Drugged
The prevalence of cannabis-involved driving in California
Mark Johnson et al.
Drug and Alcohol Dependence, 1 June 2012, Pages 105-109
Background: Various national surveys suggest that cannabis use is rising nationally and many States have passed legislation that has potential to increase usage even further. This presents a problem for public roadways, as research suggests that cannabis impairs driving ability.
Methods: Anonymous oral fluid samples and breath tests were obtained from more than 900 weekend nighttime drivers randomly sampled from six jurisdictions in California. Oral fluid samples were assayed for the presence of Schedule I drugs. Drivers also completed information on self-reported drug use and possession of a medical cannabis permit. Data from the 2007 National Roadside Survey (collected using comparable methods) were used as a comparison.
Results: Using the 2010 data, a total of 14.4% of weekend nighttime drivers tested positive for illegal drugs, with 8.5% testing positive for delta-9-tetrahydrocannabinol (THC). THC-positive rates varied considerably among jurisdictions, from a low of 4.3% in Fresno to a high of 18.3% in Eureka. A comparison with the 2007 NRS data found an increase in THC-positive drivers in 2010, but no increase in illegal drugs other than cannabis. Drivers who reported having a medical cannabis permit were significantly more likely to test positive for THC.
Conclusions: Cannabis-involved driving has increased in California since 2007. Nearly 1-in-10 weekend, nighttime drivers tested positive for THC, and in some jurisdictions, the rate was nearly 1-in-5. The possible contribution of cannabis legislation, such as decriminalization and medical cannabis usage, is discussed.
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Laurent Bègue et al.
British Journal of Psychology, forthcoming
Abstract:
This research examines the role of alcohol consumption on self-perceived attractiveness. Study 1, carried out in a barroom (N= 19), showed that the more alcoholic drinks customers consumed, the more attractive they thought they were. In Study 2, 94 non-student participants in a bogus taste-test study were given either an alcoholic beverage (target BAL [blood alcohol level]= 0.10 g/100 ml) or a non-alcoholic beverage, with half of each group believing they had consumed alcohol and half believing they had not (balanced placebo design). After consuming beverages, they delivered a speech and rated how attractive, bright, original, and funny they thought they were. The speeches were videotaped and rated by 22 independent judges. Results showed that participants who thought they had consumed alcohol gave themselves more positive self-evaluations. However, ratings from independent judges showed that this boost in self-evaluation was unrelated to actual performance.
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Victor Capoccia et al.
Health Affairs, May 2012, Pages 1000-1008
Abstract:
The Affordable Care Act is aimed at extending health insurance to more than thirty million Americans, including many with untreated substance use disorders. Will those who need addiction treatment receive it once they have insurance? To answer that question, we examined the experience of Massachusetts, which implemented its own universal insurance law in 2007. As did the Affordable Care Act, the Massachusetts reform incorporated substance abuse services into the essential benefits to be provided all residents. Prior to the law's enactment, the state estimated that a half-million residents needed substance abuse treatment. Our mixed-methods exploratory study thus asked whether expanded coverage in Massachusetts led to increased addiction treatment, as indicated by admissions, services, or revenues. In fact, we observed relatively stable use of treatment services two years before and two years after the state enacted its universal health care law. Among other factors, our study noted that the percentage of uninsured patients with substance abuse issues remains relatively high - and that when patients did become insured, requirements for copayments on their care deterred treatment. Our analysis suggests that expanded coverage alone is insufficient to increase treatment use. Changes in eligibility, services, financing, system design, and policy may also be required.
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The Impact of the 2009 Federal Tobacco Excise Tax Increase on Youth Tobacco Use
Jidong Huang & Frank Chaloupka
NBER Working Paper, April 2012
Abstract:
This study examined the impact of the 2009 federal tobacco excise tax increase on the use of cigarettes and smokeless tobacco products among youth using the Monitoring the Future survey, a nationally representative survey of 8th, 10th, and 12th grade students. The results of this analysis showed that this tax increase had a substantial short-term impact. The percentage of students who reported smoking in the past 30 days dropped between 9.7% and 13.3% immediately following the tax increase, depending on model specifications, and the percentage of students who reported using smokeless tobacco products dropped between 16% and 24%. It is estimated that there would have been approximately 220,000 - 287,000 more current smokers and 135,000 - 203,000 more smokeless tobacco users among middle school and high school students (age 14 - 18) in the United States in May 2009 had the federal tax not increased in April 2009. The long-term projected number of youth prevented from smoking or using smokeless tobacco that resulted from the 2009 federal tax increase could be much larger given the resulting higher tobacco prices would deter more and more children from initiating smoking and smokeless tobacco use over time.
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Cigarette Quitlines, Taxes, and Other Tobacco Control Policies: A State-Level Analysis
Henry Shelton Brown & Steve Karson
Health Economics, forthcoming
Abstract:
This paper estimates monthly quitline calls using panel data at the state level from January 2005 to June 2010. Calls to state quitline numbers (or 1-800-QUITNOW) were measured per million adult smokers in each state. The policies considered include excise taxes, workplace and public smoking bans, and a Peter Jennings television-based program warning of the health risks of smoking. We found that people anticipating increases in prices begin attempting to quit by calling quitlines. Finally, the Peter Jennings media campaign was highly correlated with quitline calls.
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Shared Environmental Contributions to Substance Use
Jessica Baker, Hermine Maes & Kenneth Kendler
Behavior Genetics, May 2012, Pages 345-353
Abstract:
The current study examined the association between substance use in the household during childhood, parental attitudes towards substance use and lifetime substance use in males. Subjects included 1081 monozygotic and 707 dizygotic twins from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Retrospective reports of substance use and features of the family environment (adult household substance use and parental attitudes towards substance use) were obtained using a life history interview. A trivariate Cholesky decomposition was conducted using the program Mx to decompose common shared environmental variance. Findings suggest that family environmental factors accounted for a large proportion of the shared environmental effects for illicit drug use. Results illustrate an important way of extending behavior genetic research to reveal specific etiological environmental mechanisms.
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Rajeev Goel & Michael Nelson
Empirical Economics, June 2012, Pages 1079-1095
Abstract:
Using state-level U.S. data over 1956-2008 this paper examines the demand for cigarettes. The long data span enables us to compare and evaluate the effectiveness of various policies and to examine cigarette demand across individual states. Our results show cigarette demand to be price inelastic, smoking-habit effects to be strong, income effects to be small, and border price effects can be significant. These findings are quite robust across alternate model specifications. None of the three smoking control policies considered (Fairness Doctrine, Broadcast Ban, and Master Settlement Agreement) were shown to be effective in curbing overall smoking, although most were effective in a few states. Policy implications are discussed.
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Does Staying in school (AND NOT WORKING) Prevent Teen Smoking and Drinking?
Robert Jensen & Adriana Lleras-Muney
Journal of Health Economics, forthcoming
Abstract:
Previous work suggests but cannot prove that education improves health behaviors. We exploit a randomized intervention that increased schooling (and reduced working) among male students in the Dominican Republic, by providing information on the returns to schooling. We find that treated youths were much less likely to smoke at age 18 and had delayed onset of daily or regular drinking. The effects appear to be due to changes in peer networks and disposable income. We find no evidence of a direct impact of schooling on rates of time preference, attitudes towards risk or perceptions that drinking or smoking are harmful to health, though our measures of these factors are more limited.
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Left-handedness is statistically linked to lifetime experimentation with illicit drugs
Antonio Preti et al.
Laterality: Asymmetries of Body, Brain and Cognition, May/June 2012, Pages 318-339
Abstract:
Handedness has been linked to an enhanced risk of alcohol abuse, while less is known about other drugs. A convenience sample of 1004 male and female Italian participants (females=58%) from the general community (18 to 65 years old: average age = 30; standard deviation = 10, median = 25) was asked about: handedness (preference in writing); lifetime use of alcohol, tobacco, and illicit drugs; levels of psychological distress, as measured by the General Health Questionnaire (GHQ); and levels of delusion proneness, as measured by the Peters et al. Delusions Inventory (PDI). Overall, 92 individuals (9.2%) were classified as left-handed, with no significant difference reported among genders. Lifetime use of illicit drugs, primarily cannabis, was reported by 20% of the sample. In a multiple logistic regression analysis, after taking into account sex, age, and caseness on GHQ and PDI, left-handed people in the sample were statistically more likely to report lifetime experimentation with heroin, ecstasy/amphetamine, and, marginally, hallucinogens, but not alcohol or tobacco. Different mechanisms might contribute to an explanation of greater lifetime experimentation with some illicit drugs among left-handed people as compared to right-handed people. However, replications with clinical samples are necessary before any definitive statements can be made.
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Madhabika Nayak et al.
Drug and Alcohol Dependence, 1 June 2012, Pages 213-219
Background: Research on alcohol use among victims of physical and sexual violence has focused mostly on women and alcohol use disorders. It is also limited by the relative lack of consideration of victimization over the lifetime and of population data on both men and women. We critically examined associations between lifetime victimization and diverse past year alcohol use patterns and problems and whether these associations differ for men and women.
Methods: Population data from the 2005 U.S. National Alcohol Survey (NAS11, n = 6919) are reported for 4256 adult men and women drinkers. Logistic regressions assessed associations between physical only or any sexual victimization experienced over the lifetime and past year heavy episodic drinking, drinking to intoxication, alcohol-related consequences and any alcohol use disorder. Models controlled for demographics and parental history of alcohol abuse and examined interactions of gender with victimization.
Results: Associations between victimization experienced over the lifetime and all past year alcohol measures were significant for both men and women. These associations did not differ by type of lifetime victimization (physical only vs any sexual). The association of physical only victimization with drinking to intoxication was stronger for victimized vs non-victimized women compared to victimized vs non-victimized men. This gender difference ceased to be significant when specific victimization characteristics were controlled for.
Conclusions: Lifetime victimization is associated with increased risk for diverse alcohol use problems for both men and women. All prevention and treatment programs should screen men and women for lifetime victimization and diverse alcohol use problems.
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Adolescent romantic couples influence on substance use in young adulthood
Lauren Gudonis-Miller et al.
Journal of Adolescence, June 2012, Pages 638-647
Abstract:
Research has demonstrated that adolescent peer group affiliations are consistent predictors of substance use initiation and maintenance; it is less clear how adolescent romantic relationships influence substance use behavior. Data were drawn from the National Longitudinal Study of Adolescent Health. Participants in the final dataset for the current study included adolescents (321 males and 321 females) who were identified in reciprocated romantic relationships at Wave 1 (1994-1995; mean age 16.7 years) that were followed into young adulthood and reassessed at two different time points (Wave 2 in 1996, mean age 17.7, and Wave 3 in 2001-2002, mean age 23.1). Data were gathered from both partners, and included demographic variables, longitudinal measures of substance use (alcohol, tobacco, and marijuana), and relationship seriousness. Hierarchical linear modeling using SAS PROC MIXED were utilized to test for individual versus partner influences. Results revealed individual and partner effects for the prediction of alcohol and tobacco, although individual effects were generally greater than partner influences. For marijuana use, as self-reported relationship seriousness increased, future marijuana use decreased. These findings suggest the developmental significance of adolescent romantic relationships on the prediction of future substance use behavior during young adulthood.
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Does Smoking Affect Schooling? Evidence from Teenagers in Rural China
Meng Zhao, Yoshifumi Konishi & Paul Glewwe
Journal of Health Economics, forthcoming
Abstract:
Youth smoking can biologically reduce learning productivity. It can also reduce youths' expected returns to education and lower their motivation to go to school, where smoking is forbidden. Using rich household survey data from rural China, this study investigates the effect of youth smoking on educational outcomes. Youth smoking is clearly an endogenous variable; to obtain consistent estimates of its impact, we use counts of registered alcohol vendors and a food price index as instrumental variables. Since the variable that measures smoking behavior is censored for non-smoking adolescents, we implement a two-step estimation strategy to account for the censored nature of this endogenous regressor. The estimates indicate that smoking one cigarette per day during adolescence can lower students' scores on mathematics tests by about 0.08 standard deviations. However, we find no significant effect of youth smoking on either Chinese test scores or total years of schooling.
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A Dynamic Model of US Adolescents' Smoking and Friendship Networks
David Schaefer, Steven Haas & Nicholas Bishop
American Journal of Public Health, June 2012, Pages e12-e18
Objectives: We investigated the associations between smoking and friend selection in the social networks of US adolescents.
Methods: We used a stochastic actor-based model to simultaneously test the effects of friendship networks on smoking and several ways that smoking can affect the friend selection process. Data are from 509 US high school students in the National Longitudinal Study of Adolescent Health, 1994-1996 (46.6% female, mean age at outset = 15.4 years).
Results: Over time, adolescents' smoking became more similar to their friends. Smoking also affected who adolescents selected as friends; adolescents were more likely to select friends whose smoking level was similar to their own, and smoking enhanced popularity such that smokers were more likely to be named as friends than were nonsmokers, after controlling for other friend selection processes.
Conclusions: Both friend selection and peer influence are associated with smoking frequency. Interventions to reduce adolescent smoking would benefit by focusing on selection and influence mechanisms.
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Neighborhood safety as a correlate of tobacco use in a sample of urban, pregnant women
Freda Patterson et al.
Addictive Behaviors, forthcoming
Objectives: Environmental context has been increasingly recognized as an important determinant of health behavior. This study examined the effects of self-reported neighborhood violence and perceived safety on tobacco use in a sample of low-income, pregnant women.
Methods: Pregnant women (N = 1521) being treated at an urban Emergency Room completed a baseline interview where neighborhood safety (self-reported neighborhood violence and perceived safety) as well as individual (demographics, depression symptoms, stress, tobacco use, substance abuse) and social variables (prenatal social environment and number of close friends) were evaluated cross-sectionally. Tobacco use was measured again in a telephone interview at 22 weeks gestation.
Results: In a logistic regression model of baseline smoking status, self-reported neighborhood violence was significantly associated with being a smoker independent of age, education status, lifetime use of cocaine and marijuana and current use of cocaine and marijuana. In a regression model estimating the relationship between these baseline variables and continued prenatal smoking, baseline smoking emerged as the strongest correlate of continued smoking during pregnancy.
Conclusions: These findings suggest that self-reported neighborhood violence had a stronger association with early pregnancy cigarette use compared to ongoing cigarette use in a sample of low-income, pregnant women. Prospective trials are needed to fully elucidate the relationship between individual and social-environmental determinants of tobacco use in this high-risk population.
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Helga Ask et al.
Behavior Genetics, May 2012, Pages 354-365
Abstract:
Spouses tend to have similar lifestyles. We explored the degree to which spouse similarity in alcohol use, smoking, and physical exercise is caused by non-random mating or convergence. We used data collected for the Nord-Trøndelag Health Study from 1984 to 1986 and prospective registry information about when and with whom people entered marriage/cohabitation between 1970 and 2000. Our sample included 19,599 married/cohabitating couples and 1,551 future couples that were to marry/cohabitate in the 14-16 years following data collection. All couples were grouped according to the duration between data collection and entering into marriage/cohabitation. Age-adjusted polychoric spouse correlations were used as the dependent variables in non-linear segmented regression analysis; the independent variable was time. The results indicate that spouse concordance in lifestyle is due to both non-random mating and convergence. Non-random mating appeared to be strongest for smoking. Convergence in alcohol use and smoking was evident during the period prior to marriage/cohabitation, whereas convergence in exercise was evident throughout life. Reduced spouse similarity in smoking with relationship duration may reflect secular trends.
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Darren Mays et al.
Addictive Behaviors, forthcoming
Abstract:
Adolescent sports participants are less likely to smoke cigarettes, and sports participation may prevent young people from smoking. Research suggests that the relationship between sports participation and smoking may vary by race/ethnicity and is also possibly moderated by exposure to peer smoking. We investigated these relationships in a sample of 311 adolescents ages 13 - 21 presenting for well-visit medical appointments. Participants completed valid assessments of demographics, sports participation, exposure to peer smoking, and smoking behavior. The primary outcome was smoking status (never smoked, tried smoking, experimental/current smoker). Ordinal logistic regression was used separately for non-Hispanic White (n = 122) and non-White (n = 189; 70.4% Black, 14.3% Hispanic, and 15.3% other) adolescents. Among White adolescents, sports participants had significantly lower odds of smoking than non-sports participants, independent of age, gender, and peer smoking. For non-Whites, the adjusted effect of sports participation on smoking depended upon exposure to peers who smoke. Compared with non-sport participants with no exposure to peer smoking, sports participants with no exposure to peer smoking had significantly lower odds of smoking, whereas sports participants with exposure to peer smoking had significantly higher odds of smoking. Sports appear to be protective against smoking among non-Hispanic White adolescents, but among non-White adolescents exposure to peer smoking influences this protection. Interventions incorporating sports to prevent smoking should consider these racial/ethnic differences to address disparities in smoking-related disease.
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Doctor and Pharmacy Shopping for Controlled Substances
Gretchen Peirce et al.
Medical Care, June 2012, Pages 494-500
Background: Prescription drug abuse is a major health concern nationwide, with West Virginia having one of the highest prescription drug death rates in the United States. Studies are lacking that compare living subjects with persons who died from drug overdose for evidence of doctor and pharmacy shopping for controlled substances. The study objectives were to compare deceased and living subjects in West Virginia for evidence of prior doctor and pharmacy shopping for controlled substances and to identify factors associated with drug-related death.
Methods: A secondary data study was conducted using controlled substance, Schedule II-IV, prescription data from the West Virginia Controlled Substance Monitoring Program and drug-related death data compiled by the Forensic Drug Database between July 2005 and December 2007. A case-control design compared deceased subjects 18 years and older whose death was drug related with living subjects for prior doctor and pharmacy shopping. Logistic regression identified factors related to the odds of drug-related death.
Results: A significantly greater proportion of deceased subjects were doctor shoppers (25.21% vs. 3.58%) and pharmacy shoppers (17.48% vs. 1.30%) than living subjects. Approximately 20.23% of doctor shoppers were also pharmacy shoppers, and 55.60% of pharmacy shoppers were doctor shoppers. Younger age, greater number of prescriptions dispensed, exposure to opioids and benzodiazepines, and doctor and pharmacy shopping were factors with greater odds of drug-related death.
Conclusions: Doctor and pharmacy shopping involving controlled substances were identified, and shopping behavior was associated with drug-related death. Prescription monitoring programs may be useful in identifying potential shoppers at the point of care.
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Female smokers show lower pain tolerance in a physical distress task
Kim Pulvers et al.
Addictive Behaviors, forthcoming
Abstract:
Numerous studies have established a link between distress tolerance and smoking cessation outcomes. The present study examined whether smoking status affected physical distress tolerance, and considered this question separately for men and women. The sample was comprised of healthy adults, 56 smokers (63% male) and 58 nonsmokers (62% female). The pain stimulus was a cold pressor task. Outcome variables were seconds immersed in cold water when pain was first reported (threshold), and total seconds immersed in cold water (tolerance). Participants verbally reported their pain rating on a 0-100 scale after the task, and then completed the McGill Pain Questionnaire-Short Form. Smokers displayed lower pain tolerance than nonsmokers (p = .045), and women displayed lower pain tolerance than men (p = .017). Female smokers had significantly lower pain tolerance than other groups (p = .001). There were no significant differences in pain threshold or pain perception by smoking status or gender (p > .05). Lower physical distress tolerance could place female smokers at risk for difficulty in quitting smoking. This population needs additional research to better understand their unique pain experience and how physical distress tolerance impacts their smoking cessation outcomes.
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Examining the link between collision involvement and cocaine use
Gina Stoduto et al.
Drug and Alcohol Dependence, 1 June 2012, Pages 260-263
Background: Cocaine is one of the more commonly found illicit drugs in injured drivers. In this work, we examine the association between self-reported past year cocaine use and past year collision involvement in a large representative sample of adult drivers in Ontario.
Methods: Data are based on the CAMH Monitor, an ongoing cross-sectional telephone survey of Ontario adults aged 18 and older. Five years of data (2002, 2003, 2004, 2006, 2008) were merged for this study (N = 8107) due to survey item availability. Logistic regression analysis was performed to identify the risk of self-reported collision involvement within the past 12 months associated with past year use of cocaine, while controlling for sociodemographic, driving exposure and drinking-driving (as a function of drinking status) factors. Due to listwise deletion, the logistic regression model was based on a reduced sample (N = 7284).
Results: The prevalence of self-reported collision involvement within the past year was 18.9% among those who used cocaine in the past year compared to 7.4% of non-users. Logistic regression analysis, controlling for the potential confounding effects of age, gender, income, driving exposure and drinking-driving measures, found the odds of collision involvement in the preceding year among cocaine users was over twice that of non-users (OR = 2.11, 95% CI = 1.06-4.18).
Conclusions: This study suggests that cocaine users are significantly more likely to report collision involvement in the past year. Additional work to confirm these observations, and to assess possible causal pathways, is needed.
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Erick Guerrero et al.
Addictive Behaviors, forthcoming
Rationale: A growing body of research has revealed disparities with respect to drug use patterns within Latino subgroups. However, the extent to which these potential disparities enable different Latino subgroups to respond favorably to treatment is unclear.
Methods: This study analyzed a subset of multicross-sectional data (2006-2009) on Latinos collected from publicly funded facilities in Los Angeles County, CA (N = 12,871). We used multilevel logistic regressions to examine individual and service-level factors associated with treatment completion among subgroups of first-time Latino treatment clients.
Results: Univariate analysis showed that Cubans and Puerto Ricans were less likely to complete treatment than Mexicans and other Latinos. Cubans and Puerto Ricans entered treatment at an older age and with higher formal education than Mexicans, yet they were more likely to report mental health issues and use of cocaine and heroin as primary drugs of choice respectively. Multivariate analysis showed that age, having mental health issues, reporting high use of drugs at intake, and use of methamphetamines and marijuana were associated with decreased odds of completing treatment among all Latino subgroups. In contrast, age at first drug use, treatment duration, and referral monitoring by the criminal system increased the odds of completing treatment for all members.
Conclusion: These findings have implications for targeting interventions for members of different Latinos groups during their first treatment episode. Promising individual and service factors associated with treatment completion can inform the design of culturally specific recovery models that can be evaluated in small-scale randomized pilot studies.
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Michelle Lofwall, Paul Nuzzo & Sharon Walsh
Drug and Alcohol Dependence, 1 June 2012, Pages 229-238
Background: Approximately 1.9 million persons in the U.S. have prescription opioid use disorders often with concomitant bodily pain, but systematic data on the impact of pain on abuse liability of opioids is lacking. The purpose of this study was to determine whether pain alters the intranasal abuse liability of oxycodone, a commonly prescribed and abused analgesic, in males and females.
Methods: Sporadic prescription opioid abusers (10 females, 10 males) participated in this mixed (between and within-subject), randomized inpatient study. Experimental sessions (n = 6) tested intranasal placebo, oxycodone 15 or 30 mg/70 kg during cold pressor testing (CPT) and a warm water control. Observer- and subject-rated drug effect measures, analgesia, physiologic and cognitive effects were assessed.
Results: The CPT significantly increased blood pressure, heart rate, pain, stress, and "opiate desire" compared to the no-pain control but did not alter opioid liking, high or street value. Intranasal oxycodone produced effects within 10 min, significantly decreasing pain and significantly increasing subjective measures of abuse liability (e.g., high). Females had higher ratings of street value, high, and liking for one or both active doses.
Conclusions: The CPT was a reliably painful and stressful stimulus that did not diminish the abuse liability of intranasal oxycodone. Females were more sensitive to oxycodone on several abuse liability measures that warrant further follow-up. Snorting oxycodone rapidly produced psychoactive effects indicative of substantial abuse liability.