Young adult marijuana use in relation to antecedent misbehaviors.
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Adolescent↗
Biomedical subjects
J C Anthony
Publications and source records attributed to J C Anthony.
Epidemiologic study of regular analgesic use and end-stage renal disease.
A case-control study of the relationship between regular analgesic consumption and end-stage renal disease (ESRD) development was conducted and was made up of 527 patients with ESRD and 1,047 matched controls from southeastern Pennsylvania and southern New Jersey. The study was unable to demonstrate an increased risk of ESRD associated with use of analgesics either as single compounds or in combinations. In addition, no consistent dose or duration relationship was shown for users of specific analgesic combinations or for single compounds. We suggest that if there is an association between the use of analgesics and ESRD development, the risk is not large or at least not large in the geographic area where the study was carried out.
Adult↗
The NIMH diagnostic interview schedule modified to record current mental status.
The National Institute of Mental Health Diagnostic Interview Schedule (DIS) was modified to record detailed information on current mental status in addition to the lifetime symptom history. Use of the modified DIS in a field survey indicates that information on current symptoms is required to distinguish persons who meet all DSM-III criteria for Major Depressive Episode at or around the time of interview from former cases who fail to meet all criteria at interview. Thus, the unmodified DIS may overestimate the 1-month period prevalence rates for Major Depressive Episode, by counting symptomatic former cases as having the disorder at or around the time of the interview. An analysis of symptom count data also suggests that the unmodified DIS count of lifetime depressive symptoms is not a good measure of current symptom status.
Depressive Disorder↗
Limits of the 'Mini-Mental State' as a screening test for dementia and delirium among hospital patients.
With a psychiatrist's standardized clinical diagnosis as the criterion, the 'Mini-Mental State' Examination (MMSE) was 87% sensitive and 82% specific in detecting dementia and delirium among hospital patients on a general medical ward. The false positive ratio was 39% and the false negative ratio was 5%. All false positives had less than 9 years of education; many were 60 years of age or older. Performance on specific MMSE items was related to education or age. These findings confirm the MMSE's value as a screen instrument for dementia and delirium when later, more intensive diagnostic enquiry is possible; they reinforce earlier suggestions that the MMSE alone cannot yield a diagnosis for these conditions.
Adult↗
The effect of federal drug law on the incidence of drug abuse.
The Controlled Substances Act (CSA) is the prevailing "drug abuse" control statute in the United States. Its manifest objective is to prevent or reduce drug use's "substantial and detrimental effect on the health and general welfare of the American people." Evaluating CSA's effectiveness in 1975, a Domestic Council Task Force reported in a White Paper to President Gerald Ford that its control measures do "reduce abuse of dangerous drugs." The Task Force's evidence was based upon a before-and-after analysis of the frequency of "drug abuse episodes" reported to the nation's Drug Abuse Warning Network (DAWN). This research note challenges the conclusion of the Domestic Council Task Force, subjecting the DAWN evidence to more rigorous scrutiny, and concluding that we do not presently have adequate materials to assess whether CSA meets its health objectives. The context of this conclusion is that of drug control, but its implications apply to health policy and health policy evaluation in general.
Drug and Narcotic Control↗
The association between sniffing inhalants and injecting drugs.
There is evidence that the use of inhalants might prove to be a modifiable risk factor for intravenous (IV) drug use, or possibly an important vulnerability marker. However, this evidence has come from studies using samples of convenience, such as a mixture of psychiatric patients, felons, and their relatives. If there is a link between these two different forms of drug-using behaviors, then a statistical association should be found in epidemiologic studies with rigorous sampling procedures--even after statistical adjustment for plausible confounding variables such as sex, age, socioeconomic status, and the use of drugs such as marijuana. To probe this suspected causal association, we analyzed epidemiologic data from the 1990 National Household Survey on Drug Abuse sponsored by the National Institute on Drug Abuse. The population for this survey consisted of all household residents aged 12 years and older in the conterminous United States, with respondents selected by probability sampling. A total of 9,259 respondents completed the confidential self-report interview conducted by trained interviewers; 192 persons reported a history of injecting drugs for nonmedical reasons (e.g., to get high), and 9,067 reported never injecting drugs. As hypothesized, inhalant use was found to be associated with injecting drugs (relative odds [RO] = 11.8). After adjustment for sex, age, race, socioeconomic status, and use of marijuana, inhalant users still were 5.35 times more likely than nonusers to have injected drugs (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)
Administration, Inhalation↗
Association of school dropout with recent and past injecting drug use among African American adults.
We hypothesized that, among African American adults, starting and maintaining injecting drug use (IDU) would be associated with dropping out of high school, and that starting and stopping IDU would be associated with earning the general equivalency diploma (GED) after school dropout. Drawn from the 1991-1993 National Household Surveys on Drug Abuse (NHSDA), the nationally representative sample of African Americans consisted of 117 recent and 109 past IDUs. Conditional multiple logistic regression was used to estimate the hypothesized associations. African American high school dropouts and GED holders were 2-3 times more likely to have started and maintained IDU, as compared to high school graduates. Earning the GED was associated with starting and then stopping IDU. These findings merit further investigation because they might have significant public health implications for the prevention of IDU among African Americans.
Adolescent↗
Influence of prenatal cocaine exposure on full-term infant neurobehavioral functioning.
This study investigated infant neurobehavioral functioning during the newborn period in 334 full-term, African American neonates (187 cocaine exposed, 147 non-cocaine exposed) enrolled prospectively at birth, with documentation of drug exposure status through maternal interview and urine and meconium toxicology assays. Infants were assessed using the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) during the newborn period (0-6 postnatal days). Findings from multivariate profile analyses support a consistent, modest effect of prenatal cocaine exposure on neurobehavioral functioning in full-term neonates. All of the BNBAS cluster scores, with the exception of abnormal reflexes, were similarly affected, sharing a common slope (D=-0.14; 95% CI=-0.27, -0.003; P=.046) representing a -0.14 point difference between cocaine-exposed and non-cocaine-exposed infants after controlling for prenatal exposure to alcohol, tobacco, and marijuana (ATM); maternal age, education, employment, primigravida status, and prenatal care visits; and infant sex and postnatal age in days. Fetal growth was also related to neurobehavioral functioning and, in part, mediated the relationship between cocaine exposure and the BNBAS cluster scores. Cocaine exposure during each trimester similarly influenced infant neurobehavioral profiles, with cocaine-associated deficits most pronounced in infants with exposure in all three trimesters. Results from qualitative and quantitative urine and meconium bioassay indicators further substantiated these results. Findings, while significant, represent modest effect sizes in full-term infants.
Black or African American↗
Longitudinal investigation of task persistence and sustained attention in children with prenatal cocaine exposure.
The present study estimates the longitudinal effects of prenatal cocaine exposure on indicators of sustained attention processing at 3, 5 and 7 years of age in an urban sample of full-term African-American children (235 cocaine-exposed, 207 noncocaine-exposed). The sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview, urine and meconium toxicology assays. Sustained attention was measured at age 3 years using a standardized measure of task persistence during a challenging task [G.A. Morgan, N.A. Busch-Rossnagel, C.A. Maslin-Cole and R.J. Harmon, Individualized Assessment of Mastery Motivation: Manual for 15-36 Month Old Children, 1992.], and at ages 5 and 7 years using omission error scores from computerized continuous performance tasks (CPT) [L. Greenberg, R. Leark, T. Dupuy, C. Corman, C. Kindschi, M. Cenedela, Test of Variables of Attention (T.O.V.A. and T.O.V.A.-A.), 22, Universal Attention Disorders, Los Alamitos, CA, 1996; C.K. Conners, Conners' Continuous Performance Test (CPT), second ed., Multi-Health Systems, Canada, 1995.]. Findings from longitudinal GLM/GEE analyses of the three measured time points support a stable influence of prenatal cocaine exposure on indicators of sustained attention, after controlling for prenatal exposure to alcohol, marijuana, tobacco and over 20 additional medical and social-demographic covariates drawn from potentially confounding influences assessed at birth and later assessment visits (D=0.21; 95% CI=0.04, 0.38; P=.017). This effect was not mediated by fetal growth or gestational age and remained highly stable with increasing levels of covariate control. Separately, using the age 7 data, a structural equations model (SEM) was constructed combining all available self-report and bioassay data to measure magnitude of cocaine exposure in relationship to attention task performance. Results indicated a gradient of influence, with each standard deviation increase in the level of prenatal cocaine exposure relating to a 16% standard deviation increase in omission error scores at age 7. Overall findings support a stable cocaine-specific effect on indicators of sustained attention processing during the early childhood years. Results are discussed within the context of neurobiological and behavioral research linking prenatal cocaine exposure to long-lasting disruption of the brain systems subserving arousal and attention.
Black or African American↗
The US National Comorbidity Survey: overview and future directions.
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Adolescent↗
The use of the case-crossover design in studying illicit drug use.
The case-crossover design was developed to study time-varying exposures that cause transient excess risk of acute health events. It is a variant of case-control and subject-as-own-control research designs, involving use of information about exposure history of each case to estimate the transient effect. This kind of self-control design can help to reduce sampling bias otherwise introduced in the selection of controls, as well as confounding bias that might be derived from enduring individual characteristics, especially personality traits and other long-standing inherited or acquired vulnerabilities. When the subject is used as his or her own control, these personal vulnerabilities are matched. In this paper we discuss strengths and weaknesses of the case-crossover design and suggest applications of the case-crossover design in epidemiologic studies on suspected hazards of illicit drug use, and in studies of drug use and co-occurring psychiatric disturbances. We conclude that the case-crossover design can play a useful role, but it discloses a need to secure fine-grained measurements in epidemiologic research on psychiatric comorbidity. As explained in the paper, we also believe the case-crossover method may be of use to criminologists who study the drugs-crime nexus, to services researchers and clinicians who seek to understand treatment entry and compliance behavior, and to etiologists interested in polydrug use.
Case-Control Studies↗
Use of alternating logistic regression in studies of drug-use clustering.
This article describes the alternating logistic regression (ALR) method, and places this method in the context of other statistical approaches to the analysis of complex survey data, including the conditional form of logistic regression with matching on neighborhood characteristics. Unlike conditional logistic regression, the ALR method provides for an explicit estimation of the magnitude of clustering of drug use within neighborhoods and within subgroups of the neighborhood defined by male-female or age indicators, with and without covariate adjustments. The application of these ALR methods is illustrated with estimates for the magnitude of clustering of daily marijuana use and weekly marijuana use within neighborhoods of the United States, based on data from the National Household Survey on Drug Abuse samples from 1990 through 1996.
Humans↗
Black-white differences in alcohol use by women: Baltimore survey findings.
Although black women suffer disproportionately from alcohol-related illnesses and causes of death, little is known about the extent to which poorer outcomes are a function of differences in drinking, the use of health services, or some combination of these factors. This study, using interview data obtained in the Baltimore Epidemiologic Catchment Area household survey, compares racial differences in alcohol use and abuse among a sample of 2,100 women. After controlling for differences in sociodemographic characteristics, black women were found to be at no greater risk than whites for heavy drinking or for suffering from alcohol abuse or dependence. Racial differences, however, were observed in heavy drinking by years of education. A similar percentage of black women and white women who had not completed high school were heavy drinkers, but black women with 12 or more years of education were less likely to be heavy drinkers than whites with comparable education. These findings raise questions about the extent to which differences in drinking contribute to the poorer alcohol-related health outcomes of black women in Baltimore. Additionally, the finding that education was inversely related to heavy drinking among black women may be helpful in shaping early alcohol abuse intervention and treatment services that target black women.
Adolescent↗
Human immunodeficiency virus infection in diabetic intravenous drug users.
OBJECTIVE: --To evaluate the association between diabetes and human immunodeficiency virus (HIV) seroprevalence in a population of intravenous (IV) drug users. DESIGN: --Cross-sectional survey in a cohort of IV drug users. SETTING: --Community-based study clinic. SUBJECTS: --The study included 2921 individuals with a history of IV drug use in the past 10 years; over 90% had injected drugs in the past year and 77% in the past month; only 15% were receiving drug treatment. OUTCOME MEASURES: --The HIV seroprevalence among IV drug users with and without a history of diabetes. RESULTS: --Those IV drug users with a history of diabetes had significantly lower HIV seroprevalence (9.8%) than nondiabetic IV drug users (24.3%; P = .03). Despite similar duration and intensity of drug use and sexual practices, diabetic IV drug users tended not to share injection paraphernalia and were less likely to attend shooting galleries than nondiabetic IV drug users. CONCLUSION: --Our data suggest that the apparent protective effect of diabetes against HIV infection in IV drug users is most likely due to their safer injection practices afforded by their ready access to sterile injection equipment.
Adult↗
The prevalence of substance abuse among registered nurses.
The purpose of this research was to estimate the prevalence of substance abuse and depression among a population-based sample of registered nurses. In addition, to estimate the degree to which substance abuse and depression were associated with nurses, a comparison was made between nurses and other employed individuals. Respondents were obtained from a probability sample of households that were part of the National Institute of Mental Health Epidemiologic Catchment Area Program (ECA). Of the adults interviewed as part of the ECA, 143 were under age 65 and currently working as registered nurses. These nurses were matched by neighborhood of residence (census tract) and gender to a comparison group of non-nurses from the ECA who were also employed at the time of interview. Estimates of the odds of substance use and depression among the nurses (n = 143) and non-nurses (n = 1410) were calculated. Nurses were no more likely to have engaged in illicit drug use or to have experienced depression than non-nurses. Nurses were also less likely to have experienced problems with alcohol abuse than non-nurses.
Adult↗