A growth curve analysis of stress and adolescent drug use.

The purpose of this paper is to describe and examine one pathway by which adolescent drug use increases during early and mid-adolescence. It draws upon recent research on adolescent stress, drug use, and family processes to describe an important stage of the life course. A chief principle underlying the proposed pathway is that the cumulative effect of stressful life experiences over time can lead to a steeper escalation of drug use in adolescence. Furthermore, based on previous stress research, we propose that this effect may be moderated by factors such as sex, income, family attachment, self-esteem, and mastery. Using 4 years of panel data from the Family Health Study (n = 651 adolescents ages 11-14 during Year 1), we estimate a hierarchical growth curve model that examines the time-varying effects of stressful life events and peer relations on drug use. The results indicate that experiencing a high number of life events over time is related to a significant "growth" of drug use, even after controlling for "growth" due to age or peer relations. In addition, this relationship is moderated by family attachment; high levels of attachment serve to diminish this growth significantly.

A bibliographic essay: the relationship between stress and substance use.

The purpose of this review is to outline and critique studies that have examined the link between stress and substance use. Studies are categorized according to the age of the sample and the type of substance use measure considered. The research is mostly limited to studies that operationalize stress as stressful life events, daily hassles, or subjective stress. This paper concludes that there is a robust relationship between stress and substance use. However, there is a clear need for general population studies to address age, gender, and cultural differences to better assess the specificity and complexity of the stress/substance use relationship.

Services research outcomes study: overview of drug treatment population and outcomes.

The study examined a representative sample of the 1,060,000 individuals discharged from drug user treatment in the United States in the 12 months before September 1990, and compared self-reports of behavior 5 years before to 5 years after treatment. Self-reports about recent drug use were compared with urine samples, and the agreement between self-report and drug-test results was high. The key findings are that the number of alcohol and drug users declined markedly, ranging from one-seventh to more than one half; those who continued using drugs after treatment used them less frequently than before treatment; criminal behavior fell between one-quarter to one-half, and primary criminal support fell by one third; full-time employment did not change; homelessness, drug injection, and suicide attempts decreased by more than one-third.

Services research outcomes study: explanation of treatment effectiveness, using individual-level and programmatic variables.

This article examines the explanatory power of programmatic and individual-level variables, using the first nationally representative sample of both treatment facilities and clients. Multivariate statistical models accounted for almost half the variance in post-treatment heroin, marijuana, and any illicit drug use and about one-third the variance in crime. Use of any illicit drug during treatment, even after controlling for pretreatment use, was predictive of every type of drug use after treatment and three of the four major crimes analyzed. In addition, longer lengths of stay decreased the likelihood of alcohol/illicit drug use and criminal behavior after treatment. However, treatment variables added little explanatory power beyond the sociodemographic and pre-treatment variables.