Substance use/abuse as a predictor to illegal and violent behavior: A review of the relevant literature

The preponderance of the research evidence supports the conclusion that abuse of certain types of illicit drugs, separately from the abuse of alcohol, predisposes to subsequent violent behavior. The relationship of cocaine/crack to violent crime has been established more clearly for users of crack in inner city areas than it has for those who are users of other forms of cocaine in the general population.In regard to any race/ethnic or socioeconomic factors in the relationships between substance use/abuse and violent behavior, most clearly established is that a higher proportion of young Black males, compared to other race/ethnic groups, are actively involved in dealing cocaine/crack in some inner city poverty areas.As for gender differences, the research evidence indicates that alcohol abuse as a predictor to and a precipitant of violent behavior, is more clearly established for males than for females. Drug abuse, as distinct from alcohol abuse, has been found to predict subsequent violent behavior, for females as well as for males. “Co-morbidity,” the combination of substance use with and psychopathology, appears more likely to predict for females to later violent behavior. Psychopathology and mental health problems are less likely to predict occurrence of either violent or criminal behavior in the future than are either alcohol abuse or drug abuse.     

Risk factors of attempted suicide in bipolar disorder

Suicide rates of bipolar patients are among the highest of any psychiatric disorder, and improved identification of risk factors for attempted and completed suicide translates into improved clinical outcome. Factors that may be predictive of suicidality in an exclusively bipolar population are examined. White race, family suicide history, and history of cocaine abuse were predictive of suicidal histories. Gender, nicotine use, medical comorbidity, and history of alcohol and other drug abuse were not, although a trend was noted for a history of benzodiazepine abuse. Attempts, although less common among African Americans, were equally as violent. Likewise, attempts were as violent among females as males, in distinction to general population studies.     

Substance use and violent behavior in women with antisocial personality disorder

The purpose of this study was to examine the relationship between substance abuse and dependence and violent behavior in a sample of incarcerated women with antisocial personality disorder (ASPD). Among male populations, substance dependence is associated with aggression and criminal behavior. Individuals with ASPD have more severe substance dependence, including higher symptom counts, earlier age of onset, and more frequent co-morbidity. Incarcerated women have a high prevalence of ASPD and substance dependence, but there has been little detailed work regarding addiction severity. Similarly, work on association of substance abuse and dependence with specific violent behaviors has been limited. This study examined a group of 41 mid-sentence female felons with a diagnosis of ASPD to determine associations with substance abuse and dependence. Data were gathered through administration of the Semi-Structured Assessment of the Genetics of Alcoholism II (SSAGA II). Substance dependence was highly prevalent (i.e., alcohol dependence, 56.1%; opiate dependence, 48.8%; cocaine dependence, 61.0%). While specific diagnoses were not associated with violent behavior and offending, symptom severity (i.e., age of onset, symptom count, co-morbidity) was associated with violent behavior in women dependent on opiates, alcohol, and cocaine. Arrest for an assault 1 was associated with alcohol dependence and opiate dependence. These data suggest that measurement of symptom severity and co-morbidity is important in assessing violent behavior in incarcerated women with ASPD. These findings are potentially important in examining non-incarcerated, substance-dependent women.     

Treatment Populations,Services, and Outcomes for Cocaine and Crack-Cocaine Dependence

This paper analyzes demographic and other pretreatment characteristics, measures of treatment services received, and treatment outcomes of participantsin the National Treatment Improvement Evaluation Study (NTIES), a large-scale longitudinal study of substance abuse treatment (D. R. Gerstein et al., 1997; R. A. Johnson & D. R. Gerstein, 2000). The focus here is those treated primarily for cocaine powder or crack-cocaine dependence, compared with those in treatment for other substances, particularly heroin. Crack-dependent users tend to be female and black, older than primary marijuana or alcohol users but younger than those in treatment for heroin. Primary cocaine powder or crack users are likely to have entered treatment under pressure from the criminal justice system. After treatment there are substantial reductions in use of cocaine powder and crack, especially among participants with fewer prior treatment episodes and lower pretreatment intensity of use. Longer duration and intensity of treatment result in greater reductions in cocaine and crack use.     

Statistical Effects of Religious Participation and Marriage on Substance Use and Abuse in Racial and Ethnic Minorities

Substance use and abuse, which includes alcohol use, alcohol dependence, drug use, and drug dependence, inflicts a substantial toll on Americans. Although studies have demonstrated the protective effect of social support, such as religious participation and via marriage, understanding their influence on racial and ethnic minorities is limited. Thus, the aim of this study is to assess the impact of social support on substance use and abuse in racial and ethnic minorities. The Collaborative Psychiatric Epidemiology Surveys, sponsored by the National Institute of Mental Health, a repository of race, ethnicity, and mental health data, was leveraged to develop four models using multivariate analysis, specifically logistic regression to estimate the probability of meeting the criteria for substance use and abuse. Racial and ethnic minorities were found to have lower rates of substance use and abuse compared to Whites, and foreign-born individuals were consistently less likely to use or abuse substances compared to American-born minorities. Mental health conditions were highly associated with substance use and abuse, and social support by way of religious participation and marriage was protective against substance use and abuse. In racial and ethnic minorities, nativity and social support were protective against substance use and abuse; however, these protective factors did not completely eliminate risk. Thus, although race and ethnicity are important to understanding health outcomes and health behaviors, such as substance use and abuse, it is the intersection of multiple factors, representing internal and external forces, which may be more informative and offer a more comprehensive picture of the landscape influencing drug and alcohol use and dependence. Targeted interventions should consider leveraging religious spaces and bilingual materials when attempting to reach racial and ethnic minorities.     

The role of delay of gratification,substance abuse,and violent behavior on academic achievement of disciplinary alternative middle school students

Disciplinary alternative education programs are academic environments where students are detained for 45 days by the county or court for delinquent and/or deviant behavior in their traditional schools. This study examined individual differences in academic performance, violence, willingness to delay gratification, and substance abuse of 391 students enrolled in a disciplinary alternative middle school program. Results revealed that students who reported a high propensity to delay gratification and low tendencies towards violent behavior and substance abuse obtained high math scores on the state standardized test. In addition, the negative association between violent behavior on math scores was attenuated by race/ethnicity status. Socio-economic status was not significantly associated with math test scores. Implications for further studies and educational implications are discussed.     

The prevalence of suicidal behaviors among Northern Plains American Indians

This study examined the prevalence of suicidal behaviors among 1,638 Northern Plains American Indians ages 15-57. Age and gender patterns were investigated as was comorbidity with psychiatric and substance use disorders. Data from a population-based survey indicated that suicidal behaviors were more frequently reported among females than males and among younger respondents than older respondents. In addition, suicidal behaviors were associated with depressive disorders, PTSD, substance abuse/dependence, and violent ideation/aggression. Results underscore the importance of effective and acceptable alcohol, drug, and mental health services in reducing the rates of suicidal behaviors in American Indian communities.     

gendered pathways into and experiences within crack cultures outside of the inner city

This study examines the life histories of male and female crack addicts outside of the inner city context, focusing on gendered variation in experiences related to childhood background, pathways into crack cocaine use, income generation strategies, and violence. We offer insight into the nature of crack use and culture outside of the inner city and question the generalizability of previous studies to communities outside of the inner city. Furthermore, the question of women's emancipation and the subsequent impact this has had on their roles and experiences within crack cultures is addressed through comparison of male and female experiences within crack cultures. Lastly, the issue of how race, class, and gender interact to shape the experiences of crack addicts is tentatively explored.     

Racial Discrimination and Racial Identity as Risk or Protective Factors for Violent Behaviors in African American Young Adults

This study examined the influences of racial discrimination and different racial identity attitudes on engaging in violent behavior among 325 African American young adults. The contributions of racial discrimination and racial identity attitudes in explaining violent behavior during the transition into young adulthood while controlling for the influences of prior risk behaviors at ninth grade were examined separately for males and females. In addition, the buffering effects of racial identity attitudes on the relationship between racial discrimination and violent behavior were tested. Results indicated that experience with racial discrimination was a strong predictor of violent behavior, regardless of gender. The centrality of race for males and the meaning others attribute to being Black for both males and females were moderators of the influence of racial discrimination on violent behavior.     

Prediction of drug and alcohol abuse in hospitalized adolescents: comparisons by gender and substance type

The authors examined psychosocial correlates of drug and alcohol abuse in 462 hospitalized adolescents, and the extent to which these associations may be affected by gender or by substance type. Participants completed a battery of psychometrically-sound, self-report measures of psychological functioning, environmental stress, drug abuse, and alcohol abuse. Four multiple regression analyses were conducted to determine the joint and independent predictors of drug abuse and alcohol abuse, for males and for females. Multiple regression analysis revealed that seven variables--age, depression, impulsivity, low self-esteem, delinquent predisposition, low peer insecurity, and history of child abuse--jointly predicted both drug and alcohol abuse, for both males and females. However, several differences were found with respect to which variables made independent contributions to the predictive models--with only delinquent predisposition making a significant independent contribution for all four conditions. We found distinct patterns of psychosocial predictor variables for drug and alcohol abuse, as well as distinct patterns for males and females. These results may reflect differing risk factors for drug abuse and alcohol abuse in adolescent psychiatric patients--and differing risk factors for males and females. Such differences have potential implications for prevention and treatment.     

Substance abuse and violence: A review of the literature

Most alcohol and drug use occurs among persons who are not violent. However, alcohol and, to a lesser extent, illicit drugs are present in both offenders and victims in many violent events. The links between psychoactive substances and violence involve broad social and economic forces, the settings in which people obtain and consume the substance, and the biological processes that underlie all human behavior. In the case of alcohol, evidence from laboratory and empirical studies support the possibility of a causal role in violent behavior. Similarly, the psychopharmacodynamics of stimulants, such as amphetamines and cocaine, also suggest that these substances could play a contributing role in violent behavior. On the other hand, most real-world studies indicate that this relationship is exceedingly complex and moderated by a host of factors in the individual and the environment. In addition to psychopharmacological effects, substance use may lead to violence through social processes such as drug distribution systems (systemic violence) and violence used to obtain drugs or money for drugs (economic compulsive violence).     

The association between heroin use and anxiety sensitivity among inner-city individuals in residential drug use treatment

The current study represents an initial investigation of the association between heroin use and anxiety sensitivity (AS). Within a sample of 172 inner-city treatment seeking drug users, AS was compared across past year (1) heroin users with no crack/cocaine use (n=12); (2) crack/cocaine users with no heroin use (n=66); (3) users of both heroin and crack/cocaine (n=45); and (4) individuals with no use of heroin or crack/cocaine (n=49). Consistent with expectations, primary heroin users evidenced higher levels of AS than all other groups, with these differences also evidenced for the physical and social subscales. Differences in AS total score and physical subscale score persisted after controlling for demographic variables, depressive symptoms, and primary use of drugs other than heroin and crack/cocaine including alcohol, nicotine, marijuana, and hallucinogens. Findings suggest a unique relationship between AS and heroin, and set the stage for future work explicating the direction of the observed association.     

Exploration of the prevalence and correlates of substance use among sheltered adolescents in South Korea

Substance use among sheltered adolescents is very serious in South Korea--a nation in the process of rapid industrialization and urbanization. However, few studies have investigated substance use among the adolescents which is a growing concern of the changing society of this nation. This study examined the prevalence of substance use and explored risk factors that predict substance abuse by sheltered adolescents. Through a questionnaire survey of sheltered adolescents, data on substance use and the risk factors were collected. The sample of the adolescents included 44 (33.3%) males and 88 (67.2%) females; their mean age was 15.8 years (SD = 1.62). The results of a logistic regression analysis showed that alcohol expectancy, physical abuse, and peer pressure were all statistically significantly associated with substance abuse. Findings on the critical issues are expected to lead to the development of urgently needed prevention programs for the high-risk adolescents in South Korea.     

Gender differences in the psychosocial correlates of suicidal ideation among adolescents.

Gender differences in the psychosocial correlates of suicidal ideation were studied. A sample of 613 high school students (ages 14-19) completed measures of suicidal ideation, depression, hopelessness, life stress, loneliness, alcohol and drug use, and reasons for living. The results of a discriminant function analysis indicated that males reported higher loneliness and substance abuse scores than females whereas females reported greater suicidal ideation, depression, and reasons for living. The results of multiple regression analyses found that, although the same four variables, depression, hopelessness, substance abuse, and few reasons for living emerged as significant predictors of suicidal ideation in both samples, the predictive equation accounted for more of the variance in ideation scores in females (57%) than in males (46%). In a final analysis a discriminant function analysis of the subscales of the reasons for living inventory revealed that females have a greater fear of death and injury whereas males have a greater fear of social disapproval over having suicidal thoughts. This may account for the greater rate of suicide completing among males. Fear of social disapproval, more anger and impulsivity, and less help-seeking behavior among males are offered as potential variables to explain the observed gender differences.     

Substance use and abuse among children and teenagers

During the past several years, there has been a renewed national concern about drug abuse, culminating in the current "war on drugs." In this review, we emphasize that even though child or teenage drug use is an individual behavior, it is embedded in a sociocultural context that strongly determines its character and manifestations. Our focus is on psychoactive substances both licit (cigarettes and alcohol) and illicit (e.g., cannabis and cocaine). We feel that it is critical to draw a distinction between use and abuse of drugs and to do so from a multidimensional perspective that includes aspects of the stimulus (drug), organism (individual), response, and consequences. Our selective review of substance use and abuse among children and adolescents covers epidemiology (patterns and extent of drug use), etiology (what generates substance use), prevention (how to limit drug use), treatment (interventions with drug users), and consequences (effects and outcomes of youthful drug use).     

Violent offenses associated with co‐occurring substance use and mental health problems: Evidence from CJDATS

The present study examines the relationship between substance use, mental health problems, and violence in a sample of offenders released from prison and referred to substance abuse treatment programs. Data from 34 sites (n = 1,349) in a federally funded cooperative, the Criminal Justice Drug Abuse Treatment Studies (CJDATS), were analyzed. Among parolees referred to substance abuse treatment, self‐reports for the six‐month period before the arrest resulting in their incarceration revealed frequent problems with both substance use and mental health. For most offenders with substance use problems, the quantity of alcohol consumed and the frequency of drug use were associated with a greater probability of self‐reported violence. Mental health problems were not indicative of increases in violent behavior, with the exception of antisocial personality problems, which were associated with violence. The paper emphasizes the importance of providing substance abuse treatment in relation to violent behavior among offenders with mental health problems being discharged to the community. Copyright © 2009 John Wiley & Sons, Ltd.     

Substance use patterns of young offenders and violent crime

The use of alcohol is a significant predictor of the involvement of young offenders in violent crime. This study found that in a sample of 300 incarcerated juveniles in New South Wales, more than 70% admitted to violent crime. Detainees from an Aboriginal or Torres Strait Islander culture were less likely than other detainees to be involved in violent crime. The substances most associated with violent crime were alcohol, followed by cocaine. However, when the likelihood that the young person has initiated violence as a response to alcohol or other substances is introduced into the equation, the direct effects for alcohol and cocaine predicting engagement in violent crime disappear. The Goldstein hypothesis that the effects of a substance directly facilitate violence, thereby accounting for the relationship between substances of use and violent crime, was supported. Aggr. Behav. 29:414–422, 2003. © 2003 Wiley‐Liss, Inc.     

Is there a Relationship between Family Structure and Substance Use among Public Middle School Students?

We investigated the relationship between family structure and substance use in a sample of 2,138 public middle school students in a southern state. The CDC Middle School Youth Risk Behavior Survey was utilized and adjusted logistic regression models were created separately for four race/gender categories (African American females/males, and Caucasian females/males) to examine associations among selected drug use variables (tobacco, alcohol, marijuana and inhalants). Analyses were adjusted for social economic status. Results suggested differences (p ≤ .05) among race/gender groups for the protective effect of living in an intact family (both mother and father, real or adoptive) regarding substance use among middle school students. In addition, family structure appeared to have a stronger relationship with substance use for Caucasians as opposed to African American adolescents. Caucasian adolescents living in cohabitated family households were more likely to report substance use, when compared to those living in intact two-parent households. Adolescents who are undergoing parental divorce may need special attention as they transition into new family structures.     

Physical Abuse Victimization and Violence in the Transition to Adulthood: The Mediating Role of Alcohol and Drug Use

In the present paper we examine the association between physical abuse victimization in childhood and violent criminal behavior in the transition from adolescence to adulthood (TAA). Of central interest is whether that association is indirect, through the impact of abuse victimization on alcohol and drug use. We employ a statistical test for indirect effects, using a design that also applies Savage and Wozniak’s (2016) “differential etiology of violence” standard. The data suggest that the effect of physical abuse on violence in the TAA is partially indirect, mediated by alcohol and drug use. A control for nonviolent offending is applied to build confidence that the dynamic between abuse victimization and substance use is a differential predictor of violence.     

Ethnic Identity and Substance Use Among Mexican-Heritage Preadolescents: Moderator Effects of Gender and Time in the United States

This study examined interactive relationships among ethnic identity, gender, time in the US, and changes in substance use outcomes among a school-based sample of 1,731 Mexican-heritage preadolescents (ages 9-13). Residual change multilevel models adjusting for school clustering and using multiply imputed data assessed changes from beginning to end of fifth grade in use of alcohol, cigarettes, marijuana and inhalants, and four substance use antecedents. Effects of ethnic identity were conditional on time in the US, and in opposite directions by gender. Among males living longer in the US, stronger ethnic identity predicted desirable changes in all but one outcome (substance offers). Among females living longer in the US, stronger ethnic identity predicted undesirable changes in alcohol use, pro-drug norms, and peer substance use. Interpretations focus on differential exposure to substance use opportunities and the erosion of traditional gender role socialization among Mexican-heritage youth having lived longer in the US.