Substance Use in the Context of Adolescent Development

2016 ◽  
pp. 18-36
Author(s):  
John E. Schulenberg ◽  
Julie Maslowsky ◽  
Megan E. Patrick ◽  
Meghan Martz
Keyword(s):  
Substance Use ◽  
Adolescent Development ◽  
Turning Point ◽  
Well Being ◽  
Risky Behaviors ◽  
Cascading Effect ◽  
Developmental Disturbance ◽  
Contextual Characteristics ◽  
The Many ◽  
Health And Well Being

Adolescence is a prime time for substance use onset and escalation. Key developmental concepts regarding continuity, discontinuity, transitions, and tasks are identified. For many young people, substance use reflects a cascading effect whereby earlier difficulties contribute to substance use onset and escalation, which then cascades into other difficulties. In contrast, this cascading flow can get interrupted, resulting in ontogenetic discontinuity whereby substance use and other risky behaviors during adolescence are more the result of developmentally proximal individual and contextual characteristics than distal ones. This discontinuity can reflect either a temporary developmental disturbance or a turning point, a permanent change in course. Substance use is intertwined with the many developmental changes of adolescence, providing some developmentally functional experiences while posing serious risks to health and well-being that can reverberate into adulthood.

scholarly journals Substance Use Disorder in Early Midlife: A National Prospective Study on Health and Well-Being Correlates and Long-Term Predictors

2015 ◽  
Vol 9s1 ◽  
pp. SART.S31437 ◽  
Author(s):  
John E. Schulenberg ◽  
Megan E. Patrick ◽  
Deborah D. Kloska ◽  
Julie Maslowsky ◽  
Jennifer L. Maggs ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Well Being ◽  
Cannabis Use ◽  
Adult Health ◽  
Senior Year ◽  
Cognitive Difficulties ◽  
Monitoring The Future ◽  
Health And Well Being

This study used national multicohort panel data from the Monitoring the Future study ( N = 25,536 from senior year classes 1977–1997 followed up to the age of 35 years in 1994–2014) to examine how early midlife (age 35 years) alcohol use disorder (AUD) and cannabis use disorder (CUD) are associated with adolescent and adult sociodemographics and health and well-being risk factors. Survey items adapted from DSM-5 diagnostic criteria were used to identify individuals who (a) showed symptoms consistent with criteria for AUD or CUD at age 35 years, (b) used the substance without qualifying for a disorder (nondisordered users), and (c) abstained from using alcohol or marijuana during the past five years. At age 35 years, the estimated prevalence of past five-year AUD was 28.0%, and that of CUD was 6.1%. Multinomial logistic regressions were used to identify variations in the relative risk of disorder symptoms as a function of sociodemographic characteristics, age 18 educational and social indices and substance use, and age 35 health and satisfaction indices and substance use. In the full models, age 18 binge drinking and marijuana use were found to be among the strongest predictors of age 35 AUD and CUD, respectively. Among age 35 health and well-being indicators, lower overall health, more frequent cognitive difficulties, and lower satisfaction with spouse/partner were consistently associated with greater risks of AUD and CUD. Some evidence was found for a J-shaped association between age 35 AUD or CUD status and health and well-being indices, such that nondisordered users were sometimes better off than both abstainers and those experiencing disorder. Finally, nondisordered cannabis use, but not CUD, was found to be more common in more recent cohorts. Implications are discussed regarding the importance of placing early midlife substance use disorder within the context of both adolescent substance use and adult health and well-being.

Health Reform and the Safety Net: Big Opportunities; Major Risks

2004 ◽  
Vol 32 (3) ◽  
pp. 426-432 ◽  
Author(s):  
Bruce Siegel ◽  
Marsha Regenstein ◽  
Peter Shin
Keyword(s):  
Health Care ◽  
Service Providers ◽  
Systems Of Care ◽  
Well Being ◽  
Safety Net ◽  
Institute Of Medicine ◽  
Health Care Safety Net ◽  
The Many ◽  
Health And Well Being ◽  
Health Care Safety

Millions of Americans are dependent on what is often called the “safety net.” These loosely-organized networks of health and social service providers serve the many Americans who are uninsured, dependent on public coverage, or for a variety of reasons unable to access other private systems of care. The Institute of Medicine (IOM) report, America’s Health Care Safety Net: Intact but Endangered, called attention to both the fragility and the resilience of this health care safety net. The IOM report underscored the critical importance of the safety net to the health and well-being of millions of individuals and called for efforts to strengthen it and improve the nation’s ability to monitor its viability. Given this central role, any health care reform efforts need to be fully informed by an understanding of what the safety net includes, how it is financed, and how it is responding to a series of challenges it now faces.

scholarly journals Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials

2019 ◽  
Vol 73 (5) ◽  
pp. 379-387 ◽  
Author(s):  
Andrew J Baxter ◽  
Emily J Tweed ◽  
Srinivasa Vittal Katikireddi ◽  
Hilary Thomson
Keyword(s):  
Substance Use ◽  
Health Outcomes ◽  
Randomised Controlled Trials ◽  
Well Being ◽  
Risk Of Bias ◽  
Housing First ◽  
Controlled Trials ◽  
Housing Stability ◽  
Randomised Controlled ◽  
Health And Well Being

BackgroundHomelessness is associated with poor health. A policy approach aiming to end homelessness across Europe and North America, the ‘Housing First’ (HF) model, provides rapid housing, not conditional on abstinence from substance use. We aimed to systematically review the evidence from randomised controlled trials for the effects of HF on health and well-being.MethodsWe searched seven databases for randomised controlled trials of interventions providing rapid access to non-abstinence-contingent, permanent housing. We extracted data on the following outcomes: mental health; self-reported health and quality of life; substance use; non-routine use of healthcare services; housing stability. We assessed risk of bias and calculated standardised effect sizes.ResultsWe included four studies, all with ‘high’ risk of bias. The impact of HF on most short-term health outcomes was imprecisely estimated, with varying effect directions. No clear difference in substance use was seen. Intervention groups experienced fewer emergency department visits (incidence rate ratio (IRR)=0.63; 95% CI 0.48 to 0.82), fewer hospitalisations (IRR=0.76; 95% CI 0.70 to 0.83) and less time spent hospitalised (standardised mean difference (SMD)=−0.14; 95% CI −0.41 to 0.14) than control groups. In all studies intervention participants spent more days housed (SMD=1.24; 95% CI 0.86 to 1.62) and were more likely to be housed at 18–24 months (risk ratio=2.46; 95% CI 1.58 to 3.84).ConclusionHF approaches successfully improve housing stability and may improve some aspects of health. Implementation of HF would likely reduce homelessness and non-routine health service use without an increase in problematic substance use. Impacts on long-term health outcomes require further investigation.Trial registration numberCRD42017064457

scholarly journals The Suspected Child Abuse and Neglect (SCAN) Programme in Malaysia: From Inception to Present

2019 ◽  
Vol 11 (7) ◽  
pp. 148
Author(s):  
Rimah Melati Ab. Ghani ◽  
Azriman Rosman ◽  
Nor Asiah Muhamad
Keyword(s):  
Child Abuse ◽  
Child Abuse And Neglect ◽  
Well Being ◽  
Hospital Staff ◽  
Government Hospital ◽  
Abuse And Neglect ◽  
Supportive Service ◽  
The Government ◽  
The Many ◽  
Health And Well Being

Issues on child abuse are very critical considering the many incidents of abuse and violence against children. Experiencing abuse in childhood has lifelong impacts on the health and well-being of children, their families and communities. Suspected Child Abuse and Neglect (SCAN) service is centralised, multidisciplinary team management in the government hospital and serve as a supportive service or programme to children, families and hospital staff. This paper outlines the history and the SCAN service available in Malaysia.

Avoiding Risky Teams in Risky Environments

2000 ◽  
Vol 44 (12) ◽  
pp. 2-800-2-803
Author(s):  
Sheryl L. Bishop ◽  
M. Ephimia Morphew ◽  
Jason P. Kring
Keyword(s):  
Real World ◽  
Group Performance ◽  
Extreme Environments ◽  
Well Being ◽  
Key Factors ◽  
Environmental Threat ◽  
The Many ◽  
The Impact ◽  
Health And Well Being ◽  
Insight Into

Data from studies on real-world groups situated in extreme environments provides us insight into the many factors that impact group performance, health and well-being. Unlike simulation studies, the impact of environmental threat, physical hardship, as well as true isolation and confinement have proven to be key factors in individual and group coping. Results from several real world teams will be discussed with the intent of focusing on interpersonal, environmental and individual factors that affected functioning and well-being at both the physiological and psychological levels.

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