scholarly journals Exploring the Relationship Between Substance Use and Allostatic Load in a Treatment/Research Cohort and in a US Probability Sample (NHANES 2009–2016)

2021 ◽  
Vol 12 ◽  
Author(s):  
Jeffrey M. Rogers ◽  
David H. Epstein ◽  
Karran Phillips ◽  
Justin C. Strickland ◽  
Kenzie L. Preston
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Allostatic Load ◽  
Theoretical Models ◽  
Adverse Outcomes ◽  
Metabolic Systems ◽  
Increased Risk ◽  
Cumulative Strain ◽  
Treatment Research ◽  
The Relationship

Allostatic load, an operationalization for cumulative strain on physiology from adaptation (allostasis) to stress over a lifetime, can manifest as damage to cardiovascular, neuroendocrine, and metabolic systems. The concept of allostatic load may be particularly useful in research on substance-use disorders (SUDs) because SUD researchers have sought to better understand the relationship between chronic stressors and drug use. Theoretical models hold that SUDs can be conceptualized as a spiral toward a state of persistent allostasis (i.e., allostasis so persistent as to represent homeostasis at a new, unhealthy set point). Regardless of the extent to which those models are accurate, increased allostatic load could be a mechanism by which frequent drug administration increases risk for adverse outcomes. We conducted two secondary analyses to evaluate allostatic load in the context of drug use, including alcohol use, in a locally recruited sample with a high proportion of illicit substance use (N = 752) and in a nationally representative sample from the NHANES 2009–2016. We hypothesized that after controlling for age and other potential confounds, people with longer histories of drug use would have higher allostatic-load scores. Multiple regression was used to predict allostatic load from participants' drug-use histories while controlling for known confounds. In the locally recruited sample, we found that longer lifetime use of cocaine or opioids was related to increased allostatic load. In NHANES 2009–2016, we found few or no such associations. Lengthy histories of problematic non-medical substance use may facilitate more rapid increases in allostatic load than aging alone, and, together with findings from previous investigations, this finding suggests increased risk for chronic disease.

Abstract 228: National Prevalence of Substance Use Disorders Among Hospitalized Heart Failure Patients

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Sarah C Snow ◽  
Gregg C Fonarow ◽  
Joseph A Ladapo ◽  
Donna L Washington ◽  
Katherine Hoggatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Substance Use ◽  
Native American ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Opioid Use ◽  
Drug Use Disorders ◽  
Increased Risk ◽  
Drug Use Disorder

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.

scholarly journals Do Stress Trajectories Predict Mortality in Older Men? Longitudinal Findings from the VA Normative Aging Study

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Carolyn M. Aldwin ◽  
Nuoo-Ting Molitor ◽  
Avron Spiro ◽  
Michael R. Levenson ◽  
John Molitor ◽  
...  
Keyword(s):  
Allostatic Load ◽  
Stressful Life Events ◽  
High Stress ◽  
Theoretical Models ◽  
Growth Mixture Model ◽  
Growth Mixture ◽  
Aging Study ◽  
Health Related ◽  
The Relationship

We examined long-term patterns of stressful life events (SLE) and their impact on mortality contrasting two theoretical models: allostatic load (linear relationship) and hormesis (inverted U relationship) in 1443 NAS men (aged 41–87 in 1985;M= 60.30, SD = 7.3) with at least two reports of SLEs over 18 years (total observations = 7,634). Using a zero-inflated Poisson growth mixture model, we identified four patterns of SLE trajectories, three showing linear decreases over time with low, medium, and high intercepts, respectively, and one an inverted U, peaking at age 70. Repeating the analysis omitting two health-related SLEs yielded only the first three linear patterns. Compared to the low-stress group, both the moderate and the high-stress groups showed excess mortality, controlling for demographics and health behavior habits, HRs = 1.42 and 1.37,ps<.01and<.05. The relationship between stress trajectories and mortality was complex and not easily explained by either theoretical model.

scholarly journals Pathways linking family stress to youth delinquency and substance use: Exploring the mediating roles of self-efficacy and future orientation

2018 ◽  
Vol 25 (2) ◽  
pp. 139-151 ◽  
Author(s):  
Dexter R Voisin ◽  
Dong Ha Kim ◽  
Sarah M Bassett ◽  
Phillip L Marotta
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Low Income ◽  
Parental Stress ◽  
Family Stress ◽  
Future Orientation ◽  
African American Adolescents ◽  
Self Esteem ◽  
Youth Delinquency ◽  
The Relationship

African American adolescents in poorer neighborhoods experience significant sanctions related to drug use and delinquency. Parental stress (i.e. substance use, mental distress, and incarceration) is associated with youth drug use and delinquency. We examined whether high self-esteem and positive future orientation mediated parental stress and youth substance use and delinquency. Demographic, family stress, future orientation, self-esteem, and drug use data were collected from 578 youths. Major findings indicated that self-esteem mediated the relationship between family stress and both drug use and delinquency. Future mediated the relationship between family stress and delinquency. Resiliency factors may promote positive development for low-income youth.

scholarly journals Characteristics of Disclosing Childhood Victimization and Risk of Revictimization in Young Adulthood

2019 ◽  
pp. 088626051988993 ◽  
Author(s):  
Michelle P. Desir ◽  
Canan Karatekin
Keyword(s):  
Young Adulthood ◽  
Previous History ◽  
Adverse Outcomes ◽  
Support Networks ◽  
Negative Reaction ◽  
Childhood Victimization ◽  
Increased Risk ◽  
History Of ◽  
The Relationship ◽  
Hispanic White

Experiencing victimization in childhood increases risk of adulthood revictimization, and it is important to understand what may contribute to such risk. One factor that may help to explain the increased risk of future victimization is disclosure. However, the literature is mixed as to whether disclosure of prior victimization is helpful for protecting against adverse outcomes, and much of the research on disclosure focuses solely on sexual victimization. The current study examines the relationship between various forms of childhood and adulthood victimization and whether disclosure moderates this relationship. In addition, this study investigates whether characteristics of disclosure are associated with revictimization risk. The sample included 275 undergraduates ( M age = 19.52 years; 75.6% female, 77.5% non-Hispanic White or Caucasian). Participants reported on previous history of various forms of childhood and adulthood victimization. They also reported whether or not they had disclosed childhood victimization, and, if so, characteristics related to disclosure. Results revealed that number of childhood victimization experiences significantly predicted number of adulthood victimization experiences, and nearly every type of childhood victimization significantly increased risk of experiencing each type of adulthood victimization. Disclosure did not moderate the relationship between childhood and adulthood victimization. Participants who disclosed were more likely to disclose crime and peer/sibling victimization and disclose to parents or friends. Positive reactions to disclosure were more common than negative reactions; however, 75% of disclosers received at least one negative reaction. Finally, revictimized individuals received more overall negative reactions than nonrevictimized individuals. They also received more reactions characterized by the person they disclosed to trying to take control of their decisions or treating them differently. Results highlight the importance of examining relationships between various forms of victimization, considering how characteristics of disclosure relate to risk of revictimization, and the importance of educating potential support networks about appropriate responses to disclosure.

The Relationship between Sexual Abuse and Drug Use: Findings from Houston's Safer Choices 2 Program

2003 ◽  
Vol 33 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Ronald J. Peters ◽  
Susan R. Tortolero ◽  
Robert C. Addy ◽  
Christine Markham ◽  
S. Liliana Escobar-Chaves ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Substance Use ◽  
Logistic Regression ◽  
Drug Use ◽  
Alternative School ◽  
Self Report ◽  
Regression Analyses ◽  
School Students ◽  
Alternative School Students ◽  
The Relationship

Self-report drug use data were collected from 282 female alternative school students surveyed through the Safer Choices 2 study in Houston, Texas. Data collection took place between October 2000 and March 2001 via audio-enabled laptop computers equipped with headphones. Logistic regression analyses indicated that sexual abuse history was significantly associated with lifetime use (OR = 1.9, p ≤ 0.05). While the relationships tested in this study are exploratory, they provide evidence for an important connection between sexual abuse and substance use among female alternative school students.

scholarly journals The Relative Contributions of Parental and Sibling Substance Use to Adolescent Tobacco, Alcohol, and other Drug Use

2005 ◽  
Vol 35 (4) ◽  
pp. 869-883 ◽  
Author(s):  
Abigail A. Fagan ◽  
Jake M. Najman
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Drug Use ◽  
Sibling Relationships ◽  
Intervention Programs ◽  
Adolescent Substance Use ◽  
Shared Environment ◽  
Related Factors ◽  
Adolescent Substance ◽  
The Relationship

While research demonstrates that parental tobacco and alcohol use increases the likelihood of children's substance use, it is unclear whether or not sibling use has a greater, weaker, or similar effect. Based upon self-reported information from Australian adolescents, their siblings and parents, this investigation examines the association between siblings' tobacco and alcohol use. The relationship is consistent, moderately strong, and remains significant when controlling for a number of family-related factors, indicating that the shared environment cannot fully explain the extent of similarity in siblings' behaviors. In addition, sibling substance use has a greater effect on adolescent substance use than does smoking or drinking by parents. These findings indicate the need to include siblings and information regarding sibling relationships in prevention and intervention programs.

scholarly journals Relationship Between the Early Initiation of Substance Use and Attempted Suicide Among in-School Adolescents in Seven Low- or Middle-Income African Countries: An Analysis of the Global School-Based Student Health Survey Data

2021 ◽  
Vol 12 ◽  
Author(s):  
Lian Li ◽  
Yuanzhi Zhao ◽  
Meijun Shi ◽  
Yucheng Wang
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Cigarette Smoking ◽  
Attempted Suicide ◽  
Early Initiation ◽  
Student Health ◽  
African Countries ◽  
Middle Income ◽  
School Based ◽  
The Relationship

Background: Preventing suicide among adolescents is an urgent global public-health challenge, especially in Africa. Accordingly, the aim of this study was to examine the relationship between the early initiation (&lt; 12 years old) of substance use (cigarette smoking, alcohol use, and drug use) and attempted suicide among in-school adolescents in seven African countries.Methods: Data on the early initiation of substance use and on attempted suicide among in-school adolescents over the previous 12 months in Benin, Liberia, Mauritius, Mozambique, Namibia, Seychelles, and the United Republic of Tanzania were collected from Global School-based Student Health Surveys and were pooled to determine the overall prevalence of these behaviors in adolescents. Univariate and multivariate logistic regressions were then performed to evaluate country-specific associations between the early initiation of substance use and attempted suicide in these adolescents, followed by meta-analyses to evaluate overall pooled associations.Results: In the abovementioned seven African low- or middle-income countries (LMICs), overall weighted prevalences of attempted suicide and early initiation of cigarette smoking, alcohol use, and drug use among in-school adolescents were 16.05, 7.76, 17.68, and 3.48%, respectively. Multivariate logistic regression analyses revealed that relative to non-smoking, the early initiation of smoking was significantly associated with attempted suicide in these adolescents [OR (95% CI) = 1.783 (1.219–2.348)]. Additionally, the relationship between early initiation of cigarette smoking and attempted suicide is mostly driven by a higher association in girls [OR (95% CI) = 1.867 (1.031–2.703)] than boys [OR (95% CI) = 1.392 (0.995−1.789)]. Moreover, relative to not using other drugs, the early and later initiation of other drug use were also significantly associated with attempted suicide in these adolescents [ORs (95% CIs) = 2.455 (1.701–3.208) and 1.548 (1.198–1.898)].Conclusion: Programs that can eliminate or decrease the early initiation of substance use among adolescents should be implemented in African LMICs to prevent subsequent suicide attempts, especially among adolescent girls.

scholarly journals Stress Allostasis in Substance Use Disorders: Promise, Progress, and Emerging Priorities in Clinical Research

2020 ◽  
Vol 16 (1) ◽  
pp. 401-430
Author(s):  
Gaylen E. Fronk ◽  
Sarah J. Sant'Ana ◽  
Jesse T. Kaye ◽  
John J. Curtin
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Clinical Research ◽  
Substance Use Disorders ◽  
Clinical Implications ◽  
Treatment Development ◽  
Etiologic Role ◽  
Stress Biology ◽  
The Relationship ◽  
Biology Research

Clinicians and researchers alike have long believed that stressors play a pivotal etiologic role in risk, maintenance, and/or relapse of alcohol and other substance use disorders (SUDs). Numerous seminal and contemporary theories on SUD etiology posit that stressors may motivate drug use and that individuals who use drugs chronically may display altered responses to stressors. We use foundational basic stress biology research as a lens through which to evaluate critically the available evidence to support these key stress–SUD theses in humans. Additionally, we examine the field's success to date in targeting stressors and stress allostasis in treatments for SUDs. We conclude with our recommendations for how best to advance our understanding of the relationship between stressors and drug use, and we discuss clinical implications for treatment development.

Alcohol, other psychoactive substance use disorders, and suicide

2021 ◽  
pp. 275-284
Author(s):  
Tine Maes ◽  
Geert Dom
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Life Events ◽  
Substance Use Disorders ◽  
Population Level ◽  
Psychoactive Substance ◽  
Increased Risk ◽  
Psychoactive Substance Use ◽  
The Relationship ◽  
Behavioural Addictions

Up to 90% of the individuals who complete suicide meet criteria for a psychiatric disorder. Specifically, substance use disorders (SUD) are highly prevalent and frequently associated with an increased risk of suicidal behaviours. Growing evidence shows that this also counts for behavioural addictions, such as gambling. Comorbidity of psychiatric disorders such as major depression, bipolar disorder, schizophrenia, and personality disorder, with SUD, increase the risk. Pathways underlying the relationship between substance abuse and suicidality are multifactorial; the short-term effect of intoxication, impulsivity as trait and state, neurobiological consequences of chronic substance abuse, and accumulating adverse life events all contribute. Assessment and management of suicidality within SUD patients are mandatory for suicide prevention. Further, the evidence is growing that treatment of SUD in itself can reduce suicidality risk. Finally, and from a prevention perspective, decreasing substance use on a general population level is associated with decreases of population-level suicidality.

An Evaluation to Establish the Acceptable Serum Triglyceride Levels in Neonates Receiving Intravenous Fat Emulsion Infusion in a Multicenter Retrospective Study

2020 ◽  
Author(s):  
Belinda Chan ◽  
Anh Lian ◽  
Vickie Baer ◽  
Mandy Robinson ◽  
Zhining Ou ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Serum Triglyceride ◽  
Adverse Outcomes ◽  
Neonatal Intensive Care Units ◽  
Reference Ranges ◽  
Univariable Analysis ◽  
Increased Risk ◽  
Multivariable Regression ◽  
Multivariable Regression Models ◽  
The Relationship

Abstract Objective This study aimed to establish neonatal serum triglyceride (TG) level reference ranges during lipid infusion and correlate peak TG with neonatal outcomes. Study Design This is a retrospective review of 356 neonates with 696 TG measures obtained in four neonatal intensive care units between 2015 and 2017. TG was evaluated collectively to establish a reference range and a threshold limit. To analyze the effects of a higher TG threshold, neonates were categorized by their peak TG: <180 (TG<180), 180 to 400 (TG180–400), and > 400 mg/dL (TG>400). Univariable and multivariable regression models were constructed to compare peak TG to patient characteristic and clinical outcomes. Results The frequency of TG > 400 mg/dL was 5% and found only in neonates weighing < 1.5 kg. Neonates in the TG180–400 (n = 91) group were significantly lower in birth weight and gestational age, had lower 5-minute APGAR scores, and had increased ventilatory requirement when compared with neonates in the TG<180 (n = 240) group (all p < 0.001). The TG180–400 group had increased risk of severe intraventricular hemorrhage (p = 0.02) and bronchopulmonary dysplasia (p = 0.03). Elevated TG was associated with mortality (odds ratio [OR]: 14.4, p < 0.001) in univariable analysis, but the relationship weakened (OR: 4.4, p = 0.05) after adjusting for comorbidities in multivariable logistic regression. Conclusion It is unclear if the adverse outcomes seen in neonates with higher peak TG were due to elevated TG alone, or whether illness severity predicted the increased TG. More prospective studies are needed to further delineate the relationships.

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