Shih-Chao Hsieh

Self-Control and Social Bonds: A Combined Control Perspective on Deviance

With longitudinal data from a sample of adult male drug offenders, this study tested 4 aspects of social bonding (attachment, involvement, religious commitment, and moral belief) and association with substance-using peers as outcomes of low self-control and as mediators of the relationship between low self-control and drug use. Low self-control was negatively related to social bonds and positively related to drug use and association with substance-using peers. The relationship between low self-control and drug use was fully mediated by moral belief and association with substance-using peers. These results support the utility of integrating self-control and social bonding perspectives on deviance.

Prior treatment experience related to process and outcomes in DATOS

Using data collected from cocaine-abusing patients who participated in the Drug Abuse Treatment Outcome Studies (DATOS), we contrasted patients in treatment for the first time and patients having extensive histories of prior treatment to identify factors associated with better outcomes in each group. Compared with first-timers, treatment-experienced patients had less favorable post-treatment outcomes. Indicators of early engagement in DATOS treatment predicted post-treatment abstinence for both groups. Importantly, the interaction of treatment history and several process measures affected post-treatment abstinence. For example, individual counseling and program compliance had greater impacts on abstinence among treatment repeaters in outpatient drug-free programs than for first-timers. Social support and environmental context were significantly related to abstinence. These findings confirm the importance of considering treatment process and aftercare in developing and implementing strategies to optimize treatment for patients with different treatment histories.

Ethnic patterns in drug abuse treatment utilization.

This study describes utilization of drug abuse treatment and related perceptions among African American, Hispanic, and Anglo drug-using arrestees in Los Angeles. The study extends prior research by, first, describing ethnic variation in treatment utilization through analyses that control for nonethnic demographic factors and by, second, exploring the degree to which ethnicity is related to two predisposing factors (attitude toward treatment and perceived need) and two enabling factors (perceived cost and availability). After nonethnic demographic factors and past drug dependence are controlled, African American and Hispanic drug users in Los Angeles are less likely to report having been in drug abuse treatment. Hispanic drug users are more likely than Anglos to say that they have not sought treatment because they do not need it. African American drug users are more likely than Anglos to hold unfavorable views of treatment.

Methadone Maintenance and Needle/Syringe Sharing

Drug users who inject drugs while in treatment share needles/syringes less often than users not in treatment. This relationship may reflect treatment processes, such as cognitive or normative change, by which treatment clients are influenced to lower their HIV infection risk. However, reduced needle/syringe sharing among treatment clients may instead be simply a collateral result of reduced injection frequency. In this sample of injection drug users, those who continued to inject while in methadone maintenance treatment reported less sharing than users not in methadone maintenance. This relationship persisted after injection frequency and drug-user background characteristics were controlled. Efforts to identify explanatory treatment processes were, however, not successful.

Predictors of drug treatment re-entry following relapse to cocaine use in datos

Many drug abusers have repeated exposure to treatment, yet little is known about the reasons some individuals re-enter treatment following relapse to drug use. This paper examines the predictors of treatment re-entry among cocaine abusers who relapsed to cocaine use (N = 347) within 5 years following their index treatment episode. In-depth assessments were conducted at treatment intake in 1991-93 and at 1 and 5 years following treatment discharge. About 44% of the sample returned to treatment, at an average of 2.6 years following discharge. A logistic regression analysis demonstrated that individuals who were African American, were previously married, used cocaine at least weekly after treatment discharge, and had more service needs at the time of index treatment were more likely to re-enter treatment. The findings suggest that a longer-term perspective on treatment utilization is needed to more fully address chronic substance abuse and the problems typically associated with it.

Influences Affecting Maintenance and Cessation of Narcotics Addiction

A sample of 354 narcotics addicts remanded to the California Civil Addict Program (CAP) in 1962–64 was followed for over twenty-four years. Self-report data collected at initial treatment admission and in two follow-up interviews (1974–75 and 1985–86) included information on family history, patterns of drug use and criminal involvement, and other behaviors. The sample was classified into four exclusive groups: Winners (N=59), who had been abstinent from narcotics and other serious drug use and had not been involved in criminal activity during the thirty-six-month period prior to interview; Striving addicts (N=46), who had been abstinent from narcotics use, but not necessarily other drugs, and had no incarceration for a period of twelve months prior to interview; Enduring addicts (N=146), who had used narcotics and typically other drugs within the prior 12-month period, but had avoided incarceration; and Incarcerated addicts (N=103), incarcerated at some time during the twelve-month period, and whose drug use was varied. Winners had generally negative familial experiences including little encouragement from parents, who in the main had adverse relationships, higher rates of sexual molestation, and were least happy in childhood. Despite this environment Winners evidenced early independence and self-confidence. Striving addicts were characterized by usually non-substance-using, church-going parents. Most had ceased narcotics use, but remained heavily involved with alcohol and marijuana. Enduring addicts, mostly from lower socioeconomic status families that exhibited extensive substance use and physical arguments, commonly accessed methadone treatment and avoided incarceration while persisting in narcotic addiction and crime. Incarcerated addicts, typically raised in dysfunctional, substance-using families, received the most parental caring along with the most severe punishment. They exhibited persistent involvement in crime, violence, and drug use.

Sexual Behaviors and Cocaine Preference among Injection Drug Users in Los Angeles

Based on a 1988–91 sample of 826 drug-using arrestees in Los Angeles, this study compares the sexual behaviors of users whose preferred injection drug is cocaine and users with a preference for heroin or no preference between the two drugs. Sex with multiple partners is more common among users whose preferred injection drug is cocaine after variables such as age, gender, and crack use are controlled. Condom use and frequency of sex while high are not related to injection cocaine preference in this sample. These results suggest that preventive outreach to injection drug users in Los Angeles might be more effective if tailored to sexual behavior patterns that vary by injection drug.

Drug-related HIV risk behaviors and cocaine preference among injection drug users in Los Angeles

Based on a 1988–91 sample of 422 drug-using arrestees in Los Angeles, this study compares the drug-related risk behavior of users whose preferred injection drug is cocaine and users with a preference for heroin or no preference between the two drugs. Cocaine preference is unrelated to the likelihood of needle sharing overall, needle sharing with strangers, needle sharing at shooting galleries, and failure to use bleach as a needle disinfectant. In analyses restricted to users who reported needle sharing, the frequency of sharing is no more closely related to heroin injection frequency than to cocaine injection frequency. These results suggest that local preventive education programs do not need to address distinctive patterns of drug-related risk behavior among injection cocaine users and injection heroin users in Los Angeles.