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Hicks TA, Bustamante D, Bountress KE, Adkins AE, Svikis DS, Gillespie NA, Dick DM, Amstadter AB. Is pre-college interpersonal trauma associated with cannabis use? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2645-2652. [PMID: 34586040 PMCID: PMC8960473 DOI: 10.1080/07448481.2021.1980399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/22/2021] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine the prevalence and correlates of lifetime cannabis use (i.e., experimental [use 1-5 times] and non-experimental [use ≥ 6 times]) in relation to interpersonal trauma (IPT) above and beyond relevant covariates. PARTICIPANTS A large (n = 9,889) representative sample of college students at an urban university in the southeastern part of the United States. METHODS Participants were 4 cohorts of first-year college students who completed measures of demographics, cannabis, alcohol, nicotine, and IPT. Associations were estimated using multinomial logistic regressions. RESULTS The prevalence of lifetime cannabis use was 28.1% and 17.4% for non-experimental and experimental cannabis use, respectively. IPT was significantly associated with experimental and non-experimental cannabis use above and beyond effects of sex, race, cohort, alcohol, and nicotine. CONCLUSIONS Results show that cannabis use is prevalent among college students and is associated with IPT above and beyond associations with sex, race, and other substance use.
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Affiliation(s)
- Terrell A Hicks
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Daniel Bustamante
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kaitlin E Bountress
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amy E Adkins
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Dace S Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Danielle M Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
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2
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Powell TW, Offiong A, Lewis Q, Prioleau M, Smith B, Johnson RM. "I've smoked weed with my daughter": Cannabis Use within Families Affected by Parental Opioid Misuse. CHILDREN AND YOUTH SERVICES REVIEW 2023; 155:107235. [PMID: 37982095 PMCID: PMC10655551 DOI: 10.1016/j.childyouth.2023.107235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Youth with parents who use opioids are more likely to engage in early substance use, especially cannabis use. The purpose of this study was to describe the context of cannabis use among families affected by parental opioid misuse. We conducted 25 in-depth interviews with families affected by parental opioid misuse. Participants were parents with a history of opioid misuse and young adults (ages 18-24) who had parents with a history of opioid misuse. Interviews were digitally recorded and professionally transcribed. Data were analyzed inductively using a qualitative content analytic approach. Familial cannabis use was common among young people and their parents. Participants described familial cannabis use as a bonding activity that felt safe and lightened the mood. Additional research is needed to understand the complex role that cannabis use may play in families affected by opioid misuse. Strategies for intergenerational substance use prevention are discussed.
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Affiliation(s)
- Terrinieka W. Powell
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe St., Baltimore, MD 21205
| | - Asari Offiong
- Child Trends, 12300 Twinbrook Pkwy suite 235, Rockville, MD 20852, United States
| | - Quiana Lewis
- Child Trends, 12300 Twinbrook Pkwy suite 235, Rockville, MD 20852, United States
| | - Morgan Prioleau
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe St., Baltimore, MD 21205
| | - Bianca Smith
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe St., Baltimore, MD 21205
| | - Renee M. Johnson
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N. Broadway, Baltimore, Maryland 21205
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Nathan Marti C, Arora S, Loukas A. Depressive symptoms predict trajectories of electronic delivery nicotine systems, cigarette, and cannabis use across 4.5 years among college students. Addict Behav 2023; 146:107809. [PMID: 37515895 DOI: 10.1016/j.addbeh.2023.107809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/07/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND This study examined the role of depressive symptoms on trajectories of electronic nicotine delivery systems (ENDS), cigarette, and cannabis use across 4.5 years in a sample of college students aged 18-19 at the initial study wave. METHODS Participants were 2,264 students enrolled in one of 24 Texas colleges that participated in a multi-wave study between 2014 and 2019. Latent growth mixture models were fit to identify longitudinal trajectories for past 30-day ENDS, cigarette, and cannabis use over a 4.5-year period. Class membership was regressed on baseline depressive symptoms in multinomial regression models. RESULTS Four trajectory classes were identified for each product: abstainer/minimal, decreasing, increasing, and high. Depressive symptoms were associated with a greater likelihood of belonging to the decreasing, increasing, and high trajectory classes relative to the abstainer/minimal class for all products, with the exception of the increasing ENDS class and the decreasing cannabis class. DISCUSSION The findings demonstrate that there is considerable similarity across trajectories of ENDS, cigarette, and cannabis use during traditional collegiate years. Furthermore, depressive symptoms increased the likelihood of belonging to substance using trajectory classes for all products.
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Affiliation(s)
- C Nathan Marti
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA.
| | - Srishty Arora
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA
| | - Alexandra Loukas
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA
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Waddell JT, Jager J, Chassin L. Maturing out of alcohol and cannabis co-use: A test of patterns and personality predictors. Alcohol Clin Exp Res 2022; 46:1603-1615. [PMID: 35994040 PMCID: PMC10325930 DOI: 10.1111/acer.14898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Reductions in substance involvement into adulthood are thought to represent a normative maturing out of substance use. However, patterns and predictors of maturing out of alcohol and cannabis co-use remain largely unstudied. Therefore, the current study tested developmental trajectories of alcohol and cannabis use from late adolescence into adulthood and whether late adolescent personality traits predicted trajectory class membership. METHODS Data come from a longitudinal study of family history of alcohol disorder (N = 458). Age bands were created to model trajectories of drinking quantity, negative alcohol consequences, and cannabis use frequency from late adolescence (age 18-22) to young adulthood (age 23-28) and adulthood (age 29-36). Participants reported on their sensation seeking, conscientiousness, and neuroticism during late adolescence and their typical drinking quantity, negative alcohol consequences, and cannabis use frequency at each age band. RESULTS Three trajectory classes were derived from an initial Parallel Process Growth Mixture Model: (1) low-risk maturing out of alcohol-only use, (2) high-risk maturing out of co-use, and (3) high-risk switchers who increased their cannabis use into adulthood. Late adolescent sensation seeking was associated with higher odds of being in both co-use trajectories, whereas a lack of conscientiousness was associated with higher odds of being a co-use switcher. CONCLUSIONS We identified heterogeneity in trajectories of co-use, which suggests that a lack of maturing out of alcohol involvement may be accompanied by increased cannabis use. Moreover, late adolescent personality traits may predispose individuals toward riskier developmental trajectories of substance use into adulthood.
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Affiliation(s)
- Jack T Waddell
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Justin Jager
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Laurie Chassin
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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Kvillemo P, Strandberg AK, Gripenberg J. Attitudes to Cannabis Use and Public Prevention Information Among Young Adults: A Qualitative Interview Study With Implications for Prevention Practice. Front Public Health 2022; 10:830201. [PMID: 35812509 PMCID: PMC9261461 DOI: 10.3389/fpubh.2022.830201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cannabis use carries an increased risk of ill health and social problems, especially when initiated at a young age. Drug use is influenced by individual beliefs, knowledge, and attitudes, which are, in turn, governed by social and environmental factors. In recent years, a less restrictive attitude toward cannabis has been observed in many countries, with concerns about increased cannabis use among young people. The aim of the current study was to gain a deeper understanding of young adults' attitudes toward cannabis use and public prevention information about cannabis. Methods A qualitative interview study was conducted among 32 anonymous informants aged 18-29 years in the Stockholm region. Participants were recruited through purposeful sampling, and semi-structured in-depth interviews were conducted using a digital video calling platform. A qualitative content analysis of the interviews was performed to generate categories and codes for cannabis use and attitudes toward prevention information. Results Both cannabis users and abstainers perceived some risks with cannabis; however, for many users, the positive effects appeared to outweigh any expected harm. Furthermore, the existing public information was perceived as less credible because of an excessive focus on harm. The informants expressed a desire for neutral facts about the effects of cannabis, delivered by credible senders. Moreover, they felt that prevention information should be delivered by individuals whom young people look up to or with whom they can identify, for example, people with authority or famous people such as influencers. The informants also underlined the importance of dialogue with the target group and taking young people's experiences into account when providing information about cannabis. Conclusion Current risk awareness associated with cannabis use among young adults is insufficient to prevent them from using cannabis. Public prevention information should preferably combine a fact-based focus on risks with recognition of cannabis' short-term desired effects, delivered by credible senders with authority or those with whom young people can identify.
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Affiliation(s)
- Pia Kvillemo
- Stockholm Prevents Alcohol and Drug Problems (STAD), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
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6
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Copeland WE, Hill SN, Shanahan L. Adult Psychiatric, Substance, and Functional Outcomes of Different Definitions of Early Cannabis Use. J Am Acad Child Adolesc Psychiatry 2022; 61:533-543. [PMID: 34416291 PMCID: PMC8850538 DOI: 10.1016/j.jaac.2021.07.824] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/09/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Research on associations of early cannabis use with adult functioning reports mixed findings. This may be due, in part, to wide variations in the definitions of early cannabis use. This study aims to compare associations of 4 commonly used definitions of early cannabis use-related to timing, dose, duration, and associated symptoms-with adult outcomes. METHOD Analyses were based on a 20+-year longitudinal, community-representative study of 1,420 participants. Between ages 9 and 21 years (8,806 observations), participants were assessed for cannabis use and DSM-5 cannabis use disorder. In early adulthood (ages 24-26 and 30; 2,424 observations of 1,266 subjects), participants were also assessed for psychiatric, substance use, and functional outcomes. RESULTS All definitions of early use were associated with multiple adult outcomes in models that adjusted for sex and race/ethnicity. In models that also adjusted for childhood psychiatric problems and family adversities, only daily use and a persistent developmental subtype (defined as daily/problematic use that began in adolescence and continued into early adulthood) were associated with later substance use/disorders, poorer functional outcomes, and derailments in the transition to adulthood. CONCLUSION Daily, continued-over-time cannabis use beginning on adolescence was most problematic for a range of adult outcomes. Cessation of early use did not fully eliminate later risks; but was associated with fewer negative outcomes, with weaker effect sizes.
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Affiliation(s)
| | - Sherika N. Hill
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
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7
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Capaldi DM, Tiberio SS, Kerr DCR, Owen LD. Associations of Cannabis Use across Adolescence and Early Adulthood With Health and Psychosocial Adjustment in Early Adulthood and Midadulthood in Men. Subst Abuse 2022; 16:11782218221096154. [PMID: 35677294 PMCID: PMC9168876 DOI: 10.1177/11782218221096154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/06/2022] [Indexed: 11/15/2022]
Abstract
Background: Associations between men’s prior cannabis use and their physical and
psychosocial adjustment were examined using prospective data across
adolescence (ages 13-20 years), early adulthood (ages 20-30 years), and
midadulthood (ages 30-38 years). The theoretical framework was based in
developmental-contextual and lifespan approaches. Method: Models were tested using men in the Oregon Youth Study who had been studied
since ages 9 to 10 years and who, in childhood, lived in neighborhoods with
higher than average rates of delinquency. Cannabis use in adolescence was
used to predict early adult outcomes (and early adult use to midadult
outcomes). In addition, a set of covariates was added to the models,
including childhood risk factors assessed at age 9 years (ie, family
socioeconomic status; externalizing behaviors; and if available, the
childhood proxy for the outcome [eg, age 9 intelligence scale]) and alcohol
use in adolescence (or early adulthood). physical health outcomes included
accidental injuries, problems resulting from a prior injury, body mass
index, self-report health, and also pain and cardiovascular risk (blood
pressure and pulse rate) in midadulthood. Psychosocial outcomes included
income, housing insecurity, intelligence, depressive symptoms, psychosis
symptoms, hostility/aggression, social problems, and attention problems. Results: Whereas there was almost no prediction from prior cannabis use to the
physical health outcomes, there were comprehensive associations of cannabis
use from the prior developmental period and psychosocial outcomes in both
early adulthood and midadulthood. Conclusion: Cannabis use in prior developmental periods was associated with a broad range
of types of poor psychosocial adjustment in adulthood.
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Affiliation(s)
- Deborah M Capaldi
- Deborah M Capaldi, Oregon Social Learning
Center, 10 Shelton McMurphey Blvd, Eugene, OR 97401, USA.
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8
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Buckner JD, Morris PE, Zvolensky MJ. Social anxiety and risky Marijuana use: The role of underutilization of protective behavioral strategies. Addict Behav 2021; 123:107078. [PMID: 34399251 DOI: 10.1016/j.addbeh.2021.107078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/22/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022]
Abstract
Social anxiety is a common mental health problem that increases the risk of experiencing cannabis-related problems. In fact, social anxiety more than quadruples the risk of developing cannabis use disorder, yet it is inconsistently related to more cannabis use. Inconsistent findings may be due to lack of attention to protective behavioral strategies (PBS) among socially anxious cannabis users. PBS are cognitive-behavioral strategies to reduce cannabis use and related problems. Yet socially anxious persons may be less likely to use PBS for a variety of reasons (e.g., fear of negative evaluation for engaging in behaviors to reduce use), leading to heavier or more frequent use and related problems. The current study examined the mediating role of PBS in the relationships of social anxiety with past-month cannabis use and related problems among current (past-month) cannabis users (N = 102). Social anxiety was significantly positively related to past-month cannabis problems, but not directly related to cannabis use. Social anxiety was significantly negatively related to PBS. Social anxiety was indirectly (via PBS) related to more frequent use, greater peak use, and more cannabis problems. Serial mediation analyses indicated that social anxiety was indirectly related to more cannabis problems via the serial effects of PBS and cannabis use variables. Findings suggest that socially anxious persons may be vulnerable to heavier cannabis use and more cannabis problems due to PBS underutilization. Treatment implications are discussed.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
| | - Paige E Morris
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Heyne Building, #126, Houston, TX 77204, USA; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
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9
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Kvillemo P, Hiltunen L, Demetry Y, Carlander AK, Hansson T, Gripenberg J, Elgán TH, Einhorn K, Skoglund C. How to prevent alcohol and illicit drug use among students in affluent areas: a qualitative study on motivation and attitudes towards prevention. Subst Abuse Treat Prev Policy 2021; 16:83. [PMID: 34743737 PMCID: PMC8573923 DOI: 10.1186/s13011-021-00420-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of alcohol and illicit drugs during adolescence can lead to serious short- and long-term health related consequences. Despite a global trend of decreased substance use, in particular alcohol, among adolescents, evidence suggests excessive use of substances by young people in socioeconomically affluent areas. To prevent substance use-related harm, we need in-depth knowledge about the reasons for substance use in this group and how they perceive various prevention interventions. The aim of the current study was to explore motives for using or abstaining from using substances among students in affluent areas as well as their attitudes to, and suggestions for, substance use prevention. METHODS Twenty high school students (age 15-19 years) in a Swedish affluent municipality were recruited through purposive sampling to take part in semi-structured interviews. Qualitative content analysis of transcribed interviews was performed. RESULTS The most prominent motive for substance use appears to be a desire to feel a part of the social milieu and to have high social status within the peer group. Motives for abstaining included academic ambitions, activities requiring sobriety and parental influence. Students reported universal information-based prevention to be irrelevant and hesitation to use selective prevention interventions due to fear of being reported to authorities. Suggested universal prevention concerned reliable information from credible sources, stricter substance control measures for those providing substances, parental involvement, and social leisure activities without substance use. Suggested selective prevention included guaranteed confidentiality and non-judging encounters when seeking help. CONCLUSIONS Future research on substance use prevention targeting students in affluent areas should take into account the social milieu and with advantage pay attention to students' suggestions on credible prevention information, stricter control measures for substance providers, parental involvement, substance-free leisure, and confidential ways to seek help with a non-judging approach from adults.
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Affiliation(s)
- Pia Kvillemo
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden.
| | - Linda Hiltunen
- Department of Social Studies, Linnaeus university, Växjö, Sweden
| | - Youstina Demetry
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Liljeholmstorget 7, 117 63, Stockholm, Sweden
| | | | - Tim Hansson
- Psychiatry North West, Region Stockholm, Sollentunavägen 84, SE-191 22, Sollentuna, Sweden
| | - Johanna Gripenberg
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden
| | - Tobias H Elgán
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden
| | - Kim Einhorn
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Charlotte Skoglund
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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Wichmann F, Braun M, Ganz T, Lubasch J, Heidenreich T, Laging M, Pischke CR. Assessment of campus community readiness for tailoring implementation of evidence-based online programs to prevent risky substance use among university students in Germany. Transl Behav Med 2021; 10:114-122. [PMID: 31330011 DOI: 10.1093/tbm/ibz060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Research suggests that online interventions preventing risky substance use can improve student health. There is an increasing interest in transferring evidence-based online programs into university health promotion practice. However, little is known about how to best tailor the implementation process to capacities and context of individual universities. The purpose of this study was to assess the level of readiness (capacity) of German universities concerning the implementation of evidence-based online programs for risky substance use prevention employing an adapted Community Readiness Assessment (CRA) and to develop tailored action plans for implementation. The CRA involved 43 semi-structured interviews with key persons at 10 German universities. The interviews addressed five dimensions (knowledge of efforts, leadership, community climate, knowledge of the issue, and resources) at nine possible readiness stages (no awareness-ownership) and additional contextual factors. Overall, readiness for implementing online interventions across universities was rather low. Universities readiness levels ranged between the denial stage with a score of 2.1 and the preplanning stage with a score of 4.4. University-specific readiness was very heterogeneous. On the basis of the results of the CRA, universities received feedback and options for training on how to take the necessary steps to increase readiness and to prepare program implementation. The adapted version of the CRA was well suited to inform future implementation of evidence-based online programs for the prevention of risky substance use at participating universities.
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Affiliation(s)
- Frauke Wichmann
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Department Qualification and Curriculum Research, Institute of Public Health and Nursing Research-IPP, University of Bremen, Bremen, Germany
| | - Michael Braun
- Faculty of Social Work, Health Care and Nursing Sciences, University of Applied Sciences Esslingen, Esslingen, Germany
| | - Thomas Ganz
- Faculty of Social Work, Health Care and Nursing Sciences, University of Applied Sciences Esslingen, Esslingen, Germany
| | - Johanna Lubasch
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Faculty of Medicine and Health Sciences, Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Thomas Heidenreich
- Faculty of Social Work, Health Care and Nursing Sciences, University of Applied Sciences Esslingen, Esslingen, Germany
| | - Marion Laging
- Faculty of Social Work, Health Care and Nursing Sciences, University of Applied Sciences Esslingen, Esslingen, Germany
| | - Claudia R Pischke
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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11
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Hanauer M, Walker MR, Machledt K, Ragatz M, Macy JT. Association between perceived risk of harm and self-reported binge drinking, cigarette smoking, and marijuana smoking in young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:345-352. [PMID: 31765288 DOI: 10.1080/07448481.2019.1676757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 09/18/2019] [Accepted: 09/20/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Evaluate the association between perceived risk of harm and self-reported binge drinking, cigarette smoking, and marijuana smoking among college students. PARTICIPANTS Participants were 599 students (ages 19-28) at a large Midwestern university recruited from October 2015 to December 2017. METHODS Hurdle regression was used to test the relationship between perceived risk of harm from substance use (i.e., binge drinking, cigarette smoking, and marijuana smoking), and self-reported use. Demographic characteristics were tested as moderators of this relationship. RESULTS Engagement in all three substance use behaviors was less likely when perceived risk was high. Age moderated the association between perceived risk and self-reported marijuana smoking with younger participants demonstrating a stronger relationship between perceived risk of smoking marijuana and self-reported marijuana smoking. CONCLUSION Intervention programs will be most effective when perceived risk of substance use is high. Therefore, intervention programs should aim to increase college students' perceived risk of substance use.
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Affiliation(s)
| | | | | | - Melissa Ragatz
- Centerstone's Research Institute, Bloomington, Indiana, USA
| | - Jonathan T Macy
- Indiana University School of Public Health - Bloomington, Bloomington, Indiana, USA
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12
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Feltmann K, Elgán TH, Strandberg AK, Kvillemo P, Jayaram-Lindström N, Grabski M, Waldron J, Freeman T, Curran HV, Gripenberg J. Illicit Drug Use and Associated Problems in the Nightlife Scene: A Potential Setting for Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4789. [PMID: 33946164 PMCID: PMC8125188 DOI: 10.3390/ijerph18094789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Illicit drug use is prevalent in the nightlife scene, especially at electronic dance music (EDM) events. The aim of the present study was to investigate illicit drug use patterns and consequences of drug use among frequent visitors of EDM events. Young adults (18-34 years old) who had visited at least six EDM events in Sweden during the past year participated in a web-based survey on drug use patterns and its consequences. Fifty-nine percent of participants had used illicit drugs during the past year, most often cannabis followed by ecstasy, cocaine, and amphetamine. Nightlife venues were identified as the main setting for the use of central stimulants, while cannabis was mostly used at home. Frequent alcohol and tobacco use was associated with illicit drug use. The most prevalent negative consequences of drug use were related to mental health, such as impairments in mood, sleep, and memory problems, but physical manifestations were also reported, such as palpitations and collapsing. These findings confirm that drug use is prevalent and associated with negative health effects among EDM nightlife attendees. The nightlife scene is a setting with promising potential to reach a high-risk target group with illicit drug use prevention interventions.
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Affiliation(s)
- Kristin Feltmann
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Tobias H. Elgán
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Anna K. Strandberg
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Pia Kvillemo
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Nitya Jayaram-Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Tom Freeman
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - Helen Valerie Curran
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Johanna Gripenberg
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
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13
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Burdzovic Andreas J, Sivertsen B, Lønning KJ, Skogen JC. Cannabis use among Norwegian university students: Gender differences, legalization support and use intentions, risk perceptions, and use disorder. Addict Behav Rep 2021; 13:100339. [PMID: 33604449 PMCID: PMC7873627 DOI: 10.1016/j.abrep.2021.100339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/16/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022] Open
Abstract
Past year cannabis use was fairly common in a sample of Norwegian college students. About 6% of users possibly met criteria for use disorder, function of use frequency. Legalization attitudes and risk perceptions were associated with cannabis use risk. Intentions to use cannabis if legal were evident even among some current non-users. Many non-users expressed uncertainty in legalization attitudes and risk perceptions.
Aims We explored past-year cannabis use and associated characteristics, focusing on legalization attitudes, use intentions, risk perceptions, and possible dependence among Norwegian university/college students. Methods We examined a nation-wide sample of Norwegian university/college students (N = 49,688; 67% female) who participated in the Students’ Health and Wellbeing Study (SHoT-study) in 2018. Participants reported past-year substance use, support for cannabis legalization, intent to use cannabis if legal, and perceived risks of weekly use. Past-year cannabis use (including use frequency) was examined in relation to these indicators. Legalization support, use intentions, and risk perceptions were examined in relation to use and gender. Potential cannabis use disorder was assessed with the Cannabis Abuse Screening Test (CAST) and examined in relation to use frequency and gender. Findings Past-year use was reported by 15.3% (11.8% women; 22.9% men). Majority of current users (roughly 90%) used no more than 50 times past year, and 6% (3.8% women; 8.5% men) met CAST use disorder criteria. Legalization support, use intentions, and no/low risk perceptions were significantly associated with greater odds of use, and greater use frequency among current users in both crude and adjusted models. Legalization support (23.0%), use intentions (14.0%), and perceptions of no/low risk (29.2%) were also relatively common even among current non-users, especially men. Male gender and more frequent use were associated with greater CAST scores and greater odds of use disorder. Conclusions Cannabis use was relatively common in this student sample. In addition to targeting frequent use, interventions may focus on cannabis-related attitudes and risk perceptions among uncertain/uninformed students.
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Affiliation(s)
- Jasmina Burdzovic Andreas
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Jussie Lønning
- The Norwegian Medical Association, Oslo, Norway.,The Student Welfare Association of Oslo and Akershus (SiO), Oslo, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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14
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Barker AK, Moreno MA. Effects of Recreational Marijuana Legalization on College Students: A Longitudinal Study of Attitudes, Intentions, and Use Behaviors. J Adolesc Health 2021; 68:110-115. [PMID: 32402801 PMCID: PMC7648724 DOI: 10.1016/j.jadohealth.2020.03.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE As legal recreational marijuana use expands rapidly across the U.S., there is growing concern that this will lead to higher rates of use among college-aged young adults. Given the limited research addressing this issue, a longitudinal study was conducted to evaluate the effects of legalizing recreational use on the attitudes, intentions, and marijuana use behaviors of college students in two different legalization contexts, Washington State and Wisconsin. METHODS Survey data assessing marijuana attitudes, intentions, and use behavior were collected from 2011 to 2016 on a longitudinal cohort of 338 students at two large public universities in Washington and Wisconsin. Time series analyses were conducted to evaluate postlegalization changes in ever use, 28-day use, and mean attitude and intention-to-use scores in Washington state, using Wisconsin participants as the control group. RESULTS Ever use, attitude, and intention-to-use scores did not change significantly more in Washington after legalization than in Wisconsin. However, among prior users, the proportion using in the last 28 days rose faster in Washington after legalization that it did in Wisconsin (p < .001). CONCLUSIONS The findings suggest that legalization had the greatest effects on current marijuana users, who are surrounded by a climate that is increasingly supportive of its use.
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Affiliation(s)
- Anna K Barker
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Megan A Moreno
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin.
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15
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Drazdowski TK, Kliewer WL, Marzell M. College students' using marijuana to sleep relates to frequency, problematic use, and sleep problems. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:103-112. [PMID: 31498749 PMCID: PMC7061072 DOI: 10.1080/07448481.2019.1656634] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/01/2019] [Accepted: 08/11/2019] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Given the rising rates of insufficient sleep and the popularity of marijuana, we investigated using marijuana as a sleep aid, marijuana use frequency, problematic marijuana use, and sleep problems. Participants: Participants included a convenience sample of college students who endorsed using marijuana in the past year from May to December 2013 (N = 354; 68% female, 57% White). Methods: Path analyses investigated if using marijuana to sleep predicted: (1) marijuana use outcomes and (2) sleep problems; and if sleep problems predicted marijuana use outcomes. Results: Using marijuana to sleep was related to increased use and problematic use, as well as worse sleep efficiency. Daytime dysfunction related to sleepiness was associated with elevated levels of marijuana use and problematic use. Similar associations were found across sex and race. Conclusions: College students should be informed of the potential misconceptions between marijuana and improved sleep and provided with evidence-based alternatives to improve their sleep.
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Affiliation(s)
- Tess K. Drazdowski
- UCLA Integrated Substance Abuse Programs, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA 90025
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401
| | - Wendy L. Kliewer
- Virginia Commonwealth University, Department of Psychology, PO Box 842018, Richmond VA 23284
| | - Miesha Marzell
- Binghamton University, Department of Social Work, PO Box 6000, Binghamton, NY 13902-6000
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16
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Abarno CN, Glover NI, Morris PE, Zvolensky MJ, Buckner JD. Functional Impairment in Response to the COVID-19 Pandemic among Cannabis Users. Subst Use Misuse 2021; 56:2221-2228. [PMID: 34608833 DOI: 10.1080/10826084.2021.1981389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic has contributed to over 2 million deaths and hospitalization of many individuals worldwide. Although preliminary evidence suggests that cannabis use has increased during the pandemic, there has been little research on the impact of cannabis use on COVID-related psychological outcomes. Cannabis use among college students is associated with problematic psychosocial outcomes; thus, it follows that cannabis users during the pandemic may experience more functional impairment problems with daily living as a result of increased psychological distress from the pandemic and difficulty with regulating that distress. METHODS The current study tested whether cannabis use status was related to functional impairment in daily activities and whether this was due to difficulty with emotion regulation and COVID-related distress. The sample comprised of 727 (184 current cannabis users) young adults in Louisiana, a state that had some of the highest rates of COVID-19 deaths and infections in the U.S. RESULTS Cannabis use was related to greater functional impairment in daily activities and this relation was mediated by the sequential effects of difficulty with emotion regulation and COVID-related distress. CONCLUSIONS Results indicated that cannabis users during the COVID-19 pandemic are experiencing problematic psychosocial outcomes further highlighting the need for the development of interventions to help target COVID-related distress and improve psychosocial functioning during the pandemic.
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Affiliation(s)
- Cristina N Abarno
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Nina I Glover
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Paige E Morris
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
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17
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Patterson A, Vu M, Haardörfer R, Windle M, Berg CJ. Motives for Alcohol and Marijuana Use as Predictors of Use and Problem Use Among Young Adult College Students. JOURNAL OF DRUG ISSUES 2020; 50:359-377. [PMID: 34290453 PMCID: PMC8291292 DOI: 10.1177/0022042620917101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined (a) differences between alcohol-only users and alcohol-marijuana co-users and (b) motives for use in relation to alcohol and marijuana use and problem use. Spring 2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use measured 4 months later. Correlates of co-use (n = 345; vs. alcohol-only use, n = 1,525) included greater alcohol and marijuana use frequency, problem drinking and marijuana use, and alcohol use motives (p's < .05). Controlling for covariates, alcohol use frequency correlated with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives, but lower Conformity alcohol use motives (p's < .001); greater Coping and Self-enhancement alcohol use motives (p's < .01) predicted problem alcohol use. Marijuana use frequency correlated with greater Coping and Expansion marijuana use motives (p's < .05); greater Expansion marijuana use motives (p = .005) predicted problem marijuana use. College-based substance use interventions should target Coping and Self-enhancement alcohol use motives and Expansion marijuana use motives.
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18
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Cooper BR, Hill LG, Haggerty KP, Skinner M, Bumpus MF, Borah P, Casey-Goldstein M, Catalano R. Investigating the efficacy of a self-directed parenting intervention to reduce risky behaviors among college students: Study protocol for a multi-arm hybrid type 2 randomized control trial. Contemp Clin Trials Commun 2020; 19:100627. [PMID: 32728650 PMCID: PMC7381512 DOI: 10.1016/j.conctc.2020.100627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Early adulthood is a critical developmental period when many youth transition from living at home to the relative autonomy of college. This transition results in increased opportunity for positive growth and identity development - and for risky substance use and sexual behaviors. Parents continue to influence young adult behavior even from a distance; however, few studies have rigorously tested parent-college student interventions. METHODS This multi-arm hybrid type 2 trial tests the short- and long-term efficacy of a self-directed handbook for parents of first-year college students. In the summer before college, parent-student dyads are randomly assigned to one of three conditions: control, Parent Handbook, or Parent Handbook Plus. Handbook parents receive encouragement via phone calls to read the handbook and complete activities with their student before leaving for college. Handbook Plus parents also receive booster messages targeted at risky or stressful times. Participants complete surveys of intervention-targeted knowledge, attitudes, and behaviors at baseline and four months after baseline. Students complete three additional surveys at nine, 16, and 21 months after baseline. Dyads in the intervention conditions also reported on handbook utilization, perceived usefulness, and engagement with intervention materials. DISCUSSION Self-directed family interventions may be a feasible strategy for involving parents of college students. This trial aimed to determine: 1) the efficacy of a self-directed handbook intervention for parents of first-year college students, including whether the addition of periodic booster messages enhanced efficacy; and 2) how variations in handbook utilization, perceived usefulness, and engagement were linked to student outcomes.
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Affiliation(s)
| | - Laura G. Hill
- Washington State University, Department of Human Development, United States
| | - Kevin P. Haggerty
- University of Washington, School of Social Work, Social Development Research Group, United States
| | - Martie Skinner
- University of Washington, School of Social Work, Social Development Research Group, United States
| | - Matthew F. Bumpus
- Washington State University, Department of Human Development, United States
| | - Porismita Borah
- Washington State University, College of Communication, United States
| | - Mary Casey-Goldstein
- University of Washington, School of Social Work, Social Development Research Group, United States
| | - Richard Catalano
- University of Washington, School of Social Work, Social Development Research Group, United States
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19
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Prevalence and Socio-Demographic, Academic, Health and Lifestyle Predictors of Illicit Drug/s Use among University Undergraduate Students in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145094. [PMID: 32679701 PMCID: PMC7400316 DOI: 10.3390/ijerph17145094] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022]
Abstract
Illicit drug/s use (IDU) among university students is a public health concern. We assessed the associations between socio-demographic, academic, and health and lifestyle characteristics (independent variables) and regular, occasional or never IDU (dependent variables). Data were collected across seven faculties (1177 students) at the University of Turku (Finland) via an online questionnaire. About 1.5% of the sample had regular IDU, 19% occasional IDU, and 79% never IDU. Independent predictors of ever (lifetime) IDU included males [adjusted odds ratio (AOR) 1.82, P = 0.001], not living with parents (AOR 2.59, P < 0.001), singles (AOR 0.51, P < 0.001), lower religiosity (AOR 1.49, P = 0.022), better self-rated general health (AOR 0.41, P = 0.003), higher health awareness (AOR 1.93, P = 0.014), more depressive symptoms (AOR 1.82, P = 0.004), daily smokers (AOR 3.69, P < 0.001), heavy episodic drinking (AOR 2.38, P < 0.001) and possible alcohol dependency (AOR 2.55, P < 0.001). We observed no independent associations between ever IDU with age, study discipline, perceived stress or academic performance. The 20.5% ever IDU is concerning. The compelling independent predictors of ever IDU included not living with parents, lower religiosity, daily smokers, heavy episodic drinking and possible alcohol dependency (AOR range 2.38-3.69). Education and prevention need to emphasize the negative consequences to reinforce abstinence from IDU. Health promotion could focus on beliefs and expectations about IDU and target students at risk for successful efforts.
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20
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Kvillemo P, Strandberg AK, Gripenberg J, Berman AH, Skoglund C, Elgán TH. Effects of an automated digital brief prevention intervention targeting adolescents and young adults with risky alcohol and other substance use: study protocol for a randomised controlled trial. BMJ Open 2020; 10:e034894. [PMID: 32404390 PMCID: PMC7228518 DOI: 10.1136/bmjopen-2019-034894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Adolescence and young adulthood is a period in life when individuals may be especially vulnerable to harmful substance use. Several critical developmental processes are occurring in the brain, and substance use poses both short-term and long-term risks with regard to mental health and social development. From a public health perspective, it is important to prevent or delay substance use to reduce individual risk and societal costs. Given the scarcity of effective interventions targeting substance use among adolescents and young adults, cost-effective and easily disseminated interventions are warranted. The current study will test the effectiveness of a fully automated digital brief intervention aimed at reducing alcohol and other substance use in adolescents and young adults aged 15 to 25 years. METHODS AND ANALYSIS A two-arm, double-blind, randomised controlled trial design is applied to assess the effectiveness of the intervention. Baseline assessment, as well as 3-month and 6-month follow-up, will be carried out. The aim is to include 800 participants with risky substance use based on the screening tool CRAFFT (Car,Relax, Alone, Forget, Friends, Trouble). Recruitment, informed consent, randomisation, intervention and follow-up will be implemented online. The primary outcome is reduction in alcohol use, measured by Alcohol Use Disorders Identification Test total score. Secondary outcomes concern binge drinking, frequency of alcohol consumption, amount of alcohol consumed a typical day when alcohol is consumed, average daily drinks per typical week, other substance use, mental health, sexual risk behaviours and perceived peer pressure. Moreover, the study involves analyses of potential moderators including perfectionism, openness to parents, help-seeking and background variables. ETHICS AND DISSEMINATION The study was approved by the Swedish Ethical Review Authority (no. 2019-03249). The trial is expected to expand the knowledge on digital preventive interventions for substance using adolescents and young adults. Results will be disseminated in research journals, at conferences and via the media. TRIAL REGISTRATION NUMBER 24 September 2019, ISRCTN91048246; Pre-results.
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Affiliation(s)
- Pia Kvillemo
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anna K Strandberg
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Johanna Gripenberg
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anne H Berman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Charlotte Skoglund
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Tobias H Elgán
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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21
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De Soto W, Tajalli H. Gendered Patterns of Drug Use on a University Campus in the United States. WORLD MEDICAL & HEALTH POLICY 2020. [DOI: 10.1002/wmh3.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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22
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23
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Epstein M, Bailey JA, Furlong M, Steeger CM, Hill KG. An intergenerational investigation of the associations between parental marijuana use trajectories and child functioning. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:830-838. [PMID: 31497987 DOI: 10.1037/adb0000510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Diverse patterns of life-course marijuana use may have differential health impacts for the children of users. Data are drawn from an intergenerational study of 426 families that included a parent, their oldest biological child, and (where appropriate) another caregiver who were interviewed 10 times from 2002 to 2018; the current study used data from 380 families in waves 6-10. Analyses linked parent marijuana use trajectories estimated in a previous publication (Epstein et al., 2015) to child marijuana, alcohol, and nicotine use; promarijuana norms; internalizing; externalizing; attention problems; and grades using multilevel modeling among children ages 6 to 21. Four trajectories had been found in the previous study: nonuser, chronic, adolescent-limited, and late-onset. Results indicate that children of parents in the groups that initiated marijuana use in adolescence (chronic and adolescent-limited) were most likely to use substances. Children of parents in the late-onset group, where parents initiated use in young adulthood, were not at increased risk for substance use but were more likely to have attention problems and lower grades. Results held when parent current marijuana use was added to the models. Implications of this work highlight the importance of considering both current use and use history in intergenerational transmission of marijuana use, and the need to address parent use history in family based prevention. Prevention of adolescent marijuana use remains a priority. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marina Epstein
- Social Development Research Group, School of Social Work, University of Washington
| | - Jennifer A Bailey
- Social Development Research Group, School of Social Work, University of Washington
| | - Madeline Furlong
- Social Development Research Group, School of Social Work, University of Washington
| | | | - Karl G Hill
- Institute for Behavioral Research, University of Colorado Boulder
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24
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Demontis D, Rajagopal VM, Thorgeirsson TE, Als TD, Grove J, Leppälä K, Gudbjartsson DF, Pallesen J, Hjorthøj C, Reginsson GW, Tyrfingsson T, Runarsdottir V, Qvist P, Christensen JH, Bybjerg-Grauholm J, Bækvad-Hansen M, Huckins LM, Stahl EA, Timmermann A, Agerbo E, Hougaard DM, Werge T, Mors O, Mortensen PB, Nordentoft M, Daly MJ, Stefansson H, Stefansson K, Nyegaard M, Børglum AD. Genome-wide association study implicates CHRNA2 in cannabis use disorder. Nat Neurosci 2019; 22:1066-1074. [PMID: 31209380 DOI: 10.1038/s41593-019-0416-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/25/2019] [Indexed: 12/22/2022]
Abstract
Cannabis is the most frequently used illicit psychoactive substance worldwide; around one in ten users become dependent. The risk for cannabis use disorder (CUD) has a strong genetic component, with twin heritability estimates ranging from 51 to 70%. Here we performed a genome-wide association study of CUD in 2,387 cases and 48,985 controls, followed by replication in 5,501 cases and 301,041 controls. We report a genome-wide significant risk locus for CUD (P = 9.31 × 10-12) that replicates in an independent population (Preplication = 3.27 × 10-3, Pmeta-analysis = 9.09 × 10-12). The index variant (rs56372821) is a strong expression quantitative trait locus for cholinergic receptor nicotinic α2 subunit (CHRNA2); analyses of the genetically regulated gene expression identified a significant association of CHRNA2 expression with CUD in brain tissue. At the polygenic level, analyses revealed a significant decrease in the risk of CUD with increased load of variants associated with cognitive performance. The results provide biological insights and inform on the genetic architecture of CUD.
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Affiliation(s)
- Ditte Demontis
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark. .,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark. .,Center for Genomics and Personalized Medicine, Aarhus, Denmark.
| | - Veera Manikandan Rajagopal
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | | | - Thomas D Als
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Jakob Grove
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Genomics and Personalized Medicine, Aarhus, Denmark.,Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Kalle Leppälä
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | | | - Jonatan Pallesen
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Carsten Hjorthøj
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Copenhagen University Hospital, Mental Health Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, Hellerup, Denmark
| | | | | | | | - Per Qvist
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Jane Hvarregaard Christensen
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Marie Bækvad-Hansen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Laura M Huckins
- Division of Psychiatric Genomic, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eli A Stahl
- Division of Psychiatric Genomic, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allan Timmermann
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Institute of Biological Psychiatry, MHC Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Copenhagen University Hospital, Mental Health Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, Hellerup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mark J Daly
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | | | - Mette Nyegaard
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Anders D Børglum
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark. .,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark. .,Center for Genomics and Personalized Medicine, Aarhus, Denmark.
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Goodhines PA, Gellis LA, Ansell EB, Park A. Cannabis and alcohol use for sleep aid: A daily diary investigation. Health Psychol 2019; 38:1036-1047. [PMID: 31169378 DOI: 10.1037/hea0000765] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE One in 5 college students use substances such as cannabis and/or alcohol to help sleep. Despite this high prevalence of sleep aid use, there remains a lack of research on the potential day-to-day sleep- and substance-related consequences. The current study examined associations of cannabis and alcohol sleep aid use with subsequent sleep and substance use consequences among college students. METHOD Of a baseline sample of 217 college students endorsing past-month cannabis and/or alcohol use (1% cannabis only, 42% alcohol only, 58% both), 83 students endorsing past-month cannabis and/or alcohol use for sleep aid (Mage = 19.33 [SD = 1.11], 30% male, 72% White) completed online questionnaires for 14 consecutive days to report daily sleep, substance use, and negative substance consequences. RESULTS Multilevel models demonstrated that nights of cannabis sleep aid use predicted longer same-night sleep duration, shorter same-night wake time after sleep onset, and greater next-day daytime fatigue within person, after controlling for daily cannabis frequency. Alcohol sleep aid use was not associated with sleep-related outcomes or negative drinking consequences after controlling for daily alcohol quantity; these null results may be due to a low frequency of alcohol sleep aid use (1% of observations) over 14 days of assessment. CONCLUSIONS Results highlight daytime fatigue as a potential adverse short-term outcome of cannabis sleep aid use, despite its proximal sleep-related benefits. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Lac A, Luk JW. Testing the Amotivational Syndrome: Marijuana Use Longitudinally Predicts Lower Self-Efficacy Even After Controlling for Demographics, Personality, and Alcohol and Cigarette Use. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019. [PMID: 28620722 DOI: 10.1007/s11121-017-0811-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The marijuana amotivational syndrome posits that cannabis use fosters apathy through the depletion of motivation-based constructs such as self-efficacy. The current study pursued a two-round design to rule out concomitant risk factors responsible for the connection from marijuana intake to lower general self-efficacy. College students (N = 505) completed measures of marijuana use, demographics (age, gender, and race), personality (extraversion, agreeableness, conscientiousness, openness, and neuroticism), other substance use (alcohol and tobacco), and general self-efficacy (initiative, effort, and persistence) in two assessments separated by a month. Hierarchical regression models found that marijuana use forecasted lower initiative and persistence, even after statistically ruling out 13 pertinent baseline covariates including demographics, personality traits, alcohol use, tobacco use, and self-efficacy subscales. A cross-lagged panel model involving initiative, effort, persistence, alcohol use, cigarette use, and marijuana use sought to unravel the temporal precedence of processes. Results showed that only marijuana (but not alcohol or tobacco) intake significantly and longitudinally prompted lower initiative and persistence. Furthermore, in the same model, the opposite temporal direction of events from lower general self-efficacy subscales to marijuana use was untenable. Findings provide partial support for the marijuana amotivational syndrome, underscore marijuana as a risk factor for decreased general self-efficacy, and offer implications and insights for marijuana prevention and future research.
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Affiliation(s)
- Andrew Lac
- Department of Psychology, University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO, 80918, USA.
| | - Jeremy W Luk
- Health Behavior Branch Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive MSC 7004, Bethesda, MD, 20817, USA
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Longitudinal Associations Between Life Satisfaction and Cannabis Use Initiation, Cessation, and Disorder Symptom Severity in a Cohort of Young Swiss Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081372. [PMID: 30995797 PMCID: PMC6518131 DOI: 10.3390/ijerph16081372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/11/2019] [Accepted: 04/13/2019] [Indexed: 01/07/2023]
Abstract
Motivations for cannabis use may include coping with negative well-being. Life satisfaction, a hallmark of subjective well-being, could play a role in cannabis use among young adults. This study aims to assess whether life satisfaction (SWLS) at age 21 is associated with cannabis initiation and cessation between the ages of 21 and 25, and with cannabis use severity (CUDIT) at age 25. Data were drawn from a cohort of young Swiss males. Associations of life satisfaction with initiation, cessation, and severity were assessed with logistic and zero-truncated negative binomial regressions. Age, family income, education, alcohol, and tobacco use at age 21 were used as adjustment variables. From a sample of 4778 males, 1477 (30.9%) reported cannabis use at age 21, 456 (9.5%) initiated use between age 21 and 25, and 515 (10.8%) ceased by age 25. Mean (SD) SWLS was significantly higher among non-users at age 21: 27.22 (5.35) vs. 26.28 (5.80), p < 0.001. Negative associations between life satisfaction at age 21 and cannabis use initiation (OR = 0.98, p = 0.029) and severity at age 25 (IRR = 0.97, p < 0.001) were no more significant in adjusted analyses (OR = 0.98, p = 0.059 and IRR = 0.99, p = 0.090). Life satisfaction at age 21 was not associated with cannabis cessation (OR = 0.99, p = 0.296). Results suggest that the predictive value of life satisfaction in cannabis use is questionable and may be accounted for by other behaviors, such as tobacco and alcohol use.
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28
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Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J, Ware M, Marmorstein N, Cipriani A, Dendukuri N, Mayo N. Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis. JAMA Psychiatry 2019; 76:426-434. [PMID: 30758486 PMCID: PMC6450286 DOI: 10.1001/jamapsychiatry.2018.4500] [Citation(s) in RCA: 419] [Impact Index Per Article: 83.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/26/2018] [Indexed: 11/14/2022]
Abstract
Importance Cannabis is the most commonly used drug of abuse by adolescents in the world. While the impact of adolescent cannabis use on the development of psychosis has been investigated in depth, little is known about the impact of cannabis use on mood and suicidality in young adulthood. Objective To provide a summary estimate of the extent to which cannabis use during adolescence is associated with the risk of developing subsequent major depression, anxiety, and suicidal behavior. Data Sources Medline, Embase, CINAHL, PsycInfo, and Proquest Dissertations and Theses were searched from inception to January 2017. Study Selection Longitudinal and prospective studies, assessing cannabis use in adolescents younger than 18 years (at least 1 assessment point) and then ascertaining development of depression in young adulthood (age 18 to 32 years) were selected, and odds ratios (OR) adjusted for the presence of baseline depression and/or anxiety and/or suicidality were extracted. Data Extraction and Synthesis Study quality was assessed using the Research Triangle Institute item bank on risk of bias and precision of observational studies. Two reviewers conducted all review stages independently. Selected data were pooled using random-effects meta-analysis. Main Outcomes and Measures The studies assessing cannabis use and depression at different points from adolescence to young adulthood and reporting the corresponding OR were included. In the studies selected, depression was diagnosed according to the third or fourth editions of Diagnostic and Statistical Manual of Mental Disorders or by using scales with predetermined cutoff points. Results After screening 3142 articles, 269 articles were selected for full-text review, 35 were selected for further review, and 11 studies comprising 23 317 individuals were included in the quantitative analysis. The OR of developing depression for cannabis users in young adulthood compared with nonusers was 1.37 (95% CI, 1.16-1.62; I2 = 0%). The pooled OR for anxiety was not statistically significant: 1.18 (95% CI, 0.84-1.67; I2 = 42%). The pooled OR for suicidal ideation was 1.50 (95% CI, 1.11-2.03; I2 = 0%), and for suicidal attempt was 3.46 (95% CI, 1.53-7.84, I2 = 61.3%). Conclusions and Relevance Although individual-level risk remains moderate to low and results from this study should be confirmed in future adequately powered prospective studies, the high prevalence of adolescents consuming cannabis generates a large number of young people who could develop depression and suicidality attributable to cannabis. This is an important public health problem and concern, which should be properly addressed by health care policy.
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Affiliation(s)
- Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Tobias Atkin
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Tomasz Zytynski
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Shouao Wang
- Division of Clinical Epidemiology, McGill University Health Centre-Research Institute, Montreal, Quebec, Canada
| | - Sorayya Askari
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre-Research Institute, Montreal, Quebec, Canada
| | - Jill Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada
| | - Mark Ware
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Nandini Dendukuri
- Division of Clinical Epidemiology, McGill University Health Centre-Research Institute, Montreal, Quebec, Canada
| | - Nancy Mayo
- Division of Clinical Epidemiology, McGill University Health Centre-Research Institute, Montreal, Quebec, Canada
- Center for Outcomes Research and Evaluation, Department of Medicine, School of Physical and Occupational Therapy, McGill University Health Center Research Institute, McGill University, Montreal, Quebec, Canada
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Welsh JW, Shentu Y, Sarvey DB. Substance Use Among College Students. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2019; 17:117-127. [PMID: 31975967 PMCID: PMC6527004 DOI: 10.1176/appi.focus.20180037] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
U.S. college campuses have witnessed a national increase of cannabis, stimulant, and illicit drug use among students over the past decade. Substance use among college students is associated with numerous negative outcomes including lower academic performance, a higher probability of unemployment after graduation, and an increased risk of committing and experiencing sexual assault. Several risk factors for substance use are specific to this population, including an affiliation with Greek life, perception of high academic pressure, and peer pressure. Students with problematic substance use also face unique challenges in planning treatment, including aspects of confidentiality, financial constraints, and potential university oversight and involvement. This article highlights the prevalence of substance use on college campuses and describes some of the specific challenges and approaches to treatment in this population, including screening tests and interventions for specific substances used on college campuses and evidence-based substance use programming for college students.
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Affiliation(s)
- Justine W Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh, Shentu); Adolescent Acute Residential Treatment, McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Sarvey)
| | - Yujia Shentu
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh, Shentu); Adolescent Acute Residential Treatment, McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Sarvey)
| | - Dana B Sarvey
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh, Shentu); Adolescent Acute Residential Treatment, McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Sarvey)
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Stewart KL, Farris SG, Jackson KM, Borsari B, Metrik J. Cannabis Use and Anxiety Sensitivity in Relation to Physical Health and Functioning in post-9/11 Veterans. COGNITIVE THERAPY AND RESEARCH 2019; 43:45-54. [PMID: 33583981 DOI: 10.1007/s10608-018-9950-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Frequency of cannabis use and cognitive vulnerabilities such as anxiety sensitivity (i.e., the fear of bodily sensations), have been independently linked with poor physical health, however the interplay between these health-mental health processes may compound poor physical health and functioning in cannabis users. Thus, the current study evaluated the direct and interactive effects of cannabis use frequency and anxiety sensitivity on physical health and functioning among cannabis-using veterans. Participants (N = 138) were post-9/11 United States veterans recruited from a Veterans Affairs hospital who reported cannabis use in the past six months. Cannabis use frequency in the past month and anxiety sensitivity were significantly negatively correlated with perceived overall physical health. There was a significant interaction between cannabis use frequency and anxiety sensitivity, such that more frequent cannabis use was associated with poorer overall health and role functioning due to health problems among veterans with higher anxiety sensitivity (but not lower). Findings suggest that anxiety sensitivity is a cognitive vulnerability linked to poor perceived physical health and impairment among frequent cannabis users and could be targeted, along with cannabis use, for health-promotion in cannabis users.
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Affiliation(s)
- Kate L Stewart
- Providence VA Medical Center, Providence, RI, 02908, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI
| | - Samantha G Farris
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI.,The Miriam Hospital, Centers for Behavioral and Preventative Medicine, Providence, RI 02903 USA.,Rutgers, the State University of New Jersey, Piscataway, NJ 08854 USA
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Brian Borsari
- San Francisco VA Health Care System, San Francisco, CA, 94121, USA.,Department of Psychiatry, University of California - San Francisco, San Francisco, CA, 94103, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA.,Providence VA Medical Center, Providence, RI, 02908, USA.,Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI 02912, USA
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31
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Butler A, Patte KA, Ferro MA, Leatherdale ST. Interrelationships among depression, anxiety, flourishing, and cannabis use in youth. Addict Behav 2019; 89:206-215. [PMID: 30321693 DOI: 10.1016/j.addbeh.2018.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/05/2018] [Accepted: 10/06/2018] [Indexed: 11/29/2022]
Abstract
AIMS The objective of the study was to examine if depression or anxiety was associated with youth cannabis use; and investigate whether flourishing, an indicator of overall wellbeing, moderates these associations. METHODS Students (N=6550) were recruited from 10 secondary schools (grade 9-12) in Ontario and British Columbia, Canada. Self-report questionnaires were used to assess symptoms of depression [CESD-R-10], anxiety [GAD-7], flourishing [Deiner's Flourishing Scale], and cannabis use. Logistic regression and product-term interactions were used to examine the associations between mental health and youth cannabis use, and the potential moderating effect(s) of flourishing. RESULTS In our sample, 32% of participants had ever used cannabis, and 42% and 32% reported elevated depressive and anxiety symptoms, respectively. Associations between depression, anxiety, and cannabis use were no longer significant when flourishing was added to the models. In addition, there was no evidence suggesting a moderating effect of flourishing (all interactions were not statistically significant). Instead, robust associations were found between flourishing and cannabis use (ever use and frequency). CONCLUSIONS Indicators of mental wellbeing, such as flourishing, appear to be associated with a lower likelihood of cannabis use, even after controlling for depression and anxiety. Results suggest prevention strategies for youth cannabis use should aim to foster mental wellbeing among all youth, rather than exclusively targeting those experiencing mental health problems. Future longitudinal studies should test the sequential relationship between cannabis use and changes in both positive and negative mental health.
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Affiliation(s)
| | - Karen A Patte
- University of Waterloo, Waterloo, Ontario, Canada; Brock University, St. Catharines, Ontario, Canada
| | - Mark A Ferro
- University of Waterloo, Waterloo, Ontario, Canada
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Allen HK, Lilly F, Beck KH, Vincent KB, Arria AM. Graduate degree completion: Associations with alcohol and marijuana use before and after enrollment. Addict Behav Rep 2018; 9:100156. [PMID: 30627627 PMCID: PMC6322074 DOI: 10.1016/j.abrep.2018.100156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 11/03/2022] Open
Abstract
Research has shown that alcohol and marijuana use are associated with academic performance difficulties, but the relationship to completion of a graduate degree has not been explored. Undergraduate students (n = 1253) were assessed during their first year of college and annually thereafter until age 29. Among the subset of the original sample who enrolled in graduate school (n = 520), measures of alcohol and marijuana use were averaged separately for the time periods before and after graduate school enrollment. Logistic regression models were developed to examine the associations between these variables and graduate degree completion, adjusting for other factors. In general, a minority of the sample were excessive drinkers or frequent marijuana users. The majority of drinkers (70%) drank an average of twice a week or less each year, and 62% of marijuana users used marijuana once a month or less each year. After adjusting for demographic and program characteristics, marijuana use frequency after graduate school enrollment was negatively associated with odds of graduate degree completion. Alcohol use frequency before graduate school enrollment was positively associated with odds of graduate degree completion. Results add to the growing body of literature on marijuana use and decreased academic achievement, but results should be interpreted with caution given the small, but significant, effect sizes found. The positive association between alcohol use frequency and degree completion might be attributed to engagement in the academic environment. Future studies should examine the potential mechanisms through which alcohol and marijuana use are related to the academic achievement of graduate students.
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Affiliation(s)
- Hannah K Allen
- Center on Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland School of Public Health, 1242 School of Public Health Building, College Park, MD 20742, USA
| | - Flavius Lilly
- University of Maryland Baltimore Graduate School, 620 W. Lexington St, Baltimore, MD 21201, USA
| | - Kenneth H Beck
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 1234 School of Public Health Building, College Park, MD 20742, USA
| | - Kathryn B Vincent
- Center on Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland School of Public Health, 1242 School of Public Health Building, College Park, MD 20742, USA
| | - Amelia M Arria
- Center on Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland School of Public Health, 1242 School of Public Health Building, College Park, MD 20742, USA
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Ames ME, Leadbeater BJ, Merrin GJ, Thompson K. Patterns of marijuana use and physical health indicators among Canadian youth. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2018; 55:1-12. [PMID: 30511434 PMCID: PMC7003924 DOI: 10.1002/ijop.12549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/28/2018] [Indexed: 12/12/2022]
Abstract
We examine how trajectories of marijuana use in Canadian youth (ages 15 to 28) are related to physical health indicators in adolescence and young adulthood. Youth were initially recruited in 2003 (N = 662; 48% male; ages 12 to 18) and followed for six waves. Five trajectories of marijuana use (Abstainers-29%, Occasional users-27%, Decreasers-14%, Increasers-20% and Chronic users-11%) were identified. Chronic users reported more physical symptoms, poorer physical self-concept, less physical activity, poorer eating practices, less sleep, and higher number of sexual partners during adolescence than other classes. Decreasers also reported poorer physical self-concept and poorer eating practices than abstainers. Other trajectory classes showed few significant health problems. Chronic users also reported more acute health problems (i.e. serious injuries, early sexual debut, higher number of sexual partners, greater likelihood of having a STI) in young adulthood than all other classes contributing to costs of healthcare. Youth who engage in early, frequent and continued use of marijuana from adolescence to young adulthood are at-risk of physical health problems in adolescence and young adulthood.
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Affiliation(s)
| | | | | | - Kara Thompson
- St. Francis Xavier University, Antigonish, NS, Canada
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34
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Marijuana eCHECKUPTO GO: Effects of a personalized feedback plus protective behavioral strategies intervention for heavy marijuana-using college students. Drug Alcohol Depend 2018; 190:13-19. [PMID: 29960918 DOI: 10.1016/j.drugalcdep.2018.05.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 04/25/2018] [Accepted: 05/21/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Marijuana use is common among U.S. college students. Liberalization of marijuana use policies is hypothesized to decrease social norms discouraging use, which protects against marijuana use. This may increase the importance of protective behavioral strategies (PBS) to reduce marijuana use harm. METHODS This study tested direct and moderated (by sex) program effects of an adapted version of the Marijuana eCHECKUPTO GO, a web-based marijuana use intervention providing university-specific personalized feedback (PF) with normative information and PBS to students attending a university in a state with legalized adult recreational marijuana. Participants were 298 heavy-using college students randomly assigned to receive Marijuana eCHECKUPTO GO or strategies for healthy stress management (HSM). General linear models (GLMs) tested direct program effects on proximal intervention targets, marijuana use, and use consequences. Multi-group GLMs then tested the moderating effect of sex on direct intervention effects. RESULTS Marijuana eCHECKUPTO GO participants reported decreases in estimated use prevalence (i.e., descriptive norms), self-reported hours high per week, days high per week, periods high per week, and weeks high per month. Sex moderated intervention effects on the use of PBS such that females in the PF condition increased their use of PBS more than males. CONCLUSION Results demonstrate preliminary support for the adapted Marijuana eCHECKUPTO GO in reducing marijuana use for "heavy college-aged users". Future research should test adapted Marijuana eCHECKUPTO GO sustained effects over time, and examine whether program effects on harm reduction manifest after sustained (e.g., booster) program implementation.
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35
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Prospective associations between cannabis use and negative and positive health and social measures among emerging adults. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 58:55-63. [DOI: 10.1016/j.drugpo.2018.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 10/30/2017] [Accepted: 05/08/2018] [Indexed: 01/30/2023]
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36
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Halladay J, Petker T, Fein A, Munn C, MacKillop J. Brief interventions for cannabis use in emerging adults: protocol for a systematic review, meta-analysis, and evidence map. Syst Rev 2018; 7:106. [PMID: 30045752 PMCID: PMC6060526 DOI: 10.1186/s13643-018-0772-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 07/10/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Rates of cannabis use are highest during emerging adulthood (age 18-25), with the prevalence of near daily and daily increasing among this age group. Emerging adults are clinically challenging in terms of harmful cannabis use due to perceptions of high rates of peer use, social acceptance, and low risk of harm. Brief interventions to increase awareness and promote motivation to change are therefore particularly important for this age group. There is existing evidence on the effectiveness of brief interventions for alcohol in emerging adults, but it is not clear if comparable evidence is present for cannabis. The objective of this systematic review is to summarize and critically appraise the existing literature of brief interventions for cannabis use both narratively, to describe the content and delivery of existing interventions, and meta-analytically, to determine the aggregated efficacy of these interventions on cannabis use and other outcomes (e.g., other substance use, mental health, help-seeking behaviors, and academic and occupational outcomes). METHODS A systematic search of randomized controlled trials, quasi-experimental trials, and pre-post designs will be conducted in the following electronic databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Ongoing trials will be identified using the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov , and Current Controlled Trials. Unpublished trials will be identified using Proquest Dissertations, OpenGrey, Google Scholar, and brief interventions on the Substance Abuse and Mental Health Services Administration webpage. Two authors will independently screen and extract data from articles using a predetermined screening and extraction forms (which will include risk of bias assessments). Calibration exercises will be performed prior to full screening and extraction. Disagreements will be resolved through discussion or consultation with a third reviewer. All studies will be reported narratively, and if appropriate, we will perform random effects meta-analyses with subgroup analyses and meta-regression. DISCUSSION Results of this review are expected to provide guidance on the content, delivery methods, and effectiveness of brief interventions for cannabis use to assist post-secondary institutions in identifying brief intervention strategies to implement prior to or in response to legalization. SYSTEMATIC REVIEW REGISTRATION CRD42018085412.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Evidence, and Impact, McMaster University, Hamilton, Ontario Canada
- Michael G. De Groote Centre for Medicinal Cannabis Research, McMaster University/St. Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8S 4L8 Canada
| | - Tashia Petker
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8S 4L8 Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada
| | - Allan Fein
- Michael G. De Groote Centre for Medicinal Cannabis Research, McMaster University/St. Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8S 4L8 Canada
| | - Catharine Munn
- Michael G. De Groote Centre for Medicinal Cannabis Research, McMaster University/St. Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8S 4L8 Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada
| | - James MacKillop
- Michael G. De Groote Centre for Medicinal Cannabis Research, McMaster University/St. Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8S 4L8 Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada
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Abstract
Objective In this study, we examined: (1) differences among never, current, and former young adult marijuana users; and (2) reasons for use and cessation. Methods We conducted interviews with 57 young adults (including 46 marijuana users) enrolled in a longitudinal study of 3418 young adults and a survey in this cohort (N = 2866). Participants reporting former but not current use on the survey (N = 607) completed the Reasons for Marijuana Cessation section. Results Interview data indicated reasons for initiating (or not initiating) use, continued use, and quitting. The Reasons for Marijuana Cessation scale included 2 factors: (1) Instrumentality and 2) Social/Legal reasons. Conclusions These findings might inform theoretical frameworks upon which marijuana cessation occurs and direct future intervention studies.
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Caffrey KS, Wright BR, Maarhuis PL. Harm reduction for cannabis: Factor analysis of a protective behavioral strategies survey. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:194-201. [PMID: 29405859 DOI: 10.1080/07448481.2018.1431894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine the psychometric properties of a measure of cannabis-specific Protective Behavioral Strategies (PBS), which assesses ways in which students may reduce cannabis-related risk. PARTICIPANTS Respondents to the American College Health Association - National College Health Assessment II (N = 580) during Spring 2015. METHODS Exploratory Factor Analysis (EFA) and Exploratory Structural Equation Modeling (ESEM) were used to identify and replicate the factor structure of the measure. RESULTS Results support a four-factor model (Respiratory Health, Frequency/Quantity, Socializing, and General Health) with close approximate fit (Χ2 (310) = 565.96, p < .001, RMSEA = .038 (.033, .043; 90% CI), CFI = .961, TLI = .929, SRMR = .033). Support for the convergent validity and construct validity of the measure was also found. CONCLUSIONS This is the initial step in the development of a standard, psychometrically validated measure of cannabis PBS that has the potential to inform future research and interventions.
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Affiliation(s)
- Kathleen S Caffrey
- a Department of Psychology , Washington State University , Pullman , Washington , USA
| | - Bruce R Wright
- a Department of Psychology , Washington State University , Pullman , Washington , USA
| | - Patricia L Maarhuis
- a Department of Psychology , Washington State University , Pullman , Washington , USA
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Wojciechowski T. Development of Marijuana Use Among Juvenile Offenders and Its Relevance for Predicting Problematic Binge Drinking: A Dual Trajectory Analysis Approach. JOURNAL OF DRUG ISSUES 2018. [DOI: 10.1177/0022042618762730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study builds on past research to examine the association of engagement in consistently high binge drinking behavior in adolescence with the concurrent development of marijuana use and to better understand the development of marijuana use during adolescence among a sample of juvenile offenders. This research used group-based trajectory analysis to examine heterogeneity in the development of marijuana use and dual trajectory analysis to examine the relevance of trajectories for predicting concurrent problematic binge drinking. A seven-group model best fit the marijuana use data. Marijuana use in adolescence predicted increased odds of assignment to the heavy chronic binge drinking group. The heavy chronic marijuana use group was overwhelmingly the best predictor of assignment to this group. Juvenile offenders are at risk of engagement in marijuana use and problematic levels of marijuana use. Engagement in marijuana use predicts higher odds of problematic binge drinking behavior during adolescence.
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Morris MA, Jacobson SR, Kinney GL, Tashkin DP, Woodruff PG, Hoffman EA, Kanner RE, Cooper CB, Drummond MB, Barr RG, Oelsner EC, Make BJ, Han MK, Hansel NN, O'Neal WK, Bowler RP. Marijuana Use Associations with Pulmonary Symptoms and Function in Tobacco Smokers Enrolled in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2018; 5:46-56. [PMID: 29629404 DOI: 10.15326/jcopdf.5.1.2017.0141] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: Marijuana is often smoked via a filterless cigarette and contains similar chemical makeup as smoked tobacco. There are few publications describing usage patterns and respiratory risks in older adults or in those with chronic obstructive pulmonary disease (COPD). Methods: A cross-sectional analysis of current and former tobacco smokers from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) study assessed associations between marijuana use and pulmonary outcomes. Marijuana use was defined as never, former (use over 30 days ago), or current (use within 30 days). Respiratory health was assessed using quantitative high-resolution computed tomography (HRCT) scans, pulmonary function tests and questionnaire responses about respiratory symptoms. Results: Of the total 2304 participants, 1130 (49%) never, 982 (43%) former, and 192 (8%) current marijuana users were included. Neither current nor former marijuana use was associated with increased odds of wheeze (odds ratio [OR] 0.87, OR 0.97), cough (OR 1.22; OR 0.93) or chronic bronchitis (OR 0.87; OR 1.00) when compared to never users. Current and former marijuana users had lower quantitative emphysema (P=0.004, P=0.03), higher percent predicted forced expiratory volume in 1 second (FEV1%) (P<0.001, P<0.001), and percent predicted forced vital capacity (FVC%) (p<0.001, P<0.001). Current marijuana users exhibited higher total tissue volume (P=0.003) while former users had higher air trapping (P<0.001) when compared to never marijuana users. Conclusions: Marijuana use was found to have little to no association with poor pulmonary health in older current and former tobacco smokers after adjusting for covariates. Higher forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) was observed among current marijuana users. However, higher joint years was associated with more chronic bronchitis symptoms (e.g., wheeze), and this study cannot determine if long-term heavy marijuana smoking in the absence of tobacco smoking is associated with lung symptoms, airflow obstruction, or emphysema, particularly in those who have never smoked tobacco cigarettes.
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Affiliation(s)
| | | | - Gregory L Kinney
- 2-Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Donald P Tashkin
- 3-Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California at Los Angeles
| | - Prescott G Woodruff
- 4-Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, School of Medicine, San Francisco
| | - Eric A Hoffman
- 5-Departments of Radiology, Medicine and Biomedical Engineering, University of Iowa, Iowa City
| | - Richard E Kanner
- 6-University of Utah Health Sciences Center, Salt Lake City.,7-Department of Biostatics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Christopher B Cooper
- 3-Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California at Los Angeles
| | - M Brad Drummond
- 8-Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill
| | - R Graham Barr
- 9-Columbia University, Division of General Medicine, New York, New York
| | | | | | | | | | - Wanda K O'Neal
- 8-Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill
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Hill S, Shanahan L, Costello EJ, Copeland W. Predicting Persistent, Limited, and Delayed Problematic Cannabis Use in Early Adulthood: Findings From a Longitudinal Study. J Am Acad Child Adolesc Psychiatry 2017; 56:966-974.e4. [PMID: 29096779 PMCID: PMC5679452 DOI: 10.1016/j.jaac.2017.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/18/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify risk profiles associated with patterns of problematic cannabis use in early adulthood. METHOD Data came from 1,229 participants in the Great Smoky Mountains Study, a prospective 20-year cohort study from 1993 to 2015 that is representative of western North Carolina with yearly assessments conducted from ages 9 and 16 years, and assessments at ages 19, 21, 26, and 30 years. Patterns of problematic cannabis use (i.e., DSM-5 cannabis use disorder or daily use) in early adulthood included the following: nonproblematic use in late adolescence (ages 19-21) and early adulthood (ages 26-30); limited problematic use in late adolescence only; persistent problematic use in late adolescence and early adulthood; and delayed problematic use in early adulthood only. Multinominal logistic regression models examined pairwise associations between these patterns and risk factors in childhood/early adolescence (ages 9-16) and late adolescence (ages 19-21). Risk factors included psychiatric disorders (e.g., anxiety, depressive), other substance use (smoking, alcohol, illicit drugs), and challenging social factors (e.g., low socioeconomic status, family functioning, peers). Sex and race/ethnicity (white, African American, American Indian) interactions were tested. RESULTS The persistent pattern (6.7% of sample) was characterized by more anxiety disorders across development and more DSM-5 CUD symptoms during late adolescence compared to the limited pattern (13.3%), which, in turn, had more childhood family instability and dysfunction. The delayed pattern (3.7%) was characterized by more externalizing disorders, maltreatment, and peer bullying in childhood compared to those in nonproblematic users. There were no significant interactions of sex or race/ethnicity. CONCLUSION Problematic cannabis use patterns during early adulthood have distinctive risk profiles, which may be useful in tailoring targeted interventions.
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Affiliation(s)
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of
Zurich, Zurich, Switzerland
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Arria AM, Caldeira KM, Bugbee BA, Vincent KB, O'Grady KE. Trajectories of energy drink consumption and subsequent drug use during young adulthood. Drug Alcohol Depend 2017; 179:424-432. [PMID: 28797805 PMCID: PMC5657439 DOI: 10.1016/j.drugalcdep.2017.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 06/01/2017] [Accepted: 06/03/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Highly caffeinated energy drinks (EDs) are popular with adolescents and young adults, but longitudinal consumption patterns are poorly understood especially in relation to other substance use. METHODS ED and other substance use were assessed annually (modal ages 21-25) among a sample (n=1099) who were originally recruited as first-year college students (modal age 18). Trajectory groups were derived based on probability of past-year use during ages 21-24, and compared for possible differences in substance use outcomes at age 25, holding constant demographics, sensation-seeking, other caffeine consumption, and age 21 substance use. RESULTS From age 21-25, ED consumption declined in both annual prevalence [62.5%wt to 49.1%wt (wt=weighted)] and frequency of use among consumers (35.2-26.3 days/year). Yet individuals exhibiting a Persistent trajectory (51.4%) of consumption outnumbered those with Non-Use (20.6%), Intermediate (17.4%), or Desisting (10.6%) trajectories. Age 25 cocaine use, nonmedical use of prescription stimulants (NPS), and alcohol use disorder (AUD) risk were significantly associated with trajectory group membership, with Persistent and Intermediate groups exhibiting the highest risk for such outcomes, even accounting for prior substance use and other risk factors. Neither marijuana nor tobacco use were associated with group membership. CONCLUSIONS The typical pattern of ED consumption among this sample was sustained use throughout young adulthood. Such individuals appear to be at high risk for adverse substance use outcomes, and results suggest possible specificity regarding cocaine use and NPS, and AUD risk. More research is needed to understand the mechanisms underlying the connection between ED and substance use.
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Affiliation(s)
- Amelia M Arria
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD 20742, USA.
| | - Kimberly M Caldeira
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD 20742, USA.
| | - Brittany A Bugbee
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD 20742, USA.
| | - Kathryn B Vincent
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD 20742, USA.
| | - Kevin E O'Grady
- Department of Psychology, University of Maryland, 3109 Biology-Psychology Building, College Park, MD 20742, USA.
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Arria AM, Caldeira KM, Allen HK, Bugbee BA, Vincent KB, O'Grady KE. Prevalence and incidence of drug use among college students: an 8-year longitudinal analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 43:711-718. [PMID: 28402711 DOI: 10.1080/00952990.2017.1310219] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Drug use among college students is associated with adverse academic and health outcomes and risks to personal safety. OBJECTIVES This study utilized data from a longitudinal study to estimate annual prevalence, cumulative lifetime prevalence, and incidence of ten types of drug use during the eight years after college entry and the average age of onset of each drug used. METHODS Participants (N = 1,253; 52% female) were young adults who were originally enrolled as first-time, first-year students at a university in the mid-Atlantic US. Annual personal interviews gathered data about the use of seven illicit drugs and three prescription drugs used nonmedically. Annual follow-up rates ranged from 76 to 91%. RESULTS Marijuana was the most commonly used drug in every year of the study, with the highest annual prevalence estimates in Year 3 (47%wt). In Year 8, when the modal age of participants was 25, 29%wt used marijuana during the past year. Nonmedical use of prescription drugs was more prevalent during college than in the later years of the study. Although the prevalence of cocaine and ecstasy use was low (cumulative prevalence estimates of 17%wt and 13%wt, respectively), incidence for these drugs was particularly high in the later years of the study. CONCLUSION Drug use is prevalent among college students, and drug use persists among young adults, even after many have graduated college. More attention should be directed at identifying and intervening with students at risk for drug use to mitigate possible academic, health, and safety consequences.
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Affiliation(s)
- Amelia M Arria
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Kimberly M Caldeira
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Hannah K Allen
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Brittany A Bugbee
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Kathryn B Vincent
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Kevin E O'Grady
- b Department of Psychology , University of Maryland , College Park , MD , USA
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Abstract
This study examines the association between exposure to microaggressions and marijuana use, using original survey data from a sample of racial/ethnic minority college students (n = 332) from a large Division I university in the United States. Nearly all of our sample (96%) reported at least one experience with microaggressions in the past 6 months, while 33% reported using marijuana regularly. We modeled regular use of marijuana using multiple logistic regression, with consideration of sex, age, race/ethnicity, and microaggression scale scores as covariates. Age, sex, the microinvalidations subscale score, and the full microaggression scale score were significantly associated with marijuana use in our full models (p < .01; p = .01; p = .02; p = .03, respectively). With each additional experience of microaggression, the odds of regular marijuana use increase. Academic communities may consider the primary prevention of discriminatory behavior when addressing student substance use.
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Affiliation(s)
- George Pro
- a The University of Iowa , Iowa City , Iowa
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45
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Pearson MR, Bravo AJ, Conner BT. Distinguishing subpopulations of marijuana users with latent profile analysis. Drug Alcohol Depend 2017; 172:1-8. [PMID: 28081515 PMCID: PMC5759308 DOI: 10.1016/j.drugalcdep.2016.10.043] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although marijuana is the most commonly used illicit drug in the United States, little is known about the effects of typical marijuana use patterns and whether there are distinct subgroups of marijuana users. METHODS The present study used latent profile analysis to determine the number of distinct subgroups of marijuana users in a large sample of college students (n=2129 past month marijuana users across 11 universities). We also examined how these distinct groups differ on several putative risk/protective factors (e.g., personality traits, perceptions of marijuana, and motives for using marijuana). RESULTS Using the Lo-Mendell-Rubin Likelihood Ratio Test, we identified four latent classes with the largest class consisting of infrequent marijuana users, and three other classes demonstrating increasingly frequent use and more negative consequences with the most severe class being the smallest class. We found the largest between-class differences (i.e., distinctions across classes) to be on identification with being a marijuana user and use of protective behavioral strategies (PBS), such that the heavier user classes showed higher identification with marijuana users and lower use of PBS. CONCLUSIONS Our findings demonstrate that college student marijuana users are a heterogeneous group with different profiles of risk/protective factors and that those who use marijuana a few times per month are different from those who are near-daily or daily users. Our findings also serve as a call to action for the field to consider examining identification with being a marijuana user and the use of PBS in future marijuana studies.
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Affiliation(s)
- Matthew R. Pearson
- Corresponding Author: Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, 2650 Yale Blvd SE MSC 11-6280, Albuquerque, NM 87106, Phone: 505 925 2325,
| | - Adrian J. Bravo
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM 87106
| | - Bradley T. Conner
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Colorado State University, Fort Collins, CO 80523-1876
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Terry-McElrath YM, O'Malley PM, Johnston LD, Bray BC, Patrick ME, Schulenberg JE. Longitudinal patterns of marijuana use across ages 18-50 in a US national sample: A descriptive examination of predictors and health correlates of repeated measures latent class membership. Drug Alcohol Depend 2017; 171:70-83. [PMID: 28024188 PMCID: PMC5263048 DOI: 10.1016/j.drugalcdep.2016.11.021] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 11/18/2016] [Accepted: 11/19/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND This descriptive study identified latent classes of longitudinal marijuana use from ages 18 through 50 among a national sample; examined covariate associations with class membership regarding use/non-use, use intensity, and use duration; and described associations between identified latent classes and age 50 health outcomes. METHODS The study involved collection and primary analysis of data from 9831 individuals first surveyed as 12th graders in the national Monitoring the Future study and followed through modal age 50. Repeated measures latent class analysis was used to identify latent classes based on self-reported past 12-month marijuana use. RESULTS Seven latent classes of marijuana use from ages 18 to 50 were identified including Non-users (44%), two classes characterized by shorter-term use patterns (totaling 28%), and four classes characterized by longer-term moderate or heavy use (totaling 28%). Use reduction appeared particularly likely during early and late 20s. Gender, parental education, alcohol/cigarette use, religious commitment, and marital status differentiated use/non-use, use intensity, and use duration after high school. In non-causal models controlling for covariates, longer-term marijuana use classes (where use extended into the late 20s or beyond) were associated with significantly higher odds of negative health outcomes at age 50. CONCLUSIONS Approximately 28% of the national sample reported longer-term moderate/heavy marijuana use, which was associated with negative health outcomes at age 50. The early and late 20s may be especially important periods for marijuana use prevention and intervention efforts, which may be strengthened by recognition of characteristics that appear to have significant associations with persistent use.
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Affiliation(s)
- Yvonne M Terry-McElrath
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248, USA.
| | - Patrick M O'Malley
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248, USA.
| | - Lloyd D Johnston
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248, USA.
| | - Bethany C Bray
- The Methodology Center and College of Health and Human Development, The Pennsylvania State University, 404 Health and Human Development Building, University Park, PA, USA.
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248, USA.
| | - John E Schulenberg
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248, USA; Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48106-1043, USA.
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Copeland WE, Hill S, Costello EJ, Shanahan L. Cannabis Use and Disorder From Childhood to Adulthood in a Longitudinal Community Sample With American Indians. J Am Acad Child Adolesc Psychiatry 2017; 56:124-132.e2. [PMID: 28117058 PMCID: PMC5564181 DOI: 10.1016/j.jaac.2016.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/30/2016] [Accepted: 11/21/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Recent changes in DSM criteria require new documentation of the prevalence and developmental sequences of cannabis use disorder (CUD). The goal of this study was to investigate the early course of DSM-5 CUD and its overlap with DSM-IV and consumption constructs in a community-representative sample of American Indians. METHOD Data came from the prospective, longitudinal, population-based Great Smoky Mountains Study in North Carolina (N = 1,420, including 349 American Indians). Cannabis use and disorder were assessed during yearly interviews from 9 to 16 years of age and at 19, 21, 26, and 30 years of age (up to 11 assessments per participant from 1993 through 2015). RESULTS By 30 years of age, approximately 70% of participants had used cannabis, 34% had used cannabis daily, and 18% had met criteria for DSM-5 CUD. Approximately 1 in 4 cannabis users met criteria for CUD at some point. Those who met criteria initiated use more than 2 years previously (at 13.3 years old) compared with other users. Despite higher risks from increased poverty, American Indians' patterns of use were similar to those of the rest of the sample. Concordance between DSM-5 CUD and DSM-IV abuse or dependence was substantial but was even higher between DSM-5 CUD and daily use. CONCLUSION It was common to have used cannabis daily or to have met criteria for DSM-5 CUD by adulthood. DSM-5 CUD was an improvement over DSM-IV diagnostic constructs by raising the threshold for diagnosis.
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Cantillano V, Del Villar P, Contreras L, Martínez D, Zuzulich MS, Ramírez C, Pons C, Bashford J. Psychometric properties of the Spanish version of the Cannabis Use Problems Identification Test among Chilean university students: A validation study. Drug Alcohol Depend 2017; 170:32-36. [PMID: 27866060 DOI: 10.1016/j.drugalcdep.2016.10.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 10/15/2016] [Accepted: 10/19/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND In Chile, concerns mount about escalating cannabis use. Thus, it is important to have tools for early identification of at-risk users. The Cannabis Use Problems Identification Test (CUPIT) is a useful screening tool, and the aim of this study was to examine the psychometric properties of its Spanish version among Chilean university students. METHODS The CUPIT was translated into Spanish, pre-tested in a focus group (n=8), and then tested through an online survey (n=3798, 28% response rate). Of the 1061 respondents, 578 reported 12-month cannabis use. Internal reliability, internal structure, and concurrent validity (using the Cannabis Abuse Screening Test [CAST]) were obtained. Test-retest reliability was calculated (n=150) at 3-4 weeks (30% of attrition rate). Discriminative validity was evaluated comparing CUPIT subscales and four DSM-IV diagnostic groups. Receiving operator characteristic (ROC) curve analysis assessed sensitivity and specificity. RESULTS Test-retest Pearson correlation between total CUPIT scores of 0.90 (p<0.001), and highly significant Kendall Tau-b coefficients for individual items (p<0.001) indicated excellent reliability. Concordance between the CUPIT and CAST (Pearson correlation 0.73, p<0.001) indicated good concurrent validity. ANOVA revealed significant differences in CUPIT scores between the four DSM-IV diagnostic groups (p<0.001), indicative of good discriminative validity. ROC analysis (gold standard: DSM-IV abuse/dependence) yielded an AUC value of 0.72, indicating acceptable discriminative capability. CONCLUSIONS The Spanish CUPIT is reliable, valid, and accepted by the university population studied, and, thus, a potentially useful tool for identifying both problematic and at-risk users.
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Affiliation(s)
- Vanessa Cantillano
- Prevention program in student's drug and alcohol use, Students' Health Center, Pontificia Universidad Católica de Chile, Chile.
| | - Paloma Del Villar
- Sociology Institute, Pontificia Universidad Católica de Chile, Chile
| | - Lorena Contreras
- Prevention program in student's drug and alcohol use, Students' Health Center, Pontificia Universidad Católica de Chile, Chile
| | - Daniel Martínez
- Prevention program in student's drug and alcohol use, Students' Health Center, Pontificia Universidad Católica de Chile, Chile
| | | | - Claudia Ramírez
- Prevention program in student's drug and alcohol use, Students' Health Center, Pontificia Universidad Católica de Chile, Chile
| | - Carmiña Pons
- Prevention program in student's drug and alcohol use, Students' Health Center, Pontificia Universidad Católica de Chile, Chile
| | - Jan Bashford
- School of Psychology, Massey University, Palmerston North, New Zealand
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Sterling KL, Fryer CS, Pagano I, Fagan P. Little Cigars and Cigarillos Use Among Young Adult Cigarette Smokers in the United States: Understanding Risk of Concomitant Use Subtypes. Nicotine Tob Res 2016; 18:2234-2242. [PMID: 27613889 DOI: 10.1093/ntr/ntw170] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 06/27/2016] [Indexed: 11/12/2022]
Abstract
INTRODUCTION In 2016, the Food and Drug Administration announced that it would regulate little cigars and cigarillos (LCCs) and expressed concern about the concomitant use of combustible tobacco products. To understand LCC use among socially-disadvantaged cigarette smokers, we assessed (1) the prevalence of concomitant use of subtypes of LCCs: LCC-tobacco, LCC-blunt, and LCC- poly use, which includes use of both LCC-tobacco and LCC-blunt and (2) and its association with sociodemographic factors and substance use behaviors using race/ethnicity and gender stratified models. METHODS In 2015, a web-based survey was administered to a national probability sample of black/African American, Hispanic/Latino, and white cigarette smokers aged 18-44 (n = 1018). Weighted estimates were used to assess current LCC-tobacco, LCC-blunt, and LCC-poly use. Multinomial regression models assessed sociodemographic, other tobacco and substance use correlates associated with LCC user subtypes. RESULTS Of cigarette smokers, 63% did not smoke LCCs; 15.1% were LCC-tobacco users; 11.1% were LCC-blunt users; and 10.5% were LCC-poly users. Black/African American and Hispanic/Latino cigarette smokers had higher odds of LCC-tobacco, LCC-blunt, and LCC-poly use compared to white cigarette smokers. Blacks/African Americans who initiated cigarette smoking before age 18 and smoked other tobacco products had greater odds of LCC-tobacco use than whites. Male cigarette smokers who smoked other tobacco products and females who had early onset of cigarette use also had greater odds of LCC-tobacco use. CONCLUSIONS Over 30% of cigarette smokers concomitantly used LCCs, which may prolong smoking. Accurate estimates of diverse LCC use behaviors may increase our understanding of the potential harms of concomitant use. IMPLICATIONS Aggregate measures of LCC smoking do not distinguish subtypes of use among socially-disadvantaged cigarette smokers (ie, young adults, blacks/African Americans, Hispanics/Latinos), who may engage in these unique smoking behaviors. We document the prevalence of young adult cigarette smokers who dual use LCC-tobacco and LCC-blunts and are poly users of LCC-tobacco + LCC-blunts, and identify sociodemographic groups at risk for use. The Food and Drug Administration is concerned about concomitant behavior, which may increase chronic disease risk and addiction. Accurate estimates of LCC smoking behaviors may increase our understanding of the harms of concomitant use; which can inform prevention programs that specifically target LCC subtypes.
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Affiliation(s)
| | - Craig S Fryer
- School of Public Health, University of Maryland College Park, College Park, MD
| | - Ian Pagano
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Pebbles Fagan
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
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