Journal of Drug Issues

This study examined (a) differences between alcohol-only users and alcohol–marijuana co-users and (b) motives for use in relation to alcohol and marijuana use and problem use. Spring 2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use measured 4 months later. Correlates of co-use (n = 345; vs. alcohol-only use, n = 1,525) included greater alcohol and marijuana use frequency, problem drinking and marijuana use, and alcohol use motives (p’s < .05). Controlling for covariates, alcohol use frequency correlated with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives, but lower Conformity alcohol use motives (p’s < .001); greater Coping and Self-enhancement alcohol use motives (p’s < .01) predicted problem alcohol use. Marijuana use frequency correlated with greater Coping and Expansion marijuana use motives (p’s < .05); greater Expansion marijuana use motives (p = .005) predicted problem marijuana use. College-based substance use interventions should target Coping and Self-enhancement alcohol use motives and Expansion marijuana use motives.

Current Russian drug policy is punitive toward people who use drugs. Moreover, criminal justice in Russia is driven by strong organizational incentives to increase performance indicators of police such as clearance rate. Taken together, these might lead to the use of extrajudicial and illegal police practices, as documented by several qualitative studies. In this article, we explore quantitative evidence of such practices, namely, weight anomalies of the seized heroin that result from minimum threshold amounts established by the law. We find significant discontinuities in the weight distribution of seized heroin near minimum threshold amounts. Placebo tests rule out alternative explanations of the discontinuity and show that the most likely source of the revealed discontinuities is police manipulations with seized heroin.

An ongoing debate exists about the implications of recreational marijuana legalization to public safety. One important public concern is how recreational marijuana legalization may affect crime in neighboring states that have not legalized. Based on Uniform Crime Report (UCR) data from 2003 to 2017, this study used difference-in-differences (DID) analysis to examine the potential spillover effect of recreational marijuana legalization in Colorado and Washington State, with a special focus on the examination of the changes in the rates of a variety of crimes in the border counties of neighboring states relative to the nonborder counties in these states following Colorado’s and Washington’s legalization. Results provide some evidence suggesting a spillover crime reduction effect of legalization, as reflected by the significant decreases in the rates of property crime, larceny, and simple assault in the Colorado region that includes six neighboring states. Results also suggest that the effects of marijuana legalization on crime in neighboring states vary based on crime type and state.

Substance use disorders (SUDs) among young people have been linked with a range of adverse health consequences that can be successfully mitigated with early SUD treatment. According to the Social Identity Theory of Cessation Maintenance (SITCM), psychosocial processes including self-perceptions and benefit finding evolve with treatment, influencing recovery-based identities that can facilitate treatment success. However, this process has only been documented with adults; thus, the current study seeks to characterize these psychosocial processes among young people in SUD treatment and their caregivers. Nineteen young people receiving SUD treatment and 15 caregivers were interviewed about treatment experiences including negative self-perceptions, positive self-perceptions, and benefit finding. Results support the SITCM: Adolescents described escaping negative self-perceptions associated with the “substance use self” identity and strengthening a new “recovery self” identity characterized by positive self-perceptions and benefit finding. Caregivers described how extrinsic sources of support can help mitigate negative self-perceptions.

Marijuana use continues to be rampant among pregnant females. This study sought to examine recent marijuana use among a national sample of pregnant females. Aggregated data from the 2015–2018 National Survey on Drug Use and Health were utilized. Weighted analyses revealed that 5.19% of females used marijuana in the past 30 days. Those at greatest risk for recent use were African American (adjusted odds ratio [aOR]: 1.91); identified as gay/lesbian (aOR: 11.9) or bisexual (aOR: 3.37); used cigarettes (aOR: 2.74), alcohol (aOR: 5.10), and/or illicit drugs in the past month (aOR: 4.52); and thought marijuana was easy to access (aOR: 7.23). Women at decreased risk were older, Native Hawaiian, in their second trimester, and thought marijuana was a great risk. We believe our findings can inform harm-reduction efforts and inform prevention messages.

This study examined individual-level characteristics and factors associated with program completion, relapse, and multidimensional status at follow-up for 213 men and 248 women who entered one of 17 peer-led recovery programs and who completed a follow-up interview 12 months later. Study results found that although there were some significant gender differences at program entry among participants entering Recovery Kentucky, there were few gender differences at follow-up. In addition, although participants had significant psychosocial problems, polysubstance use patterns, and severe substance use disorder (SUD), the majority of both men and women reported completing the program (80.3%), a small minority reported relapse (9.5%), and about one third had worse multidimensional status about 12 months after program entry. Lower quality of life rating at program entry was associated with program completion and with better multidimensional status at follow-up. Study results suggest the recovery program provides an important option for some of the most vulnerable individuals with SUD.

Police officers and emergency personnel are on the frontlines of the opioid crisis. This research examines police officer attitudes about naloxone administration, drug treatment, and their role in handling drug-related incidents through an online survey. Although officers view themselves as adequately trained in administering naloxone/Narcan, almost half (43%) believe there should be a limit on how often someone who overdoses receives Narcan and the majority (83%) view naloxone/Narcan as providing an excuse to continue drug use. Officers also view drug treatment as ineffective. Negative attitudes differed as a function of frequency of overdose responses; officers who responded to more overdose calls and administered naloxone more frequently demonstrate more pessimistic attitudes toward drug treatment and the use of naloxone/Narcan. Officers more frequently exposed to drug overdoses need education and training about drug addiction issues to decrease stigma and elicit greater empathy toward people struggling with addiction.

This study uses social learning theory to examine whether differential associations with e-cigarette-using peers is related to personal e-cigarette use among youth, and the extent to which this relationship is explained by personal risk perceptions of e-cigarettes. Moreover, this study tests whether the mediation process is moderated by type of e-cigarette user. This study uses a sample of high school seniors from the 2016 Monitoring the Future Study (N = 2,100), and a subsample of e-cigarette users (n = 523). Analyses are carried out using OLS and logistic regression. Findings demonstrate that higher levels of peer e-cigarette use are related to higher odds of personal e-cigarette use, but that risk perceptions of e-cigarettes only explain a modest portion of that relationship (about 10%). Furthermore, the mediation process does not appear to vary by type of e-cigarette user. Future directions and policy implications are discussed.

Given the 2018 decriminalization of marijuana in South Africa for personal use and medicinal consumption, the aim of this research was to explore the perceptions of university students regarding the use, impact, legalization, and decriminalization of marijuana. Key findings revealed that a fair number of participants acknowledged using marijuana. When asked about the potential impact of marijuana on users, their families and significant others, they seemed to have a good understanding of the effects of the drug. However, while some participants were aware of the addictive nature of marijuana, others were not aware of the risk of addiction from smoking or ingesting this substance. However, they were able to weigh up the risks as well as the benefits of legalization/decriminalization of marijuana. This study has implications for health care professionals working with youth who use illicit substances such as marijuana, and in developing prevention and intervention programs aimed at the youth.

In the United States, the rising prevalence of opioid addiction has led to an increase in opioid-related overdose deaths and transmission of infectious disease. This resulted in the declaration of a national public health emergency and the need for harm reduction strategies such as syringe exchange. Florida has seen increases in blood-borne diseases and fatal/nonfatal opioid overdoses, yet harm reduction policy integration has been historically limited. To inform policy change, this study explores the perspectives of community members in Manatee County, Florida, on harm reduction services. Six focus groups were conducted with findings centralized around three emergent themes related to the implementation of a syringe exchange program: (a) awareness and acceptability; (b) facilitating factors; and (c) perceived barriers. The results of this qualitative research helped to inform the successful adoption of a local syringe exchange ordinance. Recommendations for community education and engagement regarding harm reduction policy are discussed.

Since the legalization of marijuana in several U.S. states in 2012, there has been concern about increases in the development of cannabis use disorder (CUD). The current study examined rates of CUD in Colorado college students who reported regular marijuana use and assessed a range of factors associated with CUD symptoms, including coping motives, concentrate/dab use, mental health concerns (depression, anxiety), age of regular marijuana use, and alcohol use. College students were recruited from a mid-sized university and completed a baseline assessment that included a marijuana urine screen. Participants reported a median of five CUD symptoms and 90% met criteria for CUD. After adjusting for covariates, the age of regular marijuana use was negatively associated with the number of CUD symptoms, while the average daily alcohol drinks was positively associated with the number of symptoms. Prevention and intervention efforts at the university level should be increased to reduce negative outcomes associated with problem marijuana use.

This study assessed self-perception as a long-term predictor of relative changes in problems related to alcohol and marijuana use in early adulthood. Self-report questionnaires were completed by a community sample of 124 individuals in the Southeastern United States who were followed longitudinally from age 19 to 27. More problems due to substance use at age 27 were predicted by participants’ negative perceptions of their social acceptance, romantic appeal, and self-worth. Predictions remained after accounting for potential confounds including gender, income, and baseline substance use problems at age 19. Social avoidance and distress in new situations at age 19 mediated the relationship between self-perception and relative changes in substance use problems, such that increases in substance use problems from age 19 to 27 were potentially explainable by the linkage of negative self-perceptions to social avoidance and distress in new situations.

Drawing on a multisite sample of 40 persons who sell, share, or use diverted buprenorphine to manage opioid use disorder, in this study we describe why individuals seek to obtain buprenorphine outside of formal treatment contexts, and between-site variation regarding their motives and means. Findings indicate that both the provision and purchase of diverted buprenorphine support user-defined risk minimization strategies to avoid withdrawal, reduce heroin use, and satiate opioid cravings in periods of lowered tolerance. We also found that a subset of the sample used buprenorphine recreationally, and that it functioned to extend or augment illicit drug use careers. Implications of the findings are discussed in light of federal and state drug control and treatment policies.

This research focuses on associations of medical marijuana legalization with prescription drug misuse, illicit drug use, and a combination of both behaviors. Using three waves of the National Survey of Drug Use and Health (NSDUH, 2016–2018), adult participants (age ≥ 18) were selected for the final study sample (n = 127,438). Multinomial logistic regression was adjusted for biological, socioeconomic, and substance use measurements. Results from multinomial regression demonstrated that medical marijuana legalization was positively associated with illicit drug use (relative risk ratio [RRR] = 1.33, 95% confidence interval [CI] = [1.17, 1.51]; p < .01) and both prescription drug misuse and illicit drug use (RRR = 1.14, 95% CI = [1.05, 1.25]; p < .01) among U.S. adults. It is recommended to design policy interventions to counter illicit drug use and a combination of both prescription drug misuse and illicit drug use as the result of medical marijuana legalization.

Research has yet to examine stability in employment as a function of cannabis use once an individual transitions into full-time work. Using data from the Rochester Youth Development Study, trajectories of cannabis use spanning ages 14 to 30 were identified among a sample of predominantly minorities (>80%; 68% African American). After hard-classifying individuals by patterns of cannabis use, probabilities of full-time employment and conditional probabilities of full-time employment were calculated and compared across patterns of use. Abstention or rare cannabis use was associated with a higher likelihood of full-time employment compared with other cannabis use patterns. Full-time employment stability was high for each pattern of cannabis use (>89%) and differences decreased with age and prior periods of employment. The results indicate that patterns of cannabis use spanning adolescence to adulthood have limited impact on the ability to retain full-time employment once employed and are interpreted in light of growing legalization of cannabis use.

With the worsening opioid epidemic, recent changes allow pharmacies to sell naloxone through standing orders to reverse opioid overdoses. This study assesses direct dispensed naloxone availability through pharmacy chains in California in 2016, and utilizes spatial analysis techniques to suggest optimal stocking of naloxone. Rural counties were less likely to have a pharmacy selling naloxone even though overdose death rates were higher in rural counties (odds ratio [OR] = 0.225; 95% confidence interval [CI] = [0.059, 0.854]). Pharmacies closest to the center of the population in these rural counties were identified as ideal stocking locations. Rural counties with high overdose death rates have the lowest rates of naloxone, but spatial analysis can determine pre-existing chain pharmacies that can stock naloxone.