Substance Abuse in Middle Eastern Adolescents Living in Two Different Countries: Spiritual,Cultural, Family and Personal Factors

It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the USA and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the USA increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.     

The development of the Short Muslim Practice and Belief Scale

The majority of the measures of religious practice and belief found in the literature are for persons of the Christian faith; such measures for Muslims are scarce. As examining the role of religion in relation to alcohol consumption is difficult because of the lack of appropriate measures, in the current study, a brief measure of practice and belief for persons of the Islamic faith was developed. Arab Muslims living the United Arab Emirates and Oman (n = 611) and Asian Muslims living in Malaysia and Indonesia (n = 303) were surveyed. The Short Muslim Practice and Belief scale (Short-MPBS) was subjected to exploratory factor analysis and confirmatory factor analysis. These analyses indicated a 9-item measure with a two-factor structure was a good fit of the data. Internal consistency (α = 0.83) and validity were good. Participants who scored higher on the measure were likely to be lifelong alcohol abstainers.     

Culture, trauma, and wellness: a comparison of heterosexual and lesbian, gay, bisexual, and two-spirit native americans

In a community-based sample of urban American Indian and Alaska Native adults, 25 lesbian, gay, bisexual, and two-spirit participants were compared with 154 heterosexual participants with respect to sociodemographic characteristics, Native, cultural participation, trauma, physical and mental health, and substance use. Compared with their heterosexual counterparts, two-spirit participants reported higher rates of childhood physical abuse and more historical trauma in their families, higher levels of psychological symptoms, and more mental health service utilization. Two-spirit participants reported differences in patterns of alcohol use and were more likely to have used illicit drugs other than marijuana. Discussion and recommendations for health promotion interventions and future research are presented in consideration of an "indigenist" health model and the multiple minority status of two-spirit people.     

A Systematic Review of the Relationship between High School Dropout and Substance Use

A systematic review of peer-reviewed, empirical literature published between 1990 and 2006 was undertaken to determine whether existing research could provide evidence, and a deeper understanding of the relationship between dropping out of high school and the use of substances such as tobacco, alcohol, cannabis/marijuana and other illicit drugs. Forty-six articles were reviewed. The review describes the heterogeneity of theoretical frameworks employed, as well as the limited ability of any one to adequately explain the relationship between high school dropout and substance use. A refinement of the many confounding and mediating variables into coherent conceptual categories would aid more robust theory building and theory integration. In spite of differences in dropout definitions and diverse measures of substance use across studies, the main findings point to a largely consistent relationship between dropping out of high school and substance use. However, socially disadvantaged and poor persons, dropouts, and drug users are over-represented in some of the loss to follow-up groups in longitudinal studies surveyed. More rigorous mechanisms to retain participants in longitudinal studies should be employed. Suggestions for future research include comparisons between urban and rural populations, employing qualitative research methods, and research in developing countries, which have the least favourable school outcomes and a dearth of research on high school dropout.

The Incidence of Incest Histories Among Clients Receiving Substance Abuse Treatment

Volunteer participants (N = 77) enrolled in eight substance abuse treatment facilities were surveyed in order to examine the prevalence and nature of incest contacts among the group. Results indicated that approximately 49% of the participants had reported histories of incest. Data are presented regarding the age during incest contact; frequency of contacts; and involvement of force, alcohol, and drugs. In addition, comparisons by gender are presented. Implications for substance abuse training and treatment are presented.     

Correlates of success following treatment for adolescent substance abuse

To date, little research is available examining the course and features of recovery from substance abuse following adolescent treatment. The current study evaluated the functioning of 142 teens for 2 years following treatment for substance abuse. Adolescent drug and alcohol outcome was examined in relation to functioning on five major life domains: academic involvement, interpersonal problems, emotional well-being, family relations, and social and occupational activities. Results of this investigation demonstrate that psychosocial functioning is associated with adolescent posttreatment drug and alcohol use. Teens who were abstinent and those with less substance use involvement generally displayed better functioning. The relationship between teen alcohol and drug use and improvement in functioning varied across psychosocial domains. Clinical implications of these findings are discussed along with advances in teen substance abuse research and treatment.     

Understanding the Lived Experience of Formerly Homeless Adults as They Transition to Supportive Housing

The researchers conducted in-depth interviews with formerly homeless adults who had moved to supportive housing to understand their perceived occupational needs and the factors that affected their transition. A qualitative research design with four participants who had a history of substance abuse and mental illness was used. Participant interviews that addressed categories of daily living and personal satisfaction produced data that were coded for analysis using conventional content analysis. Mega themes emerged that related to factors shaping the housing transition and maintenance experience. Occupational therapists can use these findings to create informed interventions to enhance this population's occupational performance.     

A behavioral approach to substance abuse prevention in the correctional setting: A preliminary report

This study evaluated the effectiveness of a substance abuse program in a correctional institution using social skills training for secondary prevention. Forty-four male inmates with a history of substance use participated in the pilot program. Program topics included drug, alcohol, and substance abuse treatment knowledge and development of anger and stress management skills. A pretest-posttest analysis revealed significant improvement in overall knowledge of program topics and within specific areas. Areas of greatest improvement were drugs and alcohol. Clients and group leaders reported that the program was effective in facilitating attitude and behavior change regarding substance abuse. Results suggest a social competence approach to substance abuse rehabilitation in correctional institutions holds promise for both increasing knowledge and teaching effective skills to resist future substance abuse.     

Structural,Metabolic, and Functional Brain Abnormalities as a Result of Prenatal Exposure to Drugs of Abuse: Evidence from Neuroimaging

Prenatal exposure to alcohol and stimulants negatively affects the developing trajectory of the central nervous system in many ways. Recent advances in neuroimaging methods have allowed researchers to study the structural, metabolic, and functional abnormalities resulting from prenatal exposure to drugs of abuse in living human subjects. Here we review the neuroimaging literature of prenatal exposure to alcohol, cocaine, and methamphetamine. Neuroimaging studies of prenatal alcohol exposure have reported differences in the structure and metabolism of many brain systems, including in frontal, parietal, and temporal regions, in the cerebellum and basal ganglia, as well as in the white matter tracts that connect these brain regions. Functional imaging studies have identified significant differences in brain activation related to various cognitive domains as a result of prenatal alcohol exposure. The published literature of prenatal exposure to cocaine and methamphetamine is much smaller, but evidence is beginning to emerge suggesting that exposure to stimulant drugs in utero may be particularly toxic to dopamine-rich basal ganglia regions. Although the interpretation of such findings is somewhat limited by the problem of polysubstance abuse and by the difficulty of obtaining precise exposure histories in retrospective studies, such investigations provide important insights into the effects of drugs of abuse on the structure, function, and metabolism of the developing human brain. These insights may ultimately help clinicians develop better diagnostic tools and devise appropriate therapeutic interventions to improve the condition of children with prenatal exposure to drugs of abuse.     

A review of substance use research among those with mental retardation

This article reviews research conducted on the cigarette, alcohol, and illicit drug use of adolescents and adults with mental retardation (MR). The majority of the research related to substance use conducted on this population has been limited to surveys. Overall, results of these studies suggest that, although substance use is slightly lower among those with MR than among nondisabled comparison groups, it is nonetheless a problem for many individuals. This research is reviewed and a discussion of both the general and specific flaws of these studies follows. Further, the examination of education, prevention, and treatment programs for this population has been overlooked, indicating that individuals with MR are likely not receiving the services most appropriate for them. The article concludes with a discussion of several topics that need to be addressed in future studies, including research on potential best practices in the overlooked areas of substance abuse interventions.     

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.     

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.     

Preventing substance abuse in American Indian and Alaska native youth: promising strategies for healthier communities

Substance abuse has had profoundly devastating effects on the health and well-being of American Indians and Alaska Natives. A wide variety of intervention methods has been used to prevent or stem the development of alcohol and drug problems in Indian youth, but there is little empirical research evaluating these efforts. This article is an overview of the published literature on substance use prevention among Indian adolescents, providing background epidemiological information, a review of programs developed specifically for Indian adolescents, and recommendations for the most promising prevention strategies currently in practice.     

Substance abuse and panic-related anxiety: a critical review

The relationship between substance abuse and panic-related anxiety can be divided into two broad areas: the incidence of anxiety disorders in substance abuse patients and the incidence of substance abuse in patients with panic-related anxiety disorders. Studies indicate that approx. 10-40% of alcoholics have a panic-related anxiety disorder, and about 10-20% of anxiety disorder patients abuse alcohol or other drugs. The majority of patients with both an anxiety and alcohol disorder report that anxiety problems preceded alcohol problems. In some cases substance abuse (e.g. cocaine) triggers the onset of panic attacks. Most patients believe that self-medication is efficacious despite the fact that they appear to have a more serious clinical condition (e.g. higher rates of depression). Directions for future research are outlined, including the proposal for a study to examine the effects of an anxiety intervention procedure for anxious alcoholics to reduce relapse rates.     

Peer Victimization and Substance Use in Early Adolescence: Influences of Deviant Peer Affiliation and Parental Knowledge

Being the target of peer victimization contributes to alcohol and cigarette use during early adolescence. This 1-year longitudinal study extended the current literature by investigating the potential links between peer victimization and alcohol and cigarette initiation among a sample of 723 youths recruited from three middle schools in Southern China. We proposed a moderated mediation model to examine whether peer victimization is indirectly related to substance use via deviant peer affiliation, and whether the strength of this mediation is moderated by the level of parental knowledge for both genders. All participants self-reported using questionnaires to assess peer victimization, deviant peer affiliation, parental knowledge, and substance use. The results revealed that peer victimization was indirectly associated with increased alcohol use via deviant peer affiliation for both genders. However, deviant peer affiliation mediated the impact of peer victimization on trying cigarettes for only boys. Moreover, parental knowledge acted as a protective role for increases in alcohol use for girls, but not for boys. These findings highlight the potential role of deviant peer affiliation to explain the relationship between peer victimization and substance use, and provide important implications for addressing the adverse consequences of peer victimization.     

Some gender differences in alcohol and polysubstance users

Within the past 20 years, public and professional attention has focused on the legitimacy of research and treatment of substance abuse in women as a "special population." Recent efforts, however, have not as yet closed the gap in knowledge about factors promoting or perpetuating alcohol and other substance use problems in women. Materials that are presented in this article were selected to provide a broad spectrum of information about biological, psychological, and sociocultural aspects of substance abuse as it affects women. Data reported include findings from several studies conducted in our laboratories that have examined these effects. Overall, the discussion summarizes past knowledge, reviews current findings, points to unanswered questions, and concludes with a series of research recommendations that emerge from empirical data.     

Domestic violence shelter residents' substance abuse treatment needs and options

The association between intimate partner aggression and alcohol and other substance use problems is well-established in the literature. However, the nature and scope of alcohol and other substance use problems in women who seek or are likely to seek domestic violence shelter services is difficult to ascertain. The first goal of the current review was to identify and synthesize the findings of studies in which alcohol and other substance use, problem use, or diagnoses in shelter residents was assessed. Despite methodological limitations, this body of studies provides compelling evidence that a substantial number of domestic violence shelter residents (22–72%) have current or past problems with alcohol or other substances and may benefit from treatment. The second goal of the current review was to provide an overview of the availability and limitations of options that are currently available to address domestic violence shelter residents' substance abuse treatment needs. Although substance abuse is a largely under-met need of women seeking domestic violence shelter, promising findings from model integrated treatment programs, as well as the knowledge gained through implementation of these programs provide useful future directions for addressing these co-occurring issues.     

WOMEN, HOMELESSNESS, AND SUBSTANCE ABUSE Moving Beyond the Stereotypes

This study examined the characteristics of homeless women with sub stance abuse problems. Data were collected on a sample of 323 home less substance abusers. First, 49 women and 274 men were compared to demonstrate distinct problems and treatment needs of the women. Results showed that the women were more likely than the men to abuse drugs, but less likely to receive substance abuse treatment. In addition, women spent more time in doubled-up living arrangements, and were more likely to receive outpatient psychiatric treatment. Second, two subgroups of women were compared: those who had been homeless for 6 months or less, and those who had been homeless longer than 6 months during their lifetime. The women who had been homeless longer were less educated, younger when they first became homeless, and were more likely to abuse alcohol, to have been assaulted, and to have attempted suicide. Implications for research and treatment are discussed.