Editing Substance abuse (section)

==Special populations==

===Immigrants and refugees===

Immigrant and refugees have often been under great stress,<ref>{{cite journal |last=Drachman |first=D. |year=1992 |title=A stage-of-migration framework for service to immigrant populations |journal=Social Work |volume=37 |issue=1 |pages=68–72 |doi=10.1093/sw/37.1.68 }}</ref> physical trauma and depression and anxiety due to separation from loved ones often characterize the pre-migration and transit phases, followed by "cultural dissonance", language barriers, racism, discrimination, economic adversity, overcrowding, social isolation, and loss of status and difficulty obtaining work and fears of deportation are common. Refugees frequently experience concerns about the health and safety of loved ones left behind and uncertainty regarding the possibility of returning to their country of origin.<ref name="Pumariega">{{cite journal |author1=Pumariega A. J. |author2=Rothe E. |author3=Pumariega J. B. | year = 2005 | title = Mental health of immigrants and refugees | journal = Community Mental Health Journal |volume=41 | issue= 5 | pages = 581–597 | doi = 10.1007/s10597-005-6363-1 |pmid=16142540 |citeseerx=10.1.1.468.6034 |s2cid=7326036 }}</ref><ref name="NIAAA" /> For some, substance abuse functions as a coping mechanism to attempt to deal with these stressors.<ref name="NIAAA" />

Immigrants and refugees may bring the substance use and abuse patterns and behaviors of their country of origin,<ref name="NIAAA">{{Citation |last=[[National Institute on Alcohol Abuse and Alcoholism]] |title=NIAAA: Social work education for the prevention and treatment of alcohol use disorders |date=2005 |chapter-url=http://pubs.niaaa.nih.gov/publications/Social/Module10FImmigrants&Refugees/Module10F.pdf |archive-url=https://web.archive.org/web/20060907145139/http://pubs.niaaa.nih.gov/publications/Social/Module10FImmigrants&Refugees/Module10F.pdf |chapter=Module 10F: Immigrants, Refugees, and Alcohol |publisher=[[National Institutes of Health]] |id=1 U24 AA11899-04 |archive-date=7 September 2006}}</ref> or adopt the attitudes, behaviors, and norms regarding substance use and abuse that exist within the dominant culture into which they are entering.<ref name="NIAAA" /><ref>{{cite journal |author1=Caetano R. |author2=Clark C. L. |author3=Tam T. | year = 1998 | title = Alcohol consumption among racial/ethnic minorities: Theory and research | journal = Journal of Alcohol, Health, and Research | volume = 22 | issue = 4| pages = 233–241 }}</ref>

Another factor that can contribute to substance abuse among immigrants is the lack of support that they receive.  With few social and economic resources available to them, some turn to drugs as a way to cope through the stress that they are experiencing.  When examining an assimilation model it can be concluded that as immigrants settle into their new environment and adapt to the new culture they are in, the amount as which they use begins to match those of their new environment.  So in some cases, the amount in which one uses decreases as they adapt to their new society.<ref>{{Cite web |title=Alcohol and Drug Use Among Displaced Persons: An Overview {{!}} Office of Justice Programs |url=https://www.ojp.gov/ncjrs/virtual-library/abstracts/alcohol-and-drug-use-among-displaced-persons-overview?utm_source=chatgpt.com |access-date=2025-03-06 |website=www.ojp.gov}}</ref>

===Street children===
[[Street children]] in many developing countries are a high-risk group for substance misuse, in particular [[solvent abuse]].<ref name="UNODC">{{Cite web |title=Understanding Substance Use Among Street Children |url=http://www.unodc.org/pdf/youthnet/who_street_children_module3.PDF |archive-url=https://web.archive.org/web/20220907100030/https://www.unodc.org/documents/data-and-analysis/WDR2012/WDR_2012_web_small.pdf |archive-date=7 September 2022 |access-date=30 January 2014 |publisher=[[United Nations Office on Drugs and Crime]]}}</ref> Drawing on research in [[Kenya]], Cottrell-Boyce argues that "drug use amongst street children is primarily functional—dulling the senses against the hardships of life on the street—but can also provide a link to the support structure of the 'street family' peer group as a potent symbol of shared experience."<ref name=Cottrell-Boyce>{{cite journal|last=Cottrell-Boyce|first=Joe|journal=African Journal of Drug & Alcohol Studies|year=2010|volume=9|issue=2|pages=93–102|url=http://www.streetchildrenresources.org/wp-content/uploads/gravity_forms/1-07fc61ac163e50acc82d83eee9ebb5c2/2013/05/The-Role-of-Solvents-in-the-Lives-of-Street-Children.pdf|access-date=28 January 2014|doi=10.4314/ajdas.v9i2.64142|title=The role of solvents in the lives of Kenyan street children: An ethnographic perspective|doi-access=free}}</ref>

===Musicians===
In order to maintain high-quality performance, some musicians take chemical substances.<ref name = Breithenfeld>{{cite journal |author1=Breitenfeld D. |author2=Thaller V. |author3=Perić B. |author4=Jagetic N. |author5=Hadžić D. |author6=Breitenfeld T. | year = 2008 | title = Substance abuse in performing musicians | journal = Alcoholism: Journal on Alcoholism and Related Addictions | volume = 44 | issue = 1| pages = 37–42 |id={{ProQuest|622145760}} }}</ref> Some musicians take drugs such as alcohol to deal with the stress of performing. As a group they have a higher rate of substance abuse.<ref name = Breithenfeld/> The most common chemical substance which is abused by pop musicians is [[cocaine]],<ref name = Breithenfeld/> because of its neurological effects. Stimulants like cocaine increase alertness and cause feelings of [[euphoria]], and can therefore make the performer feel as though they in some ways 'own the stage'. One way in which substance abuse is harmful for a performer (musicians especially) is if the substance being abused is aspirated. The lungs are an important organ used by singers, and addiction to cigarettes may seriously harm the quality of their performance.<ref name = Breithenfeld/> Smoking harms the alveoli, which are responsible for absorbing oxygen.

=== Veterans ===
Substance abuse can be a factor that affects the physical and mental health of veterans. Substance abuse may also harm personal and familial relationships, leading to financial difficulty. There is evidence to suggest that substance abuse disproportionately affects the [[Homeless veterans in the United States|homeless veteran]] population. A 2015 Florida study, which compared causes of homelessness between veterans and non-veteran populations in a self-reporting questionnaire, found that 17.8% of the homeless veteran participants attributed their homelessness to alcohol and other drug-related problems compared to just 3.7% of the non-veteran homeless group.<ref>{{Cite journal |last1=Dunne |first1=Eugene M. |last2=Burrell |first2=Larry E. |last3=Diggins |first3=Allyson D. |last4=Whitehead |first4=Nicole Ennis |last5=Latimer |first5=William W. |date=2015 |title=Increased risk for substance use and health-related problems among homeless veterans: Homeless Veterans and Health Behaviors |journal=[[The American Journal on Addictions]] |language=en |volume=24 |issue=7 |pages=676–680 |doi=10.1111/ajad.12289 |pmc=6941432 |pmid=26359444}}</ref>

A 2003 study found that homelessness was correlated with access to support from family/friends and services. However, this correlation was not true when comparing homeless participants who had a current substance-use disorders.<ref>{{Cite journal |last1=Zlotnick |first1=Cheryl |last2=Tam |first2=Tammy |last3=Robertson |first3=Marjorie J. |date=2003 |title=Disaffiliation, Substance Use, and Exiting Homelessness |url=http://www.tandfonline.com/doi/full/10.1081/JA-120017386 |journal=[[Substance Use & Misuse]] |language=en |volume=38 |issue=3–6 |pages=577–599 |doi=10.1081/JA-120017386 |issn=1082-6084 |pmid=12747398 |s2cid=31815225|url-access=subscription }}</ref> The U.S. Department of Veterans Affairs provides a summary of treatment options for veterans with substance-use disorder. For treatments that do not involve medication, they offer therapeutic options that focus on finding outside support groups and "looking at how substance use problems may relate to other problems such as PTSD and depression".<ref>{{Cite web|url=http://www.mentalhealth.va.gov/res-vatreatmentprograms.asp|title=Treatment Programs for Substance Use Problems – Mental Health|website=mentalhealth.va.gov|access-date=2016-12-17}}</ref>

=== Sex and gender ===
{{Sex differences}}

There are many sex differences in substance abuse.<ref name=":02">{{Cite journal|last1=McHugh|first1=R. Kathryn|last2=Votaw|first2=Victoria R.|last3=Sugarman|first3=Dawn E.|last4=Greenfield|first4=Shelly F.|date=2018-12-01|title=Sex and gender differences in substance use disorders|journal=Clinical Psychology Review|series=Gender and Mental Health|volume=66|pages=12–23|doi=10.1016/j.cpr.2017.10.012|pmid=29174306|pmc=5945349|issn=0272-7358}}</ref><ref name=":12">{{Cite journal|last1=Becker|first1=Jill B.|last2=McClellan|first2=Michele L.|last3=Reed|first3=Beth Glover|date=2016-11-07|title=Sex differences, gender and addiction|journal=Journal of Neuroscience Research|volume=95|issue=1–2|pages=136–147|doi=10.1002/jnr.23963|issn=0360-4012|pmc=5120656|pmid=27870394}}</ref><ref name=":22">{{Cite journal|last1=Walitzer|first1=Kimberly S.|last2=Dearing|first2=Ronda L.|date=2006-03-01|title=Gender differences in alcohol and substance use relapse|journal=Clinical Psychology Review|series=Relapse in the addictive behaviors|volume=26|issue=2|pages=128–148|doi=10.1016/j.cpr.2005.11.003|pmid=16412541|issn=0272-7358}}</ref> Men and women express differences in the short- and long-term effects of substance abuse. These differences can be credited to [[sexual dimorphism]]s in the brain, endocrine and metabolic systems. Social and environmental factors that tend to disproportionately affect women, such as child and elder care and the risk of exposure to violence, are also factors in the gender differences in substance abuse.<ref name=":02" /> Women report having greater impairment in areas such as employment, family and social functioning when abusing substances but have a similar response to treatment. Co-occurring psychiatric disorders are more common among women than men who abuse substances; women more frequently use substances to reduce the negative effects of these co-occurring disorders. Substance abuse puts both men and women at higher risk for perpetration and victimization of sexual violence.<ref name=":02" /> Men tend to take drugs for the first time to be part of a group and fit in more so than women. At first interaction, women may experience more pleasure from drugs than men do. Women tend to progress more rapidly from first experience to addiction than men.<ref name=":12" /> Physicians, psychiatrists and social workers have believed for decades that women escalate alcohol use more rapidly once they start. Once the addictive behavior is established for women they stabilize at higher doses of drugs than males do. When withdrawing from smoking women experience greater stress response. Males experience greater symptoms when withdrawing from alcohol.<ref name=":12" /> There are gender differences when it comes to rehabilitation and relapse rates. For alcohol, relapse rates were very similar for men and women. For women, marriage and marital stress were risk factors for alcohol relapse. For men, being married lowered the risk of relapse.<ref name=":22" /> This difference may be a result of gendered differences in excessive drinking. Alcoholic women are much more likely to be married to partners that drink excessively than are alcoholic men. As a result of this, men may be protected from relapse by marriage while women are at higher risk when married. However, women are less likely than men to experience relapse to substance use. When men experience a relapse to substance use, they more than likely had a positive experience prior to the relapse. On the other hand, when women relapse to substance use, they were more than likely affected by negative circumstances or interpersonal problems.<ref name=":22" />