The purpose of this qualitative study was to identify salient beliefs about disclosing drug use to healthcare providers among a convenience sample of adults who use drugs in the United States. This study differs from previous research by using the Reasoned Action Approach as the theoretical framework which allows the intention to disclose to be explored. A sample of 5 adults were recruited from Bluelight.org, with ages above 35 years for all participants. Primary drugs differed among the sample with two participants using primarily opioids, heroin as the primary drug for one participant, and stimulants as the primary drug for two participants. Data was collected using an open-ended web survey. Content analysis was performed on the data using a pragmatic worldview. Data was analyzed using the Reasoned Action Approach concepts relating to behavioral beliefs, normative beliefs, and control beliefs. Among the sample, advantages to disclosing drug use included improved healthcare and finding help while disadvantages primarily included discrimination and stigmatization. When asked about normative referents that would encourage disclosure, family and healthcare providers were provided most. However, those who would discourage disclosure were people who know the consequence, pain patients, and support groups. Stigma and discrimination appeared again as response to a question about groups or people who would be least likely to disclose. When asked about factors that would increase the likelihood of disclosure, being listened to without consequences and a variety of healthcare provider qualities (e.g., caring, trustworthy, etc.) were provided most often. Factors that would decrease the likelihood of disclosure were less conclusive and diminished health/healthcare was the only salient belief identified. The findings of this study align with previous literature on the consequences of stigma and discrimination while also providing a base of literature for future research on the topic using the Reasoned Action Approach.

The development of multiple theoretical models and measures of impulsivity has led to inconsistent use of this term and disagreement regarding the most salient predictors of alcohol-related outcomes. The present study examined whether self-report and behavioral measures of impulsivity measure the same construct and how eight conceptually distinct facets of impulsivity relate to alcohol-related outcomes. Participants completed measures and tasks to assess alcohol use, alcohol problems, trait impulsivity, and behavioral impulsivity. The UPPS-P and behavioral measures of impulsivity were largely uncorrelated with each other. Negative urgency and alcohol use emerged as direct predictors of alcohol-related problems. Lack of premeditation demonstrated an indirect effect on alcohol-related problems. Results support previous research suggesting behavioral and self-report measures of impulsivity do not assess the same construct. Further, results suggest that negative urgency may be the most predictive of alcohol-related problems when accounting for self-report and behavioral components of impulsivity.

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Introduction: Race/ethnicity and sex disparities in substance use and substance use treatment completion are well documented in the literature. Previous literature has shown that participation in self-help groups is associated with higher rates of substance use treatment completion. While most of this research has focused on the completion of treatment for alcohol and stimulant use, research examining this relationship using an intersectional approach for individuals in treatment for opioid use is limited. Methods: Thus, the current study utilized responses from the Treatment Episodes Data Set–Discharges, 2015–2017 to examine disparities in the relationship between participation in self-help groups and substance use treatment completion for individuals undergoing treatment for opioid use based on sex, race, and ethnicity. Results: Results revealed a positive association between participation in self-help groups and treatment completion among those in treatment for opioid use across race, ethnicity, and sex. Further, the study found several differences in this association based on one's race, ethnicity, and sex. When compared to men of other races/ethnicities, the association between self-help group participation and treatment completion was highest among Black men. Conclusions: The results of the current study extend the knowledge-base about self-help participation's role in promoting successful substance use treatment completion to individuals in treatment for opioid use. Results also highlight the need to examine treatment outcomes with an intersectional lens.

The purpose of this study was to examine the interaction between substance use messages in music media and how it impacts perception of substance and current substance use for different ethnicities. Four hundred and eighty four participants were recruited from a large southeastern university. Participant ethnicities included Caucasian, Hispanic, African American and Asian. This study examined frequency of substance use messages in popular music lyrics and music videos, along with participant self-reported ethnicity and, rates of substance use and perceived risk from substance use. Differences in perception of risk and current substance use were indicated between Caucasian and African American participants. Interestingly, an inverse relationship between exposure to substance use messages and perception of risk of harm from substance use was noted, with more frequent exposure being correlated with greater perceived risk and lower current substance use. Regression analysis indicated that ethnicity predicted frequency of substance use messages in music media, and exposure to substance use messaged predicted both perception of risk of harm from substance use and current substance use, supporting the hypothesized role of music as a mediator between ethnicity and substance use.

Alcohol and substance use among a college population has become a norm for our society. Even more intriguing are the possible factors that may lead to use and abuse of alcohol and substances. The purpose of the current study was to examine the relationship between multiple participant characteristics (i.e., ethnicity, gender, year in college, socioeconomic status) and alcohol and substance use. A total of 902 participants from the University of Central Florida answered multiple questionnaires via the Sona system. Items in the questionnaires included topics such as demographic variables, social class variables, and items regarding alcohol and substance use in the past thirty days. The majority of participants were white females with an average age of 21.58. This study hypothesized that participants who identify as white males, those classified as a junior or senior in class standing, as well as those in a higher socioeconomic status would be more likely to report alcohol and substance use when compared to other participants. The current study also sought to assess how these different factors combine to best predict alcohol and substance use among a college sample. Data in the study was analyzed using SPSS in which correlations, t-tests, and an ANOVA were used to determine how participant characteristics and alcohol and substance use among college students are related. Linear regression analyses were conducted as well to determine how different participant characteristics can combine to best predict alcohol and substance use among college students. Results indicated that those participants whom identify as being white males, participants in a higher socioeconomic status, and, participants in later years of college are more likely to partake in alcohol and substance use. Results also indicated that the main factors that predicted alcohol and substance use are social class and year in college.

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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)