New Research on the Opioid Addiction Epidemic

Editor’s Note: Frequent Points readers are aware of Jonathon Erlen’s ongoing bibliography of dissertations related to alcohol, tobacco, and other drugs. Entries were formerly published in the Social History of Alcohol and Drugs journal but have since moved to the Points blog. Below are a few highlights concerning the United States’ opioid addiction epidemic. Contact Dr. Erlen through the link above.

Comparative Study of Compliance among Patients Attending an Opiate Outpatient Treatment Center in Rural Appalachia

Author: Morris, Jerry R.

Abstract: Adults with an opiate addiction have a higher rate of noncompliance with treatment, which limits its effectiveness and increases the burden of care for society. Effective treatment decreases emergency room visits, and overdoses. The tristate area of Kentucky, West Virginia, and Ohio has experienced increased opiate-related arrests and deaths. This study sought to measure the extent to which treatment type (medical treatment (MS) or faith-based component of service (FBS)) predicts compliance when measured by number of clean urine drug screens (UDSs) and number of kept pill count, over and above dual diagnosis, college education, and income. The on-site records of voluntary enrollees in an outpatient facility that used either MT alone or MT with FBS were reviewed. Spearman’s rho and multiple stepwise regression revealed that, with respect to clean UDSs or kept pill count, the association between dual diagnosis and college education was not found to be statistically significant. Rather, income explained about 5% of the variance in clean UDSs with a significant f change of .019, while type of treatment did not significantly impact clean UDSs. Dual diagnosis, income, and college education were not found to be significantly associated with the number of kept pill count. According to this study, type of treatment did not significantly impact compliance in the tristate area of Appalachia as measured by clean UDSs or kept pill count. Since MT and FBS are so similar in their relationship to compliance, attendance and participation in treatment may be areas for future study.

Publication year: 2015

Advisor: Denning, Pamela

University/institution: Walden University

Department: Human Services


Rural Opioid and Other Drug Use Disorder Diagnosis: Assessing Measurement Invariance and Latent Classification of DSM-IV Abuse and Dependence Criteria

Author: Brooks, Billy

Abstract: The rates of non-medical prescription drug use in the United States (U.S.) have increased dramatically in the last two decades, leading to a more than 300% increase in deaths from overdose, surpassing motor vehicle accidents as the leading cause of injury deaths. In rural areas, deaths from unintentional overdose have increased by more than 250% since 1999 while urban deaths have increased at a fraction of this rate. The objective of this research was to test the hypothesis that cultural, economic, and environmental factors prevalent in rural America affect the rate of substance use disorder (SUD) in that population, and that diagnosis of these disorders across rural and urban populations may not be generalizable due to these same effects. This study applies measurement invariance analysis and factor analysis techniques: item response theory (IRT), multiple indicators, multiple causes (MIMIC), and latent class analysis (LCA), to the DSM-IV abuse and dependency diagnosis instrument. The sample used for the study was a population of adult past-year illicit drug users living in a rural or urban area drawn from the 2011-2012 National Survey on Drug Use and Health data files (N = 3,369| analyses 1 and 2; N = 12,140| analysis 3). Results of the IRT and MIMIC analyses indicated no significant variance in DSM item function across rural and urban sub-groups; however, several socio-demographic variables including age, race, income, and gender were associated with bias in the instrument. Latent class structures differed across the sub-groups in quality and number, with the rural sample fitting a 3-class structure and the urban fitting 6-class model. Overall the rural class structure exhibited less diversity and lower prevalence of SUD in multiple drug categories (e.g. cocaine, hallucinogens, and stimulants). This result suggests underlying elements affecting SUD patterns in the two populations. These findings inform the development of surveillance instruments, clinical services, and public health programming tailored to specific communities.




Publication year: 2015

Advisor: Alamian, Arsham

University/institution: East Tennessee State University

Department: Biostatistics and Epidemiology


Determinants of Social Disorganization as Predictors of Illicit Drug Use During Recessionary Years

Author: Westmoreland, Daniel Kirk, Jr.

Abstract: Research suggests evidence of an association between sociodemographic determinants and illicit drug use. However, these data do not take into consideration the effect an economic obstacle, such as a recession, could have on an individual’s urge to cope with this stressful period with illicit drugs. Furthermore, there is no research to suggest how clinicians and/or treatment institutions can forecast whether the use of monetary resources will be sustainable due to private and/or governmental fund reductions during an economic recession. Based on theories of social learning and social disorganization within an ecological framework, this study employed a quantitative trend analysis to explore the impact the 2007-2009 economic recession had on illicit drug use throughout the United States. A sample of respondents from the Substance Abuse and Mental Health Data Archive from 2006 to 2010 surveys was used to run the statistical analysis. Based on the analyses, age and gender (covariates) and all variables (social disorganization and Gross Domestic Product) were found to be significant predictors of illicit drug use. Although methamphetamine was not significant for prevalence over time, total drug use, cocaine, and heroin were prevalent over time based on predictors. These findings suggest local, state, and federal policies regarding the prosecution and imprisonment of nonviolent and minor drug offenders should be reprioritized towards the rehabilitation of addicts while enforcing firmer laws upon the most disruptive and severe aspects of the drug trade in order to promote a genuine positive change towards social organization.



Publication year: 2015



Advisor: Greiner, Jay

University/institution: Walden University

Department: Psychology




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