Substance abuse is a frequent comorbid condition with other psychiatric disorders including schizophrenia and depression. These disorders may share a common substrate at the neurotransmitter or neurocircuit level. One candidate is hypofunction of the glutamate system. Several lines of evidence suggest that N-methyl-D-aspartate (NMDA) receptors may hypofunction in schizophrenia. Thus, NMDA receptor antagonists are schizophrenogenic; postmortem and imaging results point to reduced NMDA receptor function in schizophrenic brains; a number of genes that have been linked to schizophrenia code for proteins that influence NMDA function; and there is preliminary evidence that pro-NMDA drugs may be therapeutic in the treatment of schizophrenia. One of the most effective therapeutics for the treatment of substance abuse in schizophrenic people is clozapine, and clozapine may act at the glycine modulatory site to enhance NMDA receptor function. This preliminary line of evidence may link schizophrenia and drug abuse to a common neurochemical base, subnormal NMDA receptor function. People with schizophrenia and drug abusers similarly show deficits in tasks known to be sensitive to ventromedial prefrontal cortical damage, and both groups show decreased activation in the ventral striatum during reward anticipation in functional magnetic resonance imaging studies. These observations implicate common prefrontal cortical-striatal circuits and their modulation by hippocampal projections in schizophrenia and substance abuse. Withdrawal from substance abuse and depression both have been linked to changes in the function of several neurotransmitters including serotonin, dopamine and glutamate. These findings suggest possible common substrates and novel therapeutic approaches. Further studies are needed to fully characterize the neurocircuits and transmitters involved in various psychiatric disorders and their possible common elements in comorbid drug abuse.

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.

This project analyzes drug use in Mexico City between 1960 and 1980, the decades when the Mexican state began criminalizing common drugs like marijuana, and prosecuting the consumers of legal drugs such as toxic inhalants. In order to explain this contradiction, this dissertation assesses more than 3,000 Juvenile Court records, police files, health department and hospital documents, journal articles, drug legislation, and personal anecdotes. It argues that consumption and prosecution trends largely corresponded to socioeconomic class. Furthermore, these class-based consumption trends affected Mexican drug policies. According to the Mexican health department and penal reports examined in this dissertation, the Mexican state responded to the rise in drug use by pushing legislation to further criminalize marijuana. Yet the inner workings of that legislation tell a different story. Police records and Juvenile Court cases expose a rise in the detention and arrest of children who consumed toxic inhalants, a legal substance. The Mexican state found it more difficult to punish the children of middle-class government employees and professionals than the poor. In criminalizing poor, young drug users, the government could demonstrate its active efforts to address rising drug use. Consequently, the state created a new criminal class out of lower-class children who inhaled toxic legal substances in Mexico City. From a criminal and health perspective, this dissertation emphasizes the need to consider the impact of Mexican drug use trends on drug policy from the 1960s to the 1980s.

The purpose of the literature review is to identify consistent patterns regarding adolescent use and abuse of chemical substances, especially alcohol and marijuana. Acute physical, cognitive and social effects of alcohol and marijuana use are outlined, and environmental and personal determinants of drug use and abuse are examined. Methods of prevention and intervention are discussed and, from the research findings, a model group counseling program designed for the school setting is proposed. Adolescent use of both marijuana and alcohol is found to be modal by age 16-17. The physical, cognitive and social effects are pervasive and especially damaging to chronic users. Youth are extremely vulnerable to suffering adversity from their drug use patterns.

No description available.

A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements for the Degree of Master of Arts, Clinical Psychology. Johannesburg, September 1992 / No abstract provided.

The purpose of this essay is to explore the significance for former drug addicts who, during their treatment against drug abuse, have had a therapist with a drug addiction in his or her past. A qualitative case study has been used as method in which four former drug users have been interviewed. We have compiled the results based on five key themes in order to get a comprehensive picture of the relevance of common experiences regarding drug abuse, based on former addicts’ experiences. This has been done in connection with a review of different theoretical perspectives that we have found relevant to the investigation. Our findings have then been compared with previous research in the field. We have, in our investigation, come to the conclusion that the therapist’s and the drug addict’s mutual experience of drug abuse regarding drug addiction treatment, is that it is not important. However, there are aspects concerning the relation between drug users and their therapists in which the mutual experience is important.

Electronic nicotine delivery systems emerged during the 2010s as a novel way to consume (i.e., vape) nicotine. Public health authorities became concerned that vaping could cause nicotine-naïve youth to begin using tobacco products and that a new generation of youth could become tobacco-dependent. Though millions of youth have vaped, authorities' fears about a new generation of youth tobacco dependence has not materialized. A more recent concern is nicotine vaping’s potential effects on cannabis use and the use of other substances. An increase in cannabis use among some adolescent groups and young adults could be because of nicotine vaping’s rise. Additionally, cannabis can be vaped, so transitioning from nicotine vaping to cannabis vaping may be easier than transitioning from nicotine vaping to other forms of cannabis use. Furthermore, nicotine product use was historically associated with later use of cannabis and other substances; this trend may be renewed with the advent of nicotine vaping. To date, most studies on the associations between nicotine vaping and cannabis/other substance use are cross-sectional, so more longitudinal evidence is needed. If evidence suggests that nicotine vaping does affect the use of cannabis and other substances, specifying a mechanism would help with developing potential interventions and with testing the validity of total effects. The overarching goal of this dissertation is to advance evidence of nicotine vaping's potential harmful effects on youth and young adults, which could be used to support interventions aimed at reducing the burden of nicotine vaping's outcomes. First, I conducted a systematic review in which I examined the extent to which confounding, measurement errors, and loss to follow-up could alternatively explain reported longitudinal effects of nicotine vaping on cannabis use or other substance use. I also identified studies that tested effect modification and mediation. This systematic review revealed that nicotine vaping likely increases the risk of subsequent cannabis use and other substance use for up to 24 months. It also revealed that some studies evaluated effect measure modification, while no study assessed mechanisms. These observations suggest that future studies should assess long-term effects on initiation and evaluate potential mechanisms. Second, I evaluated whether nicotine vaping affected the initiation of cannabis and other substances over a six-year period among adolescents as they age into adulthood. Results suggested that nicotine vaping had harmful effects on both outcomes over the six-year period. I also found evidence that nicotine vaping's harmful effects in later years appeared stronger than in earlier years; the absence of age effects suggest the absence of cohort effects. Furthermore, I found that effects appeared stronger among individuals who had a history of non-vaping tobacco product use than among individuals without a history of non-vaping tobacco product use, suggesting that tobacco use is key to nicotine vaping's harms. Finally, I evaluated possible mechanisms of the effects based on a theory that I developed from prior empirical literature and behavioral theory. I posited that nicotine vaping caused deviant peer affiliation, which caused conduct problems and subsequently, the outcomes. I found no evidence that three conduct problems (considered together) were mechanisms of the effects. Future studies of mechanisms can reveal potential intervention targets, lead to studies of other potential mechanisms, and help test the validity of total effects. This dissertation achieved its goal of advancing evidence that nicotine vaping may harm youth and young adults. Public health bodies tasked with addressing potential public health concerns about nicotine vaping products should consider evidence from this dissertation.

Traditional help services have problems reaching out to people with substance abuseproblems. Some individuals choose to seek help for recovery from anonymous others online.This study examines the social support within an online support group for individualssuffering from drug abuse, specifically, the drug rehabilitation forum on the Internetcommunity Flashback forum. By looking at the social support in the forum through aqualitative content analysis nine forum threads have been examined. To seek help from otherswithout the pressure of going straight edge as well as an easily accessible tool for differentstages of the process of recovery, the Internet community and forum is an alternative helpchannel and/or complement to traditional services and support. The study also shows that, aswell as social learning theory can explain how individuals begin drug abuse, the theory canalso shed light on how individuals learn to stop their drug abuse.

This study examined characteristics of 100 intensive probationers and 100 regular probationers to have a better understanding of why some probationers recidivate and others do not. Logistic analysis was used to analyze the following variables: age, race, gender, employment status, level of education, convicted offense, prior misdemeanor arrests, prior felony arrests, history of drug abuse, and type of probation. It was discovered that age, prior misdemeanor arrests, and offender category were significant variables correlated to recidivism. These findings are consistent with prior research and provide information that can be helpful to probation and parole officers in their supervision of offenders as well as to the criminal justice system when placing offenders on probation or parole.