Sehun Oh

Trends and correlates of marijuana use among late middle-aged and older adults in the United States, 2002-2014

BACKGROUND Recent trend studies suggest that marijuana use is on the rise among the general population of adults ages 18 and older in the United States. However, little is known about the trends in marijuana use and marijuana-specific risk/protective factors among American adults during the latter part of adulthood. METHOD Findings are based on repeated, cross-sectional data collected from late middle-aged (ages 50-64) and older adults (ages 65 and older) surveyed as part of the National Survey on Drug Use and Health between 2002 and 2014. RESULTS The prevalence of past-year marijuana use among late middle-aged adults increased significantly from a low of 2.95% in 2003 to a high of 9.08% in 2014. Similarly, the prevalence of marijuana use increased significantly among older adults from a low of 0.15% in 2003 to a high of 2.04% in 2014. Notably, the upward trends in marijuana use remained significant even when accounting for sociodemographic, substance use, behavioral, and health-related factors. We also found that decreases in marijuana-specific protective factors were associated with the observed trend changes in marijuana use among late middle-aged and older adults, and observed a weakening of the association between late-middle aged marijuana use and risk propensity, other illicit drug use, and criminal justice system involvement over the course of the study. CONCLUSIONS Findings from the present study provide robust evidence indicating that marijuana use among older Americans has increased markedly in recent years, with the most evident changes observed between 2008 and 2014.

Prevalence and correlates of alcohol and tobacco use among pregnant women in the United States: evidence from the NSDUH 2005–2014

Alcohol and tobacco use during pregnancy are among the strongest and most preventable risk factors for adverse neonatal health outcomes, but few developmentally sensitive, population-based studies of this phenomenon have been conducted. To address this gap, the present study examined the prevalence and correlates of alcohol and tobacco use among pregnant adolescents (aged 12-17) and adults (aged 18-44) in the United States. Data were derived from the population-based National Survey of Drug Use and Health (80,498 adolescent and 152,043 adult women) between 2005 and 2014. Findings show disconcerting levels of past-month use among pregnant women with 11.5% of adolescent and 8.7% of adult women using alcohol, and 23.0% of adolescent and 14.9% of adult women using tobacco. Compared to their non-pregnant counterparts, pregnant adolescents were less likely to report past 30-day alcohol use (AOR=0.52, 95% CI=0.36-0.76), but more likely to report past 30-day tobacco use (AOR=2.20, 95% CI=1.53-3.18). Compared to their non-pregnant adult counterparts, pregnant adults were less likely to report using alcohol (AOR=0.06, 95% CI=0.05-0.07) and tobacco (AOR=0.47, 95% CI=0.43-0.52). Compared to pregnant abstainers, pregnant women reporting alcohol/tobacco use were more likely to have had a major depressive episode in the past 12months, report criminal justice system involvement, and endorse comorbid alcohol/tobacco use. Given alcohol and tobaccos deleterious consequences during pregnancy, increased attention to reducing use is critical. Findings suggest that tobacco use is especially problematic for both adolescents and adults and is strongly linked with depression and criminal justice involvement, especially among adults.

Marijuana use during pregnancy: A comparison of trends and correlates among married and unmarried pregnant women

BACKGROUND/PURPOSE While recent evidence indicates increases in marijuana use among adult women in the United States (US), important questions remain with respect to marijuana use during pregnancy. This study examines trends and correlates of prenatal marijuana use and the effects of marijuana-specific risk/protective factors on marijuana use trends using a nationally representative sample. METHOD Data were derived from the National Survey on Drug Use and Health (2005-2014), a nationally representative survey that included 3640 married and 3987 unmarried pregnant women in the United States. The significance of marijuana use trends was tested using logistic regression analyses while adjusting for complex sampling design effects and controlling for sociodemographic and marijuana-specific factors. RESULTS From 2005-2014, marijuana use prevalence among unmarried pregnant women increased by 85% from 5.4% to 10.0% while the prevalence among married pregnant women remained stable (mostly under 1.5%). The increasing trend among unmarried pregnant women was associated with their lower disapproval and risk perceptions of marijuana use. In addition, past-year anxiety (AOR=3.30, 95% CI=1.87-5.82) and depression (AOR=3.85, 95% CI=2.33-6.36) diagnoses were linked with marijuana use among unmarried, but not married, pregnant women. DISCUSSION Increased attention should be paid to reducing prenatal marijuana use among unmarried women. Findings also suggest the need to attend to unmarried pregnant womens mental health problems as well as their physical health-risk behaviors.

Gender differences in the trends and correlates of major depressive episodes among juvenile offenders in the United States

PURPOSE Although it is well-established that juvenile offenders are at an elevated risk for depression and that, within this group, females have the highest risk, little is known regarding the trends in the prevalence of depression among juvenile offenders in the United States. In the present study, we systematically examine secular trends in major depressive episodes (MDE) and their correlates among male and female juvenile offenders and non-offenders in the United States. METHODS Data were collected between 2005 and 2014 as part of the National Survey on Drug Use and Health (NSDUH). The NSDUH uses multistage area probability sampling methods to select a representative sample of the civilian, non-institutionalized population in the United States. Participants included 171,118 youth aged 12-17 (159,449 non-offenders and 11,669 offenders). The primary variable of interest was self-reported past year MDE. Logistic regression assessed whether sociodemographic factors and psychosocial and behavioral correlates affected the risk of MDE. RESULTS Between 2005 and 2014, the prevalence of MDE among female youth increased for both offender and non-offender groups: from 24.4% to 33.0% for the offenders and from 12.4% to 16.7% for the non-offenders. No significant trend changes were observed among male youth. In both male and female juvenile offenders, MDEs were associated with increased risk of illicit drug use (males OR=1.61, 95% CI=1.18-2.18; females OR=1.83, 95% CI=1.45-2.31). Additional correlates include alcohol use among male offenders (OR=1.36, 95% CI=1.01-1.83), and binge drinking in female offenders (OR=1.24, 95% CI=1.02-1.49). CONCLUSIONS The prevalence of past year major depressive episodes is increasing for female juvenile offenders, highlighting a need for improved efforts to target these populations for prevention and treatment.

Military service and crime: new evidence

BackgroundEvidence indicates that a substantial proportion of military personnel are involved in high-risk and antisocial behaviors that place them at jeopardy for criminal justice system involvement. However, prior research on military service and crime has disproportionately focused on veterans from the Vietnam War era (1955–1975), and has tended to focus on either current or former military members.MethodsThis study employed data from a population-based study (i.e., National Study on Drug Use and Health [NSDUH] between 2002 and 2014). It systematically examines the prevalence of self-reported antisocial behaviors, criminal justice system involvement, and substance abuse among the US civilian population and military service members, including reservists (n = 2206) and those who reported having been separated or retired from military service (n = 20,551). These factors are further examined across the developmental spectrum of adulthood (ages 18–34, 35–49, and 50–64).ResultsResults showed that military members were more prone to lifetime arrests and overall substance misuse. However, additional findings emerged suggesting that, while the military population overall seems to be positively associated with higher criminal activity than that found in the civilian population, these findings were based on a specific subgroup of the veteran population. This subgroup is comprised of individuals who likely did not fit in with the military culture and were discharged from the military early in their careers.ConclusionAdditional research on identifying this subgroup of military members is encouraged to better concentrate on prevention and treatment measures.

Abstention from drug use and delinquency increasing among youth in the United States, 2002-2014

ABSTRACT Background: Trends in abstaining from substance use and delinquency among adolescents ages 12–17 in the United States was examined. Methods: Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic white, African American, and Hispanic respondents (n = 98,620) and spanning the years 2002–2014. Logistic regression was used to examine significance of trend year and correlates of low-risk and high-risk behavioral groups relative to abstaining. Results: Overall, the prevalence of abstaining was 47.56% between 2002 and 2014. Prevalence increased significantly among all adolescents from 44.85% in 2002 to 53.58% in 2014. Relative to abstainers nonabstaining youth were more likely to be male, and report lower household income, poorer grades, depression, and lower levels of parental affirmation and control. Conclusions: Findings indicate that there is a corresponding increase in abstaining mirroring the recent decreases found in adolescent drug use found in national surveys.

Trends in depression among low-income mothers in the United States, 2005–2015

BACKGROUND Prior research has examined the association between low-income status and maternal depression; however, important questions remain in terms of trends in the prevalence of major depressive episodes (MDE) and treatment seeking among mothers in the United States. The objective of the present study is to examine trends in MDE among low-income mothers and explore perceived barriers to mental health treatment seeking. METHODS Using data from the National Survey on Drug Use and Health (NSDUH; 2005-2015), we examined the prevalence of past-year MDE among mothers living in poverty (0-99% federal poverty line [FPL]; n = 23,264) and near-poverty (100-200% FPL; n = 21,655). Consistent with the Center for Disease Control and Prevention (CDC) guidelines, we conducted survey-adjusted logistic regression analyses to examine the significance of survey year in relation to MDE while controlling for key social demographic correlates. RESULTS The overall decreasing MDE trend was found only among mothers in near-poverty, not mothers in poverty. Only for mothers in poverty, financial (AOR = 0.70, 95% CI = 0.52-0.95) and information barriers (AOR = 0.53, 95% CI = 0.39-0.73) were associated with mental health service use. LIMITATIONS Self-reports of depressive symptoms and service receipt may have led to over or underreporting due to recall or social desirability bias. Additionally, NSDUH data are cross-sectional and thereby limit our ability to make causal inferences. CONCLUSIONS Greater attention should be paid to the prevention/treatment of depression among mothers in poverty. Efforts may include expanding financial assistance for mental health service use and educational campaigns to increase awareness of services available.

Declining trends in drug dealing among adolescents in the United States

INTRODUCTION The link between drug selling and other delinquent behaviors in adolescence is well established. Less is known regarding the trends in drug selling among youth in the US and whether they are consistent with the recently observed decline in problem behaviors among this population. METHODS Data were collected between 2002 and 2015 as part of the National Survey on Drug Use and Health (NSDUH). Participants included 233,435 US youth aged 12-17. The primary variable of interest was self-reported past year drug-selling. Logistic regression assessed trends in drug-selling among male and female subgroups. RESULTS Between 2002 and 2015, the prevalence of drug-selling decreased significantly across all youth (AOR = 0.970, p < .001). Analysis of gender differences revealed that the rate of drug-selling decreased significantly among boys (AOR = 0.962, p < .001), however, the trend remained stable for girls (AOR = 0.987, p > .05). The decrease in drug-selling was observed for nearly all male subgroups, African-American girls (0.946, p < .01) and girls reporting no illegal substance use in the past year (0.960, p < .05). CONCLUSIONS The prevalence of past year drug-selling among youth in the US is declining significantly, especially for boys.

Substance use and use disorders and treatment receipt among adults in families receiving Temporary Assistance for Needy Families (TANF), 2003–2014

BACKGROUND/PURPOSE Legalization of marijuana for medical and/or recreational use in some U.S. states has increased attention to substance use and related problems. However, little attention has been paid to these phenomena among adults in families receiving Temporary Assistance for Needy Families (TANF) whose adverse life experiences may put them at elevated risk of substance use disorders (SUDs). METHODS Data from the 2003-2014 National Survey on Drug Use and Health (NSDUH) were used to test trends in past-month binge drinking and past-year marijuana, other illicit drug, and any illicit drug use and to examine SUD prevalence and treatment correlates among adults in TANF families. RESULTS While rates of binge drinking and any illicit drug use remained steady, marijuana use increased from 15.8% in 2003/2004 to 21.6% in 2013/2014, a 36.7% increase. Increased marijuana use was strongly related to changes in marijuana risk perception. Among adults in TANF families, 19.5% of men and 10.8% of women had a past-year SUD, but only one in five received treatment. Those aged 18-25, Black or Hispanic women, and those who had children at home when surveyed were less likely to have received treatment. DISCUSSION Preventive efforts to address substance use, especially marijuana use, among adults in TANF families are needed. Moreover, given greater odds of unmet SUD treatment need among these economically disadvantaged adults, particularly racial/ethnic minority women and those who are in emerging adulthood, uninsured, and have children at home, measures to provide more inclusive services such as integrated behavioral health care are needed.

Sex Differences in the Prevalence and Correlates of Handgun Carrying Among Adolescents in the United States

Handgun carrying is associated with a wide range of delinquent behaviors, but very little is known about sex differences in this behavior and current trends in handgun carrying in the United States. Using data from the 2002 to 2015 National Study of Drug Use and Health surveys, we found that the prevalence of handgun carrying among girls nearly doubled from 0.9% to 1.7% with most of this increase seen among non-Hispanic White and Hispanic girls. Although boys are more likely to carry handguns, approximately 20% of the total handgun carrying by adolescents in the United States occurs among girls. Both male and female adolescents who have carried a handgun in the past year evince a behavioral profile that is characterized by substance use, versatile delinquency, elevated risk propensity, and substantial school and family problems. However, adjusted odds ratios are consistently higher for females, suggesting that girls who engage in handgun carrying represent an important subgroup of potentially pernicious offenders that should be targeted for primary and tertiary prevention and juvenile justice system oversight.