Comorbidity and Risk Behaviors Among Drug Users Not in Treatment

Abstract

In a sample of 700 drug users, 64% evidenced comorbidity (i.e., coexisting substance use and psychiatric disorders). Robust relationships between the presence of comorbidity and increased levels of risk behavior, such as needle sharing and trading sex for money, were revealed.

Psychiatric correlates of injection risk behavior among young people who inject drugs.

“…A number of studies with methadone maintenance or other drug treatment patients (Camacho, et al, 1996; Kleinman, et al, 1994; Malow, et al, 1992; Metzger, et al, 1991; Perdue, et al, 2003; Pilowsky, et al, 2011; Woody, et al, 1997), and drug users not in treatment (Johnson, et al, 2003; Johnson, et al, 2002; Simpson, et al, 1993; Strathdee, et al, 1997), including syringe exchange program participants (Kidorf, et al, 2010), have found that symptoms of psychological distress or dysfunction, particularly symptoms of depression, are associated with injection risk behavior, including sharing syringes and other equipment, number of sharing partners, sharing with strangers, and sharing with a person known to be HIV-positive.…”

“…Young people who inject drugs (PWID) frequently experience mental health problems, including mood, anxiety, and personality disorders, as well as alcohol and other substance use disorders (Brooner, King, Kidorf, Schmidt, & Bigelow, 1997; Callaly, Trauer, Munro, & Whelan, 2001; Kessler, 2004; Kessler et al, 2005; Mackesy-Amiti, Donenberg, & Ouellet, 2012; Mason et al, 1998; Teesson et al, 2005). A number of studies with methadone maintenance or other drug treatment patients (Camacho, Brown, & Simpson, 1996; Kleinman et al, 1994; Malow, Corrigan, Pena, Calkins, & Bannister, 1992; Metzger et al, 1991; Perdue, Hagan, Thiede, & Valleroy, 2003; Pilowsky, Wu, Burchett, Blazer, & Ling, 2011; Woody, Metzger, Navaline, McLellan, & O’Brien, 1997), and drug users not in treatment (Johnson, Brems, Wells, Theno, & Fisher, 2003; Johnson, Yep, Brems, Theno, & Fisher, 2002; Simpson, Knight, & Ray, 1993; Strathdee et al, 1997), including syringe exchange program participants (Kidorf et al, 2010), have found that symptoms of psychological distress or dysfunction, particularly symptoms of depression, are associated with injection risk behavior, including sharing syringes and other equipment, number of sharing partners, sharing with strangers, and sharing with a person known to be HIV-positive.…”

Effects of Familial Attachment, Social Support, Involvement, and Self-Esteem on Youth Substance Use and Sexual Risk Taking

“…Although smaller in proportion, U.S. high school students also report across multiple national surveys illicit drug use including cocaine, heroin, methamphetamines, ecstasy, and prescription medications without a prescription (CDC, 2010;Johnston, O'Malley, Bachman, & Schulenberg, 2008;Substance Abuse and Mental Health Services Administration, 2009). In addition, substance use has often been associated with risky sexual behavior (Elkington, Bauermeister, & Zimmerman, 2010;Johnson, Brems, Wells, Theno, & Fisher, 2003;Mott, Fondell, Hu, Kowaleski-Jones, & Menaghan, 1996;Trepka et al, 2008). Although the total number of adolescents engaging in sexual intercourse has significantly declined since 1991 (CDC, 2010), about half continue to report having had intercourse (Stevens & Griffin, 2001), with more than a third failing to use condoms and only 20% using birth control pills to prevent pregnancy (CDC, 2010).…”