Substance Abuse

abstract: "More than one-third of the approximately two million people entering publicly funded substance abuse treatment in the United States do not complete treatment. Additionally, racial and ethnic minorities with addiction disorders, who constitute approximately 40 percent of the admissions in publicly funded substance abuse treatment programs, may be particularly at risk for poor outcomes. Using national data, we found that blacks and Hispanics were 3.5-8.1 percentage points less likely than whites to complete treatment for alcohol and drugs, and Native Americans were 4.7 percentage points less likely to complete alcohol treatment. Only Asian Americans fared better than whites for both types of treatment. Completion disparities for blacks and Hispanics were largely explained by differences in socioeconomic status and, in particular, greater unemployment and housing instability. However, the alcohol treatment disparity for Native Americans was not explained by socioeconomic or treatment variables, a finding that warrants further investigation. The Affordable Care Act could reduce financial barriers to treatment for minorities, but further steps, such as increased Medicaid funding for residential treatment and better cultural training for providers, would improve the likelihood of completing treatment and increase treatment providers' cultural competence. "

"Neither physicians' attitudes nor self-efficacy had any impact on physicians' counseling, but greater perceived self-efficacy in screening, assessing and intervening with patients was associated with more drinking by patients six months later."

Abstract: " Binge drinking is a dangerous behavior but is not widely recognized as a women's health problem. Drinking too much - including binge drinking* - results in about 23,000 deaths in women and girls each year. Binge drinking increases the chances of breast cancer, heart disease, sexually transmitted diseases, unintended pregnancy, and many other health problems. Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol spectrum disorders. About 1 in 8 women aged 18 years and older and 1 in 5 high school girls binge drink. Women who binge drink do so frequently - about 3 times a month - and have about 6 drinks per binge. There are effective actions communities can take to prevent binge drinking among women and girls."

"Like many sectors of society, the U.S. military has a long history of alcohol and other drug misuse and abuse. In recent years, the face of the issue has been transformed by increasing rates of prescription drug abuse among service members. Heavy alcohol use and binge drinking continues to be a concern within the military. To better understand the current substance use problems within the U.S. military, the Department of Defense (DoD) asked the IOM to analyze policies and programs that pertain to prevention, screening, diagnosis, and treatment of substance use disorders for active duty service members in all branches, members of the National Guard and Reserve, and military families. The IOM concludes that to deal with this public health crisis, the DoD will need to consistently implement evidence-based prevention, screening, diagnosis, and treatment services and take leadership for ensuring that these services expand and improve. "

National data from the Treatment Episode Data Set (TEDS) 2009, on dually-addicted

From the introduction: "This 4-part report examines new systems of care for substance use conditions under health reform. 1. We briefly review the prevailing general system of care for the treatment for substance-related conditions. 2. We provide a detailed exploration of the emerging systems of publicly and privately funded substance use disorders treatment, which-driven by new insurance regulations and new mechanisms for payment reimbursement-will change significantly under health care reform. 3. We examine 3 case studies of expanded care for clinically distinct subsets of patients-those with unhealthy substance use who do not yet have addiction (persons with hazardous use), those with the highest recent rate of increase in mortality among substance use disorders (persons with opioid addiction), and those with the highest overall incidence of substance-related deaths (persons with nicotine addiction)-to examine how persons with different disorders should be able to receive better, more frequent care through federally mandated health care reforms. 4. We examine how health information technology systems will drive substance use disorders treatment toward greater connectivity, accountability, and improved outcomes."

" Methods: The present study estimated the frequency of alcohol use disorder, marijuana use disorder, and co-occurring alcohol and marijuana use disorder and their associated public health and social problems in Whites, African Americans, and Hispanics. This cross-sectional study included 13,872 individuals and used data from the 2005-2007 National Survey on Drug Use and Health. Frequency was calculated and multinomial regression was used to assess associations between substance use disorder and psychosocial, adverse consequences such as history of being arrested, substance use treatment, and sexually transmitted infection. Results: Alcohol use disorder was comparable between, and most prevalent among, Whites and Hispanics compared to African Americans, whereas marijuana use disorder was greatest among African Americans compared to other race/ethnicities. Co-occurring alcohol and marijuana use disorders were most prevalent for African Americans versus Whites and Hispanics, and similar in Whites and Hispanics. In general, major depressive episode was more prevalent for respondents with co-occurring use disorders or single marijuana use disorders. However, race/ethnicity differences in associations between substance use disorder and psychosocial correlates and adverse consequences were observed. Conclusions: Findings have implications for race/ethnicity appropriate integrated prevention and treatment of single and co-occurring use disorders and psychiatric comorbidities."

"Experience of childhood maltreatment is associated with problematic patterns of adolescent substance use and may shape the longitudinal course of substance use during adolescence"

"Method An Alcohol Purchase Task (APT) was used to generate a demand curve measure of alcohol reinforcement in a sample of 133 college students (50.4% male, 64.4% Caucasian, 29.5% African-American) who reported at least one heavy drinking episode (5/4 or more drinks in one occasion for a man/woman) in the past month. Participants also completed standard measures of alcohol consumption and symptoms of depression and PTSD. Results Regression analyses indicated that symptoms of depression were associated with higher demand intensity (alcohol consumption when price = 0; ΔR2 = .05, p = .002) and lower elasticity (ΔR2 = .04, p = .03), and that PTSD symptoms were associated with all five demand curve metrics (ΔR2 = .04-.07, ps < .05). Conclusions These findings provide support for behavioral economic models of addiction that highlight the role of aversive visceral states in increasing the reward value of alcohol and provide an additional theoretical model to explain the association between negative affect and problematic drinking patterns."

"Massachusetts is the top state in the country for opioid overdoses, and lifetime heroin use in Worcester is almost 5%, twice the state and national average. Founder and Director of the Massachusetts Organization for Addiction Recovery (MOAR), Maryanne Frangules, says that their group is working closely with the state legislature and the Worcester Division of Public Health to combat this complex issue."

Study involving "Fourteen focus groups were conducted with 118 youth (78.3% male; 66.1% Latino) enrolled in participating substance abuse treatment programs (4 young adult and 10 adolescent) throughout Los Angeles County."

"Aspects of both abstinence-based and harm reduction approaches can benefit youths "

Abstract:"The idea of abstinence as a prevention technique against addiction is a non sequitur. The approach AA takes with confirmed alcoholics makes no sense for children, whose worlds - like adults' - are strewn with too many potentially addictive involvements to make lifelong abstinence feasible as an answer to all situations for all times. Furthermore, purveying the need for abstinence communicates that various involvements are so fearsome that they can easily topple young people - taking control of their own decision-making out of their hands. Alternative approaches based on affirming young people's self-efficacy are presented."

"Suggestions include public-private partnerships as a way to fund R&D in this area"

Victoria Bekiempis: The growing taste for prescription opioids in the US is a concern. What is it about our way of life that necessitates such relief?

Cause to think twice about sober living facilities

Easy-to-read information about the effects of commonly abused drugs, drug addiction, and drug addiction recovery and treatment from the National Institute on Drug Abuse

role gender plays in addiction