1. National Institute
on Alcohol Abuse
and Alcoholism
Time to Regular Substance Use in Alcohol Dependent and Non-Dependent African Americans
Supported in part by NIAAA grant #AA-11898, AA-12553, AA014643, GCRC Grant M01-RR10284
N. Kalu; J. Kwagyan; V.J. Marshall; D. M. Scott; G. Cain; K. Louis; R.E. Taylor
Howard University Alcohol Research Center, Washington, D.C
INTRODUCTION
RESULTS
RESULTS (Cont’d)
Substance dependence often starts with initiation, then regular use, followed by abuse and/or dependency. At any point in time, an individual may use multiple substances. Duration between initiation and regular use may affect the transition from regular substance use to dependence. In 2002, alcohol dependence among African Americans between the ages of was 6.03%, an increase from 5.07% the previous year (Grant et al, 2006). Diagnosis of alcohol dependence in African Americans occurs later in the age group compared to Caucasians or Native Americans (Hesselbrock et al 2003; Reardon & Buka, 2002). As such, we may need to look for novel indicators of dependence. One such indicator may be the duration between initiation and regular substance use.
AD were approximately the same current age as ND. However, AD were mostly male, had less than a high school education, and earned less than $20000 annually (Table 1). The mean age of diagnosis of AD was 26.36± 7.75 years.
Cocaine was the only substance with a significantly different time to regular use (Table3). AD had a shorter time to regular cocaine use compared to ND (Figure 1).
Table 3: Interval between First Use and Regular Use of Substances
Figure 1: Kaplan Meier Plot of Time to Regular Cocaine Use
Table 1: Demographics
*p<0.05
OBJECTIVE
CONCLUSIONS
To examine if duration between initiation and regular use– time to regular use– plays a role in the progression to alcohol dependence in African Americans.
This represents preliminary data on time to regular substance use among a cohort of urban African Americans.
Transition to regular use of substances, particularly cocaine, is faster in alcohol dependent participants compared to non-alcohol dependent participants.
These results can direct prevention efforts for both alcohol dependence and hard drug use in populations, such as African Americans, where onset of dependence traditionally occurs later than other ethnic groups.
**p<0.01
***p<0.001
METHODS
AD had an earlier age of initiation of tobacco and marijuana. AD also had an earlier age of regular use of alcohol and marijuana (See Table 2).
Participants: The sample consisted of 323 African Americans, 174 alcohol dependent (AD) and 149 non-alcohol dependent (ND).
Instruments: Alcohol dependence was based on endorsement of any of three criteria –DSMIIIR, ICD-10, DSMIV – or best final diagnosis. Substance use was assessed using the Semi-Structured Assessment for the Genetics of Alcoholism, SSAGA. Participants used at least one substance (alcohol, marijuana, tobacco, opiates, cocaine, stimulants, sedatives, other) at least once every week for a month or more.
Data Analysis: Analysis was run on SPSS Demographics were analyzed with either Pearson's Chi-Square or T-test as applicable. Differences in time from initiation to regular use were contrasted using Kaplan-Meier survival analysis with Mantel Cox Log Rank for significant differences. Significance was established at p<. 05.
Table 2:Age of Initial and Regular Substance Use
REFERENCES
Grant, BF; Dawson, DD; Stinson, FS; Chou, P; Dufour, MC; Pickering, RP. The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United states and Alcohol Research and Health: Journal of the National Institute on Alcohol Abuse and Alcoholism (2)
Hesselbrock, MN; Hesselbrock, VM; Segal, B; Schukitt, MA; Bucholz, K. Ethnicity and psychiatric comorbidity among alcohol dependent persons who receive inpatient treatment: African Americans. Alaska Natives, Caucasians and Hispanics. Alcoholism: Clinical and Experimental Research (8):
Reardon, SF and Buka, SL. Differences in onset and persistence of substance abuse and dependence among Whites, Blacks, and Hispanics. Public Health Reports (S1):S51-S59.
**P<0.01
***p<0.001
For additional information contact:
Website: