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

A systematic review of research on illicit substance use and a meta-analysis of its prevalence among college students in Türkiye

In this study, we attempted to systematically review and meta-analysis the prevalence and risk factors for illicit substance use (ISU) in Türkiye. Based on the PRISMA 2020 statement and checklist, we considered only full-text research articles on ISU among college students (CS) in Türkiye. We searched relevant research via Web of Science, PubMed, MEDLINE, Scopus, ScienceDirect, Google Scholar, and ULAKBIM between 11.06.2022-12.31.2022. We applied double arcsin transformation to the prevalence values and used the LFK index and trim and fill method to measure publication bias. In addition, we generated doi and funnel plots of the prevalence values reported in the selected studies. Among systematically reviewed 53 studies, we identified and meta-analyzed ISU prevalence in 37 studies. The mean prevalence of ISU was determined to be 0.06 (95% CI: 0.04 to 0.07). We discovered that cannabis was the most commonly used substance, with an aggregate prevalence rate of 0.044 (95% CI: 0.026 to 0.066). Common risk factors for ISU were found to be gender, parental education, income, mental problems/suicide/attempted suicide, ISU in family members/relatives, smoking, and alcohol use. Despite the lower prevalence of ISU among students in Türkiye, the research findings emphasized that it has recently become a significant public health problem among the young.

Is the 21st birthday a turning point for alcohol and cannabis use? A monthly study of young adults

BACKGROUND

An important life-course event with respect to alcohol and cannabis use is turning 21 years of age, which may be associated with increases in use of these substances due to celebrations during the month and easier access to them on and following this birthday. We examined the trajectories of alcohol and cannabis use behaviors in the months leading up to, during, and following the 21st birthday month. We also examined whether the use trajectories vary by college status and baseline levels of use.

METHODS

We used data from 203 young adults recruited from the Greater Seattle region who turned 21 during the course of the study. Surveys were administered each month for 24 consecutive months. Measures included the typical number of drinks per week for the past month, the frequency of heavy episodic drinking, the number of cannabis use days, and any simultaneous alcohol and cannabis use. Multilevel spline models were run that estimated linear slopes over time at four intervals: (1) up to 1 month before the 21st birthday month; (2) from 1 month before to the month of the 21st birthday; (3) from the 21st birthday month to 1 month following; and (4) from 1 month following the 21st birthday month through all following months.

RESULTS

Alcohol use, generally, and simultaneous alcohol and cannabis use showed sharp increases from the month before the 21st birthday month to the 21st birthday month and decreases following the 21st birthday month. For cannabis use, there were significant increases in the months leading up to the 21st birthday and no other significant changes during other time intervals. Patterns differed by baseline substance use and college status.

CONCLUSIONS

Findings from the current study have implications for the timing and personalization of prevention and intervention efforts. Event-specific 21st birthday interventions may benefit from incorporating content targeting specific hazardous drinking behaviors in the month prior to the 21st birthday.

The Mediating Effect of Danger Invulnerability in the Relationship Between Sensation Seeking and Gambling Among University Students

The association between sensation-seeking and gambling is well established, yet the research on mediators of this relationship is limited. The proposed model of the present study includes sensation seeking as an antecedent variable, danger invulnerability as a mediator, and gambling frequency as an outcome variable.Self-report data obtained from a convenient sample of 641 university students aged 18-40 years (Mage = 21.25; F = 52.7%, M = 47.3%) were analysed. This study supported proposed hypothesis that both sensation seeking and danger invulnerability are in significant positive relation with the frequency of gambling. Moreover, the results show that tested mediation model fit the data well, and that danger invulnerability completely mediates the relationship between sensation seeking and gambling frequency, such that higher sensation seeking is related to higher danger invulnerability and higher danger invulnerability is related to higher gambling frequency. The model explained 42.4% of the variance in danger invulnerability and 32.7% of the variance in gambling frequency. This study underscores the importance of examining both the direct and indirect effects of different variables on gambling behaviour.

Evaluation of clinical knowledge of drugs causing addiction and associated social determinants among male pharmacy and nursing students in Riyadh, Saudi Arabia - A Cross-Sectional study

Drug abuse is a rising psychological concept in many countries, and its use among individuals is increasing. Therefore, this study aimed to assess the Knowledge and demographic factors associated with drug abuse among male pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. This study used a cross-sectional design targeting male entry-level pharmacy and nursing students in their first and second years of Bachelor of Nursing and Doctor of Pharmacy courses. Of them, 85.3 % of the pharmacy and 75.3 % of nursing students thought that cocaine causes drug addiction, followed by heroin (pharmacy 80.7 %; nursing students 71 %), and morphine (pharmacy 75.2 %; nursing students 59.1 %). In this study, 52 % (n = 105) claimed low awareness, whereas 48 % (n = 97) indicated good understanding regarding drug addictions. Furthermore, the mean knowledge score among pharmacy students was higher (7.073 ± 2.570) in comparison to nursing (5.806 ± 2.494) (t = 3.540; p = 0. 0001). In addition, the father's occupation was found to be significantly associated with the mean knowledge score of drug addiction (F = 2.667; p = 0.034). According to the findings, 52 % of male students had insufficient knowledge about drugs that cause addiction. Age, course of study, and father's occupation all had a substantial impact on knowledge scores. The knowledge score on the complications of addictive substances was not significantly associated with the characteristics of the students (p = 0.05). As a result, we advocate for the introduction of educational initiatives that educate students about the harmful consequences of drug addiction and how to avoid issues.

Using Latent Profile Analysis to Examine Cannabis Use Contexts: Associations with Use, Consequences, and Protective Behaviors

OBJECTIVE

College students represent a large portion of the population, and report high rates of cannabis use and related negative outcomes, including interpersonal problems, risky behaviors, or physical dependency. The contexts in which students use cannabis (e.g., at a party, when feeling down or depressed, after a fight with a loved one) likely affect their risk of experiencing consequences. We aimed to discern profiles of cannabis use contexts and compare profiles on use frequency, consequences, and the use of cannabis protective behavioral strategies (PBS).

METHOD

College students were surveyed regarding their cannabis use contexts, frequency, consequences, and PBS use (n = 265; female = 72.8%). We used Latent Profile Analysis to identify patterns of cannabis use contexts and auxiliary testing to compare profiles on use frequency, consequences, and PBS use.

RESULTS

Our examination revealed three latent profiles of cannabis use. The Social Use Profile was associated with use in predominantly social/uplifting contexts. The Physical & Emotional Pain Profile was also associated with use in these contexts but was defined by additional use in response to pain. The All Contexts Profile was associated with frequent use in all contexts, including those that were least endorsed by the other profiles. Profiles differed in cannabis use frequency, PBS use, and the number of consequences experienced, such that profiles were more likely to be associated with more frequent cannabis use, higher risk of experiencing use-consequences, and using fewer PBS as the number of use contexts increased across the profiles.

CONCLUSIONS

The contexts in which people use cannabis are associated with cannabis risk and protection. Prevention and intervention efforts may benefit from considering contexts of cannabis use.

Salient Beliefs Associated with Unsanctioned Adult Cannabis Use in an Evolving Socio-Political Environment

Background: The changing cannabis legal climate in the United States has been associated with increased prevalence of use, more favorable general attitudes, and cultural norms toward its use among young adults. The purpose of this study was to conceptualize salient beliefs governing illicit cannabis use within a state where medical use is legal and adult use remains illegal. Methods: Following an initial qualitative pilot, a prospective study (baseline and a 30-day follow-up) that utilized an electronic survey design was conducted. Students at a large US university (N = 514) completed a baseline assessment of cannabis use and Theory of Planned Behavior (TPB) constructs, and 169 completed the follow-up assessing actual behavior. Results: Roughly 60% reported illicit cannabis use. Attitude and subjective norms accounted for 57% of the variation in intention for cannabis use in the next 30 days, while intention and perceived behavioral control (PBC) explained 51% of the variation in prospective use. The majority of salient beliefs identified exhibited moderate to strong correlations with intention and behavior among the larger sample. Close friends and partners were identified as important referents, outcome expectations of relaxation, improved social functioning, and more enjoyment, as well as environmental factors, such as proximity to use, safe utilization location, and continued illegality of adult use exhibited strong associations to intention and behavior. Conclusions: The practical utility of the salient belief measures identified herein presents a useful foundation for interventions aimed at reducing illicit cannabis utilization among young adults.

Is pre-college interpersonal trauma associated with cannabis use?

OBJECTIVE

To examine the prevalence and correlates of lifetime cannabis use (i.e., experimental [use 1-5 times] and non-experimental [use ≥ 6 times]) in relation to interpersonal trauma (IPT) above and beyond relevant covariates.

PARTICIPANTS

A large (n = 9,889) representative sample of college students at an urban university in the southeastern part of the United States.

METHODS

Participants were 4 cohorts of first-year college students who completed measures of demographics, cannabis, alcohol, nicotine, and IPT. Associations were estimated using multinomial logistic regressions.

RESULTS

The prevalence of lifetime cannabis use was 28.1% and 17.4% for non-experimental and experimental cannabis use, respectively. IPT was significantly associated with experimental and non-experimental cannabis use above and beyond effects of sex, race, cohort, alcohol, and nicotine.

CONCLUSIONS

Results show that cannabis use is prevalent among college students and is associated with IPT above and beyond associations with sex, race, and other substance use.

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

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

Social norms of college students engaging in non-medical prescription drug use to get high: What's sex got to do with it?

Background: Relationships exist between perceived peer and own use of alcohol, cannabis, and tobacco, particularly when peers and participants are sex-matched. We investigated sex influences on social norms effects for college students' non-medical prescription drug use (NMPDU). Methods: N = 1986 college students reported on their perceptions of male and female peers' NMPDU frequency and their own past-month NMPDU. Results: Approximately 3% of students self-reported past month NMPDU, with no sex differences. In a linear mixed model, participants who engaged in NMPDU perceived significantly more frequent peer use. Female participants perceived more frequent peer NMPDU than did male participants, particularly when perceiving male peers' NMPDU. Significant positive correlations were found between perceived peer NMPDU frequency and participants' own NMPDU for all peer-participant sex combinations, with no evidence for stronger correlations with sex-matched pairs. Conclusions: While social norm interventions may be effective for college student NMPDU, sex-matching of these interventions is likely unnecessary.

Polydrug Use among Students in a Public University in a Lower Middle-Income Country

Recreational drug use among students in tertiary institutions remains a public health concern. Despite documentation of drug use in Kenyan universities, most of the studies are based on self-reported history which is prone to social desirability bias. It is in this context that we sought to establish lifetime and current drug use among university students. The study investigated self-reported and confirmed drug use. Using proportionate to size and snowball sampling methods, 380 respondents were enrolled from three university campuses. Actual drug use was confirmed qualitatively using a 6 panel plus alcohol saliva test kit. The study participants' median (IQR) age was 22 (20-23) years, and 262 (69%) were male; 328 (86%) were degree-level students, while 127 (33%) were in their fourth year and above. A total of 221 (58%) students reported a lifetime ever use of drugs, while 193 (51%) tested positive for at least one drug. Alcohol, tobacco products (cotinine), marijuana, and amphetamine or khat were the most preferred drugs. The usage was either solely, concurrently, or simultaneously. Having multiple sexual partners compared to students with no sexual partner (adjusted risk ratio (aRR) of 2.33 (95% CI 1.45, 3.76)) and residing in Mishomoroni and Kisauni (aRR 1.50 (95% CI 1.08, 2.09)) were associated with risk of testing positive for any drug. Having one (aRR of 1.54 (95% CI 1.05, 2.26)) and multiple sexual partners (aRR 2.03 (95% CI 1.27, 3.25) and residing in Mishomoroni and Kisauni (aRR 1.48 (95% CI 1.05, 2.08)) were associated with self-reported drug use. One out of two students was currently using drugs. Irrespective of the method used to record data, alcohol, tobacco products, marijuana, and amphetamine or khat were the most preferred drugs. The usage was solely, concurrently, or simultaneously. Future interventions should focus on continuing students, students' residences, and those who are sexually active.

Bridging the gap between genetic epidemiological research and prevention: A randomized control trial of a novel personalized feedback program for alcohol and cannabis use

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.

Is Mindfulness Associated With Safer Cannabis Use? A Latent Profile Analysis of Dispositional Mindfulness Among College Students Who Use Cannabis

Objectives

Previous research cites mindfulness as a protective factor against risky substance use, but the specific association between dispositional mindfulness (DM) and cannabis use has been inconsistent. Despite known heterogeneity of DM facets across college students, much of the prior research in this area has relied on variable-centered approaches. Only a handful of prior studies within the cannabis literature have utilized person-centered approaches, and only one has specifically examined unique profiles of dispositional mindfulness in relation to patterns of use among college students.

Method

The present study used latent profile analysis (LPA) to identify subtypes of DM and their relationships with cannabis use behaviors (i.e., hazardous use and consequences of use) in a sample of 683 U.S. college students who endorsed past-month cannabis use and participated in an online survey of substance use behaviors, hypothesizing that a three-profile model would be replicated. We also examined whether age and prior experience with mindfulness predicted DM profile membership (hypothesizing that these variables would differentially predict membership) and explored mean differences in alcohol use across profiles.

Results

LPA results revealed three discrete profiles of DM: non-judgmentally aware, judgmentally observing, and moderate traits. Participants in the non-judgmentally aware profile were less likely to have prior mindfulness experience than the other profiles, but age did not predict profile membership. Judgmentally observing had more hazardous cannabis use and consequences than the other profiles, and no mean differences emerged on alcohol use.

Conclusions

These results build upon the only known study that investigated how DM relates to cannabis use. Further research is needed to elucidate this relationship, which can inform the application of mindfulness interventions for hazardous cannabis use in college students.

Pre-registration

This study was not pre-registered.

Investigation of Addiction Potential and Its Related Health Profile in Medical Students

BACKGROUND

Substance use among medical students is a concern due to its relationship with students' health and the nature of the medical profession. Therefore, this study aimed to assess addiction potential and its relationship with health in medical students.

METHODS

This cross-sectional study was conducted on 200 medical students who were selected through convenience sampling. Students' demographic information, including age, gender, marital status, place of residence, educational level, and substance abuse in first-degree relatives (FDRs), as well as information obtained from the Duke Health Profile and Iranian Addiction Potential Scale (IAPS), were collected in person or online and analyzed using SPSS software (v. 26).

FINDINGS

The mean age of the participants was 23.27±2.4 years and 57.5% of the participants were female. The results indicated a statistically significant relationship between addiction potential score and gender, family history of substance use, and educational level, but not with age, marital status, or place of residence. Moreover, a significant negative correlation was observed between addiction potential and physical, mental, social, and general health scores.

CONCLUSION

This study demonstrated that paying special attention to the health of medical students and planning to improve their health indicators can effectively reduce addiction potential.

Intranasal Use of Prescription Stimulants Among Adults Aged 18 to 30: Results From A Crowdsourcing Platform

OBJECTIVE

Few studies of prescription stimulant non-oral, non-medical use (NMU) (defined by use not as prescribed) have been conducted in adults beyond the college population. The purpose of this study was to characterize prescription stimulant non-oral use, specifically intranasal (IN) use (snorting) in young adults.

METHOD

Amazon's MTurk platform was used to recruit participants for an online survey. Data were collected from March to April 2020.

RESULTS

Thirty-two percent (n = 157) of survey respondents (N = 975), aged 18 to 30, reported IN prescription stimulant use (average of 32.1 episodes of lifetime IN use). Adderall was the most-reported prescription stimulant used intranasally (89.2%). Most IN users (82%; n = 68) reported spending no more than 5 minutes tampering with prescription stimulants. Intranasal users said they would take the medication orally if unable to tamper or manipulate medication for IN use.

CONCLUSION

These data help quantify a complex public health issue of ongoing IN use of prescription stimulants and suggest a potential role for manipulation-deterrent medications.

Predictors of illicit substance abuse/dependence during young adulthood: A machine learning approach

Prior studies have found an especially high prevalence of illicit substance use among adolescents and young adults in Brazil. The current study aimed to employ machine learning techniques to identify predictors of illicit substance abuse/dependence among a large community sample of young adults followed for 5 years. This prospective, population-based cohort study included a sample of young adults between the ages of 18-24 years from Pelotas, Brazil at baseline (T1). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assess illicit substance abuse/dependence. A clinical interview was conducted to collect data on sociodemographic characteristics and psychopathology. Elastic net was used to generate a regularized linear model for the machine learning component of this study, which followed standard machine learning protocols. A total of 1560 young adults were assessed at T1, while 1244 were reassessed at the 5-year follow-up period (T2). The strongest predictors of illicit substance abuse/dependence at baseline (AUC of 0.83) were alcohol abuse/dependence, tobacco abuse/dependence, being in a current major depressive episode, history of a lifetime manic episode, current suicide risk, and male sex. The strongest predictors for illicit substance abuse/dependence at the 5-year follow-up (AUC: 0.79) were tobacco abuse/dependence at T1, history of a lifetime manic episode at T1, male sex, alcohol abuse/dependence at T1, and current suicide risk at T1. Our findings indicate that machine learning techniques hold the potential to predict illicit substance abuse/dependence among young adults using sociodemographic/clinical characteristics, with relatively high accuracy.

Association between binge eating and physical violence perpetration among U.S. college students

BACKGROUND

To date, no known research has explored the link between binge eating and physical violence perpetration despite overlapping psychological constructs that underpin these behaviors (i.e., emotion regulation difficulties, impulsivity). Therefore, this study aimed to determine the association between binge eating and self-reported physical violence perpetration.

METHODS

Cross-sectional data from four survey years (2016-2020) of the national (U.S.) Healthy Minds Study (N = 6210) were analyzed. Unadjusted (Independent samples t test) and adjusted (logistic regression) analyses were conducted to determine the associations between binge eating in the past four weeks and violence perpetration in the past 12 months, while adjusting for potential confounders.

RESULTS

The unadjusted mean number of days of binge eating was significantly higher among participants who reported physical violence perpetration (M = 2.6, SD = 5.2) compared to those who did not (M = 1.8, SD = 3.7). Logistic regression analysis demonstrated that each additional day of binge eating was associated with 5% higher odds (95% confidence interval 1.02-1.09) of self-reported physical violence perpetration, while adjusting for potential confounders.

CONCLUSIONS

Results from this study are the first known to identify an association between binge eating and physical violence perpetration among U.S. college students. Findings are supported by the potential mechanistic overlap of emotion regulation and impulsivity associated with both binge eating and violence perpetration, underscoring the need for more research.

Smoking Mostly Alone as a Risk Factor for Cannabis Use Disorders and Depressive Symptoms

The empirically grounded etiological models of cannabis use already include a vast range of psychological factors (within an individual), paving the ground for individualized prevention and intervention programs. However, the interpersonal (among individuals) and relational variables influencing the emergence of excessive cannabis use are less understood. Particularly, the impact of consumption context (i.e., smoking alone or with others) on cannabis use intensity in youth remains to be clarified. We evaluated how smoking mostly alone modulates cannabis use disorders (CUD) and depressive symptoms in college students. A sample of 854 individuals from France (568 women, 286 men) who used cannabis in the last 6 months completed self-report questionnaires evaluating cannabis consumption, CUD symptoms, and depressive symptoms. Mostly alone users presented higher current use frequency as well as increased CUD and depressive symptoms compared to mostly social users. Smoking mostly alone remained positively correlated with CUD and depressive symptoms, even when controlling for current use frequency. The association between smoking mostly alone and depressive symptoms was significant before adjustment for symptoms of CUD. The loss of significance of this association after control reflected the mediating effects of symptoms of CUD on the relationship between smoking mostly alone and depressive symptoms. These results suggest that smoking mostly alone constitutes a risk factor for uncontrolled cannabis use and promote the relationship between cannabis use and depressive disorders, potentially through loneliness and social isolation. Longitudinal studies are required to identify the causal mechanisms underlying the links between smoking mostly alone, cannabis use and psychopathological disorders.

Professor Hippo-on-Campus: Developing and evaluating an educational intervention to build mental health literacy among university faculty and staff

Objective: The development and evaluation of the Professor Hippo-on-Campus Student Mental Health Education Program, a mental health literacy intervention for post-secondary faculty and staff, is described. It includes 3-hour virtual, asynchronous e-modules and an optional 2-hour, synchronous workshop. Participants: All faculty and staff in a single university were invited to participate (February 2020-January 2021). Methods: Pre-and post-module and post-workshop surveys were conducted, assessing knowledge, attitudes, stigma, behavioral intentions, and confidence. Paired t-tests and regressions assessed change. Satisfaction was assessed through closed and open-ended questions, analyzed descriptively and through qualitative content analysis. Results: Four hundred and fifty staff and faculty completed the pre-survey, 262 completed the post-survey, and 122 completed a workshop survey. Participation resulted in improvements in knowledge, attitudes, stigma, and confidence with high levels of satisfaction. Conclusion: The program provides tailored student mental health training to post-secondary staff and faculty, which appears to increase their mental health literacy.

Posttraumatic stress and risky sex in trauma-exposed college students: the role of personality dispositions toward impulsive behavior

Objectives: Posttraumatic stress disorder (PTSD) has been linked to risky sexual behavior (RSB). However, little is known regarding the role of impulsivity in this relation among college students. Participants: The present study examined the moderating role of impulsivity dispositions on the relation between PTSD symptoms and past-year RSB in a sample of 221 trauma-exposed undergraduate students (77.4% female). Results: Two separate negative binomial regression models examined each impulsivity disposition's unique moderating effect on the association between PTSD symptoms and high risk/casual sex. In the high risk model, significant interactions were found for the urgency dispositions, (lack of) premeditation and (lack of) perseverance, though the pattern of these relations differed across these dispositions. Only positive main effects for negative urgency and (lack of) premeditation emerged in the casual sex model. Conclusions: The present study expands on the limited literature on the role of impulsivity in the relation between PTSD and RSB in trauma-exposed college students.

Exploring risk factors of food and alcohol disturbance (FAD) in U.S. college students

PURPOSE

Current research examining mental health and history of childhood trauma as risk factors of food and alcohol disturbance (FAD) is limited. College students may be at greater risk to engage in FAD behaviors because of the common co-occurrence of alcohol misuse and disordered eating behaviors within college populations. Therefore, the current study examined anxiety, depression, and adverse childhood experiences as possible risk factors of FAD behaviors in a college student sample.

METHODS

Two-hundred and seven undergraduate students from a large Midwest university completed a cross-sectional survey assessing history of adverse childhood experiences, depressive symptoms, anxiety symptoms, FAD behaviors, and frequency of alcohol use.

RESULTS

Current symptoms of generalized anxiety were significantly associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.13, F(1, 204) = 4.10, p = 0.04; Bulimia subscale, β = 0.17, F(1, 204) = 6.19, p = 0.01; Diet and Exercise subscale, β = 0.19, F(1, 204) = 9.05, p < 0.01). Adverse childhood experiences were associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.14, F(1, 204) = 4.27, p = 0.04). Current depressive symptoms were not significantly associated with FAD behaviors.

CONCLUSIONS

Study findings suggest that students who experience greater current symptoms of anxiety are at a greater risk to engage in FAD behaviors. Further understanding the role of anxiety in the development and maintenance of FAD behaviors may provide clinically useful information for the prevention and treatment of FAD behaviors. These findings highlight the need for further research to examine psychological distress as a risk factor for engagement in FAD behaviors longitudinally, in a larger, more diverse study sample.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

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

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

Recreational Nitrous Oxide Use and Associated Factors among Health Profession Students in France

The first aim of this study was to investigate the recreational use of nitrous oxide (N₂O) among health profession students at Montpellier University (France). The second aim was to identify the factors associated with N₂O use. All students in medicine, dentistry, pharmacy and midwifery of the Montpellier University were contacted by email to participate in the survey. The students answered directly online by filling out anonymously a questionnaire including demographic information and questions about N₂O, illicit drugs and alcohol use. Ethical approval was granted by the ethics committee of the Montpellier University. The sample comprised 593 students (mean age = 22.3 ± 2.6 yr), with 68.6% of females. Lifetime N₂O use was reported by 76.6% and frequent alcohol use by 30.5% of the respondents. The lifetime use of cannabis, 'poppers', cocaine, ecstasy and LSD was 26.8%, 54.6%, 9.6%, 10.1% and 2.0% respectively. In multivariate analysis, the substances significantly associated with lifetime N₂O were alcohol drinking and 'poppers' use. With respect to this self-nominated sample, our results indicate that respondents who were alcohol drinkers, were poppers users, follow longer studies, divert medical products for recreational use or were members of a students' corporation had higher odds of lifetime N₂O use.

Compulsive exercise and vaping among a sample of U.S. College students aged 18-26 years

PURPOSE

To determine the association between compulsive exercise and vaping among college students aged 18-26 years, and to characterize the type of vaping used among participants who report compulsive exercise.

METHODS

Cross-sectional, pooled data from two survey years (2018-2020; N = 2125) of the national (U.S.) Healthy Minds Study were analyzed. Compulsive exercise was measured based on number of occurrences in the past 28 days (analyzed continuously and among those who reported  ≥ 1 and ≥ 20 occurrences). Vaping was measured based on reported use in the past 30 days. Most recent type of vaping was assessed only among participants who reported vaping. Logistic regression analyses were conducted to estimate the associations between compulsive exercise and vaping, while adjusting for covariates.

RESULTS

For every additional occurrence of compulsive exercise reported by participants, their odds of also reporting vaping increased by 5% (95% CI 1.01-1.09). Participants who reported 20 or more occurrences of compulsive exercise in the past 28 days, a clinical threshold, had 3.71 (95% CI 1.28-10.76) higher odds of vaping in the past 30 days. Among participants who endorsed vaping, nicotine vaping was the most common recent type for those who reported any (76.2%) or 20 or more (50.2%) occurrences of compulsive exercise.

CONCLUSION

Compulsive exercise is associated with vaping in a national, U.S. sample of college students, with nicotine vaping being the most common type used. Screening for both compulsive exercise and vaping, particularly if either is reported, among college-age young adults is necessary to implement prevention and intervention strategies.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study.

Compulsive exercise among college students: 5-year time trends in prevalence and demographic, substance use, and mental health correlates

PURPOSE

To provide 5-year time trends in prevalence and demographic, substance use, and mental health correlates of compulsive exercise among a national sample of college men and women.

METHODS

We analyzed 4 academic survey years (2016-2020; N = 8251) of the national (USA) Healthy Minds Study. Compulsive exercise was measured by self-report of any occurrence of "compulsive" exercise in the past 4 weeks. Unadjusted prevalence of compulsive exercise in the past 4 weeks was estimated across the 4 survey years by sex. Multiple logistic regression analyses were conducted among the pooled sample and stratified by sex to estimate the associations between compulsive exercise in the past 4 weeks and demographic, substance use, and mental health correlates.

RESULTS

Among the pooled sample, 11% (95% confidence interval [CI] 9.60-12.42%) of men and 17% (95% CI 15.86-18.24%) of women reported compulsive exercise in the past 4 weeks. Prevalence across the 4 survey years remained stable among men and women. Higher body mass index was associated with greater odds of any compulsive exercise in the past 4 weeks among men, while any sports participation was associated with greater odds of any compulsive exercise in the past 4 weeks among women. Compulsive exercise in the past 4 weeks was associated with greater odds of all mental health symptoms and illicit drug use among men and women, and higher odds of alcohol use among women.

CONCLUSION

Compulsive exercise is relatively common among college men and women and is associated with substance use behaviors and poor mental health symptoms.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study.

Associations between discrimination and substance use among college students in the United States from 2015 to 2019

Discrimination has been associated with adverse health behaviors and outcomes, including substance use. Higher rates of substance use are reported among some marginalized groups, such as lesbian, gay, and bisexual populations, and have been partially attributed to discrimination. This study uses 2015-2019 National College Health Assessment data to determine whether college students reporting discrimination due to sexual orientation, race/ethnicity, gender, or age report greater substance use than their peers who do not report such experiences. Additionally, we assess exploratory questions regarding whether substance choices differ among students who reported facing discrimination. Over time, about 8.0% of students reported experiencing discrimination in the past year. After applying inverse probability treatment weights (IPTWs), exposure to discrimination was associated with an excess of 44 cases of marijuana use per 1000 students, an excess of 39 cases of alcohol use per 1000 students, and an excess of 11 cases of prescription painkiller use per 1000 students. Multivariable logistic regression models with IPTW demonstrated that students who experienced discrimination were more than twice as likely to use inhalants and methamphetamine. These students were also significantly more likely to use other drugs, including opiates, non-prescribed painkillers, marijuana, alcohol, hallucinogens, cocaine, and cigarettes; however, the differences with peers were smaller in magnitude. Students who experienced discrimination did not differ from peers who reported non-prescribed antidepressants use and were significantly less likely to use e-cigarettes and smokeless tobacco. Associations between discrimination and substance use vary by race, gender, sexual orientation, and age. These findings indicate that discrimination has significant associations with many kinds of substance use; however, the magnitude varies by substance type. More institutional efforts to address sources of discrimination affecting college students are needed.

Latent Classes of Substance Use in Young Adults - A Systematic Review

Background: This systematic review provides an overview of studies on latent classes related to the substance use among young adults (18-25 years). Identifying these classes helps to detect high-risk groups, setting a base for selective prevention.Methods: This systematic literature review included peer-reviewed studies (published up to February, 2021) that identified latent classes and investigated predictors of latent classes relating to the use of marijuana, alcohol and/or other substances within samples of young adults.Results: Twenty studies (sample sizes N = 171 to N = 21945) met the inclusion criteria. 14 studies identified 'low-level engagers', 'light alcohol and tobacco use', 'heavy alcohol and tobacco use' and 'heavy use/polysubstance use' classes. Four studies differentiated within the 'heavy/polysubstance' class and found 'traditional clubdrugs', 'hallucinogens' and 'wide-range illicit drugs' classes. Male gender and white race predicted membership of the 'heavy use/polysubstance use' class consistently across studies. Other predictors of polysubstance use that were consistent across studies were peer substance use, depressive symptoms, parental drinking and participating in an honor society.Conclusions: The investigated predictors of class membership provide insight into social settings and characteristics that predict heavy use or polysubstance use. They can contribute to the development of effective prevention interventions by allowing for a more targeted approach.

Factors Associated with Having Family/Whānau or Close Friends Who Used Alcohol or Other Drugs in Harmful Ways among University Students in New Zealand

The consequences of alcohol and other drug (AoD) use are well documented. This study investigated factors associated with having family/whānau or close friend who used AoD in harmful ways in New Zealand. Data came from a July-August 2020 cross-sectional survey of students from eight universities (n = 946). Participants were asked if they had family/whānau or close friends in New Zealand who consumed alcohol or used other drugs (cannabis, ecstasy/MDMA, methamphetamine, cocaine, heroin, prescription drugs, inhalants, or other) in a way that negatively impacted them, their family, or close friends in the last 12 months. Logistic regression assessed associations of having family/whānau or close friend who used AoD harmfully with student characteristics. Of respondents, 36.2% (33.1-39.4) had family/whānau or close friend who had consumed alcohol harmfully, and 42.9% (39.5-46.3) had family/whānau or close friend who had used at least one drug harmfully. Respondents' age and ethnicity were significantly associated with having family/whānau or close friend who used AoD harmfully. The results suggest widespread harmful AoD use and potentially significant second-hand effects of AoD use in New Zealand. These data can be used to supplement information from traditional in-person surveys of individuals using alcohol and other drug (e.g., the New Zealand Health Survey).

"This Program Helped Save Our Lives so We All Can Bond over That": A Preliminary Study of the First Oxford House Collegiate Recovery Home

College settings can be challenging environments for students recovering from substance use disorder. Collegiate Recovery Programs (CRP) have emerged on college campuses across the United States to help mitigate the risks recovering students face and to promote academic and recovery success. The current article describes the first collegiate recovery home to follow an Oxford House [OH] model, established at the University of North Carolina at Chapel Hill. In the present preliminary study, qualitative data were utilized to explore the strengths and challenges of this recovery model and students' experiences in the OH collegiate recovery home. Key stakeholders in the creation of this collegiate recovery home (n =2), as well as current and former student participants (n = 6), were interviewed. The key stake-holders' interviews revealed insights on the home's creation, modifications made from the traditional OH model, and the challenges faced in implementing a collegiate recovery home. Rapid qualitative analysis of the interviews of residents revealed salient themes that describe students' experiences within the collegiate recovery home: (1) resident social support, (2) connection to the student body, (3) anonymous status of the house, (4) lifestyle, (5) optimism, (6) self-independence, (7) Collegiate OH is essential for sobriety, and (8) UNC involvement and oversight. The implications of these findings for collegiate recovery homes are discussed, as well as suggestions for future studies.

College-based social and situational predictors of real-time prescription drug misuse in daily life

BACKGROUND

This study examined social and situational context predictors of prescription drug misuse among college-students at a large public university in the Midwest. Social and situational context predictors considered were hour of the day, weekend vs weekday, whether participants were at home or another place, and who they were with during instances of misuse. Salient social events, including home football games, city-regulated parties, and the 2019 Midwest polar vortex were also recorded.

METHOD

Using ecological momentary assessment methodology, 297 students completed momentary reports for 28 days. Participants indicated whether they had misused prescription medication (sedatives or sleeping pills, tranquilizers or anxiety medications, stimulants, and pain relievers) and reported on their social and situational context in the moment of misuse.

RESULTS

Multilevel modeling indicated that participants were more likely to misuse prescription medication earlier in the day vs. the evening, on weekdays vs. weekends, when at home vs. not at home, and while alone vs. with others.

CONCLUSIONS

This study provides descriptive information on the social context in which prescription drug misuse is most likely to occur among college students. Our findings suggest that social and situational contexts of prescription drug misuse likely differ as compared to other substances (e.g., alcohol) among college students. Further research aimed at identifying momentary predictors of prescription drug misuse in this population is warranted.

Family Climate and Intention to Use Cannabis as Predictors of Cannabis Use and Cannabis-Related Problems among Young University Students

Determining the predictive variables associated with cannabis use and cannabis-related problems can ease the identification of young cannabis consumers who can benefit from prevention interventions. This study aimed: (1) to describe, among university students, the cannabis use and cannabis-use problems, intention to use cannabis and family climate based on the gender and the people the student lives with; (2) to explore whether the family climate and intention to use cannabis are predictors of cannabis use and cannabis-related problems. The sample was composed of 339 Spanish undergraduates (51.9% females) in a 17-to-25 age range (19.67 ± 1.53). The variables were assessed through a battery based on the ESPAD survey, cannabis abuse screening test, cannabis use intention questionnaire and family climate scale. More men than women had used cannabis in the precedent year and showed greater intention to use cannabis, whereas more women than men showed greater self-efficacy in not using cannabis. The family climate did not predict cannabis use and cannabis-related problems. However, subjective norms and self-efficacy were key predictors of cannabis use and cannabis-use problems, respectively. Different factors seemed to predict the use cannabis in the past year versus cannabis-related problems, and these differences may help inform the development and delivery of preventative efforts.

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

Research suggests that online interventions preventing risky substance use can improve student health. There is an increasing interest in transferring evidence-based online programs into university health promotion practice. However, little is known about how to best tailor the implementation process to capacities and context of individual universities. The purpose of this study was to assess the level of readiness (capacity) of German universities concerning the implementation of evidence-based online programs for risky substance use prevention employing an adapted Community Readiness Assessment (CRA) and to develop tailored action plans for implementation. The CRA involved 43 semi-structured interviews with key persons at 10 German universities. The interviews addressed five dimensions (knowledge of efforts, leadership, community climate, knowledge of the issue, and resources) at nine possible readiness stages (no awareness-ownership) and additional contextual factors. Overall, readiness for implementing online interventions across universities was rather low. Universities readiness levels ranged between the denial stage with a score of 2.1 and the preplanning stage with a score of 4.4. University-specific readiness was very heterogeneous. On the basis of the results of the CRA, universities received feedback and options for training on how to take the necessary steps to increase readiness and to prepare program implementation. The adapted version of the CRA was well suited to inform future implementation of evidence-based online programs for the prevention of risky substance use at participating universities.

Prevalence and demographic, substance use, and mental health correlates of fasting among U.S. college students

BACKGROUND

Fasting is an unhealthy behavior that has been frequently used as part of weight loss attempts. To date, little research has been conducted to determine the prevalence and substance use and mental health correlates of fasting among college students. Therefore, the aim of this study was to estimate the prevalence and associations between any (≥ 1 time) and regular (≥ 13 times) occurrences of fasting in the past 4 weeks and substance use and mental health correlates among a large sample of college students from 2016 to 2020.

METHODS

Data from four academic survey years (2016-2020; N = 8255) of the national (USA) Healthy Minds Study were analyzed. Unadjusted prevalence of any and regular fasting by survey year and gender was estimated. Multiple logistic regression analyses were conducted to estimate the associations between any and regular fasting and the demographic (age, body mass index, race/ethnicity, sexual orientation, highest parental education), substance use (cigarette use, marijuana use, other illicit drug use, alcohol use), and mental health (depression, anxiety, eating disorder symptoms, suicidal ideation, non-suicidal self-injury) correlates.

RESULTS

Any fasting in the past 4 weeks was common among both men (14.77%) and women (18.12%) and significantly increased from 2016 (10.30%) to 2020 (19.81%) only among men. Regular fasting significantly increased among both men and women from 2016 (men: 1.46%; women: 1.79%) to 2020 (men: 3.53%; women: 6.19%). Among men and women, both any and regular fasting in the past 4 weeks were associated with higher odds of all mental health symptoms, including a positive depression, anxiety, and eating disorder screen, suicidal ideation, and non-suicidal self-injury. Among women, but not men, any and regular fasting in the past 4 weeks were associated with higher odds of marijuana use and other illicit drug use (e.g., cocaine, ecstasy).

CONCLUSIONS

The results from this study underscore both the high and increasing prevalence of fasting among a national sample of college students, as well as the substance use and mental health symptoms associated with this behavior. Healthcare professionals both on and off campus should consider screening for fasting behaviors among college students and provide appropriate intervention when needed.

Associations between eating disorders and illicit drug use among college students

OBJECTIVE

To estimate the associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among a large, diverse sample of college students.

METHOD

We analyzed data from the national (United States), cross-sectional 2018-2019 Healthy Minds Study (HMS; n = 42,618; response rate: 16%). HMS collects information on the physical, mental, and social health of college students. Multiple logistic regression analyses were used to estimate the association between a positive eating disorder screen (measured using the SCOFF) and any self-reported lifetime eating disorder diagnosis and self-reported illicit drug use in the past 30 days (any illicit drug use and use of marijuana, cocaine, heroin, methamphetamines, stimulants, ecstasy, opioids, benzodiazepines), while adjusting for potential confounders.

RESULTS

Among the sample, 54.34% (n = 28,608) were female and the mean age of participants was 23.30 (SE ± 0.05) years. Logistic regression analyses revealed unique associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among the sample of college student participants. A positive eating disorder screen was most strongly associated with methamphetamine use (adjusted odds ratio [AOR] 3.93, 95% confidence interval [CI] 1.43-10.78), and any lifetime eating disorder diagnosis was most strongly associated with benzodiazepine use (AOR 3.42, 95% CI 2.28-5.13).

DISCUSSION

Illicit drug use is common among college students who screen positive for an eating disorder and report any lifetime eating disorder diagnosis. The co-occurring nature of eating disorders and illicit drug use may complicate treatment and lead to compounded adverse health outcomes.

Reducing drug-use harms among higher education students: MyUSE contextual-behaviour change digital intervention development using the Behaviour Change Wheel

BACKGROUND

Digital harm-reduction interventions typically focus on people with severe drug-use problems, yet these interventions have moderate effectiveness on drug-users with lower levels of risk of harm. The difference in effectiveness may be explained by differences in behavioural patterns between the two groupings. Harnessing behavioural theories to understand what is at the core of drug-use behaviours and mapping the content of new interventions, may improve upon the effectiveness of interventions for lower-risk drug-users. To the best of our knowledge, this is the first study to systematically apply the Behaviour Change Wheel (BCW) approach to understand the components, influencing capabilities, opportunities, and motivations (COM-B) of higher education students to change their drug-use behaviors. It is also the first study which identifies specific patterns of behaviours that are more responsive to harm reduction practices through the use of the Theoretical Domain Framework (TDF).

METHODS

We employed an explanatory sequential mix-method design. We first conducted an on-line survey and a Delphi exercise to understand the factors influencing COM-B components of higher education students to change their drug-use. Subsequently, we mapped all evidence onto the COM-B components and the TDF domains to identify clusters of behaviours to target for change, using a pattern-based discourse analysis. Finally, a series of multidisciplinary group meetings identified the intervention functions-the means by which the intervention change targeted behaviours and the Behavioural Change Techniques (BCTs) involved using the behaviour change technique taxonomy (v.1).

RESULTS

Twenty-nine BCTs relevant to harm-reduction practices were identified and mapped across five intervention functions (education, modelling, persuasion, incentivization, and training) and five policy categories (communication/marketing, guidelines, regulation, service provision, and environmental/social planning). These BCTs were distributed across eight identified saturated clusters of behaviours MyUSE intervention attempts to change.

CONCLUSIONS

The BCTs, identified, will inform the development of a digitally delivered behaviour change intervention that focuses on increasing mindful decision-making with respect to drug-use and promotes alternatives to drug-use activities. The findings can also inform implementation scientists in applying context-specific harm-reduction practices in higher education. We present examples of how the eight identified clusters of target behaviours are mapped across the COM-B components and the TDF, along with suggestions of implementation practices for harm reduction at student population level.

Associations between opioid misuse and social relationship factors among American Indian, Alaska Native, and Native Hawaiian college students in the U.S

BACKGROUND

Despite declining overall rates of opioid misuse among college students, racial and ethnic differences in percentage and correlates of opioid misuse among student populations remains unclear. This study seeks to estimate percentages of opioid misuse among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) college students and determine whether problems in social bonds affect AI/AN/NH opioid misuse.

METHODS

Guided by social relationship factors associated with substance use in the Social Development Model, we used 2015-2019 data from the American College Health Association-National College Health Assessment survey in multivariable logistic regression models to examine the role of social bonds with peers and family in opioid misuse (prescription and non-prescription) among AI/AN/NH college students across the U.S.

RESULTS

The percentage of opioid misuse was highest among AI/AN/NH college students (7.12 %) relative to other race/ethnicity groups. AI/AN/NH college students who reported experiencing loneliness (aOR: 1.68; 95 % CI 1.33-2.12; P < .0001), difficult social relationships (aOR: 1.27; 95 % CI 1.04-1.55; P = 0.0196), family problems (aOR: 1.32; 95 % CI 1.07-1.63; P = 0.0097), and intimate partner violence (aOR: 1.92; 95 % CI 1.56-2.36; P < .0001) were significantly more likely to misuse opioids than students who did not report experiencing these relationship problems.

CONCLUSIONS

Relationship problems with peers and family increase AI/AN/NH college student risk for opioid misuse, indicating opportunities for colleges to support programs addressing healthy social relationships as a means to reduce opioid misuse among AI/AN/NH students.

Associations between social network characteristics and alcohol use alone or in combination with cannabis use in first-year college students

OBJECTIVE

Simultaneous use of alcohol and cannabis is common among young adults, but little research has examined social ties and their relation to simultaneous use. This study investigated the social network characteristics of college students at two time points in the first year of college. Participants were categorized into those who used alcohol and cannabis, such that their effects overlap (simultaneous users), those who used both substances without overlapping effects (concurrent users), and those who used alcohol only.

METHOD

First-year college students (N = 1,294) completed online questionnaires during the fall and spring semester. At both assessments, participants nominated up to 10 important peers in their class, reported on peers' alcohol and cannabis use, and reported their own use of alcohol or cannabis with each peer.

RESULTS

Concurrent and simultaneous users reported a greater proportion of drinking buddies than those who used alcohol only. A greater proportion of friends who used alcohol or cannabis, but not the proportion who were "drinking buddies" or "cannabis buddies," was associated with increased odds of simultaneous use relative to concurrent use. Participants nominated network ties that paralleled their own substance use (e.g., the majority of simultaneous users' networks ties were also simultaneous users).

CONCLUSION

Having a larger percentage of friends who use cannabis and alcohol is associated with increased odds of using both substances at the same time, perhaps because it gives access to both substances at the same time. Interventions should account for amount of exposure to alcohol and cannabis use from network members. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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

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

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

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

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

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Many non-users expressed uncertainty in legalization attitudes and risk perceptions.

Aims

We explored past-year cannabis use and associated characteristics, focusing on legalization attitudes, use intentions, risk perceptions, and possible dependence among Norwegian university/college students.

Methods

We examined a nation-wide sample of Norwegian university/college students (N = 49,688; 67% female) who participated in the Students’ Health and Wellbeing Study (SHoT-study) in 2018. Participants reported past-year substance use, support for cannabis legalization, intent to use cannabis if legal, and perceived risks of weekly use. Past-year cannabis use (including use frequency) was examined in relation to these indicators. Legalization support, use intentions, and risk perceptions were examined in relation to use and gender. Potential cannabis use disorder was assessed with the Cannabis Abuse Screening Test (CAST) and examined in relation to use frequency and gender.

Findings

Past-year use was reported by 15.3% (11.8% women; 22.9% men). Majority of current users (roughly 90%) used no more than 50 times past year, and 6% (3.8% women; 8.5% men) met CAST use disorder criteria. Legalization support, use intentions, and no/low risk perceptions were significantly associated with greater odds of use, and greater use frequency among current users in both crude and adjusted models. Legalization support (23.0%), use intentions (14.0%), and perceptions of no/low risk (29.2%) were also relatively common even among current non-users, especially men. Male gender and more frequent use were associated with greater CAST scores and greater odds of use disorder.

Conclusions

Cannabis use was relatively common in this student sample. In addition to targeting frequent use, interventions may focus on cannabis-related attitudes and risk perceptions among uncertain/uninformed students.

The Prevalence of Substance Misuse and its Effects among Omani College Students: A Cross-sectional Study

Objectives

Many studies have confirmed that the use of alcohol, tobacco, and cannabis is prevalent among university students. This study aimed to assess the prevalence of substance misuse among college students in Oman, identifying the most commonly used substances, and reviewing the effect of substance misuse on the students’ performance.

Methods

This cross-sectional study was conducted in a higher learning institution in an urban setting in Oman from April 2018 to December 2018. A descriptive, self-administered online questionnaire, the Alcohol, Smoking, and Substance Involvement Screening Test, version 3.0 (Arabic version), adapted from the World Health Organization was sent to 12 000 students at the college. The sample size was calculated using online software (Raosoft), with a margin of error of 5% and a confidence level of 95%.

Results

A total of 375 students responded (response rate = 3.1%). The overall lifetime prevalence for any substance misuse (including tobacco and alcohol) among the participants was 41.3%, with the overall prevalence without tobacco or alcohol at 29.9%. Tobacco was the most common substance used, with a prevalence of around 23.5%, followed by alcohol at 10.7%. Male students had a significantly higher rate of substance abuse, for any substance, compared to female students (p < 0.001). There was a significant correlation between tobacco use, alcohol misuse, and misuse of other substances. Most of the adverse effects attributed to substance misuse reported by the respondents in this study were social (27.7%) and health-related (25.8%) problems. The impact of substance abuse on their performance was also high (23.8%). Furthermore, 15.4% of the respondents had financial problems, and 4.7%% were struggling with legal issues. Notably, only 49.1% of the respondents perceived that substance misuse was a serious problem.

Conclusions

Although college students are expected to be more aware of the negative impacts of substance misuse, this study found a high prevalence of smoking, alcohol, and other substance misuses among the group of Omani college students. Further research in this field is essential, and the results of this study have shed light on a critical problem among Omani college students. It is hoped that the findings of this study will be used and built on in future research to recognize students at risk of substance misuse from early school life, leading to early intervention, and potentially preventing the possible negative consequences.

Risk for alcohol use/misuse among entering college students: The role of personality and stress

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We examined unique and joint effects of stress and personality on alcohol misuse.

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Factor-level Neuroticism is not uniquely associated with more alcohol misuse.

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Higher Neuroticism—Depression facet scores are associated with more alcohol misuse.

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Neuroticism—Depression moderates the association between stress and alcohol misuse.

Introduction

Excessive alcohol use amongst college students is associated with low grades, poor mental health, and risks to physical safety. Neuroticism, characterized by emotional instability and anxiety, and self-reported stress have both been shown to be strong predictors of alcohol use and misuse, however, previous studies have shown that measures of stress and Neuroticism are frequently confounded. This study tests the hypothesis that personality traits, and Neuroticism in particular, predict alcohol use/misuse in matriculating freshmen above and beyond reported levels of stress.

Methods

Data were collected as part of an IRB-approved longitudinal study, MAPme, examining behavioral health in college. Participants were 303 first-year college students (70% female) with an average age of 18.58 (SD = 0.39). Data were collected during the first eight weeks of the first semester at college.

Results

Overall, domain-level Neuroticism was not associated with alcohol use/misuse above and beyond perceived levels of stress and other Big Five domains (β = 0.14, p = 0.088). Notably, the depression facet of Neuroticism (Neuroticism—Depression), was positively associated with alcohol use/misuse when accounting for the shared effects of stress. Results demonstrated that the Neuroticism—Depression facet moderated the relationship between stress and alcohol use/misuse (β = 0.18, p = 0.020).

Conclusions

The Neuroticism—Depression facet is a better predictor of alcohol use/misuse than the Neuroticism domain, even when accounting for stress and other personality domains.

At low levels of the Depression facet, stress was negatively associated with alcohol use/misuse, but at high levels of the Depression facet, stress was positively associated with alcohol use/misuse. Taken together, our results shed new light into the combined and independent effects of Neuroticism and stress on alcohol use/misuse.

Effects of Recreational Marijuana Legalization on College Students: A Longitudinal Study of Attitudes, Intentions, and Use Behaviors

PURPOSE

As legal recreational marijuana use expands rapidly across the U.S., there is growing concern that this will lead to higher rates of use among college-aged young adults. Given the limited research addressing this issue, a longitudinal study was conducted to evaluate the effects of legalizing recreational use on the attitudes, intentions, and marijuana use behaviors of college students in two different legalization contexts, Washington State and Wisconsin.

METHODS

Survey data assessing marijuana attitudes, intentions, and use behavior were collected from 2011 to 2016 on a longitudinal cohort of 338 students at two large public universities in Washington and Wisconsin. Time series analyses were conducted to evaluate postlegalization changes in ever use, 28-day use, and mean attitude and intention-to-use scores in Washington state, using Wisconsin participants as the control group.

RESULTS

Ever use, attitude, and intention-to-use scores did not change significantly more in Washington after legalization than in Wisconsin. However, among prior users, the proportion using in the last 28 days rose faster in Washington after legalization that it did in Wisconsin (p < .001).

CONCLUSIONS

The findings suggest that legalization had the greatest effects on current marijuana users, who are surrounded by a climate that is increasingly supportive of its use.

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

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

Problematic internet use/computer gaming among US college students: Prevalence and correlates with mental health symptoms

BACKGROUND

Despite widespread internet use and computer gaming, as well as concerns about online addiction, little is known regarding the relationship between problematic internet use/computer gaming and mental health (MH) symptomatology among US college students. To address this gap, the present study examines a large, nation-wide sample of US college students to assess the rate of problematic internet use/computer gaming and its association with MH symptoms.

METHODS

Using data from 43,003 undergraduates participating in the 2017 American College Health Association-National College Health Assessment, we examined rates of problematic internet use/computer gaming, defined as self-reported internet use/computer gaming that negatively affected academic performance. Logistic regression using a generalized estimating equations approach to adjust for clustering by school examined whether rates of MH symptomatology differed among students who reported problematic versus nonproblematic internet use and computer gaming.

RESULTS

Ten percent of students reported problematic internet use/computer gaming that had negatively impacted academic performance. Adjusting for a range of covariates, students reporting problematic internet use/computer gaming had higher rates of all 11 MH indicators examined, with odds ratios ranging from 1.42 ("ever attempted suicide") to 3.90 ("ever felt overwhelmed by all you had to do").

CONCLUSIONS

Problematic internet use/computer gaming is reported by 10% of undergraduate students and represents a significant correlate of MH symptomatology. These findings suggest that problematic internet use/computer gaming will be an important public health focus for college campuses.

Coping strategy utilization among posttraumatic stress disorder symptom severity and substance use co-occurrence typologies: A latent class analysis

OBJECTIVE

There is a lack of research on primary prevention of posttraumatic stress disorder (PTSD) symptoms and substance use among trauma-exposed populations. To guide the development of more effective prevention efforts, the current study sought to identify underlying coping mechanisms that impact PTSD-substance use co-occurrence.

METHOD

A person-centered analytic approach (latent class analysis) examined PTSD-substance use co-occurrence typologies (classes) and identified theoretically adaptive (e.g., active coping) and maladaptive (e.g., denial) coping strategies that differentiated between classes among a sample of 1,270 trauma-exposed participants (Mage = 20.71, 73.5% female, 45.7% White).

RESULTS

Latent class analysis identified five distinct typologies, reflective of extant epidemiological and etiological work. Generally, behavioral disengagement and self-blame coping increased the likelihood of being in more severe PTSD-illicit substance use (e.g., cocaine) comorbidity classes. Positive reframing and planning differentiated between low and moderate illicit substance typologies with moderate PTSD severity. Venting, acceptance, and self-distraction differentiated between asymptomatic and moderate PTSD severity typologies with low illicit substance use.

CONCLUSIONS

Findings identify general coping strategies associated with increased likelihood of being in more severe comorbidity typologies, as well as several unique coping strategies associated with risk of transitioning between low/moderate PTSD and illicit substance use classes. Relevant interventions (e.g., trauma psychoeducation, guilt-reduction therapy, psychological first aid) that may be targets for future prevention-oriented work are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Prescription drug misuse, other substance use, and sexual identity: The significance of educational status and psychological distress in US young adults

BACKGROUND

The aim was to examine the effects of sexual identity, educational status, and their interaction on the past-year prevalence of controlled prescription use and prescription drug misuse (PDM) in U.S. young adults, 18-25 years. Methods: Data were from the 2015-2017 National Survey on Drug Use and Health (young adult N = 38,298). Past-year prescription opioid, stimulant and benzodiazepine use and PDM were outcomes, with PDM defined as use without a prescription or in ways not intended by the prescriber. Separate regressions by sex evaluated the relationship between prescription medication use or PDM prevalence and sexual identity, educational status/attainment (college student/graduate versus non-college), their interaction and past-year psychological distress. Results: Sexual identity minority young adults had higher rates of prescription use and PDM than heterosexual young adults. After accounting for educational status, though, bisexual men rarely differed from heterosexual men; after including psychological distress, gay men rarely differed from heterosexual men. Versus heterosexual women, lesbian (adjusted odds ratio [AOR] = 2.33, 95% confidence interval [95% CI] = 1.47-2.30) and bisexual (AOR= 1.78, 95% CI = 1.27-2.50) young adult women had higher rates of prescription opioid misuse, after adjusting for educational status, psychological distress and sociodemographics. Versus heterosexual men, benzodiazepine PDM was elevated in gay men (AOR = 1.91, 95% CI= 1.02-3.58). Educational status was generally associated with lower rates of prescription use and PDM, except for stimulant PDM. Conclusions: Screening for psychological distress and PDM is needed in sexual identity minority young adults, especially for prescription opioid misuse among sexual identity minority women. Culturally-sensitive intervention should be considered for those with elevated psychological distress or signs of PDM. Further research on the sex differences found in the link between psychological distress and sexual identity minority opioid and stimulant PDM is warranted.

Motivations for the nonmedical use of prescription drugs in a longitudinal national sample of young adults

INTRODUCTION

People's motivations for nonmedical use of prescription drugs (NMUPD) are not well studied, particularly in longitudinal representative samples. However, understanding which motivations are most popular and how these change over time for specific groups is important to inform interventions for NMUPD.

METHODS

The current study examined how young adults' motives for NMUPD changed over young adulthood, using a nationally representative sample of 12,223 young adults in 36 cohorts (1976-2012) as part of the Monitoring the Future study across three biennial waves (waves 1, 2, 3: modal ages 19/20, 21/22, and 23/24 years). We investigated these young adults' motivations for using stimulants, central nervous system depressants, and opioids when controlling for possible cohort effects. We included sex and college attendance as potential moderators.

RESULTS

Participants commonly reported recreational and self-treatment motivations over time and across drug classes, reporting four to five popular motivations in each drug class. Generalized estimating equations repeated measure analyses revealed relatively stable NMUPD motivations across young adulthood. Participants reported some reductions in experimentation and boredom as motivations for NMUPD and increases in certain self-treatment motivations, depending on prescription drug class. Overall, men were more likely to endorse recreational motivations, whereas women were more likely to endorse self-treatment motivations, though this varied somewhat by prescription drug class. Young adults not enrolled in college courses were more likely to endorse using stimulants nonmedically for different reasons than their peers who were enrolled.

CONCLUSIONS

NMUPD prevention and treatment efforts tailored to the young adult population should include methods to reduce both self-treatment and recreational use and need to consider prescription drug class, sex, and college attendance.

Prescription Drug Misuse: Taking a Lifespan Perspective

Prescription drug misuse (PDM), or medication use without a prescription or in ways not intended by the prescriber, is a notable public health concern, especially in the United States. Accumulating research has characterized PDM prevalence and processes, but age-based or lifespan changes in PDM are understudied. Given age-based differences in the medical or developmental concerns that often underlie PDM, it is likely that PDM varies by age. This review summarizes the literature on PDM across the lifespan, examining lifespan changes in prevalence, sources, motives and correlates for opioid, stimulant, and tranquilizer/sedative (or benzodiazepine) PDM. In all, prevalence rates, sources and motives vary considerably by age group, with fewer age-based differences in correlates or risk factors. PDM prevalence rates tend to decline with aging, with greater use of physician sources and greater endorsement of self-treatment motives in older groups. Recreational motives (such as to get high) tend to peak in young adulthood, with greater use of peer sources or purchases to obtain medication for PDM in younger groups. PDM co-occurs with other substance use and psychopathology, including suicidality, across age groups. The evidence for lifespan variation in PDM is strongest for opioid PDM, with a need for more research on tranquilizer/sedative and stimulant PDM. The current literature is limited by the few studies of lifespan changes in PDM within a single sample, a lack of longitudinal research, little research addressing PDM in the context of polysubstance use, and little research on minority groups, such as sexual and gender minorities.

Attentional bias for alcohol cues in visual search-Increased engagement, difficulty to disengage or both?

Cognitive models emphasise the importance of attentional bias in addiction. However, many attentional bias tasks have been criticised for questionable psychometric properties and inability to differentiate between engagement and disengagement processes. This study therefore examined the suitability of two alternative tasks for assessing attentional bias within the context of alcohol use. Participants were undergraduate students (N = 169) who completed the Visual Search Task and Odd-One-Out Task, the latter of which is designed to differentiate between engagement and disengagement processes of attention, at baseline and one week later. Participants also completed baseline measures of alcohol consumption, craving, and alcohol use problems. Internal consistency was adequate for the Visual Search Task index, and weak for the Odd-One-Out Task indices. Test-retest reliability was weak for both tasks. The Visual Search Task index and the disengagement (but not the engagement) index of the Odd-One-Out Task showed a positive association with alcohol consumption. This study was restricted to a non-clinical student sample. The relatively high error rate of the Odd-One-Out Task might have reduced its sensitivity as an index of attentional bias. Both tasks showed some merit as attentional bias measures, and results suggested that attentional disengagement might be particularly related to alcohol use. However, the reliability of the current measures was inadequate. One potential explanation for the low reliability is that non-clinical samples may have weak and unstable attentional biases to alcohol. Future efforts should be made to improve the psychometric qualities of both tasks and to administer them in a clinical sample.