Browsing by Author "Schlenger, William E"

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    Alcohol use disorders and the use of treatment services among college-age young adults.
    (Psychiatric services (Washington, D.C.), 2007-02) Wu, Li-Tzy; Pilowsky, Daniel J; Schlenger, William E; Hasin, Deborah
    OBJECTIVES:This study examined the utilization of and the perceived need for alcohol treatment services among college-age young adults (18-22 years) according to their educational status: full-time college students, part-time college students, noncollege students (currently in school with the highest grade level below college), and nonstudents (N=11,337). This breakdown of young adults had not been addressed previously. METHODS:Secondary analyses were conducted on data from the 2002 National Survey on Drug Use and Health. RESULTS:Full-time college students (21%) were as likely to have an alcohol use disorder as nonstudents (19%), but were more likely than part-time college students (15%) and noncollege students (12%). Only 4% of full-time college students with an alcohol use disorder received any alcohol services in the past year. Of those with an alcohol use disorder who did not receive treatment services, only 2% of full-time college students, close to 1% of part-time college students, and approximately 3% of young adults who were not in college reported a perceived need for alcohol treatment. Full-time college students were less likely than noncollege students to receive treatment for alcohol use disorders. All young adults with an alcohol use disorder were very unlikely to perceive a need for alcohol treatment or counseling. CONCLUSIONS:College-age adults have a high prevalence of alcohol use disorders, yet they are very unlikely to receive alcohol treatment or early intervention services or to perceive a need for such services. Underutilization of alcohol-related services among college-age young adults deserves greater research attention.
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    Concurrent use of methamphetamine, MDMA, LSD, ketamine, GHB, and flunitrazepam among American youths.
    (Drug and alcohol dependence, 2006-09) Wu, Li-Tzy; Schlenger, William E; Galvin, Deborah M
    The magnitude and the characteristics of the use of methamphetamine, MDMA (Ecstasy), LSD (d-lysergic acid diethylamide), ketamine, GHB (gamma-hydroxybutyrate), and flunitrazepam (Rohypnol) were examined in a probability sample of the U.S. civilian population that included multiethnic urban, suburban, and rural youths aged 16-23 (N=19,084).Data were drawn from the National Survey on Drug Use and Health (NSDUH). Logistic regression analyses were conducted to identify the characteristics associated with the use of each of these drugs and of multiple drugs.Approximately 20% of youths aged 16-23 reported having ever used one or more of these drugs. Less than 1% of club drug users used club drugs only, and 82% of them had ever used three or more drug classes. Females were more likely than males to report using multiple club drugs. Recent users of methamphetamine were most likely to be females and adolescents aged 16 or 17. Recent users of MDMA tended to be young adults aged 18-21 and residents of metropolitan areas. Most recent users of LSD were adolescents aged 16-19 and those in low-income families. Ketamine users were primarily employed youths. Staying in school and getting married were associated with decreased odds of club drug use. Club drug use was highly associated with the presence of criminal behaviors and recent alcohol abuse or dependence.Adolescents are more likely than young adults to use multiple drugs. The clustering of multidrug use and alcohol use disorder is a cause of concern.
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    High prevalence of substance use disorders among adolescents who use marijuana and inhalants.
    (Drug and alcohol dependence, 2005-04) Wu, Li-Tzy; Pilowsky, Daniel J; Schlenger, William E
    BACKGROUND: We examined the association between the use of inhalants, marijuana, and other drugs and recent DSM-IV substance use disorders among adolescents aged 12-17 years. METHODS: Data were drawn from 2000 to 2001 National Household Surveys on Drug Abuse. Adolescents aged 12-17 years who reported having ever used an illicit drug in their lifetime were categorized into four mutually exclusive groups: inhalant users (16%), marijuana users (53%), inhalant and marijuana users (16%), and other drug users (15%). Logistic regression models were used to estimate associations with recent substance use diagnoses among lifetime adolescent drug users (N=10,180). RESULTS: We found that 31% of lifetime drug users reported having never used marijuana. One half of these atypical drug users were predominantly nonmedical users of pain relievers. Adolescents who used inhalants or other drugs but not marijuana were least likely to report multidrug use. Adolescents who reported using both inhalants and marijuana were most likely to use three or more classes of drugs (73%) and to receive a diagnosis of past year alcohol (35%) and drug (39%) abuse or dependence. CONCLUSIONS: Our study findings suggest that among lifetime adolescent drug users, those who use both inhalants and marijuana are at very high risk for alcohol and drug use disorders.
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    Inhalant abuse and dependence among adolescents in the United States.
    (Journal of the American Academy of Child and Adolescent Psychiatry, 2004-10) Wu, Li-Tzy; Pilowsky, Daniel J; Schlenger, William E
    To examine the patterns of inhalant use and correlates of the progression from inhalant use to abuse and dependence among adolescents aged 12 to 17.Study data were drawn from the 2000 and 2001 National Household Surveys on Drug Abuse. Multinominal logistic regression was used to identify the characteristics associated with progression to inhalant abuse and dependence.Inhalant use was common among the studied adolescents. Among adolescents aged 12 to 17, 0.4% met DSM-IV inhalant abuse or dependence criteria in the past year. Inhalant abuse and dependence affected adolescents regardless of gender, age, race/ethnicity, and family income. The progression from inhalant use to abuse or dependence was related to early first use, use of multiple inhalants, and weekly inhalant use. Adolescents with inhalant use disorders reported coexisting multiple drug abuse and dependence, mental health treatment, and delinquent behaviors.Adolescents with an inhalant use disorder may represent a subgroup of highly troubled youths with multiple vulnerabilities. Because early use is associated with progression to abuse and dependence, prevention programs should target elementary school-age children.
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    Injection drug use among stimulant users in a national sample.
    (The American journal of drug and alcohol abuse, 2004-01) Wu, Li-Tzy; Pilowsky, Daniel J; Wechsberg, Wendee M; Schlenger, William E
    OBJECTIVE:This study examined the correlates of injection drug use (IDU) in a community sample of psychostimulant users. Factors related to the cessation of illicit drug use and substance abuse service utilization were also determined among a subsample of stimulant users who reported IDU. METHOD:The study sample consisted of 3408 lifetime psychostimulant users from the National Household Survey on Drug Abuse. Logistic regression procedures were used to estimate independent associations of correlates of IDU. RESULTS:Approximately one in seven lifetime stimulant users reported IDU in their lifetime. Stimulant users with a lifetime history of IDU were more likely than those who did not inject to be African-American, not have received a high school diploma, have a history of multiple drug use, and report an onset of stimulant use before age 18. Among recent stimulant users, being aged 26 or older, using stimulants at least weekly, and getting drunk in the past year were associated with increased odds of recent IDU. Only one-half of all injection drug users reported having ever used substance abuse services. Cessation of illicit drug use among injectors with a history of stimulant use is common (44%). CONCLUSIONS:Further studies should clarify the natural history of IDU among stimulant users, including the cessation of drug use without participating in substance abuse treatment services.
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    Misuse of methamphetamine and prescription stimulants among youths and young adults in the community.
    (Drug and alcohol dependence, 2007-07) Wu, Li-Tzy; Pilowsky, Daniel J; Schlenger, William E; Galvin, Deborah M
    Gender differences in the prevalence and characteristics of misuse of methamphetamine (meth) and prescription stimulants were examined in a representative US sample of youths and young adults aged 16-25 (N=24,409).Stimulant misusers were categorized into three mutually exclusive subgroups: meth users only, meth and prescription stimulant users, and prescription stimulant users only (e.g., Benzedrine, Ritalin, or Dexedrine). Multinominal logistic regression analyses identified the characteristics associated with misuse of meth and prescription stimulants.About 1 in 10 youths reported any misuse of stimulants in their lifetime. Prescription stimulant misuse occurred earlier and was more frequent than meth misuse. About 47% of meth misusers also reported prescription stimulant misuse. Among misusers of meth and prescription stimulants, males were more likely than females to misuse methylphenidate (82% versus 65%) but were less likely to misuse diet pills or amphetamines (37% versus 49%). Multinominal logistic regression analyses indicated that all subgroups of lifetime stimulant misuse were associated with past year substance abuse. The characteristics of meth misusers differed slightly from prescription stimulants misusers.Multidrug use is common among stimulant misusers. Parents should be informed about the risk of prescription stimulant misuse by their youths.
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    Private health insurance coverage for substance abuse and mental health services, 1995 to 1998.
    (Psychiatric services (Washington, D.C.), 2004-02) Wu, Li-Tzy; Schlenger, William E
    Four years of data from the National Household Survey on Drug Abuse were combined to examine the characteristics of underinsurance in a sample of privately insured Americans aged 18 to 64. Among these adults, 38 percent (45 million) reported not having behavioral health coverage or not knowing their coverage. Young adults aged 18 to 25, Hispanics, Asians, adults in the lowest income level, and less educated adults were more likely to be underinsured. Untreated addictive and psychiatric problems are costly to society. Underinsurance among socially disadvantaged subgroups deserves greater attention from researchers and policy makers.
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    Psychostimulant dependence in a community sample.
    (Substance use & misuse, 2003-01) Wu, Li-Tzy; Schlenger, William E
    OBJECTIVE:To examine the prevalence of psychostimulant dependence and the characteristics associated with nonmedical users' development of dependence. METHODS:The study sample was drawn from the 1995 to 1998 National Household Surveys on Drug Abuse. Statistical analysis was conducted on a total of 1047 individuals aged 12 or older who reported nonmedical use of stimulants in the past year. Multiple multinomial logistic regression identified factors related to stimulant dependence and dependence problems. RESULTS:Among all past year stimulant users, 19% met criteria for stimulant dependence in the past year, and an additional 16% reported having one to two dependence problems. Adjusting for demographics and drug use characteristics, female stimulant users were an estimated 2.6 times more likely than male users to develop dependence. Not only did the Western region of the United States have more recent stimulant users than other regions, its users also were more likely to meet criteria for dependence or experience dependence problems. Stimulant users who had increased odds of progressing into dependence were characterized by an early onset of stimulant use, coexisting multiple illicit drug use, and an onset of daily cigarette smoking between the ages of 13 and 17 years. CONCLUSIONS:Gender differences in initial stimulant use and progression to dependence require further investigation, including contextual, cultural, or perceptual factors related specifically to the choice of drugs by females.
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    Substance use, dependence, and service utilization among the US uninsured nonelderly population.
    (American journal of public health, 2003-12) Wu, Li-Tzy; Kouzis, Anthony C; Schlenger, William E
    OBJECTIVES:We examined the prevalence and correlates of substance use, dependence, and service utilization among uninsured persons aged 12 to 64 years. METHODS:We drew study data from the 1998 National Household Survey on Drug Abuse. RESULTS:An estimated 80% of uninsured nonelderly persons reported being uninsured for more than 6 months in the prior year. Only 9% of these uninsured persons who were dependent on alcohol or drugs had received any substance abuse service in the past year. Non-Hispanic Whites were an estimated 3 times more likely than Blacks to receive substance abuse services. CONCLUSIONS:Compared with the privately insured, uninsured persons had increased odds of having alcohol/drug dependence and appeared to face substantial barriers to health services for substance use problems.
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    The relationship between employment and substance use among students aged 12 to 17.
    (The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2003-01) Wu, Li Tzy; Schlenger, William E; Galvin, Deborah M
    PURPOSE:To examine the association between employment status and substance use among students aged 12 to 17 years. METHODS:Secondary analysis of data from the 1995 and 1996 National Household Surveys on Drug Abuse was conducted. The survey is a primary source of data on licit and illicit drug use among noninstitutionalized Americans aged 12 years or older. Participants are interviewed at their places of residence. Multiple logistic regression procedures yielded estimated associations. RESULTS:About one in six adolescents reported both going to school and holding a job. Approximately one-fourth of students smoked cigarettes, and one-third consumed alcohol in the past year. An estimated 1.6% of students were current heavy cigarette smokers, and 2.6% were current heavy alcohol users. One-year prevalence estimates of any illicit drug use and heavy illicit drug use were 16.7% and 1.8%, respectively. Among students employed full time, prevalence estimates increased to 9.7% for heavy cigarette smoking, 13.1% for heavy alcohol use, 38.1% for any illicit drug use, and 5.0% for heavy illicit drug use. Logistic regression analyses supported relatively high rates of cigarette use, alcohol use, illicit drug use, and heavy substance use among working students. Mental health problems, especially externalizing behavioral syndromes, were found to coexist with the use and heavy use of substances. The observed associations varied somewhat by gender. CONCLUSIONS:The workplace may be an appropriate venue for establishing substance use prevention and early intervention programs focused on younger workers, including adolescents who work part time.
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    Use of nitrite inhalants ("poppers") among American youth.
    (The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2005-07) Wu, Li-Tzy; Schlenger, William E; Ringwalt, Chris L
    PURPOSE: We examined the patterns and correlates of nitrite inhalant use among adolescents aged 12 to 17 years. METHODS: Study data were drawn from the 2000 and 2001 National Household Surveys on Drug Abuse. Logistic regression was used to identify the characteristics associated with nitrite inhalant use. RESULTS: Among adolescents aged 12 to 17 years, 1.5% reported any lifetime use of nitrite inhalants. The prevalence of lifetime nitrite inhalant use increased to 12% and 14% among adolescents who were dependent on alcohol and any drug in the past year, respectively. Many nitrite inhalant users used at least three other types of inhalants (68%) and also met the criteria for alcohol (33%) and drug (35%) abuse or dependence. Increased odds of nitrite inhalant use were associated with residing in nonmetropolitan areas, recent utilization of mental health services, delinquent behaviors, past year alcohol and drug abuse and dependence, and multi-drug use. CONCLUSIONS: Adolescents who had used nitrite inhalants at least once in their lifetime tend to engage in delinquent activities and report co-occurring multiple drug abuse and mental health problems in the past year.