LaTrice Montgomery

Motivational enhancement therapy for African American substance users: a randomized clinical trial.

Limited empirical evidence concerning the efficacy of substance abuse treatments among African Americans reduces opportunities to evaluate and improve program efficacy. The current study, conducted as a secondary analysis of a randomized clinical trial conducted by the Clinical Trials Network of the National Institute of Drug Abuse, addressed this knowledge gap by examining the efficacy of motivational enhancement therapy (MET) compared with counseling as usual (CAU) among 194 African American adults seeking outpatient substance abuse treatment at 5 participating sites. The findings revealed higher retention rates among women in MET than in CAU during the initial 12 weeks of the 16-week study. Men in MET and CAU did not differ in retention. However, MET participants self-reported more drug-using days per week than participants in CAU. Implications for future substance abuse treatment research with African Americans are discussed.

Moderating effects of race in clinical trial participation and outcomes among marijuana-dependent young adults

BACKGROUND Few studies have examined clinical trial participation rates and treatment outcomes among underserved young adults who are dependent on marijuana, the most commonly abused illicit drug. METHOD The present study was a secondary analysis of a trial of court-referred marijuana-dependent young adults (ages 18-25) randomized to one of four treatment conditions: Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT), MET/CBT+Contingency Management (CM), Drug Counseling (DC) or DC+CM. African American (N=81) participants were compared to White (N=31) participants with respect to rates of participation in phases of treatment and substance use outcomes. In addition, the interaction of race and treatment condition was examined to ascertain if the interventions yielded different effects based on race. RESULTS Among those who started treatment, African American young adults were significantly less likely to complete the treatment and posttreatment phases of the clinical trial than their White counterparts. Irrespective of treatment type, substance use outcomes (i.e., percentage of marijuana-negative specimens and longest duration of continuous abstinence) did not vary by race. However, there was a significant interaction effect between treatment type and race; African American young adults did not benefit differentially from any specific type of treatment, but CM was effective in reducing proportion of marijuana positive samples among White young adults. CONCLUSIONS Findings suggest that clinical trial treatment and posttreatment completion rates vary by race in this population, as does response to specific treatment types. More treatment research focusing specifically on African American marijuana-dependent young adults is warranted.

Marijuana and tobacco use and co-use among African Americans: results from the 2013, National Survey on Drug Use and Health.

BACKGROUND Although studies have identified an increased likelihood of marijuana and tobacco co-use among African Americans as compared to other racial groups, few studies have specifically examined the prevalence and substance use characteristics of co-users among African Americans in a national survey. METHODS The current secondary analysis examined the prevalence rates and substance use characteristics (e.g., marijuana dependence) of 2024 African American past month marijuana and tobacco users and co-users participating in the 2013 National Survey on Drug Use and Health. RESULTS Findings revealed that 18.5%, 53.8% and 27.7% of African Americans smoked marijuana only, tobacco only and marijuana and tobacco in the past 30days, respectively. Relative to participants who smoked marijuana only, African Americans who smoked marijuana and tobacco were more likely to be marijuana dependent in the past year and report more days of marijuana use in the past month. Further, relative to participants who smoked tobacco only, African Americans who smoked marijuana and tobacco were less likely to be dependent on nicotine, reported fewer days of cigarette use in the past month, and began smoking cigarettes, cigars and marijuana at a younger age, but were more likely to be marijuana dependent in the past year and reported more days of cigar use in the past month. CONCLUSIONS Marijuana and tobacco co-use is a significant public health problem, especially among African Americans. Additional research on effective prevention and treatment interventions for African Americans who smoke marijuana and tobacco is warranted.

The truth about marijuana is all rolled up in a blunt: prevalence and predictors of blunt use among young African–American adults

Abstract Several studies suggest that African–American young adults are more likely than other racial groups to smoke marijuana in blunts (i.e., hollowed-out cigars filled with marijuana). Given that tobacco content is found in the wrapper leaf of cigars that are used to make blunts, more studies are needed to assess the co-occurring use of marijuana and tobacco among African–American young adults. The present study was designed to address this gap by examining the prevalence rates and predictors of blunt usage among young African–American men and women (ages 18–25) participating in the 2012 National Survey on Drug Use and Health. Among participants who reported using marijuana in the past month, 74.4% of African–American women (N = 246) and 82.7% of men (N = 312) smoked marijuana in a blunt in the past 30 days (current blunt smokers). Logistic regression analyses revealed that current blunt smokers, both men and women, were approximately five times more likely to drive under the influence of illegal drugs in the past year than former and non-blunt smokers. Future marijuana research should examine the dual use of marijuana and tobacco rather than focusing solely on marijuana use, especially among young African–American men and women.

Does treatment readiness enhance the response of African American substance users to Motivational Enhancement Therapy

The development of effective treatments for African Americans and other ethnic minorities is essential for reducing health disparities in substance use. Despite research suggesting that Motivational Enhancement Therapy (MET) may reduce substance use among African Americans, the findings have been inconsistent. This research examined the extent to which readiness-to-change (RTC) affects response to MET among African American substance users. The study was a secondary analysis of the 194 African American substance users participating in a multisite randomized clinical trial evaluating MET originally conducted within the National Drug Abuse Treatment Clinical Trials Network. The participants were randomly assigned to receive either three sessions of MET or Counseling-As-Usual (CAU) followed by the ordinary treatment and other services offered at the five participating outpatient programs. Participants were categorized as either high or lower on RTC based on their scores on the University of Rhode Island Change Assessment. The participants reported their substance use at baseline and throughout the 16 weeks after randomization. Among the high RTC participants, those in MET tended to report fewer days of substance use per week over time than participants in CAU. However, among the lower RTC participants, the CAU group tended to report fewer days of substance use over time than MET participants. In contrast to previous thinking, the findings suggest that MET may be more effective for high than lower RTC African American participants.

The influence of potentially traumatic household characteristics on blunt use among Black youth

ABSTRACT The residential status of mothers and fathers in the household has been shown to influence drug use and other health outcomes among adolescents. However, no studies have examined if these household characteristics influence blunt use (marijuana mixed with or replacing tobacco in cigar paper), specifically among Black adolescents. Using data from the 2012 National Survey on Drug Use and Health, this study was designed to examine the relationship between household characteristics (non-residential mother vs. residential mother and non-residential father vs. residential father) and blunt use among Black male and female adolescents. Findings revealed that Black males with non-residential fathers were more likely to have smoked blunts in their lifetime than Black males with residential fathers, illustrating the importance of fathers in the lives of Black males.

A scoping review and meta-analysis of psychosocial and pharmacological treatments for cannabis and tobacco use among African Americans.

The rates of co-occurring cannabis and tobacco use are higher among African Americans relative to other racial/ethnic groups. One plausible approach to treating co-use among African Americans is to examine the effectiveness of treatments for the sole use of cannabis and tobacco to identify effective approaches that might be combined to treat the dual use of these substances. The current meta-analysis sought to include studies that reported cannabis and/or tobacco use outcomes from randomized clinical trials (RCTs) with 100% African American samples. A total of 843 articles were considered for inclusion, 29 were reviewed by independent qualitative coders, and 22 were included in the review. There were no articles on cannabis use treatment with a 100% African American sample, resulting in a need to lower the threshold (60%) and conduct a scoping review of cannabis studies. Preliminary evidence from a small number of studies (k = 7) supports the use of Motivational Interviewing and Cognitive–Behavioral Therapy to treat cannabis use among African Americans, but not Contingency Management. Results from a meta-analysis of 15 tobacco studies found higher rates of smoking abstinence in the treatment condition relative to control conditions overall and across short and long-term follow-up periods. Significant differences in smoking abstinence were also found when examining the effects of pharmacological treatments relative to their control conditions. The clinical and research implications of these findings for future psychosocial and pharmacological trials for cannabis and tobacco use and co-use among African Americans are described.

Psychosocial determinants of marijuana use among African American youth

ABSTRACT This study examines the psychosocial determinants of marijuana use among youth. A total of 7,488 African American middle and high school students from 133 metropolitan private and public schools completed a survey assessing psychosocial factors associated with annual marijuana use. The PRIDE survey, a nationally recognized survey on substance use, was used to assess the frequency of marijuana use and the influence of psychosocial factors on marijuana use among African American students. Results indicated that 18.5% of African American youth used marijuana in the past year. Males were significantly more likely than females to report using marijuana. Engaging in risky behaviors, such as getting in trouble at school and with police and attending a party with alcohol and other drugs, were significantly correlated with annual marijuana use. Conversely, having multiple parent, teacher, and school protective factors reduced annual marijuana use in this population. Such findings may assist prevention specialists in developing interventions to reduce and prevent marijuana use.

Does change in readiness influence retention among African American women and men in substance abuse treatment

ABSTRACT African Americans are less likely than other racial groups to engage in and complete outpatient substance abuse treatment. The current study, conducted as a secondary analysis of a multisite randomized clinical trial, examined whether readiness to change (RTC) over time influences retention and whether gender moderates the relationship between changes in RTC and retention among 194 African American women and men. Participants completed the University of Rhode Island Change Assessment at baseline and at the end of the 16-week study. Findings revealed a significant relationship between RTC over time and retention. Specifically, the more RTC increased throughout the 16-week study, the longer participants remained in treatment. In addition, gender moderated the relationship between changes in RTC and retention, with a stronger association between changes in RTC and retention among men relative to women. One approach to improving substance abuse treatment retention rates is to focus on increasing RTC during treatment, especially among African American men.

Rolling and scrolling: The portrayal of marijuana cigars (blunts) on YouTube

ABSTRACT Background: Blunts are partially or fully hollowed-out cigars or cigarillos that are filled with marijuana. Despite the high prevalence of blunt use, very few studies assess this specific method of cannabis administration. YouTube, a popular video-sharing website, has the potential to provide insights into blunt use. Methods: The purpose of this study was to examine the content of YouTube videos that discuss blunts. A sample of 41 videos was coded for content. Results: The 41 videos had a total of 27,579,636 views. Most of the individuals in the videos were male (85%) and many appeared to be White (80%) and under the age of 25 (46%). Only 34% of the videos had an age restriction. The majority of messages in the videos promoted blunt use (93%) and showed at least one person rolling (76%) and/or smoking (66%) a blunt. The videos mainly consisted of introductions to blunt use (76%) and tips and personal experiences with blunt use (73%). Conclusions: YouTube videos on blunt use are readily available and primarily promote the use of blunts. Future research should continue to monitor YouTube content and develop videos on social media platforms that inform consumers of the health effects associated with blunt use.