Into the World of Illegal Drug Use: Exposure Opportunity and Other Mechanisms Linking the Use of Alcohol, Tobacco, Marijuana, and Cocaine

Wagner, Fernando A.; Anthony, James C.

doi:10.1093/aje/155.10.918

Cited by 348 publications

(283 citation statements)

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“…One advantage of this analytical approach to defining concordance and discordance is to increase the number of 'discordant' twin pairs, with increasing precision of study estimates and statistical power to detect environmental influences upon vulnerability to drug dependence. Determinants of lag time from first use to each drug to first dependence may become an issue in twin studies and other research on etiology of drug dependence, just as 'rapid' or slower transition from drug exposure opportunities to actual first use has become an issue for research on the causes of initial drug involvement (e.g., see Van Etten and Anthony 1999;Wagner and Anthony 2001).…”

Section: Discussionmentioning

confidence: 99%

From First Drug Use to Drug Dependence Developmental Periods of Risk for Dependence upon Marijuana, Cocaine, and Alcohol

Wagner

Anthony

2002

Neuropsychopharmacology

642

394

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The focal point of this paper is the transition from drug use to drug dependence. We present new evidence on risk for starting to use marijuana, cocaine, and alcohol, as well as risks for progression from first drug use to the onset of drug dependence, separately for each of these drugs. Data from the National Comorbidity Survey (NCS) were analyzed. The NCS had a representative sample of the United States population ages 15-54 years (n ϭ 8,098In an earlier report of evidence from the National Comorbidity Survey, our research group described some interesting features about the comparative epidemiology of drug dependence. For example, as a summary population average value for the estimated millions of Americans age 15-54 years who had tried cocaine at least one time by the early 1990s, about one in six had become dependent upon cocaine (about 16-17% NO . 4 marijuana at least one time, about one in 11 had become dependent upon it (about 9%). By comparison, among persons who had tried alcoholic beverages at least once, about one in 6 or 7, or 15%, had become alcohol dependent (Anthony et al. 1994). In the present study, we extend this look at the comparative epidemiology of drug dependence, but here our focus is upon estimation of the age-specific and time-specific risks of progression from first drug use to dependence, separately for marijuana, cocaine, and (for comparison) alcoholic beverages (hereinafter, 'alcohol').Prior studies have conveyed estimates of age-specific risk for first alcohol use and alcohol dependence, as well as risk estimates for initiation of illicit use and dependence on controlled drugs in general (e.g., Kandel and Logan 1984;Eaton et al. 1989;Warner et al. 1995;Chen and Kandel 1995;Johnson and Gerstein 1998;Perkonigg et al. 1999;DeWit et al. 2000). The role of early onset of drug use and progression to initial and problematic use of other drugs also has been studied in some detail (e.g., Kandel 1985;Anthony and Petronis 1995;Grant 1998;Grant and Dawson 1998). However, what is especially novel about the present study is its new look at both the cumulative and instantaneous risk of drug dependence in relation to time elapsed since first use of marijuana and cocaine, with alcohol for comparison.Whereas epidemiological studies of this type generally are regarded as valid sources of evidence, it is possible that some critics might call into question the validity or reliability of drug dependence assessments obtained in large-sample survey research as compared with what can be obtained via intensive clinical study of smaller samples (e.g., see Anthony et al. 1985;Brugha et al. 1999). Nonetheless, at least with respect to the drug dependence syndromes, recent empirical research provides evidence that epidemiologic studies can and do provide generally valid and reliable estimates of the occurrence of these conditions, as well as their corresponding ages of onset (e.g., see Prusoff et al. 1988;Langenbucher et al. 1994;Shillington et al. 1995;Wittchen et al. 1989Wittchen et al. , 1998Wittchen et ...

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Section: Discussionmentioning

confidence: 99%

From First Drug Use to Drug Dependence Developmental Periods of Risk for Dependence upon Marijuana, Cocaine, and Alcohol

Wagner

Anthony

2002

Neuropsychopharmacology

642

394

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“…Underage use of alcohol and tobacco were also noted as risk factors (Caris et al, 2009;Ellickson and Hays, 1992;Neumark et al, 2012;Wagner and Anthony, 2002). Moreover, youth with problem behaviors and with drug-using peers were more likely to encounter cannabis use opportunities (Neumark et al, 2012;Pinchevsky et al, 2012), while delinquent youth were more likely to receive offers to purchase illegal drugs (Rosenberg and Anthony, 2001).…”

Section: Introductionmentioning

confidence: 98%

“…That is, irrespective of any individual desire to engage in drug use, opportunity --be it indirect (i.e., being present in a situation where drugs are readily available) or direct (i.e., being directly offered drugs for purchase or sharing) --to do so is necessary as well. However, although 'drug exposure opportunity' has been recognized as the initial stage in the natural history of drug use (Van Etten et al, 1997;Van Etten and Anthony, 1999;Wagner and Anthony, 2002), it is still relatively unknown if some youth are at greater risk than others for encountering such opportunities.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, cannabis availability accounted for the majority of shared environmental risk for cannabis initiation (Gillespie et al, 2009), and the rate of transition from opportunity exposure to actual use tend to be higher for cannabis than for substances such as cocaine and amphetamines (Manning, 2001). Moreover, cannabis use is associated with an increased risk of progression to harder drugs (Fergusson et al, 2006;Wagner and Anthony, 2002), and some studies suggest that this in part may reflect a causal effect (Bretteville-Jensen et al, 2008;Bretteville-Jensen and Jacobi, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Drug use opportunity has typically been operationalized as any situation in which individuals perceived that they had the chance to use drugs if they wished to (Van Etten et al, 1997;Wagner and Anthony, 2002), including receiving explicit drug offers or being present when others were using (Parker et al, 1998;Storr et al, 2011;Wells et al, 2011). Focusing specifically on cannabis, Storr and colleagues (2011) identified aggressiveness as a risk factor for early opportunity to try cannabis.…”

Section: Introductionmentioning

confidence: 99%

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Who receives cannabis use offers: A general population study of adolescents

Andreas¹,

Pape²

2015

Drug and Alcohol Dependence

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Background: Drug use is predicated on a combination of "willingness" and "opportunity". That is, independent of any desire to use drugs, a drug use opportunity is required; be it indirect (i.e., being in a drug-use setting) or direct (i.e., receiving a direct drug offer). However, whether some youth are more likely to encounter such direct drug use opportunities is not fully known. Aims:We examined whether certain characteristics placed adolescents at greater risk for being offered cannabis, after accounting for a number of demographic-, contextual-, interpersonal-, and personal-level risk factors. Methods:We utilized data from a Norwegian school survey (N=19,309) where the likelihood of receiving cannabis offer in the past year was estimated using logistic regression models. Substantive focus was on the individual and combined effects of personal (i.e., delinquency) and interpersonal (i.e., cannabis-using close friend) risk factors. Separate models were fit for middle-and high-school students.Results: Delinquency was a significant risk factor for receiving cannabis offers, as was a cannabis-using best friend. In addition, peer cannabis use increased the risk of cannabis offers mostly for adolescents on the lower delinquency spectrum, but less so for highly-delinquent adolescents. These interaction effects were primarily driven by the middle-school cohort. Conclusions:Cannabis offers were more likely to be extended to youth of certain high-risk profiles.Targeted prevention strategies can therefore be extended to a general profile of younger adolescents with externalizing problems and cannabis-using peers.

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Assessment of Exposure to High-Performing Schools and Risk of Adolescent Substance Use

et al. 2018

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Importance Although school environments are thought to influence health behaviors, experimental data assessing causality are lacking, and which aspects of school environments may be most important for adolescent health are unknown. Objective To test whether exposure to high-performing schools reduces risky adolescent health behaviors. Design We used admission lotteries—which mimic random assignment—to estimate the causal effect of school environments on adolescent health. We surveyed 1270 students who applied to high-performing public charter schools in low-income minority communities in Los Angeles. We followed lottery “winners” (Intervention) and “losers” (Control) from the end of 8th grade/beginning of 9th grade through the end of 11th grade. Intent-to-Treat (ITT) and Instrumental Variables (IV) techniques estimate the effects of “winning” the lottery and attending high-performing schools on health behaviors and whether effects varied by gender. Setting: Charter and non-charter public high schools in Los Angeles. Participants: Students applying to one of the 5 public charter schools in Los Angeles where the majority enrolled were economically disadvantaged, the school’s academic performance ranked in the top tertile of LA County public high schools, there were at least 50 more applicants than seats available, and they used an admissions lottery. Main Outcomes and Measures: Primary outcomes were 30-day marijuana use and high-risk marijuana use. Additional health outcomes included 30-day alcohol use, alcohol misuse, ever being in a fight, ever having sex and past year delinquency. We also examined potential intermediate factors (time studying, truancy, school mobility, school culture, school order, teacher support, and proportion of substance using peers in students’ social networks). Results Intent-to-treat analysis showed that lottery “winners” (n=694) reported less marijuana misuse than loterry “losers” (n=576), as well as fewer substance using peers, more time studying, less truancy, greater teacher support, more orderly schools, and less school mobility(all p<0.05). Stratified analyses suggest more consistent effects for boys with treatment effects noted as early as 9th grade. Conclusions and Relevance This natural experiment provides evidence that school environments can improve risky behaviors for low-income minority adolescents.

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Into the World of Illegal Drug Use: Exposure Opportunity and Other Mechanisms Linking the Use of Alcohol, Tobacco, Marijuana, and Cocaine

Cited by 348 publications

References 24 publications

From First Drug Use to Drug Dependence Developmental Periods of Risk for Dependence upon Marijuana, Cocaine, and Alcohol

From First Drug Use to Drug Dependence Developmental Periods of Risk for Dependence upon Marijuana, Cocaine, and Alcohol

Who receives cannabis use offers: A general population study of adolescents

Assessment of Exposure to High-Performing Schools and Risk of Adolescent Substance Use

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