Browsing by Subject "substance use"
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Item Illicit Substance Use Among a Sample of Subsidized Housing Residents: Concordance, Longitudinal Trends, and Quality of Life(2019-05) Rendon, Alexis; Walters, Scott T.; Spence-Almaguer, Emily; Mun, Eun-Young; Livingston, Melvin D.; Suzuki, SumihiroThis three-paper model dissertation investigates issues related to self-reported substance use. Self-report is a less invasive and expensive method of collecting substance use behavior when compared to a toxicological test, but the self-report method has been shown to be unreliable in some populations. We found that self-report missed some use captured by a saliva toxicological test administered to a subsidized housing population enrolled in a technology-assisted health coaching program. Concordance was highest among marijuana users and increased over time. Higher rates of concordance were found when the recall window was expanded from a restricted biological recall window to match the toxicological test to the full 90 day window of the Timeline Follow-Back. Participants who reported using substances more frequently reported having more problems related to their substance use. We also found that both substance use problems and the frequency of consumption of a combined Other category of substances, including cocaine, amphetamine, methamphetamine, opiates, prescription pills, or phencyclidine were predictive of lower quality of life. This dissertation validates previous literature indicating that self-report is a fair to moderately good measure of actual substance use behavior in vulnerable populations that may intentionally or unintentionally misreport their substance use. Programs limited to self-reported measures may consider widening their recall windows to increase accuracy of self-report.Item Serious mental illness and negative substance use consequences among adults on probation(BioMed Central Ltd., 2018-03-22) Rossheim, Matthew E.; Livingston, Melvin D.; Lerch, Jennifer A.; Taxman, Faye S.; Walters, Scott T.BACKGROUND: Adults on probation are at greater risk of both using substances and having a mental disorder compared to the general population. Several theories explain the relationship between substance use and poor mental health. However, the interaction between substance use, mental health, and substance-related consequences is not well understood. A better understanding of this relationship may help treatment programs become more responsive to people with serious mental illness (SMI). METHOD: The current study used interview data from 313 adults on probation who reported recent substance use. We examined associations between SMI risk, substance use, and substance use consequences. RESULTS: A substantial proportion of the sample (37.5%) screened at risk of having a SMI. Adjusting for type and amount of substance use, those who screened at risk of having a SMI reported more negative substance use consequences. Significant interaction effects were observed between use of alcohol or opiates and SMI risk. Alcohol use was associated with more negative substance use consequences among those at risk of SMI, while opiate use was associated with more consequences among those not at risk. CONCLUSIONS: Programs are sorely needed to identify and treat adults with comorbid substance use and mental health symptoms, particularly for adults in the justice system. Clinicians should carefully consider how mental health may interact with substance use to exacerbate consequences.Item Using machine learning to identify predictors of imminent drinking and create tailored messages for at-risk drinkers experiencing homelessness(Elsevier Inc., 2021-04-20) Walters, Scott T.; Businelle, Michael S.; Suchting, Robert; Li, Xiaoyin; Hebert, Emily T.; Mun, Eun-YoungAdults experiencing homelessness are more likely to have an alcohol use disorder compared to adults in the general population. Although shelter-based treatments are common, completion rates tend to be poor, suggesting a need for more effective approaches that are tailored to this understudied and underserved population. One barrier to developing more effective treatments is the limited knowledge of the triggers of alcohol use among homeless adults. This paper describes the use of ecological momentary assessment (EMA) to identify predictors of "imminent drinking" (i.e., drinking within the next 4 h), among a sample of adults experiencing homelessness and receiving health services at a homeless shelter. A total of 78 mostly male (84.6%) adults experiencing homelessness (mean age = 46.6) who reported hazardous drinking completed up to five EMAs per day over 4 weeks (a total of 4557 completed EMAs). The study used machine learning techniques to create a drinking risk algorithm that predicted 82% of imminent drinking episodes within 4 h of the first drink of the day, and correctly identified 76% of nondrinking episodes. The algorithm included the following 7 predictors of imminent drinking: urge to drink, having alcohol easily available, feeling confident that alcohol would improve mood, feeling depressed, lower commitment to being alcohol free, not interacting with someone drinking alcohol, and being indoors. The research team used the results to develop intervention content (e.g., brief tailored messages) that will be delivered when imminent drinking is detected in an upcoming intervention phase. Specifically, we created three theoretically grounded message tracks focused on urge/craving, social/availability, and negative affect/mood, which are further tailored to a participant's current drinking goal (i.e., stay sober, drink less, no goal) to support positive change. To our knowledge, this is the first study to develop tailored intervention messages based on likelihood of imminent drinking, current drinking triggers, and drinking goals among adults experiencing homelessness.