Drug use predictors vary by drug type: Family, Community and Trait Influences

Introduction: Both family history of drug/alcohol use and neighborhood/community factors are linked to drug use risk. However, few studies have compared the relative contributions of family vs. community on drug use. We examined how the family micro-environment, community macro-environment, and traits including emotional regulation, stress, trauma, and coping influence drug use in a community sample.

Methods: Approximately 500 participants in Baltimore or surrounding areas were recruited from 2016-2018. Assessments of family micro-environment included the Children of Alcoholics Screening Test (CAST-6) and family questions on the Addiction Severity Index (ASI). Community macro-environment measures included subjective assessments using the Perceived Neighborhood Scale (PNS) and neighbor conflict (ASI), and objective assessments using the CDC Social Vulnerability Index (SVI) and tax code data. Drug use was assessed with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and/or ASI. Additional assessments included the Life Events Checklist (LEC), Perceived Stress Scale (PSS), Difficulties in Emotion Regulation Scale (DERS), Coping Orientation to Problems Experienced (COPE), and age at first drug use (PhenX Toolkit). Covariates included gender, age, race, ethnicity, marital status, education level, number of children, and years living in a neighborhood. Data were examined using ANOVA and stepwise regression.

Results: Overall, 154 participants reported no lifetime drug use, 139 reported heroin/ stimulant use, and 207 reported other drug use (marijuana, alcohol). Compared to no drug use, participants with any lifetime use reported significantly greater family drug/alcohol use and conflict, adverse community environments (PNS, SVI), and higher (worse) scores on the PSS, LEC, and DERS (3.8

Conclusions: Family measures were stronger predictors of drug use than community. However, among the measures collected in this study, individual factors, in particular emotion regulation and coping style, contributed more to drug use than either family history or community, and varied significantly by drug type. While prior family and community experiences cannot be changed, intervention efforts can focus on improving coping styles and addressing emotion regulation difficulties to mitigate or prevent future drug use.

References: Hertzel, SK, Schroeder, J, Moran, LM, Alvanzo, AA, Kowalczyk, WJ, Epstein, DH, Preston, KL, Phillips, KA. (2017). Perceptions of neighborhood mediate the relationship between ptsd symptoms and coping in a neighborhood-matched substance-using sample. J Addict Med, 11(6):440-448.

Newton-Howes, G, Cook, S, Martin, G, Foulds, JA, Boden, JM. (2018). Comparison of age of first drink and age of first intoxication as predictors of substance use and mental health problems in adulthood. Drug Alcohol Depend, 194(1): 238-243.

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Learning Objective: Poster attendees will learn about statistical analyses of drug use in a community sample and acquire greater comprehension of the factors, both environmental (family, neighborhood) and individual (behavioral traits such as emotion regulation and coping strategies) that can influence drug use and drug addiction to different types of drugs (heroin and other opioids, stimulants such as cocaine, and more).