The Effects of State Alcohol and Pregnancy Policies on Women’s Health and Healthy Pregnancies

US states have enacted a wide range of laws to address health challenges associated with alcohol use during pregnancy. Some have taken punitive approaches that restrain women’s behavior, and some have taken supportive approaches aimed at improving women’s health and supporting healthy pregnancies. In this article we report on a study of implementation of supportive and punitive policies when both types of policies operate simultaneously in the same jurisdiction. Effects of mixed use laws on multiple stakeholder groups, especially pregnant and postpartum women, are studied. We conclude by identifying how our findings can be extended for future comparative state research.     

A cross-country comparison of alcohol,tobacco, and marijuana use among youth who are employed,in school or out of the labor force and school (OLFS)

Labor force and school attachment may influence alcohol, tobacco, and marijuana use in the US and Canada. Differences in social welfare provision, which provide protections for individuals with insecure attachments to the labor force or education, may in turn impact the behavior and health of youth in these countries. Yet, there is little research to understand the health consequences for youth of being out of the labor force and school (OLFS). Data of 25–29 year old participants of the National Longitudinal Survey of Youth (year 2010) and the Canadian Community Health Survey (2009–2010) were used to examine differences in substance use by labor force and school attachment. Logistic regression suggests that OLFS in the US and Canada were less likely to report alcohol uptake and more likely to use tobacco compared to employed youth. Unemployment was differentially associated with substance use behaviors by country. Country of residence and subsequent exposure to social welfare policy does not appear to impact substance use behaviors among OLFS. However, associations of unemployment and gender by country indicates differences in substance use behavior. More research should seek to understand factors that influence alcohol, tobacco, and marijuana use among OLFS and unemployed youth.     

Provider Preparedness for Treatment of Co-occurring Disorders: Comparison of Social Workers and Alcohol and Drug Counselors

Substance use and mental health disorders remain significant behavioral health concerns in the United States and other Western nations. Nearly half of the 20.3 million adults with substance use disorders in the US have a co-occurring mental illness . Despite growing research support, integrated treatment by providers with expertise in both mental health and substance use is critically lacking. As part of a co-occurring disorders (COD) training initiative in the USA, this study investigated providers' (n = 438) past training, current COD service provision, and future training needs. Specifically, we examined the extent to which social workers were prepared to treat individuals with COD compared to alcohol and drug counselors. Unsurprisingly, social workers reported receiving significantly more mental health related training, while alcohol and drug counselors reported more substance use related training. Alcohol and drug counselors reported significantly more COD-specific training including general COD, psychopharmacology, COD treatment, and relapse prevention. Social workers were significantly more likely than alcohol and drug counselors to report wanting more training in substance use disorders and culturally-specific intervention techniques. These findings suggest that tailored training and licensure changes are needed to enhance social workers' capacity for competent COD treatment.     

Binge Drinking Among Undergraduate College Students in the United States: Implications for Other Substance Use

Abstract

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report “ever” using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.     

Binge drinking among undergraduate college students in the United States: implications for other substance use

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report "ever" using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.     

Comparing the effectiveness of behavioral interventions in adults with co-occurring tobacco and substance use disorders: a systematic review of literature

ABSTRACT

This systematic literature review compares the e?ectiveness of various behavioral interventions delivered to persons with co-occurring tobacco and substance use disorders. It examines ?ndings of six randomized trials and three secondary analyses from randomized trials. Based on the ?ndings of this literature review, support is given to the following: (1) The consequences of tobacco use and smoking are deadly, costly, and can have an inhibitory e?ect on the progress of people in substance abuse treatment, (2) tobacco cessation options are a preventive intervention that can be easily incorporated into a treatment facility’s standard of practice and should be made available within the context of all substance abuse treatment facilities, and (3) concurrently treating tobacco use disorder and substance use disorder(s) is an e?ort that will help meet the social work profession’s Grand Challenge to ‘Close the Health Gap.’     

Substance Use Training Experiences and Needs: Findings From a National Survey of Social Care Professionals in England

For more than 30 years there have been calls in the UK to improve training for social workers in relation to substance use. Yet very little research has explored what training practitioners have received or what their training needs are. This study sought to establish practitioners' experiences of previous training in substance use and identify their current training needs. An online survey was disseminated to 3,164 practitioners in adults' (AS) and children's (CS) social care and 12 vignette-based focus groups were also held. Of the final sample of 597, more than a third of social workers had not received any training and a further fifth only received between one and four hours. Other social care staff fared worse. Overwhelmingly, respondents said that substance use knowledge and skills were very important to their practice but their professional education had not prepared them well. They identified a number of training needs including ‘how to talk to people about substance use’ and ‘the types of intervention and treatment available’. Most social care professionals report not being adequately prepared for working with substance use, particularly basic knowledge and skills which would help them to conduct assessments and signpost people to specialist substance services.     

Trafficking in Humans: The TIP Report

Human trafficking occurs throughout the world and is considered to be ‘modern day slavery’. To end such victimization, the United States began to take an aggressive stance against human trafficking by enacting the Trafficking Victims Protection Act (TVPA) in 2000. Pursuant to the TVPA, the US government has attempted to assess the nature and extent of human trafficking. Since 2001, the US Department of State has compiled data on various forms of international human trafficking and published an annual Trafficking in Persons (TIP) report. Within the report, countries are designated as Tier 1, Tier 2, Tier 2 Watch List, or Tier 3 depending upon whether they are taking active measures articulated in the TVPA to create strong laws, assist victims, and punish traffickers. Until this past year, 2010, the United States did not include itself within the report. Such an omission enabled other nations to challenge the objectivity of the tiered system. In June 2010, for the first time, the TIP Report included the United States in its analysis. This paper will review the positive and negative aspects of the TIP Report and indicate what the potential impact of the US’s self‐analysis could be on future efforts to end worldwide human trafficking.     

‘..It takes a lot of brain space’: Understanding young carers’ lives in England and the implications for policy and practice to reduce inappropriate and excessive care work

This qualitative study, undertaken in England, explored young carers’ perspectives on the nature of their caring responsibilities. The findings are significant, particularly in the context of England's Care Act 2014, which seeks to prevent children engaging in ‘excessive’ or ‘inappropriate’ caring. Our research placed children at the heart of the debate on what constitutes appropriate care. The findings raise key questions regarding effective implementation of contemporary child policy, duties of care towards children in caring roles and priorities for child protection and family support policy and practices, with the potential to inform thinking around child's well-being in wider contexts.     

THE CONSTITUTIONAL CONTEXT: UNIVERSITIES, NEW INFORMATION TECHNOLOGIES AND THE US SUPREME COURT

The legal context in which universities operate is among the forces shaping the ways in which new information technologies are taken up and used. In the USA, constitutional law - that law which addresses how society is to be structured and what types of processes should be permitted within it - is particularly important in determining what institutions can do. The ultimate arbiter of constitutional law is the US Supreme Court, the decisions of which establish basic principles for the US legal system. This article reviews the entire body of US Supreme Court decisions that deal with higher education and mines them for their implications for the use of new information technologies by universities.     

Social Norms of Alcohol,Smoking, and Marijuana Use Within a Canadian University Setting

Abstract

Objective: To study actual and perceived substance use in Canadian university students and to compare these rates with US peers. Participants: Students (N = 1,203) from a large Canadian university. Methods: Participants were surveyed using items from the National College Health (NCHA) Assessment of the American College Health Association questionnaire. Results: Alcohol was the most common substance used (65.8%), followed by marijuana (13.5%) and cigarettes (13.5%). Substance use and norms were significantly less than the NCHA US data. Overall, respondents generally perceived the typical Canadian student to have used all 3 substances. Perceived norms significantly predicted use, with students more likely to use alcohol, cigarettes, or marijuana if they perceived the typical student to use these substances. Conclusions: Similar to their US peers, Canadian university students have inaccurate perceptions of peer substance use. These misperceptions may have potentially negative influences on actual substance use and could be a target for intervention. Further research examining the cross-cultural differences for substance abuse is warranted.     

Preparing social workers for practice with LGBT populations affected by substance use: perceptions from students,alumni, and service providers

Trends in the field of service among those with alcohol and other drug addictions highlight the urgent need for schools of social work to effectively train students to serve clients with substance use disorders, and have cultural humility to effectively serve disproportionately affected LGBT consumers. Online surveys and interviews examined perceptions of graduate social work students and alumni in a certified alcohol and drug counselor program, along with several service providers within an urban setting in the US. Results indicated that students and alumni did not feel adequately prepared through coursework to practice with LGBT populations affected by substance use, while feeling more clinically competent to practice with LGB individuals, than with transgender consumers. Similar findings related to unique differences associated with perceptions of faculty support, along with field preparedness to practice with LGB individuals when compared to transgender individuals. Service providers noted an overall commitment and to serve LGBT consumers as well as positive perceptions of students and alumni to do the same. Implications examine the role of faculty in addressing challenges related to preparation of social work students to practice with LGBT consumers affected by substance use disorders, along with suggestions for curricular changes, and ongoing field trainings.     

Linking Self‐Regulation and Risk Proneness to Risky Sexual Behavior: Pathways through Peer Pressure and Early Substance Use

The linkages between self‐regulation in childhood, risk proneness in early adolescence, and risky sexual behavior in mid‐adolescence were examined in a cohort of children (N=518) from the National Longitudinal Survey of Youth. The possible mediating role of two early adolescent variables (substance use and negative peer pressure) was also examined. Self‐regulation was assessed by maternal report at ages 8–9, and risk proneness, comprising aspects of sensation seeking and decision making, was assessed by adolescent self‐report at ages 12–13. Structural equation models predicting risky sexual behavior at ages 16–17 indicated that self‐regulation operated partly through early adolescent substance use, whereas risk proneness operated through early adolescent substance use and negative peer pressure. The overall model did not differ significantly for boys and girls, although there were gender differences in the strength of particular paths. These long‐term longitudinal results support the importance of early self‐regulation and risk proneness in setting the stage for adolescent sexual risk taking and implicate substance use and negative peer pressure as processes through which risk proneness and poor self‐regulation lead to risky sexual behavior.     

Taste clusters of music and drugs: evidence from three analytic levels

This article examines taste clusters of musical preferences and substance use among adolescents and young adults. Three analytic levels are considered: fixed effects analyses of aggregate listening patterns and substance use in US radio markets, logistic regressions of individual genre preferences and drug use from a nationally representative survey of US youth, and arrest and seizure data from a large American concert venue. A consistent picture emerges from all three levels: rock music is positively associated with substance use, with some substance‐specific variability across rock sub‐genres. Hip hop music is also associated with higher use, while pop and religious music are associated with lower use. These results are robust to fixed effects models that account for changes over time in radio markets, a comprehensive battery of controls in the individual‐level survey, and concert data establishing the co‐occurrence of substance use and music listening in the same place and time. The results affirm a rich tradition of qualitative and experimental studies, demonstrating how symbolic boundaries are simultaneously drawn around music and drugs.     

Sex differences in psychosocial consequences of alcohol and drug abuse

This paper reports analyses of the 1985 National Household Survey on Drug Abuse to evaluate three perspectives on sex differences in the relationship of psychosocial problems to levels of substance use. The results are more consistent with a styles of deviance perspective than with either the generalized feminine vulnerability or the convergence theses. Compared to women, men report higher levels of alcohol and drug abuse during the past year and are more likely than women to have experienced each of 17 psychosocial problems resulting from alcohol or drug use. Significant sex by substance use interaction tests for problem indices and for individual problems suggest that substance abuse is related more strongly to intrapsychic problems among women and to problems in social functioning among men. Decompositions of the sex differences in mean levels of psychological and social/behavioral problems suggest that most of the differences can be explained by males' greater frequency of intoxication and drug use.     

Posttreatment 12-Step Program Affiliation and Dropout: Theoretical Model and Qualitative Exploration

ABSTRACT

Treatment outcome research has repeatedly demonstrated that involvement in twelve-step (TS) programs (e.g., Alcoholics Anonymous or Narcotics Anonymous) following treatment is associated with improved substance use outcomes. Treatment providers widely encourage TS program attendance during treatment and for aftercare; yet, evidence suggests that minimal and sporadic attendance or complete dropout is the more common occurrence. Providers would benefit from knowledge that would contribute to a greater understanding of factors that influence posttreatment TS program affiliation or dropout to guide treatment strategies. This article reviews the literature on TS affiliation, advances theory and a model to explain affiliation, and reports findings from a qualitative research study focused on understanding what people in TS facilitative treatment report as good (the pros) and not so good (the cons) about TS program involvement. Results suggest that unresolved ambivalence as well as socio-cultural barriers to support contribute to poor TS program utilization.     

Campus attitudes toward alcohol and drugs in a deep southern university.

In our zeal to deal with alcohol and drug abuse, we may have a distorted picture of what the majority of college students actually think about alcohol and drug use. Students in this study done at a public university located in the Deep South report being generally intolerant of substance abuse.     

Using census data to study elderly migration: problems and possibilities

Although the elderly are the fastest growing of all age groups in developed countries, their migration remains little studied. Elderly migration differs in several fundamental ways from that of other age groups, but many of the data collection and analysis procedures, as well as basic concepts used in censuses, have been developed with the working population in mind and are of limited utility in studying elderly migration. This article discusses some of the problems using census data to identify movers among the elderly population, and to analyze the characteristics of movers and the causes of migration. The author concludes that it is clear that what is needed with respect to census data on elderly migration is not necessarily new questions to be included. Instead, more appropriate decisions need to be made at the stages of deciding what variables to code and what categories are to be included. In addition, at the stage of determining tabulation programs there needs to be greater sensitivity to finer age breakdowns among elderly migrants and to the selection of cross-tabulation variables which are more relevant to issues and problems of the aged. Hugo suggests that an authoritative agency convene a working group to establish guidelines which address the following issues. 1) What are appropriate age breakdowns? 2) What are appropriate variables for detailed cross-tabulations? 3) Exactly what is an appropriate form for migration data to be prepared for multi-regional analysis? 4) What is the most appropriate way of formatting public use sample tapes to make analyses for assisting in the study of elderly migration? 5) How should the institutional population among the aged be dealt with? Another recommendation which arises out of the issues raised here is that, analysts should give a clear indication of what movers are actually missed by census data and which types of movers are included. Awareness of the limitations of particular data sources is of critical significance to meaningful interpretation of results if one is seeking a better understanding of the causes and consequences of important social phenomena.