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Prenatal cigarette smoke exposure, childhood aggression and adolescent cigarette use
Abstracts / Drug and Alcohol Dependence 146 (2015) e202–e284
confidence to employ each strategy listed on the scale might serve as a form of education by informing users of strategies of which they are otherwise unaware. Financial support: None. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.169 Effects of family relationships quality on drug use: Mediating effects of moral conviction Alexandra N. Davis, Gustavo Carlo, Cara Streit University of Missouri, Columbia, MO, United States Aims: Previous research demonstrates the importance of both family relationships and moral development in predicting substance use. The present study will extend this literature by examining the mediating role of moral conviction (i.e., strength of moral motivation) in the associations between parent and sibling relationship positivity and substance use outcomes (i.e., tobacco use, alcohol use, binge drinking, and marijuana use). We hypothesized that family positivity would be positively associated with moral conviction, and that moral conviction would be negatively associated with substance use. Methods: Participants were 303 college students (M age = 18.71; 62.7% female). Participants completed measures of mother, father, and sibling positivity, their moral convictions regarding substance use, and their frequency of tobacco, alcohol, marijuana, and binge drinking in the past year. Results: Structural path analysis was conducted to examine the relations among the study variables. The model displayed acceptable fit (2 = 2.74; CFI = .98; RMSEA = .08). The results demonstrated that sibling positivity was positively associated with moral conviction, which in turn, was negatively associated with the substance use. Parental positivity was also directly associated with substance use. These results provide support for partial mediation of moral conviction in the associations between relationship quality and substance use. Future analyses will examine potential gender differences. Conclusions: The findings address important gaps in the literature by demonstrating the importance of both parent and sibling relationship quality on substance use, as well as examining the strength of adolescents’ convictions in accounting for college students’ substance use. The discussion will focus on the influence of both family relationship quality and moral convictions in predicting substance use outcomes. Financial support: Mizzou Advantage Grant from the University of Missouri. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.170 Crack cocaine use and perceived life chances Jeffrey Davis, Dennis G. Fisher, Grace L. Reynolds, Lucy Napper, Stephanie A. Meyers Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA, United States Aims: Adolescents who perceive limited potential future success are at risk for substance use. This study investigates the utility of the Perceived Life Chances scale (PLCS) to model crack cocaine use with an adult (M age = 35.7 years, SD = 14.51 years) street population (N = 332) specifically, the association between the PLCS and whether participants have: ever used crack, age of first use of crack, and number of days used crack.
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Methods: In addition to the PLCS, the participants were administered the Risk Behavior Assessment. Results: The PLCS was negatively related to the decision to use or not use crack cocaine. In contrast to our hypotheses, greater pessimism was related to an older age of first use and not associated at all with the number of days using crack cocaine. The strong covariates of crack cocaine use included: sex trading for either drugs or money; use of other drugs such as opiates, powder cocaine, and marijuana; and history of sexually transmitted infections such as gonorrhea, syphilis, and Chlamydia. Conclusions: PLC has implications for the use of Decisional Balance in interventions with crack users in that those who predict a bleak future for themselves may only value immediate consequences of their drug use behavior and may not value long-term negative consequences given that they are pessimistic about their long-term opportunities. Financial support: The project described was supported by Award Numbers R01DA030234 from the National Institute on Drug Abuse, P20MD003942 from the National Institute of Minority Health and Health Disparities, and ID10-CSULB-008 from the California HIV Research Program. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.171 Prenatal cigarette smoke exposure, childhood aggression and adolescent cigarette use Natacha De Genna 1,2 , Lidush Goldschmidt 2 , Marie Cornelius 1,2 1 University of Pittsburgh School of Medicine, Pittsburgh, PA, United States 2 Western Psychiatric Institute and Clinic (WPIC), Pittsburgh, PA, United States
Aims: Studies have demonstrated a relation between prenatal cigarette smoke exposure (PCSE) and subsequent smoking among exposed offspring. There is also a relation between PCSE and child behavior problems. In this prospective study of teenage mothers, we examined a potential pathway to adolescent smoking in offspring via childhood aggressive behavior. Methods: Pregnant teenagers (n = 413) were recruited from an urban prenatal clinic and interviewed during pregnancy. Mothers and children were assessed at delivery and during follow-up visits when the children were 6, 10, 14, and 16 years old. The PCSE measure was maternal report of any cigarette use during the third trimester. Our outcome measure was self-reported current smoking in offspring at the age 16 follow-up. Child aggressive behavior was measured with the Child Behavior Checklist (CBCL) at age 6. Path analysis using Mplus evaluated proposed pathways and tested for an indirect effect of PCSE on adolescent cigarette use through childhood aggressive behavior. Results: Half of the offspring in this cohort had PCSE, and PCSE significantly predicted child aggression at age 6 (p = .011, onetailed). By the age 16 follow-up visit, 20% of the adolescents were smokers (14% of the non-exposed and 22% of the exposed offspring). Adolescent cigarette use was directly associated with age 6 aggression scores, less strict parenting during adolescence, and White race. There was also an indirect path between PCSE and adolescent cigarette use via age 6 aggression scores (p = .035, one-tailed). Conclusions: We found that childhood aggression was a significant pathway linking PCSE to adolescent cigarette use. These results suggest several opportunities for early intervention with mothers who smoke and exposed offspring. A two-pronged approach addressing both maternal and child behavior may help prevent cigarette use in the next generation. Future work should
e260
Abstracts / Drug and Alcohol Dependence 146 (2015) e202–e284
examine potential mediators and moderators including maternal stress, maternal aggression and child association with deviant peers. Financial support: AA08284; DA009275; DA025734. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.172
Florida’s prescription drug monitoring program and oxycodone-caused mortality: A monthly time series analysis, 2003–2012 Chris Delcher 1,2,4 , Alexander Wagenaar 1,4 , Bruce Goldberger 3 , Mildred Maldonado-Molina 1,4 1
The impact of opioid substitution therapy on mortality post-release from prison Louisa Degenhardt 1,2 , Sarah Larney 1,3 , Jo Kimber 1 , Natasa Gisev 1 , Michael Farrell 1 , Timothy Dobbins 4 , Don J. Weatherburn 5 , Amy Gibson 6 , Richard Mattick 1 , Tony Butler 7 , Lucy Burns 1 1
National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, Australia 2 School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia 3 Alpert Medical School, Brown University, Providence, RI, United States 4 Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia 5 New South Wales Bureau of Crime Statistics and Research (BOCSAR), Sydney, NSW, Australia 6 University of Western Sydney, Sydney, NSW, Australia 7 Kirby Institute, University of New South Wales, Sydney, NSW, Australia Aims: Mortality following release from prison is high-risk for mortality. We examined the impact of opioid substitution therapy (OST) for opioid dependence during and after incarceration, upon mortality post-release. Methods: A cohort included all opioid dependent people who entered OST in New South Wales, Australia, 1985–2010, released from prison at least once, 2000–2012 (N = 16,453). We linked data on OST history, court appearances, prison episodes, and deaths. N = 60,161 eligible prison releases occurred. Demographics, criminographic and treatment histories were examined; crude mortality rates (CMRs) calculated according to retention in OST; and Cox regressions run to examine the association between OST exposure (a time dependent variable) and mortality in the postrelease period. Results: Individuals were observed for 100,978 person-years post-release; 1050 deaths occurred. Most received OST sometime while incarcerated (76.5%); individuals were receiving OST in 40% of releases. Lowest post-release mortality was among those continuously retained in OST post-release, highest among those with no OST. Multivariable models showed OST exposure in the 4 weeks post-release reduced hazard of death by 75% (adjusted hazard ratio 0.25; 95%CI: 0.15, 0.52); OST receipt in prison had a short-term protective effect that decayed quickly across time. Conclusions: OST in prison and post-release reduces mortality risk in the immediate post-release period. OST in prison should be scaled up, and post-release OST maximised. Financial support: Australian National Health and Medical Research Council; Australian Institute of Criminology (AIC); Australian Government Department of Health and Ageing. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.173
Health Outcome and Policy, University of Florida, Gainesville, FL, United States 2 Epidemiology, University of Florida, Gainesville, FL, United States 3 Pathology, University of Florida, Gainesville, FL, United States 4 Institute of Child Health Policy, University of Florida, Gainesville, FL, United States Aims: In Florida, oxycodone-caused deaths declined substantially (52%) from peak levels of 126 (2010) to 61 per month (2012). Several important pharmacy, law enforcement, and health policy factors likely contributed to this decline, including the implementation of Florida’s prescription drug monitoring program (PDMP). In the current study, we examine whether the PDMP had an effect on oxycodone-caused mortality. Methods: We used a time-series, quasi-experimental research design, including internal (Florida) and external (New York City) controls for comparison. The dataset included 120 monthly observations of oxycodone-caused mortality in Florida over a 10-year period (2003–2012). We used an autoregressive integrated moving average (ARIMA) model with covariates. We operationalized the introduction of re-formulated Oxycontin® (pharmacy), Operation Pill Nation (law enforcement), and Florida House Bill 7095 (health policy) using a single continuous variable representing the number of pain clinics closed in Florida. Results: Oxycodone-caused mortality declined by 4.1% [CI: 0.97%, 7.25%] after the implementation of Florida’s PDMP in October 2011, or approximately 30 deaths averted annually. The association remained after excluding decedents with alprazolam. However, mortality from all opioids exclusive of oxycodone did not change. Conclusions: This is the first study to show that the PDMP had a significant impact on reducing oxycodone-caused mortality in Florida. These results have implications for national efforts to reduce the negative outcomes related to the prescription drug epidemic. Financial support: University of Florida. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.174 Recent cannabis use among adolescent and young adult immigrants in the Netherlands: The roles of acculturation strategy and linguistic acculturation Monique Delforterie 1,2 , Hanneke Creemers 1,2 , Anja Huizink 1 1
Faculty of Psychology & EMGO, VU University, Amsterdam, Netherlands 2 Child Development and Education, University of Amsterdam, Amsterdam, Netherlands Aims: The cultural values paradigm proposes that cultural values of the host country shape attitudes and behaviors toward substance use, thereby promoting or protecting against substance use. Following this theory, becoming more acculturated to a culture with more positive values toward substance use will increase the risk of substance use. This study examined the relation of linguistic acculturation and the acculturation strategies integration, separation and marginalization with past year cannabis use among
confidence to employ each strategy listed on the scale might serve as a form of education by informing users of strategies of which they are otherwise unaware. Financial support: None. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.169 Effects of family relationships quality on drug use: Mediating effects of moral conviction Alexandra N. Davis, Gustavo Carlo, Cara Streit University of Missouri, Columbia, MO, United States Aims: Previous research demonstrates the importance of both family relationships and moral development in predicting substance use. The present study will extend this literature by examining the mediating role of moral conviction (i.e., strength of moral motivation) in the associations between parent and sibling relationship positivity and substance use outcomes (i.e., tobacco use, alcohol use, binge drinking, and marijuana use). We hypothesized that family positivity would be positively associated with moral conviction, and that moral conviction would be negatively associated with substance use. Methods: Participants were 303 college students (M age = 18.71; 62.7% female). Participants completed measures of mother, father, and sibling positivity, their moral convictions regarding substance use, and their frequency of tobacco, alcohol, marijuana, and binge drinking in the past year. Results: Structural path analysis was conducted to examine the relations among the study variables. The model displayed acceptable fit (2 = 2.74; CFI = .98; RMSEA = .08). The results demonstrated that sibling positivity was positively associated with moral conviction, which in turn, was negatively associated with the substance use. Parental positivity was also directly associated with substance use. These results provide support for partial mediation of moral conviction in the associations between relationship quality and substance use. Future analyses will examine potential gender differences. Conclusions: The findings address important gaps in the literature by demonstrating the importance of both parent and sibling relationship quality on substance use, as well as examining the strength of adolescents’ convictions in accounting for college students’ substance use. The discussion will focus on the influence of both family relationship quality and moral convictions in predicting substance use outcomes. Financial support: Mizzou Advantage Grant from the University of Missouri. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.170 Crack cocaine use and perceived life chances Jeffrey Davis, Dennis G. Fisher, Grace L. Reynolds, Lucy Napper, Stephanie A. Meyers Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA, United States Aims: Adolescents who perceive limited potential future success are at risk for substance use. This study investigates the utility of the Perceived Life Chances scale (PLCS) to model crack cocaine use with an adult (M age = 35.7 years, SD = 14.51 years) street population (N = 332) specifically, the association between the PLCS and whether participants have: ever used crack, age of first use of crack, and number of days used crack.
e259
Methods: In addition to the PLCS, the participants were administered the Risk Behavior Assessment. Results: The PLCS was negatively related to the decision to use or not use crack cocaine. In contrast to our hypotheses, greater pessimism was related to an older age of first use and not associated at all with the number of days using crack cocaine. The strong covariates of crack cocaine use included: sex trading for either drugs or money; use of other drugs such as opiates, powder cocaine, and marijuana; and history of sexually transmitted infections such as gonorrhea, syphilis, and Chlamydia. Conclusions: PLC has implications for the use of Decisional Balance in interventions with crack users in that those who predict a bleak future for themselves may only value immediate consequences of their drug use behavior and may not value long-term negative consequences given that they are pessimistic about their long-term opportunities. Financial support: The project described was supported by Award Numbers R01DA030234 from the National Institute on Drug Abuse, P20MD003942 from the National Institute of Minority Health and Health Disparities, and ID10-CSULB-008 from the California HIV Research Program. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.171 Prenatal cigarette smoke exposure, childhood aggression and adolescent cigarette use Natacha De Genna 1,2 , Lidush Goldschmidt 2 , Marie Cornelius 1,2 1 University of Pittsburgh School of Medicine, Pittsburgh, PA, United States 2 Western Psychiatric Institute and Clinic (WPIC), Pittsburgh, PA, United States
Aims: Studies have demonstrated a relation between prenatal cigarette smoke exposure (PCSE) and subsequent smoking among exposed offspring. There is also a relation between PCSE and child behavior problems. In this prospective study of teenage mothers, we examined a potential pathway to adolescent smoking in offspring via childhood aggressive behavior. Methods: Pregnant teenagers (n = 413) were recruited from an urban prenatal clinic and interviewed during pregnancy. Mothers and children were assessed at delivery and during follow-up visits when the children were 6, 10, 14, and 16 years old. The PCSE measure was maternal report of any cigarette use during the third trimester. Our outcome measure was self-reported current smoking in offspring at the age 16 follow-up. Child aggressive behavior was measured with the Child Behavior Checklist (CBCL) at age 6. Path analysis using Mplus evaluated proposed pathways and tested for an indirect effect of PCSE on adolescent cigarette use through childhood aggressive behavior. Results: Half of the offspring in this cohort had PCSE, and PCSE significantly predicted child aggression at age 6 (p = .011, onetailed). By the age 16 follow-up visit, 20% of the adolescents were smokers (14% of the non-exposed and 22% of the exposed offspring). Adolescent cigarette use was directly associated with age 6 aggression scores, less strict parenting during adolescence, and White race. There was also an indirect path between PCSE and adolescent cigarette use via age 6 aggression scores (p = .035, one-tailed). Conclusions: We found that childhood aggression was a significant pathway linking PCSE to adolescent cigarette use. These results suggest several opportunities for early intervention with mothers who smoke and exposed offspring. A two-pronged approach addressing both maternal and child behavior may help prevent cigarette use in the next generation. Future work should
e260
Abstracts / Drug and Alcohol Dependence 146 (2015) e202–e284
examine potential mediators and moderators including maternal stress, maternal aggression and child association with deviant peers. Financial support: AA08284; DA009275; DA025734. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.172
Florida’s prescription drug monitoring program and oxycodone-caused mortality: A monthly time series analysis, 2003–2012 Chris Delcher 1,2,4 , Alexander Wagenaar 1,4 , Bruce Goldberger 3 , Mildred Maldonado-Molina 1,4 1
The impact of opioid substitution therapy on mortality post-release from prison Louisa Degenhardt 1,2 , Sarah Larney 1,3 , Jo Kimber 1 , Natasa Gisev 1 , Michael Farrell 1 , Timothy Dobbins 4 , Don J. Weatherburn 5 , Amy Gibson 6 , Richard Mattick 1 , Tony Butler 7 , Lucy Burns 1 1
National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, Australia 2 School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia 3 Alpert Medical School, Brown University, Providence, RI, United States 4 Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia 5 New South Wales Bureau of Crime Statistics and Research (BOCSAR), Sydney, NSW, Australia 6 University of Western Sydney, Sydney, NSW, Australia 7 Kirby Institute, University of New South Wales, Sydney, NSW, Australia Aims: Mortality following release from prison is high-risk for mortality. We examined the impact of opioid substitution therapy (OST) for opioid dependence during and after incarceration, upon mortality post-release. Methods: A cohort included all opioid dependent people who entered OST in New South Wales, Australia, 1985–2010, released from prison at least once, 2000–2012 (N = 16,453). We linked data on OST history, court appearances, prison episodes, and deaths. N = 60,161 eligible prison releases occurred. Demographics, criminographic and treatment histories were examined; crude mortality rates (CMRs) calculated according to retention in OST; and Cox regressions run to examine the association between OST exposure (a time dependent variable) and mortality in the postrelease period. Results: Individuals were observed for 100,978 person-years post-release; 1050 deaths occurred. Most received OST sometime while incarcerated (76.5%); individuals were receiving OST in 40% of releases. Lowest post-release mortality was among those continuously retained in OST post-release, highest among those with no OST. Multivariable models showed OST exposure in the 4 weeks post-release reduced hazard of death by 75% (adjusted hazard ratio 0.25; 95%CI: 0.15, 0.52); OST receipt in prison had a short-term protective effect that decayed quickly across time. Conclusions: OST in prison and post-release reduces mortality risk in the immediate post-release period. OST in prison should be scaled up, and post-release OST maximised. Financial support: Australian National Health and Medical Research Council; Australian Institute of Criminology (AIC); Australian Government Department of Health and Ageing. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.173
Health Outcome and Policy, University of Florida, Gainesville, FL, United States 2 Epidemiology, University of Florida, Gainesville, FL, United States 3 Pathology, University of Florida, Gainesville, FL, United States 4 Institute of Child Health Policy, University of Florida, Gainesville, FL, United States Aims: In Florida, oxycodone-caused deaths declined substantially (52%) from peak levels of 126 (2010) to 61 per month (2012). Several important pharmacy, law enforcement, and health policy factors likely contributed to this decline, including the implementation of Florida’s prescription drug monitoring program (PDMP). In the current study, we examine whether the PDMP had an effect on oxycodone-caused mortality. Methods: We used a time-series, quasi-experimental research design, including internal (Florida) and external (New York City) controls for comparison. The dataset included 120 monthly observations of oxycodone-caused mortality in Florida over a 10-year period (2003–2012). We used an autoregressive integrated moving average (ARIMA) model with covariates. We operationalized the introduction of re-formulated Oxycontin® (pharmacy), Operation Pill Nation (law enforcement), and Florida House Bill 7095 (health policy) using a single continuous variable representing the number of pain clinics closed in Florida. Results: Oxycodone-caused mortality declined by 4.1% [CI: 0.97%, 7.25%] after the implementation of Florida’s PDMP in October 2011, or approximately 30 deaths averted annually. The association remained after excluding decedents with alprazolam. However, mortality from all opioids exclusive of oxycodone did not change. Conclusions: This is the first study to show that the PDMP had a significant impact on reducing oxycodone-caused mortality in Florida. These results have implications for national efforts to reduce the negative outcomes related to the prescription drug epidemic. Financial support: University of Florida. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.174 Recent cannabis use among adolescent and young adult immigrants in the Netherlands: The roles of acculturation strategy and linguistic acculturation Monique Delforterie 1,2 , Hanneke Creemers 1,2 , Anja Huizink 1 1
Faculty of Psychology & EMGO, VU University, Amsterdam, Netherlands 2 Child Development and Education, University of Amsterdam, Amsterdam, Netherlands Aims: The cultural values paradigm proposes that cultural values of the host country shape attitudes and behaviors toward substance use, thereby promoting or protecting against substance use. Following this theory, becoming more acculturated to a culture with more positive values toward substance use will increase the risk of substance use. This study examined the relation of linguistic acculturation and the acculturation strategies integration, separation and marginalization with past year cannabis use among