Classification of Students by Race and Hispanic/Latino/a/x Ethnicity Impacts Estimates of the Prevalence of Substance Use.

Multiracial and Hispanic/Latino/a/x youth are rapidly growing populations in the United States. When considered in substance use studies, they are often treated as homogeneous groups despite important demographic and cultural differences. The current study explores how substance use prevalence may differ depending on how precisely race and ethnicity groups are categorized. Data are from the 2018 High School Maryland Youth Risk Behavior Survey (n = 41,091, 48.4% female). We estimate prevalence of past 30-day substance use (i.e., alcohol, combustible tobacco, e-cigarettes, and marijuana) for all combinations of race and Hispanic/Latino/a/x ethnicity. Substance use prevalence across the specific Multiracial and Hispanic/Latino/a/x categories showed a wider range of estimates than within the traditional CDC racial and ethnic categories. Findings from this study suggest that state- and national-level surveillance of adolescent risk behavior should add further measures of race and ethnic identity to improve researchers' ability to increase precision of substance use prevalence estimates.

Sexual minorities and substance use treatment utilization: New evidence from a national sample.

INTRODUCTION: Minority stress theory suggests that sexual minorities would be, on average, less likely than heterosexual individuals to seek out substance use treatment (due to concerns of stigma and rejection). However, prior research on the subject is mixed, and largely dated. In light of historic increases in societal acceptance and legal protections for sexual minorities, the field needs an up-to-date assessment of treatment utilization among this population. METHODS: This study used data from the 2015-2019 National Survey on Drug Use and Health to examine the association between key independent variables (sexual identity, gender) and substance use treatment utilization using binary logistic regression. We conducted analyses using a sample of adults with a past-year substance use disorder (N = 21,926). RESULTS: Controlling for demographic factors, with heterosexual individuals as the comparison group, gay/lesbian individuals (AOR = 2.12, CI = 1.19-3.77) were significantly more likely and bisexual individuals (AOR = 0.49, CI = 0.24-1.00) significantly less likely to report treatment utilization. Bisexual individuals were also less likely than gay/lesbian individuals to report treatment utilization (AOR = 0.10, CI = 0.05-0.23). Interaction tests examining sexual orientation and gender showed no difference in treatment utilization between gay men and lesbian women, and revealed that bisexual identity was associated with decreased likelihood of treatment utilization for men (p = .004) but not for women. CONCLUSION: Sexual orientation, particularly in the context of social identity, plays a significant role in substance use treatment utilization. Bisexual men face unique barriers to treatment, which is concerning given the high rates of substance use among this and other sexual minority populations.

Prevalence and correlates of driving under the influence of stimulants: Evidence from a national sample.

BACKGROUND: Several million Americans use illicit stimulants every month and national data suggest stimulant use is increasing. However, little evidence exists that examines the prevalence and correlates of driving under the influence of stimulants (DUIS). The present study aimed to provide new evidence on the prevalence of DUIS in the U.S. adult population. METHODS: This study examined data from 170,944 adults 18 and older in the 2016-2019 National Survey on Drug Use and Health. Using Stata and R, we estimated the prevalence and key correlates of DUIS among adults in the United States. RESULTS: The overall prevalence of DUIS was 0.7% among adults in general and 28.3% among past-year stimulant users. Among the full adult sample, the prevalence of DUI cocaine was 0.5% and the prevalence of DUI methamphetamine was 0.3%. More than one in five (21.6%) adults with past year cocaine use reported DUI of cocaine, while nearly one half (47.2%) of adults with past year methamphetamine use reported DUI of methamphetamine. There is also a substantially higher likelihood of driving under the influence of stimulants among individuals reporting early onset of use and among those meeting criteria for cocaine/methamphetamine use disorders. Among adults who used cocaine/methamphetamine, those who reported driving under the influence of stimulants were more than 2 times more likely to experience a depressive episode or psychological distress. CONCLUSION: Findings suggest that prevention/treatment approaches focused on multiple substances as well as mental health needs may be most appropriate for addressing the challenge of DUIS.

Health risk behavior and cultural stress among Venezuelan youth: a person centered approach.

BACKGROUND: In recent years, more than 5 million Venezuelans have left their once prosperous country, with several hundred thousand settling in the United States (US). At present, our understanding of the health risk behavior profiles of Venezuelan émigré youth, and their links with cultural stress, remains limited. OBJECTIVES: Drawing from a sample of recently-immigrated Venezuelan youth in the US, we aim to identify subtypes of youth according to their involvement in health risk behaviors (i.e., substance use, sexual risk behavior, violence) and assess the associations between class membership and key constructs related to cultural stress theory (i.e., negative context of reception, family communication/support). METHOD: Latent profile analysis and multinomial regression were performed using data from a community-based convenience sample of 402 recently-arrived Venezuelan immigrant youth (ages 10-17; 56% male). RESULTS: We identified five subtype classes: (1) "Abstainer" (36%), (2) "Alcohol Only" (24%), (3) "Alcohol/Tobacco" (24%), (4) "Aggression" (8%), and (5) "Multidimensional Risk" (8%). Compared to Class #1, youth in Classes #3 and #5 reported significantly higher levels of negative context of reception and lower levels of family functioning while controlling for demographic factors. Youth in Class #5 reported the lowest levels of family economic hardship and the longest duration in the US. CONCLUSION: It is vital that we support both Venezuelan youth who abstain from risk behavior and, at the same time, develop and implement programs that target the needs of those who are at elevated risk for serious consequences related to substance use, sexual risk behavior, and violence.

Disconcerting levels of alcohol use among Venezuelan immigrant adolescents in the United States.

BACKGROUND: It is estimated that more than 4 million Venezuelans have left their country as a direct result of their nation's widespread social and economic challenges. Although recent research identifies Venezuela as one of the nations with the highest rates of harmful alcohol consumption in the Americas, no research has been conducted on alcohol use among Venezuelan youth in diaspora. METHODS: Data was collected between November 2018 and June 2019 from 373 Venezuelan immigrant youth ages 12-17 in the United States. The prevalence of past-month and lifetime alcohol use among Venezuelan youth is compared to that of other Hispanic and immigrant youth from the National Survey on Drug Use and Health (NSDUH), and the Construyendo Oportunidades Para Adolecentes Latinos (COPAL) study using independent sample t tests. RESULTS: The prevalence of past-month and lifetime alcohol use was significantly higher among Venezuelan immigrant youth (15% and 52%, respectively) compared to other Hispanic (9% and 28%) and immigrant (4.5% and 28%) youth in the NSDUH, and youth ages 14-17 in the COPAL study (4.0% and 22%). Among Venezuelan youth reporting alcohol use initiation, 1.5% of youth ages 12-14 and 19% ages 15-17 report lifetime alcohol intoxication. DISCUSSION: Although preliminary, results indicate that a disconcerting proportion of Venezuelan crisis migrant youth in the US report lifetime alcohol initiation and past-month use. These findings suggest the importance of future research to examine the prevalence and correlates of alcohol use in this population using recruitment and sampling methods that will allow for population-level estimates.

Immigrants and mental disorders in the united states: New evidence on the healthy migrant hypothesis.

OBJECTIVES: Despite experiencing migration-related stress and social adversity, immigrants are less likely to experience an array of adverse behavioral and health outcomes. Guided by the healthy migrant hypothesis, which proposes that this paradox can be explained in part by selection effects, we examine the prevalence and comorbidity of mental disorders among immigrants to the United States (US). METHODS: Findings are based on the National Epidemiologic Survey on Alcohol and Related Conditions (2012-2013), a nationally representative survey of 36,309 adults in the US. RESULTS: Immigrants were significantly less likely than US-born individuals to meet criteria for a lifetime disorder (AOR = 0.63, 95% CI = 0.57-0.71) or to report parental history of psychiatric problems. Compared to US-born individuals, the prevalence of mental disorders was not significantly different among individuals who immigrated as children; however, differences were observed for immigrants who arrived as adolescents (ages 12-17) or as adults (age 18+). DISCUSSION: Consistent with the healthy migrant hypothesis, immigrants are less likely to come from families with psychiatric problems, and those who migrate after childhood-when selection effects are most likely to be observed-have the lowest levels of psychiatric morbidity.

Trajectory classes of cannabis use and heavy drinking among rural African American adolescents: multi-level predictors of class membership.

AIMS: To inform research on the etiology and prevention of substance use among rural African American youth by (a) identifying developmental trajectory classes of cannabis use and heavy drinking across adolescence and young adulthood and (b) examining associations between trajectory class membership and multi-level assessments of risk factors. DESIGN: A prospective study spanning 9 years with assessments of cannabis use and heavy drinking, the catecholamines epinephrine and norepinephrine, perceived stress and psychosocial risk factors. SETTING: Rural communities in the southeastern United States. PARTICIPANTS: African American youth (n = 518). MEASUREMENTS: Participants were assessed for cannabis use and heavy drinking at seven assessments beginning at 16 years of age and continuing to 25 years of age. At age 19, participants provided overnight urine voids that were assayed for catecholamines, a biological marker of life stress resulting from sympathetic nervous system activation. At ages 16 and 19, participants provided information on malleable psychosocial risk factors. FINDINGS: Latent class growth models revealed three distinct trajectory classes for cannabis use and for heavy drinking. Higher levels of circulating stress hormones and perceived stress were associated with classes reporting greater substance use over time (all Ps < 0.05). A composite of selected risk factors discriminated class membership (all Ps < 0.05). Trajectory classes characterized by rapid usage increases in early adulthood exhibited the greatest increase in deviant peer affiliations between ages 16 and 19 years. CONCLUSIONS: Rural African American youth's cannabis use and heavy drinking across adolescence and young adulthood demonstrate distinct developmental courses; a small number of risk factors and measures of biological and perceived stress differentiate class membership prognostically. Variability over time in these measures, specifically an increase in deviant peer affiliation, may help to account for steep increases in young adulthood.