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Matson TE, Williams EC, Lapham GT, Oliver M, Hallgren KA, Bradley KA. Association between cannabis use disorder symptom severity and probability of clinically-documented diagnosis and treatment in a primary care sample. Drug Alcohol Depend 2023; 251:110946. [PMID: 37688980 PMCID: PMC10655701 DOI: 10.1016/j.drugalcdep.2023.110946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/01/2023] [Accepted: 08/13/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Brief cannabis screening followed by standardized assessment of symptoms may support diagnosis and treatment of cannabis use disorder (CUD). This study tested whether the probability of a medical provider diagnosing and treating CUD increased with the number of substance use disorder (SUD) symptoms documented in patients' EHRs. METHODS This observational study used EHR and claims data from an integrated healthcare system. Adult patients were included who reported daily cannabis use and completed the Substance Use Symptom Checklist, a scaled measure of DSM-5 SUD symptoms (0-11), during routine care 3/1/2015-3/1/2021. Logistic regression estimated associations between SUD symptom counts and: 1) CUD diagnosis; 2) CUD treatment initiation; and 3) CUD treatment engagement, defined based on Healthcare Effectiveness Data and Information Set (HEDIS) ICD-codes and timelines. We tested moderation across age, gender, race, and ethnicity. RESULTS Patients (N=13,947) were predominantly middle-age, male, White, and non-Hispanic. Among patients reporting daily cannabis use without other drug use (N=12,568), the probability of CUD diagnosis, treatment initiation, and engagement increased with each 1-unit increase in Symptom Checklist score (p's<0.001). However, probabilities of diagnosis, treatment, and engagement were low, even among those reporting ≥2 symptoms consistent with SUD: 14.0% diagnosed (95% CI: 11.7-21.6), 16.6% initiated treatment among diagnosed (11.7-21.6), and 24.3% engaged in treatment among initiated (15.8-32.7). Only gender moderated associations between Symptom Checklist and diagnosis (p=0.047) and treatment initiation (p=0.012). Findings were similar for patients reporting daily cannabis use with other drug use (N=1379). CONCLUSION Despite documented symptoms, CUD was underdiagnosed and undertreated in medical settings.
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Affiliation(s)
- Theresa E Matson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Health Services Research & Development (HSR&D) Center for Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA 98101, USA.
| | - Emily C Williams
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Health Services Research & Development (HSR&D) Center for Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA 98101, USA
| | - Gwen T Lapham
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA
| | - Malia Oliver
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA
| | - Kevin A Hallgren
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Katharine A Bradley
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
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Mattingly DT, Neighbors HW, Mezuk B, Elliott MR, Fleischer NL. Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 148:208958. [PMID: 37102192 DOI: 10.1016/j.josat.2023.208958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/11/2022] [Accepted: 01/09/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. METHODS We used cross-sectional data on adults (18+) from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0-24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). RESULTS Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07-1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12-1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. CONCLUSIONS Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.
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Affiliation(s)
- Delvon T Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Harold W Neighbors
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
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Intersectional stigma subgroup differences in unhealthy drinking and disordered marijuana use among Black and Latino cisgender sexual minority young men. Drug Alcohol Depend 2022; 241:109652. [PMID: 36332595 PMCID: PMC10082566 DOI: 10.1016/j.drugalcdep.2022.109652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated associations of intersectional stigma subgroups with alcohol and marijuana use among Black and Latino sexual minority young men. Subgroups included Minimal Stigma (low to no stigma), Select Social Stigma (occasional stigma in social relationships), Multiform Heterosexism (internalized and interpersonal heterosexism from family/friends), Multiform Racism (racism across diverse contexts), Compound Stigma (frequent, ubiquitous racism and heterosexism). METHODS Cohort of Black and Latino cisgender sexual minority young men (n = 414; baseline ages 16-25) surveyed semiannually 2016-2019. Generalized estimating equations integrated with latent class analysis modeled linear and quadratic age effects and association of stigma subgroups with past 6-month alcohol use, marijuana use, unhealthy drinking, and marijuana use disorder symptoms. RESULTS All past 6-month substance use peaked between ages 21-23 years old. Across all ages and relative to Minimal Stigma, odds of drinking were higher in every subgroup and highest in Compound Stigma (OR=2.72, 95% CI 1.17-6.35); unhealthy drinking was higher in every subgroup and highest in Multiform Heterosexism (β = 3.31, 95% CI 1.92-3.89); marijuana use disorder symptoms were higher in most subgroups and highest in Compound Stigma (β = 1.30, 95% CI 0.76-1.85). Marijuana use odds did not differ among groups. CONCLUSION By examining intersectional stigma subgroups, we identified subgroups for whom substance use was elevated during a development period when use tends to be highest. Young men experiencing stigma patterns characterized primarily by heterosexism or heterosexism together with racism may be especially at risk for developing unhealthy drinking behaviors and marijuana use disorder symptoms.
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Jones DM, Masyn KE, Spears CA. Discrimination, psychological functioning, and substance use among U.S. young adults aged 18-28, 2017. Exp Clin Psychopharmacol 2022; 30:884-896. [PMID: 34398638 PMCID: PMC9134875 DOI: 10.1037/pha0000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to test whether (a) discrimination is associated with past 30-day/current alcohol, cigarette, e-cigarette, alcohol, marijuana, and other illicit drug use among Black and White U.S. adults aged 18-28, (b) psychological distress (PD) and positive well-being (PW) are mediators of the discrimination-substance use relationships, and (c) the associations are moderated by race and sex. Using data from a 2017 U.S. nationally representative survey we conducted multiple-group moderated mediation analyses among 2,192 young adults aged 18-28 (508 Black males, 594 Black females, 533 White males, 557 White females). Black males had higher discrimination, Whites had higher PW, and females had higher PD scores. Discrimination was positively associated with PD and negatively associated with PW. Among all groups, discrimination was positively associated with other illicit drug (direct and indirect), and marijuana use through PD. Indirect effects were stronger among White males for other illicit drugs and Black males for marijuana. The indirect effect of discrimination and alcohol use through PW was positive for Black females and negative for all other groups examined. Among Black males only, discrimination was positively associated with cigarette and alcohol use through PD (positive) and cigarette smoking through PW (negative). This study highlights the negative influence of perceived discrimination on current licit and illicit substance use among Black and White young adults. Our results suggest that this relationship may be partially mediated by PD and PW, especially among Black male young adults. Future discrimination and substance use studies should consider potential mediation effects of poor mental health and differences by race and sex. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Dina M. Jones
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Katherine E. Masyn
- Department of Population Health Sciences, School of Public Health, Georgia State University
| | - Claire Adams Spears
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University
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Zvolensky MJ, Kauffman BY, Garey L, Buckner JD. Abstinence phobia among adult African American/Black cannabis users. Addict Behav 2022; 132:107344. [PMID: 35569320 PMCID: PMC10029065 DOI: 10.1016/j.addbeh.2022.107344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE African American/Black individuals experience significant health disparities, particularly as it relates to cannabis use. As such, there is a need to identify intrapersonal factors related to more severe patterns of use among this subpopulation. Worry about quitting or reducing cannabis as a result of the anticipated anxiety-related states during deprivation (i.e., abstinence phobia) is one factor that is theoretically important in the context of cannabis-related disparities. METHOD The current study sought to examine the cross-sectional association between abstinence phobia and cannabis use problems, perceived barriers for cannabis cessation, and cannabis withdrawal symptoms. Participants included 83 African American/Black cannabis users (31.3% female, Mage = 38.12, SD = 10.42). RESULTS Cannabis abstinence phobia was associated with greater severity of cannabis use problems, more perceived barriers for quitting cannabis use, and more severe cannabis withdrawal symptoms. CONCLUSIONS Abstinence phobia may represent an underrecognized intervention target for addressing cannabis use problems and quit success.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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6
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Motley RO, Byansi W, Siddiqi R, Bills KL, Salas-Wright CP. Perceived Racism-based police use of force and cannabis use among Black emerging adults. Addict Behav Rep 2022; 15:100430. [PMID: 35495418 PMCID: PMC9046117 DOI: 10.1016/j.abrep.2022.100430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/23/2022] [Accepted: 04/17/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Robert O. Motley
- School of Social Work, Boston College School of Social Work, Chestnut Hill, MA, United States
- Corresponding author at: Racism-based Violence Injury & Prevention Lab, Boston College School of Social Work, 140 Commonwealth Ave, McGuinn Hall, Chestnut Hill, MA 02467, United States.
| | - William Byansi
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, United States
| | - Rebekah Siddiqi
- School of Social Work, Boston College School of Social Work, Chestnut Hill, MA, United States
| | - Kaycee L. Bills
- School of Social Work, Fayetteville State University, Fayetteville, NC, United States
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Ahuja M, Haeny AM, Sartor CE, Bucholz KK. Perceived racial and social class discrimination and cannabis involvement among Black youth and young adults. Drug Alcohol Depend 2022; 232:109304. [PMID: 35124388 DOI: 10.1016/j.drugalcdep.2022.109304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/09/2021] [Accepted: 12/10/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The current study examines the association of perceived racial and social class discrimination with cannabis involvement among Black youth and young adults. METHODS This secondary analysis used data from the Missouri Family Study (MOFAM), a high-risk longitudinal family study of alcohol use disorder, oversampled for Black families. Offspring (n = 806) and their mothers were interviewed by telephone. Cox proportional hazards regression analyzes were used to examine associations of racial and social class discrimination (experienced by offspring and their mothers) with offspring cannabis involvement. Two stages of cannabis involvement were analyzed: timing of 1) initiation and 2) transition from initiation to first cannabis use disorder (CUD) symptom. RESULTS The study found that offspring report of experiencing racial (HR: 1.28, CI: 1.01-1.62) and social class discrimination (HR: 1.45, CI: 1.14-1.84) were associated with cannabis initiation in our fully adjusted model. Mothers' report of discrimination predicted a lower hazard of cannabis initiation among offspring (HR: 0.79, CI: 0.64-0.98). Offspring social class discrimination (HR: 2.45, CI: 1.71-3.51) predicted an increased hazard of transition from initiation to first CUD symptom, while offspring racial discrimination (HR: 0.57, CI: 0.39-0.85) was associated with lower hazard of transition in our fully adjusted model. CONCLUSIONS As rates for cannabis use among Black youth are disproportionately rising, there is a critical need to identify pathways to its use among Black youth. These findings suggest racial and social class discrimination may be important targets in efforts to prevent cannabis involvement among Black youth and emerging adults.
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Affiliation(s)
- Manik Ahuja
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN, United States.
| | - Angela M Haeny
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Carolyn E Sartor
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Psychiatry, Washington University School of Medicine, United States
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, United States
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Montgomery L, Dixon S, Mantey DS. Racial and Ethnic Differences in Cannabis Use and Cannabis Use Disorder: Implications for Researchers. CURRENT ADDICTION REPORTS 2022; 9:14-22. [PMID: 35251891 PMCID: PMC8896813 DOI: 10.1007/s40429-021-00404-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Heavy and prolonged use of cannabis is associated with several adverse health, legal and social consequences. Although cannabis use impacts all U.S. racial/ethnic groups, studies have revealed racial/ethnic disparities in the initiation, prevalence, prevention and treatment of cannabis use and Cannabis Use Disorder (CUD). This review provides an overview of recent studies on cannabis and CUD by race/ethnicity and a discussion of implications for cannabis researchers. FINDINGS The majority of studies focused on cannabis use and CUD among African American/Black individuals, with the smallest number of studies found among Native Hawaiians/Pacific Islanders. The limited number of studies highlight unique risk and protective factors for each racial/ethnic group, such as gender, mental health status, polysubstance use and cultural identity. SUMMARY Future cannabis studies should aim to provide a deeper foundational understanding of factors that promote the initiation, maintenance, prevention and treatment of cannabis use and CUD among racial/ethnic groups. Cannabis studies should be unique to each racial/ethnic group and move beyond racial comparisons.
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Affiliation(s)
- LaTrice Montgomery
- University of Cincinnati College of Medicine, Center for Addiction Research/Addiction Sciences Division, Cincinnati, Ohio
- Corresponding Author: LaTrice Montgomery, Ph.D., University of Cincinnati College of Medicine, Center for Addiction Research/Addiction Sciences Division, 3131 Harvey Avenue, Suite 204, Cincinnati, Ohio 45229; ; Phone: 513-585-8286
| | - Shapree Dixon
- University of Cincinnati College of Medicine, Center for Addiction Research/Addiction Sciences Division, Cincinnati, Ohio
| | - Dale S. Mantey
- Department of Health Promotion and Behavioral Science, University of Texas Health Science Center, Houston, Texas
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Nicholson HL, Wheeler PB, Smith NC, Alawode OA. Examining the Relationship between Discrimination and Prescription Drug Misuse: Findings from a National Survey of Black Americans. Subst Use Misuse 2022; 57:1014-1021. [PMID: 35395923 DOI: 10.1080/10826084.2022.2052096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Research shows that substance use may be a way individuals cope with psychosocial stressors. Less is known about whether discrimination contributes to prescription drug misuse. Methods: Using a national sample of Black Americans, we examined whether two psychosocial stressors (i.e., everyday and lifetime major discrimination) were associated with lifetime prescription drug misuse (i.e., opioids, tranquilizers, sedatives, or stimulants). Results: Our logistic regression models separately examining the influence of everyday and major discrimination controlling for relevant demographic, health, and other drug use variables showed that only everyday discrimination was associated with higher odds of prescription drug misuse. In the model simultaneously considering both types of discrimination, only unit increases in everyday discrimination were associated with higher odds of prescription drug misuse. Conclusions: Encounters with everyday discrimination may be an important psychosocial stressor linked to prescription drug misuse in Black adults and possibly other racial-ethnic minorities. Intervention strategies aiming to reduce prescription drug misuse should consider developing ways to curb the negative health-related consequences of discriminatory experiences. Strategies to combat discrimination-related prescription drug misuse and limitations of this study are discussed.
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Affiliation(s)
- Harvey L Nicholson
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, Florida, USA
| | - Paris B Wheeler
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Nicholas C Smith
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Oluwatobi A Alawode
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, Florida, USA
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Desalu JM, Goodhines PA, Park A. Vicarious racial discrimination, racial identity, and alcohol-related outcomes among Black young adults: An experimental approach. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:283-294. [PMID: 33705156 PMCID: PMC8084893 DOI: 10.1037/adb0000707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: Racial discrimination is a known risk factor for alcohol-related outcomes among young Black American adults. However, vicarious racial discrimination's associations with alcohol-related outcomes and the role of racial identity in these associations remain unknown. This within-subject experiment study tested whether associations of vicarious racial discrimination with alcohol craving and attentional bias differed by three components of racial identity (centrality, private regard, and public regard). Method: Black young adult, at-risk drinkers (N = 51; Mage = 21 [SD = 3.02]; 60% female) completed two vicarious racial discrimination conditions (manipulated by video) followed by alcohol craving and attentional bias tasks. Results: Associations of vicarious discrimination with alcohol craving were exacerbated by high centrality and buffered by high private regard, but did not differ by public regard. No associations of vicarious discrimination with alcohol attention bias were found. Conclusion: Findings highlight the important role of Black racial identity in within-group differences in the impact of vicarious racial discrimination on select implicit indicators of alcohol risk among Black young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Nicholson HL, Ahmmad Z. Associations between everyday and major discrimination and health status among a diverse national sample of ten Asian ethnic subgroups. Ann Epidemiol 2021; 59:5-9. [PMID: 33845112 DOI: 10.1016/j.annepidem.2021.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE We examined the associations between major and everyday discrimination and self-rated health among a national sample of ten Asian ethnic subgroups, including Vietnamese, Chinese, Hmong, Cambodians, Pakistanis, Indians, Bangladeshis, Japanese, Filipinos, and Koreans. METHODS We used data from the 2016 National Asian American Survey (n = 4427). Logistic regression analyses were conducted to explore the associations between major and everyday discrimination and self-rated health among ten Asian ethnic subgroups, controlling for relevant sociodemographic factors. RESULTS Findings showed that major discrimination was associated with higher odds of poorer self-rated health among Asians as a group. Subgroup analyses revealed that encounters with major discrimination were associated with poorer self-rated health among Vietnamese, Filipinos, Cambodians, and Hmong. Everyday discrimination was associated with poorer self-rated health only among Hmong. CONCLUSION Overall, the negative health consequences of everyday and major discrimination vary by Asian ethnic subgroup. Targeting certain forms of discrimination facing specific Asian ethnic groups is needed to reduce their risk of adverse health outcomes.
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Affiliation(s)
- Harvey L Nicholson
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL.
| | - Zobayer Ahmmad
- Department of Sociology, University of Utah, Salt Lake City, UT.
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Archibald PC, Thorpe RJ. Life Stressors and Sleep Problems as Predictors of the Likelihood of Lifetime Cannabis Use among Black Adults with Criminal Justice Contact. Ethn Dis 2021; 31:187-196. [PMID: 33883859 DOI: 10.18865/ed.31.2.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The criminal justice system is the second largest referral source to publicly funded marijuana use disorder treatment. Individuals with criminal justice contact (being unfairly treated or abused by the police, lifetime arrest, incarceration, or parole) have reported notably high levels of stress, sleep problems, and marijuana use. There are well-known race and sex disparities in marijuana use and criminal justice contact. However, understanding is limited on the role that stressors and sleep problems contribute to marijuana use among Black adults who experience criminal justice contact. Objectives To determine whether life stressors and sleep problems contribute to lifetime marijuana use among Black adults with criminal justice contact and if there are sex differences. Methods We performed multivariate logistic analysis, using nationally representative data of a non-institutionalized population sample (n=1508) of the National Survey of American Life from 2001 to 2003. We compared life stressors and sleep problems between Black adults with criminal justice contact who had lifetime marijuana use and those who did not have lifetime marijuana use. All analyses were stratified by sex. Results In the sample of Black males with criminal justice contacts, individuals who reported financial stress (PR: 1.34, 95% CI: 1.12-1.60) had a higher prevalence of experiencing lifetime marijuana use than Black males who reported no financial stress. Black males who reported that they were spiritual (PR: .76, 95% CI: .61-.93) had a lower prevalence of experiencing lifetime marijuana use than Black males who indicated that they were not spiritual. Black females who reported family stress (PR: 1.38, 95% CI: 1.04-1.82) had a higher prevalence of experiencing lifetime marijuana use than Black females who reported no family stress. Conclusions These results underscore the importance of considering sex differences in life stressors when developing etiologic models of marijuana use disorder for Black adults who have experienced criminal justice contact.
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Affiliation(s)
- Paul C Archibald
- City University of New York, School of Health Sciences, Department of Social Work, Staten Island, NY
| | - Roland J Thorpe
- Johns Hopkins University, Bloomberg School of Public Health, Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Baltimore, MD
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Dogan JN, Thrasher S, Thorpe SY, Hargons C, Stevens-Watkins D. Cultural race-related stress and cannabis use among incarcerated African American men. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:320-325. [PMID: 33555899 DOI: 10.1037/adb0000694] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research suggests African American men use cannabis to cope with racial discrimination. This conjecture may also be true for incarcerated African American men, who report high rates of cannabis use prior to and after incarceration. However, no studies to date have examined the association between race-related stress and chronic cannabis use among incarcerated African American men. As this population encounters pervasive negative cultural stereotypes and devaluation from larger society, cultural race-related stress may predict cannabis use among this population. Therefore, the purpose of this brief report was to examine the relationship between cultural race-related stress and years of regular cannabis use among a sample of incarcerated African American men. METHOD Study staff completed interviews with N = 177 African American men nearing release from four prisons in Kentucky. The interviews focused on mental health, drug use, and HIV risk behaviors. Participants provided their demographics (e.g., age, years of education, and length of incarceration), self-reported their years of regular cannabis use (3 times or more per week), and completed the Brief Index of Race-Related Stress (IRRS-B; Utsey, Measurement & Evaluation in Counseling & Development, 1999, 32, 149). RESULTS Multivariate regression analyses demonstrated cultural race-related stress was significant and positively associated with the number of years of regular cannabis use (p = .003) among this population. CONCLUSIONS This finding has implications for culturally tailored substance abuse treatment, specifically for cannabis use, with African American men upon their community re-entry from prison. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jardin N Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | | | - Shemeka Y Thorpe
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | - Candice Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky
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Xie TH, Ahuja M, McCutcheon VV, Bucholz KK. Associations between racial and socioeconomic discrimination and risk behaviors among African-American adolescents and young adults: a latent class analysis. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1479-1489. [PMID: 32417956 PMCID: PMC9036724 DOI: 10.1007/s00127-020-01884-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Discrimination is a common stressor among African Americans and may increase vulnerability to risk behaviors, such as early initiation of substance use, substance use problems, and physical aggression; however, few studies have examined different types of discrimination and their associations with patterns of risk behaviors. This study examines the relationship between experiences of racial and socioeconomic discrimination and risk behaviors in African-American adolescents and young adults. METHODS We investigated associations of two discrimination types with risk behavior patterns identified with latent class analysis in a high-risk sample of African Americans (N = 797, Mage = 17.9 years, 50.2% female). RESULTS Four distinct classes of risk behaviors were characterized by High Use and Aggression (10%), Moderate Use and Aggression (10%), High Alcohol (17%), and Low Use and Aggression (63%). Classes that exhibit general risk behaviors, including substance use and aggression, were significantly associated with racial and socioeconomic discrimination, even in the fully adjusted model. Relative to other classes, the High Use and Aggression class demonstrated an elevated likelihood of experiencing both racial and socioeconomic discrimination. CONCLUSIONS Findings support a link between racial and socioeconomic discrimination and risk behavior in African-American youth, which may be stronger for socioeconomic discrimination. Understanding the relationship between discrimination and risk behavior can inform future interventions to prevent substance misuse and conduct problems in youth. Further study is needed to elucidate the relationship between discrimination and other risk behaviors.
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Affiliation(s)
- Tiffany H. Xie
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States,Indiana University, Bloomington, IN, United States
| | - Manik Ahuja
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States,Brown School of Social Work, Washington University in St. Louis
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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Montgomery L, Webb Hooper M. Gender Differences in the Association between Marijuana and Menthol Cigarette Use among African American Adult Cigarette Smokers. Subst Use Misuse 2020; 55:1335-1342. [PMID: 32253967 PMCID: PMC7281863 DOI: 10.1080/10826084.2020.1741633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Despite the strong relationship between marijuana and tobacco use, especially among African American individuals and males, very few studies have examined the association between marijuana and menthol cigarette use. This study was designed to identify the prevalence of past month, past year and lifetime marijuana use and marijuana dependence among menthol and non-menthol cigarette smokers, as well as the association between marijuana and menthol cigarette use among African American female and male cigarette smokers. Methods: Data were drawn from 1,173 African American adult cigarette smokers in the 2017 National Survey on Drug Use and Health. Results: Overall, 8.8%, 13.9% and 44.7% of African American menthol and non-menthol cigarette smokers reported past month, past year and lifetime marijuana use, respectively. Weighted multivariable logistic regression models revealed a significant interaction between gender and past month marijuana use on menthol cigarette use (AOR = 1.49, 95% CI: 1.21-2.42, p < .05). Past month marijuana use was associated with an increased odds of past month menthol cigarette use (relative to non-menthol cigarette use) among females, but a decreased odds of past of past month menthol cigarette use among males. Conclusions: When stratified by gender, marijuana use is differentially related to menthol cigarette use among African American adults. Given the prevalence of menthol cigarette use among this population, it is important to examine factors such as marijuana use that could be targeted in prevention and treatment interventions for African Americans, especially females, who are at risk for smoking or are currently smoking menthol cigarettes. Implications: This study found that marijuana use was associated with an increased odds of menthol cigarette use among African American females, while marijuana use was associated with a decreased odds of menthol cigarette use among their male counterparts. The impact of marijuana use on menthol cigarette smoking differs among females and males, highlighting the need for gender-tailored interventions that target marijuana use among African American individuals, especially females, who are at risk for smoking or are currently smoking menthol cigarettes.
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Affiliation(s)
- LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, Addiction Sciences Division, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Abstract
BACKGROUND Prescription opioid misuse (POM) is a significant problem among U.S. adults, including Blacks, as indicated by past research. Despite potential gender differences in POM among Black adults, previous research has yet to examine this possibility. OBJECTIVES This study identified the prevalence and unique correlates of POM among both Black men and Black women. Results were compared to those of Whites. METHODS We used data from 2015-2016 National Survey on Drug Use and Health (N = 60,133). Weighted logistic regression models stratified by race and gender were estimated. One model was stratified by gender only, with race serving as the primary predictor. RESULTS Findings revealed 3.4% of Black women, 4.9% of Black men, 4.1% of White women, and 5.4% of White men reported past-year POM; although, no significant differences were found. Among Black women only, lower socioeconomic status increased odds of POM. Higher educational attainment, residence in rural areas and older age lowered odds of POM. Encounters with drug dealers, illicit drug, marijuana, and tobacco use, other prescription drug misuse, and poor health were associated with increased odds of POM among Black men. In the gender stratified models, White men were more likely to report POM than Black men. However, White women were not more likely to report POM compared to Black women. CONCLUSIONS Clear gender differences exist in the prevalence and correlates of POM among Black adults. Prevention and intervention strategies must be cognizant of these differences when developing programs to decrease POM.
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Affiliation(s)
- Harvey L Nicholson
- a Department of Sociology , University of Central Florida , Orlando , Florida , USA
| | - Jolene Vincent
- b Department of Sociology , College of William and Mary , Williamsburg , Virginia , USA
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Taggart T, Brown AL, Kershaw T. Neighborhood Contexts and Marijuana Use Among Urban Dwelling Emerging Adult Men. Am J Mens Health 2018; 12:944-951. [PMID: 29388489 PMCID: PMC6131435 DOI: 10.1177/1557988317753222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Neighborhoods are key socio-environmental contexts for marijuana use during
emerging adulthood. This study examined the relationships between neighborhood
context, traditional masculine norms (status, toughness, and anti-femininity),
and marijuana use among 119 majority African American emerging adult men in a
small urban community. Poisson regression models were used to determine the
associations between neighborhood problems, social cohesion, and marijuana use.
Moderator effects were examined to determine if masculinities modified these
associations. Neighborhood problems and social cohesion were positively
associated with marijuana use. Men who had a lower endorsement of some
traditional masculine norms had greater marijuana use compared to men with a
higher endorsement of these norms. These findings have implications for
intervention strategies and policies.
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Affiliation(s)
- Tamara Taggart
- 1 Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Andre L Brown
- 2 Center for LGBT Health Research, Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Trace Kershaw
- 3 Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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