(from Mosher and Akins, Drugs and Drug Policy: The Control of Consciousness Alteration, Sage Publications, 2007, pages 147-169.

Age

• Use increases rapidly during adolescence
  • Independence
  • Lack of responsibility
  • Boredom
• Peaks--18-21
• Same issues for young adults
• Positive functions of limited experimentation
  • Peer bonding
  • Independence
  • Identity experimentation
• Young less likely to experience serious health problems compared to older adult users
• Resurgence of use among older adults
  • Mainly alcohol and prescription drugs
  • Retirement, free-time, and lack of commitments
  • Issue--aging baby-boomers: 65 million

Gender

• Boys experiment early
• Late adolescence--similar rates
• Adulthood--males higher rates
  • Social stigma for female users
  • Women view use as more risky and are less tolerant
  • Societal institutions reinforce norms of gender difference
  • "Traditional female role" and motherhood
• Males use in more problematic ways
• Women more likely to use prescription drugs: more likely to visit physicians

Race/Ethnicity

Past Month Illicit Drug Use among Persons Aged 12 or Older, by Race/Ethnicity: 2002-2013 (Latest NSDUH)

• Lower levels of use among minorities. "Asians" lowest levels.
• Issue of under-reporting: drop-outs and school-based surveys, yet differences apparent at 8th grade prior to drop-outs
• Problems in minority communities are higher
  • "Two worlds," large population practicing temperance and small, heavy using
  • Hyperavailability: legal and illegal
    • Easy to obtain
    • Visible sales
    • Visible users (drunk and high)
    • Negative and positive effects
      • deterrent
• African-American Adults--use rates similar to Whites
  • SES: $25,000 and above--similarities; those in poverty: 5 times higher.
  • Educational levels same relationship
  • "Truly Disadvantaged"
    • Inner-city isolation
    • Under-class
    • Lack of supporting institutions
• Hispanics
  • Similar to Whites, but...
  • Diversity
  • Residence: exposure factor--even rural area Rio Arriba County (NM)--highest drug mortality rates
  • Puerto Ricans versus other groups: Acculturation
    • Traditional norms--protect against illegal (even legal, re: Mexico)
• American Indians
  • Again diversity, highest levels of use
  • Extreme social and economic disadvantage
  • Unemployment
  • Limited health care access--self-medication, no rehab
    
• Asian and Pacific Islanders
  • Diversity
  • Model Minority Myth
  • Overall, lowest rates of use
    • Income
    • Education
  • Acculturation factor: Pacific Islanders--most likely to use
  • Others--illiterate and poor (South East Asia)
    • Linguistic (and social) isolation
    • Traditional value system--traditional norms of use

Social Class

• Important, but not "determining
• Lower class NOT more likely to use
• Adults: high levels of education--high levels of use
• Poverty (poor similar to wealthy, BUT "Extreme Poverty" (200% below poverty line)
  • Relevant for minorities versus whites
  • Exposure to numerous sources of disadvantage

Urban/Rural

• Urban: access, exposure.
• Rural: high levels of legal drug use (alcohol and tobacco)
  • Prominent role of family and church
  • Yet, Arriba County and Methamphetamine in midwest
    • Fewer resources
    • Cultural traditions resist seeking help

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