A network analysis of alcohol-related harms: An exploratory study in United Kingdom adolescents

BACKGROUND

This study applied a network analysis approach to the study of individual self-reported alcohol-related harms (ARHs) across four waves of data.

METHODS

Data were from a large clustered randomised control trial (N = 12,738) involving 105 schools. Data were collected at 4 time points over 4 academic years (mean age 12.5 [Time 0], 13.5 [T1], 14.5 [T2], and 15.3 years [Time 3]). Data were gathered on the experience of 16 separate ARHs experienced during the previous six months, and these were dichotomised (yes/no). We estimated cross-lagged panel networks for the 16 ARHs, capturing both the auto-regressive relationships (a harm predicting itself at follow up) and the cross-lagged relationships (a harm predicting another harm at follow-up) across the study (T0 → T1; T1 → T2; T2 →T3).

RESULTS

Exposure to all ARHs increased with age. However, the most serious ARHs (e.g., getting in trouble with the police because of your drinking) remained relatively rare, even at age 15. Actively planning to get drunk, coupled with an inability to control levels of intoxication (drinking more than planned) appeared central to each network, facilitating the emergence of all other ARHs. While the prevalence of ARHs increased with age, network complexity declined, and networks becoming more stable.

CONCLUSIONS

Interventions aimed at improving the capacity to self-regulate alcohol consumption, and actively challenging the planning of drunken episodes, may be pivotal in reducing the emergence of both acute and chronic ARHs in adolescence.

Resilience Through Harm Reduction? Protective Behavioral Strategies as a Factor of Resilience Among Polish Young Adults Using Various Psychoactive Substances

Resiliency theory might provide a conceptual framework for understanding why adverse substance-related consequences vary considerably among young adults using psychoactive substances. Protective behavioral strategies (PBS) are behaviors that reduce substance use and related consequences. Despite such suggestions, to date no research has explicitly treated PBS as resilience factors. The purpose of this study was to examine compensatory and protective models of resilience among young adults using various substances. Data were obtained from an online questionnaire distributed through online social networks. Participants were Polish young adults (18-30 years old; M = 22, SD = 3.6; about 30% female and 1.3% non-binary; N = 7253), who reported using substances, other than alcohol or nicotine, in the last 12 months. After controlling for sociodemographics, hierarchical regression analyses of both substance-related harms and SUDs indicated the main effects of risk and protective factors, and the interaction between substance use and PBS. The models explained about 50% and 52% of the dependent variables variance, respectively. The results of this cross-sectional study provide support for both compensatory and protective models of resilience. This presents a rationale for recognizing PBS use as resilience factors that help young adults reduce substance-related harms. Theoretical discussion and practical implications are provided.

Investigating self-regulation in young adults who drug-drive

OBJECTIVE

Drug-driving among young adults is a growing concern. Methods other than enforcement are required to reduce engagement in such behavior. Research has identified satisfaction of individual's inherent psychological needs is predictive of positive behavioral outcomes sustainable in the long-term via the internalization of self-regulatory processes. Drug-driving behavior and self-regulation was explored through the lens of self-determination theory's needs-supportive model.

METHODS

An online cross-sectional survey of 304 participants (males = 78), aged 18-24 years (M = 20.61, SD = 1.92) was conducted. Participants were recruited via convenience sampling across Queensland, Australia. Measures included drug use, drug-driving behavior and self-regulation.

RESULTS

A hierarchical binary logistic regression showed that, aside from problematic drug use predicting drug-driving, higher scores for age, effort/importance, an indicator of internalization of regulatory processes, and trait self-regulation significantly predicted a decrease in the likelihood of young adult drug-driving, with 61% variance accounted for in the model.

CONCLUSIONS

Problematic drug use as the underlying issue contributing to drug-driving requires continued attention. However, viewing the issue of drug-driving as the result of unmet inherent psychological needs supports the notion that meeting these needs may reduce drug-driving in the long-term, instead of relying on the short-term effectiveness of enforcement measures. The study contributes to the limited research understanding the role of self-regulation in drug-driving behaviors. The implications of these findings include recommendations for psychological-based interventions guided by self-determination theory targeting young adults' drug-driving and more generally their long-term safe driving practices.

"It'll Never Be Safe, But You Can Limit the Harms". Exploring Adolescents' Strategies to Reduce Harms Associated with Psychoactive Substance Use

Introduction: Harm reduction strategies are behaviors that may be applied in order to reduce adverse consequences associated with psychoactive substance use. Adolescents who use substances make up a large population that may benefit from applying such strategies. However, previous research in this area has focused on adults. Therefore, the purpose of this qualitative study was to describe and examine harm reduction strategies among adolescents who use psychoactive substances. Methods: Semi-structured individual interviews were conducted with 72 adolescents of equal sex distribution (aged 17-18 years) who had used various substances at least three times in the past 12 months and had no history of substance use disorders (SUD) treatment. Data were transcribed and then analyzed thematically based on the Consensual Qualitative Research approach. Findings: Adolescents who use substances described the harm reduction strategies they use. According to the meaning youth attributed to these strategies, five themes were developed, that included approaches to risk, substance use safety conditions, preparation for use, manner of use, and controlled use. Most of the identified strategies correspond to those found in studies on adults. The main source of adolescents' knowledge about these strategies was the Internet. Peers appeared to play an important role in reducing substance-related risks. Conclusions: Despite risk-taking, adolescents in our study showed active engagement in reducing their substance-related risks and harms. Practical implications are provided, including supporting harm reduction strategies, enhancing the active role of peers and the Internet as communication channels in preventing SUDs as well as other substance-related problems among adolescents.

Ancient psychoactive plants in a global village: The ritual use of cannabis in a self-managed community in Catalonia

BACKGROUND

Cannabis is a plant with a rich history of medical, recreational, industrial and spiritual uses. This paper aims to explore drug use rituals as methods of community-controlled use that help maintain a self-regulated and healthy relation to the substance in questions. Furthermore, it explores how cannabis is used in developing spirituality and a sense of community. The ritual use of cannabis is discussed in the context of drug policy.

METHODS

Ethnographic research methods, such as fieldwork, participant observation, in-depth interviews, and qualitative analysis, were used to research a phenomenological community in rural Catalonia, where ancient psychoactive plants (APP), such as ayahuasca and cannabis, are regularly used in a ritual context.

RESULTS

Cannabis has a long history of ritual/spiritual uses and is still being used for such purposes in Catalonia. The rituals are effective harm reduction techniques and can even generate beneficial effects for the individual as well as the community by strengthening bonds between community members. The rituals associated with APP are seen as spiritual or religious practices, as well as forms of self-care and community-care, rather than involving drug dependence or addiction.

CONCLUSION

The contemporary use of APP in Western societies is gaining popularity. International drug policies and the schedule of controlled drugs claim to be based on scientific evidence, but this evidence is limited. The contemporary myopic focus on the risks and harms of drugs overlooks important realities, such as the benefits of non-problematic drug use. These omissions could in part be rectified through the consideration of scientific findings from the field of ethnography regarding the spiritual and community dimensions of drug use.

Why Switch? - Motivations for Self-Substitution of Illegal Drugs

Self-substitution is the conscious switch from one drug to another for reasons such as price, availability, desired effect, or perceived benefit of the substitute drug. Purpose/Objectives: This study aimed to describe drug use patterns and motivations associated with substitution. We examined correlates of lifetime substitution among individuals with substance use disorder. Methods: A cross-sectional study of 771 treatment-enrolled individuals. We used self-report for determining the lifetime prevalence, correlates, and motivations for substitution. Results: Of the 771 respondents, 570 (73.9%) reported ever substituting their preferred substance. The main incentives for substitution were availability (23.7%) and curiosity (20.2%). Among heroin or cannabis preferers, improved effects or less adverse effects of the substitute drug, self-medication, and managing withdrawal symptoms were significant substitution incentives. Increased odds for substitution were observed for past 12 months use of cannabis (OR = 1.51, CI = 1.06-4.52), prescription opioids (OR = 2.86, CI = 1.81-4.52), novel psychoactive substances (OR = 2.68, CI = 1.64-4.36), and repeated admission (OR = 1.50, CI = 1.05-2.14). Older age at onset-of-use was negatively associated with substitution (OR = 0.95, CI = 0.93-0.98). Conclusions: Self-substitution of one substance for another is a highly prevalent behavior among treatment-enrolled patients with substance use disorder. Clinicians caring for substance use disorder patients should be aware of substitution patterns involving the use of highly potent substances, which constitutes a risk to patients. Results underscore the benefit of substitution patterns analyses, as they reveal important information on the characteristics of persons who use drugs and their motivations.

Interplay Between Sensation Seeking and Parental Rules in the Emergence of Heavy Episodic Drinking

This study examined the parallel mediational processes between sensation seeking and parental rules on alcohol, in the emergence of heavy episodic drinking (HED) in adolescents. Data were drawn from a U.K. clustered randomized control trial (control arm only, N ≈ 6,300, M_age at baseline = 12.5). Using parallel process latent growth curve analysis, stricter parental rules at baseline were found to be associated with greater declines in sensation seeking over time and a lower risk of HED at follow-up (+33 months). Higher initial levels of sensation seeking predicted a faster relaxation of parental rules and a greater risk of HED. By maintaining strict rules about alcohol, parents may promote a positive reduction in sensation seeking and a lower risk of HED.

Nonproblematic Illegal Drug Use

Given the scant knowledge regarding illicit drug users who maintain an overall conventional lifestyle, we aimed to develop a conceptual framework to understand how they manage to keep their drug use nonproblematic. We were interested in the individual’s experiential component, so we interviewed nonproblematic, ex-problematic and problematic Portuguese drug users. The conceptual framework was developed through the first group’s data and then validated through a new consultation with these participants and a triangulation of sources and methodologies (observation). Findings show that some subjects managed to keep their drug use nonproblematic through ongoing self-regulation as a result of cost-benefit analysis and drug use management strategies. These strategies resulted mainly from the users’ characteristics, the quality of drug using experiences, and experiences with other users. The importance of this study is in recognizing that nonproblematic drug use exists and that therein may lie important clues on how to minimize problematic use.

Longitudinal Relationships Between Self-Management Skills and Substance Use in an Urban Sample of Predominantly Minority Adolescents

We explored changes in self-management skills and substance use from 7th to 11th grade in a multiwave study of predominantly minority adolescents (N = 1,756). Using latent growth curve analysis, we found that substance use significantly increased, whereas self-management skills significantly decreased. In a parallel process model, we found that participants who reported higher self-management skills in the 7th grade had smaller increases in substance use. Participants who had larger decreases in self-management skills tended to have greater increases in substance use. We also explored the influence of grades and gender and found that (a) participants with higher grades at baseline had lower initial substance use, higher initial self-management skills, and smaller increases in substance use, and (b) male participants had greater increases in substance use. These results suggest that the provision of self-management skills may be an effective strategy for preventing substance-use initiation and escalation during adolescence.

A social operational model of urban adolescents' tobacco and substance use: a mediational analysis

This study tested a mediation model of the relationship with tobacco use, social network quality (level of risk or protection in a network), and substance use (alcohol and/or illicit drugs) with a sample of 301 urban adolescents. It was theorized that social network quality would mediate the effect of tobacco use, accounting for PTSD symptoms and parent-teen relationships, on substance use. Results of path modeling with AMOS showed that the model provided an overall very good fit to the data and demonstrated partial mediation effects of social network quality on substance use. An effect-size measure was applied to determine what proportion of the total effect was mediated by the intervening (social network) variable and produced a moderate effect size (0.31). Results highlight the mediating role of social network quality on risk factors for adolescent substance use and are informative to prevention science in advancing social operational models of substance use.