Objectives: We investigated the prevalence of substance use disorders among emerging adults and quantified the extent to which emerging adults, compared to young adults, are at increased odds for substance use disorders. Methods: Data come from the 2012 Canadian Community Health Survey – Mental Health (CCHS-MH). Respondents were 15–39 years of age (n=9228) and were categorized as: early emerging adults (15-22 years); late emerging adults (23-29 years); and, young adults (30-39 years). Substance use disorders (alcohol or drug abuse/dependence) were measured using the Composite International Diagnostic Interview 3.0. The prevalence of substance use disorders was compared across age groups using design-based χ2 analyses. Odds ratios (OR) and 95% confidence intervals (CI) were computed from logistic regression models adjusting for sociodemographic and health covariates. All analyses were weighted to maintain representativeness of the study sample to the Canadian population. Results: The prevalence of alcohol use disorder was 8.0%, 6.6%, and 2.7% for early emerging adults, late emerging adults, and young adults respectively. For drug use disorder, the prevalence was 6.4%, 3.6%, and 1.3%. Compared to young adults, early and late emerging adults were more likely to report substance use disorders (p<0.01). The prevalence of drug use disorder was higher among early versus late emerging adults (χ2=119.8, p=0.01). Among all age groups, males were more likely to report alcohol or drug use disorders (p≤0.01 for all). After covariate adjustment, early and late emerging adults had greater odds of reporting alcohol (OR=3.2, 95% CI=2.2-4.9 and OR=2.4, 95% CI=1.6-3.4, respectively) or drug (OR=4.2, 95% CI=2.5-7.0 and OR=2.5, 95% CI=1.6-4.1, respectively) use disorders compared to young adults. Conclusion: Emerging adulthood represents an important developmental period in which individuals are at increased odds of reporting substance use disorders. This finding has implications for the provision of screening and treatment of substance use disorders as these individuals transition from the pediatric to adult healthcare system. / Thesis / Master of Health Sciences (MSc)

Mass incarceration in the United States has led to millions of parents of minor children being incarcerated, many of whom are Black Americans. The consequences of parental incarceration have rippling effects across generations and result in poor social, economic, and health outcomes among children of incarcerated parents throughout the lifecourse. Research on the effects of parental incarceration on children has focused primarily on externalizing behaviors as a means to control crime and the intergenerational transmission of crime. However, such perspectives are rooted in racism and negates the role of structural racism in maintaining social and economic policies that keep Black American families and communities disenfranchised and under the control of the majority. Theoretical perspectives suggest that parental incarceration increases the risk of adolescent substance use and externalizing behaviors, while others suggest that parental incarceration decreases the risk of adolescent substance use and externalizing behaviors. However, when examining the literature, there are discrepant findings regarding the direction and magnitude of the association between parental incarceration and adolescent externalizing behaviors. This dissertation focuses on explaining reasons for and reconciling these discrepant findings, and exploring and expanding the literature on parental incarceration and adolescent substance use which has not been adequately synthesized to date. This dissertation consists of five chapters. The first chapter is an introduction to the dissertation. Chapter 2 is a systematic review of the literature on parental incarceration and adolescent cigarette, alcohol, and cannabis use. Chapter 3 is an empirical study that assessed the association between parental incarceration and past year adolescent alcohol and cannabis use, and externalizing behaviors using data from the Fragile Families and Child Well-Being Study (Fragile Families). Fragile Families is well-suited for assessing the association between parental incarceration and adolescent substance use and externalizing behaviors because it includes a diverse sample of adolescents and their parents, various measures of parental incarceration over time, and a wealth of information on adolescent outcomes. This diverse sample also makes it possible to assess effect modification by race/ethnicity, which other studies may have been underpowered to assess considering the lack of racially and ethnically diverse samples. Chapter 4 used data from Fragile Families and The National Longitudinal Study of Adolescent to Adult Health (Add Health) to empirically examine if discrepant findings existed across these datasets regarding the association between parental incarceration and adolescent cannabis use. Prior studies have shown discrepant findings regarding parental incarceration and offspring externalizing behaviors across these datasets; however, adolescent cannabis use has not been assessed in Fragile Families to identify potential discrepancies. This dissertation concludes with Chapter 5, which provides a summary of the key findings, and discusses the public health impact of this research and future directions. The systematic review provided evidence that there is a positive association between parental incarceration and adolescent cigarette and cannabis use. However, more research is needed to determine if these associations are purely correlational or potentially causal. Findings from the review did not suggest that parental incarceration was associated with adolescent alcohol use. Two out of three studies included in the review assessed binge drinking/episodes of heavy drinking, which may have impacted results. In contrast, Chapter 3 showed support for a positive association between parental incarceration and adolescent alcohol use in the past year (any vs. none; relative risk [RR]=1.54, 95% CI=1.17-2.03) using data from Fragile Families. Chapter 3 showed that both maternal and paternal incarceration were associated with adolescent alcohol and cannabis use (RR=1.25, 95% CI=1.01-1.55), and externalizing behaviors (delinquency scale: incidence rate ratio [IRR]=1.18, 95% CI=1.01-1.36 and CBCL: IRR=1.14, 95% CI=1.02-1.28). Findings also suggested that the associations between lifetime parental incarceration and adolescent alcohol and cannabis use, and externalizing behaviors were different by adolescent race; however, data were not sufficient to assess interaction effects. In Chapter 4, the association between parental incarceration and adolescent cannabis use was shown to be different across Fragile Families and Add Health (association between maternal incarceration during adolescence and adolescent past month cannabis use: RRFragile Families=2.09, 95% CI=1.36,3.21 vs. RRnon-post-stratification-weighted Add Health=1.27, 95% CI=0.77-2.10, magnitude of difference=39.2%), which was expected based on prior studies assessing parental incarceration and adolescent externalizing behaviors across these studies. Generally, findings were in the positive direction, but the magnitude of associations were inconsistent. Reweighting Add Health to have the sample distribution of adolescent gender, age, and race as Fragile Families was hypothesized to lead to congruent findings across these studies. Nonetheless, reweighting Add Health resulted in measures of association being further away from those in the non-poost-stratification-weighted Add Health sample; thereby further away from the Fragile Families sample (association between lifetime paternal incarceration and adolescent past month cannabis use: RRFragile Families=1.34 vs. RRnon-post-stratification-weighted Add Health=1.44 vs. RRpost-stratification-weighted Add Health=1.53). In conclusion, results from these studies indicate that there is a positive association between parental incarceration and adolescent cannabis use, and externalizing disorder. However, findings are inconsistent regarding the effect of parental incarceration on adolescent alcohol use, and regarding the association between parental incarceration and adolescent outcomes across Fragile Families and Add Health. These studies attempted to reconcile discrepant findings and provide a novel method for reconciling discrepant findings across different exposures and outcomes in future studies.

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Background: Typical users of cocaine are socially integrated individuals of higher education, higher income. They use it recreationally. It is a hidden population standing outside the range of addiction treatment. According to population research cocaine users in the Czech Republic create a minor subpopulation of drug users whose characteristics and behavior have not been adequately described. Aims: The primary aim is to describe patterns of cocaine use among recreational users using qualitative research methods. The secondary aim is to track how cocaine users value this drug in their lives. Methods: The concept of the study is based on qualitative research methodology. The snowball sampling was used as a selection method. Chosen respondents were given semi- structural interviews. The study sample contains 11 respondents, 7 men and 4 women in average age 26,7 (the youngest 20 years old, the oldest 33 years old) with a predominance of secondary or higher education. Data were analyzed according to the procedures of grounded theory. Results: Cocaine was consumed mainly during social events, mostly in night clubs in groups of friends. The predominant form of use was intranasal application with average frequency of 3-5 doses per party in the time range of single doses of 30-60 min. Cocaine was always...

High rates of nonmedical use of pain relievers and stimulants have been documented in the United States, putting substance abusers at risk of addiction and possible arrest for illegal possession and use. Treatment programs can help stop patterns of abuse. This thesis explores the factors impinging on substance abuse treatment seeking for nonmedical pain reliever and stimulant users. Data from the National Survey of Drug Use and Health 2014 were analyzed in order to find the most recent patterns of pain reliever and stimulant abuse and potential determinants of receiving treatment. Descriptive statistics about the population reporting nonmedical use of pain relievers and/or stimulant use are first presented. Logistic regression analyses are then conducted on one dependent variable: respondents stating if they ever received treatment. Possible determinants that may influence one’s potential to receive treatment included income, insurance coverage, race/ethnicity, age, sex, psychological state, and metro/nonmetro residency status.

Thesis (M.A. (Social Work)) --University of Limpopo, 2015 / Please refer to the document / University of Limpopo

This study is a sub-analysis ofthe previously collected cross-sectional DRUGNET survey data. The sample included 1,178 current users of illicit drugs and 389 former users. This study was delimited to U.S. citizens, aged 18 years and older, who completed the DRUGNET survey (n =1,567). DRUGNET was a descriptive online survey of self - reported attitudes and behaviors among a group of adult, self - identified drug users (i.e., not drug abusers). The purpose of the sub-analysis was to explore the importance of religion, spirituality, and religious service attendance in the context of an otherwise normal healthy adult life. Moreover, it also looked into potential patterns of association between aspects of religiosity/spirituality and illicit drug use. The study explored if there was a relationship between the strength of a respondent's spiritual or religious beliefs and the patterns of their recreational drug use. A canonical correlation analysis was conducted using self-rated spirituality, self-rated religiosity, and attendance at services as variables on the left (entered in MANOVA as dependent variables) and self-reported use of six groups of drugs as variables on the right (entered in MANOV A as covariates). One significant function was found, which showed that attending religious services and importance of religion were negatively associated with the use of alcohol, marijuana, cocaine, and hallucinogens. That is, people who reported a higher level of religiosity and who attended religious services were less likely to use these psychoactive drugs.

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The purpose of this qualitative research study was to understand the facilitators and/or barriers to safer drug use and sexual practices among a sample of young female injection drug users (IDUs) who live in small towns/rural communities in Cape Breton, Nova Scotia. This study examined how economic status, relationships, social roles, small town/rural living, and stigma function as facilitators and/or barriers to safer practices. Eight female IDUs aged 20-31, living in small towns/rural communities in Cape Breton, engaged in face-to-face, semi-structured interviews. The women described what day-to-day life is like for female IDUs living in small towns/rural communities. They spoke about managing drug addiction, their understanding of safer and unsafe injection drug use and risky and safer sexual practices, as well as their experiences with services/supports. The information obtained from this study will help to inform harm reduction policy and program initiatives.

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