Neighborhood environment and urban African American marijuana use during high school

Effect of Perceived Neighborhood Environment on Cannabis Use during Pregnancy among African American Women

Environmental context is an important predictor of health behavior. Understanding its effect on cannabis use among pregnant women is yet to be understood. The aim of the study is to assess the impact of perceived neighborhood environment on prenatal cannabis use and explore the mediating role of stress. Data are from the Life-Course Influences on Fetal Environments Study (LIFE), a retrospective cohort of postpartum African American women in Metropolitan Detroit, Michigan (2009-2011). Prenatal cannabis use was defined as self-reported ever use during pregnancy. Three perceived neighborhood scales were considered: social cohesion and trust, social disorder, and danger and safety. Out of 1,369 women, 151 (11.0%) self-reported using cannabis during pregnancy. After adjusting for age, marital status, income, years of education, and general social support scale, the odds of cannabis use significantly increased among the lowest quartiles of all the neighborhood scales suggesting higher cannabis use among women who perceived their neighborhoods to have the worst conditions. Compared to the highest quartile, the odds ratio (OR) for the lowest quartiles for social cohesion and trust, social disorder, and danger and safety were 1.77 (95% confidence interval (CI): 1.04-3.03), 1.83 (95% CI: 1.15-2.91), and 1.93 (95% CI: 1.12-3.31) respectively. Evidence of mediation by perceived stress was only present between the association of perceived levels of safety and danger with cannabis use during pregnancy. Future prospective studies are warranted to understand the causal associations between individual correlates and social and physical environmental factors of prenatal cannabis use.

Perceived neighborhood disorder as a moderator of the relationship between marijuana use and disinhibition in a sample of emerging adult African American females

Disinhibition is associated with myriad risk-taking behaviors and adverse outcomes. Both marijuana use and poor neighborhood conditions have been associated with disinhibition. However, the extent to which neighborhood disorder interacts with marijuana use to influence disinhibition has not been studied, extensively. A better understanding of these relationships has implications for designing more effective tailored place-based interventions that aim to reduce risk taking behaviors and related adverse social and health outcomes associated with marijuana use. Thus, the purpose of this study was to examine the interactive effects of perceived neighborhood disorder and marijuana use on disinhibition. The sample included 120 African American female residents of disadvantaged neighborhoods (Mage = 23.6 ± 3.46). We employed hierarchical linear regression analysis to examine the interactive effects of marijuana use and perceived neighborhood disorder on disinhibition, while controlling for age and education. The interaction term was marginally significant (b = 5.66; t(109) = 1.72, p = .08). Next, the conditional effects were explored. Results indicated the association of marijuana use with disinhibition was stronger for females in the higher neighborhood disorder group, compared to those in the lower neighborhood disorder group (10.40 and 4.51, respectively). Our findings support the need for more research on the potential of neighborhood disorder to amplify the effects of marijuana use on disinhibition and related neurobehavioral traits. The identification of contextual moderators and high-risk sub-groups will aid in the design of more tailored place-based interventions that aim to reduce risk-taking behavior among those most vulnerable.

A scoping review of social determinants of health's impact on substance use disorders over the life course

BACKGROUND

Substance use is a public crisis in the U.S. Substance use can be understood as a series of events in the life course, from initiation to mortality. Social Determinants of Health (SDoH) have increasingly been recognized as essential contributors to individuals' health. This scoping review aims to examine available evidence of SDoH impact on the life course of substance use disorder (SUD).

METHODS

This study identified peer-reviewed articles that reported longitudinal studies with SDoH factors as independent variables and substance use and disorders as dependent variables from PubMed, Embase, and Web of Science. The reported associations between SDoH and substance use stages over the life course were narratively and graphically summarized.

RESULTS

Among the 50 studies identified, ten revealed parental monitoring/support and early childhood education as protective factors, while negative peer influences and neighborhood instability were risk factors of substance use initiation. Nineteen articles reported factors associated with escalation in substance use, including unemployment, neighborhood vulnerability, negative peer influence, violence/trauma, and criminal justice system (CJS) involvement. Ten articles suggested that employment, social support, urban living, and low-barrier medication treatment facilitated treatment participation, while stigma and CJS involvement had negative impact on treatment trajectory. Social support and employment could foster progress in recovery and CJS involvement and unstable housing deterred recovery. Four studies suggested that unemployment, unstable housing, CJS involvement, and lack of social support were associated with overdose and mortality.

CONCLUSIONS

This review underscores the influence of social networks and early life experiences on the life course of SUD. Future SDoH research should investigate overdose and mortality and the impact of broader upstream SDoH on SUD. Interventions addressing these social factors are needed to mitigate their detrimental effects on the trajectories of SUD over the life course.

Brief Parent-Child Substance Use Education Intervention for Black Families in Urban Cities in New Jersey: Protocol for a Formative Study Design

BACKGROUND

Substance use continues to remain a public health issue for youths in the United States. Black youths living in urban communities are at a heightened risk of poor outcomes associated with substance use and misuse due to exposure to stressors in their neighborhoods, racial discrimination, and lack of prevention education programs specifically targeting Black youths. Many Black youths, especially those who live in urban communities, do not have access to culturally tailored interventions, leaving a critical gap in prevention. Since family is a well-known protective factor against substance misuse for Black youths, it is essential to create sustainable and accessible programming that incorporates Black youths' and their families' voices to develop a suitable prevention program for them.

OBJECTIVE

We aim to understand the cultural and environmental level factors that influence substance use among Black youths and develop a prevention program to increase parent-child substance use education among Black families.

METHODS

This study will take place within urban cities in New Jersey such as Paterson and East Orange, New Jersey, which will be the main study sites. Both cities have a large population of Black youths and this study's team has strong ties with youths-serving organizations there. A formative, qualitative study will be conducted first. Using the first 3 steps of the ADAPT-ITT (Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, and Testing) framework we begin the development of an intervention for Black families. Three aims will be described: aim 1, collect qualitative data from Black parents and youths aged 11-17 years from parent-child dyads (N=20) on the challenges, barriers, and facilitators to communicating about substance use; aim 2, adapt a selected evidence-based intervention for Black families and develop a family advisory board to guide the adaptation; and aim 3 assess the feasibility of the intervention through theater testing, involving the family and community advisory board.

RESULTS

This study is part of a 2-year research pilot study award from the National Institutes of Drug Abuse. Data collection began in May 2023, and for aim 1, it is 95% complete. All aim 1 data collection is expected to be complete by December 30, 2023. Data analysis will immediately follow. Aim 2 activity will occur in spring 2024. Aim 3 activity may begin in fall 2024 and conclude in 2025.

CONCLUSIONS

This study will be one of the few interventions that address substance use among youths and uses parents and families in urban communities as a protective factor within the program. We anticipate that the intervention will benefit Black youths not only in New Jersey but across the nation, working on building culturally appropriate, community-specific prevention education and building on strong families' relationships, resulting in a reduction of or delayed substance use.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/55470.

Cumulative Exposure to Neighborhood Conditions and Substance Use Initiation among Low-Income Latinx and African American Adolescents

PURPOSE

While previous research underscores the important role that neighborhood contexts play for child and adolescent health and well-being, how these neighborhood contexts influence substance use initiation among adolescents from low-income and ethnic minority families has been understudied.

METHODS

This study is a secondary analysis of data from the Denver Child Study a retrospective survey that uses a natural experiment aimed at assessing neighborhood effects on developmental outcomes of Latinx and African American adolescents (N = 736). Cox cause-specific hazards models were estimated to test: (1) the effects of cumulative exposure to neighborhood social disorder, neighborhood violent and property crime rates, and neighborhood social capital during preadolescence (ages 8-11) on the likelihood of initiating alcohol, cigarette, and marijuana use during adolescence (ages 12-18), after controlling for youth, caregiver, and household factors; and (2) whether the effects of these cumulative neighborhood factors vary by Latinx and African American ethnicity.

RESULTS

5.6% of adolescents in this study initiated cigarette use, 5.4% initiated alcohol use and 5.2% used marijuana for the first time during adolescence. The results indicate that exposure to neighborhood social disorder during preadolescence is a significant risk factor, especially for the initiation of cigarette use (HR = 1.36, 95% CI = 1.062-1.745, p = 0.015) particularly among Latinx adolescents (HR = 1.42, 95% CI = 1.031-1.966, p = 0.032).

CONCLUSIONS

The findings suggest the need for further research on the relationship between exposure to neighborhood social disorder and adolescent substance use initiation in order to develop and implement community-based prevention and intervention programs to reduce substance use initiation and facilitate healthy adolescent development.

Local variation in cannabis use patterns among young adults in the San Francisco Bay Area

This study evaluated whether neighborhood-level disorder, social cohesion, and perceived safety, were associated with days of cannabis use in the prior month in a representative sample of young adults in Alameda and San Francisco Counties in California (N = 1272). We used multiscale geographically weighted regression, modeled by county, to measure associations between cannabis use days and neighborhood attributes, adjusting for sociodemographic characteristics and self-rated health. Positive associations were found between number of cannabis use days and neighborhood disorder, and greater perceived safety. Higher levels of social cohesion predicted fewer cannabis use days. Racial/ethnic, sex and, socioeconomic compositions of participants residing in areas with significant neighborhood-level associations varied substantially, suggesting that risk factors for young adult cannabis use may be highly localized. Public health efforts in cannabis education and intervention should be tailored to fit the culture and composition of local neighborhoods.

Recreational Marijuana Legalization and Use Among California Adolescents: Findings From a Statewide Survey

OBJECTIVE

The legalization of recreational marijuana use and retail sales raises concerns about possible effects on marijuana use among adolescents. We evaluated the effects of recreational marijuana legalization (RML) in California in November 2016 on use among adolescents and investigated subgroup differences in these effects.

METHOD

We analyzed data from successive cross-sectional samples of 7th, 9th, and 11th grade students (N = 3,330,912) who participated in the California Healthy Kids Survey from 2010-2011 to 2018-2019. Participants reported grade, sex, ethnicity, race, and lifetime and past-30-day marijuana use.

RESULTS

Multilevel analyses showed that RML was associated with increases in the likelihood of lifetime (odds ratio = 1.18, 95% CI [1.15, 1.21], p < .01) and past-30-day marijuana use (odds ratio = 1.23, 95% CI [1.20, 1.26], p < .01) relative to previous downward trends. RML was more strongly associated with increases in prevalence of marijuana use among 7th versus 9th and 11th graders, females versus males, non-Hispanic versus Hispanic youth, and White versus African American, American Indian/Native Alaskan, and multiracial youth. Overall, RML was not significantly associated with frequency of past-30-day use among users, although stronger positive associations between RML and frequency of use were found for 11th graders, Asian Americans, and African Americans. The association was weaker for females.

CONCLUSIONS

RML in California was associated with an increase in adolescent marijuana use in 2017-2018 and 2018-2019. Demographic subgroup differences in these associations were observed. Evidence-based prevention programs and greater local control on retail marijuana sales may help to reduce marijuana availability and use among adolescents.

The role of negative emotional reactivity and neighborhood factors in predicting marijuana use during early adolescence

INTRODUCTION

Negative emotional reactivity and the neighborhood environment have been individually associated with marijuana use outcomes; however, less is known about whether neighborhood factors differentiate the association between negative emotional reactivity and marijuana use. The present study examined whether neighborhood risk (i.e., neighborhood problems) and protective factors (i.e., neighborhood social cohesion) moderated the relation between negative emotional reactivity and marijuana use during early adolescence.

METHODS

Participants were 775 adolescents (M = 10.95 ± 0.88 years; 69% male; 76% Caucasian), who reported on their past month frequency of marijuana use at Time 1 (when adolescents were 10-12 years old) and Time 2 (when adolescents were 12-14 years old). Mothers reported on neighborhood problems and neighborhood social cohesion at Time 1. Youth reported on their negative emotional reactivity at Time 2.

RESULTS

Negative binomial regression analyses indicated that neighborhood problems moderated the relationship between negative emotional reactivity and marijuana use. In particular, in the context of low neighborhood problems, individuals with lower negative emotional reactivity were at attenuated risk for marijuana use compared to individuals higher in negative emotional reactivity. In the context of high neighborhood problems, individuals were at heightened risk for marijuana consumption regardless of their negative emotional reactivity levels.

CONCLUSIONS

Findings suggest that individual-level factors alone do not sufficiently account for early marijuana use and that neighborhood problems play a role in risk for or abstention from using marijuana during early adolescence. Implications for prevention and intervention for marijuana use during adolescence are discussed.

Does marijuana use among African American adolescent males differ based on school factors?

Marijuana use among adolescents is a major public health problem. The purpose of this study was to examine whether past-year marijuana use among African American adolescent males differed based on age and school factors. Data from the 2015-2018 National Survey on Drug Use and Health (NSDUH) were analyzed. A national sample of African American students in grades 7 through 12 (n = 5,738) completed the survey. Results indicated that 14.7% reported using marijuana in the past year. Those at highest risk for past-year marijuana use were those who were male, were 16 to 17 years old, were in 9th through 12th grade, did not like going to school, and thought that most/all students in their grade used marijuana. Prevention professionals should consider the links among school attitudes, perceived social norms, and marijuana use when developing programs and interventions. Efforts are needed that are culturally competent and culturally sensitive to help reduce marijuana use rates among African American male adolescents. Future research is needed to further examine school perceptions and marijuana use among this population.

Perceived neighborhood disorder and frequency of marijuana use among emerging adult African American females

Emerging adult African American females are at increased risk for cannabis use disorders. Ecological models suggest that African Americans' increased risk for substance use disorders and associated adverse outcomes may result from chronic exposure to contextual disadvantages, such as living in economically deprived and disorganized communities. However levels of vulnerability for developing cannabis use disorders vary, even among residents of disadvantaged neighborhoods. Therefore, studies focused on within group differences are necessary. This study examined the relationship between frequency of marijuana use and perceived neighborhood disorder. The sample included 117 African American emerging adult females (M_age = 23.6 ± 3.4). After providing informed consent, participants completed a semi-structured interview that included the Neighborhood Environment Scale and a self-report measure of marijuana use. Additionally, participants provided a urine sample that was tested for the presence of psychoactive drugs. 46% tested positive for marijuana and 45% reported using marijuana in the past 30 days. 27% reported frequent/heavy use. Results from multinomial logistic regression analysis indicated a significant relationship between perceived neighborhood disorder and heavy marijuana use (AOR = 3.3; 95% CI = 1.06 - 10.29). Findings suggest African American emerging adult female residents of economically disadvantaged neighborhoods who appraise their environments as disorganized may be at heighten risk for problematic marijuana use and should be targeted for intervention. Moreover, the findings support the need for multi-systems interventions. As policy makers consider the legalization of marijuana, it is important that differences in marijuana use behaviors and negative outcomes across groups and contexts are taken into consideration.

Sex Differences in the Association Between School Experiences and Marijuana Use Among African American Adolescents

This study examined whether past month marijuana use among African American adolescents differed based on school experiences and individual feelings toward school. A secondary analysis of the 2012 National Survey on Drug Use and Health was conducted to answer research questions. Results from the multivariable logistic regression analyses revealed that female students at highest risk for recent use included those who held negative feelings toward school (OR 2.723, CI 1.683, 4.406, p < .001), felt courses were not interesting (OR 2.695, CI 1.513, 4.798, p < .01), and received mostly C's/D's/ F's in the last semester (OR 2.520, CI 1.614, 6.711,p < .001). For males, results indicated that male students at highest risk included those who held negative feelings toward school (OR 2.364, CI 1.365, 4.094, p < .01), felt things learned in school would not be important later in life (OR 3.470, CI 1.951, 6.173, p < .001), and received mostly C's/ D's/F's in the last semester (OR 2.733, CI 1.734, 4.309, p < .001). In the final model, of those who felt that most or all students in their grade used marijuana, males were 3 ½ times (OR 3.418, CI 1.741, 6.711, p < .001) and females were 8 times (OR 8.288, CI 3.526, 19.480, p < .001) more likely to have recently used marijuana. Such findings can be used by prevention specialists and health educators to develop and implement marijuana prevention programs and interventions specifically tailored to African American adolescents. Recommendations for future research are included.

Neighborhood context and transitions in marijuana use among urban young adults

BACKGROUND

In emerging adulthood when many youth are maturing out of marijuana use, Blacks continue to have high rates of use and disorder. Theory suggests that factors tied to neighborhood disadvantage may partially explain this phenomenon but research is limited.

OBJECTIVES

This study examines the influence of neighborhood physical and social disorder on transitions in marijuana use during emerging adulthood in a low-income urban sample.

METHODS

379 primarily Black young adults residing in low-income neighborhoods in Baltimore City were followed-up annually from ages 18 to 21. Neighborhood environment was evaluated using a valid and reliable field-rater assessment of the residential block. Longitudinal latent class and latent transition analyses were performed.

RESULTS

Fit indices supported three-classes of marijuana use: no use, infrequent use and frequent use. Between ages 18 and 21, young adults tended to transition toward lower levels of use. However, neighborhood physical disorder was associated with transitioning to increased marijuana use (no use to frequent use; AOR = 2.712; p = .023) while positive neighborhood social activity was associated with a decreased risk (AOR = 0.002; p = .013). Neighborhood social activity was also associated with decreases in use (frequent to infrequent use; AOR = 2.342; p = .020). Conclusions/Importance: These findings demonstrate that physical disorder within the context of a low-income urban neighborhood adversely impacts marijuana use. However, even in the presence of physical disorder, interventions that foster collective efficacy among residents through positive social activity may prevent initiation and progression of marijuana use.

The Impact of the Urban Neighborhood Environment on Marijuana Trajectories During Emerging Adulthood

Although there is little difference in rates of marijuana use between White and Black youth, Blacks have significantly higher rates of marijuana use and disorder in young adulthood. Theory suggests that factors tied to social disadvantage may explain this disparity, and neighborhood setting may be a key exposure. This study sought to identify trajectories of marijuana use in an urban sample during emerging adulthood, neighborhood contexts that predict these trajectories and social role transitions or "turning points" that may redirect them. Data are from a longitudinal cohort study of 378 primarily Black emerging adults who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually. Group-based trajectory modeling identified three groups: No Use (68.8%), Declining Use (19.6%), and Chronic Use (11.7%). Living in close proximity to an alcohol outlet, and living in a neighborhood with more female-headed households and higher rates of violent crime increased the odds of membership in the Chronic Use group relative to No Use. Living in a neighborhood with more positive social activity increased the odds of membership in the Declining Use group relative to No Use. Not receiving a high school diploma or GED, pregnancy, and parenting also increased the odds of membership in the Declining Use group relative to No Use. These findings provide support that minority youth living in socially toxic and disordered neighborhoods are at increased risk of continuing on a trajectory of marijuana use during emerging adulthood while positive social activity in neighborhoods has the potential to redirect these negative trajectories. Besides taking on the responsibilities of parenting, emerging adults in the marijuana user groups had similar educational and family outcomes, suggesting that early marijuana use may have long-term implications.

Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors

The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physical health or risky behavior. Further examination revealed that support for BWT-related hypotheses has been overstated owing to data censoring and the failure to consistently include critical covariates, like socioeconomic status and collective efficacy. Even where there is evidence that BWT impacts outcomes, it is driven by studies that measured disorder as the perceptions of the focal individual, potentially conflating pessimism about the neighborhood with mental health.

DSM-5 cannabis use disorder in the National Epidemiologic Survey on Alcohol and Related Conditions-III: Gender-specific profiles

OBJECTIVE

The objective of this study was to present current information on the prevalence, correlates, comorbidity and quality of life among men and women with cannabis use disorder (CUD).

METHODS

In 2012-2013, 36,309 respondents ≥18years old participated in face-to-face interviews in the National Epidemiologic Survey on Alcohol and Related Conditions-III.

RESULTS

Prevalence of 12-month CUD was greater among men (3.5%) than women (1.7%). Women experienced shorter duration from onset of cannabis use to onset of CUD than men (mean=5.8years, men; mean=4.7years, women). In both men and women, prevalences of CUD were greater among young adults, Blacks, and those with lower income and greater among Native American women relative to White women. CUD was highly comorbid with other substance use disorders, PTSD, ASPD and borderline and schizotypal PDs for men and women. Quality of life for individuals with CUD was low regardless of gender.

CONCLUSIONS

DSM-5 CUD among men and women is highly prevalent, comorbid and characterized by low quality of life. Results highlighted the need for integrated treatment of CUD and comorbid disorders and the urgency of identifying and implementing effective prevention and intervention approaches, especially for those sociodemographic subgroups for which both men and women are at greater risk for the disorder.

A scoping review and meta-analysis of psychosocial and pharmacological treatments for cannabis and tobacco use among African Americans

The rates of co-occurring cannabis and tobacco use are higher among African Americans relative to other racial/ethnic groups. One plausible approach to treating co-use among African Americans is to examine the effectiveness of treatments for the sole use of cannabis and tobacco to identify effective approaches that might be combined to treat the dual use of these substances. The current meta-analysis sought to include studies that reported cannabis and/or tobacco use outcomes from randomized clinical trials (RCTs) with 100% African American samples. A total of 843 articles were considered for inclusion, 29 were reviewed by independent qualitative coders, and 22 were included in the review. There were no articles on cannabis use treatment with a 100% African American sample, resulting in a need to lower the threshold (60%) and conduct a scoping review of cannabis studies. Preliminary evidence from a small number of studies (k = 7) supports the use of Motivational Interviewing and Cognitive-Behavioral Therapy to treat cannabis use among African Americans, but not Contingency Management. Results from a meta-analysis of 15 tobacco studies found higher rates of smoking abstinence in the treatment condition relative to control conditions overall and across short and long-term follow-up periods. Significant differences in smoking abstinence were also found when examining the effects of pharmacological treatments relative to their control conditions. The clinical and research implications of these findings for future psychosocial and pharmacological trials for cannabis and tobacco use and co-use among African Americans are described. (PsycINFO Database Record

Correlates of Blunt Smoking Among African American, Hispanic/Latino, and White Adults: Results From the 2014 National Survey on Drug Use and Health

BACKGROUND

Blunt use is highly prevalent in the United States and has been associated with several negative health consequences, such as an increased risk for cardiovascular and pulmonary diseases. Although recent studies have identified characteristics (e.g., gender) that are associated with blunt use, it is unclear if these factors correlate with blunt use equally across racial/ethnic groups.

METHODS

Using cross-sectional data from the 2014 National Survey on Drug Use and Health, this study aimed to determine if demographic, health and substance use correlates of current (i.e., past 30-day) and lifetime blunt use were similar across 37,628 non-Hispanic African American, Hispanic/Latino and non-Hispanic White adults.

RESULTS

Findings revealed 8.3% of African American, 3.3% of Hispanic/Latino and 2.5% of White adults reported current blunt smoking. Across all racial/ethnic groups, age and current and lifetime cigarette and illicit drug use were associated with current and lifetime blunt use. However, gender, educational level, income, current alcohol use and self-reported health status were differentially associated with current and lifetime blunt use across racial/ethnic groups. Employment status and lifetime depression were not associated with blunt use behaviors among any of the racial/ethnic groups.

CONCLUSIONS

The relationship between gender, socioeconomic status, alcohol use and self-reported health status and blunt use differs among African American, Hispanic/Latino and White adults. Researchers and providers should consider the heterogeneity in factors that are associated with blunt use when designing prevention and treatment interventions for African American, Hispanic/Latino and White adult blunt smokers.

Assessing the Role of Context on the Relationship Between Adolescent Marijuana Use and Property Crimes in Mexico

BACKGROUND

A limited amount of research has been conducted on the association between marijuana use and adolescent crime in developing countries such as Mexico, where crime rates are high and marijuana use is increasing.

OBJECTIVES

To examine the association between the frequency of marijuana use and the likelihood of committing of a property crime, and to identify contextual factors explaining individual differences in the likelihood of committing a property crime.

METHODS

The contribution of marijuana use to property crimes was examined based on two nationwide probabilistic surveys of public high school students, using a multilevel mixed effects logistic regression model.

RESULTS

Marijuana use significantly increased the odds of committing a property crime. Differences between schools were observed in the random effects of marijuana use, suggesting that the likelihood of committing a property crime was differentially affected by contextual factors. In addition, students who were victims of bullying by peers and who had parents that abused alcohol had higher odds of committing a property crime. Perceived disorder in students' schools and neighborhoods also increased students' odds of reporting that they had committed a property crime.

CONCLUSIONS

The importance of the effect of school context on the relationship between marijuana use and the commission of a property crime among Mexican public high school students seemed to increase over time. However, these results may also be due to changes in sampling designs over time.

Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic

Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly funded STI clinic in the U.S. (54 % male, M age = 27.93, 68 % African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective.

Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III

OBJECTIVE

Attitudes toward marijuana are changing, the prevalence of DSM-IV cannabis use disorder has increased, and DSM-5 modified the cannabis use disorder criteria. Therefore, updated information is needed on the prevalence, demographic characteristics, psychiatric comorbidity, disability, and treatment for DSM-5 cannabis use disorder.

METHOD

In 2012-2013, 36,309 participants ≥18 years old were interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III. Psychiatric and substance use disorders were assessed with the Alcohol Use Disorders and Associated Disabilities Interview Schedule-5.

RESULTS

The prevalences of 12-month and lifetime cannabis use disorder were 2.5% and 6.3%. Among those with 12-month and lifetime diagnoses, the mean days of marijuana use per year were 225.3 (SE=5.7) and 274.2 (SE=3.8). The odds of 12-month and lifetime cannabis use disorder were higher for men, Native Americans, unmarried individuals, those with low incomes, and young adults (e.g., among those age 18-24 years versus ≥45: odds ratio for 12-month disorder, 7.2; 95% confidence interval, 5.5-9.5). Cannabis use disorder was associated with other substance use disorders, affective disorders, anxiety, and personality disorders. Twelve-month cannabis use disorder was associated with disability. As disorder severity increased, virtually all associations became stronger. Only 13.2% with lifetime cannabis use disorder participated in 12-step programs or professional treatment.

CONCLUSIONS

DSM-5 cannabis use disorder is prevalent, associated with comorbidity and disability, and largely untreated. Findings suggest the need to improve prevention and educate the public, professionals, and policy makers about possible harms associated with cannabis use disorders and available interventions.

Local spatial clustering in youths' use of tobacco, alcohol, and marijuana in Boston

BACKGROUND

Understanding geographic variation in youth drug use is important for both identifying etiologic factors and planning prevention interventions. However, little research has examined spatial clustering of drug use among youths by using rigorous statistical methods.

OBJECTIVES

The purpose of this study was to examine spatial clustering of youth use of tobacco, alcohol, and marijuana.

METHODS

Responses on tobacco, alcohol, and marijuana use from 1,292 high school students ages 13-19 who provided complete residential addresses were drawn from the 2008 Boston Youth Survey Geospatial Dataset. Response options on past month use included "none," "1-2," "3-9," and "10 or more." The response rate for each substance was approximately 94%. Spatial clustering of youth drug use was assessed using the spatial Bernoulli model in the SatScan™ software package.

RESULTS

Approximately 12%, 36%, and 18% of youth reported any past-month use of tobacco, alcohol, and/or marijuana, respectively. Two clusters of elevated past tobacco use among Boston youths were generated, one of which was statistically significant. This cluster, located in the South Boston neighborhood, had a relative risk of 5.37 with a p-value of 0.00014. There was no significant localized spatial clustering in youth past alcohol or marijuana use in either the unadjusted or adjusted models.

CONCLUSION

Significant spatial clustering in youth tobacco use was found. Finding a significant cluster in the South Boston neighborhood provides reason for further investigation into neighborhood characteristics that may shape adolescents' substance use behaviors. This type of research can be used to evaluate the underlying reasons behind spatial clustering of youth substance and to target local drug abuse prevention interventions and use.

Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013

IMPORTANCE

Laws and attitudes toward marijuana in the United States are becoming more permissive but little is known about whether the prevalence rates of marijuana use and marijuana use disorders have changed in the 21st century.

OBJECTIVE

To present nationally representative information on the past-year prevalence rates of marijuana use, marijuana use disorder, and marijuana use disorder among marijuana users in the US adult general population and whether this has changed between 2001-2002 and 2012-2013.

DESIGN, SETTING, AND PARTICIPANTS

Face-to-face interviews conducted in surveys of 2 nationally representative samples of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions (data collected April 2001-April 2002; N = 43,093) and the National Epidemiologic Survey on Alcohol and Related Conditions-III (data collected April 2012-June 2013; N = 36,309). Data were analyzed March through May 2015.

MAIN OUTCOMES AND MEASURES

Past-year marijuana use and DSM-IV marijuana use disorder (abuse or dependence).

RESULTS

The past-year prevalence of marijuana use was 4.1% (SE, 0.15) in 2001-2002 and 9.5% (SE, 0.27) in 2012-2013, a significant increase (P < .05). Significant increases were also found across demographic subgroups (sex, age, race/ethnicity, education, marital status, income, urban/rural, and region). The past-year prevalence of DSM-IV marijuana use disorder was 1.5% (0.08) in 2001-2002 and 2.9% (SE, 0.13) in 2012-2013 (P < .05). With few exceptions, increases in the prevalence of marijuana use disorder between 2001-2002 and 2012-2013 were also statistically significant (P < .05) across demographic subgroups. However, the prevalence of marijuana use disorder among marijuana users decreased significantly from 2001-2002 (35.6%; SE, 1.37) to 2012-2013 (30.6%; SE, 1.04).

CONCLUSIONS AND RELEVANCE

The prevalence of marijuana use more than doubled between 2001-2002 and 2012-2013, and there was a large increase in marijuana use disorders during that time. While not all marijuana users experience problems, nearly 3 of 10 marijuana users manifested a marijuana use disorder in 2012-2013. Because the risk for marijuana use disorder did not increase among users, the increase in prevalence of marijuana use disorder is owing to an increase in prevalence of users in the US adult population. Given changing laws and attitudes toward marijuana, a balanced presentation of the likelihood of adverse consequences of marijuana use to policy makers, professionals, and the public is needed.

The role of neighborhood in urban black adolescent marijuana use

BACKGROUND

The present study examined the influence of neighborhood factors on transitions in marijuana involvement during adolescence in a sample of primarily low-income, urban Black youth.

METHODS

556 Black adolescents were interviewed annually beginning in first grade as part of a longitudinal study. Latent class analysis (LCA) was used to examine stages of marijuana involvement from 6th to 9th grades. The influence of neighborhood disorder, drug activity, violent crime, safety and disadvantage on transitions in marijuana involvement was tested using latent transition analysis (LTA).

RESULTS

There was evidence for three stages of involvement: no involvement, offered, and use and problems. Involvement increased steadily during adolescence with a slightly greater risk to transition from offers to use between 6th and 7th grades. Neighborhood disorder (AOR=1.04, CI=1.00, 1.08), drug activity (AOR=1.12, CI=1.02, 1.22) and disadvantage (AOR=1.44, CI=1.10, 1.92) were associated with the transition from marijuana offers to use and problems. Neighborhood disorder (AOR=1.07, CI=1.02, 1.11), drug activity (AOR=1.19, CI=1.10, 1.29) and violent crime (AOR=1.17, CI=1.03, 1.32) were associated with transitioning rapidly from no involvement to use and problems.

CONCLUSIONS

Understanding how neighborhoods could be organized and provided with supports to discourage marijuana use and promote non-drug using behaviors should be an important goal of any prevention program in low-income, urban Black neighborhoods. Enhancing citizen participation and mobilization to address the social processes of neighborhood disorder has the potential to reduce marijuana involvement in these neighborhoods.