Examining Recovery Status and Supports before and after Substance Abuse Disorder Treatment Among Clients Who Experienced Lifetime and Recent Firearm-Related Threats

• Author: TK Logan,Maggie Schroeder,Jennifer Cole
• Date: 01 July 2022
• DOI: 10.1177/00220426211056601
• Published date: 01 July 2022
• Subject Matter: Articles

Article

Journal of Drug Issues

2022, Vol. 52(3) 306–328

© The Author(s) 2021

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DOI: 10.1177/00220426211056601

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Examining Recovery Status and

Supports before and after

Substance Abuse Disorder

Treatment Among Clients

Who Experienced Lifetime and

Recent Firearm-Related

Threats

TK Logan

1

, Jennifer Cole

1

and Maggie Schroeder

2

Abstract

Firearm-related risks have often been overlooked in the sequela of substance use and substance

use disorders. This study compares adult substance abuse disorder treatment (SADT) clients who

experienced recent (n= 274) and lifetime (n= 889) f‌irearm threats to adults who were not

threatened with a f‌irearm (n= 2029) before and 12 months after program entry. More men

experienced f‌irearm threats (38.8%) than women (34.2%). However, among those with any

f‌irearm threats, more women (27.2%) experienced f‌irearm threats in the year before program

entry than men (20.2%). Being threatened with a f‌irearm was associated with increased econo mic

vulnerability, criminal justice system involvement, mental health problems, and victimization both

before and after SADT program entry. A higher number of adverse childhood experiences were

associated with f‌irearm threats and particularly recent f‌irearm threats. Results of this study

underscore the importance of screening for f‌irearm-related risks in substance abuse disorder

treatment programs.

Keywords

gun violence, substance abuse treatment, recovery, f‌irearm-related risks

Firearm-related risks and substance use are often treated independently; however, f‌irearm-related

risks intersect with alcohol and illicit drug use in multiple ways (Branas, Han, & Wiebe, 2016;

1

University of Kentucky, Lexington, KY, USA

2

Kentucky Department of Behavioral Health, Developmental and Intellectual Disabilities, Frankfort, KY, USA

Corresponding Author:

TK Logan, Department of Behavioral Science, University of Kentucky, 333 Waller Avenue, Suite 480, Lexington, KY 40504,

USA.

Email: tklogan@uky.edu

Buschmann, Prochaska, Baillargeon, & Temple, 2017;Dittmer, Davenport, Oyler, & Bernard,

2021;Lu & Temple, 2020). For example, both impact younger adults (18–30 years old) at higher

rates and early involvement in either is associated with negative outcomes in later adulthood

(Everytown for Gun Safety, 2020;Grant et al., 2006;Moss, Chen, & Yi, 2014;Parsons,

Thompson, Vargas, & Roco, 2018;Teplin et al., 2021). Additionally, f‌irearm-related risks

have often been overlooked in the sequela of substance use and substance use disorders (Schulte &

Hser, 2013). Several recent studies have found that one-third to one-half of adults entering

substance abuse disorder treatment (SADT) or residential recovery housing programs have

experienced f‌irearm-related victimization (Logan & Cole, 2021a,2021b). However, no studies to

date have examined SADT outcomes among clients who have experienced f‌irearm victimization.

Firearm victimization has been associated with increased psychological symptoms and

substance use (Boeck, Strong, & Campbell, 2020;Vella et al., 2020). More specif‌ically, several

studies have found that individuals exposed to f‌irearm-related threats had higher emotional

distress and functioning problems than those victimized without a weapon or those victimized

with a weapon other than a f‌irearm (Kagawa et al., 2020;Weigend Vargas & Hemenway, 2021).

Women who experience f‌irearm threats from an abusive intimate partner also report increased

distress compared to women with abusers who did not threaten them with a f‌irearm (Logan &

Cole, 2021;Logan & Lynch, 2018;Logan, Lynch, & Walker, 2021;Logan & Lynch, 2021a;

Lynch & Logan, 2018;Sullivan & Weiss,2017). Several studies have also found that victimization

with a f‌irearm is associated with increased substance use (Farrell & Zimmerman, 2017;Vella et al.,

2020). In addition, research suggests that individuals exposed to f‌irearm threats are at increased

risk of revictimization including revictimization with f‌irearms as well as increased risk of f‌irearm

violence perpetration (Beardslee et al., 2018;Goldstick et al., 2019a;Kalesan, Zuo,

Ramachandran, & Galea, 2019;Rowhani–Rahbar et al., 2015;Schmidt et al., 2019;Teplin

et al., 2021;Turner, Phillips, Tigri, Williams, & Hartman, 2016;Wallace,2017). One study found

that both men and women who had access to, or were threatened with, a f‌irearm during ado-

lescence were more likely to own a gun, carry a gun in public, perpetrate f‌irearm violence, and to

be threatened with a weapon in adulthood (Teplin et al., 2021).

Although f‌irearm victimization has been associated with prior victimization (Goldstick et al.,

2019b;Logan & Cole, 2021a,2021b;Rajan, Branas, Myers, & Agrawal, 2019;Turner et al., 2016;

Wallace, 2017), there has been limited examination of whether there is an association of adverse

childhood experiences and f‌irearm victimization. One study found that childhood trauma was

associated with f‌irearm violence among homeless youth (Hsu et al., 2021). In general, adverse

childhood experiences have been associated with negative outcomes in adults including poorer

mental health outcomes, suicidality (Hughes et al., 2017;Thompson, Kingree, & Lamis, 2019),

physical health outcomes, and substance use (Hughes et al., 2017;Letendre & Reed, 2017;

Merrick et al., 2019;Petruccelli, Davis, & Berman, 2019) as well as economic vulnerability in

adulthood (Merrick, Ford, Ports, & Guinn, 2018;Merrick et al., 2019). In particular, those

experiencing more adverse childhood experiences had a higher risk of substance use disorders and

other negative mental and physical health outcomes (Boullier & Blair, 2018;Hughes et al., 2017;

Merrick et al., 2019;Waehrer, Miller, Silverio Marques, Oh, & Burke Harris, 2020). This study

expands the literature by examining adverse childhood experiences among adults entering SADT

and whether there are differences in adverse childhood events among clients who have, and clients

who have not, been threatened with a f‌irearm.

Relapse, or return to use of alcohol or illegal drugs, are typically the primary outcome measures

in evaluations of SADT programs (Richardson, Blount, & Hanson–Cook, 2019;White, 2012).

However, recovery extends beyond the use of substances to include enhancements in physical

health, mental well-being, quality of life, and community reintegration, and these goals can often

be met even when there are minor relapses (Kaskutas et al., 2014;Laudet & White, 2008;

Logan et al. 307