ISRN Addiction http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Older Adults and Substance-Related Disorders: Trends and Associated Costs Wed, 24 Apr 2013 15:01:16 +0000 http://www.hindawi.com/isrn/addiction/2013/905368/ Purpose. The aim of this study is to examine the changing service profile of older adults receiving substance abuse services over the past decade and the increased costs of treating this population. Design and Methods. Medicaid claims for mental health and substance abuse services data from a medium sized county in an eastern state were analyzed for individuals aged 50 years and older in calendar year 2000 or 2009. Univariate statistics are presented to describe the substance abuse and mental health services used by older adults in these two years. Results. The number of low-income older adults who accessed services for treatment and who had a substance-related diagnosis grew from 545 individuals in 2000 to 1,653 individuals in 2009. Costs for services utilized by older adults with a substance-related diagnosis rose by 358% from $2.1 million in 2000 to $9.5 million in 2009. Implications. The increase in the number of low-income older adults with a substance-related disorder and the concomitant rise in total spending for Medicaid reimbursed services indicate that local and state social service providers need to prepare for an older adult population who will need appropriate substance abuse prevention and treatment programs. Daniel Rosen, Emily Heberlein, and Rafael J. Engel Copyright © 2013 Daniel Rosen et al. All rights reserved. A Lifespan Developmental-Stage Approach to Tobacco and Other Drug Abuse Prevention Thu, 18 Apr 2013 10:49:45 +0000 http://www.hindawi.com/isrn/addiction/2013/745783/ At least by informal design, tobacco and other drug abuse prevention programs are tailored to human developmental stage. However, few papers have been written to examine how programming has been formulated as a function of developmental stage throughout the lifespan. In this paper, I briefly define lifespan development, how it pertains to etiology of tobacco and other drug use, and how prevention programming might be constructed by five developmental stages: (a) young child, (b) older child, (c) young teen, (d) older teen, and (e) adult (emerging, young-to-middle and older adult substages). A search of the literature on tobacco and other drug abuse prevention by developmental stage was conducted, and multiple examples of programs are provided for each stage. A total of 34 programs are described as examples of each stage (five-young children, 12-older children, eight-young teens, four-older teens, and five-adults). Implications for future program development research are stated. In particular, I suggest that programming continue to be developed for all stages in the lifespan, as opposed to focusing on a single stage and that developmentally appropriate features continues to be pursued to maximize program impact. Steve Sussman Copyright © 2013 Steve Sussman. All rights reserved. The Choice of Screening Instrument Matters: The Case of Problematic Cannabis Use Screening in Spanish Population of Adolescents Tue, 04 Dec 2012 11:52:00 +0000 http://www.hindawi.com/isrn/addiction/2013/723131/ The aim of this study was to examine the feasibility of problem cannabis use screening instruments administration within wide school surveys, their psychometric properties, overlaps, and relationships with other variables. Students from 7 Spanish regions, aged 14–18, who attended secondary schools were sampled by two-stage cluster sampling (net sample 14,589). Standardized, anonymous questionnaire including DSM-IV cannabis abuse criteria, Cannabis Abuse Screening Test (CAST), and Severity of Dependence Scale (SDS) was self-completed with paper and pencil in the selected classrooms. Data was analysed using classical psychometric theory, bivariate tests, and multinomial logistic regression analysis. Not responding to instruments’ items (10.5–12.3%) was associated with reporting less frequent cannabis use. The instruments overlapped partially, with 16.1% of positives being positive on all three. SDS was more likely to identify younger users with lower frequency of use who thought habitual cannabis use posed a considerable problem. CAST positivity was associated with frequent cannabis use and related problems. It is feasible to use short psychometric scales in wide school surveys, but one must carefully choose the screening instrument, as different instruments identify different groups of users. These may correspond to different types of problematic cannabis use; however, measurement bias seems to play a role too. Danica Thanki, Antónia Domingo-Salvany, Gregorio Barrio Anta, Amparo Sánchez Mañez, Noelia Llorens Aleixandre, Josep Maria Suelves, Begoña Brime Beteta, and Julián Vicente Copyright © 2013 Danica Thanki et al. All rights reserved. Male Adolescent Substance Use Disorder and Attention-Deficit Hyperactivity Disorder: A Review of the Literature Wed, 28 Nov 2012 09:52:14 +0000 http://www.hindawi.com/isrn/addiction/2013/815096/ Approximately, one-third of male adolescents in treatment for a substance use disorder (SUD) also have an Attention-Deficit Hyperactivity Disorder (ADHD). This strongly suggests that ADHD is a major risk factor for the development of SUD which practitioners must address if they are to provide adequate treatment for adolescents with SUD/ADHD. This paper supports a causal role for ADHD in the development of SUD and examines the developmental mechanisms whereby ADHD increases risk for SUD. These mechanisms include increased risk for conduct disorder, academic failure, deviant peer affiliation, engaging in risk behaviors, and self-medication. Assessment and treatment recommendations for those comorbid for SUD/ADHD are provided. Robert Eme Copyright © 2013 Robert Eme. All rights reserved. Significant Others, Knowledge, and Belief on Smoking as Factors Associated with Tobacco Use in Italian Adolescents Tue, 27 Nov 2012 09:20:18 +0000 http://www.hindawi.com/isrn/addiction/2013/968505/ Tobacco use is dramatically increasing among youth. Growing attention has been addressed towards possible predictors of smoking in such a population. We evaluated a sample of Italian adolescents to verify whether adults and peers might influence their smoking status. Cross-sectional study was conducted in 16 schools of North Italy. Data were collected from 2001 to 2010 by means of a self-administered questionnaire on sociodemographic data and individual/social possible predictors of smoking. 2,444 students (56.7% boys; 43.3% girls; mean = 14.32 ± 1.384 years) were analysed. 607 (24.8%) were current smokers; 1,837 (75.2%) were nonsmokers. The presence of smokers in the family, seeing teachers who smoke, the influence of friends, and the feeling of inferiority were predictors of youth smoking as well as unawareness of nicotine dangerous action to health. Running the logistic multivariate analysis with all the variables listed above in the same model, the strongest predictors of smoking were as follows: being unaware that pipe/cigar is harmful to health as cigarettes; not knowing that passive smoking is harmful to the growth of children; having seen teachers smoking. The present findings help to identify the variables that might favour smoking in youth. Such variables should become the target of prevention programs. Fiammetta Cosci, Vincenzo Zagà, Giuly Bertoli, and Aquilele Campiotti Copyright © 2013 Fiammetta Cosci et al. All rights reserved. What Aspect of Dependence Does the Fagerström Test for Nicotine Dependence Measure? Tue, 27 Nov 2012 08:40:53 +0000 http://www.hindawi.com/isrn/addiction/2013/906276/ Although the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) are widely used, there is a uncertainty regarding what is measured by these scales. We examined associations between these instruments and items assessing different aspects of dependence. Adult current smokers (, mean age 33.3 years, 61.9% female) completed a web-based survey comprised of items related to demographics and smoking behavior plus (1) the FTND and HSI; (2) the Autonomy over Tobacco Scale (AUTOS) with subscales measuring Withdrawal, Psychological Dependence, and Cue-Induced Cravings; (3) 6 questions tapping smokers’ wanting, craving, or needing experiences in response to withdrawal and the latency to each experience during abstinence; (4) 3 items concerning how smokers prepare to cope with periods of abstinence. In regression analyses the Withdrawal subscale of the AUTOS was the strongest predictor of FTND and HSI scores, followed by taking precautions not to run out of cigarettes or smoking extra to prepare for abstinence. The FTND and its six items, including the HSI, consistently showed the strongest correlations with withdrawal, suggesting that the behaviors described by the items of the FTND are primarily indicative of a difficulty maintaining abstinence because of withdrawal symptoms. Joseph R. DiFranza, Robert J. Wellman, Judith A. Savageau, Ariel Beccia, W. W. Sanouri A. Ursprung, and Robert McMillen Copyright © 2013 Joseph R. DiFranza et al. All rights reserved. Deficits of Affect Mentalization in Patients with Drug Addiction: Theoretical and Clinical Aspects Sun, 11 Nov 2012 10:40:28 +0000 http://www.hindawi.com/isrn/addiction/2013/250751/ Traditionally treated with wariness, drug addictions have provoked a serious interest in psychodynamically oriented clinicians in recent decades. This paper discusses the development of contemporary psychodynamic conceptualizations of addictions, focusing specifically on mentalization-based theories. The concept of mentalization refers to a complex form of self-regulation which includes attribution of psychological meaning to one’s own behavior and affective states, as well as those of the others. We hypothesize that drug-addicted patients have severe impairments in mentalizing, associated with developmental deficits, characteristic for the borderline personality disorder and psychosomatic conditions. Psychodynamic models of mentalization and their corresponding research operationalizations are reviewed, and implications for a contemporary understanding of drug addictions and psychotherapy are drawn. The authors propose that mentalization-oriented theories provide an adequate conceptualization, which is open to empirical testing and has clear and pragmatic guidelines for treatment. Svetoslav Savov and Nikola Atanassov Copyright © 2013 Svetoslav Savov and Nikola Atanassov. All rights reserved. The Dysregulation Profile Predicts Cannabis Use in the Offspring of Teenage Mothers Sun, 11 Nov 2012 10:24:58 +0000 http://www.hindawi.com/isrn/addiction/2013/659313/ Background. Offspring of teenage mothers are at greater risk of early drug use. Research has identified a child behavior checklist (CBCL) profile for children with high levels of comorbid behavior problems, the dysregulation profile (DP), as another risk factor for drug use. Method. Teenage girls (12–18 years old; 71% African-American, 29% White) were recruited during pregnancy. Data were collected during pregnancy and when offspring were 6, 10, and 14 years old (). Mothers completed the CBCL when children were at ages 6 and 10, and children who scored 60 or higher on all 3 DP subscales (aggression, anxiety/depression, and attention problems) were categorized as dysregulated. At ages 10 and 14, the offspring (50% male, 50% female) reported on their cannabis use and completed the childhood depression inventory (CDI). Results. DP at age 6 and depressive symptoms at age 14 predicted recent cannabis use in the offspring. There was a significant interaction between race and pubertal timing such that White offspring who matured earlier were at greater risk of recent cannabis use. Conclusions. The results of this study suggest that it may be possible to identify a subset of children at risk of dual diagnosis as early as age 6. Natacha M. De Genna, Cynthia Larkby, and Marie D. Cornelius Copyright © 2013 Natacha M. De Genna et al. All rights reserved.