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Considerable studies have been conducted in search of variables
which will explain drug abuse, and present markers of individuals
especially at risk to drug dependency. The purpose of these
studies is to identify variables that have high correlations
with drug use. This process eliminates variables with low
statistical correlations and identifies the few variables
that are likely to explain drug use in a particular statistical
sample. Several thousand of these correlations between various
independent variables and school-age drug use have been quantified
in hundreds of different social science research projects.
A review and summary of these thousands of correlations
would be extremely valuable to analysts converting such basic
research into policy or scheduling decisions. In the early
1990's the Congressional Office of Technology Assessment contracted
with a professor at the Bowman Gray School of Medicine at
Wake Forest University for this sort of report on "Drug Abuse
in Schools: Contributing Factors and Preventive Interventions."(38)
The report is described by OTA in a 1994 publication:
"OTA commissioned a review of the survey research literature
on school-aged substance use that compiled, classified, and
examined 9,930 statistical analyses from 242 separate studies.
This is by far the most extensive systematic examination of
this body of research conducted so far. Most of the studies
dealt with school-based populations, but some focused on school-age
army recruits, dropouts, children of alcoholics, and individuals
involved in clinics. The studies reported statistical relationships
between substance use and its postulated causes. Statistical
findings from the study reports were sorted into 11 major
categories and 50 subcategories, and then analyzed to identify
strong, moderate, and weak statistical relationships, as well
as those that had been insufficiently studied."(39)
Use of tobacco, alcohol, and marijuana accounted for
82 percent of the analyses in the report, prepared by William
B. Hans
"In part, the focus on use rather than abuse reflects
much of the philosophy that has guided research and educational
funding. Namely, for youth, any use of illegal substances
(including alcohol and tobacco) has been considered abuse
by some. Use has received the most extensive attention perhaps
in part because use among youth is easier to define than abuse
but there are also multiple methods for defining use. These
include any use versus no use definitions as well as intensity,
frequency, quantity and problematic measures. The point at
which use becomes abusive escapes definition.
"At a minimum, use is a precursor to abuse although abuse
does not necessarily follow from use . . . Nearly half of
the youth who experiment with cigarettes go on to develop
long-term smoking habits. The use of alcohol and marijuana
by youth who use but have no definable chronic problems contribute
to the highway death toll, violence, and crime. The public
costs of these alone support the study and prevention of even
low levels of use.
"This report addresses the causes of school-aged substance
use as examined through the use of survey research methods."(40)
As described by OTA the analyses were sorted into 50
subcategories, and the average correlations in each sub category
were determined.
Four categories of evaluation were established. First,
the most important variables are those with a relatively strong
statistical relationship, and these should be used in explanatory
models regarding experimentation and progression of use behaviors.
The next category includes variables with moderate relationships,
and these variables provide secondary explanations. The third
category is variables with weak relationships.
"These are variables with no empirical support for playing
a causal role in the onset of substance use or transition
from experimentation to abuse."(41)
Finally, there are some variables that have not been
sufficiently studied.
How will the correlations of variables in different studies
be compared?
"The average magnitude of correlations for each category
will be examined. Previous research has suggested that correlations
with absolute values above .300 have clear meaning and contribute
important information to understanding the nature of such
behaviors as substance use. On the other hand, correlations
of less than .200 have minimal importance. Correlational values
in between are of moderate importance."(42)
Meta-analyses are difficult to interpret because of the
possible variations in the manner individual studies define
and measure their variables.(43) This paper reports unweighted
mean correlation coefficients, and most of the variables produced
consistent measures in the meta-analysis (standard deviations,
for example).(44)
For the Hansen meta-analysis, primary correlations were
defined as over .30, secondary correlations were between .20
and .30, and correlations under .20 were considered tertiary
and of minimal importance.
"The four variables that dominate as correlates of and
possible contributors to substance use are: 1) prior and concurrent
use of substances, 2) substance use by peers and friends,
3) perceived peer attitudes about substance use, and 4) offers
to use substances. The prominence of prior and concurrent
use is consistent with the reinforcing nature of substance
use itself. The prominence of the other three variables emphasizes
the importance of the social environment in contributing to
and reinforcing substance use among school-age youth."(45)(emphasis
added)
Section one above discusses contemporary standards for
evaluating the reinforcing nature of a substance, which are
based on self-administration of the drug in animal models.
The evidence in this petition asserts that marijuana does
not have a significant dependence liability. The Hansen report
supports the assertion that it is not the drug, but the set
and setting, which have the greatest influence on school-age
use of marijuana. Consequently, negative effects of marijuana
on adolescents can not be an indication or predictor of the
substance's effects on adult users.
"The first variable clearly speaks to the behavioral
and neuropharmacological nature of substance use, suggesting
that substance use is patterned behavior that is highly influenced
by neurological reinforcement. The remaining three variables
all suggest that a major cause of substance use among school-age
youth is the social environment. That is, theories of substance
use and abuse must include social processes as central explanations
of the onset and development of patterns of consumption. Social
norms (including issues about prevalence and acceptability),
the process of social development, the ready availability
of substances in the social environment, and the structure
of social groups must all be considered as central elements
for explaining substance use."(46) (emphasis added)
The role of risk perception, for example, is integral
to the social environment; it is a component of the "set"
in drug, set, and setting. However as an explanatory variable
for marijuana use, it is secondary to prior use of alcohol
and tobacco.
Here is a summary of the variables that have secondary
explanatory value, many of which can be considered corollaries
of the primary correlates above.
"An additional fifteen variables were judged to be of
secondary importance. These included (a) self-efficacy (assertiveness,
resistance skills and susceptibility to peer pressure), (b)
deviance, (c) attitudes toward drug use, (d) beliefs about
psychological consequences of substance use, (e) age and grade,
(f) beliefs about social consequences of substance use, (g)
intimacy, (h) intentions, (i) school bondedness, (j) others'
attitudes about drug use, (k) independence, (l) achievement
values, (m) parental attitudes about drug use, (n) non-structured
activities, and (o) peer group characteristics."(47)
One of the great contributions of the Hansen meta-analysis
is the following list of variables which can be considered
somewhat irrelevant to explaining substance use among school-age
youths.
"This analysis leaves 38 variables with minor or no justifiable
role in causing substance use onset or development. Among
these are variables that have been extensively examined in
research projects, including (a) substance use by parents,
(b) personality traits, (c) intelligence (d) social personality
traits, (e) parental relations, (f) affect, (g) participation
in structured activities, and (j) self-esteem. Based on the
observations that each of these variables were included in
at least 100 correlational analyses, the popularity of these
issues can be judged to be high. Each contribute in only a
minor way to understanding substance use. The practical value
of including these in theories of substance use is minimal
and, without compelling empirical findings that support strong
theoretical arguments, should be removed from theories of
substance use onset and development.
"Ten of the remaining tertiary variables had 50 or more
analyses reported, suggesting that researchers considered
them of relative importance. Included in this list were (k)
general values, (l) school performance, (m) stress management
skills, (n) non-peer, non-family attitudes about drug use,
(o) church attendance, (p) availability, (q) academic expectations,
(r) drug use by extended relatives, (s) drug use by siblings,
and (t) socioeconomic status. Given the frequency with which
these variables have been examined, these variables also seem
to play little or no role in explaining substance use onset
or development."(48)
The variables with insufficient study to draw conclusions
from were religious affiliation, motivation to comply, self-management
skills, exposure to moral codes, media influences, and values
specific to substance use. It is interesting to note that
when called upon to explain recent increases in teenage marijuana
use, both Donna Shalala and Lloyd Johnston attributed the
rise to the media influences of grunge, rap and rock music
stars (see section 4).
Hansen did several confirmatory analyses, and one specific
to marijuana shows that regardless of the factors that shape
them, peer attitudes have an overwhelming influence on the
decision to use marijuana. The top seven variables with the
highest mean correlations with marijuana use are (a) Peer
attitudes about Drug Use (.677); (b) Drug Use by Peers (.381);
(c) Offers (.377); (d) Deviance (.344); (e) Previous Drug
Use (.335); (f) Beliefs about social consequences (.314);
and (g) attitude toward drug use (.291).(49)
The .677 correlation coefficient between marijuana use
and peer attitudes is inconsistent with the other measures.
According to Dr. Hansen, this particular variable was "unusual"
because it only relied on 18 correlation coefficients from
5 studies. Over half the correlations came from one study.
A reanalysis based on equally weighted studies (compensation
for differing study sizes) produced a mean correlation coefficient
of .53 with a standard deviation of .21, still higher than
all the others.(50) The high standard deviation suggests "that
in some cases, the particular method of measurement differed
or the sample was unusual."(51) In this case, the .67 figure
is an anomaly, a piece of data that sticks out of the distribution.
It is easy to pluck this figure out of context and claim that
peer attitudes explain more about teenage marijuana use than
any other variable, especially since this would confirm the
NIDA hypothesis that risk perception is the key to discouraging
teen marijuana use. A closer examination of the data suggests
that the some odd data has skewed the distribution in this
particular sub-category distribution.
Hansen's paper is an early but valuable attempt to provide
a statistically-based review of quantified social science
data regarding the use of drugs by school-aged youths. Future
reviews will refine Hansen's analytical techniques and build
on his findings.(52) The meta-analysis discussed above was
only one aspect of the paper OTA requested from Hansen; future
reviews of this material will have a closer focus on the material
than the scope of OTA's request allowed in this review.
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