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Introduction This paper describes methamphetamine (MA) use patterns, specifically duration of continuing abstinence (“time to relapse”) for periods averaging 5 years post-discharge from treatment for MA use, and the relationship with selected user and treatment characteristics. Methods A sample of 350 treatment admissions from a large county substance use disorder (SUD) treatment system was randomly selected (within gender, race/ethnicity, treatment modality strata). Retrospective self-report data are from natural history interviews (NHI) conducted approximately 3 years after treatment and a follow-up 2-3 years later. Relapse is defined as any use of MA with time as the number of months of continuous MA abstinence after treatment discharge until relapse. This outcome was constructed from a monthly MA use timeline using NHI data. A Cox model was used to examine time to relapse and predictors. Results Sixty-one percent of the sample relapsed to MA use within 1 year after treatment discharge and 25% during years 2-5. Significant protective factors predicting longer time to relapse included having experienced serious MA-related psychiatric/behavioral problems (hazard ratio [HR]=0.75, p=0.027), longer duration of the index treatment episode (HR=0.93, p=0.001), and participating in self-help or other treatment during the post-treatment abstinence period(HR=0.29, p<0.001); risk factors for shorter time to relapse included having a parent with alcohol and/or drug use problems (HR =1.35, p=0.020) and involvement in MA sales (HR=1.48, p=0.002). Conclusions Results contribute a long-term perspective on patterns of MA use following treatment and support a need for early post-treatment and long-term continuing care and relapse- prevention services.

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A typical approach to categorizing substance users for epidemiologic purposes or to identify substance use problems at treatment admission is by indicating the primary substance used and/or for which treatment is sought. But does such singular focus on the primary drug limit the validity of conclusions from longitudinal analysis of drug use patterns over time? This analysis combined data from five longitudinal studies conducted in California and examined 10-year patterns of heroin, cocaine, methamphetamine (meth), marijuana, and alcohol use for primary users of heroin (n=629), cocaine (n=694), and meth (n=474). Results suggest relatively low levels of use of non-primary heroin, cocaine, and meth, but moderate levels of alcohol and marijuana use. Growth models showed declining primary drug levels for heroin and meth users and relatively consistent levels over 10 years for cocaine users, while levels of non-primary drugs remained at consistently low levels or declined in tandem with the primary drug. Results indicate that group descriptions of primary heroin, cocaine, or meth use trajectories over time may present valid information about drug use patterns in general.

The early findings of this study demonstrate that pregnant adolescents benefit from both traditional and more intense public health nursing care in terms of prenatal and perinatal outcomes. The EIP was associated with decreased infant morbidity during the first 6 weeks of life and decreased maternal school dropout. Long-term outcomes for the EIP are being evaluated.

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Current literature has shown that heroin addiction is characterized by long periods of regular use persisting over the life course, whereas the course of stimulant use is less understood. The current study examined long-term trajectories of drug use for primary heroin, cocaine (crack/powder cocaine), and methamphetamine (meth) users. The analyses used data from five studies that collected longitudinal information using the Natural History Instrument, including 629 primary heroin users, 694 cocaine users, and 474 meth users. Drug use trajectories over the 10 years since initiation demonstrated the persistence of use over time for all three drugs, with heroin use at the highest level (13 to 18 days per month), cocaine at the lowest level (8 to 11 days), and meth in between (approximately 12 days per month). Application of growth mixture models revealed five distinctive groups: Consistently High Use (n = 545), Increasing Use (n = 260), Decreasing Use (n = 254), Moderate Use (n = 638), and Low Use (n = 100). Heroin users were disproportionately overrepresented in the Consistently High Use group and underrepresented in the Low Use group; cocaine and meth users were mostly in the Moderate Use group. Users in the High Use group also had earlier onsets of drug use and crime, longer incarceration durations, and were the least employed. Clinical/service policy and practice need to recognize and adapt to the specific patterns and needs of users of different drugs while being mindful of the stage drug users are at in their life course.

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