Coming to terms with the nonmedical use of prescription medications

In this commentary we highlight limitations with the way nonmedical use of prescription medications has been measured in U.S. national studies. We also offer an alternative way of conceptualizing the nonmedical use of prescription medications for future study

Desistance, Self-treatment, or Substitution: Decisions about Cannabis Use During Pregnancy

Cannabis is the most commonly used drug during pregnancy in the United States and Canada, and the American College of Obstetricians and Gynecologists recommends that all pregnant individuals be screened for cannabis use and counseled regarding potential adverse health impacts of use. However, those considering or using cannabis during pregnancy report experiencing stigma and lack of information from health care providers and, thus, frequently rely on friends, family, and the internet for information. This article describes 3 types of decisions individuals may be making about cannabis use during pregnancy and suggests approaches health care providers may take to minimize judgment and provide optimal support for informed cannabis use decisions among pregnant individuals. Desistance decisions involve consideration of whether and how to reduce or stop using during pregnancy. Self‐treatment decisions are made by those exploring cannabis to help alleviate troublesome symptoms such as nausea or anxiety. Substitution decisions entail weighing whether to use cannabis instead of another substance with greater perceived harms. Health care providers should be able to recognize the various types of cannabis use decisions that are being made in pregnancy and be ready to have a supportive conversation to provide current and evidence‐based information to individuals making desistance, self‐treatment, and substitution decisions. Individuals making desistance decisions may require support with potential adverse consequences such as withdrawal or return of symptoms for which cannabis was being used, as well as potentially navigating social situations during which cannabis use is expected. Those making self‐treatment decisions should be helped to fully explore treatment options for their symptoms, including evidence on risks and benefits. Regarding substitution decisions, health care providers should endeavor to help pregnant individuals understand the available evidence regarding risks and benefits of available options and be open to revisiting the topic over time

The antecedents of women's crack cocaine abuse: Family substance abuse, sexual abuse, depression and illicit drug use

Young African-American women are the fastest growing group of crack cocaine users in the United States. Despite this increase, relatively little is known about women who use crack cocaine and the possible reasons for their drug use. This descriptive, exploratory study focused on data from a sample of 105, predominantly African-American women who use(d) crack cocaine, of whom 60 were in drug treatment and 45 were still using crack cocaine. Significant correlations were found between variables such as family drug use, first age of sexual abuse, age of first depressive symptoms and age of first illicit drug use. These data are consistent with other studies which have noted high rates of depression and sexual abuse in samples of predominantly Euro-American, alcoholic women. Implications for the treatment of women are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30608/1/0000245.pd

Race/ethnicity and gender differences in drug use and abuse among college students

This study examines race/ethnicity and gender differences in drug use and abuse for substances other than alcohol among undergraduate college students. A probability-based sample of 4,580 undergraduate students at a Midwestern research university completed a cross-sectional Web-based questionnaire that included demographic information and several substance use measures. Male students were generally more likely to report drug use and abuse than female students. Hispanic and White students were more likely to report drug use and abuse than Asian and African American students prior to coming to college and during college. The findings of the present study reveal several important racial/ethnic differences in drug use and abuse that need to be considered when developing collegiate drug prevention and intervention efforts.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377408/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377408/Accepted manuscrip

Illicit Methylphenidate Use in an Undergraduate Student Sample: Prevalence and Risk Factors

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90236/1/phco.23.5.609.32210.pd

Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults

Background and AimsSexual minority (SM) populations experience higher rates of substance use disorder (SUD) associated with increased sexual orientation‐related stress. Social support may moderate the impact of stress on SUD among SM adults. This study assessed associations between social support and DSM‐5 SUD by sex and sexual minority identity.DesignCross‐sectional study using data from the 2012–13 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC‐III).Setting and participantsA nationally representative cross‐sectional sample of adults (n = 36 309) in the United States.MeasurementsSUD were defined based on the DSM‐5 criteria for alcohol use (AUD), tobacco use (TUD) and drug use (DUD) disorders. Structural social support was measured as the type and frequency of kin and non‐kin contact, and functional social support was measured by the Social Provision Scale.FindingsSM adults had higher odds of all SUD compared to heterosexual adults [AUD = 1.535, 95% confidence interval (CI) = 1.782–1.844; TUD = 1.512, 95% CI = 1.234–1.854; DUD = 1.520, 95% CI = 1.139–2.028]; SM women experienced the highest proportion of all SUD (AUD = 27.1%, TUD = 29.1%, DUD = 10.9%). Type of social support was differentially associated with SUD by sex and sexual identity status. Higher social provision was associated with lower rates of AUD [adjusted odds ratio (aOR) = 0.771, 95% CI = 0.705–0.844], TUD (aOR = 0.747, 95% CI = 0.694–0.804] and DUD (aOR = 0.558, 95% CI = 0.490–0.636). Marriage was associated with lower SUD among heterosexual men (AUD, aOR = 0.500, 95% CI = 0.432–0.579; TUD, aOR = 0.603, 95% CI = 0.521–0.699; DUD, aOR = 0.504, 95% CI = 0.369–0.689) and women (AUD, aOR = 0.637, 95% CI = 0.529–0.767; TUD = 0.0.584, 95% CI = 0.507–0.671; DUD, aOR = 0.515, 95% CI = 0.372–0.712). Compared to heterosexual adults, SM women with at least one child under the age of 18 years had higher odds of TUD (aOR = 1.990, 95% CI = 1.325–2.988). SM‐related discrimination was not associated with SUD among some SM subgroups, but discrimination among male heterosexually identifying individuals reporting same‐sex attraction or behavior was associated AUD (aOR = 4.608, 95% CI = 1.615–13.14).ConclusionsIn the United States there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and substance use disorder (SUD) which differ by sex and sexual identity status.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154284/1/add14819.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154284/2/add14819_am.pd

Initiation Sequence of E‐Cigarette and Cigarette Smoking among US Adolescents: A National Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149688/1/ajad12886_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149688/2/ajad12886.pd

Illicit Use of Specific Prescription Stimulants Among College Students: Prevalence, Motives, and Routes of Administration

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90069/1/phco.26.10.1501.pd

Sexual Trauma, Substance Abuse, and Treatment Success in a Sample of African American Women Who Smoke Crack Cocaine

The purpose of this descriptive study was to examine the relationship among sexual trauma, severity of substance use, and treatment success for African American women who smoke crack cocaine. Using a convenience sample of 208 African American women with a history of crack smoking, participants were interviewed for 2 to 4 hr and asked a variety of questions about their health, relationships, sexuality, and drug use. Women with a history of sexual trauma ( N = 134) reported being addicted to more substances than women who had not been sexually traumatized ( N = 74), despite the fact that the two groups did not differ on the number of substances used. Differences in the self-reported level of substance abuse was corroborated with external evidence of group differences in substance abuse severity. Women with a history of sexual trauma, compared to women without such a history, were admitted to the hospital or emergency room more often for health issues related to their substance use and were more likely to be negligent in caring for their children because of their drug use. We also found evidence to suggest that there are differences in treatment success between the two groups; women with a history of sexual trauma reported having been to substance abuse treatment programs more often than women without such a history. These findings are discussed in light of the particular treatment needs of women with a history of sexual trauma.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45667/1/11226_2004_Article_221613.pd

Sports involvement, injury history, and non‐medical use of prescription opioids among college students: An analysis with a national sample

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141733/1/ajad12657.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141733/2/ajad12657_am.pd