Thomas Nicholson

Using Internet-based surveys to reach hidden populations: case of nonabusive illicit drug users.

OBJECTIVE To examine the potential of surveys delivered via the World Wide Web (WWW) as a method for reaching hidden populations such as that of nonabusive users of illicit drugs. METHODS Past and current approaches to collecting data from hidden populations were reviewed. RESULTS A number of approaches have been used in the past efforts to reach drug users but the use of the WWW has produced the largest sample of successful illicit drug users ever surveyed. CONCLUSION Further application of this approach (WWW) is recommended when hidden populations are surveyed.

Harm reduction: an emerging new paradigm for drug education

Harm reduction is a new paradigm now emerging in the field of drug education. This strategy recognizes that people always have and always will use drugs and, therefore, attempts to minimize the potential hazards associated with drug use rather than the use itself. The rationale for a harm reduction strategy is presented, followed by an example of the kind of needs assessment which may be needed for planning a harm reduction strategy.

The Baby Boomer Effect: Changing Patterns of Substance Abuse Among Adults Ages 55 and Older

Between now and 2030, the number of adults aged 65 and older in the United States will almost double, from around 37 million to more than 70 million, an increase from 12% of the U.S. population to almost 20%. It was long held that, with only a few isolated exceptions, substance abuse simply did not exist among this population. In light of the impact of the baby boom generation, this assumption may no longer be valid. The authors examined admissions of persons 55 years and older (n = 918,955) from the Treatment Episode Data Set (1998–2006). Total admissions with a primary drug problem with alcohol have remained relatively stable over this time. Admissions for problems with a primary drug other than alcohol have shown a steady and substantial increase. Clearly, data from the Treatment Episode Data Set indicate a coming wave of older addicts whose primary problem is not alcohol. The authors suspect that this wave is led primarily by the continuing emergence of the baby boomer generation.

Drugnet: A Pilot Study of Adult Recreational Drug Use via the WWW

This study was intended (1) to explore the potential of using the World Wide Web (WWW) of the Internet to sample hidden populations and (2) to collect exploratory data on the hidden population of nonabusive, recreational users of illicit drugs. The survey modules were designed to assess demographics and lifestyle, drug experiences (including absence of DSM-IV criteria for abuse or dependence), legal history (drug-related arrests, etc.), and mental health as measured by the General Well-Being Schedule (GWBS). The survey was completed by 276 persons, aged 18 to 62, with a mean age of 32.34. The sample was predominantly white (93%), male (78%), college educated (75%), and employed full-time (76%). The WWW is a useful tool for reaching hidden populations but is likely to impose a bias toward male, better educated, and more computer-involved samples on the respondents reached. This survey further documents the existence of a nonclinical population of drug users which is generally healthy, well-adjusted, and productive.

Drug use and mental well being among a sample of undergraduate and graduate college students.

Stress related disorders in college students are widespread and largely preventable. Students do not have the preventative skills necessary to manage stress in their lives and, because of the inability to cope, students may turn to alcohol and drugs to alleviate the pressures they are experiencing. The purpose of this study was to describe the association between stress and alcohol and drug use. A total of 772 undergraduate and graduate students from a small, elite, private university were randomly selected from 4000 students to complete two anonymous questionnaires. The Core Alcohol and Drug Survey identified the frequency and consequences of alcohol and drug use, and the General-Well Being Schedule was used to assess subjective well being and mental health status. The results of this study revealed that, for this sample of students, health behaviors such as using drugs recreationally and drinking alcohol played an associative role with general well being. A significant relationship was also found between student participation in intramural or club sports and positive mental well being.

RETROSPECTIVE PRETEST-POSTTEST ANALYSIS VERSUS TRADITIONAL PRETEST-POSTTEST ANALYSIS

Traditional pretest-posttest comparisons of self-report data are distorted by response-shift bias. Administration of a retrospective pretest in lieu of the traditional pretest eliminates a form of response-shift bias which distorts the comparability of pretest-posttest measurements. The present study compared the sensitivity of a retrospective pretest-posttest measurement versus a traditional pretest-posttest measurement in detecting a treatment effect for a university stress counseling program. The substitution of the retrospective pretest for the traditional pretest as the covariate in the analysis of covariance yielded the same conclusion of no treatment effect.

Stressful Life Events and Loss of Hair among Adult Women, a Case-Control Study

A case-control design was used to compare stress (as measured with the Social Readjustment Rating Scale) in the lives of 25 women who had experienced recent, unexplained hair loss with that of 25 women with no hair loss. High stress was reported by 22 of the women experiencing hair loss and 10 not experiencing hair loss. An odds ratio of 11 suggests that women who experience high stress are 11 times more likely to experience hair loss. Replication is encouraged.

Public attitudes toward smoking bans in a tobacco-producing County

Objectives: Allen County, KY, is a rural county with a population of approximately 18,000. The county has a tobacco crop and is in a state in which tobacco interests are influential. The tobacco control program at the public health department developed a goal to reduce environmental tobacco smoke by restricting smoking in public places. To progress toward that goal, a public opinion poll was conducted to determine citizens’ views regarding smoking restrictions in the county courthouse. Methods: A telephone survey was conducted using the Allen County telephone directory as a sampling frame. The survey instrument included questions on support for smoking restrictions in the courthouse, restaurants, and workplaces as well as support for increasing Kentucky’s cigarette tax. Interviews with 374 individuals—53.6% of the initial sample—were completed. Results: Banning all smoking in the Allen County Courthouse was supported by 163 (43.4%) of the respondents. Designated smoking areas were supported by 168 (44.7%) of the respondents. Twenty-four (6.4%) of the respondents opposed any smoking restrictions at the courthouse. Women were more likely to support a ban on all smoking at the courthouse (45.4% compared with 40%). Males were more likely to support designated smoking areas (46.2% of males versus 43.8% of females). There was a small association between opposition to smoking restrictions at the courthouse and smoking by the respondent. An increase in Kentucky’s cigarette tax was supported by 132 (35.1%) of the respondents and opposed by 184 (48.9%). There was no association between ownership of a tobacco-farming allotment and opinion regarding any of the tobacco control measures. Conclusions: Most Allen County residents support some form of restriction on smoking in public places (including the county courthouse and restaurants) and in workplaces. Only approximately one-third, however, supported an increase in the cigarette tax, perhaps reflecting a general antitax feeling. Ownership of tobacco allotments does not appear to be an important factor in determining attitudes on smoking control issues.

The general well-being of recreational drug users: a survey on the WWW

American drug policy is predicated upon a dichotomy between legal drugs and illegal drugs - good drugs that enhance health and bad drugs which damage health. The fact of psychiatric co-morbidity between substance misuse disorders and other mental disorders is commonly taken to mean that drug use is damaging to mental health. The purpose of this study was to examine the mental well-being of a sample of occasional, recreational drug users. DRUGNET was an on-line survey of recreational drug use by non-deviant adults via the WWW. Volunteer subjects (n=906) completed the survey over the internet between March and September 1997. Mental health was assessed utilizing the General Well-being Schedule (GWBS). A complete demographic profile of the sample was taken. The GWBS correlated with frequency of use, intoxication levels and types of drugs consumed. This study demonstrates the existence of healthy, normally functioning adults who occasionally use psychoactive drugs.

Is recreational drug use normal

The purpose of this paper is to define drug use and differentiate this behaviour from drug abuse. We argue that one fundamental principle of the War on Drugs, namely that all use of illicit drugs is harmful and must be prohibited, is invalid. Statistically, clinically, and socio-culturally, drug use is normal behaviour. Current drug policy is based on the flawed premise that any use of illicit drugs is unhealthy. A public health model emphasizing demand reduction (as opposed to supply reduction), individual freedom, reason, and tolerance is recommended.