The relationship of higher education to substance use trajectories: variations as a function of timing of enrollment.

Objective: This study examined the association between time to enrollment into postsecondary education and trajectories of heavy episodic drinking (HED) and marijuana use using a prospective longitudinal study.

Method: Participants included 391 postsecondary students (55% female) drawn from the Victoria Healthy Youth Survey, a five-wave, multi-cohort sample interviewed biennially between 2003 and 2011. Using piecewise latent growth modeling, we compared changes in the trajectories of HED and marijuana use before and after postsecondary enrollment across three groups of young adults: (a) direct entrants (enrolled directly out of high school), (b) gap entrants (took a year off), and (c) delayed entrants (took longer than a year off).

The rate ratio of injury and aggressive incident for alcohol alone, cocaine alone and simultaneous use before the event: a case-crossover study.

Objectives: (i) To estimate the rate ratio (RR) of use of alcohol alone, cocaine alone, and both substances simultaneously on acute injury or an aggressive incident, (ii) to compare the RRs for simultaneous use within 3 or 6h of the event; and (iii) to compare the RRs of two measures of exposure, "hours of feeling effects" vs estimates based on self-reported quantity and frequency of use.

Methods: The study employed a case-crossover design with the frequency approach. Clients (N=616) in substance abuse treatment for alcohol or cocaine issues from 2009 to 2012 completed a self-administered questionnaire on their substance use within 3 and 6h before a recent injury or physically aggressive incident.

"Everybody else is doing it"--norm perceptions among parents of adolescents.

Objective: Parents are a common source of alcohol for adolescent drinking. Few studies have examined the possible determinants of parental alcohol supply. We investigated the associations between parents' supply of alcohol, their attitudes concerning the supply of alcohol (personal norms), and their beliefs about other parents' attitudes and behavior (injunctive and descriptive social norms).

Reenvisioning success for programs supporting pregnant women with problematic substance use.

Community-based, integrated, primary care maternity programs for pregnant women affected by problematic substance use are emerging as effective models for engaging women affected by multiple health and social issues. Although addictions services have historically been evaluated by individual achievement of abstinence, new definitions of program success are required as addiction comes to be viewed as a chronic illness. We conducted a mixed-methods study to follow the formative development stages of a community-based program, identifying key evaluation indicators and processes related to this program, program team members, and women and families served.

Methodological biases in estimating the relationship between alcohol consumption and breast cancer: the role of drinker misclassification errors in meta-analytic results.

Background: While alcohol consumption has been linked to breast cancer in women, few studies have controlled for possible biases created by including former or occasional drinkers in the abstainer reference group. We explored the potential for such misclassification errors as sources of bias in estimates of the alcohol-breast cancer relationship.

Methods: Meta-analyses of population case-control, hospital case-control, and cohort studies to examine relationships between level of alcohol use and breast cancer morbidity and/or mortality in groups of studies with and without different misclassification errors.

Harmful alcohol use as a predictor of intimate partner violence during the transition to parenthood: interdependent and interactive effects.

Harmful alcohol use is known to increase the risk of intimate partner violence (IPV), however very little is known about the role of alcohol use during the transition to parenthood. The current study was designed to examine harmful alcohol use as a dyadic and interactive time-varying risk factor for psychological and physical IPV across the transition to parenthood using a sample of 98 couples assessed prenatally and again at one and two years postpartum. Longitudinal actor-partner interdependence models demonstrated that changes in harmful alcohol use during the transition to parenthood were significantly related to changes in psychological IPV for both men and women and with physical IPV for men only, whereas harmful alcohol use was actually negatively related to variations in women's physical IPV.

Reduction in fatalities, ambulance calls, and hospital admissions for road trauma after implementation of new traffic laws.

Objectives: We evaluated the public health benefits of traffic laws targeting speeding and drunk drivers (British Columbia, Canada, September 2010).

Methods: We studied fatal crashes and ambulance dispatches and hospital admissions for road trauma, using interrupted time series with multiple nonequivalent comparison series. We determined estimates of effect using linear regression models incorporating an autoregressive integrated moving average error term.

Trajectories of marijuana use in youth ages 15-25: implications for postsecondary education experiences.

Objective: This study examined associations between longitudinal trajectories of marijuana use from adolescence to young adulthood and postsecondary education (PSE) experiences. Outcomes examined included the type of PSE undertaken, the timing of enrollment, and the likelihood of dropping out.

Method: Participants (N = 632; 332 females) were from the Victoria Healthy Youth Survey, a five-wave multicohort study of young people interviewed biennially between 2003 and 2011.

A Reasoned Action Model of Male Client Involvement in Commercial Sex Work in Kibera, A Large Informal Settlement in Nairobi, Kenya.

Male clients of female sex workers (FSWs) are epidemiologically important because they can form bridge groups linking high- and low-risk subpopulations. However, because male clients are hard to locate, they are not frequently studied. Recent research emphasizes searching for high-risk behavior groups in locales where new sexual partnerships form and the threat of HIV transmission is high.

Barriers to access for Canadians who use cannabis for therapeutic purposes.

Background: There is increased interest in the therapeutic potential of cannabis in recent decades. Canada, the Netherlands, Israel and some states in the United States have developed programs to allow access to cannabis for therapeutic purposes (CTP). In Canada, enrollment in the federal CTP program represents fewer than 5% of the estimated users of CTP.

The Effect of Types of Postsecondary Education on Drinking: Does Age of Enrollment Matter?

Using longitudinal data from early adolescence through young adulthood, this study examined the association between different types of postsecondary education (PSE), age of enrollment in PSE, and the trajectory of alcohol use for Canadian young adults ( = 521). Trajectories of alcohol use were compared across young adults at 2-year colleges, 4-year universities, transfer programs (started at a 2-year college and transferred to a 4-year university), and terminal high school graduates. While initial findings revealed significant differences in the drinking trajectories of 2-year college students and 4-year university students, all differences were accounted for by variability in the age of enrollment.

Who under-reports their alcohol consumption in telephone surveys and by how much? An application of the 'yesterday method' in a national Canadian substance use survey.

Background And Aims: Adjustments for under-reporting in alcohol surveys have been used in epidemiological and policy studies which assume that all drinkers underestimate their consumption equally. This study aims to describe a method of estimating how under-reporting of alcohol consumption might vary by age, gender and consumption level.

Method: The Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) 2008-10 (n = 43 371) asks about beverage-specific 'yesterday' consumption (BSY) and quantity-frequency (QF).

Impacts of drinking-age laws on mortality in Canada, 1980-2009.

Background: Given the recent international debates about the effectiveness and appropriate age setpoints for legislated minimum legal drinking ages (MLDAs), the current study estimates the impact of Canadian MLDAs on mortality among young adults. Currently, the MLDA is 18 years in Alberta, Manitoba and Québec, and 19 years in the rest of Canada.

Methods: Using a regression-discontinuity approach, we estimated the impacts of the MLDAs on mortality from 1980 to 2009 among 16- to 22-year-olds in Canada.

Providers' constructions of pregnant and early parenting women who use substances.

The research literature indicates that problematic substance use as a form of health behaviour is poorly understood, being sometimes viewed as deviance, at other times as a disease, and most often as a combination of these states. The use of substances by women who are pregnant or new parents is often conceptualised within an individualised framework. Yet drinking alcohol and using other drugs during pregnancy and early parenthood cuts across social divisions and is shaped by socio-structural contexts including health care.

Exploring stigma by association among front-line care providers serving sex workers.

Stigma by association, also referred to as "courtesy stigma," involves public disapproval evoked as a consequence of associating with stigmatized persons. While a small number of sociological studies have shown how stigma by association limits the social support and social opportunities available to family members, there is a paucity of research examining this phenomenon among the large network of persons who provide health and social services to stigmatized groups. This paper presents results from a primarily qualitative study of the work-place experiences of a purposive sample of staff from an organization providing services to sex workers.

A comparison of motivations for use among users of crack cocaine and cocaine powder in a sample of simultaneous cocaine and alcohol users.

This study examined the motivations for using cocaine and alcohol comparing those who primarily smoked crack and those who primarily used cocaine powder when using simultaneously with alcohol. Motivations examined included: 1) to cope with a negative affect, 2) enhancement, 3) to be social and 4) to conform. The research design was a cross-sectional study in which clients in treatment for cocaine and alcohol problems completed a self-administered questionnaire about their substance use.

Cannabis for therapeutic purposes: patient characteristics, access, and reasons for use.

Background: The authorized and unauthorized use of cannabis for therapeutic purposes (CTP) has increased dramatically in recent years, and physicians have called for further research to better clarify the parameters of effective and appropriate use. We report findings from a large cross-sectional study of the use of CTP in Canada and compare use across medical conditions and across authorized and unauthorized users.

Methods: We examined cannabis use history, medical conditions and symptoms, patterns of current use of CTP, modes of access and perceived effectiveness among 628 self-selected Canadians consumers of CTP.

Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada.

Introduction: This paper reports results from a preliminary observational study of ayahuasca-assisted treatment for problematic substance use and stress delivered in a rural First Nations community in British Columbia, Canada.

Methods: The "Working with Addiction and Stress" retreats combined four days of group counselling with two expert-led ayahuasca ceremonies. This study collected pre-treatment and six months follow-up data from 12 participants on several psychological and behavioral factors related to problematic substance use, and qualitative data assessing the personal experiences of the participants six months after the retreat.

Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions.

Objectives: We investigated whether periodic increases in minimum alcohol prices were associated with reduced alcohol-attributable hospital admissions in British Columbia.

Methods: The longitudinal panel study (2002-2009) incorporated minimum alcohol prices, density of alcohol outlets, and age- and gender-standardized rates of acute, chronic, and 100% alcohol-attributable admissions. We applied mixed-method regression models to data from 89 geographic areas of British Columbia across 32 time periods, adjusting for spatial and temporal autocorrelation, moving average effects, season, and a range of economic and social variables.

The relationship between minimum alcohol prices, outlet densities and alcohol-attributable deaths in British Columbia, 2002-09.

Aim: To investigate relationships between periodic increases in minimum alcohol prices, changing densities of liquor stores and alcohol-attributable (AA) deaths in British Columbia, Canada.

Design: Cross-section (16 geographic areas) versus time-series (32 annual quarters) panel analyses were conducted with AA deaths as dependent variables and price, outlet densities and socio-demographic characteristics as independent variables.

Setting And Participants: Populations of 16 Health Service Delivery Areas in British Columbia, Canada.

The raising of minimum alcohol prices in Saskatchewan, Canada: impacts on consumption and implications for public health.

Objectives: We report impacts on alcohol consumption following new and increased minimum alcohol prices in Saskatchewan, Canada.

Methods: We conducted autoregressive integrated moving average time series analyses of alcohol sales and price data from the Saskatchewan government alcohol monopoly for 26 periods before and 26 periods after the intervention.

Results: A 10% increase in minimum prices significantly reduced consumption of beer by 10.

An examination of injection drug use trends in Victoria and Vancouver, BC after the closure of Victoria's only fixed-site needle and syringe programme.

Background: Needle and syringe programmes (NSPs) have been established as effective harm reduction initiatives to reduce injection drug use (IDU)-related risk behaviours, including sharing needles. On May 31, 2008, Victoria, BC's only fixed site NSP was shut down due to community and political pressure. This study examines and compares IDU trends in Victoria with those in Vancouver, BC, a city which has not experienced any similar disruption of IDU-related public health measures.