Young men (N=400) and women (N= 552) 19-21 years of age, some with, some without college experience represented a targeted sample of 2,071 who completed a questionnaire while in the sixth grade in 1987-88. Questionnaires to assess current substance use and sex behavior were mailed to the study participants. Early substance use (as reported in the 1987-88 questionnaire) placed study participants in one of three categories: Frequent users (n=148), experimental users (n=603), or abstainers (n=200). ANOVA with post hoc analyses was used. Results indicate that frequent users of both genders were younger than experimenters and female experimenters were younger than female abstainers at first intercourse. There was a significant interaction between gender and educational level and a significant main effect for number of sexual partners with college experience serving as a protective factor. Overall, the results of the study support the hypothesis that substance use at an early age is related to earlier initiation of sexual activity. Staton, M., Leukefeld, C., et al. Risky Sex Behavior and Substance Use Among Young Adults. Health & Social Work, 24 (2), 1999.

Gender Differences at Admission and Follow-Up in a Sample of Methadone Maintenance Clients

Although one-third of clients enrolled in methadone treatment (MMT) in the United States are female, few studies have looked at gender differences at admission and follow-up. An understanding of these differences can lead to improved treatment strategies. The investigation reported is based on data collected as part of the Drug Abuse Treatment and AIDS-Risk Reduction (DATAR) project. Using interview data from 435 opioid dependent clients (31% female) collected at admission and approximately one year after discharge, females were found to have more dysfunctional families of origin and greater prior and current psychological and medical problems. Both genders showed significant improvement from admission to follow-up in terms of reduced drug use, criminal activity and HIV/AIDS-risky behaviors. In some areas such as improved family relationships and improved psychosocial status, females seemed to benefit more from treatment than did the males. In addition, females were more likely to seek further help for both drug misuse and psychological problems subsequent to discharge. Chatham, L.R., Hiller, M.L., Rowan-Sal, G.A., Joe, G.W., and Simpson D.D. Substance Use & Misuse, June 1999, 34(8), pp. 1137-1165, 1999.

Cocaine Use and High Risk Sexual Behavior Among STD Clinic Patients

This study examined the effect of cocaine use and other correlates on participation in high-risk sexual behavior among STD clinic patients. This was a cross-sectional study of 1,490 consecutive patients attending three Los Angeles County STD clinics between 1992 and 1994. Male patients number 892 and females, 598. Analyses found high-risk sexual activity was associated with being male and being of younger age. Among women, high-risk sexual behavior was associated with crack cocaine use and a perceived need for help. Among the men in the study, ethnicity (being black) and having an arrest history were associated with high-risk behavior. The present study confirmed findings from other studies that showed an association between cocaine use and high-risk sexual practices among STD clinic patients and identified several important gender differences that may be considered in planning AIDS and drug prevention programs. These gender differences also suggest that programs might employ different outreach and intervention strategies for women and men. Hser, Y., Chou, C., Hoffman, V., and Anglin, M.D. Sexually Transmitted Diseases, 26(2), February 1999.

Clinical and Services Research

Relationship of ADHD, Depression and Non-Tobacco Substance Use Disorders to Nicotine Dependence in Substance-Dependent Delinquents

In a study of 367 male and female behaviorally disordered juvenile delinquents, 13 - 19 years old, Dr. Riggs and colleagues, Department of Psychiatry, University of Colorado School of Medicine, found that attention deficit hyperactivity disorder (ADHD) and major depression significantly contributed to the severity of nicotine dependence in adolescents diagnosed with a non-tobacco substance use disorder (SUD). ADHD was associated with earlier onset of regular smoking in males, and the severity of non-tobacco SUD was related to nicotine dependence severity in both boys and girls. Riggs, P.D., Mikulich, S.K., Whitmore, E.A., and Crowley, T.J. Drug and Alcohol Dependence, 54, pp. 195-205, 1999.

Interaction Effects of Client and Treatment Program Characteristic on Retention: An Exploratory Analysis Using Hierarchical Linear Models

This study examined the interaction effects of treatment program and client characteristics on client retention in treatment for drug users. Program characteristics included services provision, funding source, staff-client gender congruence, and client characteristics included gender, age at admission, and drug use level prior to admission. The same model was applied separately to residential methadone maintenance and outpatient drug-free programs. Data were obtained from 59 treatment programs and 3,764 patients who had discharge records. A noteworthy significant interaction effect was the program's funding source and patient's gender on treatment retention in the outpatient drug-free modality. Female clients stayed in the programs that accepted only public funding for shorter periods than in programs that accepted both public and private funding. Male patients remained in treatment an average of 25.3 fewer days than female patients in programs that only accepted public funds, but stayed about the same time as females if the programs received mixed funding. Chou, C., Hser, Y., & Anglin, M.D. Substance Use & Misuse, 33(11), pp. 2281-2301, 1998.

Characteristics of Women-Only and Mixed-Gender Drug Abuse Treatment Programs

Specialized substance abuse treatment programs have been developed for women within the past two decades. This article presents the results of a secondary analysis of a regional database of drug abuse treatment programs that compared the characteristics of women-only (WO) and mixed-gender (MG) programs across three treatment modalities. In general, WO programs differed from MG programs in their policies regarding fees, sources of payment, special populations served, services offered, and treatment capacity, process, and duration. The differences in program characteristics reflect broader societal gender differences, including women's generally lower economic status and primary responsibility for child-rearing. Grella, C.E., Polinsky, M.L., Hser, Y.I., Perry, S.M. Journal of Substance Abuse Treatment. 17(1-2), pp. 37-44, July-September 1999.

Women in Residential Drug Treatment: Differences by Program Type and Pregnancy

This study compared the characteristics of 4,117 women treated in publicly funded residential drug treatment programs in Los Angeles County between 1987 and 1994 by pregnancy status and program gender composition, that is, women-only and mixed-gender programs. A logistic regression analysis determined the predictors of program completion. Women in women-only programs were more likely than women in mixed-gender programs to be pregnant, homeless, or on probation; to use methamphetamines; to use alcohol; and have prior drug treatment. Pregnant women were younger, more likely to be homeless, had fewer years of drug use, were more often referred by other service providers, and were less likely to have injected drugs or have prior drug treatment than non-pregnant women. Although women in women-only programs had more problems, they spent more time in treatment and were more than twice as likely to complete treatment as compared with women in mixed-gender programs. Grella, C.E. Journal of Health Care for the Poor and Underserved, 10(2), pp. 216-229, May 1999.

Epidemiology, Etiology and Prevention Research

The 46th meeting of the Community Epidemiology Work Group (CEWG) was held in Vancouver, British Columbia, Canada on June 8-11, 1999. The CEWG, established by NIDA in 1976 is a network of researchers from 21 U.S. metropolitan areas and selected foreign countries which meets semiannually to report surveillance data and discuss the current epidemiology of drug abuse. The following are highlights of the 46th meeting:

In the Past 6 Months

Despite the leveling epidemic, consequences of cocaine use have increased among aging users in some cities; increases among younger age groups in some indicators in several areas have been reported recently.

New heroin use among young populations continues to be reported in several cities; in general, prices continue to decline as purity increases.

Marijuana indicators continue to escalate across the country.

Use of "Club drugs," especially GHB and MDMA, continue to be reported across the country.

Despite its appearance in midwestern and southern rural areas, abuse of methamphetamine remains a predominantly western problem; however, indicators suggest declines in some areas.

Cocaine - Cocaine remains the Nation's dominant drug problem, driven mainly by aging users who continue to experience adverse consequences. Recent indicators show a mixed picture. Mortality figures increased in six cities (Chicago, Detroit, Honolulu, Phoenix, San Francisco, and Seattle) and declined or remained stable in four (Miami, Minneapolis/St. Paul, Philadelphia, and San Diego). Emergency department (ED) mentions increased significantly in four cities (Atlanta, Dallas, Philadelphia, and Washington, DC) and declined significantly in one (San Francisco). The largest shift was a 46-percent increase in Dallas. Nonsignificant increases were reported in the majority of the other cities. Among treatment admissions, cocaine (including crack) is now the foremost primary drug of abuse (excluding alcohol-only but including alcohol-in-combination) in only 8 of the 21 CEWG areas. Among adult arrestees, cocaine-positive urinalysis percentages declined in the majority of cities, especially among males in Chicago, New York City, and St. Louis, and among females in St. Louis; percentages increased, however, for males in Philadelphia and Detroit and for females in Houston. Increases generally corresponded to increases in self-reported powder cocaine use and declines in self-reported crack use. Among younger age groups, recent slight increases in some indicators have been reported: ED mentions in Dallas, Denver, and Phoenix; treatment admissions in Los Angeles; school survey data of Texas border youth; and arrestee urinalysis data in Atlanta, Los Angeles, New Orleans, Phoenix, and San Antonio. Changing sales strategies in some cities, such as New York, are masking cocaine activity that would normally appear on law enforcement indicators.

Heroin - Heroin indicators show mixed trends. Mortality figures(1) increased in seven cities (Chicago, Detroit, Miami, Minneapolis/St. Paul, Phoenix, San Francisco, and Seattle) and declined in three (Honolulu, Philadelphia, and San Diego). Heroin ED rates(2) per 100,000 population increased significantly in six cities (Atlanta, Denver, Miami, Newark, New Orleans, and Washington, DC) and nonsignificantly in another six cities; conversely, rates declined significantly in San Francisco and nonsignificantly in seven other cities. During that same time period, heroin as a percentage of total ED mentions remained generally stable, except for increases in Newark and Chicago. Heroin is now the predominant primary drug problem (excluding alcohol-only, but including alcohol-in-combination) in 8 of the 21 CEWG areas: Baltimore, Boston, Detroit, Los Angeles, Newark, New York, Phoenix, and San Francisco. Opiate-positive screens among arrestees(3) remained relatively low and generally stable; they often involved polydrug use. Heroin purity increased(4) in nearly every city, while prices generally declined. Purity increases were particularly large in Detroit, New Orleans, and Philadelphia. Younger Populations are increasingly initiating heroin use in several cities, including New York, where street informants indicate a steady increase in young buyers. In Boston and other Massachusetts areas, new and younger users are reportedly progressing from snorting to injecting. A Chicago study identified a high percentage of suburban youth, particularly young women, who are injectors. Suburban heroin activity is also reported around the Baltimore area, both among youth and young professionals.

Marijuana - Marijuana now accounts for more than 10 percent of total ED mentions in 12 cities (Atlanta, Boston, Chicago, Dallas, Detroit, Los Angeles, Miami, New Orleans, Philadelphia St. Louis, San Diego, and Washington, DC), up from just 6 cities a year earlier--the result of increases2 in 7 cities; no significant declines were noted. Marijuana is the predominant primary drug treatment problem in three cities (Denver, Seattle, an Minneapolis/St. Paul). Treatment percentages decreased in New Orleans, Newark, Chicago, and Seattle and increased in San Diego. Among adult male arrestees, marijuana-positive findings were equal to or exceeded cocaine-positives in 10 cities; percentages declined substantially in 2 cities and increased in 13. In many cities, marijuana use appears to be increasing among youth, as is reflected in the percentages of juvenile arrestees testing positive for the drug: in six of the seven CEWG sites where ADAM tests juveniles, the percentage testing positive for marijuana was substantially greater than in the adult population. In Boston, cannabis is reportedly as available as alcohol, and use among adolescents is common, approaching that of cigarettes among older students. Blunt usage continues to grow or retain popularity in Chicago, Minneapolis/St. Paul, New York City, Philadelphia, and Seattle. Marijuana is combined with crack in Chicago ("primos" or "diablitos"), Philadelphia ("turbo"), and Houston (where it is a declining fad among young people); with PCP in Chicago ("wicky sticks" or "donk"), Minneapolis/St. Paul ("happy stick"), New York, Philadelphia ("loveboat" or "wet"), and St. Louis; with formaldehyde in Minneapolis/St. Paul and Seattle; with PCP plus formaldehyde in Houston ("fry," "amp," "water-water"); and with psilocybin mushrooms in Minneapolis/St. Paul. Marijuana combinations are not frequently reported in Denver, but the drug reported to be used to come down from or temper excited highs. Stimulants - Despite its appearance in midwestern and southern rural areas, methamphetamine remains concentrated in the West. However, indicators suggest some declines in that region. Available mortality figures1show methamphetamine-related deaths declined in four cities (Honolulu, Philadelphia, San Diego, and Seattle)and increased in three (Minneapolis/St. Paul, Phoenix, and San Francisco). Following increases in 1997, methamphetamine ED mentions2 declined significantly in six cities (Denver, Los Angeles, Minneapolis/St. Paul, Phoenix, San Francisco, and Seattle) and increased only in Dallas. Methamphetamine remains the number-one primary drug treatment problem in San Diego and Honolulu. Methamphetamine-positive percentages among arrestees 3 remained stable across most sites, except for San Diego, where levels declined notably. Methamphetamine users are heterogeneous, consisting of many small subgroups, as suggested by ethnographic data in Atlanta. Furthermore, use patterns and contexts vary widely, depending on population, location, and history of use, as suggested by ethnographic research in Seattle. Injecting remains the predominant route of administration in several areas, including San Francisco and Denver; however, it has been declining somewhat while snorting or smoking have been increasing. Mexico remains the source of methamphetamine for many areas; however, local clandestine ethamphetamine labs also proliferate in several areas, including parts of Arizona, Minnesota, Texas, and Washington State.

Methylenedioxymethamphetamine (MDMA) - ("ecstasy," "blue lips," "blue kisses," "white dove,""E,"and "XTC") availability is reported, primarily as a club drug at "raves" and dance parties, in Atlanta, Austin, Boston, Chicago, Dallas, Detroit, Houston, Miami, St. Louis, Seattle, and Washington, DC. Young cohorts of users have been identified in several of those cities. Reports of increases in indicators of use of the drug continue in Boston and throughout Massachusetts. Though it is not readily available in Newark, it is becoming trendy on college campuses across New Jersey. In New Orleans, the drug is less available than crystal methamphetamine. In Austin, where it is often crushed and re-pressed with methamphetamine, psilocybin mushrooms, or LSD, three types of MDMA are available: "liquid ecstasy"; "chocolate sprinkles,"a heroin-based white pill with brown spots popular in the topless bar scene and in gay bars; and a nickel-sized wafer form. MDMA is used with methamphetamine, LSD, and marijuana in Washington, DC, where law enforcement officers recently noted increased trafficking. Methylenedioxy-amphet-amine (MDA) is reportedly available in St. Louis. Methylphenidate (Ritalin) is readily obtainable in Boston, Chicago, Detroit, and Minneapolis/St. Paul. It is crushed and snorted in Detroit and Minneapolis/St. Paul, and it is mixed with heroin instead of cocaine and injected as a "speedball" in Chicago. Phenmetrazine (Preludin) is also reportedly injected in Chicago. Despite concern about sibutramine (Meridia), a new weight loss drug, there were no reports of diversion or abuse.

Depressants - Gamma-hydroxy butyrate (GHB), a central nervous system depressant, continues to be reported across the country, with recipes for its manufacture easily accessible on the Internet. GHB has been increasingly involved in poisonings, overdoses, date rapes, and fatalities in Boston, Denver, Los Angeles, South Florida, San Diego, Seattle, and parts of Arizona and Texas. It is available at gyms, nightclubs, raves, gay male party venues, or on college campuses in Atlanta, Baltimore, Boston, Chicago, Denver, Detroit, Los Angeles, Miami, Minneapolis/St. Paul, Newark, New Orleans, San Diego, San Francisco, Seattle, and parts of Arizona and Texas. GHB is available in several forms: clear liquid, white powder, tablets, and capsules. It is used in combination with ketamine or MDMA in Detroit; alcohol in South Florida and New Orleans; and alcohol and ketamine in a "G and B" in Minneapolis. Gamma butyrolactone (GBL) is contained in commercial products (Blue Nitro, Renew-Trient, and ReVivarin); it metabolizes into GHB and produces clinical symptoms identical to GHB. The drug was responsible for overdoses, poisonings, and hospitalizations in Detroit, South Florida, Minneapolis, Newark, and in Texas, where it was also responsible for a death. Another club drug, ketamine ("Special K" or "vitamin K") is reported in cities such as Baltimore, Boston, Detroit, Miami, Minneapolis/St. Paul, Newark, New Orleans, New York City, and San Diego. It is injected intramuscularly by young, white, middle-class needle exchange clients in Boston; converted into a white powder and snorted in Minnesota; injected, smoked, or mixed in beverages in New Orleans; and boiled down to crystal form and snorted as an alternative to cocaine in New York City. Ketamine has been responsible for deaths in New Orleans and San Diego.

Clonazepam (Klonopin or Rivotril) was recently mentioned in hospital emergencies in New York City; in Texas, it is used by juveniles in combination with beer, just as flunitrazepam (Rohypnol) has been used. Alprazolam (Xanax, or "sticks"), along with clonazepam, has replaced flunitrazepam among adolescents in Miami, where "xanax candy bars" have caused several medical emergencies. In New York City, it is the most sought-after diverted prescription pharmaceutical and has almost replaced diazepam on the street. Diazepam is the most readily available and frequently used pharmaceutical depressant on the street in Chicago; it is the leading psychoactive prescription drug in New York City ED mentions; and is injected with heroin in Seattle. Flunitrazepam is common in Atlanta, popular among hard-core heroin and cocaine users in Los Angeles, continues to be abused in New Orleans, and is beginning to emerge in treatment indicators among youth along the Texas-Mexico border. In New Jersey, flunitrazepam no longer appears to be a problem. Trazedone (Desyrel) has been involved in numerous poisonings and one death in Detroit.

Depressants are used in Chicago in combination with a variety of drugs including heroin, cocaine, methamphetamine, or alcohol. In Miami, the use of diverted Schedule III and IV medications associated with concomitant upper and downer abuse appears on the rise, with "rolling and trolling" the rage among the "young and unknowing." Benzodiazepines are used in Phoenix to reduce "the edge" from cocaine or methamphetamine.

Hallucinogens - Ethnographic, ED, law enforcement, and survey data suggest continued low-level abuse of lysergic acid diethylamide (LSD) and phencyclidine (PCP). Hallucinogen use appears to be increasing in Massachusetts, where lifetime use among students has been rising since 1994. In Chicago, primary hallucinogen admissions are increasing; LSD use in New Orleans is reportedly on the rise; the drug has sporadically reappeared in St. Louis-area high schools and rural areas. A new form of LSD appearing as a hard plastic translucent bubble pack with colors of light blue or red was reported in Detroit. In Texas, blotter acid is available on sugar cubes and triangular window panes, in a gel tab form called "jelly bean" that is popular in clubs, and in liquid form that is becoming more common around university and club scenes.

PCP use appears to be increasing in Chicago, where it is sprayed on a tobaccolike substance ("mint leaf" or "love leaf"), used as a dip on cigarettes ("sherm sticks"), or mixed with marijuana ("wicky stick" or "donk"). It appeared in 1997 ED mentions for the first time this decade in Minneapolis; a resurgence of manufacturing, mostly by African-American street gangs, is noted in Los Angeles. PCP-related ED mentions are declining in New York City, where it is available as a powder sprinkled on green mint leaves or on marijuana and as a liquid in small shaker bottles. It continues to be used as a dip on marijuana joints in St. Louis. Psilocybin mushrooms ("shrooms") were reported by Minneapolis law enforcement agencies.

Other Drugs - Dextromethorphan (DXM) abuse is reported by teens in Boston, apparently encouraged by mentions on the Internet. In addition to the readily available store-bought liquid, DXM is available in Minneapolis as a white powder packaged in clear, unmarked capsules. Use of ephedrine, nitrous oxide, and other inhalants (including propane) is reported in Detroit. One accidental death in Minnesota was attributed to inhalation of an industrial solvent, and inhalant abuse has declined among students in grades 6, 9, and 12 since 1995. Toluene "huffing" is reportedly common among white males in their preteens or early teens in Philadelphia; in Texas, use of inhalants such as liquid or spray paint and correction fluid is increasing among school students. Khat seizures continue in Detroit; khat first appeared in Minnesota in 1997, and interceptions have increased in recent years.

(1) Mortality figures are for 1997 versus 1998 and were available in 10 reporting areas.

(2) Emergency department mentions are for 20 CEWG cities in the Drug Abuse Warning Network (DAWN) of SAMHSA's Office of Applied Studies; comparisons are for first half 1997 versus preliminary estimates for first half 1998; changes are noted only when statistically significant at p<0.05.

(3) arrestee urinalysis data are for the 18 cewg cities in the national institute of justice's arrestee drug abuse monitoring (adam) program; comparisons are for 1997 versus 1998; changes are noted only when they are>5 percentage points.

(4) Heroin price and purity information are from the Drug Enforcement Administration (DEA) Domestic Monitor Program; comparisons are for 1997 versus 1998.

Adolescent Substance Abuse and Psychiatric Comorbidity: Timing and Gender

This study used state of the art evaluation methods to assess a large population based sample longitudinally, relating the development of drug abuse to pre-existing psychiatric disorder, other risk factors, and sex. Boys, but not girls, who later developed dependence or abuse began substance use at earlier ages. Disruptive behavior disorders and depression were both associated with higher rates and earlier onset of substance use and abuse in both sexes, while anxiety predicted later onset of smoking. Family history of drug problems was the strongest correlate of early onset. Boys and girls showed much similarity in the course of early drug use and abuse, and in associated psychopathology. This study is notable for the size of the sample and the sophistication of the methodology and analyses, enabling new observations about development and gender in regard to onset of substance use problems. Costello, E.J., Erkanli, A., Federman, E., and Angold, A. The Development of Psychiatric Comorbidity with Substance Abuse in Adolescents: Effects of Timing and Sex. Journal of Clinical Child Psychology, 28, pp. 298-311, 1999.

Maternal Smoking During Pregnancy And Offspring Psychopathology

Data from a longitudinal study of depressed probands and normal controls were used to replicate findings from several other reports of an association between maternal smoking during pregnancy and attention deficit hyperactivity disorder, conduct disorder, and substance abuse in offspring. Among offspring of mothers who reported smoking 10 or more cigarettes per day during pregnancy, boys showed a significantly increased risk of early onset conduct disorder, and girls a significant increase in adolescent drug dependence. Controlling for several relevant factors such as maternal substance abuse and parental diagnosis did not alter the findings. Thus, findings from several other studies were supported, underscoring concerns about the potential impact of prenatal exposure to maternal smoking. Weissman, M.M., Warner, V., Wickramaratne, P.J., Kandel, D.B. Maternal Smoking During Pregnancy and Psychopathology in Offspring Followed to Adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 38, pp. 892-899, 1999.

Association between Maternal Smoking During Pregnancy and Attention Deficit Hyper-activity Disorder

This study extends previous findings regarding maternal smoking and ADHD in offspring, by studying the siblings of probands in a high-risk (ADHD) sample. Maternal smoking during pregnancy was associated with over four times the risk of ADHD in offspring (OR 4.4) even when controlling for parental ADHD, parental IQ, and socioeconomic status. These findings replicate those of these authors and others. If confirmed in other populations and using other methods, these findings have implications for the need for prevention and smoking cessation programs for women of child-bearing age. Milberger, S., Biederman, J., Faraone, S.V., and Jones, J. Further Evidence Of An Association Between Maternal Smoking During Pregnancy And Attention Deficit Hyperactivity Disorder: Findings From A High- Risk Sample Of Siblings. Journal of Clinical Child Psychology, 27, pp. 352-358, 1998.

Changing Patterns of Drug Use Among U.S. Military Recruits Before and After Enlistment

The U.S. armed forces adopted "zero tolerance" policies concerning illicit drug use in 1980 and later developed policies to discourage tobacco and alcohol abuse. This article examines drug use among young active-duty recruits both before and after enlistment compared with non-military age-mates, and documents historical shifts in such drug use across 2 decades. Analyses employed longitudinal panel data from 20 nationally representative samples of high school seniors (cohorts of 1976-1995), each surveyed just before graduation and again within 2 years. Separate analyses for men (n = 12,082) and women (n = 15,345) contrasted those who entered military service, college, and civilian employment. Illicit drug use declined more among young military recruits than among their civilian counterparts. Analyses of male recruits at multiple time periods showed (1) declines in the prevalence of marijuana use and cocaine use after the initiation of routine military drug testing and (2) lower proportions of smokers of half a pack or more of cigarettes per day who entered service after the initiation of tobacco bans during basic training. Recent military drug policies appear to deter illicit drug use among enlistees and discourage some smokers from enlisting. Bachman, J.G., Freedman-Doan, P., O'Malley, P.M., Johnston, L.D., and Segal, D.R., American Journal of Public Health, 89(5), pp. 672-677, 1999.

Initial Drug Opportunities and Transitions to First Use

Researchers at Johns Hopkins University examined initial opportunities to try selected drugs and transitions from first opportunity to first use of those drugs. Target drugs were marijuana, cocaine, heroin, and hallucinogens. Investigators examined sex and race-ethnicity differences in estimates of having a drug opportunity, and in the probability of progressing from having an opportunity to try a drug to actually using the drug. Self-report interview data collected for the National Household Surveys on Drug Abuse (NHSDA) from 1979 to 1994 were analyzed. Results showed that an estimated 51% of US residents have had an opportunity to try marijuana; comparative estimates for cocaine, hallucinogens, and heroin are 23, 14, and 5%, respectively. Among those who eventually used each drug, the vast majority made the transition from first opportunity to first use within 1 year. Males were more likely than females to have opportunities to try these drugs, but were not more likely than females to progress to actual use once an opportunity occurred. Time trends indicate recent increases from 1990 to 1994 in the estimated probability of using an illicit drug once an opportunity occurs, particularly for hallucinogens. This study sheds light on the epidemiology of the earliest stages of drug involvement in the USA. Van Etten, M.L., and Anthony, J.C. Comparative Epidemiology of Initial Drug Opportunities and Transitions to First Use: Marijuana, Cocaine, Hallucinogens and Heroin. Drug and Alcohol Dependence, 54(2), pp. 117-125, 1999.

Adolescent Drug Use and Adult Drug Problems in Women

The authors studied effects of variables assessed in adolescence on problems from drug use in adulthood in a community sample of women. One focus of this 13-year longitudinal study was moderators, which were hypothesized to exacerbate, or attenuate, the effects of early drug consumption on later drug problems. Potential moderators were sensation seeking, social conformity, academic orientation, parental support, depression, and drug problems in parents. Direct and mediating effects of these variables, as well as of drug consumption, were also evaluated. Results showed that most of the significant effects involved sensation seeking and social conformity. In addition, adolescent drug use significantly predicted adult polydrug problems. The effects of sensation seeking are consistent with the view that this variable reflects a sensitivity to drug use, which makes it more likely that drug use gets translated into drug abuse. Stacy, A.W., and Newcomb, M.D. Experimental and Clinical Psychopharmacology, 7(2), pp. 160-173, 1999.

Flunitrazepam Becoming Health Concern to Sexually Active Young Women in Southwestern U.S.

Flunitrazepam [Rohypnol"] is a short-acting benzodiazepine with general properties similar to those of diazepam. In a cross-sectional survey to determine prevalence, patterns, correlates and physical effects of voluntary flunitrazepam use in a sample of sexually active adolescent and young women 14 to 26 years of age (N=904) using university-based ambulatory reproductive health clinics, lifetime use was reported by 5.9% (n = 53) of subjects, with frequency of use ranging from 1 to 40 times. Flunitrazepam was taken most often with alcohol (74%), and 49% took this substance with other illicit drugs. Logistic regression analyses controlling for age and race/ethnicity found that users were significantly more likely than were nonusers to report lifetime use of marijuana (odds ratio [OR] = 3.6) or LSD (OR = 5.2), having a peer or partner who used flunitrazepam (OR = 21.7), pressure to use flunitrazepam when out with friends (OR = 2.7), and a mother who had at least a high school education (OR = 2.6). Finally, 10% of voluntary users reported experiencing subsequent physical or sexual victimization. Voluntary use of flunitrazepam is becoming a health concern to sexually active young women who reside in the southwestern United States. Young women who have used LSD or marijuana in the past or who have a peer or partner who used this drug appear to be at the greatest risk. Rickert, V.I., Wiemann, C.M., Berenson, A.B. Prevalence, Patterns, and Correlates of Voluntary Flunitrazepam Use. Pediatrics 103(1), pp. E61-E65, 1999.

Drinking and Driving Among U.S. High School Seniors

This article reports the prevalence of, and trends in, driving after drinking and riding in a car with a driver who has been drinking among American high school seniors, based on data from more than a decade (1984-1997) of annual national surveys. Logistic regression was used to assess the effects of demographic factors (gender, region of country, population density, parental education and race/ethnicity) and selected "lifestyle" factors (religious commitment, high school grades, truancy, illicit drug use, evenings out per week, and miles driven per week). Rates of adolescent driving after drinking and riding with a driver who had been drinking declined significantly from the mid-1980s to the early or mid-1990s, but the declines have not continued in recent years. Rates of driving or riding after drinking were higher among high school seniors who are male, White, living in the western and northeastern regions of the United States, and living in rural areas. Truancy, number of evenings out, and illicit drug use all related significantly positively with the dependent variables, whereas grade point average and religious commitment had a negative relationship. Miles driven per week related positively to driving after drinking. O'Malley, P.M., and Johnston L.D. American Journal of Public Health, 89(5), pp. 678-684, 1999.

Adolescent School Experiences and Dropout, Adolescent Pregnancy, and Young Adult Deviant Behavior

Predictive effects of school experiences were studied over a 7-year interval in a random community sample of 452 adolescents, 12 through 18 years of age. Outcomes examined included dropping out of school, adolescent pregnancy, engaging in criminal activities, criminal conviction, antisocial personality disorder, and alcohol abuse. Logistic regression showed academic achievement, academic aspirations, and learning-focused school settings to be related to a decline in deviant outcomes independent of the effects of disadvantaged socioeconomic background, low intelligence, childhood conduct problems, and having deviant friends during adolescence. Associations between school conflict and later deviancy were mediated by deviant peer relationships in adolescence and other school characteristics. Prior research reporting continuity of childhood conduct problems and the influence of adolescent affiliations with deviant peers on negative outcomes was supported. Implications for using the school context in risk factor research and the practical applications of such research for intervention are discussed. Kasen, S., Cohen, P., and Brook, J.S. Journal of Adolescent Research, 13 (1), pp. 49-72, 1998.

Victimization--Socioeconomic Impact of Interpersonal Violence on Women

Prospective data from a nationally representative sample of women were used to examine 4 objective indexes of social adjustment following direct, interpersonal crime. Household income, marital status, employment, and education level were evaluated as risk factors for, and outcomes of victimization. Data were collected in 3 waves at 1-year intervals, and 2,863 women completed all 3 waves. Results indicate that women experience increased risk for victimization when income is below poverty level and when newly divorced. Further, victimization appears to increase women's risk for unemployment, reduced income, and divorce. The cyclical nature of victimization is discussed. Byrne, C.A., Resnick, H.S., Kilpatrick, D.G., Best, C.L., and Saunders, B.E. The Socioeconomic Impact of Interpersonal Violence on Women. Journal of Consulting and Clinical Psychology 67(3), pp. 362-366, 1999.

Vulnerability to Drug Use Among Latino Adolescents

In this study, risk and protective factor indices were developed to examine vulnerability to drug use among Latino high school students. Survey data were collected from 516 Latino 9th and 10th grade youth in the Los Angeles area. Frequency and quantity of use data were collected for cigarettes, alcohol, marijuana, inhalants, cocaine, and other illicit drugs. Few gender differences emerged in prevalence of drug use and about 25% were already involved in heavy drug use. Seventeen variables were examined for inclusion in a risk factor index (RFI) or protective factor index (PFI). Bivariate, multivariate, and structural equation models (SEM) were employed in the analysis of data. All of the variables except for one were more risk-inducing than protective for these Latino youth. However, as a group, the PFI predicted several types of drug use for boys and girls, and moderated the adverse effects of the RFI. At a high level of risk, a high level of protection was associated with reduced use for some types of drugs. In the SEM, vulnerability to drug use as indicated by the RFI and PFI was strongly associated with drug use for both boys and girls and more strongly related to drug use than the RFI or PFI alone. These results have exciting implications for intervention. Felix-Ortiz, M. and Newcomb, M.D. Journal of Community Psychology, 27(3), pp. 257-280, John Wiley & Sons, Inc., 1999.

Vulnerability to Drug Use Among Latino Adolescents

In this study, risk and protective factor indices were developed to examine vulnerability to drug use among Latino high school students. Survey data were collected from 516 Latino 9th and 10th grade youth in the Los Angeles area. Frequency and quantity of use data were collected for cigarettes, alcohol, marijuana, inhalants, cocaine, and other illicit drugs. Few gender differences emerged in prevalence of drug use and about 25% were already involved in heavy drug use. Seventeen variables were examined for inclusion in a risk factor index (RFI) or protective factor index (PFI). Bivariate, multivariate, and structural equation models (SEM) were employed in the analysis of data. All of the variables except for one were more risk-inducing than protective for these Latino youth. However, as a group, the PFI predicted several types of drug use for boys and girls, and moderated the adverse effects of the RFI. At a high level of risk, a high level of protection was associated with reduced use for some types of drugs. In the SEM, vulnerability to drug use as indicated by the RFI and PFI was strongly associated with drug use for both boys and girls and more strongly related to drug use than the RFI or PFI alone. These results have exciting implications for intervention. Felix-Ortiz, M. and Newcomb, M.D. Journal of Community Psychology, 27(3), pp. 257-280, John Wiley & Sons, Inc., 1999.

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