SYMPTOMS OF DEPENDENCE AMONG SELF -IDENTIFIED ADULT RECREATIONAL ILLICIT DRUG USERS: A SUB-ANALYSIS OF THE DRUGNET SURVEY. A graduate thesis by Shakti Nagarajan, (MPH) Thesis Committee Thomas Nicholson, PhD, David Duncan, DrPH, John B. White, PhD, Lisa L. Lindley, DrPH,
A graduate thesis by Shakti Nagarajan, (MPH)
Thomas Nicholson, PhD,
David Duncan, DrPH,
John B. White, PhD,
Lisa L. Lindley, DrPH,
Fred Stickle, PhD.
Net result : Millions of Americans break federal laws to use drugs in secrecy.
Aim : Harm reduction and to raise the standard of health of illicit drug users
Conventional methods of studying this “hidden population” - Medical records, surveys.
DRUGNET survey - An online, cross-sectional, survey of nonabusive, recreational adult drug users.
1.Are there any symptoms of drug dependence or abuse, in a self-identified population of non-abusers?
2.If yes, how frequent are they?
3.Is there any pattern to them?
Important to clarify nomenclature: use, abuse, and dependence.
Note. From “Substance Dependence, Abuse, and Treatment,” by Substance Abuse and Mental Health Services Administration (SAMHSA), 2003, Results from the 2002 National Household Survey on Drug Use and Health (NHSDUH), Chapter 8.
Population - Non-clinical, adult recreational drug users having access to the Internet.
Sample Selection - American citizens aged 18 years and older, who completed the DRUGNET survey on the Internet between December, 1997 through June, 1998.
Four major subdivisions :
Demography and lifestyle indices
Experiences with drugs
Past legal history and attitudes regarding drug use And,
The general well –being schedule (GWBS)
Focus of this study - items 26 through 33 (based on DSM III-R), - demographics subdivision.
A subject who responded positively to three or more of the drug dependence questions would qualify as a potential “drug-dependent individual.”
1)Problems in life from drug use
2)Using drugs dangerously
3)Problems with legal system
4)Argument with family and friends about use of drugs
6)Problems stopping use
7)Obtaining drugs consumes a lot of time
8)Been in treatment for dependence
Coding of responses:
Responses coded as follows:
Data analyzed using SPSS.
Answered by examining responses of items 26-33
Utilizes the Frequencies subprogram of SPSS.
Reported using regular frequency and cumulative frequency tables.
Utilizes the Principal Components Analysis (PCA) subprogram of SPSS.
Initial tests of assumptions
Sample Selection - 541 United States citizens, aged 18 years or older who responded to the DRUGNET survey, between December 1997 and June 1998.
Using the frequency of these symptoms, it was ascertained that 27.4% (n = 148) of the respondents (i.e. roughly every one in four respondents) were potentially “drug dependent” individuals.
The following criterion tests were applied:
(a)The Kaiser-Meyer-Olkin Measure of Sampling Adequacy – Our study sample achieved a value of 0.763
(b)Bartlett’s Test of Sphericity – An approximate Chi-Square value of 454.525 with a 28 degree of freedom, and a significance value of 0.000 was achieved
First two components were extracted.
That is, although prevention of drug dependence is a much talked about issue in this country, it is still the legal system that drives the clinical system to implement treatment and rehabilitative measures on those individuals that it feels right for such measures. The majority of individuals who actually report symptoms of dependence have been left to fend for themselves.