Drug Related Movies
Self-Reported High-Risk Locations Of Drug Use Among Drug Offenders - Statistical Data IncludedSteve Sussman Relatively little work has described high-risk situations for drug use among adolescents or adults. Most research with adolescents or adults refers to high-risk situations as those that are stressful and for which the person does not have sufficient problem-solving or abstinence-focused coping skills (1, 2). High-risk situations also have been conceptualized as ones in which the individual experiences unpleasant emotions, physical discomfort, pleasant emotions, and testing of personal control, urges, conflict with others, social pressure to use, and pleasant times with others (3-7).
Little work has addressed high-risk situations in terms of location of use. Yet, no drug use is devoid of a location; one may be using drugs while driving, in a car, or at home, for example. In most previous work, only hypothetical situations have been utilized. For example, a subject might be asked to identify how he or she would cope in a social gathering in the evening at a friend's house with a few others present and drugs and alcohol being offered (1, 8, 9). Studies that have examined adult hard drug use as a function of environmental context generally examine city areas known for drug purchasing, such as shooting galleries (e.g., 10). Drug use across a variety of environmental contexts is not examined.
We are aware of eight published studies that have examined the relations of adult drinking and environmental contexts. Snow and Landrum (11) examined frequency of drinking among Mississippi driving-under-the-influence (DUI) offenders in seven types of drinking places. In order from most to least popularity, these locations were home, bar or lounge, friend's home, party, car, restaurant, and parking lot. They found that these seven places explained 36% of the variance in the self-reported frequency of drunkenness, and that the two best predictors were drinking in a car or at a bar or lounge (also see Ref. 12).
Hilton (13) examined reports of alcohol use among a general population sample in the United States and examined 14 situations (within seven settings: restaurants, organized club, movies, bars, party at home, sports events, beach). Highest use situations, bars and home parties, may have involved overestimates of use because use reported in these settings were of higher frequency than one's report of overall use (per month use).
Wierczorek and Miller (14) looked at several variables among New York driving-while-intoxicated (DWI) offenders, including preferred drinking locations (public bars or restaurants versus private homes). They found that preference for drinking at home might be related to available funds (those with higher income drink outside the home more). Collins et al. (15) studied heavy drinkers (mean = 22 drinks per week) in New York; the authors used ecological momentary assessment (hand-held computer) and found that most drinkers felt good right before drinking and drank during leisure times with significant others, which were generally in the home (47%), a bar (12%), or another's home (12%).
Casswell, Zhang, and Wyllie (16) also examined reports of alcohol use situations among a general population sample in New Zealand. There were 15 locations examined, and experience of problems was related to drinking in other's homes, hotels, taverns, and sports clubs, but not restaurants. These activities were not listed in full.
Finally, Stockwell, Lang, and Rydon (17) examined reports of alcohol use situations among a general population sample in western Australia; they looked at licensed premises, home, and other person's home as locations. Drinking heavily away from home, particularly on licensed premises, was associated with problem consequences of use (also see Ref. 18). In summary, popular use locations included one's home or a bar, and problem use may have been associated with use away from home, at the bar, or leaving the bar. More detailed explorations of adult drug use situations are needed.
Sussman and coworkers (19) provided a detailed, multiple-choice, self-report analysis of specific locations within the home, school, and other public locations where continuation high school youth (youth at high risk for drug abuse) use drugs. The single most frequent location of use was the subjects' bedroom with a small group of friends. Borrowing from this work (also see Ref. 20), one may infer that there are three environmental domains that adults "pass through" in the course of a day: the home, work, and public places. Home refers to one's dwelling, which includes indoor (e.g., living room) and outdoor (e.g., yard) locations on rented or owned property. Work refers to the property where one is employed outside the home, which also includes indoor (e.g., bathroom) and outdoor (e.g., outside, near the workplace doors) locations. Finally, other public locations are environmental settings other than one's home or work that might be accessed by self or others. Generally, these other settings are directly public and may be indoor (e.g., inside a church) or outdoor (e.g., empty field), although such settings also could be restricted, as in a private club or friend's home. One could ask subjects to think about time spent at home and at work and about any other public area in reference to drug use. Then, one could have subjects specify specific locations in each setting in which drug use occurs.
It is reasonable to assume that people are most likely to use drugs in locations where they are relatively unlikely to be somehow condemned by others. Thus, it would be expected that adults would be less likely to use alcohol or other drugs at locations at the work site versus one's home or other public locations. In the home setting, one may tend to use in private locations (e.g., the bedroom) or more openly (e.g., the living room), with the last option perhaps being reported if the adult perceives this whole setting as private or safe. At the work site, one might be expected to use drugs where use can be most hidden (e.g., a bathroom). In other settings, private locations such as friends' homes or locations where use is condoned, such as music clubs (bars), are relatively likely use locations. Little previous work reported an assessment of specific location of drug use within general settings (i.e., home, work).
The present study is a detailed, multiple-choice, self-report analysis of home, work site, and other public locations where adults report using drugs. In addition, these settings were examined as a function of gender, ethnicity, type of drug used, and drug abuse problem. Further, questions about mood just prior to drug use, presence of other person, time of day, and whether a party was going on were assessed. It was expected that "protected" locations would be the primary places of use. These locations were not likely to differ by type of drug since any drug can be abused. Just prior to drug use, it is possible that ones' moods are positive in anticipation of use or as a function of having made a decision. However, it is also possible that these persons are feeling sad or angry and are getting ready to use drugs to self-medicate. It is relatively likely that adults may use alone as they grow older.
It is important to investigate environmental contexts of drug use since repetitive drug use experiences are likely to be associated on multiple occasions with antecedent and consequent events that occur within specific settings. These settings may come to act as cues to begin drug use (e.g., posters on one's bedroom wall, simply sitting on one's bed); may be used to enhance or support the effects of drug use (e.g., dim lighting in a bar, ashtrays); or may reflect attempts to minimize consequences of drug use (i.e., are protective or private). Increasing our understanding of the role of environmental context in substance use may aid in identifying and counteracting existing associations, functions, and social norms of drug use behavior and assist prevention and cessation efforts to reinforce alternative behavioral choices given a variety of cues associated with the settings (e.g., social, affective, visual environmental).
The subjects for the present study were participants in drug diversion programming (California Penal Code 1000). Participants are referred to drug diversion programs by the courts after being arrested for simple possession of illicit substances and/or driving under the influence. Individuals referred to diversion programs vary in the extent to which they have been involved in the use of and/or sale of illegal substances, as well as risky behaviors associated with use (i.e., driving under the influence and possession of illegal substances). Individuals who are sentenced to drug diversion attend drug education for 6 to 12 months. Diversion may also involve drug testing, support groups, and required participation in 12-step meetings. There is some variability across programs, but they all include drug education. When sentenced by the courts to participate in drug diversion, individuals are provided a list of programs in their area and can choose a program they want to attend. This is a good sample on which to study locations of drug use since these individuals already show consequences of use.
METHOD
Subjects
Participants were 485 adults attending two Los Angeles area drug diversion schools. A self-report questionnaire was distributed to diversion participants, and 462 individuals provided complete data for the present analysis (95%). Demographics, drug use, and psychosocial data on the subsample did not differ from the full sample.
Subjects' average age was 32.4 years (standard deviation [SD] = 9.0), and 69% were male. Regarding ethnic composition, 59.4% were white, 25.4% were Latino, 4.5% were African-American, 4.1% were Asian, 2.1% were Native American, and 4.3% were of "other" ethnicity. The last four ethnic groups were re-coded as "other" (15.2%). Approximately 25% held professional jobs, 51% held office or skilled laborer jobs, 13% held semiskilled laborer jobs (e.g., cook, waitress), and 11% were unskilled workers, househusbands, or unemployed; 77% completed high school. There were 31% who reported living with a spouse or mate; 45% reported living with a roommate, parent, or other person; and 24% reported living alone.
The percentages of the sample that used cigarettes, alcohol, marijuana, or a hard drug an average of at least once per month were 61.4%, 70.3%, 29.5%, and 29.3%, respectively. Using the measure described below, a total of 4.2% of the sample was classified as non-substance abusers, 28.8% were classified as having a substance abuse disorder, and 67.0% of the sample were classified as having a substance dependence disorder. With regard to prior convictions for driving under the influence of alcohol or other drugs, 32.2% reported no convictions, 38.9% reported one conviction, 20.1% reported two convictions, and 8.7% reported three or more convictions.
Regarding the current offenses that resulted in participation in the diversion classes, 48.1% reported an alcohol-related DUI offense, 6.4% reported another drug-related DUI offense, 2.1% reported being caught with all open alcohol container, 22.2% reported being caught possessing an illegal drug, and 28.9% reported other related offenses. A total of 81.2% of the subjects were arrested within a year for the offense that brought them to the class (35% within 2-3 months), and 81.5% of the subjects reported coming to classes for 2-3 months.
Data Collection
Participants from two drug diversion programs completed the survey, which was administered in January-September 1997. Participants were informed that their participation was voluntary, that they could withdraw at any time without penalty, that their participation had nothing to do with involvement in the diversion program, and that their data would be anonymous. Participants were administered a 23-page self-report questionnaire, which took about 30 minutes to complete; they were compensated $5 for its completion. Participants were asked a variety of open-ended and multiple-choice items that addressed drug use cues and situations as part of a substance use etiology project.
Measures
Questionnaire information assessed included specific locations and cues of drug use at home, at work, and at other public places; demographic characteristics (date, age, gender, grade, ethnic background, living situation, education, and occupation); drug use; and problem consequences of drug use (to provide a rating of substance abuse and dependence disorders). Multiple (four) forms were used in the present project, but all assessed the items contained in the present study with no differential pattern of missing data. Examples of locations, cues, and drug use items are included in the Appendix.
Locations and Cues of Drug Use
Parallel sets of seven or eight items were developed for each of three environmental locations: home, work, and other public places. There were four forms of the questionnaire. Two forms asked about drug use at the location; two other forms asked about drug use at the location that was followed by driving under the influence of alcohol or another drug. Each type of drug use question header (drug use or drug use followed by a DUI offense) also provided one different item section (implicit versus explicit recall tasks) on one page of the questionnaire. Also, the drug use forms asked whether the participant drank and drove after using (one additional item). Otherwise, the questionnaire forms were identical.
The first situation item requested that the participant think about their time at the location and the places the participant goes during the day or night within this location. Then, they were asked to identify whether they used alcohol or any drug other than cigarettes at that location (or used any drug other than cigarettes at that location and then drove a car or motorcycle). The subject was asked to think about the few minutes before using a drug at that location.
Next, the second item requested where within that location the subject was the few minutes before a drug was used. There were 10 specific locations in the home, 12 specific locations at work, and 17 specific locations at another public location outside home or work offered as response choices. For each of the three general locations, included also was an additional response, "other location," with room to specify that location with an open-ended response, and there was an additional response to indicate that drugs were never used in this location.
Using an 8-point scale ranging from "1, less than I week ago," to "7, more than a year ago," and "8, never used a drug at this location," the third item asked respondents to indicate when this drug use occurred. The third item asked the subject to indicate the one feeling that best described how he or she was feeling at this time (a few minutes before using the drug in that location). There were 15 affect adjectives provided. Of these, 5 were positively valenced (e.g., very happy), and 10 were negatively valenced (e.g., angry). In addition, the subject could indicate that he or she never used the drug in that location.
The fourth item requested whether the subject was alone or with others at this time. Eight possible responses were offered, including being alone, in a small group, in a large group (five or more people), and with friends and/or family or whether there was no drug use at that location.
The fifth item requested what time (e.g., 12:00 noon to 4:59 P.M.) the subject was at this location before using the drug. There were four responses offered, as well as no drug use at this location.
The final item in the set requested whether there was a party going on at this location at that time. This item was not asked for the work location.
Demographics
Five demographic measures were assessed: age, gender, ethnicity, socioeconomic status (SES), and living situation. Ethnicity was addressed in a six-response category item, which also allowed for more specific responses through additional response options. It was re-coded into three categories: white, Latino, and others. SES was measured as one's occupational and educational levels (based on categories derived from Ref. 21; two items). Living situation was coded as living with a spouse or mate; with a roommate, parent, or other person; or living alone.
Current Drug Use Behavior
Drug use items included participant's drug use behavior adapted from self-report questionnaire items developed in previous research for which item reliability had been established (22, 23); questions were directed to frequency of use in the last 6 months (nine categories, from "never" to "every day") of cigarettes, alcohol, marijuana (weed), cocaine (crack), LSD (lysergic acid diethylamide; acid), stimulants (ice, speed, amphetamines), inhalants (rush, nitrous), and other drugs (depressants or downers, PCP [phencyclidine], steroids, heroin, etc.). Four current use measures were created from these items. Use of cigarettes, alcohol, or marijuana was coded into three binary measures (at least monthly versus less than monthly). Monthly use of any of the "hard" drugs was binary coded to create the fourth drug use measure.
Substance Abuse Disorders
A self-report measure was used that consisted of 19 personal consequences of substance abuse. The first 11 responses are the Personal Consequences subscale of the Personal Experience Inventory (PEI; 24). Eight additional responses were added to the subscale to increase its coverage of DSM-IV (25) substance abuse or substance dependence diagnostic criteria, pertaining to tolerance and withdrawal, suitable for use with older adolescents and adults (25). A sufficient number of questionnaire items was included to be able to make differential diagnoses between substance abuse and substance dependence. The 4-point rating scale indicates whether the subject has been involved in any of the "following circumstances in the last 12 months." Response choices include "never," "once or twice," "sometimes (e.g., 3-9 times)," or "often (e.g., 10 or more times)" in the last 12 months (e.g., 19).
Analysis
The analysis consisted primarily of chi-square comparisons or simple examination of frequency counts. To compare across general locations, a 7% difference between any 2 cells with the number of cells less than 10 would be significant at p [is less than] .05. Also, to compare specific locations across general locations, an adjusted percentage was calculated. This adjusted (or conditional) percentage is the percentage of subjects that used drags at a specific location given the percentage that used drugs at the general location that subsumes the specific location. The pattern of responses was virtually identical across forms, so results are presented combined across forms.
RESULTS
Drug Use at Different Locations as a Function of Gender, Ethnicity, Age, Socioeconomic Status, and Living Situation
Males were significantly more likely to use drugs at work than females (see Table 1). Whites were more likely to use drugs at home than Latinos or those from other ethnicities, whereas the last two groups did not differ. Whites were also more likely to use drugs at other public locations than Latinos or "others"; the last two groups did not differ (see Table 1). Each location was not found to be a significant concurrent predictor of age or SES (six F tests were completed; for all, F [is less than] 2.0). As a second SES analysis, job and education were analyzed separately. SES was divided into white collar versus other jobs, and education was divided into some college training versus high school graduate or less education. Still, job status and education were not associated with drug use in any of the locations (chi-square p [is greater than] .1 for all). Finally, living situation was divided into living with a spouse or mate versus another living situation. Living with one's spouse or mate and using drugs in a location was not significant in the home (90.5% versus 88.9%) or work site (51.3% versus 47.6%) locations. However, a significant association was found between living with one's spouse or mate and using drugs in other public locations (96.4% versus 90.5%; chi-square p [is less than] .05). Those persons who lived with their spouse or mate were relatively likely to use drugs in other public locations.
Table 1. Percentage That Used Drugs at Different General Locations as a
Function of Gender and Ethnicity
Gender Ethnicity
General
Location Male Female White Latino Other
Home 88.6 84.0(a) 91.6 82.1 80.0(a)
Work 51.1 38.7(a) 50.6 43.2 43.5(a)
Other 91.0 90.5(a) 93.9 86.1 87.5(a)
(a) Chi-square p < .05.
Frequency of Drug Use at Different Locations
Those who used drugs monthly or more frequently were more likely to have used alcohol and marijuana at home than lighter users, but not cigarettes or hard drugs. They were also more likely to use alcohol, marijuana, and hard drugs (but not cigarettes) at work than lighter users. Monthly or greater drug users were more likely to use cigarettes and alcohol, but not marijuana or hard drugs, than lighter users (see Table 2).
Table 2. Percentage That Used Drugs at Different
General Locations as a Function of Frequency of Drug
Use
Frequency of Drug Use
Less Than Monthly Use
Drug/Location Monthly Use or Greater
Cigarettes
Home 87.9 87.0
Work 46.4 47.8
Other 86.8 93.2(a)
Alcohol
Home 80.6 90.2(a)
Work 40.9 49.9(b)
Other 84.0 93.5(a)
Marijuana
Home 85.7 91.4(b)
Work 43.4 56.5(a)
Other 89.4 94.0
Hard drugs
Home 86.4 89.9
Work 39.9 64.8(a)
Other 90.8 90.6
(a) p < .05.
(b) p < .01.
Drug Use at Home
Of the sample, 87% reported having used any drug other than cigarettesat home, at a mean of approximately 1-2 months ago (scale mean = 3.78, SD = 2.09). A total of 40.0%, 84.8%, and 91.1% of the non-substance abuse, substance abuse disorder, and substance dependence disorder subjects, respectively, reported having used a substance at home (p [is less than] .05). Of those who did use at home, the most popular locations were the living room and the bedroom. A total of 84.2% of the responses were accounted for by the subject's living room, bedroom, kitchen, other home location, or the garage (see Table 3). Of those who indicated an "other" location, those responses indicating the home referred to a bar located in the home or outdoor locations (i.e., driveway, balcony, side of the garage). The most popular feelings reported just prior to drug use were "relaxed," "excited," "a little happy," and "very happy," which accounted for 59% of the feelings reported. The primary affect was positive among 64% of the respondents. Among the negative affect reported, feeling "nervous," "frustrated," or "sad" were the most popular, accounting for another 19% of the feelings reported. A total of 37% of the respondents reported being alone when they used; 40% reported being with a small group of friends (1-4 people), which may or may not have included a spouse or girlfriend or boyfriend; 14% reported being only with a spouse or boyfriend or girlfriend; 3% reported being with family members; and 6% reported being with a large group. There were 57% who reported using drugs between 5:00 P.M. and midnight, and 29% reported using drugs between 6:00 A.M. and 5:00 P.M.. There were 43% who used and then drove or drove only a few minutes after using; only 11% indicated that this was a party situation.
Table 3. Location of Drug Diversion Program Partici-
pants a Few Minutes Before the Last Time They Used
a Drug at Home
Conditional
Percentage Percentage
Specific Location (n = 402) (n = 462)
Living room 33.1 28.8
My bedroom 21.8 19.0
Kitchen 12.0 10.4
Other location 10.7 9.3
Garage 6.6 5.7
Yard 5.7 5.0
Bathroom 4.1 3.6
Dining room 2.7 2.4
Basement or den 1.8 1.6
Another bedroom 1.4 1.2
Attic 0.2 0.2
Note: Conditional percentage refers to the percentage
that responded that they used a drug in a specific location
given the percentage that responded that they used a drug
in that general location (87% reported using at home).
Drug Use at Work
Of the sample, 47% reported having used any drug other than cigarettes at work, at a mean of approximately 3-6 months ago (scale mean = 4.78, SD = 1.96). A total of 20.0%, 42.6%, and 56.1% of the non-substance abuse, substance abuse disorder, and substance dependence disorder subjects, respectively, reported having used a substance at work (p [is less than] .07). Of those who did use at work, the most popular locations were an "other" work location, one's workstation, in the bathroom, or in the parking lot. A total of 75% of the responses mentioned were accounted for by these four locations (see Table 4). Of those who indicated an "other" work location, those responses referred to a conference room or other office, a kitchen area, or a materials room. The most popular feelings reported were "relaxed," "a little happy," "confident," and "very happy," which accounted for 59% of the feelings reported. The primary affect was positive among 64% of the respondents. Negative affect, including feeling "pressured," "frustrated," or "nervous," accounted for an additional 24% of the feelings reported. A total of 40% of the respondents reported being alone when they used; 45% reported being with a small group of friends (1-4 people); 3% reported being with a spouse, boyfriend, or girlfriend, or family members; and 12% reported being with a large group. There were 38% who reported using drugs between noon and 5:00 P.M., and 34% reported using drugs between 5:00 P.M. and midnight at work. There were 52% who used and then drove or drove only a few minutes after using.
Table 4. Location of Drug Diversion Program Participants a Few
Minutes Before the Last Time They Used a Drug at Work
Conditional
Percentage Percentage
Specific Location (n = 217) (n = 462)
Other work location 26.5 12.5
My workstation 19.6 9.2
Bathroom 17.1 8.0
Parking lot 11.8 5.5
Outside, at a remote location 8.6 4.0
Outside, on the grounds 7.3 3.4
Outside, near workplace doors 4.1 1.9
Snack area 2.9 1.4
Roof 1.2 0.6
Hallway 0.8 0.4
Note: Conditional percentage refers to the percentage that re-
sponded that they used a drug in a specific location given the per-
centage that responded that they used a drug in that general location
(47% reported using at work).
Drug Use at Other Public Locations
Of the sample, 91% reported having used any drug other than cigarettes at other public locations, at a mean of approximately 1-2 months ago (mean = 4.17, SD = 2.00). A total of 50.0%, 78.7%, and 94.2% of the non-substance abuse, substance abuse disorder, and substance dependence disorder subjects, respectively, reported having used a substance at other public locations (p [is less than] .05). Of those who did use at other public locations, the most popular location was at a friend's home in the living room. A total of 64.7% of the responses mentioned were accounted for by the following locations: living room of friend's home, at a club with music, a specific "other" location, or at a room other than the living room at a friend's home (see Table 5). Of those who indicated a specific "other" location, those responses referred to a bar, a restaurant, or at the beach. The most popular feelings reported just prior to drug use were "relaxed," "a little happy," "very happy," and "excited," which accounted for 65% of the feelings reported. The primary affect was positive among 73% of the respondents. "Nervous" or "frustrated" accounted for 11% of the negative affect reported. A total of 16% of the respondents reported being alone when they used; 61% reported being with a small group of friends (1-4 people), which may or may not have included a girlfriend or boyfriend; 7% reported being only with a boyfriend or girlfriend; 2% reported being with family members; and 15% reported being with a large group. There were 51% who reported using drugs in other public locations between 5:00 P.M. and midnight, and 23% reported using between noon and 5:00 P.M. There were 53% who used and then drove or drove only a few minutes after using, and 22% indicated that this was a party situation.
Table 5. Location of Drug Diversion Programs Participants a
Few Minutes Before the Last Time They Used a Drug at Other
Public Locations
Conditional
Percentage Percentage
Specific Location (n = 420) (n = 462)
Friend's home/living room 26.1 23.8
Club with music 15.9 14.5
Other location 12.5 11.4
Friend's home/not living room 10.2 9.3
Store or cafe 6.8 6.2
In car in parking lot 6.1 5.6
Driving 5.9 5.4
Parking lot 4.1 3.7
Sidewalk 3.9 3.6
At work 2.7 2.5
Public park 2.3 2.1
Outdoor recreational facility 0.9 0.8
Indoor recreational facility 0.7 0.6
At school 0.7 0.6
Concert hall 0.5 0.5
Empty field 0.5 0.5
Inside a church 0.2 0.2
Note: Conditional percentage refers to the percentage that re-
sponded that they used a drug in a specific location given the per-
centage that responded that they used a drug in that general location
(91% reported using at other locations).
DISCUSSION
This article provides a first detailed analysis of drug use among adult drug diversion program attendees as a function of environmental context. Three general contexts were examined: home, work, and other public locations. Together, these locations perhaps provide all the contexts these adults enter into in the course of their daily lives. Across all locations, in general, males and whites tended to use more often than females and non-whites, which is consistent with previous research with high-risk youth (19). Use within each of the three general locations was not found to vary as a function of age of the subject or SES. Regarding living situation, those who lived with spouses or mates were relatively likely to use drugs at other public locations. This result may merely reflect that couples tend to go to other public places more than do single people. Alternatively, these data may suggest that people who use drugs tend to join with others who share the same interests. More work is needed to understand this result better.
Those who used monthly or more frequently were more likely than the lighter users to use at least some drugs at all three contexts, particularly alcohol. Interestingly, differences between heavier and lighter users were most pronounced in the work context. Perhaps heavier users are willing to take more chances regarding where they use, which may be reflective of drug dependence. Surprisingly, though, use of all types of drugs at work was reported by at least 40% of the sample, even among the lighter users. Work site drug education would appear warranted given these data.
An examination of the percentages across the three general areas revealed that the most popular locations were the living room at home (28.8%), the living room at a friend's home (23.8%), the bedroom at home (19%), a club with music (14.5%), an "other" work location (12.5%; a private room of some type), a specific "other" location within the general other location (11.4%; particularly bars), and one's kitchen at home (10.4%). Most drug use occurred at the subject's home or a friend's home in relatively open areas of the home. High-risk youth, on the other hand, are relatively likely to use within the bedroom of their parent's home (19). While private areas of the work site may have been sought, 9.2% of the time subjects still used at their workstation. Outside work or home, subjects tend to use at clubs or bars. Subjects generally reported feeling happy right before using, were alone or in a small group of friends at home or work locations, and generally were with a small group of friends in the other public location, but use was not identified as a party-type situation. Approximately 55% of drug use at home or at other public locations took place after 5:00 P.M., whereas use at work took place evenly before and after 5:00 P.M. (about a third of time at each of these time intervals). Perhaps, "burning the midnight oil" at work is associated with more than engaging in long work hours. Across locations, use was associated with driving under the influence approximately half the time.
While these data are from self-reports, the last drug use experiences reportedly occurred fairly recently (1-2 months ago at home and other public locations and 3-6 months ago at work), suggesting minimal retrospective bias for these types of data. Still, these data might best be supplemented with other strategies, such as the use of ecological momentary assessment (15), refuse analysis (26), or implicit cognition methods (27). Also, other categories or category systems could be created that might be useful, and these data may not be generalizable to a general population sample. On the other hand, there were no apparent floor or ceiling response effects.
Although the present sample of drug offenders has obviously been involved in multiple experiences related to drug use resulting in negative consequences, highly salient and meaningful negative consequences of drug use may not be the most proximal influence on risk behaviors given motivational and situational cues. Continuing to engage in high-risk behaviors affiliated with drug use (possession, sales, and driving under the influence) likely results from repetitive experiences and associations between antecedent and consequent events in specific locations that are be most predictably positive. Repeatedly illustrating adverse consequences of drug use choices affecting self and significant others in these specific high-risk locations may aid in making negative consequences more accessible and salient during crucial decision-making moments. For example, instilling information concerning driving accidents along with high-risk environmental cues may obscure or limit relatively automatic tendencies to use and then drive. More research regarding the relations among locations, social and emotional factors, and drug use may help provide novel means of prevention, cessation, and control.
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Steve Sussman,(*) Susan L. Ames, Clyde W. Dent, and Alan W. Stacy
Institute for Health Promotion and Disease Prevention Research, University of Southern California, 1540 Alcazar Street, CHP-209, Los Angeles, CA 90089
(*) Corresponding author: Fax: (323) 442-2601; E-mail: sssusma@hsc.usc.edu
APPENDIX: SAMPLE OF SURVEY LOCATION
AND DRUG USE QUESTIONS
1. Think about your time at home; the places at home that you go
during the day or night. At home, have you used alcohol or another
drug (other than cigarettes) and then drove a car or motorcycle?
1. Yes
2. No
* Think about the few minutes before the last time you drove after
using alcohol or another drug at home
2. Where were you a few minutes before the last time you drove after
using alcohol or another drug at home? Circle only one location.
1) in my bedroom
2) in another bedroom
3) in the bathroom
4) in the basement or den
5) in the attic
6) in the kitchen
7) in the living room
8) in the dining room
9) in the garage
10) in the yard
11) other location. Please specify --
12) I never used alcohol or another drug at home and then
drove
3. When did this occur? (circle one answer below)
Less About 1 2 to 3 1 to 2 3 to 6 7 to 12 More
than 1 week weeks months months months than
week ago ago ago ago ago ago 1 year
ago
(1) (2) (3) (4) (5) (6) (7)
Never used
alcohol or
another drug
at home
and drove
(8)
4. How were you mainly feeling at this time (a few minutes before you
last drove after using alcohol or another drug at home)? Circle
one feeling you felt the most.
1) very happy
2) excited
3) confident
4) a little happy
5) relaxed
6) frozen
7) nervous
8) sad
9) angry
10) pressured
11) worried
12) afraid
13) paranoid
14) frustrated
15) alienated (different from others)
16) I never used alcohol or another drug at home and then drove
5. Were you alone or with others at this time (a few minutes before
you last drove after using alcohol or another drug at home)?
Circle only one answer.
1) alone
2) with a small group of friends (1-4 people)
3) with a spouse or girlfriend or boyfriend
4) with a large group of friends (5 or more people)
5) 2 and 3 above
6) 3 and 4 above
7) with parents
8) with brothers or sisters
9) I never used alcohol or another drug at home and then
drove
6. About what time of the day was this (a few minutes before you last
drove after using alcohol or another drug at home)? Write in the
exact time here (for example, 1:00 am): --:-- --. Now circle the
best answer below:
1) 6 A.M. to 11:59 A.M.
2) 12:00 noon to 4:59 P.M.
3) 5:00 P.M. to 11:59 P.M.
4) 12:00 midnight to 5:59 A.M.
5) I never used alcohol or another drug at home and then drove
7. Was there a party at your house at this time (a few minutes before
you last drove after using alcohol or another drug at home)?
1) Yes
2) No
3) I never used alcohol or another drug at home and then drove
About how many times did you use each of these drugs in the last 6
months: Put a check in a box to indicate your answer for each drug:
Once
Once or every
twice in few
Never 6 months months
1. Cigarettes [] [] []
2. Alcohol [] [] []
3. Marijuana (weed) [] [] []
4. Cocaine (crack) [] [] []
5. LSD (acid) [] [] []
6. Stimulants (ice, [] [] []
speed, amphet-
amines)
7. Inhalants (rush, ni- [] [] []
trous)
8. Other (depressants [] [] []
or downers, PCP,
Steroids, Heroin,
etc.)
1 2 3
Once a 2 times 3 times
month a month a month
1. Cigarettes [] [] []
2. Alcohol [] [] []
3. Marijuana (weed) [] [] []
4. Cocaine (crack) [] [] []
5. LSD (acid) [] [] []
6. Stimulants (ice, [] [] []
speed, amphet-
amines)
7. Inhalants (rush, ni- [] [] []
trous)
8. Other (depressants [] [] []
or downers, PCP,
Steroids, Heroin,
etc.)
4 5 6
2 to 6
Once a times a Every
week week day
1. Cigarettes [] [] []
2. Alcohol [] [] []
3. Marijuana (weed) [] [] []
4. Cocaine (crack) [] [] []
5. LSD (acid) [] [] []
6. Stimulants (ice, [] [] []
speed, amphet-
amines)
7. Inhalants (rush, ni- [] [] []
trous)
8. Other (depressants [] [] []
or downers, PCP,
Steroids, Heroin,
etc.)
7 8 9
COPYRIGHT 2001 Marcel Dekker, Inc.
COPYRIGHT 2001 Gale Group
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