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Lewis MA, Zhou Z, Fairlie AM, Litt DM, Geusens F, Parks KA, McCabe SE. Examining within-person associations between alcohol and cannabis use and hooking up among adolescents and young adults in the United States. Addict Behav 2024; 155:108040. [PMID: 38657402 DOI: 10.1016/j.addbeh.2024.108040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study examined daily associations between alcohol use, cannabis use, and simultaneous alcohol and cannabis/marijuana (SAM) use with the likelihood of hooking up (uncommitted sexual encounter that may or may not include intercourse). METHOD We used a longitudinal measurement burst ecological momentary assessment (EMA) design with 3-week EMA bursts with daily measurements repeated quarterly across 12 months. 1,009 (57 % female, Mean age = 20.00 [SD = 3.21]) Texan adolescents and young adults ages 15-25 participated in the study. Mixed effects logistic regression models were estimated using maximum likelihood estimation to evaluate the associations between substance use and hooking up. RESULTS Within-person results indicated that participants were more likely to hook up on days with alcohol use and on days with cannabis use, but not on days with SAM use. Participants were also more likely to hook up on drinking days with higher-than-usual alcohol use. Between-person results indicated that participants who used alcohol more often or cannabis more often on average were more likely to hook up, and participants who tended to drink more on drinking days were more likely to hook up. CONCLUSIONS Given the significant daily-level associations between alcohol and cannabis use and hooking up behavior, public health initiatives should focus on developing interventions to reduce alcohol and cannabis use and promote safer hooking up behavior among adolescents and young adults.
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Affiliation(s)
- Melissa A Lewis
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States.
| | - Zhengyang Zhou
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Anne M Fairlie
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, United States
| | - Dana M Litt
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Femke Geusens
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 752 37 Uppsala, Sweden; Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Kathleen A Parks
- Department of Psychology, College of Arts and Sciences, The State University at New York at Buffalo, Park Hall, Buffalo, NY 14226, United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building Ann Arbor, MI 48109, United States
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Boness CL, Linden-Carmichael AN. Interpretations and experiences of subjective effects for alcohol alone and when combined with cannabis: A mixed-methods approach. Exp Clin Psychopharmacol 2024; 32:329-339. [PMID: 37917506 PMCID: PMC11063124 DOI: 10.1037/pha0000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Subjective effects generally describe the feelings one has when consuming substances. There are several tools available for measuring alcohol-related subjective effects but there are reasons to believe that effects are interpreted differently across participants. The assessment of alcohol-related subjective effects is further complicated by the fact that many people use other substances with alcohol, including cannabis. The present study used a mixed-methods approach to evaluate interpretations of 21 subjective effects used in common assessments among a college student sample (N = 99; primarily White [79%], Hispanic [60%] women [74%], 72% of which reported lifetime couse of alcohol and cannabis). We sought to (a) estimate the prevalence of each effect and the amount of alcohol/number of drinks (and, for those with simultaneous use, amount of cannabis/number of hits) required to experience each effect and (b) evaluate how participants interpreted each effect that they had ever experienced when drinking (for our sample who had used only alcohol) or when simultaneously using alcohol and cannabis (for our sample who had reported simultaneous use). Across both samples, we found that several effects were far more common than others and participants had varied interpretations of each subjective effect. Further, qualitative results demonstrated that participants interpreted some subjective effects in a way that differed from the original intention of the measure. Results suggest a degree of measurement error when using common subjective effects assessment tools. Findings lay the groundwork for standardized measures of subjective effects for simultaneous use and have implications for future real-world assessment and intervention work. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Wardell JD, Coelho SG, Farrelly KN, Fox N, Cunningham JA, O'Connor RM, Hendershot CS. Interactive effects of alcohol and cannabis quantities in the prediction of same-day negative consequences among young adults. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:967-979. [PMID: 38575530 DOI: 10.1111/acer.15309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Simultaneous alcohol and cannabis use is common, but observational studies examining negative consequences of simultaneous use have rarely considered dose-related interactions between alcohol and cannabis. This study examined interactions between quantities of cannabis and alcohol consumed in predicting negative consequences on simultaneous use days. METHODS Young adults (N = 151; 64% female; 62% White) reporting recent simultaneous use and at least weekly alcohol and cannabis use completed 21 daily, smartphone-based surveys assessing previous day quantities of cannabis and alcohol used, types of cannabis used (flower, concentrates, edibles), and negative substance-related consequences. Multilevel models examined: (1) whether negative consequences differed within-person across simultaneous use days and single-substance use days; and (2) whether quantities of alcohol and cannabis consumed on simultaneous use days interacted, within-person, to predict negative consequences. We focused on quantities of cannabis flower (grams) in primary analyses and explored quantities of other forms of cannabis (concentrates, edibles) in supplementary analyses. RESULTS Participants reported fewer negative consequences on alcohol-only (243 observations) and cannabis-only (713 observations) days than they did on simultaneous use days (429 observations). On simultaneous use days involving cannabis flower use (313 observations across 81 participants), the within-person association between number of standard drinks and negative consequences was weaker on days during which larger (vs. smaller) amounts of cannabis flower were consumed. Inspection of simple slopes revealed that decreased alcohol use was associated with less of a decline in negative consequences when combined with relatively greater amounts of cannabis flower. CONCLUSIONS Although simultaneous use was associated with more negative consequences than alcohol-only and cannabis-only use, negative consequences on simultaneous use days varied as a function of the interaction between alcohol and cannabis quantities. As findings suggest that using larger amounts of cannabis may attenuate declines in negative consequences associated with lighter drinking, interventions for higher-risk simultaneous use patterns may benefit from a focus on quantities of both alcohol and cannabis.
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Affiliation(s)
- Jeffrey D Wardell
- Department of Psychology, York University, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sophie G Coelho
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Kyra N Farrelly
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Nicolle Fox
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - John A Cunningham
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Addictions, Kings College London, London, UK
| | - Roisin M O'Connor
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Christian S Hendershot
- Bowles Center for Alcohol Studies, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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Pritschmann RK, Rung JM, Berry MS, Yurasek AM. Independent and concurrent cannabis use with alcohol, cigarettes, and other substances among college students: Rates and consequences. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1263-1270. [PMID: 35658020 PMCID: PMC9718891 DOI: 10.1080/07448481.2022.2076094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/06/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
Objective: The purpose of this study was to examine patterns of concurrent cannabis and other substance use and their differential associations with cannabis-related problems and academic outcomes in college students. Participants: Participants were undergraduate students (N = 263; M age = 19.1 years; 61.2% female) who were eligible if they used cannabis at least 3 days in the past month (M = 10.1 days). Method: Substance use, academic-related outcomes, and measures of Cannabis Use Disorder (CUD) severity and problems were obtained in an online survey. Results: The five groups evaluated were cannabis-only users (5.3%), cannabis and alcohol (47.1%), cannabis, alcohol and cigarettes (16.7%), cannabis, alcohol and other substances (14.8%), or all-substances (16%). Cannabis-only and all-substance users reported using cannabis most frequently (ps ≤ .034), but only the latter reported greater CUD severity, problems, and poorer academic outcomes. Discussion: College student polysubstance users may be at increased risk for poorer outcomes compared to cannabis-only users and other groups.
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Affiliation(s)
- Ricarda K Pritschmann
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA
| | - Jillian M Rung
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA
- Department of Psychology, University of Florida, Gainesville, Florida, USA
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| | - Ali M Yurasek
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA
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Gohari MR, Patte KA, Elton-Marshall T, Cole A, Turcotte-Tremblay AM, Bélanger R, Leatherdale ST. The association between single and dual use of cannabis and alcohol and driving under the influence and riding with an impaired driver in a large sample of Canadian adolescents. TRAFFIC INJURY PREVENTION 2024:1-9. [PMID: 38656911 DOI: 10.1080/15389588.2024.2342571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Dual use of cannabis and alcohol has increased in adolescents, but limited research has examined how it relates to impaired driving or riding with an impaired driver (IDR) compared to single substance use. This study aimed to examine the odds of alcohol- and/or cannabis-IDR among adolescents based on their use of alcohol and/or cannabis, and whether associations differed by gender and age. METHODS Cross-sectional survey data were used from a sample of 69,621 students attending 182 Canadian secondary schools in the 2021/22 school year. Multilevel logistic regression estimated the odds of exclusive alcohol-IDR, exclusive cannabis-IDR, and both alcohol and cannabis IDR (alcohol-cannabis-IDR). Substance use interactions with gender and age were tested. RESULTS Overall, 14.7% of participants reported IDR; 7.5% reported exclusive alcohol-IDR, 3.2% reported exclusive cannabis-IDR, 4.0% reported alcohol-cannabis-IDR, and 7.4% were unsure if they had experienced IDR. The prevalence of IDR varied across substance use groups, 8.0% among nonuse, 21.9% among alcohol-only use, 35.9% among cannabis-only use, and 49.6% among dual use groups. Gender diverse, older, and students with lower socioeconomic status exhibited a higher likelihood of reporting alcohol-cannabis-IDR. Dual use was significantly associated with 9.5 times higher odds of alcohol-cannabis-IDR compared to alcohol-only use, and 3.0 times higher odds compared to cannabis-only use. Dual use was also associated with an increased likelihood of either alcohol- or cannabis-IDR. CONCLUSIONS This study highlights that all students, regardless of substance use, are at risk of IDR, but students engaged in dual use of alcohol and cannabis face an elevated risk compared to both peers who do not use substances and those who use only a single substance. These findings emphasize the importance of targeted interventions that address the risks associated with IDR.
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Affiliation(s)
- Mahmood R Gohari
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Karen A Patte
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Tara Elton-Marshall
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Adam Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Anne-Marie Turcotte-Tremblay
- VITAM, Centre de recherche en santé durable - Université Laval, CIUSSS de la Capitale-Nationale, Québec, Canada
- Département de pédiatrie, Faculté de médecine, Université Laval, Québec, Canada
| | - Richard Bélanger
- Département de pédiatrie, Faculté de médecine, Université Laval, Québec, Canada
- Faculté des sciences infirmières, Université Laval, Québec, Canada
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Glenn D, Lau-Barraco C, Goings K. Simultaneous Substance Use With Alcohol in a Community-Based Sample of Young Adults. J Dual Diagn 2024:1-12. [PMID: 38560886 DOI: 10.1080/15504263.2024.2330633] [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: 04/04/2024]
Abstract
Objective: Simultaneous substance use is associated with worse outcomes than concurrent use. Further investigations into simultaneous use are warranted because there is limited knowledge about the co-use of substances other than alcohol and cannabis. Study aims were to examine: (1) the prevalence of simultaneous use of substances with alcohol, (2) the extent to which use patterns are related to key correlates (i.e., psychological functioning, sensation seeking), and (3) differences by college status. Methods: Participants were 623 young adult drinkers who were recruited online to complete a one-time survey. Results: Cannabis (54.3%), tobacco (53.7%), and stimulants (46.5%) were most frequently used with alcohol. Moderation analyses showed the positive association between simultaneous use and psychological distress was stronger for students whereas the positive association with sensation seeking was stronger for nonstudents. Conclusions: Results highlight the need for future research and intervention efforts that consider the link between simultaneous use and psychological wellbeing while acknowledging that educational attainment may differentially influence these factors.
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Affiliation(s)
- Douglas Glenn
- Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Cathy Lau-Barraco
- Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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Waddell JT, Corbin WR. Do Subjective Effects from Alcohol and Cannabis Predict Simultaneous Use During a Decision-Making Task? Subst Use Misuse 2024; 59:1020-1030. [PMID: 38441633 DOI: 10.1080/10826084.2024.2320366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Background: Simultaneous alcohol and cannabis use is associated with negative outcomes, yet little is known about what motivates the decision of simultaneous use. One possibility is that early-episode subjective effects motivate simultaneous use to complement or replace the first substance's effects. The current study used a hypothetical decision-making task to test this hypothesis. Objectives: College students (N = 486) were presented eight scenarios characterized by alcohol/cannabis subjective effects (i.e., high/low arousal positive [e.g., excited, relaxed], high/low arousal negative [e.g., aggressive, dizzy]) and asked their likelihood of simultaneously using the other substance per scenario. Multilevel modeling tested whether subjective effect scenarios predicted a higher likelihood of simultaneous use and whether ordering moderated this association. Results: Task-based simultaneous use likelihood was associated with self-reported simultaneous use, showing task validity. Scenarios characterized by high/low arousal positive effects were associated with higher likelihood of simultaneous use, whereas high/low arousal negative scenarios were associated with lower likelihood. Alcohol vs. cannabis-first scenarios were associated with higher likelihood of simultaneous use, and significant interactions were observed for high/low arousal positive and high arousal negative effects. High arousal positive scenarios were associated with higher likelihood of simultaneous use when cannabis was used first, low arousal positive scenarios with higher likelihood when alcohol was used first, and high arousal negative scenarios with lower likelihood when cannabis was used first. Conclusions: Beginning-of-episode subjective substance effects may be a promising event-level predictor of simultaneous use, and just-in-time interventions may benefit from targeting the ordering and subjective experiences of alcohol and cannabis use.
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Affiliation(s)
- Jack T Waddell
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - William R Corbin
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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Phillips KT, Pedula KL, Simiola V, Satre DD, Choi NG. Psychiatric and substance use disorders among adults over age 50 who use cannabis: A matched cohort study using electronic health record data. Addict Behav 2024; 150:107927. [PMID: 38086211 DOI: 10.1016/j.addbeh.2023.107927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/10/2023] [Accepted: 11/26/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION Adults over age 50 increasingly use cannabis, but few studies have examined co-occurring psychiatric and substance use disorders (SUDs) in this population. The current study utilized electronic health record (EHR) data to compare adults age 50 + with ICD-10 cannabis codes (cases) and matched controls on common psychiatric and SUDs from 2016 to 2020. METHOD Patients age 50 + from an integrated healthcare system in Hawai'i were identified using ICD-10 codes for cannabis (use, abuse, and dependence) from 2016 to 2018. In a matched cohort design, we selected non-cannabis-using controls (matched on sex and age) from the EHR (n = 275) and compared them to cases (patients with an ICD-10 cannabis code; n = 275) on depressive and anxiety disorders and SUDs (i.e., tobacco, opioid, and alcohol use disorders) over a two-year follow-up period. RESULTS Participants were 62.8 years (SD = 7.3) old on average; and were White (47.8 %), Asian American (24.4 %), Native Hawaiian or Pacific Islander (19.3 %), or Unknown (8.5 %) race/ethnicity. Conditional multiple logistic regression was used to estimate odds ratios comparing cases vs controls. Participants with an ICD-10 cannabis code had a significantly greater risk of major depressive disorder (OR = 10.68, p < 0.0001) and any anxiety disorder (OR = 6.45, p < 0.0001), as well as specific anxiety or trauma-related disorders (e.g., generalized anxiety disorder, PTSD) and SUDs (ORs 2.72 - 16.00, p < 0.01 for all). CONCLUSIONS Over a two-year period, diverse adults age 50 + in Hawai'i with ICD-10 cannabis codes experienced higher rates of subsequent psychiatric and SUDs compared to controls. These findings can guide efforts to inform older adults about possible cannabis-related risks.
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Affiliation(s)
- Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.
| | - Kathryn L Pedula
- Hawai'i Permanente Medical Group, Kaiser Permanente Hawai'i, Honolulu, HI
| | - Vanessa Simiola
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI
| | - Derek D Satre
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA; Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Namkee G Choi
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX
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Beyer E, Poudel G, Antonopoulos S, Thomson H, Lorenzetti V. Brain reward function in people who use cannabis: a systematic review. Front Behav Neurosci 2024; 17:1323609. [PMID: 38379938 PMCID: PMC10877725 DOI: 10.3389/fnbeh.2023.1323609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/18/2023] [Indexed: 02/22/2024] Open
Abstract
Rationale Cannabis is one of the most widely used psychoactive substances globally. Cannabis use can be associated with alterations of reward processing, including affective flattening, apathy, anhedonia, and lower sensitivity to natural rewards in conjunction with higher sensitivity to cannabis-related rewards. Such alterations have been posited to be driven by changes in underlying brain reward pathways, as per prominent neuroscientific theories of addiction. Functional neuroimaging (fMRI) studies have examined brain reward function in cannabis users via the monetary incentive delay (MID) fMRI task; however, this evidence is yet to be systematically synthesised. Objectives We aimed to systematically integrate the evidence on brain reward function in cannabis users examined by the MID fMRI task; and in relation to metrics of cannabis exposure (e.g., dosage, frequency) and other behavioural variables. Method We pre-registered the review in PROSPERO and reported it using PRISMA guidelines. Literature searches were conducted in PsycINFO, PubMed, Medline, CINAHL, and Scopus. Results Nine studies were included, comprising 534 people with mean ages 16-to-28 years, of which 255 were people who use cannabis daily or almost daily, and 279 were controls. The fMRI literature to date led to largely non-significant group differences. A few studies reported group differences in the ventral striatum while participants anticipated rewards and losses; and in the caudate while participants received neutral outcomes. A few studies examined correlations between brain function and withdrawal, dosage, and age of onset; and reported inconsistent findings. Conclusions There is emerging but inconsistent evidence of altered brain reward function in cannabis users examined with the MID fMRI task. Future fMRI studies are required to confirm if the brain reward system is altered in vulnerable cannabis users who experience a Cannabis Use Disorder, as postulated by prominent neuroscientific theories of addiction.
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Affiliation(s)
- Emillie Beyer
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Braincast Neurotechnologies, Melbourne, VIC, Australia
| | - Stephanie Antonopoulos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Hannah Thomson
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Shipley JL, Braitman AL. Assessment of simultaneous alcohol and cannabis use and its related consequences and cognitions in college students: A narrative review. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:230-240. [PMID: 38212143 DOI: 10.1111/acer.15258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024]
Abstract
As rates of students using cannabis continue to rise, simultaneous use of alcohol and cannabis (such that their effects overlap; commonly referred to as simultaneous alcohol and marijuana [SAM] use) is prevalent among college students who use both substances. Although research focusing on SAM use and related cognitions and consequences continues to grow, there are no common established measures, as approaches vary across studies. This narrative review identifies current methods for assessing SAM use and measures of SAM-related consequences and cognitions (motives and expectancies) among college students, evaluates how they were developed, identifies gaps in the literature, and provides recommendations for future directions of assessment. We conclude that the assessment of SAM use is limited by difficulties in the assessment of cannabis quantity and potency. However, and the lack of a psychometrically validated measure of SAM consequences. However, measures of SAM motives and expectancies have been published with support from psychometric examinations such as exploratory factor analysis, confirmatory factor analysis, and measurement invariance. Research is needed that incorporates qualitative approaches in the development of SAM use measures so that unique items specific to SAM use rather than single-substance use can be identified. Additionally, validation of these measures is needed across different samples that vary demographically, such as by race and gender or sex. Future research should consider the development of a measure of protective behavioral strategies specific to SAM use to inform interventions that target the reduction of negative consequences of SAM use.
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Affiliation(s)
- Jennifer L Shipley
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Abby L Braitman
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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11
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Karoly HC, Prince MA, Conner BT. Alcohol First, Cannabis Last: Identification of an Especially Risky Use Pattern among Individuals Who Co-Use Alcohol and Cannabis. Subst Use Misuse 2024; 59:343-352. [PMID: 37853738 PMCID: PMC10842110 DOI: 10.1080/10826084.2023.2270674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: Alcohol and cannabis co-use is common and confers increased risk for potential harms, such as negative consequences and substance dependence. The existing evidence suggests that factors such as dose of delta-9-tetrahydrocannabinol (THC) consumed and order of use of each substance (i.e., using alcohol or cannabis first or last when co-using) may impact co-use outcomes. Existing co-use research has focused primarily on college-samples or young adults, and few studies have explored these nuanced relations among community samples. Methods: We examined survey data from 87 community members (mean age 32.9 years, 49.4% female) recruited from legal market cannabis dispensaries. Using a combination of regression techniques (i.e., OLS, negative binomial, censor-inflated) we modeled relations among co-use ordering patterns, THC dose and cannabis outcomes as well as interactions with sex assigned at birth and age. Results: Individuals who endorsed co-use reported significantly higher CUDIT scores than those who had never co-used (p < 0.01). Using alcohol first and cannabis last (a pattern we refer to as "AFCL") was more common among females than males (p < 0.01). In the context of typical substance use weeks, more frequently engaging in the AFCL pattern was associated with significantly higher CUDIT scores (p < 0.001) and negatively predicted positive consequences (p < 0.001). Other patterns predicted higher CUDIT scores during heavy use weeks. Conclusions: Results indicate that co-use ordering patterns are related to substance use outcomes. Further research leveraging within-subjects, longitudinal designs is needed to test causal relations between these variables.
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Affiliation(s)
- Hollis C. Karoly
- Colorado State University, Department of Psychology, Fort Collins CO, 80525
| | - Mark A. Prince
- Colorado State University, Department of Psychology, Fort Collins CO, 80525
| | - Bradley T. Conner
- Colorado State University, Department of Psychology, Fort Collins CO, 80525
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12
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Freibott CE, McCann NC, Biondi BE, Lipson SK. Interventions to increase naloxone access for undergraduate students: A systematic review of the literature. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38227912 DOI: 10.1080/07448481.2023.2299404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE To identify and describe interventions that increase access to naloxone for undergraduate students. METHODS A systematic review across 4 databases identified interventions that expand access to naloxone at colleges in the United States from 2015-2023. Three reviewers extracted the following data to create a narrative synthesis and summary of program elements: setting, rationale for intervention, timeline, intervention components, study size, collaboration, sustainability, outcomes and results. RESULTS Seven articles met inclusion criteria. Institutions' implemented naloxone interventions due to concerns for student safety and/or student overdose fatalities. Three universities collaborated with their School of Pharmacy for program design and/or dissemination, while two partnered with state-based naloxone distribution programs. Most programs combined opioid-overdose/naloxone training; four distributed naloxone kits. Three studies included pre/post-outcomes, and all reported increases in participant knowledge, attitudes, and/or ability to respond to an overdose. CONCLUSIONS Our results indicates an opportunity for wide-scale implementation of undergraduate naloxone programs within US colleges. However, more rigorous implementation research is needed to identify barriers and facilitators to program feasibility, acceptability, and participation.
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Affiliation(s)
- Christina E Freibott
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Nicole C McCann
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Breanne E Biondi
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sarah Ketchen Lipson
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
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Todaro SM, Schulz CT, Rothstein M, Stamates AL, Ehlke S, Kelley M. Normative Perceptions of Sexual Behavior and Alcohol Use among Bisexual Women. Subst Use Misuse 2024; 59:785-791. [PMID: 38229244 DOI: 10.1080/10826084.2024.2302150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Background: As compared to heterosexual and lesbian women, bisexual women report higher rates of alcohol, other substance use, and risky sexual behavior, and they experience more negative outcomes from these behaviors. Descriptive norms (i.e., perceptions of others' behavior) are an important predictor of risky behaviors, but scant research has examined whether bisexual women's perceptions of other bisexual women's alcohol use and sexual behavior are associated with their own alcohol or drug use during sex. Objectives: Consequently, the present study examined (1) whether perceived sex norms were related to engagement in sex and (2) the relative influence of drinking and sex norms on engaging in sex while drinking among bisexual women. Method: Data were collected from 225 self-identified bisexual women who completed an online survey about their typical weekly alcohol use, engagement in alcohol or drug use during sex in the past 30 days, and normative perceptions of drinking and sexual behavior. Results: Regression models demonstrated both sexual norms and drinking frequency norms were positively associated with alcohol or drug use during sex. In addition, only perceived norms of other bisexual women, compared to perceived norms of lesbian and heterosexual women, predicted engagement in sex. Conclusions: Bisexual women may be susceptible to normative perceptions, given their connectedness to a marginalized social group. Thus, alcohol prevention and intervention efforts aimed at reducing risky consequences among bisexual women should specifically consider drinking and sexual norms of other bisexual women.
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Affiliation(s)
| | | | | | | | - Sarah Ehlke
- Old Dominion University, Norfolk, Virginia, USA
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14
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Tomko RL, Gex KS, Davis CN, Schick MR, Kirkland AE, Squeglia LM, Flanagan JC, Gray KM, McRae-Clark AL. Sex and Gender Differences in Simultaneous Alcohol and Cannabis Use: a Narrative Review. CURRENT ADDICTION REPORTS 2023; 10:628-637. [PMID: 38264339 PMCID: PMC10803059 DOI: 10.1007/s40429-023-00513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 01/25/2024]
Abstract
Purpose of Review The aim is to review recent literature on sex and gender differences in patterns of use, motives, pharmacological effects, and consequences of simultaneous alcohol and cannabis use (SAC). Recent Findings Men engage in SAC more frequently than women. Women may have more substance-specific motives for use, while men tend to consistently endorse social/enhancement motives for both alcohol and cannabis. Regarding pharmacological effects, women experience the same subjective effects as men do at lower levels of use, with some evidence that women modulate cannabis use during simultaneous use episodes to avoid greater subjective intoxication. Finally, women appear more vulnerable to experiencing a range of positive and negative consequences from SAC relative to men. Summary Research has identified several important sex/gender differences in SAC and its correlates and consequences. However, research has primarily focused on white and cisgender populations, with a need for more research among racial/ethnic and gender minorities.
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Affiliation(s)
- Rachel L. Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Kathryn S. Gex
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Christal N. Davis
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | | | - Anna E. Kirkland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Julianne C. Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Aimee L. McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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15
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Langwerden RJ, Morris SL, Fernandez SB, Contreras-Pérez ME, Hospital MM, Wagner EF. Preliminary Effects of a Guided Self-Change Intervention on Perceived Risk and Self-Efficacy in University Students Engaging in Cannabis or Alcohol Misuse. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:127-138. [PMID: 38035169 PMCID: PMC10683752 DOI: 10.26828/cannabis/2023/000173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Guided Self-Change (GSC) is a Motivational Interviewing (MI)-based early intervention program, infused with Cognitive Behavioral Therapy (CBT), for individuals with substance use problems. In this study, we implemented a 4-session GSC program with the innovative addition of mindfulness-based techniques at a minority-serving institution to reduce substance use and negative consequences among self-referred university students. We investigated processes that may be associated with behavior change, including perceived risk of use and self-efficacy ratings among university students who reported their primary substance of choice was cannabis (n = 18) or alcohol (n = 18). The sample of 36 participants (Mage = 24.4, SDage = 5, range 18-37) mostly identified as female (58.3%), then male (41.7%); 52.8% identified as Hispanic/Latine, 22.2% as Black or African American, and 19.5% as a sexual minority. Among cannabis primary using students, results indicated that the perceived risk of weekly cannabis use, confidence to change, and readiness to change showed statistically significant increases from pre- to post-assessment. Among alcohol primary using students, confidence to change and readiness to change showed statistically significant increases from pre- to post-assessments. All results yielded large effect sizes, which may be inflated due to the small sample size. Findings suggest that over the course of participation in a brief, 4-session targeted GSC program, there were significant increases in perceived risk and self-efficacy among minority university students who engage in primary cannabis or primary alcohol use.
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Affiliation(s)
- Robbert J Langwerden
- Community Based Research Institute, Florida International University, Miami, FL, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL, USA
- Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA
| | - Staci L Morris
- Community Based Research Institute, Florida International University, Miami, FL, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL, USA
- School of Social Work, Florida International University, Miami, FL, USA
| | - Sofia B Fernandez
- Research Center in a Minority Institution, Florida International University, Miami, FL, USA
- School of Social Work, Florida International University, Miami, FL, USA
| | - María Eugenia Contreras-Pérez
- Community Based Research Institute, Florida International University, Miami, FL, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL, USA
- School of Social Work, Florida International University, Miami, FL, USA
| | - Michelle M Hospital
- Community Based Research Institute, Florida International University, Miami, FL, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL, USA
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Eric F Wagner
- Community Based Research Institute, Florida International University, Miami, FL, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL, USA
- School of Social Work, Florida International University, Miami, FL, USA
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16
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O’Hara SE, Paschall MJ, Grube JW. Recreational Marijuana Legalization, Local Retail Availability, and Alcohol and Marijuana Use and Co-Use Among California High School Students. J Stud Alcohol Drugs 2023; 84:734-743. [PMID: 37219033 PMCID: PMC10600969 DOI: 10.15288/jsad.22-00277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 04/24/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE This study examined whether recreational marijuana legalization (RML) and local retail availability were associated with marijuana and alcohol use and co-use among adolescents. METHOD We investigated associations between RML and past-30-day marijuana and alcohol use and co-use, and moderating effects of retail availability of marijuana and alcohol, using data from the 2010-2011 to 2018-2019 California Healthy Kids Surveys (CHKS) of 9th and 11th grade students in 38 California cities. Multilevel mixed-effects logistic regression analyses were conducted, controlling for secular trends and student and city demographics. Additional analyses examined associations of RML and retail availability with co-use among subgroups of drinkers and marijuana users. RESULTS For the full sample, RML was inversely associated with alcohol use but was not significantly associated with marijuana use or co-use with alcohol. However, significant interactions between RML and marijuana outlet density showed that there were increases in marijuana and alcohol co-use and alcohol following legalization in cities with higher densities of marijuana outlets. RML was positively associated with co-use among non-heavy and heavy drinkers, but inversely related to co-use among occasional and frequent marijuana users. A significant positive interaction between RML and marijuana outlet density indicated that RML was associated with increases in co-use for occasional marijuana users in cities with higher densities of marijuana outlets. CONCLUSIONS RML was associated with increases in marijuana and alcohol co-use and alcohol use among California high school students, particularly those in cities with higher densities of retail cannabis stores, although this varied across alcohol and marijuana use subgroups.
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Affiliation(s)
- Sharon E. O’Hara
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Mallie J. Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Joel W. Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
- School of Public Health, University of California, Berkeley, Berkeley, California
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17
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Páramo MF, Cadaveira F, Rodríguez MS. 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. Front Psychol 2023; 14:1223597. [PMID: 37599769 PMCID: PMC10434773 DOI: 10.3389/fpsyg.2023.1223597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
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.
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Affiliation(s)
- María Fernanda Páramo
- Department of Developmental and Educational Psychology, Faculty of Psychology, Santiago de Compostela, Spain
| | - Fernando Cadaveira
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Santiago de Compostela, Spain
| | - María Soledad Rodríguez
- Department of Social, Basic Psychology and Methodology, Faculty of Psychology, Santiago de Compostela, Spain
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18
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Waddell JT. Frequency matters: Relations among alcohol and cannabis co-use frequency and alcohol use disorder symptoms in emerging adults. Exp Clin Psychopharmacol 2023; 31:780-785. [PMID: 36355682 PMCID: PMC10290519 DOI: 10.1037/pha0000616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Emerging adult alcohol and cannabis co-use is on the rise and enacts risk for alcohol misuse/alcohol use disorder (AUD). However, few studies have differentiated whether levels of cannabis use (rather than any cannabis use) moderate between-person risk. Considering low-frequency co-users may use both substances via substitution, low-risk/frequency co-use may not enact the same risk for AUD as higher risk co-use. The present study sought to test this assertion. Public access data on emerging adults from the National Study on Drug Use and Health were used (2002-2019; N = 231,681). Participants reported on their past year alcohol use, cannabis use, as well as AUD symptoms. Regression models tested whether levels of cannabis use frequency moderated the association between alcohol use frequency and AUD symptom counts. A significant interaction of cannabis use frequency by alcohol use frequency predicting AUD symptoms was detected. Individuals who co-used alcohol and cannabis reported more AUD symptoms than those who only used alcohol at the same frequency or less. However, co-use was associated with lower AUD symptom counts than alcohol-only use at higher frequency. Findings suggest that all co-users (and alcohol-only users) are not necessarily created equal, and that relations among co-use and risk for AUD symptoms are complex. Rather than a dichotomy of co-users versus alcohol-only users, between-group risk may depend on frequency of both alcohol and cannabis use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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19
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Keyes KM, Joseph V, Kaur N, Kreski NT, Chen Q, Martins SS, Hasin D, Olfson M, Mauro PM. Adolescent simultaneous use of alcohol and marijuana by trends in cigarette and nicotine vaping from 2000 to 2020. Drug Alcohol Depend 2023; 249:109948. [PMID: 37270934 PMCID: PMC10348405 DOI: 10.1016/j.drugalcdep.2023.109948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/25/2023] [Accepted: 05/24/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Simultaneous alcohol and marijuana (SAM) use is associated with adverse consequences for youth. While SAM use is overall declining among youth, prior studies indicate increasing marijuana use among US adolescents who ever used cigarettes, suggesting possible moderation of the alcohol-marijuana relationship by cigarette use. METHODS We included 43,845 12-th grade students participating in Monitoring the Future data (2000-2020). A 5-level alcohol/marijuana measure was used, including past-year SAM, alcohol-only, marijuana-only, non-simultaneous alcohol and marijuana, or no use. Multinomial logistic regressions estimated associations between time periods (categorized based on sample size: 2000-2005, 2006-2009, 2010-2014, 2015-2020) and the 5-level alcohol/marijuana measure. Models adjusted for sex, race, parental education and survey mode and included interactions of time periods and lifetime cigarette or vaped nicotine use. RESULTS While overall SAM among 12th graders decreased from 23.65% to 18.31% between 2000 and 2020, SAM increased among students who never used cigarettes or vaped nicotine (from 5.42% to 7.03%). Among students who ever used cigarettes or vaped nicotine, SAM increased from 39.2% in 2000-2005-44.1% in 2010-2014 then declined to 37.8% in 2015-2020. Adjusted models controlling for demographics indicated that among students with no lifetime cigarette or vaped nicotine use, students in 2015-2020 had 1.40 (95% C.I. 1.15-1.71) times the odds of SAM, and 5.43 (95% C.I. 3.63-8.12) times the odds of marijuana-only (i.e., no alcohol use) compared to students who used neither in 2000-2005. Alcohol-only declined over time in both students who ever and never used cigarettes or nicotine vape products. CONCLUSION Paradoxically, while SAM declined in the overall adolescent US population, the prevalence of SAM increased among students who have never smoked cigarettes or vaped nicotine. This effect arises because of a substantial decline in the prevalence of cigarette smoking; smoking is a risk factor for SAM, and fewer students smoke. Increases in vaping are offsetting these changes, however. Preventing adolescent use of cigarettes and nicotine vaped products could have extended benefits for other substance use, including SAM.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Victoria Joseph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Navdep Kaur
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Deborah Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, USA
| | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, USA
| | - Pia M Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Choi M, Driver MN, Balcke E, Saunders T, Langberg JM, Dick DM. Bridging the gap between genetic epidemiological research and prevention: A randomized control trial of a novel personalized feedback program for alcohol and cannabis use. Drug Alcohol Depend 2023; 249:110818. [PMID: 37327509 PMCID: PMC10449035 DOI: 10.1016/j.drugalcdep.2023.110818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/01/2023] [Accepted: 06/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Risky substance use among college students is widespread and associated with numerous negative consequences. We created an online Personalized Feedback Program (PFP) for college students that targets genetically influenced risk pathways for substance use and provides feedback on four risk domains (Sensation Seeking, Impulsivity, Extraversion, and Neuroticism) along with individualized recommendations and campus resources. METHODS A pilot randomized controlled trial was conducted to evaluate the effects of the PFP on alcohol and cannabis use. First-year college students were randomized to one of four groups: (1) control, (2) PFP, (3) computer-delivered brief motivational intervention (BMI), and (4) combined group that included both the PFP and BMI (PFP+BMI). Students completed a baseline survey (n=251) that assessed alcohol and cannabis use and program satisfaction. Two follow-up surveys were administered at 30-days and 3-months post-intervention to evaluate longitudinal effects on substance use. RESULTS Participants reported high satisfaction with the PFP. There were no significant effects of intervention group on alcohol use at the follow-up timepoints, though trends were in the expected direction with participants in the PFP group showing decreased odds of alcohol use. There were significant reductions in cannabis use in the PFP group as compared to other groups. CONCLUSIONS The PFP was met with high satisfaction and had a positive impact on reducing cannabis use. With cannabis use at a historic high among college-aged adults, further research evaluating the effects of the PFP is warranted.
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Affiliation(s)
- Maia Choi
- Rutgers University, Department of Psychology, 152 Frelinghuysen Road, Piscataway, NJ08854, United States.
| | - Morgan N Driver
- Virginia Commonwealth University, Department of Human and Molecular Genetics, 1101 East Marshall Street, Richmond, VA23298, United States
| | - Emily Balcke
- Rutgers University, Department of Psychiatry, 671 Hoes Lane West, Piscataway, NJ08854, United States
| | - Trisha Saunders
- Virginia Commonwealth University, Department of Recreation and Well-Being, 101 S. Linden Street, Richmond, VA23284, United States
| | - Joshua M Langberg
- Rutgers University, Graduate School of Applied and Professional Psychology, 152 Frelinghuysen Road, Piscataway, NJ08854, United States
| | - Danielle M Dick
- Rutgers University, Department of Psychiatry, 671 Hoes Lane West, Piscataway, NJ08854, United States.
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Richards VL, Turrisi RJ, Glenn SD, Waldron KA, Rodriguez GC, Mallett KA, Russell MA. Alcohol-induced blackouts among college student drinkers: A multilevel analysis. Addict Behav 2023; 143:107706. [PMID: 37001258 PMCID: PMC10150855 DOI: 10.1016/j.addbeh.2023.107706] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/10/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To identify factors (manner of drinking, combined alcohol and other substance use, physiology) that are associated with alcohol-induced blackouts (AIBs) over and above estimated blood alcohol concentration (eBAC). METHODS Students (N = 462, 51.7 % female, 87.7 % White, Mage = 20.1) were assessed across 6 weekends via e-surveys (80-97 % response rate). eBAC was calculated using standard number of drinks, drinking duration, sex, and weight. Three-level multilevel models (days, weeks, persons) were conducted to test for main effects, controlling for eBAC. RESULTS Protective behavioral strategies (PBS) were associated with decreased odds of AIBs on the daily (OR = 0.64, 95 % CI: 0.53, 0.77), weekly (OR = 0.84, 95 % CI: 0.72, 0.98), and person-levels (OR = 0.62, 95 % CI: 0.51, 0.74). Combined cannabis with alcohol was associated with increased odds of AIBs on the weekly (OR = 2.13, 95 % CI 1.13, 4.07) and person-levels (OR = 3.56, 95 % CI 1.60, 7.93). People who more frequently played drinking games (OR = 1.41, 95 % CI: 1.12, 1.77), pregamed (OR = 1.55, 95 % CI: 1.19, 2.03), and showed higher tolerance (OR = 1.22, 95 % CI: 1.08, 1.37) showed increased risk of AIBs, over and above eBAC levels. CONCLUSION We identified a number of daily-, weekly-, and person-level factors that uniquely contribute to the prediction of AIBs even at equivalent eBACs. Many of these factors were behavioral, suggesting that they may serve as malleable prevention targets for AIBs in college student drinkers.
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22
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Montemayor BN, Murfree JR, Nabil AK, Barry AE. The Alcohol and Polysubstance Behaviors of Mandated College Students Prior to Collegiate Sporting Events: An Assessment of Pregaming. Subst Use Misuse 2023; 58:1660-1667. [PMID: 37489899 DOI: 10.1080/10826084.2023.2238304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Background: Despite a litany of education and prevention efforts seeking to curtail alcohol and other drug (AOD) use behaviors of United States (U.S.) college students, AOD use remains pervasive among the American college student population. Socio-cultural reinforcement of AOD behaviors, such as pregaming (PG), are often considered normative aspects of the collegiate experience, potentially introducing, and/or exacerbating, AOD use among U.S. college students. Objective: Due to the unique relationship PG has with the U.S. college experience and sports culture, this study explored the relationship between PG prior to a live sporting event and frequency of alcohol use, and the likelihood of persons who pregame also engaging in polysubstance use (>1 substance during drinking/use event). Methods: This study was conducted with college students (n = 816) attending a large public university in the Southeastern Conference (SEC) who violated campus alcohol use policies. Results: Beyond the influence of important demographic covariates, PG (p < .001) was significantly associated with a greater frequency of alcohol use. Moreover, students who participated in PG festivities were nearly 2.5 times more likely to participate in polysubstance use. Discussion: PG prior to live collegiate sporting events has clear public health and policy implications. Future efforts should institute and enforce risk-management policies on college campuses and employ event-specific alcohol and polysubstance use prevention and intervention strategies.
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Affiliation(s)
- Benjamin N Montemayor
- Department of Health Behavior, Texas A&M University School of Public Health, College Station, Texas, USA
| | - Jessica R Murfree
- Department of Kinesiology and Sport Management, Texas A&M University, College Station, Texas, USA
| | - Anas K Nabil
- Department of Health Behavior, Texas A&M University School of Public Health, College Station, Texas, USA
| | - Adam E Barry
- Department of Health Behavior, Texas A&M University School of Public Health, College Station, Texas, USA
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23
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Tucker JS, Seelam R, Green HD, Rodriguez A, Pollard MS. Alcohol and cannabis co-use in a national sample of U.S. adults ages 30-80. Addict Behav 2023; 142:107663. [PMID: 36842190 PMCID: PMC10049786 DOI: 10.1016/j.addbeh.2023.107663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Growing cannabis legalization has coincided with an increased focus on use of both alcohol and cannabis (AC co-use) among younger people; however, little is known about AC co-use among adults over age 30. This study examines the prevalence of different types of AC co-use among adults, as well as compares AC co-users and alcohol-only users on individual, social network, and neighborhood characteristics. METHODS Data come from three annual surveys of a nationally representative sample of 1,770 U.S. adults, initially between the ages of 30-80, conducted between 2019 and 2021. The baseline sample is 52.8 years old on average, 51.8 % female, and 60.1 % non-Hispanic White. RESULTS Past month co-use at baseline was reported by 8.4% of adults, and mostly consisted of simultaneous use, with less than 5% of the sample initiating co-use over the two-year follow-up period. Multivariable models indicate AC co-use was cross-sectionally associated with respondents being male, younger, Hispanic (vs White), and having more alcohol use and related problems, and with their social network composition (e.g., having more drinking buddies and cannabis users in the network). However, co-use status was not associated with mental health, physical ailments, or neighborhood quality. Longitudinal analyses indicated that AC co-use at baseline predicted more alcohol use one year later and alcohol related problems two years later among men only. CONCLUSIONS AC co-use among adults over age 30 deserves further attention given its prevalence and associations with heavier drinking and related problems. Network-focused interventions may be a promising approach for reducing AC co-use.
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States.
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States
| | - Harold D Green
- Indiana University School of Public Health, United States
| | - Anthony Rodriguez
- RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, United States
| | - Michael S Pollard
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States
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Pielech M, Meisel S, Berey BL, Goodyear K, Treloar Padovano H, Miranda R. Leveraging Ecological Momentary Assessment to Examine Bi-directional Associations Between Sleep Quality, Adolescent/Young Adult Alcohol Craving and Use. Ann Behav Med 2023; 57:593-602. [PMID: 37061844 PMCID: PMC10312303 DOI: 10.1093/abm/kaac056] [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] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Alcohol use is common among adolescents and young adults (AYA) and linked to poor sleep quality. Poor sleep quality may also increase alcohol use and alcohol craving, yet bi-directional relations between sleep quality and AYA alcohol use are poorly understood. PURPOSE This study examined bi-directional associations between sleep quality, alcohol craving, and alcohol use in AYA using ecological momentary assessment (EMA) and explored if biological sex, age, or race moderated these associations. METHODS This pre-registered secondary analysis pooled EMA data from the baseline, pre-randomization period (M = 8.18 days, range = 1-17) in two double-blind randomized placebo-controlled clinical trials examining medication effects on alcohol use in AYA (N = 115). Each morning, participants reported sleep quality and alcohol consumption (i.e., number of standard drinks) from the previous day, and craving was rated at several random points each day. RESULTS Multilevel modeling showed that poorer average sleep quality was associated with higher levels of alcohol craving for females but not for males, and better overall levels of sleep quality were associated with decreased likelihood of engaging in alcohol use. No other person- or day-level associations between sleep and alcohol use emerged. CONCLUSIONS Better sleep quality may be protective against alcohol use in AYA, and female AYA who report poorer sleep quality may experience higher levels of alcohol craving. Research and clinical assessment of AYA sleep quality can contribute to understanding of factors promoting alcohol craving and use.
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Affiliation(s)
- Melissa Pielech
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Samuel Meisel
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- E. P. Bradley Hospital, Riverside, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Benjamin L Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Kimberly Goodyear
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Hayley Treloar Padovano
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Robert Miranda
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- E. P. Bradley Hospital, Riverside, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Waddell JT, Corbin WR, Grimm KJ, Metrik J, Lee CM, Trull TJ. Dynamic relations among simultaneous alcohol and cannabis use, subjective responses, and problem drinking during naturally occurring drinking episodes. Drug Alcohol Depend 2023; 249:110837. [PMID: 37356229 DOI: 10.1016/j.drugalcdep.2023.110837] [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] [Received: 05/02/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Simultaneous alcohol and cannabis use (SAM) is associated with riskier drinking. However, little is known regarding mechanisms of risk during drinking episodes. The current study tested whether subjective responses to simultaneous vs. alcohol-only use (i.e., high arousal positive/reward, high arousal negative/aggression, low arousal positive/relaxation, low arousal negative/impairment) were mechanisms through which SAM use was associated with daily drinking. METHODS Emerging adults who co-use alcohol and cannabis (N=85) completed 21 days of ecological momentary assessment with drink-contingent reports during drinking episodes. Participants reported on their simultaneous use and current subjective effects during drink reports and past-night total drinks consumed and negative consequences experienced the next morning. Three-level multilevel models (momentary, daily, person level) tested whether SAM use predicted subjective responses, and whether subjective responses mediated associations between SAM use, heavier drinking and negative consequences. RESULTS At the momentary and day-level, SAM (vs. alcohol-only) use predicted increased high arousal positive/rewarding, low arousal positive/relaxing, and low arousal negative/impairing subjective effects. SAM use indirectly predicted heavier day-level drinking and further negative consequences through high arousal positive/rewarding response. SAM use also indirectly predicted day-level negative consequences through low arousal negative/impairing response. At the person-level, more frequent SAM use predicted higher person-average high arousal positive/rewarding and low arousal positive/relaxing responses, and high arousal positive/rewarding response mediated relation between SAM frequency and heavier drinking. CONCLUSIONS Simultaneous use was associated with reward, relief, and impairment, and reward and impairment were mechanisms of risk between SAM use and riskier drinking. Findings may inform theory and just-in-time interventions seeking to reduce alcohol misuse.
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Affiliation(s)
- Jack T Waddell
- Department of Psychology, Arizona State University, USA.
| | | | - Kevin J Grimm
- Department of Psychology, Arizona State University, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI02903, USA; Providence VA Medical Center, Providence, RI02908, USA
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA98195, USA
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, USA
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26
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Lei A, Breit KR, Thomas JD. Prenatal alcohol and tetrahydrocannabinol exposure: Effects on spatial and working memory. Front Neurosci 2023; 17:1192786. [PMID: 37383100 PMCID: PMC10293645 DOI: 10.3389/fnins.2023.1192786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/15/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Alcohol and cannabis are widely used recreational drugs that can negatively impact fetal development, leading to cognitive impairments. However, these drugs may be used simultaneously and the effects of combined exposure during the prenatal period are not well understood. Thus, this study used an animal model to investigate the effects of prenatal exposure to ethanol (EtOH), Δ-9-tetrahydrocannabinol (THC), or the combination on spatial and working memory. Methods Pregnant Sprague-Dawley rats were exposed to vaporized ethanol (EtOH; 68 ml/h), THC (100 mg/ml), the combination, or vehicle control during gestational days 5-20. Adolescent male and female offspring were evaluated using the Morris water maze task to assess spatial and working memory. Results Prenatal THC exposure impaired spatial learning and memory in female offspring, whereas prenatal EtOH exposure impaired working memory. The combination of THC and EtOH did not exacerbate the effects of either EtOH or THC, although subjects exposed to the combination were less thigmotaxic, which might represent an increase in risk-taking behavior. Discussion Our results highlight the differential effects of prenatal exposure to THC and EtOH on cognitive and emotional development, with substance- and sex-specific patterns. These findings highlight the potential harm of THC and EtOH on fetal development and support public health policies aimed at reducing cannabis and alcohol use during pregnancy.
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Affiliation(s)
- Annie Lei
- Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA, United States
| | - Kristen R. Breit
- Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA, United States
- Department of Psychology, West Chester University of Pennsylvania, West Chester, PA, United States
| | - Jennifer D. Thomas
- Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA, United States
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27
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Linden-Carmichael AN, Mogle J, Miller SE. Associations between blackout drinking and self-reported everyday cognition among young adults. Addict Behav 2023; 141:107653. [PMID: 36773578 PMCID: PMC10001203 DOI: 10.1016/j.addbeh.2023.107653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Blackout drinking, or alcohol-induced memory loss during at least some part of a drinking occasion, is common among young adults and associated with negative alcohol-related consequences. One potential unique effect of blackout drinking episodes could be prolonged, general difficulties forming new memories through impairments in encoding, storage, or retrieval. The current study examined preliminary associations between blackout drinking and self-reported everyday cognitive functioning (i.e., memory lapses, non-memory cognitive difficulties, cognitive concerns) among a sample of young adults. We also examined the moderating role of key factors linked to blackout drinking: gender and frequent simultaneous alcohol and cannabis use. METHODS Participants (N = 479; 53% women) were aged 18-30 who reported past-year blackout drinking. Participants completed an online survey through Qualtrics Panels. RESULTS More frequent blackout experiences were found to be significantly related to more memory lapses, more non-memory cognitive difficulties, and more cognitive concerns even after controlling for typical alcohol use behavior. Men and individuals reporting frequent simultaneous use indicated stronger relationships between blackout drinking frequency and cognitive outcomes. DISCUSSION AND CONCLUSIONS Findings add to the growing body of literature supporting the uniquely hazardous effects of blackout drinking and identify individuals at heightened risk of harms. Given that associations between blackout drinking frequency and everyday cognitive functioning were identified even among a young adult sample suggests that blackout drinking may be a risky behavior that links to poorer cognitive functioning.
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Affiliation(s)
| | - Jacqueline Mogle
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, United States; Department of Psychology, Clemson University, United States
| | - Sara E Miller
- Department of Human Development and Family Studies, The Pennsylvania State University, United States
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28
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Boyle HK, Singh S, López G, Jackson KM, Carey KB, Merrill JE. Insights into the context of simultaneous alcohol and cannabis use among young adults. Exp Clin Psychopharmacol 2023; 31:662-673. [PMID: 36174141 PMCID: PMC10201978 DOI: 10.1037/pha0000607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Simultaneous alcohol and cannabis use (simultaneous use) is common among young adults and is associated with a greater number of substance use-related consequences compared to single substance use. Understanding what drives simultaneous use among young adults is crucial. This study aimed to gather qualitative data on physical, social, and situational characteristics of simultaneous use among young adults. Participants were 36 heavy drinking young adults (Mage = 21.79) who engaged in simultaneous use at least twice during the past 30 days. Individual semistructured interviews were conducted via Zoom videoconferencing. Thematic analyses were used to analyze interview data. Findings indicated that young adults are selective of where and with whom they engage in simultaneous use with. Physical characteristics associated with simultaneous use included being in familiar and safe locations. Young adults were less likely to engage in simultaneous use in public spaces. Social characteristics associated with simultaneous use included being at parties, being around close peers, and if others are approving of and/or also using alcohol and cannabis so their effects overlap. Being around family or being alone decreased the likelihood of simultaneous use. Situational characteristics associated with simultaneous use included having access to alcohol and/or cannabis, being a weekend and/or evening, pregaming, and using cannabis at the end of a drinking occasion. Young adults based their decision to engage in simultaneous use on a range of physical, social, and situational contextual factors. Future research should examine multiple characteristics of the context in order to identify specific context with an increased risk of simultaneous use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Holly K Boyle
- Department of Behavioral and Social Sciences, School of Public Health, Center for Alcohol and Addiction Studies, Brown University
| | - Samyukta Singh
- Department of Behavioral and Social Sciences, School of Public Health, Center for Alcohol and Addiction Studies, Brown University
| | - Gabriela López
- Department of Behavioral and Social Sciences, School of Public Health, Center for Alcohol and Addiction Studies, Brown University
| | - Kristina M Jackson
- Department of Behavioral and Social Sciences, School of Public Health, Center for Alcohol and Addiction Studies, Brown University
| | - Kate B Carey
- Department of Behavioral and Social Sciences, School of Public Health, Center for Alcohol and Addiction Studies, Brown University
| | - Jennifer E Merrill
- Department of Behavioral and Social Sciences, School of Public Health, Center for Alcohol and Addiction Studies, Brown University
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29
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Helle AC, Boness CL, Masters J, Sher KJ. Alcohol and cannabis co-use: Receptiveness to treatments and application to intervention planning. JOURNAL OF STUDENT AFFAIRS RESEARCH AND PRACTICE 2023; 61:86-102. [PMID: 38504868 PMCID: PMC10947103 DOI: 10.1080/19496591.2023.2177104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Given the prevalence of alcohol and cannabis co-use among college students, prevention for co-use is crucial. We examined hypothetical receptiveness to substance-specific interventions among students who reported co-use. Students who use alcohol and cannabis were more receptive to alcohol interventions than cannabis interventions. Campus prevention experts should consider offering evidence-based alcohol-focused interventions as a potential pathway for decreasing substance use among college students who engage in co-use.
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Affiliation(s)
| | - Cassandra L Boness
- Center on Alcohol, Substance use, And Addictions at the University of New Mexico
| | - Joan Masters
- Partners in Prevention in the Division of Student Affairs at the University of Missouri
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30
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Gano A, Deak T, Pautassi RM. A review on the reciprocal interactions between neuroinflammatory processes and substance use and misuse, with a focus on alcohol misuse. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:269-282. [PMID: 37148274 PMCID: PMC10524510 DOI: 10.1080/00952990.2023.2201944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 05/08/2023]
Abstract
Background: The last decade has witnessed a surge of findings implicating neuroinflammatory processes as pivotal players in substance use disorders. The directionality of effects began with the expectation that the neuroinflammation associated with prolonged substance misuse contributes to long-term neuropathological consequences. As the literature grew, however, it became evident that the interactions between neuroinflammatory processes and alcohol and drug intake were reciprocal and part of a pernicious cycle in which disease-relevant signaling pathways contributed to an escalation of drug intake, provoking further inflammation-signaling and thereby exacerbating the neuropathological effects of drug misuse.Objectives: The goal of this review and its associated special issue is to provide an overview of the emergent findings relevant to understanding these reciprocal interactions. The review highlights the importance of preclinical and clinical studies in testing and validation of immunotherapeutics as viable targets for curtailing substance use and misuse, with a focus on alcohol misuse.Methods: A narrative review of the literature on drug and neuroinflammation was conducted, as well as articles published in this Special Issue on Alcohol- and Drug-induced Neuroinflammation: Insights from Pre-clinical Models and Clinical Research.Results: We argue that (a) demographic variables and genetic background contribute unique sensitivity to drug-related neuroinflammation; (b) co-morbidities between substance use disorders and affect dysfunction may share common inflammation-related signatures that predict the efficacy of immunotherapeutic drugs; and (c) examination of polydrug interactions with neuroinflammation is a critical area where greater research emphasis is needed.Conclusions: This review provides an accessible and example-driven review of the relationship between drug misuse, neuroinflammatory processes, and their resultant neuropathological outcomes.
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Affiliation(s)
- Anny Gano
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton, NY 13902-6000, United States of America
| | - Terrence Deak
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton, NY 13902-6000, United States of America
| | - Ricardo Marcos Pautassi
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto de Investigación Médica M. y M. Ferreyra (INIMEC – CONICET-Universidad Nacional de Córdoba), Córdoba, 5000, Argentina
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31
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Carrica LK, Choi CY, Walter FA, Noonan BL, Shi L, Johnson CT, Bradshaw HB, Liang NC, Gulley JM. Effects of combined use of alcohol and delta-9-tetrahydrocannibinol on working memory in Long Evans rats. Behav Brain Res 2023; 449:114475. [PMID: 37146720 DOI: 10.1016/j.bbr.2023.114475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/31/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023]
Abstract
The increase in social acceptance and legalization of cannabis over the last several years is likely to increase the prevalence of its co-use with alcohol. In spite of this, the potential for effects unique to co-use of these drugs, especially in moderate doses, has been studied relatively infrequently. We addressed this in the current study using a laboratory rat model of voluntary drug intake. Periadolescent male and female Long-Evans rats were allowed to orally self-administer ethanol, Δ9-tetrahydrocannibinol (THC), both drugs, or their vehicle controls from postnatal day (P) 30 to P47. They were subsequently trained and tested on an instrumental behavior task that assesses attention, working memory and behavioral flexibility. Similar to previous work, consumption of THC reduced both ethanol and saccharin intake in both sexes. Blood samples taken 14h following the final self-administration session revealed that females had higher levels of the THC metabolite THC-COOH. There were modest effects of THC on our delayed matching to position (DMTP) task, with females exhibiting reduced performance compared to their control group or male, drug using counterparts. However, there were no significant effects of co-use of ethanol or THC on DMTP performance, and drug effects were also not apparent in the reversal learning phase of the task when non-matching to position was required as the correct response. These findings are consistent with other published studies in rodent models showing that use of these drugs in low to moderate doses does not significantly impact memory or behavioral flexibility following a protracted abstinence period.
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Affiliation(s)
- Lauren K Carrica
- Department of Psychology, Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
| | - Chan Young Choi
- Department of Psychology, Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
| | - Francis A Walter
- Neuroscience Program and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
| | - Brynn L Noonan
- Department of Psychology, Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
| | - Linyuan Shi
- Department of Psychology, Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
| | - Clare T Johnson
- Department of Psychological & Brain Science, Indiana University, Bloomington, Indiana
| | - Heather B Bradshaw
- Department of Psychological & Brain Science, Indiana University, Bloomington, Indiana
| | - Nu-Chu Liang
- Department of Psychology, Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign; Neuroscience Program and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
| | - Joshua M Gulley
- Department of Psychology, Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign; Neuroscience Program and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign; Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign.
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32
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Karoly HC, Conner BT, Prince MA. Associations between alcohol and cannabis use order, frequency, quantity, and consequences in a college sample of individuals who co-use alcohol and cannabis. Am J Addict 2023; 32:283-290. [PMID: 36546556 PMCID: PMC10121768 DOI: 10.1111/ajad.13370] [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: 07/29/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Using both alcohol and cannabis (either at the same time or at different times) is common among college students, and is called "co-use." Using these substances simultaneously, such that their effects overlap, is thought to be an especially risky co-use pattern. Gaining a better understanding of how co-use patterns relate to substance use and consequences could aid prevention and intervention efforts. METHODS We examined college students (N = 401) who reported using both alcohol and cannabis at least once in the past 30 days. Path analysis was used to explore relations among co-use patterns (number of days in a typical week that participants used both alcohol and cannabis; the number of days using alcohol first, cannabis first, alcohol last, and cannabis last; the number of days of simultaneous use), past-30-day alcohol and cannabis consequences, use frequency, and typical quantities used. RESULTS Each additional day of using alcohol first was associated with fewer past-30-day cannabis consequences. Each additional day of using cannabis first was associated with fewer alcohol-related consequences. Each additional day of using alcohol and cannabis on the same day and each additional day of simultaneous use were both associated with less cannabis used and alcohol consumed in a typical week. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This study is among the first to identify associations between alcohol and cannabis order and outcomes (i.e., consequences and consumption). Results suggest that modifying which substance is used first on a given day could be a practical intervention strategy for individuals who co-use alcohol and cannabis.
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Affiliation(s)
- Hollis C Karoly
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Bradley T Conner
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
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33
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Carrica LK, Choi CY, Walter FA, Noonan BL, Shi L, Johnson CT, Bradshaw HB, Liang NC, Gulley JM. Effects of combined use of alcohol and delta-9-tetrahydrocannibinol on working memory in Long Evans rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.02.526698. [PMID: 36778500 PMCID: PMC9915622 DOI: 10.1101/2023.02.02.526698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The increase in social acceptance and legalization of cannabis over the last several years is likely to increase the prevalence of its co-use with alcohol. In spite of this, the potential for effects unique to co-use of these drugs, especially in moderate doses, has been studied relatively infrequently. We addressed this in the current study using a laboratory rat model of voluntary drug intake. Periadolescent male and female Long-Evans rats were allowed to orally self-administer ethanol, Î" 9 -tetrahydrocannibinol (THC), both drugs, or their vehicle controls from postnatal day (P) 30 to P47. They were subsequently trained and tested on an instrumental behavior task that assesses attention, working memory and behavioral flexibility. Similar to previous work, consumption of THC reduced both ethanol and saccharin intake in both sexes. Blood samples taken 14h following the final self-administration session revealed that females had higher levels of the THC metabolite THC-COOH. There were modest effects of THC on our delayed matching to position (DMTP) task, with females exhibiting reduced performance compared to their control group or male, drug using counterparts. However, there were no significant effects of co-use of ethanol or THC on DMTP performance, and drug effects were also not apparent in the reversal learning phase of the task when non-matching to position was required as the correct response. These findings are consistent with other published studies in rodent models showing that use of these drugs in low to moderate doses does not significantly impact memory or behavioral flexibility following a protracted abstinence period.
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Affiliation(s)
- Lauren K. Carrica
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Chan Young Choi
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | - Brynn L. Noonan
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Linyuan Shi
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Clare T. Johnson
- Department of Psychological & Brain Science, Indiana University, Bloomington, Indiana
| | - Heather B. Bradshaw
- Department of Psychological & Brain Science, Indiana University, Bloomington, Indiana
| | - Nu-Chu Liang
- Department of Psychology, University of Illinois at Urbana-Champaign
- Neuroscience Program, University of Illinois at Urbana-Champaign
| | - Joshua M. Gulley
- Department of Psychology, University of Illinois at Urbana-Champaign
- Neuroscience Program, University of Illinois at Urbana-Champaign
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
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Lewis MA, Zhou Z, Parks KA, Evans-Polce R, Litt DM, Fairlie AM, Geusens F, LoParco C, McCabe SE. Polysubstance use among young adults and differences in negative alcohol-related sexual experiences. Addict Behav 2023; 138:107571. [PMID: 36502745 PMCID: PMC9780189 DOI: 10.1016/j.addbeh.2022.107571] [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: 08/12/2022] [Revised: 11/18/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N = 1,015; Mean age = 19.16 (SD = 0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A hurdle negative binomial model examined the associations between polysubstance use and negative alcohol-related sexual experiences. Models examined if experiences varied by demographic factors. Compared to participants that only used alcohol, those who used alcohol plus marijuana and stimulants reported a higher likelihood and average number of negative alcohol-related sexual experiences in the past 3 months. Participants that used alcohol plus marijuana had a higher likelihood of having a negative alcohol-related sexual experience in the past 3 months compared to those who only used alcohol. These findings suggest the number and risk for negative alcohol-related sexual experiences increases with the number of substances being used.
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Affiliation(s)
- Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States.
| | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Kathleen A Parks
- Department of Psychology, College of Arts and Sciences, The State University at New York at Buffalo, 1021 Main Street, Buffalo, NY 14203, United States
| | - Rebecca Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, United States
| | - Dana M Litt
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, United States
| | - Femke Geusens
- Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 box 3603, 3000 Leuven, Belgium; Research Foundation Flanders/FWO Vlaanderen, Leuvenseweg 38, 1000 Brussel, Belgium
| | - Cassidy LoParco
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, United States
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Drohan MM, Stevens AK, Gunn RL, Sokolovsky AW, White HR, Jackson KM. Acute Consequences Associated With Co-use of Alcohol and Cannabis: A Daily Survey Analysis. J Stud Alcohol Drugs 2023; 84:208-213. [PMID: 36971729 PMCID: PMC10171256 DOI: 10.15288/jsad.22-00062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Co-use of alcohol and cannabis has been associated with more total negative consequences than single-substance use, but results have been mixed depending on whether the single substance was alcohol or cannabis. The present study used within-person analyses to examine whether co-use increased the risk for experiencing specific acute negative consequences. METHOD College students who were co-users of alcohol and cannabis (N = 341; M age = 19.8 years; 51.3% female; 74.8% White) completed 56 days of five daily surveys across two bursts. We used generalized linear mixed effects models to examine the effects of type of substance use day on specific negative consequences, controlling for consumption and covariates. RESULTS Relative to both alcohol-only and co-use days, cannabis-only days were associated with decreased likelihood of experiencing hangover, blackout, nausea/vomiting, injury, rude/aggressive behavior, and unwanted sex. Relative to alcohol-only days, cannabis-only and co-use days were associated with an increased likelihood of driving high/drunk. Finally, there was an increased likelihood of hangovers on alcohol-only days compared with co-use days. CONCLUSIONS Days with different types of substance use differed in specific consequences. Most of the negative co-use consequences investigated here appear to be driven by alcohol consumption rather than cannabis use. The results also indicated that these young adults were more likely to endorse driving under the influence of cannabis than alcohol. Interventions for co-use should target alcohol consumption to reduce negative consequences such as blackout, injury, rude/aggressive behavior, and unwanted sex and highlight the dangers of driving under the influence of cannabis.
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Affiliation(s)
- Megan M. Drohan
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Angela K. Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Rachel L. Gunn
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Alexander W. Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Helene R. White
- Center of Alcohol and Substance Use Studies, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
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Kolp H, Horvath S, Fite PJ, Metrik J, Stuart GL, Lisdahl KM, Shorey RC. Development of the Alcohol and Cannabis Simultaneous Use Scale (ACSUS) in college students. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2023.2183149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Haley Kolp
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Sarah Horvath
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Paula J. Fite
- Department of Applied Behavioral Science, University of Kansas, Lawrence, Kansas, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
- Mental Health and Behavioral Sciences Service, Providence VA Medical Center, Providence, Rhode Island, USA
| | - Gregory L. Stuart
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, Tennessee, USA
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Ryan C. Shorey
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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Jun D, Fazzino TL. Associations between Alcohol-Free Sources of Reinforcement and the Frequency of Alcohol and Cannabis Co-Use among College Freshmen. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2884. [PMID: 36833579 PMCID: PMC9957030 DOI: 10.3390/ijerph20042884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Co-use of alcohol and cannabis is common among young adults in the United States. A behavioral economics framework indicates that greater engagement in substance-free sources of reinforcement may be protective against co-use frequency. The current study tested the association between proportionate alcohol-free reinforcement and the frequency of co-use among college freshmen. Participants (N = 86) were freshmen who enrolled in a freshman orientation course and completed surveys at the beginning of the semester. Past month alcohol use, cannabis use, and reinforcement from alcohol-free and alcohol-involved activities were assessed. A zero-inflated Poisson regression was used to test the association between proportionate alcohol-free reinforcement and days of co-use. The results indicated that proportionate alcohol-free reinforcement was negatively associated with co-use days in the count model when controlling for alcohol use days and gender as covariates (β: -3.28, p = 0.016). Proportionate alcohol-free reinforcement did not significantly differentiate individuals who did not engage in co-use in the zero-inflated model (β: -1.68, p = 0.497). The study suggested that greater proportionate alcohol-free reinforcement may be associated with lower engagement in the co-use of alcohol and cannabis among young adults. Increasing engagement in alcohol-free sources of reinforcement may be considered a target for co-use prevention or harm reduction efforts.
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Affiliation(s)
- Daiil Jun
- Department of Psychology, University of Kansas, Lawrence, KS 66045, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS 66045, USA
| | - Tera L. Fazzino
- Department of Psychology, University of Kansas, Lawrence, KS 66045, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS 66045, USA
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Goings TC, Salas-Wright C, Vaughn M. Toward a typology of driving under the influence of alcohol and drugs. Soc Psychiatry Psychiatr Epidemiol 2023; 58:227-238. [PMID: 36087139 PMCID: PMC10375564 DOI: 10.1007/s00127-022-02342-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 07/19/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Most research on driving under the influence (DUI) has relied upon variable-centered methods that examine predictors/correlates of DUI. In the present study, we utilize a person-level approach-latent class analysis (LCA)-to model a typology of individuals reporting DUI. This allows us to understand the degree to which individuals drive under the influence of a particular substance or do so across multiple substance types. METHODS We use public-use data collected between 2016 and 2019 from the National Survey on Drug Use and Health. The analytic sample was 189,472 participants with a focus on those reporting DUI of psychoactive substances in the past-year (n = 24,619). LCA was conducted using self-reported DUI of past-year alcohol, cannabis, cocaine, heroin, hallucinogens, and methamphetamine as indicator variables. RESULTS More than 1 in 10 Americans reported a DUI within the past-year. One in five people who reported DUI of one substance also reported DUI of at least one additional substance. Using LCA to model heterogeneity among individuals reporting DUI, four classes emerged: "Alcohol Only" (55%), "Cannabis and Alcohol" (36%), "Polydrug" (5%), and "Methamphetamine" (3%). Rates of risk propensity, drug involvement, illicit drug use disorders, and criminal justice system involvement were highest among members of the "Polydrug" and "Methamphetamine" classes. CONCLUSION Drug treatment centers should take care to include discussions of the dangers and decision-making processes related to DUI of the full spectrum of illicit substances. Greater investment in drug treatment across the service continuum, including the justice system, could prevent/reduce future DUI episodes.
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Affiliation(s)
- Trenette Clark Goings
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St., CB#3550, Chapel Hill, NC, 27599, USA.
| | | | - Michael Vaughn
- College for Public Health and Social Justice, St. Louis University, 3550 Lindell Blvd., Room 316, St. Louis, MO, 63103, USA
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Hatch MR, Bravo AJ, Looby A, Hurlocker MC. Who's at greatest risk? Latent profiles of alcohol and cannabis use and related consequences among college students. Addict Behav 2023; 137:107536. [PMID: 36334313 PMCID: PMC10259160 DOI: 10.1016/j.addbeh.2022.107536] [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: 04/26/2022] [Revised: 09/29/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is significant heterogeneity in alcohol and cannabis use patterns among college students, with some engaging in use patterns that heighten their risk for adverse consequences. Person-centered approaches can help identify those subgroups of students with riskier use patterns. Latent Profile Analyses (LPA) were conducted to identify subgroups based on alcohol and cannabis use frequency and quantity, to explore demographic covariates and to examine mean differences across subgroups on alcohol- and cannabis-related consequences, simultaneous use, and other substance use. METHODS Participants were 2,423 college students (Mage = 20.1; 72 % female) recruited from seven US universities who endorsed past-month alcohol and cannabis use and completed an online survey of substance use behaviors. RESULTS A four-profile solution was the best fitting model. Profile 1 represented "light, infrequent alcohol and cannabis use" (73.8 %), Profile 2 represented "heavy, infrequent alcohol and moderate, frequent cannabis use" (15.9 %), Profile 3 represented "moderate, frequent alcohol and cannabis use" (5.6 %) and Profile 4 represented "very heavy, frequent alcohol and heavy, frequent cannabis use" (4.7 %). Students who identify as male, White non-Hispanic, and/or Greek-affiliated were more likely to be in the heavy alcohol use profiles. Profiles 3 and 4 represent high-risk profiles, with both having a higher likelihood of simultaneous use, Profile 3 endorsing more cannabis consequences, and Profile 4 endorsing more alcohol consequences. CONCLUSION Results suggest that heavy alcohol or heavy co-use heightens risk for serious adverse consequences.
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Affiliation(s)
- Melissa R Hatch
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, P.O. Box 8795, Williamsburg, VA 23187-8795, USA.
| | - Alison Looby
- Department of Psychology, University of Wyoming, 1000 E. University Ave. Laramie, WY 82071, USA.
| | - Margo C Hurlocker
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM 87131, USA.
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Davis CN, Dash GF, Miller MB, Slutske WS. Past year high-intensity drinking moderates the association between simultaneous alcohol and marijuana use and blackout frequency among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:140-146. [PMID: 33577429 PMCID: PMC8357845 DOI: 10.1080/07448481.2021.1880415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 06/12/2023]
Abstract
Objective: The role of simultaneous alcohol and marijuana (SAM) use in the experience of blackouts among college students is unclear. To clarify discrepancies, the current study evaluated whether the association between SAM user status and blackouts was moderated by high-intensity drinking (HID). Participants and Methods: College students (N = 1,224; 63.7% female) reported on their past year experiences of blackout, marijuana use, SAM use, and HID (i.e., drinking at least twice the binge threshold). Results: SAM users had more past year blackouts than non-SAM users, but this effect was only significant among SAM users who had engaged in HID in the past year (nonbinge: F(5,37) = 0.50, p = 0.49; binge: F(5,138) = 0.23, p = 0.63; HID: F(5,328) = 4.52, p = 0.03). Conclusions: Effects of SAM user status on the experience of alcohol-related blackouts may be limited to individuals who engage in HID.
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Affiliation(s)
- Christal N. Davis
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Genevieve F. Dash
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri, 1 Hospital Drive DC067.00, Columbia 65212, USA
| | - Wendy S. Slutske
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, USA
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41
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Waddell JT, Marszalek JM. Indirect and direct effects of simultaneous alcohol and cannabis use on alcohol hangovers. Addict Behav 2022; 134:107420. [PMID: 35797779 PMCID: PMC10290518 DOI: 10.1016/j.addbeh.2022.107420] [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: 06/28/2021] [Revised: 05/17/2022] [Accepted: 06/29/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Simultaneous use of alcohol and cannabis (i.e., using both on same occasion) is a risk factor for heavier drinking and negative alcohol consequences; however, little research has investigated risk conferred for specific negative consequences. One theoretically relevant negative consequence may be alcohol hangovers; however, no studies have tested cross-sectional or prospective relations between simultaneous use and experiencing alcohol hangovers. METHOD The current study (N = 2,964) used public-access data from the National Longitudinal Study on Adolescent to Adult Health (Add Health) to test whether simultaneous alcohol and cannabis use conferred risk for hangover frequency directly or indirectly through heavier drinking. The current study also tested moderated mediation by depressive symptoms, considering simultaneous users have higher levels of depressive symptoms, and depressive symptoms largely mirror those of a hangover. RESULTS In a cross-sectional model, simultaneous use was associated with more frequent hangovers both directly and indirectly through heavier drinking. In a prospective model, simultaneous use indirectly predicted more frequent hangovers through heavier drinking; however, the direct path was not significant. None of the paths from simultaneous use to drinking or hangovers were moderated by depressive symptoms in either model. CONCLUSIONS The current study suggests that, both concurrently and prospectively, heavier drinking explained significant variance in the relation between simultaneous use and hangover frequency. The significant direct effect of simultaneous use in the cross-sectional model suggests that simultaneous users may have individual characteristics, outside of depressive symptoms, that confer risk for more frequent hangovers above and beyond heavier drinking.
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Gunn RL, Sokolovsky AW, Drohan MM, Boyle HK, Stevens AK, White HR, Jackson K. The role of alcohol and cannabis co-use in drinking rate and its impact on consequences. Alcohol Clin Exp Res 2022; 46:2110-2120. [PMID: 36124876 PMCID: PMC9968512 DOI: 10.1111/acer.14946] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/01/2022] [Accepted: 09/15/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The impact of alcohol and cannabis co-use on college student drinking and related outcomes is complex. Specific characteristics or patterns of co-use events beyond drinking quantity may be important to the experience of consequences. The present study used repeated daily surveys to examine the association between co-use (versus use of alcohol only) and drinking rate on negative consequences. METHODS The sample included 318 college students (Mage = 19.8, 47% female, 76% non-Hispanic White) who were co-users of alcohol and cannabis, recruited from three U.S. college campuses. Participants completed 56 days of data collection (number of drinking days ranged from 1 to 38). Two measures of drinking rate were examined: (1) daily rate (number of drinks divided by number of hours spent drinking per day); and (2) peak hour rate (maximum number of drinks consumed in a single hour) to account for anomalous drinking days of long duration. Generalized linear mixed models examined: (1) associations of co-use with peak hour rate (model 1a) and daily rate (model 1b); (2) associations of peak hour rate (model 2a) and daily rate (model 2b) with experiencing any negative consequence; and (3) interactions of co-use with peak hour rate (model 3a) and daily rate (model 3b) on experiencing a consequence. RESULTS Co-use was positively associated with peak hour rate but not daily rate. Both peak hour and daily rate positively predicted likelihood of experiencing a negative consequence. The interaction of both peak hour and daily rate by co-use was significant such that the association of rate with experiencing a consequence was stronger on alcohol-only days compared to co-use days. CONCLUSIONS Daily drinking rate and peak hour drinking rate are unique and should be considered when discussing drinking patterns. Both predict negative consequences and may be important aspects of interventions for negative drinking-related outcomes among college students.
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Affiliation(s)
- Rachel L. Gunn
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Alexander W. Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Megan M. Drohan
- University of Rhode Island, South Kingstown, Rhode Island, USA
| | - Holly K. Boyle
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Angela K. Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Helene R. White
- Center of Alcohol and Substance Studies, Rutgers University, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Kristina Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
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Montemayor BN, Noland M, Barry AE. College students mandated to substance use courses: Age-of-onset as a predictor of contemporary polysubstance use. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 36194393 DOI: 10.1080/07448481.2022.2128682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Objective: College campuses report alcohol and other drug policy violations as the most frequent reason students receive disciplinary referrals and, thus, are mandated to programming. This study sought to determine predictors of mandated students' alcohol use frequency, and the likelihood of early-onset alcohol using college students enrolled in mandated programming engaging in current polysubstance use. Methods and participants: Employing a purposive sampling method, n = 822 participants were recruited from a pool of students who violated their university's alcohol policy between October 2019 and July 2021. Results: Data analysis revealed early-onset alcohol use (p < .001), gender ID (p < .01), Greek Affiliation (p < .001), ethnicity (p < .05), and perceived norms (p < .001) significantly predicted alcohol frequency. Analysis also revealed engaging in early-onset alcohol use significantly predicted current participation in polysubstance use (p < 0.01), outside of controls. Conclusions: University programs should consider exploring polysubstance use targeted interventions to mitigate these harmful behaviors and associated negative consequences.
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Affiliation(s)
- Benjamin N Montemayor
- Department of Health Behavior, Texas A&M University School of Public Health, College Station, Texas, USA
| | - Melody Noland
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
| | - Adam E Barry
- Department of Health Behavior, Texas A&M University School of Public Health, College Station, Texas, USA
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Stevens AK, Boyle HK, Sokolovsky AW, White HR, Jackson KM. Nuanced relations between simultaneous alcohol and cannabis use motives and negative consequences among college students: The role of multiple product use. Exp Clin Psychopharmacol 2022; 30:593-608. [PMID: 33705200 PMCID: PMC8433268 DOI: 10.1037/pha0000454] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Simultaneous alcohol and marijuana (SAM) use is common, but it exacerbates negative consequences. Individuals use alcohol and cannabis products in different ways and have distinct reasons for use. The present study examines day-level effects of motives on consequences on SAM-use days, accounting for consumption, and tests whether using multiple alcohol (e.g., beer + liquor) and/or cannabis (e.g., concentrate + leaf) products on the same day mediates these relations. College students engaging in SAM use at least once in the past month (N = 281; Mage = 20.17) completed two bursts of 28 consecutive days of data collection. We examined within-person effects of motives (effect-enhancement, social, offered [it was offered], coping) on number of negative consequences and on experiencing hangover, nausea, or blackout; and indirect effects via two concurrent mediators: using multiple alcohol products and multiple cannabis products. Total effect models showed effect-enhancement motives were related to nausea, social motives to number of total consequences and hangover, and coping motives to blackout. Effect-enhancement, social, and offered motives evinced significant indirect effects on consequence outcomes via multiple alcohol, but not cannabis, product use. Coping motives did not exhibit significant indirect effects, and were related to multiple cannabis, but not alcohol, product use, although all other motives were related to both mediators. Findings support recent work demonstrating within-person relations between social motives and negative consequences on SAM-use days. Limiting the number of alcohol products consumed on SAM-use days may be beneficial, particularly for young adults using to enhance intoxication or for social reasons. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Waddell JT, King SE, Okey SA, Meier MH, Metrik J, Corbin WR. The anticipated effects of simultaneous alcohol and cannabis use: Initial development and preliminary validation. Psychol Assess 2022; 34:811-826. [PMID: 35549368 PMCID: PMC10029147 DOI: 10.1037/pas0001147] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Social learning theories suggest that outcome expectancies are strong determinants of behavior, and studies find that alcohol and cannabis expectancies are associated with negative substance use outcomes. However, there are no measures to date that assess expectancies for simultaneous alcohol and cannabis use (SAM), often referred to as SAM, despite strong links with negative consequences and rising time trends. The present study sought to provide initial validation of test scores for the Anticipated Effects of Simultaneous Alcohol and Cannabis Use Scale (AE-SAM), using a sample of past month college student simultaneous users (N = 434). Exploratory factor analysis and confirmatory factor analysis conducted in random half samples suggested five expectancy factors, representing high arousal positive, high arousal negative (alcohol driven), high arousal negative (cannabis driven), low arousal positive, and low arousal negative expectancies. The factor structure was invariant across sex, race/ethnicity, and simultaneous use frequency, and demonstrated convergent and discriminant validity with other alcohol/cannabis expectancy measures. AE-SAM high arousal positive expectancies were associated with simultaneous use frequency and heavier drinking/cannabis use, AE-SAM high arousal negative (cannabis driven) expectancies were associated with less frequent simultaneous use and more negative alcohol consequences, and AE-SAM low arousal negative expectancies were associated with less cannabis use. Effects of AE-SAM high arousal positive and high arousal negative (cannabis driven) expectancies remained, above and beyond other expectancy measures, suggesting that AE-SAM expectancies provide additional information beyond single substance expectancies. The results demonstrate the feasibility and utility of assessing simultaneous use expectancies, and lay groundwork for future research on simultaneous use expectancies in relation to alcohol and cannabis couse outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Jane Metrik
- Center for Alcohol and Addictions Studies, Brown University School of Public Health
- Providence VA Medical Center, Providence, Rhode Island, United States
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46
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Carey KB, Tempchin J, DiBello AM, Mastroleo NR. Use of protective behavioral strategies and blackout experience among mandated college students. Addict Behav 2022; 132:107340. [PMID: 35512439 DOI: 10.1016/j.addbeh.2022.107340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/28/2022] [Accepted: 04/18/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Alcohol-induced blackouts are experienced by approximately half of college students who drink. People who use protective behavioral strategies (PBS) tend to experience fewer alcohol-related consequences of drinking, but the relationship between PBS and blackouts is unknown. This study examines the associations among the use of protective behavioral strategies and blacking out. METHODS Participants were 484 college students, aged 18-22 (56% male, 51% first-year), who were mandated to complete alcohol education following an alcohol violation. Before the intervention, participants completed questionnaires that included questions about past month peak consumption, alcohol-related consequences, marijuana use frequency, and frequency of PBS use. Logistic regression analyses were conducted to evaluate how use of PBS was related to the odds of experiencing a blackout, controlling for consumption and other risk factors. RESULTS Participants endorsing greater overall use of PBS had decreased odds of having experienced a blackout. However, this association depended on the type of PBS being used. Participants endorsing greater use of PBS regarding manner of drinking and stopping/limiting drinking had decreased odds of having experienced a blackout, but those who endorsed greater use of PBS relating to serious harm reduction did not. CONCLUSIONS This study adds nuance to the idea that PBS protect against adverse alcohol-related consequences. Only PBS that serve to limit or slow consumption appear to be protective against experiencing blackouts. Research on specific associations between types of PBS and consequences may lead to improved outcomes in interventions that incorporate PBS.
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Affiliation(s)
- Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, United States; Department of Behavioral and Social Sciences, Brown University School of Public Health, United States.
| | - Jacob Tempchin
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, United States
| | - Angelo M DiBello
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, United States; Center of Alcohol & Substance Use Studies, Rutgers University, United States; Department of Applied Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, United States
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Griffin KW, Lindley LL, Cooper Russell E, Mudd T, Williams C, Botvin GJ. Sexual Violence and Substance Use among First-Year University Women: Differences by Sexual Minority Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10100. [PMID: 36011735 PMCID: PMC9407960 DOI: 10.3390/ijerph191610100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/11/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Sexual violence and substance use are important public health problems among university students. The present study examined rates of sexual violence victimization, perpetration, and substance use among first-year university women. Participants (n = 974) attending 14 universities across the United States completed an online confidential survey at the beginning and again later in their first year. The sample included women who identified as heterosexual, bisexual, lesbian, and asexual or questioning. The mean age was 19.1 years and 71.4% were White. Rates of victimization involving sexual harassment and sexual acts without consent were higher among sexual minority women relative to heterosexual women, with bisexual women being most likely to report these outcomes. Compared to heterosexual women, sexual minority women reported more frequent cigarette smoking, marijuana use and intoxication, use of club drugs, and overall illicit drug use. Across sexual violence and substance use outcomes, bisexual women reported the highest rates. Sexual minority women reported more accurate beliefs about sexual violence and consent relative to heterosexual women. Over the course of the first year, bisexual women and those who used illicit substances were more likely to report new incidents of sexual violence victimization. Implications for prevention of sexual violence among women, including sexual minorities, are discussed.
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Affiliation(s)
- Kenneth W. Griffin
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Lisa L. Lindley
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Elaine Cooper Russell
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Tori Mudd
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Christopher Williams
- National Health Promotion Associates, White Plains, NY 10604, USA
- Department of Psychology, Purchase College, State University of New York, Purchase, NY 10577, USA
| | - Gilbert J. Botvin
- National Health Promotion Associates, White Plains, NY 10604, USA
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10065, USA
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Hai AH, Carey KB, Vaughn MG, Lee CS, Franklin C, Salas-Wright CP. Simultaneous alcohol and marijuana use among college students in the United States, 2006-2019. Addict Behav Rep 2022; 16:100452. [PMID: 36106094 PMCID: PMC9465098 DOI: 10.1016/j.abrep.2022.100452] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/23/2022] [Accepted: 08/28/2022] [Indexed: 11/28/2022] Open
Abstract
US college students’ simultaneous alcohol and marijuana (SAM) use rate was rising. There was an upward trend of SAM use among Black college students (2006–2019). Hispanic and Asian American/Pacific Islander students’ trend remained stable.
Objective Simultaneous alcohol and marijuana (SAM) use exposes college students to a myriad of adverse consequences. However, there is no recent nationally representative study on SAM use among college students in the United States (US). To provide an update to the literature, the present study aimed to examine the trends, prevalence, and correlates of SAM use among US college students between 2006 and 2019, using nationally representative data. Method We used data from the 2006–2019 National Survey on Drug Use and Health (NSDUH) and the analytic sample was limited to the 55,669 full-time college student respondents (ages 18–22). Using logistic regression analysis, we assessed trends in SAM use prevalence and examined sociodemographic and psycho-social-behavioral correlates of SAM use. Results The proportion of US college students who reported SAM use increased significantly from 8.13% (2006–2010) to 8.44% (2015–2019). However, examination by race/ethnicity revealed that the increasing trend was largely driven by Black college students, whose SAM use prevalence increased significantly from 5.50% (2006–2010) to 9.30% (2015–2019), reflecting a 69.09% increase. SAM use rates did not change significantly among other racial/ethnic groups. Conclusions This study uncovered an upward trend and prevalence of SAM use among US college students, calling for more research and public health interventions in this area. At-risk subgroups that warrant more attention include college students who are Black, female, above the legal drinking age, have a lower than $20,000 household income, and reside in small metropolitan areas.
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Affiliation(s)
- Audrey Hang Hai
- School of Social Work, Tulane University, 127 Elk Place, New Orleans, LA 70112, USA
- Corresponding author at: Tulane University School of Social Work, New Orleans, LA, USA.
| | - Kate B. Carey
- Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Providence, RI 02903, USA
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, 121 South Main Street, Providence, RI 02903, USA
| | - Michael G. Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, 1 N. Grand Blvd., St. Louis, MO 63103, USA
- Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Christina S. Lee
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, 264 Bay State Rd, Boston, MA 02215, USA
| | - Cynthia Franklin
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, USA
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Espinosa A, Ruglass LM, Conway FN, Jackson KM, White HR. Motives, Frequency, and Consequences of Cannabis Use Among College Students. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221093608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated profiles of cannabis use motives among current cannabis-consuming college students. Then we assessed profile differences in demographic characteristics, social contexts of use, regulatory environment, alcohol use, negative affect, negative consequences, and cannabis use. Participants ( N = 1, 213) were from three universities in states with different cannabis legislation. Six profiles emerged: Low Motives, Low to Moderate Enhance, High Enhance, High Enhance & Social + Moderate Expand, High Enhance & Cope, and High Motives. Profiles differed in social contexts of use, sex, alcohol use, negative affect, and regulatory environment. Profiles endorsing high and multiple motives had higher cannabis use and negative consequences, relative to profiles with low or fewer motives. Profiles characterized by high avoidance motives (i.e., coping) had the highest cannabis use and consequences. Interventions targeting types and intensity of motives for cannabis-use may help reduce use and related consequences among college students who use cannabis.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, The City College of New York, New York, NY, USA
- Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, USA
| | - Lesia M. Ruglass
- Department of Psychology, The City College of New York, New York, NY, USA
- Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, USA
| | - Fiona N. Conway
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI USA
| | - Helene R. White
- Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, USA
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Lanza ST, Sokolovsky AW, Linden-Carmichael AN, White HR, Jackson KM. Understanding Heterogeneity Among Simultaneous Alcohol and Marijuana Users: Latent Classes Derived From Daily Diary Data. J Stud Alcohol Drugs 2022; 83:358-363. [PMID: 35590176 PMCID: PMC9134998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Simultaneous use of alcohol and marijuana (SAM) is common among U.S. college students, but little research has examined specific substance use behaviors during SAM use episodes. This study identified latent classes of SAM users based on their SAM, alcohol-only, and marijuana-only use episodes. METHOD College student SAM users (N = 284; 50.7% female; M age = 19.8 years) completed up to five surveys each day across two 4-week bursts. Latent class analysis (LCA) was used to characterize SAM users based on seven latent class indicators of use behavior. Sex was examined in relation to latent class membership. RESULTS Five unique classes emerged: Frequent Marijuana-Focused SAM users (21%); Frequent Alcohol-Initiating SAM users (29%); Heavy-Drinking Infrequent SAM users (12%); Moderate SAM users (29%); and Light Infrequent SAM users (9%). These groups were differentiated primarily by their frequency of SAM use, form of marijuana, whether marijuana was used on non-SAM occasions, and whether consequences were experienced. Groups differed significantly by sex. CONCLUSIONS College student SAM users are heterogeneous with respect not only to their degree of SAM use but also in their pattern of drinking, type of marijuana use, relative focus on alcohol versus marijuana, and risk of experiencing acute negative consequences. Describing this heterogeneity is an important step toward developing interventions for different types of users.
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Affiliation(s)
- Stephanie T. Lanza
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania,Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania,Correspondence may be sent to Stephanie T. Lanza at the Department of Biobehavioral Health, Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 302 Health and Human Development Building, University Park, PA 16802, or via email at:
| | | | - Ashley N. Linden-Carmichael
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania
| | - Helene R. White
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island
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