 |
National Institute on Drug Abuse
Women and Sex/Gender Differences Research
Director's Report to Council
Research Findings Excerpts
September, 1996
|
 |
Basic Research |
THC and Pregnancy
NIDA supported research to be published soon reports that the mouse uterus during early pregnancy has the capacity to synthesize and degrade anandamide. These findings coupled with earlier findings of cannabinoid receptors in the preimplantation mouse embryo and uterus suggest that these tissues could be targets for cannabinomimetic ligands. The researchers also observed an inverse relationship between the synthase and amidase activity at the implantation or inter-implantation sites in the uterus during the peri-implantation period suggesting embryonic influence in regulating these activities. Although the physiological significance of these findings is not yet clear, it is possible that aberrant synthesis of anandamide and/or expression of the cannabinoid receptors in the uterus and/or embryo could contribute to early pregnancy. Paria, B.C., Deutsch, D.D., and Dey, S. K. Molecular Reproduction and Development, In Press.
|
Clinical and Services Research |
Sex Differences in Plasma Cocaine Levels and Subjective Effects after Acute Cocaine Administration
Scott Lukas and colleagues at the Alcohol and Drug Abuse Research Center, McLean Hospital and Harvard Medical School reported that male occasional cocaine users achieved significantly faster peak plasma cocaine levels after an intranasal dose of cocaine hydrochloride. They also reported a greater number of intense effects. Women also differed in their menstrual cycle where peak plasma levels of cocaine were lower in the luteal compared to the follicular phase; subjective reports did not differ. However, heart rates did not differ between males and females, suggesting that females with the lower plasma cocaine had more sensitive cardiovascular sensitivity. These data demonstrate differential effects between the sexes for use of cocaine. Psychopharmacology, 125, pp. 346-354, 1996.
Matching Patients to Smoking Treatments
Relatively little is known about individual variation in withdrawal, or the determinants of such variation. Dr. Baker and colleagues at the University of Wisconsin reported findings showing that the course of smoking withdrawal symptoms varies greatly across smokers. Results from two studies reveal that 35-50% of smokers in cessation programs experience withdrawal that follows an "atypical" course over the first 2 months after a quit attempt. Dynamic cluster analysis revealed two clusters of subjects that experienced either a late exacerbation of withdrawal, or a prolonged maintenance of withdrawal symptoms. Women were more likely than men to belong to an atypical cluster, and membership in such a cluster was associated with a higher risk of relapse. This research may identify an important individual difference that predicts relapse vulnerability and may also reveal an important target for future treatments. Piasecki, T.M., Fiore, M.C., Baker, T.B. Profiles in Discouragement: Two studies of Variability in the Time Course of Smoking Withdrawal Symptoms, Submitted to Journal of Abnormal Psychology.
|
AIDS Research |
Maternal Drug Use and Mother-to-Infant HIV Transmission
Multivariate analyses in a recent report from the Women and Infants Transmission Study (WITS) indicate an almost three fold increase (Odds Ratio 2.77) in the risk of mother-to-infant HIV transmission associated with prenatal drug use (i.e., a measure combining use of cocaine, heroin/opiates, methadone, and/or injecting drug use), for women with duration of membrane rupture greater than 4 hours. The increased risk observed in this subsample was greater than that seen in univariate analysis for the total sample of 530 HIV-infected women and their infants (Odds Ratio 1.89). These results not only document a prenatal drug use-perinatal transmission relationship, but also provide a basis for further hypotheses as to the timing (intrapartum, intrauterine) and mechanisms of transmission. WITS is an ongoing study of HIV-infected pregnant women and their infants conducted at pediatric and obstetric settings in Illinois, Massachusetts, New York, Puerto Rico, and Texas. NIDA collaborates with the National Institute of Allergy and infectious Diseases and the National Institute of Child Health and Human Development in supporting WITS. Rodriguez, E.M., et al., Association of Maternal Drug Use During Pregnancy with Maternal HIV Culture Positivity and Perinatal HIV Transmission. AIDS; 10: pp. 273-282, 1996.
Barriers to Condom Use and Needle Cleaning Among Impoverished Women
Sexual behaviors and drug use factors that inhibit condom use and needle cleaning were assessed among 378 homeless African-American and Latino women. The most highly rated barriers to condom use with partners included believing the partner did not have AIDS (69%), lack of skills in using condoms (52%), inability to get condoms (52%), lack of skills in negotiating condom use with partners (49%), personal dislike of condoms (47%) and discomfort in discussing condoms (46%). African-American women were more likely than Latino women to report barriers related to lack of skills in using condoms, inability to get condoms, discomfort and lack of skills in discussing condoms with partners, not thinking about condoms when high, a belief that their partner did not have AIDS, and a belief that they could not transmit HIV to their partners. On the other hand, Latino women, as compared with African American women, were more likely to report partner's dislike of condoms. This barrier was found among almost three-quarters of the less acculturated Latinos. The most pervasive barrier to needle cleaning among women who shared needles was not having their own needle (62%). This was closely followed by a need to hide needles (60%), being high and not interested in cleaning (59%), and not having disinfectant available (57%). Nyamathi, A., Lewis, C., Leake, B., Haskerud, J., Bennett, C. Barriers to Condom Use and Needle Cleaning Among Impoverished Minority Female Injection Drug Users and Partners of Injection Drug Users. Public Health Reports, 110, pp. 166-172, 1995. Psychosocial Predictors of AIDS Risk Behavior Baseline assessments of personal and social resources, threat appraisal processes, coping styles, and barriers to risk reduction as predictors of sexual and drug use behaviors were evaluated among a sample of 714 African American and 691 Latino homeless women. Based on theoretical perspectives of the Comprehensive Health Seeking and Coping Paradigm and Health Belief Models, causal modeling was conducted. Findings revealed active coping was associated with fewer sexual AIDS risk behaviors for African-American and Latino women and less drug use behavior among African American women. High threat appraisal and avoidant coping predicted drug use behavior in both groups. Self-esteem and social resources were inversely associated with emotional disturbance for both groups. Lower self-esteem predicted more barriers to condom use among Latinos. Implications of these findings point to important cultural differences that should guide educational and outreach efforts of practitioners and social scientists. Nyamathi, A., Stein, J., Brecht, M. Psychosocial Predictors of AIDS Risk Behavior and Drug Use Behavior in Homeless and Drug Addicted Women of Color. Health Psychology, 14, pp. 265-273, 1995.
Intervening with Adolescent Girls Living with HIV
Young women who are HIV seropositive have special needs for interventions to reduce the negative consequences of their infection for themselves, for their children, partners, and families. This chapter reviews the challenges posed by HIV to these young women and outlines intervention programs designed to reduce long-term negative social, behavioral, and mental health consequences of HIV. Rotheram Borus, M.J., Murphy, D.A., Miller, S., et.al. Intervening with Adolescent Girls Living with HIV. In A. O'Leary and L. S. Jermmott (Eds.), Women and AIDS: Coping and Care, Plenum Press, pp. 87-108, New York, 1996.
|
Epidemiology, Etiology and Prevention Research |
Familial Factors in Female Drug Abuse/Dependency
Extending their research with males, Cadoret et al. studied genetic and environmental factors leading to drug abuse and dependency in female adoptees. Antisocial personality in a biologic parent was strongly related to the development of conduct disorder in female offspring; conduct disorder was associated with aggressive behavior, and both conduct disorder and aggression were strongly predictive of later drug abuse/dependence in the adoptees. Drug abuse/dependence was in turn correlated significantly with alcohol abuse/dependence. Environmental factors in the adoptive home were also found to be significant. Disturbed adoptive parenting contributed significantly to the development of aggression in the adoptees, which in turn resulted in increased risk of drug abuse/dependence. This relationship was complicated, however, by a finding suggesting selective (non-random) placement; adoptees from a biologic background of antisocial personality were less likely to be placed in a disturbed adoptive home. The environmental factors were thought to act independently of the genetic, thus offering an important avenue for preventive intervention through reducing aggressiveness early in life. Cadoret, R.J., Yates, W.R., Troughton, E., Woodworth, G., and Stewart, M.A. An Adoption Study of Drug Abuse/Dependency in Females. Comprehensive Psychiatry, 37 (2), pp. 88-94, 1996. Fatal Consequences of Cocaine and Opiate Use: Accidental Fatal Drug Overdoses in New York City: 1990-1992 Cocaine, often with opiates (predominantly heroin) and ethanol, caused almost 75% of accidental fatal drug overdoses in New York City from 1990 through 1992. This study assessed 1,986 cases in that period using data collected by the Office of the Chief Medical Examiner. This study excluded intentional (suicidal) fatal drug overdoses. Cocaine with opiates caused 752 (37.9%) deaths. Cocaine without opiates caused 629 (31.7%) deaths while opiates without cocaine caused 503 (25.3%) deaths. Drugs other than cocaine or opiates, predominantly benzodiazepines and antidepressants, caused 102 (5.1%) deaths. The highest cocaine overdose rates were found among African-American and Latino males. Rates of opiate overdose without cocaine did not differ in regard to race/ethnicity except for low rates among Asians. Males had higher overdose rates than women for all classes of drugs. The highest rates for cocaine and/or opiates were found among victims 35-44 years of age. The rates of overdose from cocaine and opiates increased from 1990-1992. A marked increase of cocaine overdoses in 1991 was followed by a slight decrease in 1992. The rates of overdoses from drugs other than cocaine or opiates showed no increase over time. Cocaine is the leading cause of accidental drug overdoses, unlike in the early 1980's when opiates prevailed as a cause of death. African-American and Latino males may be particularly susceptible to cocaine overdoses because of their exposure to crack in poor neighborhoods. Tardiff, K., Marzuk, P.M., Leon, A.C., Hirsch, C.S., Stajic, M., Portera, L., Hartwell, N., Accidental Fatal Drug Overdoses in New York City: 1990-1992. The American Journal of Drug and Alcohol Abuse, 22 (3), 1996.
Contributions of Mothers and Fathers to Cigarette Smoking in Adolescence
There is a significant dose-related association between maternal smoking and children's smoking, especially among daughters. This finding has been obtained in a study of similarity on cigarette smoking among mothers, fathers, and young adolescents (mean age = 12.6 years) in a sample of 201 triads in which each respondent was interviewed independently. Both maternal smoking and quality of parent-child interaction affect lifetime smoking by the child, but only maternal smoking affects current smoking. Their maternal role modeling effect is stronger for daughters than for sons and persists with the inclusion in the model of perceived smoking by the adolescent's close friends. The observed familial concordance on smoking between parent and child cannot disentangle environmental from genetic effects. Intervention and prevention practices targeted toward preventing or reducing cigarette smoking among children tend to target the child's life skills, knowledge, attitudes about smoking, and resistance skills toward peer pressure. The investigation points to another important and neglected focus of intervention, namely, the smoking behavior of the youth's parents in early adolescence. Kandel, D.B., Wu, P. The Contributions of Mothers and Fathers to the Intergenerational Transmission of Cigarette Smoking in Adolescence. Journal of Research on Adolescence, 52, pp. 225-252, 1995.
Prevalence of Substance Abuse and Psychiatric Disorders are High Among Incarcerated Women
In-person interviews were conducted with a near census (N=805) of women felons entering prison in North Carolina between July 1991 and November 1992. Assessments were made for eight psychiatric disorders using the Composite International Diagnostic Interview as the primary assessment measure, and 25 percent of the women were reassessed for two of these disorders for purposes of validation. Results were then compared with data from the Epidemiologic Catchment Area (ECA) Study for the North Carolina site. The researchers found the most prevalent disorders to be alcohol and drug abuse and dependence. Rates for mood disorders, antisocial personality disorders, and lifetime exposures to traumatic events were also high. Rates of disorders were found to be greater among white women than among African Americans. The researchers conclude that women prisoners have major needs for both substance abuse and mental health treatment. Jordan, B. K., Schlenger, W.E., Fairbank, J.A., and Caddell, J.M. Prevalence of Psychiatric Disorders Among Incarcerated Women. Archives of General Psychiatry, 53, pp. 513-519, 1996.
Women Who Kill in Drug Market Situations
Open ended and semi-structured interviews were used in a study with 215 women sentenced to prison in New York State for homicide, of which 19 women killed in drug market situations. The study was to explore the ways in which changing drug markets may have influenced women's involvement in lethal violence. Through qualitative analysis of the narratives offered by these women to explain their involvement in the killing, evidence was found that supports the conclusion that women will use violence, as will men, to protect or augment an economic interest in a drug market, From further analysis, however, it was concluded that even in a clearly economic context in which women are able to acquire their own economic interest, some women will kill or participate in a killing in connection with their relationship to a male business or intimate partner. That is, women who kill in the economic context of a drug market may kill for economic reasons, but the specific circumstance of involvement in a drug market does not necessarily negate the significance of gender. Brownstein, H.H., Spunt, B.J., Crimmins, S.M., Langley, S. Women Who Kill In Drug Market Situations. Justice Quarterly, 12, pp. 473-498, 1995.
Social Support Among Impoverished Women
Types of social support, their use and efficacy were assessed in a convenience sample of 3,021 homeless and drug addicted African American and Latino women. Type of support most commonly cited was someone who listens (78%) followed by someone who provides confidence (74%), advice (74%) and understanding (73%). Almost 30% of the women reported having at least one friend or neighbor with whom they could talk. However, only 12% could count on friends or neighbors to help in changing things. Only 20% had a husband or partner to confide in and receive emotional support from but their partners were less helpful when it came to explaining things or assisting with change. Professionals, such as counselors and social workers, were most helpful in facilitating change. Implications reveal that enabling factors and barriers to the use of support from professional agencies need to be explored with a view toward designing interventions that include strengthening effective social support in different populations of homeless women. Nyamathi, A., Bennett, C., Leake, B., Chen, S. Social Support Among Impoverished Women. Nursing Research, 44, pp. 376-378, 1995.
[Previous Report][Index][Next Report]
|
