The early emergence of narcotic addict types

Drug Use and Treatment Initiation Patterns: Differences by Birth-Cohorts

Data from Drug Abuse Treatment Outcome Studies (DATOS) were used to examine differences in correlates of early stages of drug use patterns by birth-cohorts and gender. Males showed a steady increase in family problems in each birth cohort, compared to females who showed a higher mean number of family problems in each birth cohort. The findings suggest different correlates of the early stages of drug-use pattern namely; experimentation with drugs before the onset of weekly drug use and early age of escalated or weekly drug use. Experimentation was associated with delayed onset of escalated drug use. “Experimenters” were associated with illegal activities and mental health problems, whereas “early escalators” were associated with childhood and school problems. The positive association of onset of illegal activities and psychological symptoms before the onset of weekly drug use with experimentation and delayed onset of escalated drug use was consistent across gender and birth-cohorts. Similarly, the association of family and school problems with early age of onset of escalated drug use was also consistent across gender and birth cohorts. Treatment providers can benefit from a better understanding of clients' pathways and progression of addiction careers in order to assess their treatment needs.

Buprenorphine Treatment for Probationers and Parolees

BACKGROUND

Pharmacotherapy studies involving buprenorphine have rarely been conducted with U.S. community corrections populations. This is one of the first reports of buprenorphine treatment outcomes of adult opioid-dependent probationers and parolees.

METHODS

This longitudinal study examined the 3-month treatment outcomes for a sample of probation and parole clients (N = 64) who received community-based buprenorphine treatment.

RESULTS

Approximately two thirds of the sample (67%) were still in treatment at 3 months post baseline. Furthermore, there was a significant decline in the number of self-reported heroin use days and crime days from baseline to 3 months post baseline. Although there was not a significant reduction in reincarcerations, there was no evidence that they had increased.

CONCLUSIONS

Given that buprenorphine is approved by the Food and Drug Administration (FDA) as a safe, effective treatment for opioid use disorders, individuals on parole or probation should have the opportunity to benefit from it through community-based programs.

30-year trajectories of heroin and other drug use among men and women sampled from methadone treatment in California

BACKGROUND

This study examines 30-year trajectories of heroin and other drug use among men and women who were in methadone maintenance treatment in California in the late 1970s and interviewed in 1978-1981.

METHODS

Nearly half (N=428; 46.8%) of the original study sample (N=914) was deceased. Of the remaining 486 subjects, 343 (44.3% female) completed a follow-up interview in 2005-2009 (70.6% of those not deceased). Average age at follow-up was 58.3 (SD=4.9) years for males and 55.0 (SD=4.1) years for females. Longitudinal data was obtained on their drug use, treatment participation, and criminal justice status over the follow-up period. Trajectory group modeling was used to identify distinctive trajectory groups based on monthly averages of heroin and other drug use per year; group differences were examined.

RESULTS

Four heroin and five alcohol and other drug (AOD) trajectory groups were identified. A greater proportion of women (60%) were in the "rapid decrease" heroin group (odds of use less than 10% by 10 years following initiation of use) as compared with the other groups. More rapid decrease of heroin use was associated with increases in AOD use, whereas a gradual decrease in heroin use was associated with a gradual decrease in AOD use. More school problems and earlier age at onset of heroin use and first arrest were associated with more persistent heroin use.

CONCLUSION

Heroin-use trajectories were linked with changes in AOD use. Childhood antecedents of heroin-use trajectories were identified as well as gender differences.

Religiosity and substance use and abuse among adolescents in the National Comorbidity Survey

OBJECTIVE

To replicate previous findings among adults of an inverse association between religiosity and substance use among a nationally representative sample of adolescents.

METHOD

Subjects were 676 (328 female and 348 male) adolescents in the National Comorbidity Survey who were assessed for substance use and abuse with the Composite International Diagnostic Interview. Religiosity was assessed through affiliation with religious denomination and through response to 7 questions concerning belief and practice.

RESULTS

Confirmatory factor analyses replicated in adolescents the 2 religiosity factors of personal devotion and personal conservatism previously identified by Kendler among adults, although the 2 factors were more highly correlated in adolescents than in adults. Personal devotion (a personal relationship with the Divine) and affiliation with more fundamentalist religious denominations were inversely associated with substance use and substance dependence or abuse across a range of substances (alcohol, marijuana, cocaine, or any contraband drug). Personal conservatism (a personal commitment to teaching and living according to creed) was inversely associated with use of alcohol only.

CONCLUSION

Low levels of religiosity may be associated with adolescent onset of substance use and abuse.