Substance use and drug overdose: Role of individual and environmental factors
Loading...
Authors
Thomas, Shawn Alan
Issue Date
2023
Type
Dissertation
Language
Keywords
Adolescent health , Drug overdose , Maternal health , Protective factor , Risk factor , Substance use
Alternative Title
Abstract
Studies have explored risk and protective factors for substance use in adolescent and maternal populations. However, even with this increased understanding of risk and protective factors, trends continue to remain the same or worsen in vulnerable populations such as sexual minority youth, pregnant people, and those who die by drug overdose. The general aims of this dissertation are to: 1) Investigate protective environmental factors among sexual minority youth for nonmedical use of prescription opioids (NMUPO); 2) Explore the direct and interactive effects of stressful life events (SLEs) and adverse childhood experiences (ACEs) among pregnant people on marijuana use; and 3) Identify social and contextual factors associated with substances used among drug overdose decedents.To achieve these aims, I first used representative data from 156,149 youth from 24 states in the U.S. and assessed environmental protective factors (state equality laws and LGBTQ supportive school environment) among sexual minority youth for NMUPO using generalized linear mixed models. In the second study, I explored individual risk factors of ACEs and SLEs and their direct and interactive effects on marijuana use among a population-based sample of 2,483 pregnant people in Nevada using generalized estimating equations. In the third study, I explored the social and contextual factors related to drug overdose deaths among 1,948 decedents in Nevada to identify potential opportunities that could have prevented their death using latent class analysis, multinomial logistic regression, and Chi-squared tests. The first study found that the school environment was associated with a reduced odds of NMUPO, while this finding did not hold up with state equality laws. The second study found that ACEs and SLEs were associated with marijuana use during pregnancy, and there was evidence of additive interaction when assessing both exposures jointly. The third study identified four distinct groups of people who die by drug overdose and several social and contextual factors associated with these groups. Collectively, these findings highlight the need for advancing research of protective factors in vulnerable populations, and finding ways to prevent drug overdose.
Description
Citation
Publisher
License
Creative Commons Attribution 4.0 United States