Academically successful drug users: an oxymoron?

The present study examines substance use among academically successful students. The data were collected in two discrete anonymous surveys of 2,288 ninth-grade and 2,653 eleventh-grade California students, and 1,043 ninth-grade and 862 eleventh-grade students from a large suburban county. Over 70 percent of the academically successful students from both samples reported some type of drug use. These successful students were divided for comparison into three groups according to their involvement with drugs: abstainers, conventional users, and high-risk users. The analyses indicated that the negative association between drug use and academic achievement may be counter-balanced by mediating factors identified in the study. These factors included high "educational aspiration," "parent educational level," and "emotional stability."     

Predictors of sexual risk‐taking among new drug users

We studied predictors of HIV‐related sexual risk‐taking among individuals who initiated the use of heroin or metham‐phetamine during the past 5 years. Many studies have linked drug use to HIV risk, but most research has been based on samples of users with long‐established drug careers. We conducted face‐to‐face interviews with 153 adult new drug users in Atlanta, GA. Drug use was not a statistically significant predictor of sexual risk, but gender, age, race, homelessness status, childhood neglect, level of paranoia, and level of (dys)functionality in handling disagreements were associated with frequency of sexual risk‐taking. We discuss the need to incorporate new drug users in HIV/AIDS and other health‐related prevention and intervention programs.     

Youth's recreation and drug sensations: is there a relationship?

Adolescents' social behaviors remain a mystery to parks and recreation providers. Adolescence is a "high-risk" time for all youth in terms of experimenting with potentially health-compromising behavior, whether alcohol, drugs, or sex. Most of these antisocial behaviors occur during adolescents' leisure time. These inferences gave impetus to this research effort. The study was designed to ascertain information on adolescents' preferences for pleasure: drugs or recreation. Data were collected from a sample of 100 high school students from a medium-sized college town, and 100 students from a rural town in Florida. Findings revealed four statistically significant associations in the motives or pleasures sought in recreation and in drug behaviors: "enhancement of popularity," "provision of a means for self-discovery," "achievement of personal goal," and means to rebel against parents. In reference to the latter motive, findings revealed that neither drugs nor recreation were used to rebel against parents. Findings also provide documentation of the value of recreation in insulating adolescents against many of the stressors of contemporary life.     

How are drugs approved? Part 3. The stages of drug development

The first article of this series on the drug development process described the historical evolution of the U.S. Food and Drug Administration (FDA), and last month's article reviewed the ethical foundations of clinical research. Before a new drug is marketed, a sequence of preclinical investigations and three phases of clinical studies are conducted. This drug development process involves the FDA, pharmaceutical companies (sponsors), clinical investigators, and institutional review boards. This article further describes this aspect of the drug development process.     

Reducing youth's drug abuse through training social workers for cognitive–behavioral integrated treatment

Cognitive–behavioral integrated treatment (CBIT) is an intervention that social workers can learn to treat youth's drug abuse by cognitive restructuring, behavioral modification, and goal setting. A way to enhance the learning is training specifically for CBIT. Evaluation of the effectiveness of such training in raising social workers' CBIT practice and their young service users' illicit-drug-free days is the aim of this experimental study. This study first randomly assigned 14 outreach social workers to receive training for CBIT and 14 outreach social workers not to receive the training. The study also assessed 222 young service users (aged 11–22 years) engaged by 28 outreach social workers before the training and 169 of them after the training in a six-month follow-up. Furthermore, the study identified the reduction in the youth's dysfunctional cognition of playfulness as a means to deter the youth's drug abuse, based on personal interviews with outreach social workers and their young service users before the training. Derived from the statistical analysis of assessment data, results principally showed cascading effects from the social worker's reception of the CBIT training to the young service user's reception of CBIT, reduced playfulness, and lengthened drug-free days. A supplementary finding was that the young service user's time in the outreach social work service prolonged drug-free days and reduced playfulness. These results imply that the outreach social work service, CBIT training, and CBIT are useful for treating youth's illicit drug abuse.     

Student transitions into drug supply: exploring the university as a ‘risk environment’

Drug use, like much criminality, is often explored in relation to the journey into adulthood. Though young people are understood to commonly ‘grow out’ of crime, protracted transitions from adolescence into adulthood have brought about a new developmental phase where many young people are freer to engage in drug-related leisure and other forms of subterranean play in a period of extended adolescence. In this article, we look to this phase with focus upon those engaged in full time higher education and explore the extent to which entry into university and ‘studenthood’ enables particular changes in levels of involvement in recreational drug use and supply. Drawing on 30 in-depth interviews undertaken with mainly ‘traditional’ undergraduate university students in South West England, this article seeks to explore the ways in which the structural circumstances of the university environment can produce favourable conditions for ‘turning points’, where university students transition into regular drug use and ‘social supply’. It is argued that the university can be understood as a specific ‘risk environment’ where certain cultural and environmental attributes including distance from guardians, the interconnected nature of the student populace, and financial insecurity can ultimately provide facilitative conditions for transitions into drug supply.     

What's the problem? A problem-based approach to the reform of the Norwegian drug rehabilitation sector

This article explores how the scope of solutions to complex problems is determined by the way in which the problem is formulated. We inquire into this by means of a theory-driven case study of the reform in the Norwegian drug rehabilitation sector and the Tyrili facility. We analyze divergent approaches to drug rehabilitation by means of a problem formulation framework, which distinguishes between (1) the value dimensions of given problems, and (2) the phases of problem solving activities. Based on this inquiry, we arrive at a set of propositions, in which we propose that the two approaches differ in their inclusion of various value dimensions. Moreover, we suggest that the reform pursued increased efficiency as a solution to a reductionist formulation of the problem, which challenged Tyrili's opportunity to solve the problem in the multidimensional manner they conceive of it. This is an argument against a one-dimensional maximization of efficiency as a pursuit of quality in social services.     

The independent’s edge in an illegal drug distribution setting: Levitt and Venkatesh revisited

Popular imagery and scholarly research have differed significantly in their perceptions and understanding of the structure and scope of organized crime and gang settings. While the common image is that of the corporate-like or formal criminal organization, past research has been more likely to argue and demonstrate in favour of market and network flexibility. In this study, we pursue this latter line of inquiry by demonstrating the market and network features that shape illegal drug distribution settings. In doing so, we rely on the Quebec Hells Angels accounting books for a one-year period, which brings us within the same empirical domain as Levitt and Venkatesh’s (2000) study of the Black Knights in 1990s Chicago. Our study sways from the main premise that oriented the Black Knight’s case study—namely that performance within the illegal drug distribution structure was directly tied to that organization’s rigid hierarchical structure. While the Hells Angels can be analyzed as a corporation, this does not mean that Hells Angels members are, by definition, at an advantage because of their organizational status in the illegal drug distribution setting in which some members are active. What our findings indicate is that a participant’s ability to adapt to market dynamics and take on a core network position within an illegal drug market (cocaine, in this study) matter most. Overall, we demonstrate that: 1) Quebec’s cocaine market was structured primarily around traditional market forces; 2) the transaction network around the Hells Angels was not centralized around a single person or small group of people; 3) Hells Angels members were not the most active participants; and 4) being a Hells Angels member did not increase one’s volume of transactions within the network—quite differently, core network positioning did.     

Why do drug treatment organizations use contingent staffing arrangements? An analysis of market and social influences

Contingent staffing arrangements are defined as conditional and transitory work arrangements. In the drug abuse treatment sector, contingent staffing arrangements have the potential to improve treatment if they are used to increase access to needed services. Alternatively, such arrangements could interfere with the development of consistent, long-term client-staff relationships. Unfortunately, little is known about the consequences of or influences on contingent staff arrangements in this sector. The goal of this study is to examine the conditions under which outpatient substance abuse treatment organizations are more likely to use contingent staffing arrangements. Building on previous research on the social organization of health care structures and practices, we develop a conceptual model based in market economics and institutional perspectives to suggest that treatment organizations choose contingent arrangements in response to market conditions and uncertainty, institutional demands, and client needs. Using data from a nationally representative study conducted in 1988, 1990, and 1995, we find limited evidence that drug treatment units use contingent staff in response to market pressures. Labor market and demand uncertainty, however, are systematically associated with greater use of contingent staff. Study results suggest that expectations and norms from the institutional environment, particularly the organizational context of the treatment unit are strong predictors of the use of contingent staff. By considering both market and social influences of contingent staffing, we contribute to a growing body of research on how markets and institutions interact to influence organizational structures and practices in the health care system.     

Past and new victimization among African American female drug users who participated in an HIV risk‐reduction intervention

This study examined to what extent a culturally and women‐specific sexual risk reduction intervention resulted in a decline of new victimization. Additionally, we sought to identify factors associated with new victimization, defined as victimization during the 6 months after enrollment in the study. Female African American drug users (N = 333, ages 18–59 years) completed questionnaires. Past victimization was a major predictor of new victimization. The likelihood of new victimization, however, declined significantly when compared to past victimization. Factors associated with victimization included enhanced intervention assignment, frequency of drug use, and lifestyle factors such as criminal behavior, drug use in a public setting, and living in an unstable situation. Results indicate the need to incorporate strategies to reduce victimization in HIV/AIDS and other health‐related prevention and intervention programs.     

Participants’ views on the strengths and limitations of drug court: Recommendations to enhance assessment and treatment of mental illnesses

ABSTRACT

Since 1989, drug courts have provided an alternative to incarceration for arrestees who have a substance use disorder. Previous research has suggested that participants who graduate from the program are less likely to recidivate than those who are terminated from the program. The majority of research on drug courts is quantitative; therefore, the benefits of qualitative methods are not fully seen in the literature. This qualitative study developed an in-depth understanding of participants’ (n = 42) views on the strengths and limitations of a Midwestern drug court. Two themes emerged from the data. First, participants felt that the drug court promoted camaraderie, which enhanced their motivation for change and supported them in graduating from the program. Second, participants felt that the drug court did not adequately treat their mental illnesses, which for some resulted in relapse and was perceived as a barrier to graduating from the program. Recommendations for drug court practice are discussed.     

Hidden dangers among circuit parties—A systematic review of HIV prevalence,sexual behaviors and drug abuse during the biggest gay events

ABSTRACT

Circuit parties (CP) are extended celebrations, lasting from a day to a week, primarily attended by gay and bisexual men in their thirties and forties. The increasing popularity of circuit parties may play a significant role in the epidemiology of HIV and other sexually transmitted diseases. We performed a systematic literature search in MEDLINE, without any temporal limit, using the term “circuit party”. Only articles reporting cross-sectional studies were analyzed. Ten articles, published in the period from 2001 to 2015 were included in our systematic review and reported data on samples ranging from 173 to 13,883 gay/bisexual men. The HIV prevalence among men who attended the CPs was very high, ranging from 6% to 40.8%. Sexual risk behaviors (e.g. unsafe sex or multiple partners) and drug use were particularly frequent. It wo'uld be useful to promote efficient strategies with the cooperation of party planners, catching the participants before nightlife activities in order to prevent HIV transmission and the use of recreational drugs.     

Chain reactions in adolescents’ cigarette,alcohol and drug use: similarity through peer influence or the patterning of ties in peer networks?

Similarity in substance use among adolescents and their peers is usually attributed to peer influence or, occasionally, to either peer influence or selection. This paper suggests that similarity is due to both peer influence and selection. For some adolescents, peer influence outside the chain occurs first and selection follows; for others, selection occurs first and peer influence within the chain follows. Whichever occurs first, all adolescents are selected and nearly all are influenced. Peer networks contribute to similarity by providing a pattern of peer ties in which peer influence can flourish. Chain reactions result from the pattern and peer influence.