Theses and Dissertations from UMD
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New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
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Item Understanding the Risk of Drug Overdose and Alcohol-Induced Deaths Among Adults with Different Types of Disabilities(2023) Aram, Jonathan; Dallal, Cher M; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Disability is associated with drug and alcohol morbidity and mortality, which have reached high levels in recent years. Previous disability studies often combine all disabilities into a single category or focus on a single type of limitation. This dissertation characterizes different types of disabilities among U.S. adults and assesses associations with drug and alcohol morbidity and mortality. Methods: Using the 2018-2019 National Survey on Drug Use and Health (NSDUH, Aim 1), a nationally representative cross-sectional survey (n=83,485), different individual disabilities and co-occurring disabilities were identified. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between disability type and prevalence of drug and alcohol use disorders. Disabilities were also characterized within the Mortality Disparities in American Communities Study (Aims 2 and 3), a nationally-representative prospective cohort with baseline data collected in 2008 and mortality follow-up through 2019 (n=3,324,000). Multivariable Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) and CIs for associations between disability type and drug overdose death (OD, Aim 2) and alcohol-induced death (AID, Aim 3). Results: Within the NSDUH analysis, adults with cognitive disability had increased odds of drug (aOR=3.3; 95% CI=2.9–3.8), and alcohol use disorder (aOR=2.3; 95% CI=2.0–2.6), compared to adults without disability. Positive associations of lesser magnitude were observed between hearing/seeing and ambulatory disabilities and drug use disorder. In MDAC analyses, OD risk was elevated among adults with cognitive (aHR=2.6; 95% CI=2.4–2.9), ambulatory (aHR=2.8; 95% CI=2.6–3.1), ambulatory and hearing/seeing (aHR=2.5; 95% CI=2.0–3.1), and hearing/seeing disability (aHR=1.6; 95% CI=1.4–1.9), compared to adults without disability. The risk of AID was elevated for adults with co-occurring ambulatory and hearing/seeing disability (aHR=1.8; 95% CI=1.5–2.2), ambulatory disability only (aHR=1.5; 95% CI=1.3–1.7), and hearing/seeing disability only (aHR=1.2; 95% CI=1.0–1.4). Conclusions: The examination of specific disability categories reveals unique associations that are not apparent when all disabilities are combined. These findings can be used to improve access to recovery support services. Expansion of educational and occupational opportunities for adults with disabilities should be considered as strategies to reduce drug and alcohol morbidity and mortality.Item International Origins of Nixon's War on Drugs(2013) Kadz, John Taylor; Sicilia, David B; History; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)President Richard Nixon initiated the modern war on drugs after being influenced by his keen interest in foreign policy and foreign influences on American society. Phases of hysteria preceded Nixon's drug war and led to development of anti-drug legislation and a global policy to control international narcotics trafficking. Nixon's drug war strategy changed over time and was mainly a three pronged all-out offensive consisting of international supply reduction, law enforcement, and drug abuse and treatment program.