Several genome-wide association (GWA) studies of alcohol dependence (AD) and alcohol-related phenotypes have been conducted; however, little is known about genetic variants influencing alcohol withdrawal symptoms (AWS). We conducted the first GWA study of AWS using 461 cases of AD with AWS and 408 controls in Caucasian population in the Collaborative Study on the Genetics of Alcoholism (COGA) sample. Logistic regression analysis of AWS as a binary trait, adjusted for age and sex, was performed using PLINK. We identified 51 SNPs associated with AWS with p<10 -4. The first best signal was rs770182 (p = 3.65 × 10 -6) at 5q21 near EFNA5 gene which was replicated in the Australian twin-family study of 273 families (p = 0.0172). Furthermore, three SNPs (rs10975990, rs10758821 and rs1407862) within KDM4C gene at 9p24.1 showed p<10 -4 (p = 7.15 × 10 -6, 2.79 × 10 -5 and 4.93 × 10 -5, respectively) in the COGA sample while one SNP rs12001158 within KDM4C with p = 1.97 × 10 -4 in the COGA sample was replicated in the family sample (p = 0.01). Haplotype analysis further supported the associations of single-marker analyses of KDM4C in the COGA sample. Moreover, two SNPs (rs2046593 and rs10497668) near FSIP2 at 2q32.1 with moderate associations with AWS in the COGA sample (p = 2.66 × 10 -4 and 9.48 × 10 -5, respectively) were replicated in the family sample (p = 0.0013 and 0.0162, respectively). In addition, several SNPs in GABRA1, GABRG1, and GABRG3 were associated with AWS (p<10 -2) in the COGA sample. In conclusion, we identified several loci associated with AWS. These findings offer the potential for new insights into the pathogenesis of AD and AWS.

Twin and family studies have shown that there is substantial evidence for a genetic component in the vulnerability to nicotine dependence (ND). The purpose of this study was to perform a meta-analysis on two genome-wide association (GWA) data involving 1079 cases of ND and 1341 controls in Caucasian populations. Through meta-analysis we identified 50 SNPs associated with ND with p<10-4. The best associated SNP rs7163369 (p=3.27×10-6) was located at 15q26 within SLCO3A1 gene while the second best SNP was rs9308631 (p=9.06×10-6) at 2q12.1 near ANAPC1. The third interesting locus rs688011 (p=1.08×10-5) was at 11q23.2 intergenic between NCAM1 and TCC12. Through meta-analysis, we found two additional ND associated genes ZCCHC14 (the top SNP was rs13334632, p=1.28×10-5) and KANK1 (the top SNP was rs13286166, p=1.49×10-5). The first top SNP rs7163369 within SLCO3A1 in the meta-analysis was replicated in the Australian twin-family study of 778 families (p=6.11×10-5) while SNP rs9653414 within ANAPC1 (p=4.61×10-5) in the meta-analysis was replicated in the family sample (p=9.31×10-4). Furthermore, rs2241617 in ZCCHC14 and rs4742225 in KANK1 showed strong associations with ND (p=1.06×10-7 and 4.81×10-7, respectively) in the replication sample. In addition, several SNPs of these loci (ANAPC1, KANK1, NACM1, TCC12, SLCO3A1 and ZCCHC14) were associated with alcohol dependence. In conclusion, we identified several loci associated with ND through meta-analysis of two GWA studies. These findings offer the potential for new insights into the pathogenesis of ND.

Family, twin and adoption studies have clearly demonstrated that genetic factors are important in modulating the vulnerability to alcohol dependence. Several genome-wide association (GWA) studies of alcohol dependence have been conducted; however, few loci have been replicated. A meta-analysis was performed on two GWA studies of 1283 cases of alcohol dependence and 1416 controls in Caucasian populations. Through meta-analysis we identified 131 SNPs associated with alcohol dependence with p<10-4. The best novel signal was rs6701037 (p=1.86 × 10-7) at 1q24-q25 within KIAA0040 gene while the second best novel hit was rs1869324 (p=4.71 × 10-7) at 2q22.1 within THSD7B. The third novel locus was NRD1 at 1p32.2 (the top SNP was rs2842576 with p=7.90 × 10-6). We confirmed the association of PKNOX2 at 11q24.4 with alcohol dependence. The top hit of PKNOX2 (rs750338 with p=1.47 × 10-6) in the meta-analysis was replicated with the Australian Twin-Family Study of 778 families (p=1.39 × 10-2) Furthermore, several flanking SNPs of the top hits in the meta-analysis demonstrated borderline associations with alcohol dependence in the family sample (top SNPs were rs2269655, rs856613, and rs10496768 with p=4.58 × 10-3, 2.1 × 10-4, and 2.86 × 10-3 for KIAA0040, NRD1 and THSD7B, respectively). In addition, ALK, CASC4, and SEMA5A were strongly associated with alcohol dependence (p<2 × 10-5) in the meta-analysis. In conclusion, we identified three new loci (KIAA0040, THSD7B and NRD1) and confirmed the previous association of PKNOX2 with alcohol dependence. These findings offer the potential for new insights into the pathogenesis of alcohol dependence.

Little is known about the impact of drug abuse/dependence on health insurance coverage, especially by race groups and income levels. In this study, we examine the disparities in health insurance predictors and investigate the impact of drug use (alcohol abuse/dependence, nicotine dependence, and illicit drug abuse/dependence) on lack of insurance across different race and income groups. To perform the analysis, we used insurance data (8057 uninsured and 28,590 insured individual adults) from the National Surveys on Drug Use and Health (NSDUH 2011). To analyze the likelihood of being uninsured we performed weighted binomial logistic regression analyses. The results show that the overall prevalence of lacking insurance was 19.6 %. However, race differences in lack of insurance exist, especially for Hispanics who observe the highest probability of being uninsured (38.5 %). Furthermore, we observe that the lowest income level bracket (annual income <$20,000) is associated with the highest likelihood of being uninsured (37.3 %). As the result of this investigation, we observed the following relationship between drug use and lack of insurance: alcohol abuse/dependence and nicotine dependence tend to increase the risk of lack of insurance for African Americans and whites, respectively; illicit drug use increases such risk for whites; alcohol abuse/dependence increases the likelihood of lack of insurance for the group with incomes $20,000–$49,999, whereas nicotine dependence is associated with higher probability of lack of insurance for most income groups. These findings provide some useful insights for policy makers in making decisions regarding unmet health insurance coverage.

Opioid use disorder (OUD) is one of the most pressing public health problems of our time, with staggering morbidity, social impact, and economic costs. Prescription opioids play a critical role in the opioid crisis as they increase exposure and availability in the general population, making them an attractive target for much needed prevention and risk mitigation strategies. Opioid exposure, including legitimate prescription use, leads to a variety of physiologic adaptations (e.g. dependence) that may be leveraged to understand and identify risk of misuse. Mobile health (mHealth) tools, including wearable sensors have great potential in this space, but have been underutilized. Of specific interest are digital biomarkers, or end-user generated physiologic or behavioral measurements that correlate with events of interest, health, or pathology. Preliminary data support the concept that wearable sensors can detect digital biomarkers of opioid use and may provide clues regarding individual physiologic adaptations to opioid use over time. This dissertation follows a path though the exploration and refinement of these digital biomarkers of opioid use in various clinical use cases. Longitudinal data from individuals treated with opioids for acute pain will be explored through various machine learning models to detect opioid use and to explore patient and treatment factors that impact model performance. Next, a signal processing approach will be undertaken to explore the effects of opioid agonism in a different population of individuals- those presenting with opioid toxicity and precipitated withdrawal. Both approaches will be combined to further refine the digital biomarker capabilities, this time with a focus on the difference between opioid naive and chronic users. And finally, usability, facilitators and barriers to use of a sensor-based monitoring system for opioids will be evaluated through a qualitative lens. Taken together, theses data support the development of a smart technology, driven by empirically derived algorithms which can be used to monitor opioid use, support safe prescribing practices, and reduce OUD and death.

Sammanfattning: Titel: "När hon la en hand på min rygg kunde jag känna om hon var full eller inte" Hur vuxna relationer formas av en uppväxt med alkoholberoende förälder/föräldrar Författare: Ida Björkman och Linda Höglund Syftet med den här studien var att undersöka hur vuxna relationer formas utifrån en uppväxt präglad av alkoholberoende förälder/föräldrar. Frågeställningarna vi utgick från för att göra det var: Hur ser de vuxna relationerna ut hos ett urval av informanter som har upplevt en barndom med en eller två föräldrar som var alkoholberoende? och Hur kan de vuxna relationerna hos informanterna förstås utifrån deras uppväxt präglad av alkoholberoende förälder/föräldrar? Det här är en kvalitativ studie utförd genom narrativa intervjuer (n=10) med vuxna personer som vuxit upp med alkoholberoende förälder/föräldrar och den visade att det görs ett val att begränsa antalet relationer man omger sig med i vuxen ålder för att minimera risken att bli sårad. Rädslan för att bli sårad beror på upprepade tillfällen av bristande tillit under uppväxten. Det finns en rädsla att brista i det egna föräldraskapet på liknande sätt som de egna föräldrarna har gjort. Beslut att avstå helt från eget föräldraskap och en beslutsamhet att lyckas i det finns också. Det finns förståelse och förlåtelse kring att de egna föräldrarna har gjort så gott de kunde utifrån sina förutsättningar och det bottnar i ett omvänt vårdnadsbehov där man från uppväxt in i vuxen ålder känner sig ansvarig för sina föräldrars välmående. Studien är genomförd med fenomenologisk ansats och har inspirerats av den hermeneutiska meningstolkningen där system- och anknytningsteori har legat till grund för analysen. Slutsatsen i den här studien är att olika situationer och relationer genom livsloppet medför reflektioner där uppfattningen av den egna uppväxten successivt förändras och det görs olika typer av anpassningar för att hantera tidigare erfarenheter. Det framträder en medvetenhet hos informanterna att relationer idag är påverkade av uppväxten, dock strävar de själva med att förstå hur den påverkar. / Abstract: Titel: "When she put a hand on my back I could tell if she was drunk or not" How adult relationships form due to an upbringing with alcohol dependent parent/parents Authors: Ida Björkman and Linda Höglund The purpose of this study was to examine how adult relationships form due to an upbringing with alcohol dependent parent/parents. The questions we used to do this were: How do the adult relationships look like in a selection of informants who have experienced a childhood with one or two parents who were alcohol dependent? and How can the adult relationships of the informants be understood due to an upbringing with alcohol dependent parent/parents? This is a qualitative study conducted through narrative interviews (n = 10) with adults who grew up with alcohol dependent parent/parents and it showed that the informants choose to limit the number of relationships they surround themselves with to minimize the risk of being hurt. The fear of being hurt is due to repeated situations of lacking continuity in childhood. Present is a fear of becoming a parent with the same shortcomings as one’s own parents. This results in the decision to not become a parent at all, or on a contrary, a determination to succeed in one’s own parenthood. They have always felt more or less responsible for their parents wellbeing and this also leads to an understanding that the parents did the best they could. The study has been conducted with a phenomenological approach and was inspired by the hermeneutical circle in the interpretation of the data, in which system- and attachment theory has been the basis for the analysis. This study concludes that the own perception of one’s upbringing gradually changes due to different situations and relationships throughout the lifecycle and different types of adaptations are made to deal with past experiences. There is an awareness among the informants that relationships today are influenced by their upbringing, however, they themselves strive to understand how it affects.

Bakgrund: Internationell forskning visar på problematik kring smärtlindring av patienter med opiatberoende. Det framkommer att otillräckliga doser analgetika administreras till denna patientgrupp och att vårdpersonal saknar kunskap gällande smärtlindring av patienter med opiatberoende. Forskning visar även att vårdpersonal kan ha en negativ inställning till drogberoende patienter och ofta misstror deras motiv gällande förfrågan om analgetika. Vidare visar forskningen att denna patientgrupp upplever sig få en sämre vård än patienter utan drogberoende. Syfte: Studiens syfte var att belysa faktorer som har inverkan på smärtlindringen av patienter med opiatberoende på en beroendeavdelning. Metod: Empirisk studie med deskriptiv kvalitativ ansats baserad på strukturerade intervjuer med fyra sjuksköterskor verksamma vid en beroendeavdelning i en svensk storstad. Data analyserades genom manifest innehållsanalys. Resultat: Under analysen utkristalliserades tre kategorier och elva underkategorier, vilka beskriver faktorer som har inverkan på smärtlindringen av patienter med opiatberoende: (I) Förhållningssätt omfattar (1) Att inte döma och (2) Bemötande. (II) Förutsättningar omfattar (3) Restriktivitet, (4) Tolerans, (5) Ångest, (6) Personalbrist och (7) Kunskap. (III) Metoder omfattar (8) Smärtskattning, (9) Lindra ångest, (10) Kämpa för patienten och (11) Interprofessionalitet. Slutsats: Studiens resultat tyder på att ett respektfullt och tillmötesgående bemötande gentemot patienterna utgör en central roll i smärtbehandlingen. Vidare visar studien att sjuksköterskornas möjlighet att smärtlindra patienter i beroendevården begränsas av kunskapsluckor, restriktiva regler, resursbrist samt en patientgrupp som är svår att smärtlindra. Studiens resultat tyder på vikten av att lindra patienternas ångest samt vinsterna med ett interprofessionellt samarbete kring smärtlindring. Klinisk betydelse: Studien kan öka medvetenheten kring de hinder som identifierats för smärtlindring av patienter med opiatberoende. Sjuksköterskornas metoder i den aktuella studien skulle kunna utnyttjas i betydligt större utsträckning i beroendevården och i andra vårdkontexter vilket därigenom skulle bespara patientgruppen onödigt vårdlidande. / Background: International research indicates several difficulties concerning pain relief for patients with opioid dependence. It appears that inadequate doses of analgesics are administered to patients with substance dependence and that health professionals lack knowledge regarding pain management of patients with opioid dependence. Research also shows that health professionals may have a negative attitude towards drug-dependent patients and often distrust their motives regarding request for analgesics. Furthermore, research shows that opioid dependent patients feel that they get poorer care than patients without drug addiction. Aim: The aim of the study was to examine factors that have an impact on pain relief in patients with opioid dependence from nurses’ perspective at a drug dependence treatment clinic. Method: Empirical study with descriptive qualitative approach based on structured interviews with four nurses working at a drug dependence treatment clinic in a major Swedish city. Data were analyzed with manifest content analysis. Results: During the analysis three categories and eleven subcategories emerged: (I) Attitude is comprised of (1) To not judge, and (2) Treatment. (II) Conditions is comprised of (3) Restrictivity, (4) Tolerance (5) Anxiety, (6) Staff shortage and (7) Knowledge. (III) Methods is comprised of (8) Pain assessment, (9) Relieving anxiety, (10) Fighting for the patient, and (11) Interprofessionalism. Conclusion: The study's results suggest that a respectful attitude towards patients plays a key role in pain management. Furthermore, the study shows that the nurses’ opportunity to relieve pain of patients in addiction treatment is limited by gaps in knowledge, restrictive regulations, lack of resources and patients that are difficult to pain relieve. The study's findings indicate the importance of alleviating the patients' anxiety and the benefits of interprofessional collaboration regarding pain treatment. Clinical significance: This study can increase the awareness of the barriers to pain management identified for patients with opioid dependence. Nursing practice in the current study could be used to a much greater extent in addiction services and other care contexts and thereby save the patients unnecessary suffering.

Bakgrund: Patienter med alkoholberoende är vanligt förekommande inom sjukvården. Forskning visar att vårdpersonalen uttrycker bristande kunskap i mötet med dessa patienter. Livsvärlden är den värld människan dagligen möter och lever i. Ett livsvärldsperspektiv innebär att vara öppen och se den andra människan där hon befinner sig. Alkoholberoende lever med känslor av skuld och skam, dessa känslor skapar ett lidande hos patienten, vilket kan förvärras av vårdpersonal. Syfte: Att beskriva människans upplevelser av att leva med alkoholberoende. Metod: Studien har en kvalitativ ansats. En kvalitativ innehållsanalys har genomförts utifrån tre självbiografier som underlag. Resultat: Upplevelsen av att leva med alkoholberoende kan ses som en rörelse mellan flykt och kamp. Flykten består i att fly från svåra känslor eller situationer, vilket leder till känslor av skuld och skam. I rörelsen infinner sig en kamplust som uttrycks i att kämpa för sitt människovärde. Insikt om problemet är ett steg i kampen för ett nyktert liv. Kampen för att bli nykter innebär självkontroll och att sluta fly. Slutsats: I rörelsen visas att den alkoholberoende människan aldrig står still, utan är i ständig rörelse mellan flykt och kamp. Förståelse för denna rörelse och förståelse för att etiketter och fördömanden från omgivningen skymmer människan är viktigt för att undvika att människan blir betraktad som ett hjälplöst objekt. Klinisk betydelse: Studiens resultat kan bidra till ökad förståelse hos vårdpersonal om hur människor med alkoholberoende lever och att de ska bli sedda och bekräftade som de personer de är. / Background: Patients with alcohol dependence are common in healthcare. Research shows that caregivers express a lack of knowledge during contact with those patients. The Life-world is the world that people encounters daily and lives in. A Life-world perspective means being open and see the other person as she is. An alcohol dependent person lives with feelings of guilt and shame and those feelings create suffering for the patient, which may be exacerbated by health professionals. Purpose: To describe the human experience of living with alcohol dependence. Method: The study was a qualitative method approach. A qualitative content analysis was carried out on three autobiographies. Results: The experience of living with alcohol addiction can be seen as a movement between escape and struggle. The escape is to run from difficult emotions or situations, which leads to feelings of living with guilt and shame. The motion raises a fighting spirit that is expressed in the fight for their human dignity. Insight into the problem is a step in the struggle for a sober life. The struggle to get sober means self-control and to stop the escape. Conclusion: The motion is that the alcohol dependent never stands still, but is in a constant movement between escape and struggle. An understanding of this movement and the understanding of that labels and condemnations from the surrounding obscure the human being, is important to avoid that the human being is seen as a helpless object. Clinical significance: The study results can be used to give health professionals a better understanding of people living with alcohol dependence and that these people are seen and acknowledged as whole people.

Introduction : La dépendance à l'alcool est un problème majeur et mondial de santé publique. Pour tenter d'en comprendre les déterminants individuels, plusieurs études se sont centrées sur l'examen de la personnalité, des styles défensifs, des stratégies de coping et de la symptomatologie anxio-dépressive au sein de populations alcoolo-dépendantes. En revanche, à notre connaissance, aucune recherche n'a étudié l'ensemble de ces facteurs simultanément. En conséquence, dans le cadre d'une approche intégrative, le but de cette thèse a été d'évaluer ces variables et d'étudier leurs relations afin d'apporter des éléments de compréhension à l'installation et au maintien de la dépendance à l'alcool. Méthode : Au cours de cette étude multicentrique (5 centres de recrutement) et transversale, 122 patients consultants pour une problématique alcoolique et 185 témoins ont répondu à un questionnaire sociodémographique et centré sur la consommation de substances, au Big Five Inventory (BFI) pour évaluer la personnalité, au Defense Style Questionnaire - 40 (DSQ-40) pour relever les styles défensifs, au Brief Cope pour estimer les stratégies de coping et à l'Hospital Anxiety and Depression Scale (HADS) pour mesurer la symptomatologie anxio-dépressive. Dans un premier temps, des analyses statistiques descriptives, comparatives et de corrélations ont été réalisées. Dans un second temps, des tests de régressions linéaires et logistiques, d'analyse en composantes principales et une analyse discriminante ont permis d'approfondir les résultats en lien avec l'objectif de la thèse (logiciel SPSS). Résultats : Les personnes alcoolo-dépendantes obtiennent des scores significativement différents pour la personnalité (névrosisme élevé, extraversion et conscience basses), pour les styles défensifs (style mature bas, styles névrotique et immature élevés), pour les stratégies de coping (stratégies centrées sur le problème basses, stratégies centrées sur les émotions et évitantes élevées) et pour la symptomatologie anxio-dépressive (symptômes anxieux et dépressifs importants) que les sujets du groupe contrôle. Les relations entre ces variables montrent le rôle des dimensions de personnalité dans l'utilisation de style défensif et/ou de stratégies de coping pouvant conduire à l'installation et au maintien d'une alcoolo-dépendance. En effet, le névrosisme entraîne l'utilisation d'un fonctionnement défensif inadapté. L'extraversion, la conscience et plus particulièrement l'ouverture à l'expérience sont associées à une activité défensive efficace. L'agréabilité, quant à elle, affiche des liens plus complexes avec l'organisation défensive. La présence de liens cohérents entre les styles défensifs et les stratégies de coping confirme l'intérêt de considérer le fonctionnement défensif de manière intégrative et globale. L'analyse discriminante, réalisée sur les facteurs principaux, permet de prédire l'appartenance au groupe « Alcool » pour 3 sujets sur 4. Les analyses de régressions linéaires multiples, exécutées selon un regroupement théorique, montrent que le style immature et les stratégies de coping évitantes prédisent le maintien d'une alcoolo-dépendance. L'ensemble des analyses, étayées par l'apport de différents modèles théoriques, permet de proposer un modèle théorico-clinique de l'installation et du maintien d'une dépendance à l'alcool. Des analyses comparatives complémentaires, exécutées sur les facteurs principaux, indiquent des scores significativement différents selon le genre chez les personnes alcoolo-dépendantes. Conclusion : Cette recherche montre la présence d'une association de déterminants individuels favorisant l'installation d'une alcoolo-dépendance en termes de personnalité, de style défensif, de stratégies de coping et de symptomatologie anxio-dépressive. Cette étude souligne l'intérêt d'appréhender le fonctionnement défensif globalement et permet de proposer un modèle théorico-clinique de l'alcoolo-dépendance et de son maintien. / Introduction: Alcohol dependence is a major and global public health problem. To try to understand the individual determinants, several studies have focused on the examination of personality, defense styles, coping strategies, anxiety and depressive symptoms in alcohol-dependent populations. However, to our knowledge, no research has studied all these factors simultaneously. Accordingly, as part of an integrative approach, the aim of this thesis was to evaluate these variables and study their relationships to bring elements of understanding the installation and the maintenance of alcohol dependence. Method: In this multicenter (5 recruitment centers) and cross-sectional study, 122 consultants patients with alcohol dependence and 185 controls answered a sociodemographic and focused on the substance questionnaire, the Big Five Inventory (BFI) to assess personality, the Defense Style Questionnaire - 40 (DSQ-40) to raise the defense styles, the Brief Cope to assess coping strategies and the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depressive symptoms. Initially, descriptive, comparative statistics and correlations were performed. Secondly, linear and logistic regression tests, principal component analysis and discriminant analysis have deepened the results related to the goal of this thesis (SPSS). Results: The alcohol-dependent obtain significantly different scores for personality (high neuroticism, low extraversion and conscientiousness), for defense styles (low mature style, high neurotic and immature styles), for coping strategies (low problem-focused strategies, high emotion-focused and avoidant strategies) and for anxiety and depressive symptoms (significant anxiety and depressive symptoms) than control subjects. The relationship found between these variables show the role of personality dimensions in adapting defense style and/or effective coping strategies to deal or not with stress. Neuroticism involves the use of an unsuitable defensive operation may lead to the alcohol dependence installation. The extraversion, conscientiousness, and particularly openness to experience are associated with effective defense activity. The agreeableness, meanwhile, appears more complex connections with the defensive organization. The presence of coherent links between defense styles and coping strategies confirms the interest in considering the defensive operation of integrative and comprehensive manner. The discriminant analysis performed on the main factors predicts group membership "Alcohol" subjects for 3 to 4. Analyses of multiple linear regressions, performed according to a theoretical regrouping show that immature style and avoidant coping strategies predict the maintenance of alcohol dependence. All analysis, supported by the contribution of different theoretical models allows proposing a theoretical-clinical model of the installation and maintenance of alcohol dependence. Further analyses comparing the main factors indicate significantly different scores by gender among alcohol-dependent people. Conclusion: This research shows the presence of a combination of individual determinants favoring the emergence of alcohol dependence in terms of personality, defense style, coping strategies and anxiety-depressive symptomatology. This study emphasizes the importance of understanding the overall defensive functioning and allows proposing a theoretical-clinical model of alcohol dependence and its maintenance.

In the wake of budgetary restraints, many local government organizations are examining existing sources of revenue to exhaust available streams without increasing constituents' financial burden. Some of these revenue streams include nontraditional sources, such as traffic citations, yet little research has explored the implications of revenue generated from fines from traffic citations. Using the theory of resource dependence as the foundation, the purpose of this study was to explore the relationship between the estimated population of the county, the unemployment rate of the county, and the personal income per capita against the number of traffic citations issued and the Florida Clerk of Court and Comptroller's (FCCC) revenues and budget attributable to traffic citations for 39 of Florida's counties for the years 2005-¬ - 2014. Data were analyzed using multiple linear regression analyses. The results of this study indicate a statistically significant (p < .001) relationship between population and personal income with increases and decreases, respectively, in the issuance of traffic citations and FCCC revenues attributable to traffic citations. Likewise, there was a statistically significant (p < .001) relationship between population and personal income with increases in the FCCC budget associated with traffic citations. Unemployment rate was not statistically associated with the issuance of traffic citations, and FCCC revenues and budget attributable to traffic citations. The findings of this study may promote positive social change by providing legislative awareness that the FCCCs continue to be dependent on the bulk of their revenues, and significant portion of their budget, from a nontraditional revenue source; the traffic citation.