Substance Use (substance + use)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Substance Use

  • adolescent substance use
  • illicit substance use
  • other substance use
  • psychoactive substance use

  • Terms modified by Substance Use

  • substance use disorder
  • substance use disorders
  • substance use pattern
  • substance use problem

  • Selected Abstracts


    ABORTION AND SUBSTANCE USE: CAUSE OR CONFOUNDING?

    ADDICTION, Issue 1 2009
    PREBEN AAVITSLAND
    No abstract is available for this article. [source]


    ABORTION, SUBSTANCE USE AND CONFOUNDING: A REPLY TO AAVITSLAND (2009)

    ADDICTION, Issue 1 2009
    WILLY PEDERSEN
    No abstract is available for this article. [source]


    PREVENTING HARMFUL SUBSTANCE USE: THE EVIDENCE FOR POLICY AND PRACTICE

    ADDICTION, Issue 6 2006
    SHANE DARKE
    No abstract is available for this article. [source]


    PREDICTORS OF SUBSTANCE USE AND FAMILY THERAPY OUTCOME AMONG PHYSICALLY AND SEXUALLY ABUSED RUNAWAY ADOLESCENTS

    JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 3 2006
    Natasha Slesnick
    There is a dearth of research that examines the impact of family systems therapy on problems among sexually and/or physically abused youth. Given this void, differential outcome and predictors of substance use change were evaluated for abused, as compared with nonabused, runaway adolescents who were randomly assigned to family therapy or treatment as usual. Abused adolescents reported lower family cohesion at baseline, although both abused and nonabused adolescents showed similar substance use reductions. Utilizing hierarchical linear modeling, we found that substance use changed with change in cohesion over time. These findings link change in family functioning to change in adolescent substance use, supporting family systems theory. Findings suggest that a potent target of intervention involves focus on increasing positive communication interactions. [source]


    The manualization of a treatment programme for personality disorder

    CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2005
    Mary McMurran
    Background The advantages of manualized psychological treatments include: the promotion of evidence-based practice, the enhancement of treatment integrity, the facilitation of staff training, and the potential replicability of treatment. Argument The manualization of a multi-component, multidisciplinary treatment programme for male personality-disordered offenders is described. The background to this development is explained and the treatment setting is described briefly, followed by a description of the eight treatment manuals: (1) the treatment overview, (2) Psychoeducation focusing on personality disorder diagnosis and core beliefs, (3) Trust and Self-awareness group exercises, (4) Stop & Think! - a social problem-solving intervention, (5) Controlling Angry Aggression, (6) Controlling Substance Use, (7) Criminal Thinking/Belief Therapy, and (8) Skills for Living - a social skills manual. Conclusions In addition to the original aims of manualization, this exercise has clarified the treatment programme, included less highly trained staff in the delivery of therapy and permitted the evaluation of treatment modules, thus contributing to the incremental evaluation of the overall programme. These manuals may usefully be shared with other practitioners in the field. Copyright © 2005 Whurr Publishers Ltd. [source]


    Neuroscience of Psychoactive Substance Use and Dependence

    ADDICTION, Issue 10 2004
    KARL MANN
    No abstract is available for this article. [source]


    The Economic Analysis of Substance Use and Abuse: An Integration of Econometric and Behavioral Economic Research edited by F.J. Chaloupka, M. Grossman, W.K. Bickel and H. Safer.

    HEALTH ECONOMICS, Issue 4 2001
    1999., Chicago, University of Chicago Press
    No abstract is available for this article. [source]


    Engaging Families to Prevent Substance Use Among Latino Youth

    JOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 4 2010
    Angela Chia-Chen Chen PhD, PMHNP-BC Assistant Professor
    Angela Chia-Chen Chen, Bonnie Gance-Cleveland, Albert Kopak, Steven Haas, and Mary Gillmore Column Editor: Bonnie Gance-Cleveland Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building. [source]


    Effects of Parental Monitoring and Peer Deviance on Substance Use and Delinquency

    JOURNAL OF MARRIAGE AND FAMILY, Issue 4 2006
    Grace M. Barnes
    From socialization theory, it was hypothesized that parental support and monitoring as well as peer deviance would influence individual trajectories of alcohol misuse, other substance use, and delinquency. Six waves of data were analyzed using interviews with 506 adolescents in a general population sample. Results from multilevel modeling showed that monitoring significantly predicted adolescents' initial levels (intercepts) of alcohol misuse and delinquency. Parental monitoring strongly predicted the rates of increase (slope) in all 3 problem behaviors. Peer deviance significantly predicted initial levels of all problem behaviors and the rates of increase in them. This study provides evidence that both effective parenting and avoidance of associations with delinquent peers are important factors in preventing adolescent problem behaviors. [source]


    Substance Use and Psychosocial Predictors of High School Dropout in Cape Town, South Africa

    JOURNAL OF RESEARCH ON ADOLESCENCE, Issue 1 2010
    Alan J. Flisher
    The aims of this study were to examine whether use of tobacco, alcohol, and illicit drugs predicts dropout among secondary school students in Cape Town, South Africa. A self-report instrument was administered to 1,470 Grade 8 students. The proportion of students that dropped out of school between the onset of the study and 4 years later was 54.9%. After adjusting for a range of confounders, dropout was significantly predicted by absenteeism, poverty (as assessed by a possession index), and past month cigarette use, but not by past month alcohol use and lifetime illicit drug use. Contrary to findings from developed countries, alcohol and illicit drug use did not predict dropout. It is possible that predictors of dropout documented elsewhere may not be pertinent in developing countries. [source]


    Adolescents' Perceived Parenting Styles and Their Substance Use: Concurrent and Longitudinal Analyses

    JOURNAL OF RESEARCH ON ADOLESCENCE, Issue 4 2001
    Sigrun Adalbjarnardottir
    The relation between parenting style and adolescent substance use (tobacco, alcohol, hashish, and amphetamines) was examined concurrently (at age 14) for licit drug use and longitudinally (from age 14 to 17) for both licit and illicit drug use in a sample of 347 youth from compulsory schools in Reykjavik, Iceland. After controlling for adolescent perceptions of parental and peer use, own previous use, and gender, results indicated that adolescents who characterized their parents as authoritative were more protected against substance use than adolescents who perceived their parents as neglectful, both concurrently and longitudinally. Compared with adolescents who characterized their parents as authoritative and neglectful, those from authoritarian and indulgent families each showed a different pattern of substance use both with regard to the type of substance and over time in a longer term perspective. [source]


    Drinks of the Father: Father's Maximum Number of Drinks Consumed Predicts Externalizing Disorders, Substance Use, and Substance Use Disorders in Preadolescent and Adolescent Offspring

    ALCOHOLISM, Issue 12 2002
    Stephen M. Malone
    Background The maximum number of drinks consumed in 24 hr seems to be an interesting phenotype related to alcoholism. The goal of the present study was to determine in an epidemiologic sample whether this measure of drinking history in fathers predicted externalizing behavioral disorders, substance use, and substance abuse in preadolescent and adolescent offspring and whether any such associations would be independent of paternal alcohol dependence diagnoses. Methods Subjects were male and female twins from both age cohorts of the Minnesota Twin Family Study, a population-based longitudinal study, and were approximately 11 or 17 years of age, respectively, upon study enrollment. In both age cohorts, diagnoses of conduct disorder, oppositional defiant disorder, and attention-deficit/hyperactivity disorder served as outcome measures. In addition, measures of lifetime substance use and of the presence of symptoms of substance abuse were derived for the 11-year-old cohort when subjects were approximately 14 years old and diagnoses of substance abuse were derived for the older cohort at age 17. An extension of logistic regression using generalized estimating equations served to assess whether paternal maximum alcohol consumption predicted filial outcome measures. Results Paternal maximum alcohol consumption was consistently associated with conduct disorder, substance use, and substance abuse or dependence in male and female offspring. These associations were not mediated by a primary effect of paternal alcoholism. Conclusions Paternal maximum alcohol consumption was uniquely associated with those offspring characteristics most reliably found in adolescent children of alcoholic parents. This phenotype might supplement DSM diagnoses of alcohol dependence to reduce the number of false positives in genetic research. [source]


    The Significance of Marijuana Use Among Alcohol-using Adolescent Emergency Department Patients

    ACADEMIC EMERGENCY MEDICINE, Issue 1 2010
    Thomas H. Chun MD
    Abstract Objectives:, The objective was to determine if adolescents presenting to a pediatric emergency department (PED) for an alcohol-related event requiring medical care differ in terms of substance use, behavioral and mental health problems, peer relationships, and parental monitoring based on their history of marijuana use. Methods:, This was a cross-sectional comparison of adolescents 13,17 years old, with evidence of recent alcohol use, presenting to a PED with a self-reported history of marijuana use. Assessment tools included the Adolescent Drinking Inventory, Adolescent Drinking Questionnaire, Young Adult Drinking and Driving Questionnaire, Center for Epidemiologic Studies Depression Scale, Behavioral Assessment System for Children, and Peer Substance Use and Tolerance of Substance Use Scale. Results:, Compared to adolescents using alcohol only (AO), adolescents who use alcohol and marijuana (A+M) have higher rates of smoking (F = 23.62) and binge drinking (F = 11.56), consume more drinks per sitting (F = 9.03), have more externalizing behavior problems (F = 12.53), and report both greater peer tolerance of substance use (F = 12.99) and lower parental monitoring (F = 7.12). Conclusions:, Adolescents who use A+M report greater substance use and more risk factors for substance abuse than AO-using adolescents. Screening for a history of marijuana use may be important when treating adolescents presenting with an alcohol-related event. A+M co-use may identify a high-risk population, which may have important implications for ED clinicians in the care of these patients, providing parental guidance, and planning follow-up care. ACADEMIC EMERGENCY MEDICINE 2010; 17:63,71 © 2010 by the Society for Academic Emergency Medicine [source]


    Exploring the Link Between Substance Use and Abortion: The Roles of Unconventionality and Unplanned Pregnancy

    PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 2 2006
    Steven C. Martino
    CONTEXT: Several studies have found a relationship between abortion and prior substance use, suggesting that a reduction in substance use might help decrease abortion rates. However, such a conclusion requires a greater understanding of the processes linking abortion and prior substance use. METHOD: Path analysis of longitudinal data from 1,224 women was used to simultaneously test two pathways from adolescent substance use to abortion by age 29, one mediated by higher rates of unplanned pregnancy and the other independent of unplanned pregnancy rates. The model was then expanded to examine how these pathways change when unconventional attitudes and behaviors (such as rebelliousness and low religiosity) are taken into consideration. RESULTS: In the analysis that did not control for unconventionality, women who reported smoking cigarettes or using marijuana or hard drugs at age 18 had an increased likelihood of subsequent unplanned pregnancy and, as a result, higher rates of abortion. In addition, women who had used marijuana had an increased likelihood of abortion independent of unplanned pregnancy rates. In the final model, unconventionality strongly predicted both abortion and unplanned pregnancy. Moreover, it explained the associations between the use of hard drugs or marijuana and abortion that were due to higher unplanned pregnancy rates. CONCLUSIONS: Unconventionality mediates certain associations between substance use and abortion, perhaps because unconventional women are more likely both to use substances and to engage in behaviors that increase their risk of unplanned pregnancy. Hence, it seems unlikely that reducing substance use will result in substantially fewer abortions. [source]


    Coming In: An Examination of People With Co-Occurring Substance Use and Serious Mental Illness Exiting Chronic Homelessness

    AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009
    Alisa K. Lincoln PhD
    Despite national efforts, the number of people who are chronically homeless in our cities remains high. People with serious mental illness and substance abuse problems continue to represent the majority of those experiencing long-term homelessness. Traditional shelters have difficulty engaging and addressing the needs of this group; however, there are an increasing number of alternative models, including the Safe Haven shelter program, developed to better meet their needs. In this article, the authors examine responses from 28 qualitative interviews conducted with 16 residents of a Safe Haven shelter serving chronically homeless people, at 3 and 9 months after entry. All had a severe mental illness and were actively substance abusing. The importance of a model that respects personhood, a place that feels like home, and challenges faced by residents as they "come in" are emphasized. [source]


    The Kappa-Opiate Receptor Impacts the Pathophysiology and Behavior of Substance Use

    THE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2009
    David Mysels MD
    There is increasing evidence that the kappa-opiate receptor, in addition to the mu-opiate receptor, plays an important role in substance use pathophysiology and behavior. As dopamine activity is upregulated through chronic substance use, kappa receptor activity, mediated through the peptide dynorphin, is upregulated in parallel. Dynorphin causes dysphoria and decreased locomotion, and the upregulation of its activity on the kappa receptor likely dampens the excitation caused by increased dopaminergic activity. This feedback mechanism may have significant clinical implications for treating drug dependent patients in various stages of their pathology. [source]


    Assessing Negative Consequences in Patients with Substance Use and Bipolar Disorders: Psychometric Properties of the Short Inventory of Problems (SIP)

    THE AMERICAN JOURNAL ON ADDICTIONS, Issue 6 2007
    Rachel E. Bender BA
    The Short Inventory of Problems (SIP), a questionnaire that measures negative consequences of alcohol use, has not been validated among substance users with co-occurring psychiatric illness. This study examined the psychometric properties of the SIP in 57 outpatients diagnosed with substance use disorder and bipolar disorder. We modified the items to assess drugs in addition to alcohol and, further, we added corresponding items to assess consequences of bipolar disorder. This modified version of the SIP was psychometrically sound, and may be useful in patients with both disorders. A greater understanding of perceived negative consequences may enhance outcome assessment in dually diagnosed populations. [source]


    Gabapentin in Comorbid Anxiety and Substance Use

    THE AMERICAN JOURNAL ON ADDICTIONS, Issue 2 2007
    Marcia L. Verduin MD
    No abstract is available for this article. [source]


    Cigarette Smoking and Substance Use among Men Court-Referred to Domestic Violence Treatment Programs

    THE AMERICAN JOURNAL ON ADDICTIONS, Issue 3 2004
    Gregory L. Stuart Ph.D.
    No abstract is available for this article. [source]


    The spectrum of substance abuse in bipolar disorder: reasons for use, sensation seeking and substance sensitivity

    BIPOLAR DISORDERS, Issue 3 2007
    Jacopo V Bizzarri
    Objectives:, To examine the spectrum of alcohol and substance abuse, including reasons for use, in patients with bipolar I disorder, compared with patients with substance use disorder and healthy controls, with a specific focus on the relationship between substance use, substance sensitivity, other comorbid psychiatric symptoms and traits related to sensation seeking. Methods:, This study included 104 patients with bipolar I disorder (BPD I), of whom 57 (54.8%) met DSM-IV criteria for lifetime alcohol or substance use disorder (BPD + SUD), 35 patients with substance use disorder (SUD) and no psychiatric disorder and 50 healthy controls. Assessments included the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS). Results:, Patients with BPD + SUD and SUD had significantly higher scores on the SCI-SUBS domains of self-medication, substance sensitivity and sensation seeking compared with patients with BPD and healthy controls. Reasons for substance use did not differ between patients with BPD + SUD and patients with SUD. Those most frequently cited were: improving mood; relieving tension; alleviating boredom; achieving/maintaining euphoria; and increasing energy. Conclusions:, Recourse to substances is associated with increased mood and anxiety symptoms, substance sensitivity, and sensation seeking among patients with BPD + SUD and SUD. Substance sensitivity and sensation seeking traits should be investigated in all patients with BPD as possible factors associated with a development of SUD, in order to warn patients of the specific risks related to improper use of medications and substances. [source]


    Effects of N-acetylcysteine on substance use in bipolar disorder: A randomised placebo-controlled clinical trial

    ACTA NEUROPSYCHIATRICA, Issue 6 2009
    Michelle Bernardo
    Objective: To evaluate the effect of N-acetylcysteine (NAC) on substance use in a double-blind, placebo-controlled trial of NAC in bipolar disorder. It is hypothesised that NAC will be superior to placebo for reducing scores on the Clinical Global Impressions scale for Substance Use (CGI-SU). Methods: Participants were randomised to a 6-months of treatment with 2 g/day NAC (n = 38) or placebo (n = 37). Substance use was assessed at baseline using a Habits instrument. Change in substance use was assessed at regular study visits using the CGI-SU. Results: Among the 75 participants 78.7% drank alcohol (any frequency), 45.3% smoked tobacco and 92% consumed caffeine. Other substances were used by fewer than six participants. Caffeine use was significantly lower for NAC-treated participants compared to placebo at week 2 of treatment but not at other study visits. Conclusions: NAC appeared to have little effect on the participants who were using substances. A larger study on a substance-using population will be necessary to determine if NAC may be a useful treatment for substance use. [source]


    Effects of N -acetylcysteine on substance use in bipolar disorder: a randomised placebo-controlled clinical trial

    ACTA NEUROPSYCHIATRICA, Issue 5 2009
    Michelle Bernardo
    Objective: To evaluate the effect of N -acetylcysteine (NAC) on substance use in a double-blind, placebo-controlled trial of NAC in bipolar disorder. It is hypothesised that NAC will be superior to placebo for reducing scores on the Clinical Global Impressions scale for Substance Use (CGI-SU). Methods: Participants were randomised to 6-months of treatment with 2 g/day NAC (n = 38) or placebo (n = 37). Substance use was assessed at baseline using the Habits instrument. Change in substance use was assessed at regular study visits using the CGI-SU. Results: Amongst the 75 participants 78.7% drank alcohol (any frequency), 45.3% smoked tobacco and 92% consumer caffeine. Other substances were used by fewer than six participants. Caffeine use was significantly lower for NAC-treated participants compared with placebo at week 2 of treatment but not at other study visits. Conclusion: NAC appeared to have little effect on substance use in this population. A larger study on a substance using population will be necessary to determine if NAC may be a useful treatment for substance use. [source]


    Substance Use in Emergency Medicine Training Programs

    ACADEMIC EMERGENCY MEDICINE, Issue 1 2008
    Brian D. McBeth MD
    Abstract Objectives:, To explore the prevalence of substance use among emergency medicine (EM) residents and compare to a prior study conducted in 1992. Methods:, A voluntary, anonymous survey was distributed in February 2006 to EM residents nationally in the context of the national in-service examination. Data regarding 13 substances, demographics, and perceptions of personal patterns of substance use were collected. Results:, A total of 133 of 134 residencies distributed the surveys (99%). The response rate was 56% of the total EM residents who took the in-service examination (2,397/4,281). The reported prevalence of most illicit drug use, including cocaine, heroin, amphetamines, and other opioids, among EM residents are low. Although residents reporting past marijuana use has declined (52.3% in 1992 to 45.0% in 2006; p < 0.001), past-year use (8.8%,11.8%; p < 0.001) and past-month use (2.5%,4.0%; p < 0.001) have increased. Alcohol use appears to be increasing, including an increase in reported daily drinkers from 3.3% to 4.9% (p < 0.001) and an increase in number of residents who indicate that their consumption of alcohol has increased during residency (from 4% to 12.6%; p < 0.001). Conclusions:, Self-reported use of most street drugs remains uncommon among EM residents. Marijuana and alcohol use, however, do appear to be increasing. Educators should be aware of these trends, and this may allow them to target resources for impaired and at-risk residents. [source]


    Impact of substance use on the physical health of patients with bipolar disorder

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010
    M. P. Garcia-Portilla
    Garcia-Portilla MP, Saiz PA, Benabarre A, Florez G, Bascaran MT, Díaz EM, Bousoño M, Bobes J. Impact of substance use on the physical health of patients with bipolar disorder. Objective:, To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients. Method:, Naturalistic, cross-sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self-reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999,2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions. Results:, Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85,5.10). Conclusion:, Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk. [source]


    Illicit substance use and its correlates in first episode psychosis

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010
    R. Mazzoncini
    Mazzoncini R, Donoghue K, Hart J, Morgan C, Doody GA, Dazzan P, Jones PB, Morgan K, Murray RM, Fearon P. Illicit substance use and its correlates in first episode psychosis. Objective:, To determine if substance use (particularly cannabis) is more frequent among first episode psychosis patients and associated with a more problematic clinical presentation. Method:, All first episode psychosis (FEP) patients presenting to secondary services were recruited from London and Nottingham, over 2 years, in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study broad framework. Clinical and sociodemographic variables were assessed using a set of standardized instruments. A schedule was created to retrospectively collate substance use data from patients, relatives and clinicians. Results:, Five hundred and eleven FEP were identified. They used three to five times more substances than general population. Substance use was associated with poorer social adjustment and a more acute mode of onset. Cannabis use did not affect social adjustment, but was associated with a more acute mode of onset. Conclusion:, Cannabis has a different impact on FEP than other substances. Large epidemiological studies are needed to disentangle cannabis effect. [source]


    Global use of alcohol, drugs and tobacco

    DRUG AND ALCOHOL REVIEW, Issue 6 2006
    PETER ANDERSON
    Abstract Humans have always used drugs, probably as part of their evolutionary and nutritional heritage. However, this previous biological adaptation is unlikely to be so in the modern world, in which 2 billion adults (48% of the adult population) are current users of alcohol, 1.1 billion adults (29% of the adult population) are current smokers of cigarettes and 185 million adults (4.5% of the adult population) are current users of illicit drugs. The use of drugs is determined largely by market forces, with increases in affordability and availability increasing use. People with socio-economic deprivation, however measured, are at increased risk of harmful drug use, as are those with a disadvantaged family environment, and those who live in a community with higher levels of substance use. Substance use is on the increase in low-income countries which, in the coming decades, will bear a disproportionate burden of substance-related disability and premature death. [source]


    Substance use and the prediction of young offender recidivism

    DRUG AND ALCOHOL REVIEW, Issue 4 2003
    ALDIS L. PUTNI
    Abstract The problem considered is whether self-reported substance use can be used in the estimation of recidivism risk among youths placed in secure care. The Secure Care Psychosocial Screening (SECAPS) and offending records of 447 youths admitted to detention centres in South Australia were examined. The target outcome was any new offending within 6 months of release. Use of a psychoactive substance at the time of committing the most recent offence was not a significant predictor of subsequent offending, nor was acknowledging having a problem with drug or alcohol use. In relation to the recent use of alcohol, marijuana, hallucinogens, sedatives/hypnotics, narcotics, stimulants and inhalants, only the use of alcohol and inhalants appeared to have significant relationships with recidivism. While the relationships were too small to permit using these items on their own to estimate re-offending risk, recent alcohol and inhalant use could be included as part of a broader recidivism risk assessment. [source]


    Drug prevention programmes for young people: where have we been and where should we be going?

    ADDICTION, Issue 10 2010
    Richard Midford
    ABSTRACT Aim Substance use by young people has long been a concern of western society, but opinion is mixed as to which prevention approach offers the greatest benefit, and whether indeed there is any benefit at all. This paper reviews the nature of prevention programmes, the research evidence that underpins these programmes and the prevention objectives against which effectiveness is measured. The aim of this is to create better understanding of the elements that maximize programme effectiveness, what can be achieved by prevention programmes and how programmes can be improved. Findings There is a range of prevention approaches for which there is evidence of effectiveness. Some are classroom-based; some focus upon parenting; some have substantial whole-of-school and community elements; and some target risk and protective factors in early childhood. All, however, are based substantially on the social influence model. In an attempt to improve practice lists of effective programmes have been developed, but there are concerns about the science behind selection. On balance, there is consistent evidence that social influence prevention programmes do have a small, positive effect on drug use, but this then raises the question as to whether harm, rather than use, would be the more worthwhile target for prevention. Prevention that seeks to reduce harm has been demonstrably effective, but has found little support in some jurisdictions. Conclusion Research has created a progressively better understanding of how to optimize programme effectiveness and what can be achieved realistically by even the most effective programmes. However, further research is required to identify which, if any, particular approach offers greater promise. The effectiveness of harm reduction should be compared with more traditional abstinence and the additional effects of whole of school, parent and community elements need to be measured more accurately. Contemporary social influence prevention programmes are flawed, but the approach is still the best way of influencing drug use behaviour in young people as a whole. Evidence-based refinement is the best option for greater benefit. [source]


    Substance use and common child mental health problems: examining longitudinal associations in a British sample

    ADDICTION, Issue 8 2010
    Anna Goodman
    ABSTRACT Aims To examine the longitudinal associations in both directions between mental health and substance use in adolescence. Design Three-year longitudinal cohort. Setting Britain (nationally representative sample). Participants 3607 youths aged 11,16 years at baseline. Measurements Externalizing and internalizing mental health problems were measured using brief questionnaires (parent-reported Strengths and Difficulties Questionnaire) and diagnostic interviews, including clinician-rated diagnoses of mental disorder. Substance use was measured by youth self-report, and included regular smoking, frequent alcohol consumption, regular cannabis use and ever taking other illicit drugs. Findings Externalizing (specifically behavioural) problems at baseline independently predicted all forms of substance use, with a particularly strong effect on smoking. In all cases this association showed a dose,response relationship. In contrast, although internalizing problems had a strong univariable association with smoking, this disappeared after adjusting for comorbid externalizing problems. There was little or no evidence that baseline substance use predicted mental health at follow-up. Conclusions Externalizing problems predict adolescent substance use, and adjusting for comorbid externalizing problems is vital when investigating the effects of internalizing problems. A dose,response effect of externalizing problems is seen across the full range. Programmes seeking to prevent adolescent substance use by reducing externalizing problems may therefore wish to consider population-wide interventions rather than targeting individuals only at the negative extreme. [source]


    Substance use and periodontal disease among Australian Aboriginal young adults

    ADDICTION, Issue 4 2010
    Lisa M. Jamieson
    ABSTRACT Aim To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. Design Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. Participants Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. Measurements Clinical dental examination and self-report questionnaire. Findings Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06,2.40], marijuana (PR = 1.44, 95% CI = 1.05,1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08,3.11), but not alcohol (PR = 0.92, 95% CI = 0.67,1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03,2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. Conclusions This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation. [source]