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Differences by gender identity for individuals in substance abuse treatment
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Abstracts / Drug and Alcohol Dependence 140 (2014) e2–e85
latent profile models. The scale of the data differs between these models, but the analytic goals are identical. Methods: The Nicotine Dependence Syndrome Scale, administered as part of the 2004 National Survey of Drug Use and Health, is analyzed with both models. Raw data were recoded to sub-scale scores and binary indicators. To reduce heterogeneity, the sample was limited to white adults who reported daily smoking in the past 30 days (N = 5926). Results: One expects data features driving the results to be strong. Arguably, the information in the positive/negative valence of the ordinal items should largely be captured in the binary data. However, starkly different results emerged, telling quite different substantive stories. In fact, psychometrically the importance of the subscales differed sharply between the analyses. In the latent class analysis, the subscales for drive/craving and tolerance are among the most important, whereas for latent profile analysis, the smoking priority sub-scale dominates. Conclusions: Causes, implications, and recommendations are considered. Theory development hinges upon an evolving body of research. If results are conditional upon data features that should be ignorable or if salient data features vary by item scale, the value of these models to subsequent theory development is reduced. Financial support: This work was supported by National Institutes of Health grant R37DA18673 and a grant from the American Legacy Foundation. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.182 Differences by gender identity for individuals in substance abuse treatment Annesa Flentje 1 , N.C. Heck 2 , J.L. Sorensen 1 1
University of California, San Francisco, San Francisco, CA, United States 2 The University of Montana, Missoula, MT, United States Aims: This study identified the characteristics and needs of transgender persons entering substance abuse treatment, a topic seldom addressed in the existing literature. Methods: Substance use, psychosocial, health risk, medical, and mental health variables were examined in a database that documented individuals entering substance abuse treatment within San Francisco, CA between July 2007 and June 2009. Transgender (n = 199) and non-transgender (n = 13,240) individuals were compared using logistic and linear regression. Results: Transgender clients had unique patterns of substance use when compared to non-transgender clients, with higher rates of primary methamphetamine use (OR = 2.01, 95% CI = 1.41–2.87) and higher rates of needle use (OR = 1.44, 95% CI = 1.05–1.98). Transgender clients were more likely to have physical health problems (OR = 1.66, 95% CI = 1.23–2.23), lifetime mental illness diagnoses (OR = 2.75, 95% CI = 2.04–3.69), be taking psychiatric medications (OR = 2.58, 95% CI = 1.92–3.47), have recent family conflict (OR = 1.96, 95% CI = 1.34–2.87), and recent alcohol use (B = 1.24, p = .023). Transgender clients were also were less likely to be involved with the legal system (OR = .70, 95% CI = .51–.95), more likely to be in recovery oriented activities (OR = 1.39, 95% CI = 1.02–1.91), more likely to have been tested for HIV/AIDS (OR = 2.50, 95% CI = 1.66–3.77), and had lower rates of recent use of their primary substance (B = −2.65, p = .002). There were no detectable differences in recent work experience, arrests, ER visits, hospitalizations, mental health emergencies, hepatitis C/STD diagnoses, severity of substance use diagnoses, nor age first used primary substance.
Conclusions: Transgender individuals have unique needs in substance abuse treatment programs, including access to mental and physical health services. Transgender individuals may also bring inherent strengths, such as recovery involvement, to treatment. Financial support: National Institute on Drug Abuse: T32DA007250, P50DA09253, and U10DA015815. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.183 Contingency management voucher spending as an indicator of delayed gratification Jesse B. Fletcher 1 , R. Dierst-Davies 1,2 , Cathy J. Reback 1,3 1 Friends Research Institute Inc., Los Angeles, CA, United States 2 Public Health, University of California, Los Angeles, Los Angeles, CA, United States 3 UCLA Integrated Substance Abuse Programs, Los Angeles, CA, United States
Aims: This secondary analysis assessed the association between ongoing drug use and delays in earned CM voucher spending. It was hypothesized that drug use would be negatively associated with delays in voucher spending. Methods: 131 homeless, substance-dependent (current methamphetamine dependence = 63.4%) MSM enrolled in a voucher-based CM intervention. Participants were randomized into either a CM-Full or CM-Lite condition. All subjects earned vouchers for attendance/participation, while participants in the CM-Full condition also received vouchers for substance abstinence and prosocial behaviors. Longitudinal multivariate negative binomial regression analysis estimated associations between incidences of delayed spending and ongoing drug use, controlling for sociodemographics, condition assignment, total number of visits attended, and total number of vouchers earned. Results: Participants were racially diverse (53.4% White) and averaged 36.4 years of age (SD = 8.7). Seven participants did not earn/spend vouchers, making the final analytical sample n = 124. Instances of delayed voucher spending were common (N = 2777; avg. delay = 13.2 days; SD = 34.0). Participants delayed voucher spending for shorter intervals when testing positive for recent cocaine (IRR = 0.77; 95% CI = 0.68–0.88), methamphetamine (IRR = 0.66; 95% CI = 0.53–0.83), marijuana (IRR = 0.75; 95% CI = 0.66–0.85), or opiate (IRR = 0.58; 95% CI = 0.40–0.83) use. Conclusions: Participants testing positive for recent drug use were less likely to delay voucher spending than those who were abstinent. Drug use has previously been associated with preference for immediate, rather than delayed gratification. Initial evidence suggests CM spending shares this association, and may be a valid indicator of the tendency to delay gratification. Thus, standard CM redemption logs may act as cost-effective and unobtrusive tools for measuring psychological functioning among participants enrolled in a CM intervention. Financial support: This study is supported by NIDA grant # R01 DA015990. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.184
Abstracts / Drug and Alcohol Dependence 140 (2014) e2–e85
latent profile models. The scale of the data differs between these models, but the analytic goals are identical. Methods: The Nicotine Dependence Syndrome Scale, administered as part of the 2004 National Survey of Drug Use and Health, is analyzed with both models. Raw data were recoded to sub-scale scores and binary indicators. To reduce heterogeneity, the sample was limited to white adults who reported daily smoking in the past 30 days (N = 5926). Results: One expects data features driving the results to be strong. Arguably, the information in the positive/negative valence of the ordinal items should largely be captured in the binary data. However, starkly different results emerged, telling quite different substantive stories. In fact, psychometrically the importance of the subscales differed sharply between the analyses. In the latent class analysis, the subscales for drive/craving and tolerance are among the most important, whereas for latent profile analysis, the smoking priority sub-scale dominates. Conclusions: Causes, implications, and recommendations are considered. Theory development hinges upon an evolving body of research. If results are conditional upon data features that should be ignorable or if salient data features vary by item scale, the value of these models to subsequent theory development is reduced. Financial support: This work was supported by National Institutes of Health grant R37DA18673 and a grant from the American Legacy Foundation. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.182 Differences by gender identity for individuals in substance abuse treatment Annesa Flentje 1 , N.C. Heck 2 , J.L. Sorensen 1 1
University of California, San Francisco, San Francisco, CA, United States 2 The University of Montana, Missoula, MT, United States Aims: This study identified the characteristics and needs of transgender persons entering substance abuse treatment, a topic seldom addressed in the existing literature. Methods: Substance use, psychosocial, health risk, medical, and mental health variables were examined in a database that documented individuals entering substance abuse treatment within San Francisco, CA between July 2007 and June 2009. Transgender (n = 199) and non-transgender (n = 13,240) individuals were compared using logistic and linear regression. Results: Transgender clients had unique patterns of substance use when compared to non-transgender clients, with higher rates of primary methamphetamine use (OR = 2.01, 95% CI = 1.41–2.87) and higher rates of needle use (OR = 1.44, 95% CI = 1.05–1.98). Transgender clients were more likely to have physical health problems (OR = 1.66, 95% CI = 1.23–2.23), lifetime mental illness diagnoses (OR = 2.75, 95% CI = 2.04–3.69), be taking psychiatric medications (OR = 2.58, 95% CI = 1.92–3.47), have recent family conflict (OR = 1.96, 95% CI = 1.34–2.87), and recent alcohol use (B = 1.24, p = .023). Transgender clients were also were less likely to be involved with the legal system (OR = .70, 95% CI = .51–.95), more likely to be in recovery oriented activities (OR = 1.39, 95% CI = 1.02–1.91), more likely to have been tested for HIV/AIDS (OR = 2.50, 95% CI = 1.66–3.77), and had lower rates of recent use of their primary substance (B = −2.65, p = .002). There were no detectable differences in recent work experience, arrests, ER visits, hospitalizations, mental health emergencies, hepatitis C/STD diagnoses, severity of substance use diagnoses, nor age first used primary substance.
Conclusions: Transgender individuals have unique needs in substance abuse treatment programs, including access to mental and physical health services. Transgender individuals may also bring inherent strengths, such as recovery involvement, to treatment. Financial support: National Institute on Drug Abuse: T32DA007250, P50DA09253, and U10DA015815. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.183 Contingency management voucher spending as an indicator of delayed gratification Jesse B. Fletcher 1 , R. Dierst-Davies 1,2 , Cathy J. Reback 1,3 1 Friends Research Institute Inc., Los Angeles, CA, United States 2 Public Health, University of California, Los Angeles, Los Angeles, CA, United States 3 UCLA Integrated Substance Abuse Programs, Los Angeles, CA, United States
Aims: This secondary analysis assessed the association between ongoing drug use and delays in earned CM voucher spending. It was hypothesized that drug use would be negatively associated with delays in voucher spending. Methods: 131 homeless, substance-dependent (current methamphetamine dependence = 63.4%) MSM enrolled in a voucher-based CM intervention. Participants were randomized into either a CM-Full or CM-Lite condition. All subjects earned vouchers for attendance/participation, while participants in the CM-Full condition also received vouchers for substance abstinence and prosocial behaviors. Longitudinal multivariate negative binomial regression analysis estimated associations between incidences of delayed spending and ongoing drug use, controlling for sociodemographics, condition assignment, total number of visits attended, and total number of vouchers earned. Results: Participants were racially diverse (53.4% White) and averaged 36.4 years of age (SD = 8.7). Seven participants did not earn/spend vouchers, making the final analytical sample n = 124. Instances of delayed voucher spending were common (N = 2777; avg. delay = 13.2 days; SD = 34.0). Participants delayed voucher spending for shorter intervals when testing positive for recent cocaine (IRR = 0.77; 95% CI = 0.68–0.88), methamphetamine (IRR = 0.66; 95% CI = 0.53–0.83), marijuana (IRR = 0.75; 95% CI = 0.66–0.85), or opiate (IRR = 0.58; 95% CI = 0.40–0.83) use. Conclusions: Participants testing positive for recent drug use were less likely to delay voucher spending than those who were abstinent. Drug use has previously been associated with preference for immediate, rather than delayed gratification. Initial evidence suggests CM spending shares this association, and may be a valid indicator of the tendency to delay gratification. Thus, standard CM redemption logs may act as cost-effective and unobtrusive tools for measuring psychological functioning among participants enrolled in a CM intervention. Financial support: This study is supported by NIDA grant # R01 DA015990. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.184