Dataset Information

A Comparison of Substance Use Patterns Among Lifetime Heroin-Injecting Individuals By Racial Groups.

ABSTRACT:

Background

Studies have identified differential substance use patterns by racial groups. One of the most commonly reported differences is a higher rate of injection drug use (IDU) among Non-Hispanic Whites compared to African Americans, but this is complicated by factors related to IDU (e.g., earlier drug-use initiation) that overlap with being White.

Objective

We explored differential substance use-patterns by racial groups within a sample of injection heroin users.

Methods

Substance-use data were collected from 373 not-in-treatment heroin users who endorsed any lifetime injection use (69.4% male). We examined differences in substance-use patterns (e.g., age of initiation, gateway adherence) by racial groups. Multiple t-tests with Bonferroni correction were conducted to understand which demographic and substance-use characteristics varied by racial groups.

Results

Relative to Non-Hispanic Whites, African Americans (45.8% of sample) were more likely to start using heroin earlier in their life, but also more likely to experience a longer delay between starting and regularly using heroin. We also identified differences in the degree of (injection) heroin-use consequences by racial groups. After correcting for multiple comparisons and controlling for age and gender, we observed differences for six substance-use and demographic characteristics by racial group. White participants were younger, started cocaine use earlier, and experienced more heroin-use consequences across two separate domains.

Conclusions

After controlling for injection use, we observed differential substance-use characteristics by racial groups. The findings could be used to develop targeted prevention and harm-reduction strategies.

SUBMITTER: Moses TEH

PROVIDER: S-EPMC7454016 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A Comparison of Substance Use Patterns Among Lifetime Heroin-Injecting Individuals By Racial Groups.

Moses Tabitha E H TEH Lister Jamey J JJ Greenwald Mark K MK

Addiction research & theory 20190630 3

<h4>Background</h4>Studies have identified differential substance use patterns by racial groups. One of the most commonly reported differences is a higher rate of injection drug use (IDU) among Non-Hispanic Whites compared to African Americans, but this is complicated by factors related to IDU (e.g., earlier drug-use initiation) that overlap with being White.<h4>Objective</h4>We explored differential substance use-patterns by racial groups within a sample of injection heroin users.<h4>Methods</h ...[more]

PMID: 32863812

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Project description:ImportanceHeroin use is an urgent concern in the United States. Little is know about the course of heroin use, heroin use disorder, and associated factors.ObjectiveTo examine changes in the lifetime prevalence, patterns, and associated demographics of heroin use and use disorder from 2001-2002 to 2012-2013 in 2 nationally representative samples of the US adult general population.Design, setting, and participantsThis survey study included data from 43 093 respondents of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and 36 309 respondents of the 2012-2013 NESARC-III. Data were analyzed from February 2 to September 15, 2016.Main outcomes and measuresLifetime heroin use and DSM-IV heroin use disorder.ResultsAmong the 79 402 respondents (43.3% men; 56.7% women; mean [SD] age, 46.1 [17.9] years), prevalence of heroin use and heroin use disorder significantly increased from 2001-2002 to 2012-2013 (use: 0.33% [SE, 0.03%] vs 1.6% [SE, 0.08%]; disorder: 0.21% [SE, 0.03%] vs 0.69% [SE, 0.06%]; P < .001). The increase in the prevalence of heroin use was significantly pronounced among white (0.34% [SE, 0.04%] in 2001-2002 vs 1.90% [SE, 0.12%] in 2012-2013) compared with nonwhite (0.32% [SE, 0.05%] in 2001-2002 vs 1.05% [SE, 0.10%] in 2012-2013; P < .001) individuals. The increase in the prevalence of heroin use disorder was more pronounced among white individuals (0.19% [SE, 0.03%] in 2001-2002 vs 0.82% [SE, 0.08%] in 2012-2013; P < .001) and those aged 18 to 29 (0.21% [SE, 0.06%] in 2001-2002 vs 1.0% [0.17%] in 2012-2013; P = .01) and 30 to 44 (0.20% [SE, 0.04%] in 2001-2002 vs 0.77% [0.10%] in 2012-2013; P = .03) years than among nonwhite individuals (0.25% [SE, 0.04%] in 2001-2002 vs 0.43% [0.07%] in 2012-2013) and older adults (0.22% [SE, 0.04%] in 2001-2002 vs 0.51% [SE, 0.07%] in 2012-2013). Among users, significant differences were found across time in the proportion of respondents meeting DSM-IV heroin use disorder criteria (63.35% [SE, 4.79%] in 2001-2001 vs 42.69% [SE, 2.87%] in 2012-2013; P < .001). DSM-IV heroin abuse was significantly more prevalent among users in 2001-2002 (37.02% [SE, 4.67%]) than in 2012-2013 (19.19% [SE, 2.34%]; P = .001). DSM-IV heroin dependence among users was similar in 2001-2002 (28.22% [SE, 3.95%]) and in 2012-2013 (25.02% [SE, 2.20%]; P = .48). The proportion of those reporting initiation of nonmedical use of prescription opioids before initiating heroin use increased across time among white individuals (35.83% [SE, 6.03%] in 2001-2002 to 52.83% [SE, 2.88%] in 2012-2013; P = .01).Conclusions and relevanceThe prevalence of heroin use and heroin use disorder increased significantly, with greater increases among white individuals. The nonmedical use of prescription opioids preceding heroin use increased among white individuals, supporting a link between the prescription opioid epidemic and heroin use in this population. Findings highlight the need for educational campaigns regarding harms related to heroin use and the need to expand access to treatment in populations at increased risk for heroin use and heroin use disorder.

Project description:BackgroundAdolescents with juvenile legal system contact face numerous barriers to participation in behavioral health intervention research, including housing disruption, legal privacy concerns, and systems mistrust. Technology, such as social media, may be a novel and developmentally appropriate adolescent research study engagement and retention tool.ObjectiveWe examined data on social media information collected for study retention purposes from adolescents participating in a substance use intervention trial.MethodsData were collected as part of a randomized controlled trial determining efficacy of a group-based substance use intervention for girls and young women (12-24 years) with substance use histories referred from legal and school systems in the United States. Baseline demographic and social media information was analyzed from the subset of 114 adolescent girls (mean age 15.7 years; range 13-18 years), of whom 31.6% (36/114) were legally involved, 87.7% (100/114) belonged to minoritized racial/ethnic groups, and 32.5% (37/114) received public assistance.ResultsMost girls (74/114, 64.9%) provided at least one social media account (Instagram, 95% [70/74]; Facebook, 27% [20/74]; and Twitter, 11% [8/74]) during study enrollment. Legally involved girls were significantly less likely to provide social media information than school-referred girls (44% [16/36] versus 74% [58/78]; χ21 [N=114]=9.68, P=.002).ConclusionsObtaining social media information for study retention purposes from adolescent girls with lifetime substance use appears possible; however, particular subgroups (ie, legally involved girls) may be less likely to provide accounts. Factors shaping legally involved girls' willingness to provide social media information, including mistrust and privacy concerns, and the impact of researcher's access to social media information on study retention are critical directions for future research.Trial registrationClinicalTrials.gov NCT02293057; https://clinicaltrials.gov/ct2/show/NCT02293057.

Dataset Information

A Comparison of Substance Use Patterns Among Lifetime Heroin-Injecting Individuals By Racial Groups.

Background

Objective

Methods

Results

Conclusions

Publications

A Comparison of Substance Use Patterns Among Lifetime Heroin-Injecting Individuals By Racial Groups.

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