrent multiple drug use for both male and female 15-year-olds. Females who experienced conduct and depressive disorders at 15 were likely to practice concurrent self-medication.

Significant differences are noted in family predictors of substance abuse among ethnic populations. A study of black, white and Asian American families indicates differences by ethnicity in family management practices, involvement in family activity, sibling deviance, parental disapproval of children's drinking and family structure, which may hinder or abet substance abuse.

Two cases of intranasal benzodiazepine use are presented. The methods of preparation and administration of the powder and accounts of the pharmacological effects of the drugs used are described. The pattern of development and progress of the habit and its associated features are delineated. Snorting benzodiazepines appears to be more common than is currently appreciated, and the clinical complications and implications of this habit are discussed., Benzodiazepine is a drug that is frequently prescribed for treating psychiatric disorders. Estimates of the prevalence of abuse of and dependence on this drug are low in the general population. Previous studies of benzodiazepine abuse and dependence have focused on the oral use of the drug; a relatively new way to use the drug is intranasally (snorting). The case reports of two patients who used benzodiazepine intranasally are presented. The first case involved a 25-year-old male with a history of drug abuse and psychiatric problems. In the two years prior to entering a treatment program, he had used Valium, Xanax, Percocet, cannabis, and crank (crystal methamphetamine) regularly. He was also being treated with alprazolam for panic attacks. The patient reported severe withdrawal symptoms associated with benzodiazepine. The second case involved a 23-year-old female with a history of drug abuse and psychiatric problems, who was being treated for her drug problem. She reported being first introduced to snorting a combination of cocaine and Xanax by a friend, and began using this combination frequently. The woman reported severe withdrawal symptoms about 30 minutes after snorting the last amount of Xanax. These two cases illustrate a new way of abusing benzodiazepines. It is suggested that due to fear of contracting AIDS, drug users are more frequently experimenting with routes of administration other than intravenous. (Consumer Summary produced by Reliance Medical Information, Inc.), INTRODUCTION The prevalence of benzodiazepine abuse and dependence in the general population and in medical practice is low. One Swiss study found the prevalence of benzodiazepine abuse was 1 in [...]

CASE Philip, a 14-year-old male, is brought to your office by his anxious parents who recently discovered that he was using marijuana. Over the past 2 months, he has appeared [...]

Clonidine has been used to assist opiate detoxification in the past 10 years. This substance is known to have multiple effects on the central nervous system and to cause withdrawal symptoms when stopped abruptly. The combination of these two effects could result in clonidine having a poten for abuse. Two cases of clonidine abuse/dependence in methadone-maintained patients are presented. Nonmedical use of clonidine in opioid-dependent persons has never been evaluated. Keywords--clonidine; methadone; abuse., The abuse potential of clonidine was evaluated in two case studies. Clonidine has been used to alleviate symptoms of opiate withdrawal. It is claimed to work synergistically with methadone, and is used for its sedative effects. However, clonidine abuse can lead to adverse central nervous system effects aside from its own withdrawal effects such as rebound hypertension. The case profiles presented recommend further studies on the use of clonidine and focus on screening of patients.