Journal of Psychoactive Drugs

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Table of Contents

Volume 42, Number 1

March 2010

 

Migration and Illicit Drug Use Among Two Types of Male Migrants in Shanghai, China Frank Y. Wong, Ph.D.; N. He, M.D., Ph.D.; Z. J. Huang, M.B.B.S., Ph.D., M.P.H.; D. Young, B.S.;        C. O’Conor; Y.Y. Ding, M.D.; C. Fu, M.D. & S. Arayasirikul, M.S.P.H., C.H.E.S. 

Increased Drug Use and STI Risk with Injection Drug Use Among HIV-Seronegative Heterosexual Methamphetamine Users W. Susan Cheng, Ph.D.; Richard S. Garfein, Ph.D.; Shirley J. Semple, Ph.D.;  Steffanie A. Strathdee, Ph.D.; James K. Zians, Ph.D. & Thomas L. Patterson, Ph.D. 

Sex Differences in the Effects of Marijuana on Simulated Driving PerformanceBeth M. Anderson, Ph.D.; Matthew Rizzo, M.D.; Robert I. Block, Ph.D.; Godfrey D. Pearlson, M.D. & Daniel S. O’Leary, Ph.D. 

Gender Differences in Psychiatric Symptomatology in Adolescents Attending a Community Drug and Alcohol Treatment Program Osamede Edokpolo, M.D.; Philip James, M.Sc; Caitriona Kearns, B.Sc.; Ann Campbell, R.N. & Dr. Bobby P. Smyth, M.B. M.R.C.Psych. 

The Association between Psychopathology and Substance Use in Young People:  A Review of the Literature Amina Saban, M.A. & Alan J. Flisher, F.C.Psych.(S.A.), Ph.D. 

How do Residents of Recovery Houses Experience Confrontation between Entry and 12-Month Follow-Up? Douglas L. Polcin, Ed.D.; Gantt P. Galloway, Pharm.D.; Jason Bond, Ph.D.; Rachael Korcha, M.A. & Thomas K. Greenfield, Ph.D. 

Young Adult Ecstasy Users Who Forego Necessary Medical Care:A Fairly Common Occurrence with Important Health Implications Kirk W. Elifson, Ph.D.; Hugh Klein, Ph.D. & Claire E. Sterk, Ph.D. 

Increasing Prenatal Care and Healthy Behaviors in Pregnant Substance Users Frankie Kropp, M.S.; Theresa Winhusen, Ph.D.; Daniel Lewis, B.A.;Diane Hague, M.S.S.W. & Eugene Somoza, M.D., Ph.D. 

 

SHORT COMMUNICATIONS

A Pilot Study of Seeking Safety Therapy with OEF/OIF Veterans Sonya B. Norman, Ph.D.; Kendall C. Wilkins, Ph.D.; Susan F. Tapert, Ph.D.;Ariel J. Lang, Ph.D. & Lisa M. Najavits, Ph.D. 

Differential Substance Abuse Patterns Distribute According To Gender In Heroin Addicts Icro Maremmani, M.D.; Canoniero Stefania, M.D.; Matteo Pacini, M.D. ; Angelo G.I. Maremmani, M.D.; Marina Carlini, M.D.; Francesca Golia, M.D.; Joseph Deltito, M.D. & Liliana Dell’Osso, M.D. 

COVER ART Lava Spirit III by Jacquelyn Paull (www.spiritcat.com)

 

 ABSTRACTS

 

Migration and Illicit Drug Use Among Two Types of Male Migrants in Shanghai, China Frank Y. Wong, Ph.D.; N. He, M.D., Ph.D.; Z. J. Huang, M.B.B.S., Ph.D., M.P.H.; D. Young, B.S.;       C. O’Conor; Y.Y. Ding, M.D.; C. Fu, M.D. & S. Arayasirikul, M.S.P.H., C.H.E.S.

Abstract—Large-scale internal migrations within China have led to speculation of increased drug use, but with little empirical evidence. This cross-sectional study examines the association between migration characteristics and illicit drug use in 100 general male migrants and 239 “money boys” (i.e., male migrants engaging in same-sex transactional sex) in Shanghai, China. Only three general male migrants reported any drug use. Among money boys, lifetime illicit drug use was 12%; Ecstasy and methamphetamine appeared to be the most popular drugs. In addition, depression prevalence was very high among both types of male migrants. Depression was associated with lifetime soft- and hard-drug use, while earning a higher income was associated with lifetime soft-drug use. These findings provide the first set of quantitative evidence of illicit drug use among Chinese male migrants. Although illicit drug use among male migrants is low compared to Western countries, its resurgence after 30 years of drug control gives cause for concern.

Keywords Chinese, drug use, male migrants, money boys, Shanghai

 

Increased Drug Use and STI Risk with Injection Drug Use Among HIV-Seronegative Heterosexual Methamphetamine Users W. Susan Cheng, Ph.D.; Richard S. Garfein, Ph.D.; Shirley J. Semple, Ph.D.; Steffanie A. Strathdee, Ph.D.; James K. Zians, Ph.D. & Thomas L. Patterson, Ph.D.

Abstract—Methamphetamine (MA) use has been found to be associated with increased risk of HIV and sexually transmitted infections (STI) among men having sex with men, but it is unknown whether those who inject MA are at greater risk for these infections than those who administer MA by other routes. Furthermore, comparable data from heterosexual MA users are lacking. We investigated whether the HIV and STI risks of male and female heterosexual MA users who inject MA differ from those of comparable users who do not inject. Between 2001 and 2005, we interviewed 452 HIV-negative men and women aged 18 and older who had recently used MA and engaged in unprotected sex. Their mean age was 36.6 years; 68% were male; ethnicity was 49.4% Caucasian, 26.8% African-American, and 12.8% Hispanic. Logistic regression identified factors associated with injecting MA. Compared to non-IDU, IDU were more likely to: be Caucasian; be homeless; have used MA for a longer period and used more grams of MA in the last 30 days; have a history of felony conviction; and report a recent STI. HIV and STI prevention interventions should be tailored according to MA users’ method of administration.

Keywordsdepression, injection drug use, methamphetamine, motivations, polydrug, sexually transmitted infections

 

Sex Differences in the Effects of Marijuana on Simulated Driving PerformanceBeth M. Anderson, Ph.D.; Matthew Rizzo, M.D.; Robert I. Block, Ph.D.; Godfrey D. Pearlson, M.D. & Daniel S. O’Leary, Ph.D.

Abstract—In the United States, one in six teenagers has driven under the influence of marijuana. Driving under the influence of marijuana and alcohol is equally prevalent, despite the fact that marijuana use is less common than alcohol use. Much of the research examining the effects of marijuana on driving performance was conducted in the 1970s and led to equivocal findings. During that time, few studies included women and driving simulators were rudimentary. Further, the potency of marijuana commonly used recreationally has increased. This study examined sex differences in the acute effects of marijuana on driving performance using a realistic, validated driving simulator. Eighty-five subjects (n = 50 males, 35 females) participated in this between-subjects, double-blind, placebo controlled study. In addition to an uneventful, baseline segment of driving, participants were challenged with collision avoidance and distracted driving scenarios. Under the influence of marijuana, participants decreased their speed and failed to show expected practice effects during a distracted drive. No differences were found during the baseline driving segment or collision avoidance scenarios. No differences attributable to sex were observed. This study enhances the current literature by identifying distracted driving and the integration of prior experience as particularly problematic under the influence of marijuana.

Keywords—acute effects, cannabis, cognition, driving, marijuana

 

Gender Differences in Psychiatric Symptomatology in Adolescents Attending a Community Drug and Alcohol Treatment Program Osamede Edokpolo, M.D.; Philip James, M.Sc; Caitriona Kearns, B.Sc.; Ann Campbell, R.N. & Dr. Bobby P. Smyth, M.B. M.R.C.Psych.

Abstract—This study examines mental health symptoms in a cohort of adolescents with substance use disorder (SUD), and attempts to determine if mental health symptoms differed by gender. We retrospectively looked at the Beck’s Youth Inventory Second Edition (BYI-II) scores of 88 clients attending a community drug and alcohol treatment service in Dublin, Ireland that were completed at intake as part of their assessment. The raw and T-scores of the male patients were compared against their female counterparts and both against their age- and gender-matched normative population. Participants were 65 boys and 23 girls with a mean age of 16.2 years. Polysubstance use was the norm. As a group, the girls had higher T scores than the boys in all the domains of the BYI-II, and these were statistically significant. Sixty (68%) of the participants had a psychological problem which was moderate or severe in at least one of the five domains. This study found that SUD girls differ from their male counterparts in having both more internalizing and externalizing psychiatric problems. We also note that comorbid psychological problems are not universal. Thus we should avoid a “one size fits all” approach to treatment such as delivering universal self-esteem enhancement interventions to all adolescents with SUD.

Keywords—adolescents, Becks Youth Inventory-II, gender differences, substance use disorder

 

The Association between Psychopathology and Substance Use in Young People:  A Review of the Literature Amina Saban, M.A. & Alan J. Flisher, F.C.Psych.(S.A.), Ph.D.

Abstract—This article reviews the recent literature on the association between psychopathology and substance use in young people. An electronic literature search, using PSYCINFO/PSYCLIT and PUBMED/MEDLINE, yielded 93 English-language articles for the period 1990-2008. Of these articles, 89 (95.7%) reported studies conducted in developed countries, 57 (61.3%) had community or population samples, 38 (40.9%) had sample sizes ranging from 500 to 2000 subjects, and 33 (36.7%) had sample sizes of between 50 and 500. The most commonly-used assessment tool (n = 29, 31.2%) was the Diagnostic Interview Schedule. Evidence exists for associations between depression and cigarette smoking, between anxiety and cigarette smoking, and between anxiety and alcohol use. The strength of the associations is increased with greater frequency and quantity of substance use, and is influenced by the nature of the psychopathology, the specific substances of use, and demographic factors such as gender, age or developmental stage. The need for more longitudinal studies on community populations, and increased access to funds and resources for researchers in developing countries is highlighted.

Keywords—comorbidity, psychopathology, substance use, young people

 

How do Residents of Recovery Houses Experience Confrontation between Entry and 12-Month Follow-Up?Douglas L. Polcin, Ed.D.; Gantt P. Galloway, Pharm.D.; Jason Bond, Ph.D.; Rachael Korcha, M.A. & Thomas K. Greenfield, Ph.D.

Abstract—The role of confrontation in recovery has been vigorously debated. Proponents suggest confrontation can break down denial and increase motivation. Critics point to counseling studies showing confrontation harms the therapeutic alliance and increases resistance. Frequently missing in these debates is an operational definition of confrontation that can be reliably measured. The Alcohol and Drug Confrontation Scale (ADCS) is a new 72-item measure that defines confrontation as “warnings about potential harm” that might result from substance use (e.g., arrests, loss of job, loss of relationships, etc.). Previous psychometric work indicated the ADCS had acceptable reliability and validity when administered to 323 individuals entering recovery houses. Confrontation from different sources (e.g., family, friends and professionals) was generally experienced as supportive and helpful. The goals of the current study were twofold: (1) to see if the psychometric properties of the ADCS among the same sample were maintained at six and 12 month follow-up, and (2) to see if experiences and perceptions of confrontation changed over time. Despite minor variations in the factor structure between baseline and follow-up, the ADCS generally maintained good reliability and validity. At follow-up, the amount of confrontation participants received declined, but it continued to be generally experienced as supportive and helpful.

Keywords—confrontation, recovery, residential treatment, social support

 

Young Adult Ecstasy Users Who Forego Necessary Medical Care: A Fairly Common Occurrence with Important Health Implications Kirk W. Elifson, Ph.D.; Hugh Klein, Ph.D. & Claire E. Sterk, Ph.D.

Abstract—This study examine the practice of foregoing necessary medical care in a population of young adult Ecstasy users. The objectives are to (1) investigate how the failure to receive needed medical care is related to drug-related outcomes, and (2) identify factors that are associated with receiving versus foregoing needed medical care. Face-to-face, computer-assisted, structured interviews were conducted with 283 active young adult Ecstasy users in Atlanta, Georgia between August 2002 and October 2007. Study participants were recruited using a targeted sampling approach. Results indicated that almost one-third of the young adult Ecstasy users interviewed did not receive the medical care that they needed during the preceding year. Foregoing such care was associated with a variety of adverse drug-related outcomes, including experiencing a greater number of negative effects from using Ecstasy, experiencing a larger number of drug dependency symptoms, a greater likelihood of ever having binged on Ecstasy, and a greater likelihood of being classified as a “high end” polydrug abuser. Several factors were found to be associated with a greater tendency not to receive the medical care they needed, including race (not being African American), educational attainment (having completed at least high school), self-identification as belonging to the lowest socioeconomic status grouping, low self-esteem, and having experienced sexual abuse during one’s formative years.

Keywords—drug use, Ecstasy use, health care, medical care, young adults

 

Increasing Prenatal Care and Healthy Behaviors in Pregnant Substance Users Frankie Kropp, M.S.; Theresa Winhusen, Ph.D.; Daniel Lewis, B.A.; Diane Hague, M.S.S.W. & Eugene Somoza, M.D., Ph.D.

Abstract—Evidence suggests that prenatal care, healthy behaviors such as exercise and nutrition, and general stress level are associated with fetal and maternal health but there is a relative dearth of research on interventions to improve these factors in pregnant substance users. Two hundred pregnant substance users entering outpatient substance abuse treatment were randomized to receive either three individual sessions of Motivational Enhancement Therapy for pregnant substance users (MET-PS) or the first three individual sessions normally provided by the program. The present study evaluated the relative efficacy of MET-PS, compared to treatment as usual, on modifiable healthy behaviors and the impact of treatment when the groups were pooled. The results suggest that MET-PS was not more effective than treatment as usual in improving modifiable healthy behaviors. When the treatment groups were pooled, the results suggest that there were significant increases in prenatal care utilization and prenatal/multi-vitamin and water consumption, and a significant decrease in stress. Limitations and recommendations for further research are discussed.

Keywords—healthy behaviors, Motivational Enhancement Therapy, pregnant, prenatal care, substance abuse

 

SHORT COMMUNICATIONS

A Pilot Study of Seeking Safety Therapy with OEF/OIF Veterans Sonya B. Norman, Ph.D.; Kendall C. Wilkins, Ph.D.; Susan F. Tapert, Ph.D.; Ariel J. Lang, Ph.D. & Lisa M. Najavits, Ph.D.

Abstract—PTSD and substance use disorder (SUD) are highly prevalent among veterans returning from Iraq and Afghanistan (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF). Seeking Safety (SS) is a cognitive-behavioral psychotherapy for co-occurring PTSD/SUD. This pilot study with fourteen male OEF/OIF veterans suggests that SS may help to reduce alcohol use, PTSD, and depression in some participants at clinically significant levels, even when providing less than half of the full model. We emphasize several SS features as especially helpful: the case management component to help engage clients in further mental health and SUD care, offering PTSD as an entry point, and emphasis on community resources. Issues particular to veterans include reintegration to civilian life and supporting their connection with other veterans.

Keywords—OEF/OIF, PTSD, psychotherapy, substance abuse

 

Differential Substance Abuse Patterns Distribute According To Gender In Heroin Addicts Icro Maremmani, M.D.; Canoniero Stefania, M.D.; Matteo Pacini, M.D. ; Angelo G.I. Maremmani, M.D.; Marina Carlini, M.D.; Francesca Golia, M.D.; Joseph Deltito, M.D. & Liliana Dell’Osso, M.D.

Abstract—This study attempts to analyse potential gender differences among a group of heroin addicts seeking treatment at a university-based medical centre. The central modality of treatment at this centre is the use of methadone maintenance. Among those patients entering this program there seems to be an emerging pattern of males who tend to use heroin as their opiate of choice, and are more likely to combine it with cannabis, while females are more likely to use to street methadone, with adjunctive use of ketamine, benzodiazepines, hypnotic drugs and/or amphetamines. Women are at higher risk of abusing opioids through a pathway of initial prescription painkiller use, and later to resort to street methadone to cope with prescription pain killer addiction. This latter pattern seems to result in an increased risk for fatal accidental overdoses. The use of these longer-acting agents in women may be influenced by psychosocial and hormonal factors.

Keywords—gender differences, heroin addiction, pain killers, polyabuse, prescription

 

 

March 2010

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