Background: \- Researchers have been studying patterns of mood and drug use in specific neighborhoods. This study will look at environmental factors that may affect drug use, addiction, and treatment seeking in Baltimore neighborhoods. The results could inform prevention efforts, enhance treatment interventions, and improve substance use outcomes. Objectives: \- To better understand why some people start to use drugs, why some people who use drugs become addicted, and why some people who become addicted enter treatment. Eligibility: \- Individuals at least 18 years of age who are living in the neighborhoods participating in the study. Design: * Participants will be screened with a physical exam and medical history. They will be separated into one of four groups: (1) people who do not use drugs, (2) people who have used drugs in the past, (3) people who are using drugs and want treatment, and (4) people who are using drugs and do not want treatment. * This study will include two outpatient visits about 12 months apart. Each visit will last about 5 hours. Each study visit may be done in 1 day or in 2 days. * At each study visit, participants will provide blood, breath, urine, and saliva samples. They will also have a heart function test and body measurements. They will complete questionnaires about personal and family history. * There will be monthly follow-up phone calls between the two visits.
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We will examine environmental factors that may impact initiation, addiction, and treatment seeking among the greater population at large (non-drug-users, current opioid/stimulant users, and current marijuana users)
Timeframe: 12 months
To provide neighborhood-matched control groups of non-drug-using individuals, Unclassified/former drug users, and current opioid/stimulant drug users not seeking treatment
Timeframe: 12 months
To explore the possible role of genetics and its interplay with environment in regards to drug use initiation, addiction, and treatment seeking among the study groups
Timeframe: 12 months
To assess, longitudinally, mediators of 12-month changes in drug-misuse status in the same three groups
Timeframe: 12 months
To assess the accuracy of stress detection in the lab and the field by the Health Tag
Timeframe: 12 months
To assess EMA reports of drug use and psychosocial stress as well as real-time environmental risk exposure in a non-treatment seeking and/or nondrug using population
Timeframe: 12 months