title: Are Stressful Life Events (SLEs) Associated with the Utilization of Substance Use Treatment-Related Services?
abstract: This study described herein explored the association of stressful life events with the utilization of substance use treatment-related services among substance users living in Puerto Rico.
  
  
  
  A secondary data analysis was conducted using data collected by a research project entitled Puerto Rico Drug Abuse Research Development Program II (PRDARDP II). The study population consisted of 378 individuals from 18 to 35 years of age who were residents of the San Juan metropolitan area and who presented evidence of substance use in the 30 days prior to the interview. The analysis considered demographic data, information on patterns of substance use, substance use treatment history, stressful events, and depression and anxiety symptomatology.
  
  
  
  As the number of stressful life events increased, substance users were more likely to report having utilized substance use treatment-related services (OR = 1.11, 95% CI [1.06, 1.17], p < 0.001). Relapsing, the inability to afford drugs, and poor working conditions were statistically significant stressful life events associated with the utilization of substance use treatment-related services.
  
  
  
  Despite the structural limitations associated with access to and with the quality of the services in the substance use treatment-related system of Puerto Rico, findings suggest that stressful life events play a significant role in the utilization of those services. Researchers and clinicians should consider screening for stressful life events in outreach and engagement strategies. At the same time, the assessment of stressful life events should be integrated into the treatment planning stage to support the recovery process of people with substance use disorders.
authors.affiliation: Institute of Research, Education, and Services in Addiction, Universidad Central del Caribe, Bayamón, PR.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Cruz-Feliciano
authors.affiliation: Public Health Program, School of Health Sciences, College of Health Sciences, Walden University, Minneapolis, USA.
authors.forename: Aimee
authors.initials: A
authors.lastname: Ferraro
authors.affiliation: Public Health Program, School of Health Sciences, College of Health Sciences, Walden University, Minneapolis, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Witt Prehn
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006296:Health Services / Q000592:standards / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D011647:Puerto Rico / Q000453:epidemiology; D011787:Quality of Health Care; D012008:Recurrence; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D055815:Young Adult
keywords: Latinos; Puerto Ricans; Relapse; Stressful Life Events; Substance Abuse Treatment