Drug involvement during and after college: Estimates of opportunity and use given opportunity

Gender and substance use among Latinx college students: An application of social structure social learning theory

Social structure social learning theory (SSSL) is a theoretical framework that has been used to understand gender differences in substance use. However, the Latinx community remains understudied in this body of research. Drawing on a Latinx college student sample, we tested the extent to which four social learning mechanisms specified by SSSL theory (positive definitions, neutralizing definitions, differential association, and differential reinforcement) explained gender differences in three substance use outcomes: alcohol intoxication, marijuana use, and illicit prescription drug use. We found that men reported greater levels of all three substance use outcomes, and that the social learning mechanisms mediated between 24% to 44% of these gender effects. We also found some evidence that the effects of differential association and differential reinforcement were stronger for men than women, suggesting that women may exhibit greater resilience when exposed to peer influence. We discuss the implications for SSSL theory and the study of substance use and gender differences in substance use among Latinx populations.

A 2-year follow-up of the effects of combined binge drinking and cannabis consumption on academic performance and adjustment in Spanish third-year university students

Introduction

The study was based on 2-year follow-up of the effects of binge drinking and cannabis co-consumption on academic performance and adjustment in Spanish Third-Year University Students and to further explore the impact of academic adjustment on this relationship.

Methods

A total of 144 students (aged 19-20 years) enrolled in the third year of university completed the study. The students were recruited during in first academic year (T1) via a survey that included items regarding the use of alcohol (AUDIT-C), cannabis and other drugs and demographic variables. Then, participants meeting the study criteria were then selected and invited by e-mail to a clinical (face-to face) structured interview. The participants completed a calendar of alcohol consumption during the 6 months prior to the interview (Alcohol Timeline Follow back), and recorded cannabis consumption in 3 months prior to the interview. To examine the effects of alcohol and cannabis co-consumption on the outcome variables, we categorized participants into three consumption groups (i.e., control, BD, and BDCA) based on the number of BD days and cannabis unit scores.

Results

Binge drinking and cannabis co-consumption in first-year students was significantly associated with poor academic performance and adjustment after 2 years of undergraduate study. Relative to controls, co-consumers (BDCA) reported significantly lower academic and personal-emotional adjustment to university as well as poorer performance. Mediation analysis showed that academic adjustment explains the mechanism by which BDCAs perform less well, mediating the relationship between co-consumption and academic performance, with an indirect effect representing 64.61% of the total effect. Furthermore, the mediating effect of academic adjustment was maintained after controlling for academic adjustment and baseline grade point average (T1).

Conclusion

This prospective follow-up study helps to further our knowledge of how combined binge drinking and cannabis consumption may affect university adjustment and academic success in Spanish university students Overall, the study results should encourage health professionals, educational psychologists and academic institutions to take ownership of the need for support and involvement in prevention, as well as for provision of guidelines for implementing appropriate intervention strategies.

A influência dos pares no consumo de Substâncias Psicoativas entre estudantes universitários/as

Entre os inúmeros fatores de influência social, os/as estudantes universitários/as são sensíveis aos comportamentos dos seus pares, sendo este considerado um preditor psicossocial robusto do consumo de substâncias psicoativas. O objetivo deste estudo prendeu-se com a análise da influência dos pares consumidores de substâncias psicoativas no consumo dessas mesmas substâncias por estudantes universitários. Este é um estudo transversal com uma amostra probabilística (n = 840) de estudantes universitários portugueses. Os dados foram recolhidos através de um questionário de autorelato anónimo e previamente validado composto por questões acerca dos consumos de substâncias psicoativas e dos consumos dessas substâncias pelos seus pares. Os resultados identificaram uma elevada prevalência de consumo de substâncias psicoativas (20.1%, 22.2% e 60.0% dos/as estudantes era fumador, consumidor de drogas ilícitas e apresentava um consumo excessivo de álcool, respetivamente). A maioria dos/as estudantes inquiridos/as referiu ter amigos/as consumidores/as de tabaco (84.8%), de drogas ilícitas (52.3%) e de álcool (93.9%). O consumo de substâncias psicoativas associou-se positivamente com ao consumo de substâncias psicoativas pelos pares. Estes resultados têm implicações práticas na investigação e intervenção em educação para a saúde no Ensino Superior. Por um lado, mostra a importância das instituições de ensino superior monitorizarem regularmente os comportamentos não-saudáveis e, por outro lado, que os programas de intervenção deverão capacitar os estudantes na tomada de decisões conscientes e positivas, promovendo o desenvolvimento de competências de regulação das emoções e a participação ativa das redes sociais mais próximas.

Characterizing prescription stimulant nonmedical use (NMU) among adults recruited from Reddit

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Adults reporting past 5-year non-oral prescription stimulant NMU were studied.

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Non-oral NMU preferences were snorting (59%) injecting (4%) or smoking (1%).

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Polysubstance use was reported by 79.1% of the sample.

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Route of administration and motivation for prescription stimulant NMU were related.

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Prescription stimulant oral and intranasal NMU was to enhance performance.

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Prescription stimulant intravenous and smoking NMU was to get high.

Objective

Increased prescription stimulant nonmedical use (NMU) is part of a growing polysubstance use landscape. The purpose of the present study was to characterize prescription stimulant NMU among adults reporting past 5-year non-oral prescription stimulant NMU.

Methods

Adults who reported non-oral prescription stimulant NMU within the last 5 years were recruited by banner ads placed on the Reddit website between February and September 2019. Types of prescription stimulants used, routes of administration, preferred routes of administration, motivations for prescription stimulant NMU, concurrent substances used simultaneously during prescription stimulant NMU, illicit substances used and factors impacting prescription stimulant NMU were queried.

Results

Respondents (n = 225) were male (86.2%), non-Hispanic (92.4%), white (78.2%), between 18 and 24 (48.0%) or 25–34 (43.1%) years with some amount of college education (81.3%). Most reported lifetime intranasal (93.8%) or oral use (85.2%). Prescription stimulants were diverted: 64.5% reported the prescription stimulants were given to them by a family or a friend and 10.5% reported that they had stolen these medications from a family or friend. Preferred route of administration was oral use (70.2%). Motivations to use were stratified by route of administration: intranasal (55.6%) or oral (63.0%) use was primarily endorsed as an attempt to enhance performance at work or at school; use by injection (57.1%) or smoking (62.5%) was primarily endorsed to get high. Most of the sample reported concurrent drug use (79.1%) including tobacco (57.3%), marijuana (52.0%), caffeine (47.6%) or alcohol (41.8%), among others. When excluding licit substances, 30.7% reported using 1 illicit substance concurrently with prescription stimulants and 25.3% reported using 2 or more illicit substances concurrently with prescription stimulants. Whether participants would undertake prescription stimulant NMU was determined by their work/school schedules or the location of the NMU (48.9%) whereas the route of administration employed was primarily influenced by the desired feeling or effect (56.9%).

Conclusions

Adults reporting lifetime non-oral prescription stimulant NMU engage in substantial risky behaviors that in addition to alternate routes of administration include polysubstance use, diversion and concurrent substance use.

Assessment of campus community readiness for tailoring implementation of evidence-based online programs to prevent risky substance use among university students in Germany

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.

Effects of a Brief Web-Based "Social Norms"-Intervention on Alcohol, Tobacco and Cannabis Use Among German University Students: Results of a Cluster-Controlled Trial Conducted at Eight Universities

Background and Aim: "Social norms" (SN)-interventions are aimed at changing existing misperceptions regarding peer substance use by providing feedback on actual norms, thereby affecting personal substance use. It is unknown whether SN-intervention effects previously demonstrated in US students can be replicated in German students. The aim of the INSIST-study was to examine the effects of a web-based SN-intervention on substance use. Design: Cluster-controlled trial. Setting: Eight Universities in Germany. Participants and Measurements: Students were recruited at four intervention vs. four delayed intervention control Universities. 4,463 students completed baseline, 1,255 students (59% female) completed both baseline and 5-months follow-up web-based surveys on personal and perceived peer substance use. Intervention participants received feedback contrasting personal and perceived peer use with previously assessed use and perceptions of same-sex, same-university peers. Intervention effects were assessed via multivariable mixed logistic regression models. Findings: Relative to controls, reception of SN-feedback was associated with higher odds for decreased alcohol use (OR: 1.91, 95% CI 1.42-2.56). This effect was most pronounced in students overestimating peer use at baseline and under or accurately estimating it at follow-up (OR: 6.28, 95% CI 2.00-19.8). The OR was 1.33 (95% CI 0.67-2.65) for decreased cannabis use in students at intervention Universities and was statistically significant at 1.70 (95% CI 1.13-2.55) when contrasting unchanged and decreased with increased use. Regarding tobacco use and episodes of drunkenness, no intervention effects were found. Conclusions: This study was the first cluster-controlled trial suggesting beneficial effects of web-based SN-intervention on alcohol and cannabis use in a large sample of German University students. Clinical Trial Registration: The trial registration number of the INSIST-study is DRKS00007635 at the "German Clinical Trials Register."

An experimental investigation of peer rejection and social anxiety on alcohol and cannabis use willingness: Accounting for social contexts and use cues in the laboratory

OBJECTIVE

Evidence suggests that social anxiety (SA) is a risk factor for problematic alcohol and cannabis use, particularly during states of social stress. Unfortunately, laboratory studies to date have overlooked decision-making mechanisms (e.g., use willingness) and contextual features of commonly used social stress tasks that may clarify what is driving these links. The current study begins to address this gap by testing the effects of SA and laboratory-induced peer rejection on acute alcohol and cannabis use willingness within a simulated party setting.

METHOD

80 emerging adults (18-25 years; 70% women) endorsing lifetime alcohol and cannabis use were randomly assigned to experience rejection or neutral social cues. They rated their willingness to use alcohol and cannabis before and after cue exposure within the simulated party. A hierarchical regression tested the main and interaction effects of SA symptoms and experimental condition (Rejection vs. Neutral) on alcohol and cannabis use willingness, controlling for past-year use frequency and willingness to accept any offers (e.g., food and nonalcoholic drinks).

RESULTS

There were statistically significant main (but not interaction) effects of SA and experimental condition on cannabis use willingness. Higher SA and Rejection exposure were each associated with greater cannabis use willingness. There were neither main nor interaction effects on alcohol willingness.

CONCLUSIONS

Results suggest that elevated SA increases cannabis use willingness across social contexts, regardless of Rejection exposure, while Rejection exposure increases use willingness similarly across levels of SA. Together, findings reinforce the need to consider social-contextual factors and polysubstance use in laboratory settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cannabis use among Norwegian university students: Gender differences, legalization support and use intentions, risk perceptions, and use disorder

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Past year cannabis use was fairly common in a sample of Norwegian college students.

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About 6% of users possibly met criteria for use disorder, function of use frequency.

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Legalization attitudes and risk perceptions were associated with cannabis use risk.

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Intentions to use cannabis if legal were evident even among some current non-users.

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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.

llicit Drug Use among College Students: The Importance of Knowledge about Drugs, Live at Home and Peer Influence

The problem of consumption of illicit psychoactive substances by students in higher education is not new, since it is in this age group that the highest prevalence of consumption of these substances continues to occur. This study aimed to describe the prevalence of illicit drug use among university students and to analyze the predictive factors and patterns of illicit drug use among university students in Portugal. A cross-sectional design and a stratified random sampling method were used (n = 840). A validated self-administered questionnaire was used, consisting of socio-demographic characteristics, information about the patterns of illicit drugs consumption, and knowledge and attitudes toward illicit drugs use. The prevalence of illicit drugs consumption was 22.2%, while overall students had a low level of knowledge and moderate scores when it came to the attitudes toward drug use. Being male, having changed residence after entering higher education, having friends who use illicit drugs and possessing knowledge on drugs increased the likelihood of consuming illicit drugs. The results of the study could help develop strategies to reduce use of illicit drugs in academic settings, giving special attention to the influence of peers and students who changed their residence after entering higher education.

Opioid-related overdose deaths among African Americans: Implications for research, practice and policy

Opioid-related overdose deaths among African Americans have only recently received national attention despite evidence of increase in death rates among this population spanning the past decade. Numerous authors have highlighted how the 'opioid epidemic' has largely been portrayed as a problem mostly affecting White America. The purpose of this commentary is to provide a synthesis spotlighting the unique structural and cultural considerations involved in research, practice and policy related to opioid use and treatment for opioid use disorders among African Americans. The commentary concludes with considerations for future research and practice intended to reduce deaths among this group.

Individualized approach to primary prevention of substance use disorder: age-related risks

Background

The misuse of legal and illegal substances has led to an increase in substance use disorder (SUD) in the United States. Although primary prevention strategies have been successfully used to target chronic physical diseases, these strategies have been less effective with SUD, given misconceptions of SUD, shortages in behavioral health professionals, and the population-based focus on specific substances. A developmental approach to the identification and primary prevention of SUD that does not fully rely upon behavioral health workers is needed. The purpose of this paper was to examine age related risk factors for developing SUD and present a novel individualized approach to SUD prevention.

Methods

A literature search was conducted to identify risk factors for SUD among children, young adults, adults, and older adults. We searched CINAHL, PsycINFO, and PubMed between the years 1989–2019, and extracted data, analyzing similarities and differences in risk factors across life stages. Broader categories emerged that were used to group the risk factors.

Results

More than 370 articles were found. Across all age groups, risk factors included adverse childhood experiences, trauma, chronic health diseases, environmental factors, family history, social determinants, and grief and loss. Despite the similarities, the contextual factors and life challenges associated with these risks varied according to the various life stages. We proposed an approach to primary prevention of SUD based on risk factors for developing the disease according to different age groups. This approach emphasizes screening, education, and empowerment (SEE), wherein individuals are screened for risk factors according to their age group, and screening results are used to customize interventions in the form of education and empowerment. Given that trained persons, including non-healthcare providers, close to the at-risk individual could conduct the screening and then educate and mentor the individual according to the risk level, the number of people who develop SUD could decrease.

Conclusions

The risk factors for developing SUD vary across the various life stages, which suggests that individualized approaches that do not overtax behavioral healthcare workers are needed. Using SEE may foster early identification and individualized prevention of SUD.

Illicit drug use among college students: The role of social norms and risk perceptions

PURPOSE

To examine the prevalence and correlates of college student use of illicit substances including cocaine, designer drugs, and nonmedical use of prescription stimulants and opioids, and to identify how different drug-related perceptions are related to past year use of these substances.

METHODS

Data were analyzed from a cross-sectional anonymous web-based survey among a sample (n = 1345, 81% female) of students attending a mid-sized liberal arts college in the US. Logistic regression models were estimated to assess the relationships between substance-specific descriptive norms, injunctive norms, perceived availability, risk perceptions and past year use of cocaine, designer drugs, prescription stimulants, and opioids, adjusting for current marijuana use, alcohol dependence, sensation seeking, and sociodemographic factors.

FINDINGS

Past year use of illicit substances ranged from 6% for nonmedical prescription opioids to 21% for nonmedical prescription stimulants. The sociodemographic correlates past year substance use differed by substance type. Descriptive norms (perceptions of peer use) and perceived risk were not consistently related to use of these substances. Current marijuana use was the strongest correlate across substances, and both injunctive norms (perceptions of peer approval) and perceived availability were consistently related to use of each substance.

CONCLUSIONS

Findings suggest that future college student drug prevention efforts should more directly target current marijuana users since they are most at risk of using other illicit substances. Additionally, findings indicate that injunctive norms may be an important consideration for education-focused drug prevention programs. However, findings should be interpreted in light of limitations of the sample, which is predominantly female.

Sources of drug acquisition among females and males in the European Web Survey on Drugs

BACKGROUND

Social networks determine the availability of drugs, which in turn affects use patterns. Yet, there is some limited evidence that as frequency of drug use increases, people who use drugs increasingly utilize drug dealers. Further, females more often report receiving drugs for free. Studies on these two phenomena are limited by the substances they examine and the countries in which they have been conducted, and they have not been considered together. We examine whether gender differences in sources is moderated by increased frequency of use across four different substances in a web survey of sixteen European countries.

METHODS

The European Web Survey on Drugs was collected from 2016-2018 among the national partners of the European Monitoring Centre for Drugs and Drug Addiction. Individuals who use drugs in sixteen European countries completed an online survey. For herbal cannabis, cannabis resin, cocaine, and MDMA, we examine drug acquisition sources by gender and frequency of use. Sources include through dealers and sharing or free, as well as growing and online markets for cannabis. We model each source with logistic regression with chained multiple imputation and a country fixed-effect and clustered standard errors.

RESULTS

Across all substances, females who use drugs at low frequencies had significantly lower probabilities than males in using dealers; however, females were equally likely to use dealers when use is frequent. The probability of acquiring drugs for free was higher for females except among those who use most frequently, where the difference became non-significant except for herbal cannabis.

CONCLUSIONS

Females and males use dealers to acquire illicit drugs at similar rates when use is more frequent. Except for highest frequency use, females are typically more likely than males to acquire drugs for free. Examinations of supply should consider these gendered differences in acquisition.

Shifting characteristics of ecstasy users ages 12-34 in the United States, 2007-2014

BACKGROUND

Ecstasy/MDMA has been one of the most prevalent party drugs for decades, and powder ecstasy recently increased in popularity. We examined trends in use to determine who to best target for prevention and harm reduction.

METHODS

Secondary analysis of the 2007-2014 National Survey on Drug Use and Health, a repeated cross-sectional, nationally representative probability sample, was conducted. Linear trends in past-year ecstasy use and trends in demographic and other past-year substance use characteristics among ecstasy users were examined among participants ages 12-34 (N=332,560).

RESULTS

Past-year prevalence of ecstasy use was stable across years at 2% (P=0.693). Over time, the proportion of ecstasy users with a college degree increased from 11.5% in 2007/08 to 24.5% in 2013/14 (P<0.001). The proportion of users who were age 12-17 decreased, as did proportions of users who are non-Hispanic black, and reported income <$20,000/year (Ps<0.001). Prevalence of past-year use of marijuana, LSD, ketamine, and DMT/AMT/Foxy increased among ecstasy users (Ps<0.05); DMT/AMT/Foxy use increased more than four-fold from 2.1% in 2007/08 to 8.7% in 2013/14. Perception of great risk associated with LSD use decreased among users and ease of obtaining LSD increased (Ps<0.05). Past-year use of 5 or more other substances also increased over time (P<0.05).

CONCLUSIONS

Ecstasy use in the US appears to be increasing among those with college degrees and use of other substances among ecstasy users is growing-particularly use of otherwise rare substances such as tryptamines. Results inform prevention and harm reduction strategies in this increasingly shifting group of ecstasy users.

Prevalence and incidence of drug use among college students: an 8-year longitudinal analysis

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.