Gregory G. Homish

Intimate partner violence and specific substance use disorders: Findings from the national epidemiologic survey on alcohol and related conditions

The association between substance use and intimate partner violence (IPV) is robust. It is less clear how the use of specific substances relates to relationship violence. This study examined IPV perpetration and victimization related to the following specific substance use disorders: alcohol, cannabis, cocaine, and opioid. The poly substance use of alcohol and cocaine, as well as alcohol and marijuana, were also examined. Data were analyzed from wave two of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005). Associations between substance use disorders and IPV were tested using logistic regression models while controlling for important covariates and accounting for the complex survey design. Alcohol use disorders and cocaine use disorders were most strongly associated with IPV perpetration, while cannabis use disorders and opioid use disorders were most strongly associated with IPV victimization. A diagnosis of both an alcohol use disorder and cannabis use disorder decreased the likelihood of IPV perpetration compared to each individual substance use disorder. A diagnosis of both an alcohol use disorder and cocaine use disorder increased likelihood of reporting IPV perpetration compared with alcohol use disorders alone but decreased likelihood of perpetration compared with a cocaine use disorder diagnosis alone. Overall, substance use disorders were consistently related to intimate partner violence after controlling for important covariates. These results provide further evidence for the important link between substance use disorders and IPV and add to our knowledge of which specific substances may be related to relationship violence.

Spousal influence on general health behaviors in a community sample

OBJECTIVE To examine if one partners premarital health behavior was longitudinally associated with his or her partners health behaviors. METHODS Newlyweds were assessed at marriage and at 3 follow-ups with respect to frequency of general health behaviors: exercise, physical examinations, and healthy and unhealthy eating. RESULTS One partners health behavior prior to marriage was associated with the other partners health behavior over time. This was true for positive and negative behaviors for both men and women. CONCLUSIONS Understanding how partners influence each others health behaviors is important for health promotion and intervention efforts. Targeting the couple for health promotion activities could benefit the couple more than simply targeting individuals.

Risky behaviors, e-cigarette use and susceptibility of use among college students

BACKGROUND Since 2007, there has been a rise in the use of electronic cigarettes (e-cigarettes). The present study uses cross-sectional data (2013) to examine prevalence, correlates and susceptibility to e-cigarettes among young adults. METHODS Data were collected using an Internet survey from a convenience sample of 1437, 18-23 year olds attending four colleges/universities in Upstate New York. Results were summarized using descriptive statistics; logistic regression models were analyzed to identify correlates of e-cigarette use and susceptibility to using e-cigarettes. RESULTS Nearly all respondents (95.5%) reported awareness of e-cigarettes; 29.9% were ever users and 14.9% were current users. Younger students, males, non-Hispanic Whites, respondents reporting average/below average school ability, ever smokers and experimenters of tobacco cigarettes, and those with lower perceptions of harm regarding e-cigarettes demonstrated higher odds of ever use or current use. Risky behaviors (i.e., tobacco, marijuana or alcohol use) were associated with using e-cigarettes. Among never e-cigarette users, individuals involved in risky behaviors or, with lower harm perceptions for e-cigarettes, were more susceptible to future e-cigarette use. CONCLUSIONS More e-cigarette users report use of another nicotine product besides e-cigarettes as the first nicotine product used; this should be considered when examining whether e-cigarette use is related to cigarette susceptibility. Involvement in risky behaviors is related to e-cigarette use and susceptibility to e-cigarette use. Among college students, e-cigarette use is more likely to occur in those who have also used other tobacco products, marijuana, and/or alcohol.

Predictors of Heavy Drinking and Drinking Problems Over the First 4 Years of Marriage

This study investigated the factors predictive of heavy drinking and drinking problems over the early years of marriage, focusing on premarital drinking and the relatively stable individual risk and protective factors that were present prior to marriage and on social-interpersonal factors that may change or emerge over marriage. Newlywed couples were assessed at the time of marriage and at the 1st, 2nd, and 4th anniversaries with respect to frequency of heavy drinking and the extent of drinking problems and a variety of factors that have been found to be predictive of adult alcohol problems. The results indicated that antisocial characteristics, family history of alcoholism, negative affect, and alcohol expectancies were related to heavy drinking and alcohol problems at the time of marriage. Changes after marriage were predicted by the drinking of ones partner and of ones peers and by alcohol expectancies for social/physical pleasure for both men and women. In addition, the quality of the marriage was longitudinally protective from the experience of alcohol problems for both men and women, although it was not related to changes in heavy drinking.

Longitudinal Moderators of the Relationship Between Excessive Drinking and Intimate Partner Violence in the Early Years of Marriage

Alcohol problems are one of the most well-established risk factors for physical intimate partner violence. Nonetheless, most individuals who drink heavily do so without ever aggressing against a partner. Laboratory research identifies hostility as an important moderator of the association between alcohol and general aggression, and correlational research suggests that stress and coping may also be important moderators of the alcohol-aggression link. Building on this research, the authors examined hostility, coping, and daily hassles as moderators of the associations between excessive drinking and intimate partner violence across the first 4 years of marriage in a sample of 634 newly married couples. Excessive drinking was a significant cross-sectional correlate, but it did not emerge as a unique longitudinal predictor of intimate partner violence perpetration in this sample. However, alcohol was longitudinally predictive of husband violence among hostile men with high levels of avoidance coping. Findings generally supported the moderation model, particularly for men. These findings implicate hostility, coping, and daily hassles, as well as alcohol, as potentially important targets for partner violence prevention strategies for young married couples.

Changes in Marijuana use over the Transition into Marriage

Reductions in substance use tend to coincide with marriage, as both may occur during emerging adulthood. During the transition to marriage, it is possible that ones spouse may be the influence that causes the reduction in substance use. Data on participants (N = 471 couples) for this report are taken from a longitudinal study of early marriage. The objective of the current analysis is to determine if having a spouse who uses marijuana is associated with a greater likelihood of ones own use. Additionally, we are interested in spousal influence and cessation. The findings support spousal influence. Husbands are more likely to start using marijuana if their wives use marijuana, but the reverse is not true. Husbands also are more likely to stop using if their spouses do not use. During the transition into marriage, the drug use of one spouse does affect the other. However, this influence appears to be unidirectional, with wives influencing their husbands more often.

A Preliminary Study Comparing Methadone and Buprenorphine in Patients with Chronic Pain and Coexistent Opioid Addiction

Patients with opioid addiction who receive prescription opioids for treatment of nonmalignant chronic pain present a therapeutic challenge. Fifty-four participants with chronic pain and opioid addiction were randomized to receive methadone or buprenorphine/naloxone. At the 6-month follow-up examination, 26 (48.1%) participants who remained in the study noted a 12.75% reduction in pain (P = 0.043), and no participants in the methadone group compared to 5 in the buprenorphine group reported illicit opioid use (P = 0.039). Other differences between the two conditions were not found. Long-term, low-dose methadone or buprenorphine/naloxone treatment produced analgesia in participants with chronic pain and opioid addiction.

Concordant and discordant alcohol, tobacco, and marijuana use as predictors of marital dissolution

This study examined concordant and discrepant alcohol, tobacco, and marijuana use among couples to determine whether they predicted marital separation or divorce over 9 years. The study recruited 634 couples as they applied for their marriage licenses; we assessed them at that time and reassessed them with mailed questionnaires at their first, second, fourth, seventh, and ninth wedding anniversaries. Approximately 60% of the men and women were European American, and approximately 33% were African American. The frequency of drinking to intoxication and binge drinking (more than 5 drinks in an occasion) was assessed, as was the use of cigarettes and marijuana. At each assessment, each member of the couple was asked about the occurrence of marital separations and divorce. Bivariate analyses indicated that tobacco and marijuana use, whether discrepant or concordant, were associated with marital disruptions. However, discrepant heavy drinking was associated with disruptions, but concordant heavy drinking was not. Concordant and discordant marijuana use were not associated with divorce when analyses controlled for alcohol and tobacco use. Concordant and discordant tobacco use was not associated with divorce when analyses controlled for sociodemographic and personality factors. However, discrepant alcohol use was related to divorce after controlling for the other substances in 1 analysis and after controlling for the sociodemographic factors in a separate analysis. Tobacco and marijuana use were related to divorce through their associations with other variables. However, results suggest that discrepant alcohol use may lead to marital disruptions and should be addressed with couples seeking marital treatment.

Antenatal risk factors associated with postpartum comorbid alcohol use and depressive symptomatology.

BACKGROUND High rates of comorbid depression and alcohol use disorders have been reported in epidemiological studies; little work has considered comorbidity in women during the perinatal period. The goal of this work was to identify prenatal factors (at each trimester) that predicted postpartum comorbid depressive symptoms and alcohol use in women. METHODS The data are from an ongoing longitudinal study of pregnancy outcome that is now in its 16th year of follow-up. The first four assessments were used in this study (fourth and seventh prenatal months, delivery, and 8 months after delivery; n = 595). Prenatal variables in five domains (psychological, substance use, social, obstetrical, and demographic) were considered in analyses to predict postpartum comorbid depressive symptoms and alcohol use in women. RESULTS At each trimester, higher rates of depressive symptoms, binge drinking (four or more drinks per occasion), and tobacco use were significantly associated with comorbidity at the eighth postpartum month. Third-trimester anxiety was also significantly associated with postpartum comorbidity. Prenatal social support, obstetrical complications, and demographic factors were not related to an increased risk for postpartum comorbidity. CONCLUSIONS Women with more depressive symptoms, who binge-drink, or who smoke cigarettes at any time during their pregnancies are at risk for postpartum comorbidity. Women should be screened for depressive symptoms and substance use, and treatment should be initiated when women exhibit the risk factors described.

Enjoyment and other reasons for electronic cigarette use: Results from college students in New York

BACKGROUND Young people are more likely to have experimented with e-cigarettes (e-cigs) compared with older adults. Few studies identify reasons for experimentation/use of e-cigs among young people; we sought to discover what drives college students to use e-cigs. METHODS Undergraduate students (ages 18-23) at four universities in New York State were surveyed. Among e-cig ever users (n=429), reasons for use were examined. A multinomial logistic regression model analyzed the relative risk of reasons for using e-cigs among discontinued, current non-daily and current daily e-cig users. RESULTS Using e-cigs for enjoyment was associated with current non-daily (RR=2.11, 95% CI=1.18-3.75) and current daily use (RR=19.1, 95% CI=3.71-98.54). Non-daily use was related to use because e-cigs are less toxic than cigarettes (RR=2.80, 95% CI=1.75-4.50). More daily users reported use to quit smoking compared with either non-daily or discontinued users (53.3% vs. 12.2% and 13.3%, respectively; p<0.05). Among current users, 72.3% used for enjoyment, compared with 42.9% of discontinued users (p<0.05). DISCUSSION In contrast to adults, who often report e-cig use to quit smoking, young people are less likely to use for this reason. The exception was daily e-cig users, who often reported use for quitting/reduction of smoking. Rather, college students report usage reasons related to affect (e.g. enjoyment). Overall, enjoyment was reported more often than was use for quitting smoking; affective reasons likely play a role in the popularity of e-cigs and should be considered in future assessments of e-cig users.