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Anderson GN, Conway CC, Bravo AJ, The Cross-cultural Addictions Study Team. Distress tolerance is linked with substance use motivations and problems in young adults across four continents. J Pers 2025; 93:706-723. [PMID: 39012203 PMCID: PMC11735688 DOI: 10.1111/jopy.12963] [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: 12/15/2023] [Revised: 05/20/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
INTRODUCTION People low in trait distress tolerance are at higher risk for harmful patterns of substance use. Some evidence suggests that maladaptive motives for substance use account for this correlation. However, the generality of these associations remains in doubt because virtually all available data come from North American samples. METHOD Using data from 7 countries (total N = 5858; U.S., Argentina, Uruguay, Spain, South Africa, Canada, and England), we examined distress tolerance's association with alcohol- and cannabis-related problems in young adults. On an exploratory basis, we examined how distress tolerance related to different substance-use motivations. RESULTS We found that distress tolerance was inversely related to problematic alcohol and cannabis use (rs = -0.14 and - 0.13). There was notable variation across countries in the magnitude of these effects, particularly for cannabis-related problems. Additionally, exploratory analyses revealed statistically significant (cross-sectional) indirect effects of distress tolerance on substance-related problems via substance-use motivations related to neutralizing negative emotions. CONCLUSIONS Distress tolerance's role in substance-use problems appears to generalize beyond North America, although effect sizes were generally small and varied notably across geographical regions. Distress tolerance's connection with negative reinforcement processes (e.g., coping motives) warrants attention as a possible mediator of its association with problematic substance use.
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Affiliation(s)
| | | | - Adrian J. Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, VA, US
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2
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Rothstein MC, Stamates AL. Co-use of alcohol and cannabis: Do social norms relate to personal use and consequences among college students? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2025:1-9. [PMID: 40338672 DOI: 10.1080/07448481.2025.2501008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 04/21/2025] [Accepted: 04/23/2025] [Indexed: 05/10/2025]
Abstract
The purpose of the present study was to examine (1) differences in descriptive and injunctive norms for alcohol, cannabis, and co-use, (2) whether descriptive and injunctive norms for alcohol, cannabis, and co-use were associated with co-use frequency, and (3) whether co-use descriptive and injunctive norms were associated with co-use consequences. Participants were 209 college students who were required to have engaged in only alcohol, only cannabis, and co-use in the past year. Participants completed an online survey about their substance use. For Aim 1, participants held the strongest descriptive and injunctive norms for alcohol use. For Aim 2, descriptive norms for co-use were related to greater co-use frequency; injunctive norms were not associated with co-use frequency. For Aim 3, both types of norms were not associated with co-use consequences. In comparison to descriptive norms for alcohol-only and cannabis-only, descriptive norms for co-use were most strongly tied with personal co-use frequency. Findings may inform intervention work focused on college students who engage in co-use by targeting normative perceptions of co-use.
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Affiliation(s)
- Melissa C Rothstein
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Amy L Stamates
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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3
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Linden-Carmichael AN, Chiang SC, Van Doren N, Bhandari S. Early-day psychosocial predictors of later-day simultaneous alcohol and cannabis use among college-attending young adults. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2025; 39:278-289. [PMID: 39621375 PMCID: PMC12045738 DOI: 10.1037/adb0001043] [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: 05/02/2025]
Abstract
OBJECTIVE Simultaneous use of alcohol and cannabis is prevalent among young adults and associated with heightened risk for harms. Individuals who engage in simultaneous use report a variety of types of use occasions and risk factors driving use occasions are unique and dynamic in nature. Intervention content may thus need to adapt to address differences across occasions. As a first step toward developing momentary interventions, it is critical to identify whether and when psychosocial factors are associated with simultaneous use. The present study aimed to identify the most critical morning and afternoon risk factors for later-day simultaneous use. METHOD Participants were 119 young adult college students (63% female; 73% non-Hispanic/Latinx White) who reported weekly simultaneous use at baseline. Participants completed an online baseline survey and an ecological momentary assessment protocol (eight prompts/day) across four consecutive weekends. RESULTS Multilevel models revealed that morning willingness to engage in simultaneous use and social motives were associated with higher odds of later-day simultaneous use. Afternoon willingness and cross-fading motives were significantly associated with higher odds of later-day use. Morning and afternoon conformity motives were associated with lower odds of use. CONCLUSIONS Early-day willingness to use, morning social motives, and afternoon cross-fading motives were the most salient predictors of later-day simultaneous use and may serve as viable tailoring variables to incorporate in momentary interventions. As simultaneous use episodes commonly start after 9 p.m., there is a large time window in between early-day predictors and use behavior during which timely intervention content could be delivered. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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Affiliation(s)
| | - Shou-Chun Chiang
- College of Health and Human Development, Pennsylvania State University
| | - Natalia Van Doren
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
| | - Sandesh Bhandari
- College of Health and Human Development, Pennsylvania State University
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4
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Fairlie AM, Calhoun BH, Fleming CB, Delawalla MLM, Martinez G, Halvorson MA, Rhew IC, Kilmer JR, Guttmannova K. Age-Related Changes in Past-Month Alcohol, Cannabis, and Simultaneous Use in a Statewide Sample of Young Adults in Washington State. J Stud Alcohol Drugs 2025; 86:367-377. [PMID: 39126660 PMCID: PMC12081167 DOI: 10.15288/jsad.24-00065] [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] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE It is unknown whether age-related decreases in substance use (maturing out) are observed in the legalized cannabis context. This study evaluated age-related changes in past-month alcohol use frequency, cannabis use frequency, and any simultaneous alcohol and marijuana/cannabis (SAM) use among young adults who engaged in the respective substance use behavior. METHOD Young adults residing in Washington State at enrollment (N = 6,509; 68.3% female; ages 18-25) provided 3-5 years of annual data in a longitudinal, cohort-sequential design from 2015 to 2019, a period after nonmedical cannabis was legalized and implemented. Multilevel growth models were conducted; poststratification weights were applied to make the sample more similar to the Washington young adult general population in demographic characteristics. RESULTS Among those who reported alcohol use at one or more time points, days of alcohol use increased from age 18 to approximately age 25 and then decreased until age 30. Among those who reported cannabis use at one or more time points, days of cannabis use increased from age 18 until approximately age 23 and then decreased until age 30. Among those who reported SAM use at one or more time points, the probability of SAM use increased from age 18 until approximately age 24 and then decreased until age 30. Age-related changes in SAM use were largely explained by concurrent changes in alcohol and cannabis use frequency. CONCLUSIONS Maturing out was observed for alcohol, cannabis, and SAM use among those who used each respective substance, with evidence that age-related changes in SAM use were tied to alcohol and cannabis use frequency.
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Affiliation(s)
- Anne M. Fairlie
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Brian H. Calhoun
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Charles B. Fleming
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Miranda L. M. Delawalla
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Griselda Martinez
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Max A. Halvorson
- Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington
| | - Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Jason R. Kilmer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
- Department of Psychology, University of Washington, Seattle, Washington
| | - Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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5
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Williams CM, Mastroleo NR, Lenzenweger MF, Zale EL. Pain predicts past-month co-use of alcohol and cannabis among emerging adults: Results from the Population Assessment of Tobacco and Health (PATH) Study. Alcohol 2025; 124:111-119. [PMID: 40015463 DOI: 10.1016/j.alcohol.2025.02.003] [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: 10/30/2024] [Revised: 02/17/2025] [Accepted: 02/20/2025] [Indexed: 03/01/2025]
Abstract
Alcohol use, cannabis use, and pain are public health concerns among emerging adults (18-24 years old). Co-use of alcohol and cannabis is of particular concern since individuals who co-use alcohol and cannabis use more of each substance and experience greater substance-related harm. Pain and substance use frequently co-occur, and a growing body of literature indicates pain is unique risk factor for substance use. The goal of the current study was to examine moderate/severe pain (vs. no/low pain) as a prospective predictor of engaging in co-use of alcohol and cannabis among emerging adults, and to test sex as a moderator of this hypothesized relationship. Data were drawn from Waves 1-5 of the Population Assessment of Tobacco and Health Study (n = 3544). Unadjusted logistic regression revealed that those with moderate/severe pain at baseline were 1.4 times more likely to engage in past-month co-use of alcohol and cannabis over the next four years (p = .046). The effects of pain on co-use were no longer significant after inclusion of covariates and a pain∗sex interaction term, which was also nonsignificant (ps > .05). These findings provide initial support for pain as a risk factor for engaging in co-use of alcohol and cannabis during emerging adulthood. Future research should continue investigating how pain may motivate co-use of alcohol and cannabis, exploring how pain is associated with other measures of co-use, and determining how providers can incorporate pain-substance use psychoeducation for emerging adults in clinical settings.
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Affiliation(s)
| | | | - Mark F Lenzenweger
- Department of Psychology, Binghamton University, USA; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Emily L Zale
- Department of Psychology, Binghamton University, USA.
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6
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Wycoff AM, Trull TJ. Affective reinforcement of simultaneous versus single use of alcohol and cannabis. Drug Alcohol Depend 2025; 270:112612. [PMID: 40020640 PMCID: PMC11951136 DOI: 10.1016/j.drugalcdep.2025.112612] [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: 04/26/2024] [Revised: 01/30/2025] [Accepted: 02/10/2025] [Indexed: 03/03/2025]
Abstract
BACKGROUND Simultaneous alcohol and cannabis use is prevalent among adults who drink alcohol and is associated with more negative consequences than use of either substance alone. Understanding reinforcement processes that maintain simultaneous versus single-substance use will highlight intervention targets specific to this pattern of use. In individuals' daily lives, we tested whether simultaneous use moments are associated with more affectively reinforcing outcomes compared to single use moments. METHODS We used ecological momentary assessment with 6 + daily reports for 14 days. Participants were 88 adults ages 18-44 who reported simultaneous use at least twice per week. Mean age was 25.22 years and participants were 60.2 % female. At each momentary survey, participants reported alcohol and cannabis use, affect, momentary coping and enhancement motives, and subjective appraisals of use. RESULTS Simultaneously using cannabis during alcohol-use moments attenuated the increase in negative affect that accompanied coping-motivated drinking (anxious mood b = -0.11, 95 % CI = [-0.19, -0.02], p = .016; depressed mood b = -0.14, 95 % CI = [-0.23, -0.05], p = .003). Simultaneously using cannabis during alcohol-use moments attenuated the positive association between enhancement drinking motives and subjective drinking-contingent pleasure (b = -0.34, 95 % CI = [-0.50, -0.18], p < .001). CONCLUSIONS Simultaneously using cannabis during alcohol-use moments altered the subjective effects of alcohol, whereas simultaneously consuming alcohol during cannabis-use moments did not alter the subjective effects of cannabis. Individuals may perceive that simultaneous cannabis use mitigates undesirable effects of coping-motivated drinking, thereby driving simultaneous use of cannabis alongside alcohol.
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Affiliation(s)
- Andrea M Wycoff
- Department of Psychiatry, University of Missouri, Columbia, MO 65212, United States.
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, United States
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7
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Bedillion MF, Ansell EB. The association between cannabis and alcohol co-use and momentary subjective effects: Risks for increasingly hazardous cannabis use. Drug Alcohol Depend 2025; 269:112595. [PMID: 39970575 PMCID: PMC11890099 DOI: 10.1016/j.drugalcdep.2025.112595] [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: 09/10/2024] [Revised: 01/28/2025] [Accepted: 01/29/2025] [Indexed: 02/21/2025]
Abstract
BACKGROUND Co-use of cannabis and alcohol is associated with a higher prevalence of health-related, psychiatric, and psychosocial impairments. The aims of this study were to 1) examine the association between cannabis and alcohol co-use and subjective effects, 2) determine whether the time between cannabis and alcohol use is associated with subjective effects, and 3) examine whether subjective responses to co-use are associated with hazardous cannabis use over time. METHODS Young adults who co-used cannabis and alcohol (N = 155, 55.5 % women, Mean age=21 yo) completed baseline, six-month, and twelve-month assessments of hazardous cannabis use. Co-use and subjective effects were assessed across 21 days of EMA at baseline. FINDINGS Co-use was associated with greater momentary subjective intoxication, compared to cannabis- and alcohol-only, and stimulation and bad effects, compared to cannabis-only. Subjective intoxication was significantly higher for co-use within 0-90minutes compared to cannabis-only. Subjective intoxication was significantly higher for co-use within 0-120minutes compared to alcohol-only. Co-use within 0-30minutes was associated with significantly greater stimulation and bad effects, compared to cannabis-only use moments. The extent to which an individual becomes more intoxicated when co-using the greater the risk the individual had for increasing hazardous cannabis use six and twelve months later. CONCLUSION Findings indicate that co-use is associated with increased intoxication, compared to cannabis or alcohol use alone, and increased stimulation and bad effects, compared to cannabis use alone. Subjective responses to co-use in a naturalistic setting are important to consider when evaluating long-term risk of cannabis use among young adults.
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Affiliation(s)
| | - Emily B Ansell
- The Pennsylvania State University, University Park, PA, USA
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8
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Richards VL, Turrisi RJ, Glenn SD, Mallett KA, Altstaedter A, Ackerman S, Russell MA. Serious harm reduction protective behavioral strategies reduce consequences associated with alcohol-induced blackouts in college students. Addict Behav 2025; 162:108234. [PMID: 39709755 PMCID: PMC11770633 DOI: 10.1016/j.addbeh.2024.108234] [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: 09/30/2024] [Revised: 12/16/2024] [Accepted: 12/16/2024] [Indexed: 12/24/2024]
Abstract
OBJECTIVE Alcohol-induced blackouts (AIBs) have been associated with increased alcohol-related consequences. Serious harm reduction (SHR) protective behavioral strategies may reduce consequences when students are drinking heavily. We examined whether SHR weakened the relationship between AIBs and a) total consequences and b) serious consequences (e.g., sexual assault) only. METHODS Students were eligible if they were aged 18-22 years, in their second or third year of college, reported drinking 4 + drinks on a typical Friday or Saturday, experienced ≥ 1 AIB in the past semester, owned an iPhone, and were willing to wear a sensor for 3 days each weekend. Students (N = 79, 55.7 % female, 86.1 % White, Mage = 20.1) wore sensors and completed daily diaries over four consecutive weekends (852 total surveys; 89.9 % completion rate). Linear multilevel models were conducted to test for moderating effects of SHR. RESULTS SHR weakened the association between AIBs and total consequences. At low (-1 SD) SHR, days with an AIB had an additional 1.46 consequences compared to days without an AIB, on average. At high (+1 SD) SHR, days with an AIB had an additional 0.94 consequences compared to days without an AIB, on average. SHR did not change the association between AIBs and serious consequences. CONCLUSIONS Students experienced approximately 50% more consequences on nights when they had an AIB and used below average numbers of SHR compared to nights when they had an AIB and used above average numbers of SHR. These findings suggest that student drinking interventions should include SHR to reduce harm associated with drinking and AIBs.
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Affiliation(s)
- Veronica L Richards
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Tulsa, OK, USA; Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Tulsa, OK, USA.
| | - Robert J Turrisi
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA; Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
| | - Shannon D Glenn
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA; Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
| | - Kimberly A Mallett
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA
| | - Alyssa Altstaedter
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA
| | - Sarah Ackerman
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA
| | - Michael A Russell
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA; Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
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9
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López G, Boyle HK, Haikalis M, Miller MB, Jackson KM, Carey KB, Merrill JE. Day-level associations among alcohol use, simultaneous alcohol and cannabis use, and both regretted and positive romantic/sexual experiences. Addict Behav 2025; 162:108232. [PMID: 39705931 PMCID: PMC11831967 DOI: 10.1016/j.addbeh.2024.108232] [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: 07/21/2024] [Revised: 12/09/2024] [Accepted: 12/13/2024] [Indexed: 12/23/2024]
Abstract
BACKGROUND Young adults who drink heavily, including those who simultaneously use cannabis, experience both positive and regretted romantic/sexual experiences. Both gender and past sexual assault severity may also play a role in the valence of romantic/sexual experiences. The current study focuses on day-level correlates of romantic/sexual experiences, assessing whether: (1) number of drinks or simultaneous alcohol and cannabis use (vs. alcohol only) are associated with likelihood of regretted or positive romantic/sexual experiences and (2) past sexual assault severity or gender moderate these associations. METHODS Two hundred and one young adults (Mage = 22.06) reporting high intensity drinking (8+/10+ drinks for females/males) completed baseline and 28 daily assessments of alcohol use, simultaneous use, and romantic/sexual experiences. RESULTS Consumption of more drinks increased likelihood of both positive and regretted romantic/sexual experiences. Simultaneous alcohol and cannabis use had no effect on positive romantic/sexual experiences. There was a significant interaction between simultaneous use and gender in the prediction of a regretted romantic/sexual experience when controlling for number of drinks. Among women, simultaneous use (vs. alcohol only) significantly decreased likelihood of regretted romantic/sexual experiences. Among men, simultaneous use was unrelated to likelihood of regretted romantic/sexual experiences. Past sexual assault was not a significant moderator of effects of either number of drinks or simultaneous use. CONCLUSIONS Among heavy-drinking young adults, a greater number of drinks is associated with both more regretted and positive romantic/sexual experiences. Findings highlight a unique protective effect of simultaneous use for women, even when controlling for how much alcohol is being consumed.
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Affiliation(s)
- Gabriela López
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, United States; Department of Adult Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI, United States; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States.
| | - Holly K Boyle
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Michelle Haikalis
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Mary Beth Miller
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States; Department of Psychiatry, University of Missouri, Columbia, MO, United States
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States; Rutgers Addiction Research Center, Brain Health Institute, Rutgers University, Piscataway, NJ, United States
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Jennifer E Merrill
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
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10
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Lee K, Fung HW. The mediated model of PTSD between ADHD symptoms and alcohol abuse in a population of college students in Taiwan. J Formos Med Assoc 2025; 124:284-289. [PMID: 39209668 DOI: 10.1016/j.jfma.2024.08.008] [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: 01/23/2024] [Revised: 06/28/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE Impulsivity, inattention, childhood trauma, PTSD, and depressive symptoms were the high-risk factors of alcohol abuse in ADHD symptoms. There is a lack of a comprehensive framework of trauma and PTSD in ADHD symptoms with alcohol abuse to explain why ADHD college students become problematic alcohol drinking. METHOD 521 college students were recruited from online platforms (e.g., Facebook, LINE, or Google) after informed consent (females, 67.9%, n = 354; averaged age = 20.34, S.D. = 1.98). All of them completed the questionnaires, which included symptoms of ADHD, inattention and impulsivity, depressive symptoms, childhood trauma, PTSD symptoms, and problematic alcohol drinking. One-way ANOVA and path analysis were applied to examine the significance of eight paths. RESULTS Our results supported the mediating effects of childhood trauma and PTSD symptoms in ADHD symptoms with problematic alcohol drinking. DISCUSSION The effect of complex PTSD between impulsivity and problematic alcohol drinking is still unclear. In addition to impulsivity and inattention to ADHD symptoms with problematic alcohol drinking, the impact of hyperactivity also needs to be considered. CONCLUSION Effective treatment for ADHD symptoms with alcohol abuse could focus on self-control training and emotional regulation in the future.
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Affiliation(s)
- Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Taiwan.
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
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11
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Folivi F, Bravo AJ, Pearson MR. Mindfulness Profiles and Substance Use Outcomes in University Students: The Role of Alcohol and Cannabis Use Motives. Mindfulness (N Y) 2025; 16:1046-1060. [PMID: 40230595 PMCID: PMC11993505 DOI: 10.1007/s12671-025-02544-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2025] [Indexed: 04/16/2025]
Abstract
Objectives The present study aimed to identify distinct profiles of mindfulness among a sample of university students in the USA who use alcohol and cannabis. Further, we examined whether these mindfulness profiles were indirectly associated with alcohol and cannabis-related outcomes via alcohol and cannabis use motives. Method Latent profile analysis (LPA) was used to determine the number of latent classes among 771 US university students (75.7% White, 66.8% female) who consumed alcohol and cannabis in the prior month. Additionally, parallel mediation analyses were conducted to determine whether mindfulness profiles were indirectly associated with alcohol- and cannabis-related outcomes via alcohol and cannabis use motives. Results LPA indicated a 4-class solution fit optimally. Further, the high mindfulness group was generally the most adaptive (lower scores) across alcohol and cannabis outcomes, whereas the judgmentally observing group was generally the most maladaptive (higher scores). Indirect effect analyses revealed that compared to the low mindfulness group, the high mindfulness group reported lower scores on alcohol- and cannabis-related outcomes via lower alcohol- and cannabis-related coping motives. Conclusions These findings can inform prevention and intervention efforts using mindfulness techniques and interventions among students who engage in problematic alcohol and cannabis use. Preregistration This study is not preregistered. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-025-02544-5.
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Affiliation(s)
- Folly Folivi
- Department of Psychological Sciences, William & Mary, Williamsburg, VA USA
| | - Adrian J. Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, VA USA
| | - Matthew R. Pearson
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM USA
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12
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Waddell JT, McDonald AE, Quiroz SI, Corbin WR. Simultaneous use of alcohol, cannabis, and energy drinks predicts increased daily alcohol consumption and alcohol consequences. Exp Clin Psychopharmacol 2025; 33:8-15. [PMID: 39509207 PMCID: PMC11913311 DOI: 10.1037/pha0000736] [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: 11/15/2024]
Abstract
Simultaneous alcohol and cannabis (SAM) use and alcohol mixed with energy drinks (AmED) days are associated with heavier drinking and negative consequences compared to alcohol-only days. However, it remains unclear if SAM and AmED days differ from one another in terms of consumption and negative consequences. It also remains unclear how often days characterized by both SAM + AmED occur and if these days are associated with incremental risk for heavier drinking and negative consequences. College students who engage in SAM use and AmED completed a 30-day timeline followback interview. Day-level data on drinking days were curated to test whether days characterized by alcohol only, SAM use only, AmED use only, or SAM + AmED were associated with increased drinking quantity, negative alcohol consequences, and positive alcohol consequences. Twenty-one percent of drinking days were AmED days, 19% were SAM days, and 15.4% were SAM + AmED days. SAM-only, AmED-only, and SAM + AmED days were associated with increased drinking and negative consequences compared to alcohol-only days. However, SAM-only and SAM + AmED (but not AmED-only) days were associated with more positive consequences than alcohol-only days. SAM-only and AmED-only days did not differ in drinking quantity or consequences, whereas SAM + AmED days were associated with increased drinking and negative (but not positive) consequences compared to both SAM-only and AmED-only days. Combined SAM + AmED days are common and associated with increased risk for negative outcomes. Prevention efforts should consider how to reduce the occurrence of SAM + AmED use and how to reduce risk on days when it does occur. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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Shute IM, Fitzke RE, Buch KD, Brown ME, Prince MA, Murray SB, Pedersen ER. Associations Between Food Restriction, Alcohol and Marijuana Use and Co-Use, and Consequences Among College Students. Subst Use Misuse 2025; 60:704-714. [PMID: 39763062 DOI: 10.1080/10826084.2024.2447419] [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: 02/16/2025]
Abstract
BACKGROUND Simultaneous alcohol and marijuana use (SAM) and food restriction on days students intend to drink are associated with an increased risk of substance use-related consequences. However, these negative outcomes have been studied mostly in alcohol-only use contexts. Little is known about the combination of alcohol, marijuana, SAM, and food restriction. Therefore, the current cross-sectional study investigated whether alcohol, marijuana, or SAM use and food restriction on substance use days were associated with an increased risk of negative substance-use outcomes. METHOD 901 college students completed a survey about their substance use and eating behaviors. Hierarchical regression analyses tested the relations between these patterns and use-related consequences. RESULTS Among past 30-day alcohol users, alcohol use quantity and food restriction on substance use days independently associated with greater alcohol use consequences. Past 30-day frequency of food restriction on alcohol use days moderated the effect between average drink quantity and alcohol use consequences. Among past 30-day marijuana users, number of hours high and food restriction on use days independently associated with greater marijuana use consequences. For past 30-day SAM users, alcohol use quantity on SAM days significantly associated with greater alcohol consequences. Food restriction on SAM days moderated the effect of marijuana use quantity (i.e., number of times used) on marijuana use consequences. CONCLUSIONS These results provide the basis for further exploration of food restriction and SAM, as well as targeted interventions among at-risk populations.
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Affiliation(s)
- Ireland M Shute
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Reagan E Fitzke
- Department of Psychology, University of Colorado, Springs, Colorado, USA
| | - Keegan D Buch
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Megan E Brown
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Stuart B Murray
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Eric R Pedersen
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
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14
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Farrelly KN, Amini T, Coelho SG, Fox N, Dimitrova N, Hendershot CS, Wardell JD. Proximal antecedents and acute outcomes of simultaneous alcohol and cannabis use: Systematic review of daily- and event-level studies. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2025; 49:43-61. [PMID: 39552023 PMCID: PMC11740185 DOI: 10.1111/acer.15484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 10/18/2024] [Indexed: 11/19/2024]
Abstract
Many studies have revealed that individuals who engage in simultaneous use of alcohol and cannabis report elevated substance-related consequences relative to those who use only alcohol or cannabis; however, evidence from emerging studies examining within-person differences across simultaneous use and single substance use occasions is less consistent. This systematic review aimed to synthesize findings from existing day- and event-level studies of within-person differences in the proximal antecedents and acute outcomes associated with simultaneous use versus single substance use episodes. Our search strategy revealed 30 eligible articles. Two categories of antecedents (i.e., internal [e.g., motives] and external [e.g., social context]) and three categories of outcomes (i.e., consumption behavior, general positive and negative consequences, and specific consequences) were identified. The current literature consistently suggests that greater day- or event-level social and enhancement motives, as well as being in a social context, predict greater likelihood of engaging in simultaneous use compared with alcohol- or cannabis-only use. However, there was heterogeneity in findings regarding the role of other person-level antecedents. Further, while most evidence pointed to heavier alcohol consumption on simultaneous use occasions versus alcohol-only occasions, findings for elevations in acute negative and positive substance-related consequences on simultaneous use versus single substance use occasions were mixed. Additionally, four studies found that increased consequences on simultaneous use occasions depended on the level of alcohol consumed. This review identifies several antecedents for simultaneous use events but suggests that simultaneous use occasions are not always associated with more acute harms than single substance use occasions. Given the extent to which the current literature is mixed, this review emphasizes the importance of methodological improvements and future research examining the mechanisms linking simultaneous use with substance-related consequences to help reconcile findings across within-person and between-person studies.
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Affiliation(s)
| | - Tahmina Amini
- Department of PsychologyYork UniversityTorontoOntarioCanada
| | | | - Nicolle Fox
- Department of PsychologyYork UniversityTorontoOntarioCanada
| | | | - Christian S. Hendershot
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Institute for Addiction ScienceUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jeffrey D. Wardell
- Department of PsychologyYork UniversityTorontoOntarioCanada
- Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
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15
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Vieira JL, Coelho SG, Snaychuk LA, Tabri N, Dawson SJ, Hodgins DC, Keough MT, Shead NW, Kim HS. Mental Health and Dispositional Predictors of Simultaneous Versus Concurrent Cannabis and Alcohol Use in a Canadian Context. CANNABIS (ALBUQUERQUE, N.M.) 2024; 7:41-60. [PMID: 39781556 PMCID: PMC11705038 DOI: 10.26828/cannabis/2024/000256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/12/2025]
Abstract
Objective Cannabis has become more available in Canada since its legalization in 2018. Many individuals who use cannabis also use alcohol (co-use), which can be used either at the same time such that their effects overlap (simultaneous use) or at different times (concurrent use). Though studies have identified predictors of co-use relative to single-substance use, less is known about the predictors of specific types of co-use. The present study examined the mental health and dispositional predictors of simultaneous relative to concurrent use of the two legal substances (cannabis and alcohol) among adults in Canada. Method Canadian adults reporting past-year use of both cannabis and alcohol (N = 1,761) were recruited from Academic Prolific and six Canadian universities. Participants completed online self-report measures of demographic characteristics, cannabis and alcohol co-use, mental health symptoms, impulsivity, and personality traits. Results Binary logistic regression analyses revealed that when independent variables were each examined individually, greater severity of depression, anxiety, PTSD, and ADHD symptoms; greater negative urgency and lack of premeditation; and greater impulsivity each predicted an increased likelihood of reporting past-year simultaneous use relative to concurrent use. When independent variables were grouped into three separate models (mental health, impulsivity, and personality variables), greater anxiety symptom severity, ADHD symptom severity, negative urgency, and sensation seeking were each uniquely associated with an increased likelihood of simultaneous relative to concurrent use. Conclusions Individuals with elevated anxiety and ADHD symptoms, as well as negative urgency and sensation seeking, may be more inclined to engage in simultaneous use to self-medicate and achieve greater symptom reduction. Future studies may examine the directionality of these relations and motives (e.g., coping) that may differentiate simultaneous and concurrent use.
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Affiliation(s)
| | | | | | | | | | | | | | - N. Will Shead
- Department of Psychology, Mount Saint Vincent University
| | - Hyoun S. Kim
- Department of Psychology, Toronto Metropolitan University
- Department of Psychology, University of Calgary, Calgary
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16
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Linden-Carmichael AN, Stull SW, Lanza ST. Alcohol and cannabis use in daily lives of college-attending young adults: Does co-use correspond to greater reported pleasure? Addict Behav 2024; 159:108130. [PMID: 39178638 PMCID: PMC11381134 DOI: 10.1016/j.addbeh.2024.108130] [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: 05/28/2024] [Revised: 07/23/2024] [Accepted: 08/12/2024] [Indexed: 08/26/2024]
Abstract
Co-use of alcohol and cannabis is prevalent and linked with heightened risk for substance-related harms. The current study investigated the role of substance-related pleasure as a reinforcing factor for co-use relative to alcohol or cannabis use. Specifically, we used data from a 21-day diary study of college students to examine day-level associations between co-use and self-reported substance-related pleasure (any, level of pleasure). Participants were 237 college students (65 % female sex at birth, ages 18-24) who reported 1+ alcohol and cannabis co-use occasion. Participants completed daily surveys across 21 consecutive days about yesterday's substance use and experiences of pleasure, yielding 2,086 daily surveys involving alcohol and/or cannabis use. Multilevel models indicated that odds of substance-related pleasure were higher on days with co-use relative to days with single-substance use, and level of pleasure was higher on co-use days relative to cannabis but not alcohol use days. Pleasure may serve as a reinforcing property of co-use that may be related to continued use despite experience of negative consequences. Intensity of pleasure related to co-use appears to be largely driven by use of alcohol. However, given mixed findings concerning level of pleasure, individuals may report co-use increases feelings of pleasure but do not actually experience more pleasure. Pleasure may serve as a viable target in future prevention and intervention programming targeting co-use.
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17
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Davis CN, Ramer NE, Squeglia LM, Gex KS, McRae‐Clark AL, McKee SA, Roberts W, Gray KM, Baker NL, Tomko RL. Alcohol use and cannabis craving in daily life: Sex differences and associations among young adults. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:2331-2340. [PMID: 39579151 PMCID: PMC11629456 DOI: 10.1111/acer.15461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 09/19/2024] [Indexed: 11/25/2024]
Abstract
BACKGROUND Alcohol and cannabis are commonly used together by young adults. With frequent pairings, use of one substance may become a conditioned cue for use of a second, commonly co-used substance. Although this has been examined for alcohol and cannabis in laboratory conditions and with remote monitoring, no research has examined whether pharmacologically induced cross-substance craving occurs in naturalistic conditions. METHODS In a sample of 63 frequent cannabis-using young adults (54% female) who completed 2 weeks of ecological momentary assessment, we tested whether alcohol use was associated with stronger in-the-moment cannabis craving. We also examined whether sex moderated this association and whether cannabis craving was stronger at higher levels of alcohol consumption. RESULTS Although alcohol use and cannabis craving were not significantly associated at the momentary level, there was evidence that this relation significantly differed by sex. Among female participants, there was a negative association between alcohol use since the last prompt and momentary cannabis craving (b = -0.33, SE = 0.14, p = 0.02), while the association among male participants was positive (b = 0.32, SE = 0.13, p = 0.01). Similarly, alcohol quantity was negatively associated with cannabis craving at the momentary level for female participants (b = -0.10, SE = 0.04, p = 0.009) but was not significantly associated for male participants (b = 0.05, SE = 0.04, p = 0.18). CONCLUSIONS Alcohol may enhance cannabis craving among male individuals but reduce desire for cannabis among female individuals. This may point to differing functions of co-use by sex, highlighting a need for research to elucidate the mechanisms underlying this increasingly common pattern of substance use.
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Affiliation(s)
- Christal N. Davis
- Department of Psychiatry and Behavioral Services, College of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
- Ralph H. Johnson VA Medical CenterCharlestonSouth CarolinaUSA
- Mental Illness Research, Education, and Clinical CenterVeterans Integrated Service Network 4PhiladelphiaPennsylvaniaUSA
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Nolan E. Ramer
- Department of Psychiatry and Behavioral Services, College of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Services, College of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Kathryn S. Gex
- Department of Psychiatry and Behavioral Services, College of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Aimee L. McRae‐Clark
- Department of Psychiatry and Behavioral Services, College of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
- Ralph H. Johnson VA Medical CenterCharlestonSouth CarolinaUSA
| | - Sherry A. McKee
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Walter Roberts
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Services, College of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Nathaniel L. Baker
- Department of Public Health SciencesMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Rachel L. Tomko
- Department of Psychiatry and Behavioral Services, College of MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
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18
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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 2024; 72:2710-2717. [PMID: 36194393 DOI: 10.1080/07448481.2022.2128682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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19
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Romm KF, Dearfield CT, Berg CJ. Longitudinal patterns of alcohol and cannabis use among US young adults: Correlates and implications for problematic health outcomes. Addict Behav 2024; 158:108123. [PMID: 39127025 PMCID: PMC11563046 DOI: 10.1016/j.addbeh.2024.108123] [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: 12/21/2023] [Revised: 06/25/2024] [Accepted: 07/28/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION Alcohol and cannabis use are common during young adulthood. Less is known regarding correlates of alcohol-cannabis use patterns and related problematic health outcomes. METHODS Using longitudinal survey data (Fall 2018, 2019, 2020) from 2,194 young adults (YAs; ages 18-34), bivariate analyses and multivariable logistic regressions examined: (1) Wave 1 (W1) sociodemographics and psychosocial factors (i.e., adverse childhood experiences [ACEs], depressive symptoms, personality traits, parent and peer alcohol and cannabis use) in relation to W3 past-month use group (i.e., use of neither, alcohol only, cannabis only, both/co-use); and (2) W3 use group in relation to W5 problematic alcohol use (Alcohol Use Disorder Identification Test), problematic cannabis use (Cannabis Use Disorder Identification Test), and depressive/anxiety symptoms (Patient Health Questionnaire - 4 item). RESULTS Overall, 42.3% reported W3 alcohol-only use, 34.9% co-use, 17.8% no use, and 5.0% cannabis-only use. Those reporting W3 co-use reported greater W1 extraversion, openness, friend alcohol/cannabis use, and were more likely to report parent cannabis use (vs. no use); reported less conscientiousness, greater friend cannabis use, and were more likely to report depressive symptoms and parent cannabis use (vs. alcohol-only use); and reported greater friend alcohol use, and were more likely to report parent alcohol use (vs. cannabis-only use). W3 co-use was associated with higher odds of W5 problematic alcohol use (vs. alcohol-only use) and problematic cannabis use (vs. cannabis-only use). CONCLUSIONS Substance use messaging and interventions should consider YAs' alcohol-cannabis co-use and the unique correlates of such use.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA.
| | - Craig T Dearfield
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
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20
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Buckner JD, Vargo LA, Thomas KL. The relations of difficulties in emotion regulation and distress intolerance with cannabis problems: The role of protective behavioral strategies underutilization. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 166:209462. [PMID: 39059769 PMCID: PMC11392617 DOI: 10.1016/j.josat.2024.209462] [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: 02/22/2024] [Revised: 05/28/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION Difficulties with emotion regulation and distress tolerance are related to more cannabis problems, yet little research has identified why this is the case. Cannabis-related protective behavioral strategies (PBS; behaviors used to mitigate cannabis related problems) are related to less cannabis consumption and related problems. Potentially, these individuals may use cannabis to alleviate the distress and/or in an attempt to regulate their emotions. Thus, the present study aimed to examine the mediational role of PBS on the relations of emotion dysregulation and distress intolerance with cannabis problems. METHODS Undergraduate students who endorsed past-month cannabis use (N = 339, Mage = 19.33, SDage = 1.37; 77.9 % female) at a southern United States university completed a survey online via Qualtrics. RESULTS More emotion dysregulation and less distress tolerance predicted less PBS use and more cannabis problems, but not cannabis use frequency. After statistically controlling for sex, the relation of each transdiagnostic factor with cannabis problems occurred indirectly via the relations of less PBS use and greater cannabis use frequency CONCLUSIONS: The present study supports previous claims that emotion dysregulation and distress intolerance are related to more cannabis problems. Additionally, results suggest that individuals with high levels of these problems underutilize PBS which, in turn, is associated with more frequent cannabis use and use-related problems. Clinical implications are discussed.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
| | - Luke A Vargo
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Katharine L Thomas
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
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21
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Freibott CE, Auty SG, Stein MD, Lipson SK. Opioid misuse and mental health in college student populations: A national assessment. J Affect Disord 2024; 363:72-78. [PMID: 39038626 PMCID: PMC11348281 DOI: 10.1016/j.jad.2024.07.078] [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: 03/15/2024] [Revised: 06/28/2024] [Accepted: 07/14/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Despite growing concern about opioid misuse and mental health of college students, little is known about this population who are at high risk of co-occurrence and unmet needs. This national study aims to estimate the prevalence of opioid misuse, examine correlates with anxiety and depression symptoms, and quantify help-seeking behaviors among U.S. college students. METHODS Data come from students in the Healthy Minds Study between 2017 and 2020 (n = 176,191). Validated screening tools assessed mental health symptoms (PHQ-9, GAD-7). Marginal effects of logistic regression models estimate the effect of opioid misuse on mental health symptoms, help-seeking and academic performance. RESULTS 782 students indicated past month opioid misuse. Student opioid misuse was associated with 24.1 percentage point increase in the probability of screening positive for anxiety/depression (p < 0.001) and 3.6 percentage point increase in the probability of informal help-seeking (p = 0.017). Less than half of students with opioid misuse and a positive depression/anxiety screen received any treatment in the past year. LIMITATIONS Limitations to this study include: possible non-response bias, as it is unknown whether students with opioid misuse may be differentially-likely to respond to the survey; differing time frame for opioid misuse and mental health questions; and data was collected prior to the COVID-19 pandemic. CONCLUSIONS This large, multi-campus study underlines the need for more partnership between substance use and mental health services on campus. It also highlights that college peers could receive training in ways to best help students who misuse opioids, directing them to on- or off-campus care.
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Affiliation(s)
| | - Samantha G Auty
- 715 Albany Street, Talbot Building, Boston, MA 02118, United States of America
| | - Michael D Stein
- 715 Albany Street, Talbot Building, Boston, MA 02118, United States of America
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22
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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; 20:279-290. [PMID: 38560886 PMCID: PMC11442680 DOI: 10.1080/15504263.2024.2330633] [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: 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
- Virginia Consortium Program in Clinical Psychology
| | - Cathy Lau-Barraco
- Old Dominion University
- Virginia Consortium Program in Clinical Psychology
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23
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Pedersen ER, Fitzke RE, Atieh T, Tran DD, Davis JP, Gunn RL, Micalizzi L, Prince MA. Order of Cannabis and Alcohol Use on Pregaming and Non-Pregaming Days Among College Students. J Stud Alcohol Drugs 2024; 85:728-736. [PMID: 38517753 PMCID: PMC11533921 DOI: 10.15288/jsad.23-00043] [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: 02/10/2023] [Accepted: 01/30/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVE Pregaming is common among college students and is associated with heavy drinking and negative alcohol-related consequences. The use of cannabis on pregaming days may exacerbate negative alcohol-related consequences, and the ordering of when cannabis is used on these days may buffer against or intensify these consequences. Considering the growing rates of simultaneous use of cannabis and alcohol among college students, it is necessary to examine the role of pregaming behaviors in the context of cannabis use and its effects on alcohol-related consequences. METHOD In the present study, college students (N = 485) completed a baseline survey and 14 days of daily surveys, reporting on daily alcohol and cannabis use and alcohol-related negative consequences. Multilevel structural equation models were fit to evaluate cannabis outcomes on pregaming versus non-pregaming drinking days and ordering effects on alcohol-related consequences, controlling for number of drinks, age, and sex. RESULTS Across all drinking days, pregaming on that day as well as cannabis use during drinking on that day were associated with a greater risk for alcohol-related consequences. On days that did not involve pregaming, the use of cannabis before drinking was associated with a greater risk for negative alcohol-related consequences, whereas cannabis use after drinking was associated with less risk for consequences. These effects were observed on non-pregaming days only and not on days with pregaming. CONCLUSIONS Findings have implications for brief interventions with students, as analyses suggested that both cannabis use and pregaming--independent of number of drinks consumed--are risky behaviors associated with alcohol-related consequences.
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Affiliation(s)
- Eric R. Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Reagan E. Fitzke
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Toni Atieh
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Denise D. Tran
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Rachel L. Gunn
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island
- Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island
| | - Lauren Micalizzi
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island
- Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island
| | - Mark A. Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado
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24
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Graupensperger S, Calhoun BH, Fairlie AM, Walukevich-Dienst K, Patrick ME, Lee CM. Simultaneous use of alcohol and cannabis and attenuated age-related declines in alcohol and cannabis use disorder symptoms across young adulthood. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 12:100252. [PMID: 39040477 PMCID: PMC11262175 DOI: 10.1016/j.dadr.2024.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/11/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024]
Abstract
Most young adults naturally mature out of high-risk substance use patterns, but it is important to identify factors that may impede normative declines. Use of alcohol and cannabis simultaneously (i.e., simultaneous alcohol and marijuana/cannabis [SAM]) is cross-sectionally associated with alcohol and cannabis concerns, and SAM use increases acute risks at the daily level. However, less is known about long-term risks of SAM use and, specifically, how SAM use relates to maturing out of alcohol and cannabis use. Using four consecutive years of survey data from young adults who reported SAM use (N=409; 1636 responses; aged 18-25 at baseline), we first estimated age-related changes in symptoms of alcohol and cannabis use disorder (AUD/CUD) using multilevel growth modeling. Findings supported a maturing out process, as both AUD and CUD symptom severity significantly declined across young adulthood, on average (4 % and 5 % per year respectively, with significant acceleration). Cross-level interactions tested whether participants' mean SAM use frequency across all four timepoints moderated age-related trajectories in AUD/CUD symptom severity. Significant interactions indicated that, relative to less-frequent SAM use, participants with more frequent SAM use showed less steep declines in AUD (1 % decrease per year vs. 6 % per year) and CUD symptoms (0 % decrease per year vs. 7 % per year); thus, SAM frequency was associated with slower/delayed maturing out of hazardous alcohol and cannabis use. Findings highlight that SAM use may be a correlate or risk-factor for prolonged high-risk substance use during young adulthood that relates to deviations from maturing out processes.
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Affiliation(s)
- Scott Graupensperger
- Dept. of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Brian H. Calhoun
- Dept. of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Anne M. Fairlie
- Dept. of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | | | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Christine M. Lee
- Dept. of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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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] [Grants] [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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Morgan RM, Trager BM, Boyle SC, Rainosek LM, LaBrie JW. Changes in Parent-Student Text Message and Phone Call Communication During the Transition to College as Predictors of Cannabis and Simultaneous Use During the First Year. CANNABIS (ALBUQUERQUE, N.M.) 2024; 7:24-37. [PMID: 38975595 PMCID: PMC11225983 DOI: 10.26828/cannabis/2024/000227] [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: 07/09/2024]
Abstract
Parent communication can be protective against cannabis use among young adults. However, changes in parent-student communication frequency naturally occur during the transition from high school to college. Recent research suggests declines in parent-student communication frequency predict increased drinking and consequences during the first year of college, yet these effects on other risky behaviors are unknown. The current study investigated whether post-matriculation changes in frequency of texting/calling with parents predict cannabis use and simultaneous use of cannabis and alcohol, and whether pre-matriculation cannabis and simultaneous use predict changes in communication. First-year students (N = 287, 61.3% female, 50.9% White) reported cannabis and simultaneous use pre- and post-matriculation (T1 & T3) and changes in frequency of texting/calling their mother/father per day (T2). Negative binomial hurdle models examined whether T2 changes in communication frequency predicted T3 cannabis and simultaneous use, and logistic regression models examined whether T1 cannabis and simultaneous use predicted T2 changes in communication frequency. Results revealed that increasing (vs. decreasing) frequency of calling with mothers and texting with fathers was protective against cannabis use, whereas increasing frequency of calling with fathers was associated with greater risk of use. Changes in communication did not significantly predict simultaneous use, nor did pre-matriculation cannabis or simultaneous use predict changes in either mode of communication with parents during the college transition. These findings highlight that changes in mother and father communication may be both beneficial and detrimental to cannabis use depending on the parent and mode of communication. Implications for these findings are discussed.
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Affiliation(s)
- Reed M Morgan
- Department of Psychology, Fordham University, Bronx NY
- Department of Psychological Science, Loyola Marymount University, Los Angeles CA
| | - Bradley M Trager
- Department of Psychological Science, Loyola Marymount University, Los Angeles CA
| | - Sarah C Boyle
- Department of Psychological Science, Loyola Marymount University, Los Angeles CA
| | - Layla M Rainosek
- Department of Psychological Science, Loyola Marymount University, Los Angeles CA
| | - Joseph W LaBrie
- Department of Psychological Science, Loyola Marymount University, Los Angeles CA
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Dickie DT, Langhinrichsen-Rohling J, McAnulty RD. College students' adverse childhood experiences and their anticipated risky behaviors: Early maladaptive schemas and emotion regulation difficulties as potential mediators. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38917370 DOI: 10.1080/07448481.2024.2369854] [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: 06/14/2024] [Indexed: 06/27/2024]
Abstract
Objective: This study explicates the relationship between college student's adverse childhood experiences (ACEs) and their anticipated engagement in five types of risky behaviors. Two transdiagnostic mechanisms were tested cross-sectionally: disconnection/rejection early maladaptive schemas (cognitive) and difficulties in emotional regulation (emotional). Participants: 521 college student participants were majority female (66.8%), White (57.2%), freshman (54.9%), and heterosexual (72.2%). Methods: Participants completed an online, self-report, survey. Pearson bivariate correlations and parallel mediation analyses were conducted. Results: Sixty percent of students endorsed at least one ACE. Among the total sample, disconnection/rejection schemas partially mediated the relationship between ACEs and anticipated engagement in irresponsible academic/work behaviors, drug use, aggressive/illegal activities, and heavy drinking. Difficulties in emotion regulation partially mediated anticipated risky sexual activities and irresponsible academic/work behaviors. Sex differences were noted. Conclusions: Preventing irresponsible academic activity and other risky behaviors is critically important to college students, parents, and administrators. Intervention efforts should address cognitive and emotional mechanisms.
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Affiliation(s)
- Daniel T Dickie
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Richard D McAnulty
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
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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: 2] [Impact Index Per Article: 2.0] [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; 25:765-773. [PMID: 38656911 DOI: 10.1080/15389588.2024.2342571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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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 PMCID: PMC11232501 DOI: 10.1080/10826084.2024.2320366] [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: 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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Guo Y, Dai CL, Ward RM, Mason WA. The Interaction of Cannabis Consumption with Heavy Episodic Drinking and Alcohol-induced Blackouts in Relation to Cannabis Use Consequences Among Recent Undergraduate College Cannabis Users. CANNABIS (ALBUQUERQUE, N.M.) 2024; 6:23-32. [PMID: 38883276 PMCID: PMC11178058 DOI: 10.26828/cannabis/2023/000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Introduction Risky alcohol use patterns, characterized by heavy episodic drinking (HED) and alcohol-induced blackout, are prevalent in college students. However, it is not clear if experiencing HED and blackout among college-attending cannabis users heightens risk for adverse cannabis use consequences. The purpose of this study was to examine whether heavy episodic drinking and blackout episodes moderate the relationship between cannabis consumption and cannabis use consequences among college students. Methods Undergraduate college students (n = 4331) were recruited from a Midwest University in 2021. This analysis used a subset of data from past 6-month cannabis users (n= 772; 17.8% of the full sample). Among cannabis users, 64.5% identified as female and 87.8% were White with an average age of 19.99 (SD=2.88). A linear regression was conducted with two two-way interactions of cannabis consumption and HED frequency as well as cannabis consumption and alcohol-induced blackout episodes. Results Results showed a statistically significant positive association between cannabis consumption and cannabis use consequences (B=0.73, p<.001), adjusting for the other variables in the model. Blackout, but not HED, was a significant moderator (B=0.19, p=.003). Discussion The findings of this study indicate that blackout experiences amplify the relationship between cannabis use and cannabis-related consequences among college students. This underscores that blackouts not only signal a risk of problematic drinking but also exacerbate the association between cannabis use and its negative consequences. Conclusion Findings may inform college campus interventions targeting cannabis and alcohol concurrent-users who experience alcohol-induced blackouts to reduce their additional risk for cannabis-related consequences.
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Gette JA, Sokolovsky AW, Gunn RL, Boyle HK, Jackson KM, White HR. Latent Classes of Simultaneous Alcohol and Cannabis Use and Associations with Consequences using Daily Data. CANNABIS (ALBUQUERQUE, N.M.) 2024; 6:33-48. [PMID: 38883280 PMCID: PMC11178057 DOI: 10.26828/cannabis/2023/000184] [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: 06/18/2024]
Abstract
Objective Simultaneous alcohol and cannabis use (i.e., marijuana, [SAM], using alcohol and cannabis so effects overlap) is associated with increased consumption and consequences compared to single-substance use. SAM use prevalence is increasing, yet there is heterogeneity in use patterns among those engaging in SAM use, which may lead to differential consequences. Method This study drew on daily data to characterize latent profiles of cannabis, alcohol, and SAM use patterns and to test class differences on related consequences after 3 months among college students engaging in SAM use (77.08% White, 51.67% female). Class indicators were 10 person-level substance use variables derived from repeated daily surveys. Results Results yielded a three-class solution: Heavy Alcohol, Cannabis, and SAM (Heavy Use, n = 105); Heavy Alcohol-Light Cannabis (n = 75); and Light Alcohol-Heavy Cannabis (n = 60). There were significant person-level differences between classes on all substance use indicators (e.g., quantity and frequency of alcohol, cannabis, and SAM) but not sex or race/ethnicity. At 3-month follow-up, the Heavy Use class endorsed more SAM consequences than the other classes. The Heavy Use class did not differ on alcohol or cannabis consequences compared to the Heavy Alcohol-Light Cannabis or Light Alcohol-Heavy Cannabis classes, respectively. The Light Alcohol-Heavy Cannabis class endorsed the fewest alcohol consequences. The Heavy Alcohol-Light Cannabis class endorsed the fewest cannabis consequences. Conclusions Findings highlight distinct patterns of co-use and their association with consequences at follow-up. Heavy alcohol or cannabis use was associated with consequences for that substance, but heavy use of only one substance was not indicative of SAM-specific consequences.
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Affiliation(s)
- Jordan A Gette
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | | | - Rachel L Gunn
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Holly K Boyle
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Helene R White
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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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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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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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 PMCID: PMC11250916 DOI: 10.1080/07448481.2023.2299404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [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 PMCID: PMC11841474 DOI: 10.1080/10826084.2024.2302150] [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: 01/18/2024]
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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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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Rahal D, Linden-Carmichael AN, Lanza ST. Affect Variability in Relation to Alcohol Use Frequency, Intensity, and Concurrent Cannabis Use Among College Students during the COVID-19 Pandemic. ADDICTION RESEARCH & THEORY 2023; 32:375-383. [PMID: 39444433 PMCID: PMC11495852 DOI: 10.1080/16066359.2023.2284209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 10/25/2024]
Abstract
Although alcohol use is related to daily affect, findings regarding affect variability-the degree to which individuals exhibit day-to-day fluctuations in affect-and alcohol use have been mixed. The present study assessed whether individuals who use alcohol tend to have higher positive and negative affect variability than individuals who do not, as well as whether higher affect variability is related to more frequent and intense alcohol use among individuals who use alcohol. We also explored whether affect variability differed between individuals who use alcohol and those who concurrently use alcohol and cannabis. College students (N=1909; M=20.1, SD=1.3; 67.7% female; 76.6% white; n=1147 individuals who use alcohol) completed a 21-day protocol between February-December 2021 in which they reported daily affect, number of drinks consumed, and any cannabis use. As hypothesized, individuals who used alcohol had higher positive and negative affect variability than individuals who did not. Among individuals who used alcohol, individuals with higher negative affect variability drank alcohol more frequently, and both higher positive and negative affect variability were related to more intense alcohol use. No differences emerged between individuals who used alcohol and those who concurrently used alcohol and cannabis. Taken together, higher positive and negative affect variability were related to higher odds of using alcohol and more frequent and intense use among individuals who use alcohol, over and above average affect. Higher affect variability could relate to alcohol use because of difficulties with emotion regulation or heightened sensitivity to the environment.
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Affiliation(s)
- Danny Rahal
- University of California, Santa Cruz, Psychology Department, Santa Cruz, CA 95064, USA
| | - Ashley N. Linden-Carmichael
- The Pennsylvania State University, Edna Bennett Pierce Prevention Research Center, University Park, PA 16802, USA
| | - Stephanie T. Lanza
- The Pennsylvania State University, Edna Bennett Pierce Prevention Research Center, University Park, PA 16802, USA
- The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA 16802, USA
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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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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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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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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] [Key Words] [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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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 PMCID: PMC10330827 DOI: 10.1016/j.drugalcdep.2023.110837] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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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: 3] [Impact Index Per Article: 1.5] [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: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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Affiliation(s)
- Veronica L Richards
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States.
| | - Robert J Turrisi
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States; Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, United States.
| | - Shannon D Glenn
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States; Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, United States.
| | - Katja A Waldron
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States; Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, United States.
| | - Gabriel C Rodriguez
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, United States.
| | - Kimberly A Mallett
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States.
| | - Michael A Russell
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States; Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, United States.
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