It is imperative to acknowledge the crisis state of African American adolescents as they transit into young adulthood. Professional literature has documented the usage of cigarettes, alcohol, marijuana and other drugs during the transitional period. Chemical substance misusage among some adolescents resulting in critical incidents continues to gain increased interest for the counseling profession and others. Special emphasis is placed on drug prevention education program in schools. A selected group of adolescents were administered the PRIDE survey instrument for this research study. The instrument was designed to assess the student's history, pattern, attitude, prevalence and critical incidents involving cigarettes, alcohol, marijuana and other drug misusage. Descriptive research techniques were utilized for this study. Ninety-one respondents were randomly selected among the population of two hundred students. The research findings were overwhelming. Based on the findings, there is no significant difference in drug usage among adolescents in rural and metropolitan areas in the United States.

Introduction: African American adolescents have a higher prevalence of risky sexual behavior compared to Hispanic and White adolescents. African American adolescents account for 65% of HIV diagnoses among individuals aged 13 to 24 years (Jackson et al., 2015). The rising rate of new STI and HIV cases remains a public health concern and the need for intervention in target populations is outstanding. The objective of this study is to measure the association between alcohol and other substance use and risky sexual behaviors in African American adolescents in the United States. Methods: Data from the Centers for Disease Control and Prevention’s (CDC) 2015 National Youth Risk Behavior Surveillance Survey (YRBS) was used in this study. SAS 9.3 software package was used for descriptive analysis, univariate logistic regression, and multivariate logistic regression of assessing the relationship between alcohol and drug use with risky sexual behaviors in black adolescents in comparison with white adolescents. Results: When controlling for age, gender, and all other variables, African American adolescents that reported ever consuming alcohol were 2.2 (OR=2.2 95% CI=1.6-3.2 p= <.0001) times more likely to ever had sex, 3.8 (OR=3.8 95% CI= 2.9-4.9 p= <.0001) times more likely to have had sex with 4 or more people in the past 3 months, and 1.3 (OR=1.3 95% CI=0.8-2.1 p= <.0001) times more likely to have had sexual intercourse with at least 4 people in their lifetime. When asked if they ever used marijuana, adolescents that reported at least once were 4.5 (OR=4.5 95% CI= 3.2-6.5 p=<.0001) likely to have engaged in sexual intercourse, 3.8 (OR=3.8 95% CI=2.6-5.5 p= <.0001) times more likely to have had sex with four or more people in the past 3 months, and 6.1 (OR=6.1 95% CI=3.7-10.2 p= <.0001) times more likely to have at least 4 sexual partners in their lifetime. Conclusions: The findings of this study indicate that use of illicit substances does increase risky sexual behaviors in African American Adolescents. Further implications of this study can be utilized in the development of intervention programs. Intervention programs should target African American adolescents that engage in risky sexual behaviors and any substance use.

Research suggests that substance use is a risk factor for increased suicidal ideation. This study explored the relationship between substance use, suicidal ideation, and impulsivity in a sample of college students and individuals seeking outpatient treatment. Participants were interviewed for information on severity of suicidal ideation and substance use. Participants completed the Psychiatric Diagnostic Screening Questionnaire, the substance use section of the Structured Clinical Interview for the DSM-IV, the Alcohol Use Disorders Identification Test, the Scale for Suicide Ideation, and the UPPS-P Impulsivity Behavior Scale. These measures were used to determine the amount of variance in suicidal ideation accounted for by substance use. Variables reflecting substance use classification, frequency, and severity were used to predict severity of suicidal ideation.

African Americans have been disproportionately affected by HIV since the beginning of the epidemic and the disparities have worsened over time (CDC, 2013a). African Americans comprise about 12% of the U.S. population but represented about 44% of all new HIV infections in 2010 (CDC, 2014a). Young people (age 13–24) accounted for 26% of all new HIV infections in 2010, despite persons in this age range comprising just 17% of the population (CDC, 2014c). Young African Americans (age 13-24) are affected in particular. In 2010, they comprised 57% of infections in this age range (CDC, 2014c). Substance use is a major factor in the sexual risk taking of young people. Substance use has been associated with risky behaviors such as unprotected sex and having multiple partners, which may put one at risk for contracting sexually transmitted infections (STIs) (Kaiser Family Foundation, 2002). This may help to explain why STIs are more prevalent among 18 to 24 year olds than any other age group. Prevalence estimates suggest that young people (age 15–24) acquire half of all new STIs (Satterwhite et al., 2008). Program evaluation is a social science activity that entails “collecting, analyzing, interpreting, and communicating information about the workings and effectiveness of social programs” (p. 2) (Rossi, Lipsey, & Freeman, 2004). This dissertation is an evaluation of the Raise 5 Project, which aimed to provide HIV and substance abuse prevention services to the African American students attending Virginia Commonwealth University (VCU). The project utilized four strategies: 1) evidence based interventions, 2) peer education and awareness, 3) HIV testing and counseling, and 4) a social marketing campaign. Two forms of evaluation, process and outcome, were utilized to assess the Raise 5 Project. Process evaluation assesses service utilization (i.e., program engagement) and program organization. This process evaluation sought to determine if the project’s four strategies operated as intended. Outcome evaluation assesses the intended outcomes of a program. This outcome evaluation examined if participants in the project’s evidence based interventions had reduced substance use and risky sexual behaviors.

The objective of this study was to investigate the relationship between stressful events in adolescents and negative outcomes of substance use, depressive symptoms, and anxiety symptoms. Parental support and unsupportive parental responses were examined as moderators of this relationship. The research design was cross-sectional, and self-report data were collected from 100 adolescents in the 8th and 9th grades. As hypothesized, significant positive associations were found between perceived stressors and each of the three negative outcomes, as well as between unsupportive parental responses and the outcomes. Also consistent with hypotheses, and previous literature, was the finding of a significant inverse association between parental support and negative outcomes. Multiple linear regression analyses supported one of the moderator hypotheses, showing that parental support buffered the association between stressful events and adolescent substance use, such that adolescents with high stress and high perceived parental support engaged in significantly less substance use than adolescents with high stress and low perceived parental support. However, no significant evidence was found for parental support as a buffer of the associations between adolescent stressful events and either depressive symptoms or anxiety symptoms. Contrary to hypotheses, no significant moderation effects of unsupportive parental responses were found for the associations between stressful events and adolescent substance use, depressive symptoms, or anxiety symptoms. A major contribution of the present study is the evidence for unsupportive parental responses as a significant predictor of negative outcomes in adolescence. The present findings further suggest that unsupportive parental responses are a distinct construct from parental support, rather than simply opposite ends of the same continuum.

The aim of this thesis is to expand our understanding of the etiology of alcohol misuse and related disorders in African Americans using genetically informative study designs. Specifically, we take advantage of the candidate-gene approach and polygenic score analysis to extend the literature specific to African American populations. Chapter 2 explores gene x environment (GxE) interactions through the candidate gene approach to explore the relationship between two genes chosen on their potential relevance to stress response and adolescent alcohol use and misuse, among African American youth living in highly impoverished neighborhoods, as moderated by stressful life events. Chapter 3 implements polygenic score analyses to examine the effect of an aggregate of markers. We explore whether polygenic risk for alcohol dependence – derived from GWAS estimates in one discovery sample – predict alcohol use and broader externalizing behaviors and interact with stressful life events to predict alcohol use/misuse among high-risk African American youth.

This research study examined the effects of high levels of sugar intake on mental health in marijuana smokers. Because the literature demonstrates a similarity between refined sugar and other commonly addictive drugs, those who ingest a higher percentage of dietary sugar will score more poorly on the DASS21, meaning that with higher levels of sugar ingestion, a greater deficit in mental health functioning will be measurable. Of 16 participants, nine were female and seven were male, and the participants ranged from a normal weight to obese. The results did support the hypothesis of sugar dependence. This has implications for future studies on the impact of sugar on mental health. The results to this study may provide insight into potential for greater understanding of eating disorders associated with sugar dependence, thereby potentially leading to the development of more effective treatment options.

Magister Artium (Social Work) - MA(SW) / Substance abuse has become a serious global problem affecting individuals, families and communities. The effects of substance abuse devastate both the user and their families. This study aimed to describe the adverse effects that substance abuse has on the levels of care giving and well-being of families. The study explored family members perceptions of the ways in which an adolescent’s substance abuse affects family care giving and well-being. The study was conducted within a qualitative approach in order to gather an in depth understanding of the family’s experiences. Furthermore, the study was aligned with Family Systems and Bowens Family Theories, which served as reference points to allow the researcher to discern how substance abuse influences family roles, dynamics and functioning. The researcher used the case study design which focused on an issue of concern (such as adolescent substance abuse) and thus selected one case to elucidate the issue i.e. a single case study. The case would be the family members of substance abusing adolescents in Mitchells Plain. The population of interest were the parents and siblings of adolescents who abused substances. Purposive sampling was used to select families with participants who had the specific qualities and experiences needed for the study. The study sample consisted of 12 participants, seven parents (mothers) and five siblings. The participants were female which corresponds with literature, as females are perceived as more willing to share and speak about their experiences. Individual semi-structured interviews were used for data collection through the use of interview schedules. Data verification methods ensured credibility (member checking), transferability (using thick, rich descriptions), dependability (an inquiry audit), and confirmability (using researcher reflexivity). The data was analysed in the form of qualitative thematic analysis achieving data reduction by seeking themes, sub-themes and categories of data. Four themes emerged from the findings, namely, (1) parents/sibling reactions to discovering the substance abuse, (2) the effects of substance abuse on the parents/siblings living with a substance abuser, (3) effects on family communication, and (4) measures used to assist the substance abuser. Each theme was further delineated into 12 sub-themes and 23 categories which were based on both predefined and emergent codes. Permission to conduct this study was obtained from the university’s Faculty of Community and Health Sciences Ethics Committee by its Humanities and Social Sciences Research Ethics Committee (HSSREC); and by the Department of Social Development’s Research Ethics Committee. Ethics compliance was assured through confidentiality and privacy, securing and handling of confidential information, and debriefing opportunities to ensure that emotional harm is minimised together with sensitive interviewing techniques.

South Africa has experienced a drastic shortage of social workers. This shortage has affected many social welfare organizations, particularly those who offer services in the area of substance abuse. According to a recent study conducted by Earle (2008) many reasons could be ascribed to the high social work turnover, these include: poor working conditions; poor compensation of work; lack of resources and support; and increased demands for services. Hence, social workers are experiencing work stress, burnout and compassion fatigue taxing their personal and professional coping strategies which could lead to staff turnover. The primary aim of this study was to understand the work experiences, coping strategies and organisational retention of social workers in Gauteng inpatient substance abuse treatment centres. The study had an exploratorydescriptive design, incorporating both quantitative and qualitative paradigms to explore the work environment of the organisations and participants. Purposive sampling was used to select and divide the participants into three categories: entry level social workers; experienced social workers and social workers that had left the substance abuse field. Data was collected through conducting indepth interviews and through a questionnaire completed by the representatives from in-patient substance abuse treatment centres. This questionnaire was piloted with an in-patient treatment centre in KwaZulu Natal. The results of the quantitative data were analysed using descriptive statistics, which were illustrated via tables and figures and the qualitative data were analysed using thematic content analysis. The main findings of this study confirmed most of the reasons for work stress and burnout that may lead to staff turnover identified in previous studies by Ross (1997) and Earle (2008). These findings are incorporated into a retention model developed by the researcher. The model incorporated five stages: stage one focussed on the reasons for entering the substance abuse field (personal interests, undergraduate studies and/or accidental); stage two explored preparation of social workers by organisations after entry to the field; stage three identified four general factors that effects the sustainability of social workers (external/environmental influences, organisational factors, the type of client population, career opportunities and personal factors); stage four explained the individual differences in coping responses (negative or positive) to job stress either through fight responses, self-care strategies for retention or flight responses, staff turnover; lastly, stage five focussed on what organisations can do to reduce staff turnover. These findings can assist the occupational social worker to identify these retention challenges and develop strategies to reduce the risk of staff turnover.

The Local Drug Action Committee (LDAC) is the closest body to the community which is made up of individuals from different stakeholders at a local level to coordinate the activities aimed at the prevention of substance abuse and illicit drug trafficking within the communities. Since the implementation of the committees, the sustainability of these committees has been a challenge in the Free State Province. The study endeavoured to explore factors which influence the sustainability of these committees in the Free State Province. A qualitative research approach that was explorative and descriptive in nature was employed. A case study design was used. Purposive sampling was applied to select the participants from two LDACs in Mangaung Municipality. A semi-structured interview schedule was used to collect the data during individual in-depth interviews with five participants. Thematic content analysis was used to analyse the data. The main findings indicated that there was a lack of knowledge among the committee members about their roles, responsibilities and mandates. Their inability to coordinate the stakeholder activities as well as the limited knowledge about the relationship between the Free State Mini Drug Master Plan (FSMDMP) and the LDACs also appeared to be challenging. The main conclusions drawn from the study are that despite the excellent structure of the LDACs to coordinate the implementation of the FSMDMP, the members of the LDACs are neither knowledgeable about nor capacitated to fulfil their roles and responsibilities to meet the intended requirements and implement the activities of the FSMDMP, factors which hamper sustainability. The lack of financial support from Government to fund the activities of the LDACs in the Province is another major impediment in terms of sustainability.