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Adolescence is a high-risk period for substance use, and the prevalence of adolescent substance use is a public health concern. Contributing factors for adolescent substance use are adverse childhood experiences (ACEs). ACEs are potentially traumatic childhood events that have negative associations with health and risk behaviors. The purpose of this study is to examine how the accumulation, timing, and duration of early ACEs (by age 5) impacts adolescent substance use. In addition, this study examines differences in these relationships by gender. Data from the Fragile Families and Child Wellbeing Study (FFCW) were used for the logistic regression analyses. The results generally showed significant relationships for early cumulative ACEs and early ACE timing and duration variables for the full and female sample when considering bivariate models, recency of trauma, and demographic variables. For male samples, statistical significance was only reached for extreme early cumulative ACEs and extreme early ACE timing and duration variables in all models. No significant relationships existed between early ACEs (accumulation, timing, or duration) and adolescent substance use when considering other major predictors of adolescent substance use at year 15. There were also no significant gender differences for early ACEs and adolescent substance use (accumulation, timing, or duration). Future studies should consider the impact of mediating variables on the relationship between early ACEs and adolescent substance use.

BACKGROUND: Suicide is a leading but preventable cause of death and is preceded by domains of thoughts, plans, and attempts. We assessed the prevalence of suicidality domains and determined the association of suicidality domains with sexual identity, mental health disorder symptoms, and sociodemographic characteristics. METHODS: We used the 2019 National Survey on Drug Use and Health (NSDUH) data to perform weighted multivariable logistic regression and margins analyses to examine between and within-group differences in suicidality by sexual identity among adults aged ≥ 18 years. RESULTS: About 4.89%, 1.37%, and 0.56% of the population experienced suicidal thoughts, plans, and attempts, respectively. Those aged 18-25 years old had a higher odds of suicidality compared to those aged 26 years or older. Compared to those who reported having no alcohol use dependence, illicit drug use dependence, and major depressive episodes (MDEs), those who reported alcohol use dependence, illicit drug use dependence, and MDE had higher odds of suicidal thoughts, plans, and attempts. Between all sexual identity groups, bisexuals who experienced MDEs had the highest probability of having suicidal thoughts while lesbians and gays who experienced MDE showed a higher probability of suicidal plans and attempts compared to heterosexuals. Within each sexual identity group, the probability of having suicidal thoughts, suicidal plans, and suicidal attempts was higher for those who had experienced MDEs compared to those who had not experienced MDEs. CONCLUSION: Substance use disorder and MDE symptoms were associated with increased suicidality, especially among young adults and sexual minority people. This disparity underscores the need for tailored interventions and policies to enhance the provision of prompt mental health screening, diagnosis, and linkage to care for mental health services, particularly among the most vulnerable in the population.

Youth with co-occurring mental illness and substance use disorders are at higher risk for vocational rehabilitation exclusion. This study aimed to (a) explore the personal factors associated with vocational outcomes of youth with co-occurring mental illness and substance use disorders and (b) highlight services that have shown the greatest promise for this population in the state-federal rehabilitation program in the United States. Our analytic sample was extracted from the Rehabilitation Services Administration's Case Service Report data set for 2013, 2014, and 2015 fiscal years. Multiple regression analyses results identified personal factors such as gender, race/ethnicity, level of education, and severity of disability as predictors of the achievement of competitive employment, hours worked, and income. The receipt of vocational rehabilitation services such as job search support, job placement assistance, vocational training, and on-the-job support are significantly associated with the achievement of competitive employment, higher work hours, and income. These finding have implications for vocational rehabilitation practice as they highlight who is at higher risk for poor outcomes, effective services, and additional factors to consider when working with youth with co-occurring mental illness and substance use disorders.

Objectives: Concurrent substance use disorder (SUD) and posttraumatic stress disorder (PTSD) occur at high rates and are typically associated with poor treatment outcomes in both sexes. However, women have a propensity to cope with increased negative affect via substance use in comparison to men; thus, it is important to elucidate the sex-specific bidirectional relationships between SUD and PTSD to improve our understanding of concurrent SUD/PTSD in men and women. Methods: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-Wave 3; n = 36,309), the present study evaluated the impact of sex on the relationship between past-year SUDs (new, remitted, ongoing), including alcohol and drug use, and retrospective transitions in new vs. absent and ongoing vs. remitted diagnoses of PTSD. Additionally, the impact of sex was explored in models examining past year PTSD (new, remitted, ongoing) and retrospective transitions in new vs. absent and ongoing vs. remitted diagnosis of SUDs. Diagnostic transitions were based on retrospective reporting. Results: Results indicated that new, remitted, and ongoing SUDs increase the likelihood of new PTSD diagnoses (OR range = 2.53–8.11; p < 0.05). Among individuals with ongoing drug use disorders (DUD), there were greater odds of ongoing PTSD (OR = 2.10, p < 0.01). When examining the relationship reciprocally, new, remitted, and ongoing PTSD increased the likelihood of new SUDs (OR range = 2.50–8.22; p < 0.05), and ongoing PTSD increased the likelihood of ongoing SUD and DUD (OR = 1.40, 1.70, respectively; p < 0.05). Sex-specific analyses revealed that the relationship between PTSD and SUDs varies between sexes, particularly among women. For instance, women with new PTSD had higher odds of SUDs, and women with ongoing PTSD were almost 2.5 times more likely to have an ongoing DUD. Women with a new PTSD diagnosis were more likely to be diagnosed with a new SUD (OR = 3.27) and an ongoing DUD (OR = 3.08). Conclusions: Results indicate a bidirectional relationship between PTSD and SUD that is in many instances larger in women. Thus, illustrating potential sex-specific differences in underlying mechanisms implicated in SUD/PTSD, warranting additional research.

Studies find consistently that survivors of childhood sexual abuse (CSA) are likely to suffer from depression, post-traumatic stress, and problematic substance use, and may experience also a variety of adjustment difficulties in several emotional, behavioral, and interpersonal domains. Involvement with the legal system is one such outcome to consider, especially given the increasing number of women serving time in correctional facilities with nearly two-thirds of these women being survivors of CSA (e.g., Browne, Miller, & Maguin, 1999). The current literature lacks comparisons between female survivors of CSA who have legal involvement and those who do not; hence, the current study addresses the need for a comprehensive investigation of early victimizations and later adjustment. Data were obtained from 169 female inmates and 420 female college students, a number of whom were survivors of CSA (66% and 35.5%, respectively), so that group differences could be examined and relationships among family environment, abuse disclosure history, coping, perceived social support, adjustment (i.e., trauma symptoms, substance abuse, depressive symptomatology, revictimization), and criminal history could be explored. Results suggested that inmate survivors experience poorer functioning overall relative to student survivors of CSA, including more depressive symptoms, trauma symptoms, and substance abuse. Further, avoidance coping by using substances mediated fully the relationship between trauma symptoms and substance abuse for both groups. Finally, severity of CSA, problematic substance use, and social support emerged as significant predictors of incarceration among survivors of CSA. Findings may aid in the refinement of interventions, prevention efforts, and educational programs regarding CSA, and shed light on pathways to incarceration.

Substance use, such as alcohol, cigarette, and marijuana, is a threat to the health and well-being of the youth, their families, and society as well. Government supports and implements several programs to protect youth from substance use. The aim of this study is to evaluate the impact of social capital on youth behavior and to suggest evidence-based policy interventions. Social capital refers to individual embeddedness in web of social relations and their behaviors guided by social structure. Therefore, adolescents' social interactions with their peers, parents, and community were investigated. The substance use was measured by the usage of cigarettes, alcohol, marijuana, and inhalants in the past year. The type of activities adolescents participate in, the time and type of intra-familial interactions between parents and adolescents, and the type of peer groups adolescents interact with were employed as indicators of social capital. In other words, this study focuses on the relationship between youth substance use and the impact of parents, peers, and youth activities. Moreover, the study examined not only the correlation between social capital and substance use, but also the variation in substance use among youth by age, gender, ethnicity, income level, and mobility. The data, National Survey on Drug Use and Health (2005, 2006, and 2007), was collected by the United States Department of Health and Human Service, Substance Abuse and Mental Health Services Administration Office of Applied Studies. The sample size for each year was around 17.000. Structural Equation Modeling (SEM) was used to test the hypothesized. The results of the statistical analysis supported the research hypothesis. Findings show that there is a relationship between youth substance use and social capital. All three dimensions of social capital (peer impact, family attachments, and youth activities) were found to be statistically significant. While peer influence is positively correlated with substance use, family attachment and youth activities have a negative relationship with substance use. The impact of social capital however varies by age, gender, ethnicity, mobility, and income level. The study also contributes to the social capital literature by integrating different perspectives in social capital and substance use literature. Moreover, it successfully demonstrates how social capital can be utilized as a policy and intervention tool.

<p>Racial microaggressions are associated with multiple negative health outcomes, including increased distress, anxiety (Blume et al., 2012; Schoulte et al., 2011), and substance use (Su et al., 2019). The negative effects of racial microaggressions have been observed through daily assessments (Burrow & Ong, 2010; Ong et al., 2009; Swim et al., 2003). However, these studies have been conducted almost exclusively among Black adults. Thus, the first aim of the current study is to examine the impact of daily experiences of racial microaggressions on health outcomes among Black adolescents. Further, it is also important to examine factors that might influence the relationship between racial microaggressions and health outcomes. One factor that has received a considerable amount of attention is racial identity, with more recent studies examining the impact of racial identity profiles. Thus, the second aim of the current study was to explore variability in these risk pathways based on racial identity profiles. Participants were Black adolescents (N = 48; 79.2% girls; Mage=17.13). Respondents completed measures of racial identity at baseline and daily diary measures of racial microaggressions, depression, anxiety, aggression, and substance use for 14 days. Participants reported an average of 5.56 experiences of racial microaggressions per day. Neither concurrent or lagged-day associations between racial microaggressions and symptoms of depression or symptoms of anxiety were significant. Concurrent analyses indicated that the between-person effect of racial microaggressions on aggression was significant (estimate=0.345, SE=0.138, t=2.495, p=0.016), and that effect was still evident one day later (estimate=0.107, SE=0.040, t=2.686, p=0.007). The concurrent, within-person effect of racial microaggressions on cannabis use was also significant (OR=1.524, 95%CI[0.103, 0.740], p=0.010). Four racial identity profiles were identified (labeled race- focused, undifferentiated, integrationist, and multiculturalist) and a number of effects were significant within profiles. This study further highlighted that Black youth are experiencing an overwhelming number of racial microaggressions on a daily basis. Additionally, this project represents a crucial step in advancing our understanding of how racial microaggressions operate to influence health outcomes among Black adolescents on the daily level and highlights several areas for needed study and intervention. </p>

Thesis (M.S.)--Boston University / The purpose of this study is to learn to what extent the various treatments available for alcoholics and drug addicts, in addition to detoxication and drug withdrawal, were used by patients who were admitted to the Washingtonian Hospital; to ascertain to what extent social work services were used, and to ascertain, as far as possible, what services were offered by either the medical staff or the social service department but not accepted.

Opioid use disorder (OUD) is a chronic relapsing condition associated with significant patient morbidity and mortality. Patients suffering from OUD have an increased risk of death from suicide, HIV, infectious disease, and trauma, among other causes. Patients suffering from OUD often manage various comorbid psychiatric illnesses and homelessness. From 1999 to 2017, an estimated 400,000 people died from prescription opioid related overdoses. In 2014, there were 28,647 opioid related overdose deaths in the United States. The current standard of care for treatment of OUD is an opioid receptor agonist methadone or buprenorphine combined with a psychosocial intervention, like cognitive behavioral therapy (CBT), contingency management (CM), or motivational interviewing (MI). MI has proven to be effective in treating OUD when combined with methadone and buprenorphine. Other studies have found increased rates of opioid abstinence when study subjects were provided recovery housing contingent on urine that was free of opioids and other substances (CM). Among patients with a history of incarceration and co-morbid OUD, stable housing in some form -- private residence or living with a friend or family -- has been found to be effective in reducing opioid use when compared to homelessness as a control, suggesting homelessness confers a higher risk of opioid use. This prospective observational study aims to evaluate the effect of stable housing on opioid use disorder treatment and recovery. Study subjects will be Boston area residents who are prescribed methadone. Investigators will follow study subjects over six months while they attend weekly motivational interviewing sessions as part of their treatment regime and attend methadone clinics as usual. Once per week, study subjects will submit urine samples to study affiliated Medical Assistants (MA). Urine samples will be sent to LabCorp for toxicology analysis. At the conclusion of the study, investigators will examine which patients had longer time to relapse based on their housing status. We hypothesize that subjects with stable housing will have longer abstinence, as measured by urine toxicology, than subjects without stable housing. Positive findings could be used to help influence policy makers and federal and state legislation to promote stable housing for patients recovering from OUD.