Journal Articles

Prevalence of Pharmacotherapy for Attention-Deficit/Hyperactivity Disorder and Prescription Stimulant Misuse: A National Study of US College Students

Increasing rates of attention-deficit/hyperactivity disorder (ADHD) pharmacotherapy may simultaneously benefit patients and increase the availability of stimulants for misuse. We measured the association between university-level prevalence of ADHD medication treatment and prevalence of prescription stimulant misuse (PSM) among college students. This was an observational study using cross-sectional data from the American College Health Association–National College Health Assessment III. Data included 395 participating universities between Fall 2019 and Fall 2022. Our sample included 224,469 undergraduates aged 18–25 years (65.2% cisgender female; 58.7% White). Students self-reported any life-time clinical ADHD diagnosis, past-year ADHD medication treatment and past-3-month PSM. We defined university-level ADHD medication prevalence as the proportion of included students endorsing past-year ADHD medication treatment. Secondary outcomes included life-time PSM and moderate- to high-risk alcohol and cannabis use. We also measured university-level depression medication prevalence as a negative control exposure. Among the included students, 9.6% reported a life-time clinical ADHD diagnosis, 5.1% reported past-year medication treatment and 2.4% reported past-3-month PSM. The prevalence of ADHD medication treatment varied among universities. In adjusted models, prevalence of PSM was 7% relatively greater for every 1% increase in university-level medication prevalence. Further, individuals with non-medication-treated ADHD were 40% more likely to report PSM than those without ADHD. There was no statistically significant difference in PSM among individuals with ADHD who did or did not receive medication. Results for secondary outcomes and the negative control partially supported the specificity of the findings. Among university students in the United States, there appears to be a positive association between attending universities with a greater prevalence of attention deficit/hyperactivity disorder (ADHD) medication treatment and risk of prescription stimulant misuse (PSM). This study provides further support for the possibility that ADHD medication treatment prevalence is a risk factor for PSM. Read more.

Prospective Examination of How Alcohol Consumption Might Drive Changes in Urgency and Drinking Motives Over the First Year of College

Negative and positive urgency are risk factors for alcohol escalation during college, partly through increasing motives for alcohol use, which then contribute to subsequent drinking. Research has focused on the causal direction from trait to motives to alcohol consumption. The current study conducted an initial test of how alcohol use might drive changes in urgency, and subsequent changes in motives over the first year of college. 418 first-year college students (Mage = 18.16, 73.7% female, 86.5% White) were sampled at three timepoints. Mediation models were used to test hypotheses. Alcohol use at baseline predicted increased enhancement motives through increased positive urgency. Alcohol use at baseline did not predict coping motives through changes in negative urgency. Changes in positive urgency and enhancement motives secondary to alcohol use appear to occur early in one’s drinking history, making them prime targets for early prevention strategies. Read more.

 

A Longitudinal Study of the Association Between E-Cigarette Use Contexts and Alcohol Use Problems Among College Students

Previous studies had explored the associations between e-cigarette use and alcohol use problems, yet they did not fully consider e-cigarette use contexts. This longitudinal study conducted a prospective examination of e-cigarette use contexts and alcohol use problems among college students. College e-cigarette users at three public universities from Fall 2019 to Fall 2020 were included (N = 377). A linear mixed model with a random intercept and random slope was employed to examine the longitudinal associations. Higher frequencies of e-cigarette use, being hooked on e-cigarettes, using e-cigarettes for socializing purposes, and more occasions of co-using e-cigarettes with alcohol were linked to more alcohol use problems. Intervention efforts should incorporate comprehensive screening that includes both e-cigarette and alcohol use, enhance awareness of peer influence, and provide at-risk populations with education regarding the potential synergistic effects of e-cigarette and alcohol co-use. Read more.

 

Nonmedical Use of Controlled Medications by Adolescents and Young Adults: Clinical Report

Nonmedical prescription drug use (NMPDU), the use of controlled prescription medications for purposes other than initially intended by the prescriber, is common among adolescents and young adults (AYAs). Prescription stimulants, sedatives, and opioid medications are the 3 main categories of controlled medications nonmedically used by AYAs. The intent of this clinical report is to provide an overview of the epidemiology, motives, sources, and risk factors of NMPDU among AYAs. This report also describes acute and long-term morbidity and mortality associated with NMPDU and discusses the importance of primary and secondary prevention to reduce the burden of NMPDU among AYAs. This report concludes with a series of recommendations on how pediatricians can address NMPDU with patients and their families. Read more.

 

Opioid Misuse and Mental Health in College Student Populations: A National Assessment

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. 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. 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 and 3.6 percentage point increase in the probability of informal help-seeking. Less than half of students with opioid misuse and a positive depression/anxiety screen received any treatment in the past year. 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. 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. Read more.

 

Patterns of Alcohol, Cannabis, and E-Cigarette Use/Co-Use and Mental Health Among US College Students

Substance use and mental health are highly correlated, though few studies assess the risk for depression and anxiety associated with dual and polysubstance use among college students. The purpose of this study was to characterize the relationship between alcohol, cannabis, and e-cigarette exclusive, dual, and polysubstance use and depression and anxiety among U.S. college students by racial and ethnic subgroup and stratified by sex. Data from 83,467 undergraduate students participating in the 2020–2021 Health Minds Survey, a multi-campus, web-based survey, were used. Sex-stratified logistic regression models examined the effects of exclusive (past 30-day cannabis use, past 30-day e-cigarette use, past 2-week heavy alcohol use), dual (two among cannabis, e-cigarette, or alcohol use), and polysubstance (all three substances) use on anxiety (≥10 GAD-7 score) and depression (≥15 PHQ-9 score). The study included 60,746 females and 22,721 males. Among females, compared to those who exclusively used alcohol, dual users of cannabis and e-cigarette had the largest odds for depression and anxiety followed by polysubstance users. Among males, compared to those who exclusively used alcohol, dual users of cannabis and e-cigarette had the largest odds for depression and anxiety followed by polysubstance users. African American female and male students had lower odds of anxiety and depression compared to White students. The results suggest that single, dual, and polysubstance use are associated with anxiety and depression among U.S. college students, though not necessarily in additive ways. Read more.

 

The Association Between Vaping and Health Behaviors Among Undergraduate College Students in the United States

This research’s objective was to examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Socio-demographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Of all participants (n = 1,775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults. Read more.

 

Web-Based Alcohol Use and Cannabis Screening, Brief Intervention, and Referral to Treatment: College Students' Experience and Perceived Norms

The objectives were to examine students’ experience, perceived student norms, and perceived campus norms regarding web-based SBIRT based on substance use risk level. One hundred forty-three students completed an alcohol SBIRT program and survey, and 80 students completed a cannabis SBIRT program and survey. Undergraduates were recruited through campus-wide emails and a research management system. The majority of students found the SBIRT programs to be understandable, comfortable, and useful. Students reporting moderate/high-risk alcohol use were less likely to believe the information in the SBIRT program. Students with moderate/high-risk cannabis use were less likely to indicate that students on campus would be open to taking the web-based SBIRT. Understanding students’ experience and perceived norms regarding web-based SBIRT can inform efforts to utilize this approach as part of campus prevention efforts. Read more.

 

Alcohol and Cannabis Use in Daily Lives of College-Attending Young Adults: Does Co-Use Correspond to Greater Reported Pleasure?

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. Read more.

 

Demographic, Substance Use, and Mental Well-Being Correlates of High-Intensity Drinking Among College Students and Non-College Young Adults: Implications for Intervention

This research’s objective was to assess demographic, substance use, and mental wellbeing factors associated with high-intensity drinking (HID; 10+ drinks on one occasion) among college- and non-college young adults, to inform prevention and intervention efforts. Participants were a total of 1,430 young adults (819 in college and 611 not attending college) in a Midwestern state who reported trying alcohol at least once. Participants were recruited via social media between November 2019 and February 2020 to complete a web-based survey assessing demographics, substance use, and mental well-being. Logistic regression was conducted to assess relationships between these measures and HID among (1) college students and (2) non-college young adults. About 14.0% of participants reported past-month HID. Among both college- and non-college young adults, men, those who perceived slight or no risk of harm from binge drinking, and those who used alcohol and marijuana simultaneously in the past year had greater odds of reporting past-month HID. Among students, past-year prescription drug misuse was also associated with HID. High intensity-drinking is concerning given potential adverse consequences. Campus programming should address norms that may promote such drinking and other high-risk substance use associated with HID. Read more.

 

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Independent and Concurrent Cannabis Use with Alcohol, Cigarettes, and Other Substances Among College Students: Rates and Consequences

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 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. Substance use, academic-related outcomes, and measures of Cannabis Use Disorder severity and problems were obtained in an online survey. 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, but only the latter reported greater CUD severity, problems, and poorer academic outcomes. College student polysubstance users may be at increased risk for poorer outcomes compared to cannabis-only users and other groups. Read more.

 

Nonmedical Use of Prescription Stimulants and Nicotine Among Community College Students

Despite community colleges accounting for 34% of all undergraduate enrollment, research on substance-use patterns among community college students is limited. Community college students may engage in substance use differently than their 4-year university counterparts due to differences in psychosocial factors and decreased availability of mental health services. The current study aimed to elucidate risk factors underlying non-medical use of prescription simulants (NMUS) and nicotine use by community college students. A web-based survey was administered to 10 of 13 community colleges within a southeastern state’s Board of Regents school system. The survey included questions related to NMUS, nicotine use, alcohol use, mental health diagnosis, and demographics. Overall, 9% of the participants reported NMUS, and 24.6% used nicotine. Multivariate analysis of variance and χ2 tests revealed group differences among individuals using only nicotine, only NMUS, both nicotine and NMUS, and neither nicotine nor NMUS. Post-hoc 2 × 2 χ2 tests indicated that individuals using both nicotine and NMUS had higher incidence of mental health diagnoses, were more likely to live in urban areas, reported higher weekly alcohol consumption, and were more likely to be male as compared to individuals using neither substance. Attention-deficit hyperactivity disorder symptoms were higher in individuals using only NMUS and both NMUS and nicotine as compared to those using only nicotine or neither substance. These findings provide insight into demographic and psychological variables associated with NMUS and nicotine use among community college students that could be benefitted by greater access to affordable mental health services. Read more.

 

Alcohol and Marijuana Use, Consequences, and Perceived Descriptive Norms: Differences Between Two- and Four-Year College Students

Among two-year college students, alcohol and marijuana use, related consequences, and risk factors for use are not well understood. We examined differences between two- and four-year students in alcohol and marijuana use, consequences, and perceived descriptive norms, and explored whether two-year status moderated associations between norms and use. Data were drawn from a cross-sectional subsample of two- and four-year students aged 18–23 (n = 517) participating in a longitudinal study on alcohol use. Four-year students reported greater alcohol use and consequences than two-year students; two-year students reported greater marijuana use than four-year students. Perceived alcohol and marijuana norms were positively related with use; two-year status did not moderate these associations. Perceived alcohol and marijuana norms function similarly for two- and four-year students in terms of associations to actual use. Adapting normative interventions for two-year students may be an effective strategy for reducing high-risk use among this underserved population. Read more.

 

Protective Behavioral Strategies as a Protective Factor Against Suicide Ideation Among College Student Drinkers

Research shows that alcohol use is linked to suicidal ideation, while depression is strongly associated with SI. Protective behavioral strategies are safe drinking strategies. PBS are broadly protective across alcohol-related problems; however, it is unclear if these effects extend to those at risk for SI. We hypothesized that alcohol use and depressive symptoms would be risk factors for SI, and that these factors would moderate the effects of PBS. PBS was hypothesized to be protective for individuals with elevated depressive symptoms and alcohol use. Participants: College student drinkers (n = 990; M age = 19.97, SD = 3.75) from a Southeastern University. Participants completed an online survey inquiring about demographics, depressive symptoms, SI, alcohol use, and PBS use. Depressive symptoms were associated with an increased likelihood of SI; however, alcohol use was not. PBS were most protective for individuals with high levels of alcohol use and/or depressive symptoms. PBS may be protective for heavier drinkers who are at heightened risk for SI. Read more.

 

Are Campus Services Reaching Those in Need? Substance Use and Awareness of University Counseling Services

Help-seeking is uncommon among college students with substance use concerns. Perceived access to services is associated with greater help-seeking behavior. This study identifies substance use-related risk factors associated with awareness of campus counseling services. College students aged 18 to 25 (N = 995) self-administered a web-based survey, reporting their demographics, substance use history, well-being, and counseling services available at their institution. Multiple logistic regression was used to identify factors associated with awareness of services. Overall, 78% of students were aware of counseling services available at their institution. Full-time enrollment and better mental well-being were associated with greater odds of awareness of services. Early initiation of substance use and past month high-intensity drinking were associated with lower odds of awareness of services. Innovative strategies are needed to ensure campus counseling services reach students at risk for substance use-related problems. Read more.

 

Substance Use and College Completion Among Two-Year and Four-Year College Students From a Nationally Representative Longitudinal Study

Young adults from disadvantaged populations access higher education through two-year colleges, but substance use research among young adults focuses on four-year colleges. Filling this research gap is important given recent policy changes that have increased marijuana availability for young adults. This study uses a subsample of college-enrolled participants from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to evaluate whether substance use predicts educational attainment seven years later, comparing 888 students attending a two-year college with 1,398 matched students attending a four-year college. Matched students were identified using a propensity score method so that students were comparable on 15 measures, including precollege grades, precollege test scores, and precollege substance use. Compared with similar four-year college students, two-year college students were more likely to use methamphetamines, cocaine, or marijuana; more likely to report problematic substance use; and less likely to use alcohol. Two-year college students who used methamphetamines in the past year or past month or completed alcohol abuse treatment were less likely to complete college than two-year college students without those risk factors. Among the matched four-year college students, students who reported that drugs interfered with school or work in the past year, used cocaine in the past year, and used marijuana in the past year, past month, or ≥5 times in the past month were less likely to complete college than the matched four-year college students without those risk factors. Substance use interventions should target both two-year and four-year college students. Two-year colleges that better accommodate students who complete substance use treatment may improve these students’ completion. Students who use marijuana or cocaine or whose drug use impairs functioning may benefit from an incremental approach of completing a two-year degree prior to transferring to a four-year degree rather than enrolling directly in a four-year program. Read more.

 

A Scoping Review of Interventions for US College Students' Harmful Cannabis Use and a Call for a College Cannabis Intervention Matrix

We aimed to identify interventions for college students’ harmful cannabis use in the United States and determine whether (and what type of) additional randomized clinical trials are needed. We conducted a scoping review of RCTs of individual-focused cannabis interventions for U.S. college students. Database searches yielded 13 RCTs—seven interventions were effective. Effective interventions typically comprised one session, representing various modalities and intervention types (e.g., personalized feedback interventions [PFIs]; brief motivational interventions [BMIs]), and reduced frequency of cannabis use or consequences in the target population across variable follow-up periods. Single-session PFIs and BMIs that engage subgroups reporting cannabis-related consequences may be effective. There is a need for a tool like the College Alcohol Intervention Matrix, but focused on cannabis prevention, to increase the dissemination and uptake of effective, evidence-based strategies. Researchers are called on to fill gaps and strengthen content within a possible College Cannabis Intervention Matrix. Read more.

 

I Need New Friends! Changes in Perceived Peer Drinking Norms and Developmental Outcomes Across the Transition to College

The current study investigated changes in proximal descriptive alcohol use norms from high school to college, social integration as a predictor of stable versus shifting peer norms, and the consequences of norm profile membership for developmental outcomes. Using data (N = 9,753 12th grade students; 59% female; 80% White, 7% Black, 5% Hispanic, 5% Asian/Pacific Islander, 3% other races/ethnicities) from the Monitoring the Future panel study, we identified five distinct norm profiles-three stable profiles (high, moderate-high, and low) and two shifting profiles (increasing, declining)-that had unique patterns of perceived friend alcohol use norms. Social integration distinguished norm profile membership, and we observed particular detriments to outcomes for those in the stable high peer norm profile. Read more.

 

Psychological Distress and Alcohol Use Disorder in College Students of Color: Social Support's Moderating Properties

Alcohol use is prevalent among college students. Research has found that psychological distress in the form of depression, anxiety, or loneliness has been consistently associated with greater alcohol use. Because Students of Color (SoC) disproportionately experience greater psychological distress than White students, it is critical to determine buffers against psychological distress and subsequent alcohol use consequences. Previous literature found that social support can protect against the effects of psychological distress and weaken its link with alcohol use. This study aimed to determine the moderating effect of social support in the relation between psychological distress and alcohol use among SoC. College Students of Color from across the U.S. (n = 211) were recruited via Prolific to answer an online survey through Qualtrics. Linear regression analyses showed that psychological distress variables (i.e., depression, anxiety, and loneliness) were positively associated with alcohol use. However, moderation analysis did not find any form of social support to moderate the relation between psychological distress variables and alcohol use. Future research needs to identify other protective factors against alcohol use to support SoC in their academic journey. Read more.

 

First Semester College Experiences: Associations with Substance Use and Mental Health

Substance use and mental health concerns often occur as students transition from high school to college and may be associated with first semester experiences. Incoming first-year college students at a U.S., predominantly white, midwestern university were recruited for an intervention study. Participants reported on substance use, mental health, and college experiences at the end of their first semester of college (n = 781; 62.9 % female, mean age = 18.06 [SD = 0.24]; 77.2 % non-Hispanic white; 84.6 % heterosexual). Data for these current analyses were cross-sectional. Identifying as Black, Indigenous, or another Person of Color, as a sexual minority, or as female was associated with more challenging first semester experiences. Social experiences that represent more social engagement were associated with greater substance use. College experiences reflecting an easier transition were associated with fewer mental health concerns. Alcohol use moderated the relation between academic challenges and mental health with stronger associations found at greater levels of alcohol use. First semester experiences were related to student mental health and substance use, suggesting the importance of early, targeted support for students to adjust to campus life. Read more.

 

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A Scoping Review of Determinants of Drinking and Driving Behavior Among Young Adult College Students in the US

College students are a primary population for risky alcohol use behaviors, with one of every eleven students grappling with severe alcohol-related issues. The objective of this scoping review was to synthesize the existing literature to identify factors influencing the prevalence of drinking and driving (DAD) behaviors among college students. A scoping review was conducted using Medline (PubMed), ERIC, The American Journal on Addictions, and the NCHA databases. Criteria for article selection included being published in English and focused on DAD behaviors among college students. Articles excluded from the review were systematic reviews and discussion pieces without empirical findings related to college DAD. Of the included studies (n = 23), most identified a range of factors as being influential in college students’ DAD behavior including a family history of alcohol misuse, the use of other substances such as marijuana, age of initial alcohol consumption, place of residence, propensity for sensation seeking, affiliation with sorority/fraternity groups, and the perception of associated risks. Effective strategies may include education on the risks of combined alcohol and substance use, screening and brief interventions tailored to at-risk students, and the implementation of campus policies that promote responsible alcohol consumption and deter DAD. Read more.

 

Stigma Related to the Non-Medical Use and Diversion of Prescription Stimulant Drugs: Should We Care

Non-medical use and diversion of prescription stimulants are prevalent on college campuses. Diversion represents a primary source of acquisition for NMU among young adults. This study examined relationships between stigmatizing beliefs related to NMU and diversion of stimulant medications and engagement in these behaviors, as well as how such perceptions are associated with indicators of psychological distress among those who engage in these behaviors. Young adults (N = 384) were recruited from a large US university to participate in this cross-sectional electronic survey-based study. Relationships between stigma variables and NMU and diversion were assessed. Among those who engage in NMU and diversion, we tested relationships between stigma variables and indicators of psychological distress, using validated instruments. Perceived social and personal stigmatic beliefs did not significantly predict NMU. However, perceived social and personal stigma of diversion significantly reduced diversion likelihood. For NMU, associations were found between stigma variables and indicators of psychological distress. Markedly, we found that as stigmatic perceptions of NMU increased, so did depressive, anxiolytic, and suicidal symptomatology among those who engage in NMU. Stigmatization does not deter NMU; however, stigmatization is positively associated with psychological harm among those who engage in NMU. Interventions should be developed to reduce stigmatization in order to improve psychological health among those who engage in NMU. Stigmatic perceptions of diversion were not predictive of psychological harm, though they are negatively associated with diversion behavior. Read more.

 

Sleep, Alcohol, and Cannabis Use in College Students With and Without Attention-Deficit/Hyperactivity Disorder

Relations among attention-deficit/hyperactivity disorder, sleep, and substance-related negative consequences are largely unknown. In this cross-sectional study, we examined associations among ADHD diagnosis, sleep, and alcohol-related consequences. We also evaluated the independent and interactive effects of sleep and ADHD on alcohol-related negative consequences, above and beyond levels of alcohol use. College students who drink alcohol with (n = 51) and without (n = 50) ADHD completed an assessment that included a diagnostic interview assessing ADHD, and questionnaire measures of sleep quality, substance use, and associated consequences. Analyses utilized a series of hierarchical linear regression models and explored these aims for cannabis use in a subset of participants (n = 52 participants that used cannabis). College students who drink alcohol with ADHD reported significantly worse sleep quality and more alcohol-related consequences, relative to those without ADHD. When ADHD and sleep quality were included in the model, ADHD-but not sleep quality-was independently associated with alcohol consequences, but not cannabis consequences. There were no moderating effects of ADHD on the associations between sleep and substance-related consequences. Students who drank alcohol with ADHD may be particularly vulnerable to experiencing poor sleep and consequences from their substance use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk. Read more.

 

Individual Differences in Substance Use Motives, Trauma, and Stress Among College-Based Polysubstance Users

Co-use of alcohol and other drugs within a certain time frame (i.e., polysubstance use) has become increasingly prevalent, particularly among college-aged individuals, but understanding motives for co-use remains limited. Polysubstance use has been associated with a higher likelihood of negative health consequences as compared to single substance use. The current study examined associations between motivations for using alcohol, tobacco, and cannabis among college students who use multiple substances versus students using only one substance or no substances. Additionally, we examined the effect of trauma and daily stress on polysubstance use in self-report data from individuals (N=134) participating in the MAPme Study. First, the observed prevalence of polysubstance use was greater than expected by chance, with most individuals co-using alcohol and cannabis. "Alcohol and Other Drug Users" were more frequently motivated to drink for social, enhancement, and coping reasons compared to individuals who consumed alcohol alone. Individual differences in motivations for use were partly explained by frequency of alcohol use and alcohol problem severity, but not by history of trauma or stress. Finally, while patterns of correlations among motivations for use across substances suggested a general tendency to be motivated to use substances for similar reasons, this was not supported by confirmatory factor models. Overall, shared motives may inform potential behavioral patterns for co-use of substances during college and might advise future treatment efforts. Read more.

 

Text Messages Conveying Parent Drinking Limits: A Potential Avenue for Preventing and Reducing Alcohol Use in College Students

Although previous research has established that students who perceive that their parents have lower drinking limits consume less alcohol, optimal approaches for effectively communicating these limits are less understood. To address this gap in the literature, the present study examined the effects of hypothetical limit-focused text messages on estimated drinking behavior. Undergraduate college students (N=253) completed an online survey in which they were instructed to imagine a scenario where they were planning to go out at night to an event involving drinking. Participants were randomly assigned to a condition where they would receive one of four hypothetical text messages from their mother and/or father containing a range of drinking limits. They were then asked to report how much alcohol they would realistically consume on this night if they were and were not obligated to check in with their parent at the end of the night. Hypothetical text messages from mothers and fathers containing lower drinking limits resulted in lower estimated alcohol consumption. A drinking limit of zero resulted in the least amount of expected alcohol consumption but specifying 1-2 drinks as a limit might produce a similar effect if parents also required their student to check-in at the end of the night. Findings from this study provide initial support for future studies to investigate the effects of limit setting text messages sent from parents on college student drinking, as well as the effects of text messages sent from parents requiring that students check-in. Read more.

 

Latent Profile Analysis of College Students' Alcohol and Cannabis Co-Use Patterns After Recreational Cannabis Legalization

Evidence is mixed on how young adults’ cannabis and alcohol use and co-use patterns have changed following recreational cannabis legalization (RCL). Incorporating measures of frequency and intensity of use we examined changes in college students' use and co-use patterns following RCL. Four-year college students (n = 845,589) ages 18–24 years participated in the National College Health Assessment between 2008 and 2018, including students from 7 states that enacted RCL and 42 that did not. Latent profile analyses identified six patterns of use from four indicator variables tapping frequency of cannabis use and frequency and intensity of alcohol use: Abstainers, Light Alcohol Only, Heavy Alcohol Only, Predominantly Heavy Cannabis Use, Moderate Co-use, and Heavy Co-use. Regression models that adjusted for time and person- and institution-level covariates indicated that students’ exposure to RCL was associated with lower odds of being in the two alcohol-only use classes, higher odds of being in the Predominantly Heavy Cannabis Use, Heavy Co-Use and Abstainers classes, and was not significantly related to Moderate Co-Use class membership. RCL was positively associated with patterns of frequent cannabis use and frequent and intense co-use but also with abstinence. Use of alcohol-only became less prevalent after RCL. Research on how RCL influences the prevalence of problematic patterns of substance use will inform and improve prevention efforts. Read more.

 

College Students' Prescription Drug Misuse Over Time and Links With Their Mental Health and Well-Being

Prescription drug misuse is a mounting public health concern in the U.S., particularly among college students. The field’s reliance on cross-sectional designs and limited controls for other substance use has failed to capture the specific role of misuse for longer-term health. Therefore, the present study tested associations between trajectories of PDM problems and college students’ mental health and subjective happiness over time. Participants were 300 students who completed a baseline assessment (T1) and follow-ups every 6 months for two years (T2-T5). Participants self-reported problems associated with PDM and mental health. Results from univariate latent growth models indicated that problems with PDM were initially on an increasing trajectory. Based on parallel process models, problems with PDM were concurrently associated with higher levels of depressive symptoms, disinhibition, callousness/aggression, and lower levels of subjective happiness at T1. Further, we found support for parallel trajectories between PDM problems and both depressive symptoms and general disinhibition. Participants whose PDM problems were on an increasing (worsening) trajectory at baseline showed an increase in depressive symptoms and general disinhibition over the next two years. Participants whose PDM problems accelerated over time (got worse at a faster and faster rate over time) also showed a significant increase in their depressive symptoms over time. Most findings, however, were no longer statistically significant in sensitivity analyses that controlled for alcohol and other drug problems. Findings highlight college as an important time for interventions to prevent substance use and its associated negative consequence on later young adult mental health. Read more.

 

A Cross-Sectional Examination of Race, Gender, and Intersectionality on Protective Behavioral Strategies and Alcohol Outcomes Among Black and White College Students

College students consistently report problematic alcohol use (e.g., excessive drinking). Protective behavioral strategies are behaviors for reducing alcohol use and/or problems and are negatively associated with alcohol misuse among college students. Studies suggest PBS are used more often and/or more effectively by female individuals. Additionally, examinations specifically between Black and White students have yielded mixed findings and are typically underpowered. Scant studies have investigated the intersectionality between race and gender or examined perceived effectiveness of PBS use related to alcohol outcomes. The current cross-sectional study examined if (a) race, (b) gender, and (c) their interaction moderate the associations between perceived effectiveness of PBS use on PBS use (a path) and between PBS use on alcohol outcomes (i.e., alcohol quantity, peak drinks, and problems; b path). A sample size of N = 528 college drinkers ages 18-24 years old (Mage = 19.85; 52.5%, Black, 40.3% White) completed an online survey and were used for analyses. A series of moderated mediation models were conducted. Race did not moderate the a or b paths. The positive association for the a path as well as the indirect effect of PBS perceived effectiveness on lower alcohol outcomes through PBS use were stronger for female students than male students. The intersectionality examination indicated a stronger association between more PBS use and lower consumption, specifically for White male students, and lower problems for Black female students. More attention is needed toward considering intersectionality when identifying at-risk groups and tailoring alcohol intervention efforts. Read more.

 

Daily Stress, Drinking Motives, and Alcohol Co-Use With Other Drugs

Recent evidence indicates that alcohol and other substance co-use, compared to alcohol-only use, might be more closely associated with negative reinforcement processes, and thus more likely during periods of increased stress. The present study examined this possibility by using data from an intensive longitudinal (daily) study of college student drinkers (N = 1,461, 54% women). We also examined individual differences in coping and enhancement drinking motives as predictors of alcohol and other substance co-use. We used multilevel multinomial logistic regression to predict, relative to alcohol-only days, the likelihood of alcohol co-use with either cigarettes or marijuana, along with alcohol use with multiple substances and other substance-only use from daily interpersonal and academic stress, day-of-the-week, sex, and individual differences in coping and enhancement drinking motives. We found that, relative to alcohol-only, alcohol and marijuana co-use was more likely, and non-alcohol related substance use was less likely, on weekends. Alcohol and marijuana co-use was less likely, and other substance-only use was more likely, on days characterized by greater academic stress, whereas alcohol and cigarette co-use was more likely on days characterized by greater interpersonal stress. Individuals with higher levels of drinking to cope motivation were more likely to engage in alcohol and cigarette co-use, other substance-only use, and alcohol plus multiple substances, relative to alcohol-only. Individuals with higher levels of enhancement motives were more likely to engage in all types of alcohol and other substance co-use and other substance-only use relative to alcohol-only. Findings are discussed in terms of the complex nature of different patterns of co-use patterns when evaluating indicators of positive- and negative-reinforcement processes. Read more.

 

The Relation Between ADHD Symptoms and Alcohol and Cannabis Use Outcomes in a Cross-Sectional Study of College Students: The Mediating Role of Experiential Avoidance

Individuals with attention-deficit/hyperactivity disorder are at greater risk for alcohol and cannabis misuse compared to peers. College students with ADHD are particularly vulnerable to problematic alcohol/cannabis use, given widespread misuse of these substances. Experiential avoidance has been positively associated with ADHD symptoms and substance use problems. However, it is unclear what role experiential avoidance plays in the relation between ADHD and alcohol/cannabis use. This study examined whether experiential avoidance mediates the relation between ADHD symptoms and alcohol and cannabis use and related problems (e.g., driving under the influence). In addition, we examined two exploratory aims: (a) whether mediation effects differ by sexual/gender minoritized status (SGM; e.g., lesbian, bisexual, transgender) and (b) whether mediation effects differ by ADHD symptom dimension (i.e., hyperactive/impulsive, inattentive). Participants (N = 2,158; M age = 19.72) were college students in the U.S. with and without ADHD who reported past-month alcohol or cannabis use. Participants completed an online, self-report survey at a single time point. Experiential avoidance mediated the relation between ADHD symptoms and alcohol- and cannabis-related problems. Moderated mediation analyses showed that indirect effects did not differ according to SGM status; however, SGM status moderated the relation between ADHD symptoms and experiential avoidance, such that the relation was more robust for the non-SGM group compared to the SGM group. Finally, indirect effects were larger when inattentive symptoms were entered in mediation models versus hyperactive/impulsive symptoms. Implications for future research and clinical practice are discussed. Read more.

 

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The Substance Use Behaviors Change of First-Year College Students Before and During COVID-19 Pandemic

This article tests the substance use behaviors of college students before and during COVID-19 pandemic. In-depth assessment and nightly survey data was used from a longitudinal study (n = 675) which examined student substance use during the 2019–2020 academic year, both before and during the onset of the COVID-19 pandemic. Changes in beer/wine, tobacco, liquor, and marijuana use before versus during the pandemic, in addition to the interaction of COVID-19, were tested with gender and subjective social status. Marijuana use significantly decreased from a weekly prevalence of 9.9% before COVID-19 to 6.4% during COVID-19. A similar decrease was seen in liquor use (10.6% before COVID to 6.4% during COVID). There was no significant change observed for beer/wine use or for tobacco use. In the wake of the COVID-19 pandemic, liquor, and marijuana use decreased for college students, while other substance use stayed the same. Read more.

 

Primary Prevention of Prescription Stimulant Misuse in First-Year College Students

Eight percent of college students report past year prescription stimulant misuse (nonmedical use of stimulants defined as taking stimulants in a manner other than prescribed). Despite this high prevalence rate, primary prevention efforts are lacking on college campuses. A prescription stimulant misuse primary prevention intervention targeting first-year college students was developed, refined, and pilot tested. Existing substance use treatment (motivational interviewing) and time management (cognitive behavioral therapy for adult ADHD) techniques were integrated into the novel brief prevention intervention. Focus groups provided feedback to help refine the prevention intervention. Following refinements, 484 first-year college students were randomly assigned to condition (327 treatment, 157 control) and followed for 3 months. Participants rated the intervention as satisfactory. After controlling for time invariant covariates, condition significantly predicted prescription stimulant misuse. There was a lower rate of past 3-month prescription stimulant misuse reported in the intervention group (4.9%) compared to the control group (11.5%). Academic expectancies remained stable in the intervention group yet increased in the control condition over time. Time management skill ratings remained stable in both groups. Changes in academic expectancies, yet not time management skills, were a partial mediator of the prevention efficacy in prescription stimulant misuse at 3-month follow-up. These results provide preliminary support for the acceptability and efficacy of a brief primary prevention intervention for college student prescription stimulant misuse. Changes in positive prescription stimulant expectancies, yet not time management skills, appear to be potential targets for future preventive efforts. Read more.

 

Comparing Drinking Game Motives, Behaviors, and Consequences Among Varsity Athletes, Recreational Athletes, and Non-Student Athletes: A Multisite University Study

Among college students, student-athletes are at increased risk for heavy alcohol consumption, participation in risky drinking practices (e.g., playing drinking games [DG]), and adverse alcohol-related consequences relative to non-student-athletes. Within the student-athlete population, level of sports participation (e.g., recreational or varsity sports) can affect alcohol use behaviors and consequences but our understanding of the extent to which level of sports participation influences engagement in DG is limited. Thus, in the present study, we examined differences in frequency of participation in DG, typical drink consumption while playing DG, negative DG consequences, and motives for playing DG among varsity, recreational, and non-student-athletes. College students (N=7,901 across 12 U.S. colleges/universities) completed questionnaires on alcohol use attitudes, behaviors, and consequences. Student-athletes (recreational or varsity sports) were more likely to have participated in DG within the past month than non-student-athletes. Among students who reported past month DG play, recreational athletes played more often and endorsed more enhancement/thrills motives for playing DG than non-student-athletes, and student-athletes (recreational or varsity) endorsed higher levels of competition motives for playing DG than non-student-athletes. These findings shed light on some risky drinking patterns and motives of recreational athletes who are often overlooked and under-resourced in health research and clinical practice. Recreational and varsity student-athletes could benefit from alcohol screening and prevention efforts, which can include provision of competitive and alcohol-free social activities and promotion of alcohol protective behavioral strategies to help reduce recreational athletes’ risk for harm while playing DG. Read more.

 

Anxiety, Depression, Coping, Alcohol Use and Consequences in Young Adult College Students

Young adult college students experience a high risk for heavy alcohol use and resulting consequences. Symptoms of anxiety and depression increase this risk. Coping style has been associated with alcohol use and consequences, with approach coping being inversely related to use and consequences, and avoidance coping being directly related to use and consequences. The purpose of this study is to examine whether coping style moderates or mediates the relationship between anxiety/depression and alcohol use and consequences. 250 young adult college students ages 18 to 25 years (Women = 85, 34%) anonymously self-reported anxiety, depression, coping style, alcohol use and consequences. Path analysis showed that avoidance coping was positively related to alcohol use, social consequences, and personal consequences, while approach coping was inversely related to use. Coping did not moderate the relationship between anxiety and depression and alcohol use or consequences. Avoidance coping mediated the relationship between depression and alcohol use, social consequences, and personal consequences. Findings build on alcohol use and consequences research, and support further research into implementing coping-based alcohol use interventions. Interventions aimed at reducing avoidance coping and increasing approach coping may be beneficial for young adult college students. Read more.

 

Nonmedical Use of Prescription Stimulants and Nicotine Among Community College Students

Despite community colleges accounting for 34% of all undergraduate enrollment, research on substance-use patterns among community college students is limited. Community college students may engage in substance use differently than their 4-year university counterparts due to differences in psychosocial factors and decreased availability of mental health services. The current study aimed to elucidate risk factors underlying non-medical use of prescription simulants (NMUS) and nicotine use by community college students. A web-based survey was administered to 10 of 13 community colleges within a southeastern state’s Board of Regents school system. The survey included questions related to NMUS, nicotine use, alcohol use, mental health diagnosis, and demographics. Overall, 9% of the participants reported NMUS, and 24.6% used nicotine. Multivariate analysis of variance and χ2 tests revealed group differences among individuals using only nicotine, only NMUS, both nicotine and NMUS, and neither nicotine nor NMUS. Post-hoc 2 × 2 χ2 tests indicated that individuals using both nicotine and NMUS had higher incidence of mental health diagnoses, were more likely to live in urban areas, reported higher weekly alcohol consumption, and were more likely to be male as compared to individuals using neither substance. Attention-deficit hyperactivity disorder (ADHD) symptoms were higher in individuals using only NMUS and both NMUS and nicotine as compared to those using only nicotine or neither substance. These findings provide insight into demographic and psychological variables associated with NMUS and nicotine use among community college students that could be benefitted by greater access to affordable mental health services. Read more.

 

Student' Perceptions on the Effectiveness of a Computer-Delivered Alcohol Intervention

Social adjustment, including alcohol use, directly affects the success of college students. Due to an increased reliance on computer-delivered alcohol interventions, a need has emerged to further investigate alcohol use and web-based interventions. In-depth focus group interviews were conducted with 51 undergraduate students to elicit information from students on the shared experience of participating in a CDI. Participants identified the influence of gender, culture, parents, and family on alcohol use behavior. A difference in personal factors, previous exposure, and experiences can affect the attitudes, behaviors, and outcomes of a CDI. Multiple approaches geared towards a wide variety of students from different backgrounds and environments are needed to be truly successful in preventing alcohol misuse. Read more.

 

Associations Between Alcohol and Cannabis Use and Pain Among College Student-Athletes

Pain motivates alcohol and cannabis use, with evidence that pain catastrophizing (i.e., ruminative exaggeration of pain) mediates these associations. Student-athletes represent a unique population who engage in riskier substance use, experience more substance-related consequences, and are more likely to develop chronic pain compared to non-athletes. This study examined relationships between pain, catastrophizing, alcohol and cannabis use, and consequences. Student-athletes from two Division I universities (N = 549; 51% female) completed a cross-sectional survey. Moderated mediation tested the conditional indirect effect of pain catastrophizing on associations between pain and alcohol- and cannabis- use and consequences, separately, with sex moderating the a and b paths. There was a significant direct effect between pain and alcohol-related consequences (b = 0.11, p = .008). Pain and pain catastrophizing were positively associated in all four models (bs = 0.68-0.72, ps <.001), and this relationship was stronger among female than male athletes. No other direct or conditional indirect effects were observed. Student-athletes experiencing pain report more alcohol-related consequences, and pain catastrophizing may be particularly relevant for student-athletes with greater pain. Future research should examine other factors proposed by theoretical models, such as negative affect, while focusing on athletes with more significant pain (e.g., injured athletes). Read more.

 

Affect Variability in Relation to Alcohol Use Frequency, Intensity, and Concurrent Cannabis Use Among College Students During the COVID-19 Pandemic

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. Read more.

 

Microaggressions, Perceptions of Campus Climate, Mental Health, and Alcohol Use Among First-Year College Students of Color

Depressive and anxiety symptoms are increasingly common, and problematic alcohol use remains prevalent in college. To expand on prior research on mostly white samples, we surveyed first-year students of color from our predominately white university (Southeastern US) to identify risk factors for mental health symptoms and potentially co-occurring problematic alcohol use. Results showed significant associations between microaggressions and poor campus climate (hypothetical predictors) with depressive, anxiety, somatic symptoms (hypothetical outcomes) that were indirectly linked through perceived stress, poor sleep, and academic burnout (hypothetical mediators). Poor campus climate, academic burnout, and using alcohol to cope were the most relevant to alcohol use disorder symptoms. Results support efforts to address and reduce racial microaggressions and promote a positive campus climate for all. Read more.

 

Cannabis Use in Adolescent and Young Adult Athletes: A Clinical Review

Cannabis use among the general population has increased over time, in part due to decriminalization of use and greater social acceptance of cannabis use. These changes have contributed to increased availability of cannabis products, thus raising the likelihood that a subset of adolescent and young adult athletes will use cannabis. Therefore, it is imperative that clinicians and other providers working with young athletes have a thorough understanding of the impact cannabis can have on the athletic performance and overall health of a young athlete. PubMed (Medline), CINAHL, PsycINFO, and SportDiscus databases were used to perform a literature search of articles published between January 1, 2010 and December 31, 2022. Additional articles were reviewed based on references obtained from initial articles. Survey studies suggest that up to 1 in 4 athletes have used cannabis at least once in the last year. Age, sex, race, sexual orientation, level of competition, and country of residence of an athlete all contribute to differing rates of cannabis use among athletes. The scientific literature does not support using cannabis for athletic performance, and multiple studies have demonstrated notable impairments in objective athletic performance measures. Cannabis use can also negatively impact an athlete's overall health via cardiovascular, gastrointestinal, and mental health symptoms and disorders. Cannabis use among adolescent and young adult athletes is common, and rates of use are influenced by many different factors. Current evidence suggests that cannabis use can worsen sport performance, negatively impact an athlete's general health, and contribute to negative mental health outcomes. Read more.

 

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A Longitudinal Test of Problematic Alcohol Use and Binge Eating Among College Women: The Moderating Role of Shame

Problematic alcohol use and binge eating frequently co-occur. High levels of negative affect, negative urgency, and/or shame may increase the likelihood that problematic alcohol use and binge eating co-occur over time. Objectives included examine (1) the temporal relationship between problematic alcohol use and binge eating among college women, who are at high risk for both, and (2) the additive and moderating effects of shared, emotion-based risk factors in models involving both problematic alcohol use and binge eating. In 302 college women assessed at two time points across 8 months, we used hierarchical linear regression to investigate our objectives. Baseline problematic alcohol use and baseline shame independently predicted increases in follow-up binge eating, controlling for baseline binge eating. In addition, the interaction between problematic alcohol use and shame accounted for further variance in subsequent binge eating (the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame). The reciprocal relationship was not significant: baseline binge eating did not predict follow-up problematic alcohol use independently or in conjunction with risk factors. Neither negative affect nor negative urgency showed predictive effects beyond prior behavior and shame. Results support (1) problematic alcohol use as a prospective risk factor for binge eating, (2) shame as an additive predictor of binge eating, and (3) shame as a positive moderator of prediction from problem drinking. Addressing shame and problematic alcohol use may be warranted in binge eating interventions for college women. Read more.

 

College Students' Prescription Drug Misuse Over Time and Links With Their Mental Health and Well-Being

Prescription drug misuse is a mounting public health concern in the U.S., particularly among college students. The field's reliance on cross-sectional designs and limited controls for other substance use has failed to capture the specific role of misuse for longer-term health. Therefore, the present study tested associations between trajectories of PDM problems and college students' mental health and subjective happiness over time. Participants were 300 students who completed a baseline assessment (T1) and follow-ups every 6 months for two years (T2-T5). Participants self-reported problems associated with PDM and mental health. Results from univariate latent growth models indicated that problems with PDM were initially on an increasing trajectory. Based on parallel process models, problems with PDM were concurrently associated with higher levels of depressive symptoms, disinhibition, callousness/aggression, and lower levels of subjective happiness at T1. Further, we found support for parallel trajectories between PDM problems and both depressive symptoms and general disinhibition. Participants whose PDM problems were on an increasing (worsening) trajectory at baseline showed an increase in depressive symptoms and general disinhibition over the next two years. Participants whose PDM problems accelerated over time (got worse at a faster and faster rate over time) also showed a significant increase in their depressive symptoms over time. Most findings, however, were no longer statistically significant in sensitivity analyses that controlled for alcohol and other drug problems. Findings highlight college as an important time for interventions to prevent substance use and its associated negative consequence on later young adult mental health. Read more.

 

Alcohol and Cannabis Use Among Rural University Students: A Quantitative Analysis of Barriers to Care, Student Resilience, and School Climate

This article examines impacts of student resilience, school climate, and barriers to mental health care on problematic drinking behavior and cannabis use among rural university students. Participants were a total of 948 students from a public university in a southeastern state that completed the 2019-2020 Healthy Minds Study. Cross-tabulations and multivariate logistic regression analyses were employed to test study hypotheses. Students who binge drink are more likely to engage in problematic drinking behaviors than students who do not binge drink; students who engage in problematic drinking are more likely to use cannabis than those who do not engage in problematic drinking. As students face more barriers to mental health care, they are more likely to engage in problematic drinking and cannabis use; students who are more resilient are less likely to engage in problematic drinking. To promote health and well-being, universities must understand factors that impact substance use among students. Read more.

 

Initial Results From a New College Substance Use Prevention Program Targeting Externalizing and Internalizing Traits

College students engage in high rates of risky substance use. Standard college prevention strategies focus on providing feedback about current substance use behaviors and harm reduction strategies but do not address the underlying genetically-influenced risk factors impacting these behaviors. We created an online Personalized Feedback Program for college students that targets genetically-influenced externalizing and internalizing risk pathways and provides personalized recommendations and campus resources. College students received personalized feedback on four risk domains (Sensation Seeking, Impulsivity, Extraversion, and Neuroticism). An open trial (n = 300) was conducted at a large public university in spring of 2021 to assess initial responses to the PFP and evaluate intentions related to future substance use and campus resource use. 81% of students in the open trial reported they enjoyed the Personalized Feedback Program. Participants reported intending to use significantly more campus resources after completing the PFP. Among participants that drank, 39% reported they intended to decrease their alcohol consumption and 41% reported they intended to decrease the number of times they get drunk after completing the PFP; these intentions to reduce use after completing the PFP are higher than rates found in previous studies. Preliminary data indicate that the Personalized Feedback Program may be a complementary method to enhance current college substance use prevention programs. Read more.

 

Effort-Related Decision Making and Cannabis Use Among College Students

Cannabis exerts an indirect effect on dopamine output in the mesolimbic projection, a circuit implicated in reward processing and effort expenditure, and thus may be associated with aberrant effort-based decision making. The “amotivation syndrome” hypothesis suggests that regular cannabis use results in impaired capacity for goal-directed behavior. However, investigations of this hypothesis have used divergent methodology and have not controlled for key confounding variables. The present study extends these findings by examining the relation between cannabis use and effort-related decision making in a sample of college students. Cannabis using (n = 25; 68% meeting criteria for Cannabis Use Disorder) and noncannabis using (n = 22) students completed the Effort Expenditure for Rewards Task. In generalized estimating equation models, reward magnitude, reward probability, and expected value predicted greater likelihood of selecting a high-effort trial. Furthermore, past-month cannabis days and cannabis use disorder symptoms predicted the likelihood of selecting a high-effort trial, such that greater levels of both cannabis use days and symptoms were associated with an increased likelihood after controlling for Attention Deficit/Hyperactivity Disorder symptoms, distress tolerance, income, and delay discounting. The results provide preliminary evidence suggesting that college students who use cannabis are more likely to expend effort to obtain reward, even after controlling for the magnitude of the reward and the probability of reward receipt. Thus, these results do not support the amotivational syndrome hypothesis. Future research with a larger sample is required to evaluate possible associations between cannabis use and patterns of real-world effortful behavior over time. Read more.

 

College Students' Prescription Drug Misuse Over Time and Links With Their Mental Health and Well-Being

Prescription drug misuse is a mounting public health concern in the U.S., particularly among college students. The field’s reliance on cross-sectional designs and limited controls for other substance use has failed to capture the specific role of misuse for longer-term health. Therefore, the present study tested associations between trajectories of PDM problems and college students’ mental health and subjective happiness over time. Participants were 300 students who completed a baseline assessment (T1) and follow-ups every 6 months for two years (T2-T5). Participants self-reported problems associated with PDM and mental health. Results from univariate latent growth models indicated that problems with PDM were initially on an increasing trajectory. Based on parallel process models, problems with PDM were concurrently associated with higher levels of depressive symptoms, disinhibition, callousness/aggression, and lower levels of subjective happiness at T1. Further, we found support for parallel trajectories between PDM problems and both depressive symptoms and general disinhibition. Participants whose PDM problems were on an increasing (worsening) trajectory at baseline showed an increase in depressive symptoms and general disinhibition over the next two years. Participants whose PDM problems accelerated over time (got worse at a faster and faster rate over time) also showed a significant increase in their depressive symptoms over time. Most findings, however, were no longer statistically significant in sensitivity analyses that controlled for alcohol and other drug problems. Findings highlight college as an important time for interventions to prevent substance use and its associated negative consequence on later young adult mental health. Read more.

 

The Relationships Between Parental and Peer Norms and Moderate Drinking Among First-Year College Students: Similarities and Differences in Typical and Celebration Drinking

The study explored how perceived parental and peer norms toward moderate drinking can be related to first-year college students’ drinking behavior across two occasions: typical days and celebrations. First-year college students were recruited to participate in an online survey (n = 127). For typical drinking, perceived peer descriptive norms during celebration showed a statistically significant relationship. Both perceived peer descriptive and injunctive norms were statistically associated with typical and celebratory drinking by first-year students. Unlike the predictions, perceived parental norms regarding moderate drinking were not associated with alcohol consumption across two occasions. The results emphasize the subtle impact of various social contexts and reference groups on the drinking habits of the first years. Read more.

 

Associations Between Trait Boredom and Frequency of Cannabis, Alcohol, and Tobacco Use in College Students

Boredom is a common emotion associated with substance use in college students – a group already at risk for substance misuse. The purpose of this study is to understand how two types of trait boredom (susceptibility and proneness) in college students are associated with frequency of cannabis, alcohol, and tobacco use. Data were collected from an online survey completed by a sample of undergraduate students (N = 414, Mage = 19.55, 84.5% female; 64.3% White) enrolled at a large public university in the northwest. Multivariate logistic regression was used to evaluate the association between trait boredom and frequency of cannabis, alcohol, and tobacco use after controlling for age, sex, and race. Boredom susceptibility was a significant predictor of annual, monthly, and weekly cannabis and alcohol use, but only annual and monthly tobacco use. Boredom proneness was only a significant predictor for monthly alcohol use. Findings were generally consistent across types of substances and frequency of use for boredom susceptibility, indicating students higher in susceptibility, rather than proneness, are a subgroup to target prevention interventions to alleviate boredom and subsequent maladaptive coping mechanisms. Read more.

 

Psychosocial Functioning Associated With Prescription Stimulant and Opioid Misuse Versus Illicit Drug Use Among College Students

College students' prescription stimulant and opioid misuse share psychosocial risks with other substance use. We sought to extend a prior study of these issues. National College Health Assessment (2015-2016) participants ages 18-24 years (n = 79,336) reporting 12-month PSM (defined as use of a drug not prescribed to them), 30-day other illicit drug use (non-cannabis), both, or neither, were compared on other substance use, psychopathology, academic adjustment, attention deficit hyperactivity disorder, and chronic pain. Models were repeated for POM. Relative to those who only misused the prescription drug, those who used other illicit drugs had lower odds of chronic pain and academic problems, but higher odds on nearly every other outcome especially if they also misused the prescription drug. Findings suggest PSM and POM are on a continuum of risk shared with illicit drug use, but also are linked to outcomes specific to these drugs' perceived medical purposes. Read more.

 

Drug Overdose Deaths With Evidence of Counterfeit Pill Use — United States, July 2019 - December 2021

Using data from CDC’s State Unintentional Drug Overdose Reporting System, this report describes trends in overdose deaths with evidence of counterfeit pill use during July 2019–December 2021 in 29 states and the District of Columbia and characteristics of deaths with and without evidence of counterfeit pill use during 2021 in 34 states and DC. The quarterly percentage of deaths with evidence of counterfeit pill use more than doubled from 2.0% during July–September 2019 to 4.7% during October–December 2021, and more than tripled in western jurisdictions (from 4.7% to 14.7%). Illicitly manufactured fentanyls were the only drugs involved (i.e., caused death) in 41.4% of deaths with evidence of counterfeit pill use and 19.5% of deaths without evidence. Decedents with evidence of counterfeit pill use, compared with those without evidence, were younger (57.1% versus 28.1% were aged <35 years), more often Hispanic or Latino (18.7% versus 9.4%), and more frequently had a history of prescription drug misuse (27.0% versus 9.4%). Smoking was the most common noningestion drug use route among deaths with evidence of counterfeit pill use (39.5%). Overdose prevention messaging that highlights the dangers of pills obtained illicitly or without a prescription (because they might be counterfeit), encourages drug product testing by persons using drugs, and is tailored to persons most at risk (e.g., younger persons) could help prevent overdose deaths. Read more.

 

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Longitudinal Patterns of Cannabis and Tobacco Co-Administration and Concurrent Use Among Young Adult College Students

Co-use, including concurrent use or co-administration, of cannabis and tobacco is most prevalent in young adulthood and associated with worse health outcomes than use of either substance alone. This study examined latent classes of tobacco and cannabis concurrent use and co-administration, and transitions between classes from 2016 to 2019, among a sample of young adult college students in Texas. Participants included 4,448 young adults (64.2% female, 64.7% non-white, mean age = 20.5) in a longitudinal cohort study. Measures included past 30-day use of cigarettes. hookah, cigars, ENDS, cannabis, and cannabis and tobacco co-administration. Latent Markov models were used to estimate latent class membership and transitions between classes from 2016 to 2017 and 2017 to 2019. Four latent classes emerged: non-use (58% of students) characterized by low/no probability of any use; general use (19%) characterized by some level of use of all behaviors; blunt and cannabis use class (13%) characterized by high probabilities of cannabis use and co-administration with blunts; and concurrent and co-administration use (10%) with high probabilities of cigarette, cannabis, blunt, and spliff use. Most students remained in the same latent class from 2016 to 2019. While most students reported low/no tobacco and cannabis co-use, those who used cannabis and/or tobacco remained in their use classes over the course of the study (2016 to 2019). Public health advocates on college campuses should consider prevention and cessation programs that incorporate the constellation of behaviors related to cannabis and tobacco co-use and educate students about the health consequences of co-use. Read more.

 

Faculty, Staff, and Student Perceptions of Substance Use Disorder Stigma in Health Profession Training Programs: A Quantitative Study

Research indicates that stigma impacts the care provided to individuals with Substance Use Disorders, but perceptions of SUDs in various healthcare training programs are not well known. We aimed to characterize perceptions of faculty, staff, and students about SUD stigma in professional healthcare training programs. We conducted a cross-sectional survey of faculty, staff, and students employed at or enrolled in one of six health-related colleges at one Mid-South health science center in the United States, including medicine, pharmacy, dentistry, nursing, health professions, and graduate health sciences. Data collection occurred between February and March 2021. We used descriptive and frequency statistics to assess the constructs within the survey instrument. A total of 572 respondents participated in this study (response rate = 9%; students, n = 428, 75%; faculty, n = 107, 19%; staff, n = 32, 6%). Most respondents reported interacting with persons with a SUD, cited challenges with the interaction, and perceived SUDs to be mental health condition (n = 463) or biological disease (n = 326). Most respondents believed that their college: emphasizes learning about SUDs; promotes an accurate perception of SUDs; and fosters respect for persons with. Few respondents reported they hear faculty, staff, or students express negative comments about persons with SUDs, but they were sometimes expressed by students. Most faculty, staff, and students reported experiencing challenges when interacting with a person with a SUD, mainly communication, but few recalled hearing negative comments from their peers. Whether interventions tailored towards improving communication in academic healthcare training settings could minimize challenges experience by faculty, staff, and students when serving individuals with SUDs should be further evaluated. Read more.

 

A Dual-Process Decision-Making Model Examining the Longitudinal Associations Between Alcohol-Induced Blackouts and Alcohol Use Disorder Risk Among College Student Drinkers

Utilize a dual-process decision-making model to examine the longitudinal associations between alcohol-induced blackouts (blackouts) and alcohol use disorder risk symptoms among college student drinkers. Undergraduate drinkers (N = 2,024; 56% female; 87% White; 5% Hispanic) at a large northeastern university completed online surveys each semester during their first (T1, T2), second (T3, T4), third (T5, T6), and fourth (T7, T8) years of college (87% retention across the study). Path analyses were examined testing the longitudinal associations between T1 willingness to experience a blackout, T1 intentions to avoid a blackout, T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms. Hypotheses 1-2 tested the associations between T1 willingness, T1 intentions, T2-T8 drinking, and T2-T8 blackouts. Hypothesis 3 tested the associations between T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms. Students experienced an average of 8 (SD = 8) blackouts during college. Approximately 1,457 (88.8%) of participants reported experiencing 1 of 8 AUD risk symptoms. T1 willingness was positively associated with T2-T8 blackouts. T2-T8 drinking and T2-T8 blackouts were positively associated with T8 AUD risk symptoms. T1 willingness significantly indirectly impacted T8 AUD risk symptoms through its association with T2-T8 blackouts. Results estimated that, on average, college student drinkers experienced 8 blackouts across 4 years of college and 88% of participants reported experiencing at least one symptom of AUD in the last semester of college. Willingness to experience a blackout influenced students' AUD risk symptoms through the number of blackouts they experienced throughout college. Read more.

 

Shame and Guilt for Alcohol-Related Transgressions and Hazardous Drinking Among Male and Female College Students

Shame and guilt are often present prior to and consequent to alcohol use among college students. Little is known about the propensity to experience these emotions in the context of transgressions that occur while drinking alcohol. We examined the association between shame and guilt propensity for alcohol-related transgressions with hazardous drinking, and the role of gender in these relationships. Participants were college student drinkers (N = 130; Mage=19.39; 68% females; 86% White) from a mid-south college. An online confidential survey included measures of hazardous drinking, guilt and shame propensity, and guilt and shame propensity specific to alcohol-related transgressions. Our preliminary findings suggest that experiencing guilt (but not shame) after alcohol-related transgressions was related to less hazardous drinking when controlling for general guilt and shame propensity for male and female students. Targeting components of guilt (e.g., reparative behaviors) after alcohol-related transgressions may help to reduce problematic drinking among college students. Read more.

 

Who's at Greatest Risk? Latent Profiles of Alcohol and Cannabis Use and Related Consequences Among College Students

There is significant heterogeneity in alcohol and cannabis use patterns among college students, with some engaging in use patterns that heighten their risk for adverse consequences. Person-centered approaches can help identify those subgroups of students with riskier use patterns. Latent Profile Analyses were conducted to identify subgroups based on alcohol and cannabis use frequency and quantity, to explore demographic covariates and to examine mean differences across subgroups on alcohol- and cannabis-related consequences, simultaneous use, and other substance use. Participants were 2,423 college students (Mage = 20.1; 72  % female) recruited from seven US universities who endorsed past-month alcohol and cannabis use and completed an online survey of substance use behaviors. A four-profile solution was the best fitting model. Profile 1 represented “light, infrequent alcohol and cannabis use” (73.8%), Profile 2 represented “heavy, infrequent alcohol and moderate, frequent cannabis use” (15.9%), Profile 3 represented “moderate, frequent alcohol and cannabis use” (5.6%) and Profile 4 represented “very heavy, frequent alcohol and heavy, frequent cannabis use” (4.7%). Students who identify as male, White non-Hispanic, and/or Greek-affiliated were more likely to be in the heavy alcohol use profiles. Profiles 3 and 4 represent high-risk profiles, with both having a higher likelihood of simultaneous use, Profile 3 endorsing more cannabis consequences, and Profile 4 endorsing more alcohol consequences. Read more.

 

Communicating With College Student Nondrinkers: Using the Six-Segment Message Strategy Wheel to Create Advertising Messages That Resonate

Some students enter college eager to experiment with drinking while others choose not to drink. Yet nondrinkers cope with many pressures that can jeopardize their commitment. This raises the question: How can colleges and universities help nondrinkers remain nondrinkers? This qualitative study utilized online focus groups to give voice to 40 college student nondrinkers, who shared their insights for staying true to their goals and helping other nondrinkers. Using Taylor’s (Citation1999) six-segment message strategy wheel, participants evaluated a series of statements to discover which message strategy resonated best and why. They also shared their ideas for making nondrinking more visible on campus. Read more.

 

Examining Engagement Effects in an Adaptive Preventive Intervention for College Student Drinking

This study determined the characteristics of engagement and whether engagement in an adaptive preventive intervention was associated with reduced binge drinking and alcohol-related consequences. Incoming students were recruited for a sequential multiple assignment randomized trial (SMART; N = 891, 62.4% female, 76.8% non-Hispanic White) with an assessment-only control group. The API occurred during the first semester of college, with outcomes assessed at the end of the semester. The API involved two stages. Stage 1 included universal intervention components (personalized normative feedback [PNF] and self-monitoring). Stage 2 bridged heavy drinkers to access additional resources. We estimated the effect of engagement in Stage 1 only and in the whole API (Stages 1 and 2) among the intervention group, and the effect of the API versus control had all students assigned an API engaged, on alcohol-related outcomes. Precollege binge drinking, intention to pledge a fraternity/sorority, and higher conformity motives were most associated with lower odds of Stage 1 engagement. Action (readiness to change) and PNF engagement were associated with Stage 2 engagement. API engagement was associated with significant reductions in alcohol-related consequences among heavy drinkers. Compared to the control, we estimated the API would reduce the relative increase in alcohol-related consequences from baseline to follow-up by 25%, had all API students engaged. Even partial engagement in each component of the "light-touch" API rendered benefits. Analyses suggested that had all students in the intervention group engaged, the API would significantly reduce the change in alcohol-related consequences over the first semester in college. Read more.

 

Adverse Childhood Experiences and Alcohol Use Among Black College Students: Examining the Mediating Roles of Depression and Coping Drinking Motives

Over the past two decades, research has linked adverse childhood experiences to adult health-risk behaviors such as excessive alcohol use. Yet, few have investigated health-risk behaviors among Black college students. Research suggests that Black college students are at lower risk for hazardous drinking patterns, yet ACEs appear to alter the drinking patterns of Black students. Other studies have also shown depressive symptoms and coping-motivated drinking to predict greater alcohol consumption for this ethnic group. The current study investigated the relationship between ACEs and hazardous patterns of drinking, including frequency of alcohol use, binge, and heavy drinking episodes, using a sample of 282 Black students attending a historically black college/university. Depressive symptoms and coping drinking motives were tested as serial mediators between ACEs and the three drinking patterns. Results revealed a significant indirect effect of ACEs on the frequency of alcohol use, binge, and heavy drinking episodes, through depressive symptoms and coping drinking motives. Depressive symptoms also independently mediated the relationship between ACEs and heavy drinking episodes. The finding suggested that drinking perhaps serves as a maladaptive coping strategy to address underlying early life stress and depression for Black students. Read more.

 

Cannabis Use Associations With Adverse Psychosocial Functioning Among North American College Students

Adolescent-onset cannabis use (before age 18) is associated with multiple adverse psychosocial outcomes, but rates of CU peak between the ages of 18 and 22, coinciding with college matriculation. Whether CU among college-enrolled young adults is associated with similar psychosocial outcomes is poorly understood. In the present study, we examined relationships between CU and multiple psychosocial outcomes in North American college students. Data for this report come from N = 40,250 North American college students ages 18-to-25 years (mean age = 20.7 years, 69% female, 66% Caucasian) who participated in the Healthy Minds Study 2016-17. HMS is a web-based annual survey querying multiple mental health, substance use, and psychosocial variables in representative student populations from 53 universities across North America. Student respondents were stratified in two groups based upon their self-report of past 30-day CU and compared on psychosocial variables. Approximately 20% (n = 8,327) of student respondents reported past 30-day CU. After adjusting for socio-demographics, knowledge of campus services, and use of other drugs, the odds of depression, suicidal thoughts and behaviors, anxiety, eating disorders, and violence victimization were all higher for CU students. Additionally, CU students had higher rates of other drug use and lower rates of perceived supportive relationships. Our results indicated that CU is common among North American college students and associated with adverse psychosocial consequences across multiple domains. Based upon these findings, colleges should consider expanding educational, prevention, and early-intervention programs for students who use cannabis. Read more.

 

Women Who Pre-Game: A Study of Stress and Alcohol Use in Female Collegiate Predrinkers

This study examined the relationship between stress and pre-gaming (i.e., drinking prior to going out to an event) in female college students. Thirty-four female college students were grouped as pre-gamers or non-pre-gamers based on self-reported drinking patterns. They completed surveys about alcohol use and mental health and provided a set of salivary cortisol samples upon waking, 30 min. later, and at 10am on the same day. Pre-gamers and non-pre-gamers did not differ on demographics or psychosocial variables. Pre-gamers reported riskier drinking overall and had greater endorsement of social, coping, and enhancement drinking motives. Pre-gamers also had lower cortisol levels 30 min. after waking and exhibited attenuated CAR. Female collegiate pre-gamers may differ from their peers not only in terms of alcohol consumption and drinking motives, but also on attenuated CAR, a physiological biomarker associated with stress dysregulation and vulnerability to addictive behaviors. Read more.

 

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Food Insecurity and Substance Use Among Young Adult College Students in the United States

Food insecurity is prevalent among college students in the United States and has been associated with substance use. We sought to provide updated prevalence estimates and associations between food insecurity and a broad range of substances during the SARS-CoV-2 pandemic. Using cross-sectional data from the Health Minds Study (N = 94,722; September 2020-June 2021), we used multivariable logistic regression to examine associations between food insecurity and several substances, adjusting for age, gender, race/ethnicity, hours worked, and residence. We then added a block of adjustments consisting of mental health factors (depression, anxiety, loneliness, financial stress). Food insecurity was associated with significantly greater odds of having used most individual substances, including greater odds of binge drinking, cigarette use, vaping, and a range of illicit or prescription drugs (using any illicit/prescription drug). These associations attenuated and many lost significance after adjusting for mental health factors. This study found evidence to suggest that food insecurity is related to substance use in a large sample of young adult college students in the United States, calling for targeted interventions. Read more.

 

Quantitative Survey on Prevalence of Prescription Pain Medications and Stimulants Use in Young Adults

Prescription drug use including pain relievers and stimulants has been a growing problem in young adults and the issue has been a public health concern for years. This Quantitative Cross-sectional study aimed to collect preliminary data regarding prescription opioid use, prescription stimulant drug use, and overdose treatment knowledge in young adults between 18 and 24 years old in a southern New Jersey university through administering an online survey. Of the 1,663 students who completed the survey, 33% reported using prescription pain relievers and 15% reported using prescription stimulant drugs. Stimulant drug users were found to be more likely to use prescription pain relievers (49%) as compared to nonstimulant users (30%). Furthermore, students with overdose treatment knowledge of opioids were more likely to report misuse of prescription drugs (15%) than students with less knowledge (8%). This study reiterates the increasing usage of prescription drugs and stimulant use among college students. There is a need for effective education strategies to inform students about the prescription medication uses and misuse to reduce nonmedical use of prescription medications. Read more.

 

The Alcohol and Polysubstance Behaviors of Mandated College Students Prior to Collegiate Sporting Events: An Assessment of Pregaming

Despite a litany of education and prevention efforts seeking to curtail alcohol and other drug use behaviors of United States college students, AOD use remains pervasive among the American college student population. Socio-cultural reinforcement of AOD behaviors, such as pregaming (PG), are often considered normative aspects of the collegiate experience, potentially introducing, and/or exacerbating, AOD use among U.S. college students. Due to the unique relationship PG has with the U.S. college experience and sports culture, this study explored the relationship between PG prior to a live sporting event and frequency of alcohol use, and the likelihood of persons who pregame also engaging in polysubstance use (>1 substance during drinking/use event). This study was conducted with college students (n = 816) attending a large public university in the Southeastern Conference who violated campus alcohol use policies. Beyond the influence of important demographic covariates, PG (p < .001) was significantly associated with a greater frequency of alcohol use. Moreover, students who participated in PG festivities were nearly 2.5 times more likely to participate in polysubstance use. PG prior to live collegiate sporting events has clear public health and policy implications. Future efforts should institute and enforce risk-management policies on college campuses and employ event-specific alcohol and polysubstance use prevention and intervention strategies. Read more.

 

Depressive Symptoms Predict Trajectories of Electronic Delivery Nicotine Systems, Cigarette, and Cannabis Use Across 4.5 Years Among College Students

This study examined the role of depressive symptoms on trajectories of electronic nicotine delivery systems, cigarette, and cannabis use across 4.5 years in a sample of college students aged 18–19 at the initial study wave. Participants were 2,264 students enrolled in one of 24 Texas colleges that participated in a multi-wave study between 2014 and 2019. Latent growth mixture models were fit to identify longitudinal trajectories for past 30-day ENDS, cigarette, and cannabis use over a 4.5-year period. Class membership was regressed on baseline depressive symptoms in multinomial regression models. Four trajectory classes were identified for each product: abstainer/minimal, decreasing, increasing, and high. Depressive symptoms were associated with a greater likelihood of belonging to the decreasing, increasing, and high trajectory classes relative to the abstainer/minimal class for all products, with the exception of the increasing ENDS class and the decreasing cannabis class. The findings demonstrate that there is considerable similarity across trajectories of ENDS, cigarette, and cannabis use during traditional collegiate years. Furthermore, depressive symptoms increased the likelihood of belonging to substance using trajectory classes for all products. Read more.

 

Substance Use Among College Students

U.S. college campuses have witnessed a national increase of cannabis, stimulant, and illicit drug use among students over the past decade. Substance use among college students is associated with numerous negative outcomes including lower academic performance, a higher probability of unemployment after graduation, and an increased risk of committing and experiencing sexual assault. Several risk factors for substance use are specific to this population, including an affiliation with Greek life, perception of high academic pressure, and peer pressure. Students with problematic substance use also face unique challenges in planning treatment, including aspects of confidentiality, financial constraints, and potential university oversight and involvement. This article highlights the prevalence of substance use on college campuses and describes some of the specific challenges and approaches to treatment in this population, including screening tests and interventions for specific substances used on college campuses and evidence-based substance use programming for college students. Read more.

 

Driving Under the Influence of Cannabis and Alcohol: Evidence from a National Sample of Young Drivers

Driving under the influence of psychoactive substances is an important public health and criminal justice issue, impacting the lives of millions of Americans. Although recent research provides up-to-date information regarding DUI among adults, there is a pressing need for research that focuses specifically on younger/underage drivers. We draw from a large, nationally-representative sample to provide up-to-date evidence as to the prevalence and key criminal justice, substance use, and behavioral health correlates of DUI of cannabis and alcohol among drivers ages 16 to 20 in the United States. We used data from the 2020 and 2021 National Survey on Drug Use and Health (young drivers ages 16-20; N=12,863). All analyses—survey adjusted prevalence estimates, logistic regression—were conducted using Stata SE 17.0 and weighted to account for the study’s stratified cluster sampling design. The prevalence of DUI-cannabis for the full sample—including those not endorsing past-year use—was 6.3%. Among youth endorsing past-year cannabis use, 24.5% reported DUI of cannabis. In the full sample and among cannabis users, DUI-cannabis risk was elevated among older and male youth. The prevalence of DUI-alcohol was 2.6% among all youth and 6.1% among youth reporting past-year alcohol consumption. Estimates indicate that more than one million young drivers each year are placing their lives and those of others at risk by operating motor vehicles after consuming cannabis and/or alcohol. Findings underscore the importance of prevention efforts targeting underaged cannabis and alcohol-impaired driving. Read more.

 

Early Onset Marijuana Use and Suicidal Ideation Among African American College Students

Between 2013 and 2019 the suicide rate for African American young persons 15–24 years of age rose by 47% for males and 59% for females. Presently, little is known about factors that contribute to the suicidal behavior of African Americans in late adolescence and emerging adulthood. However, considering the coinciding increase in high potency marijuana use among African American young persons and literature suggesting a potential link between marijuana use and suicidal behavior, we examined early onset marijuana use as a risk factor for suicidal ideation. The sample included 221 African American students (70% female and Mage = 20.3, SD = 1.97) attending an HBCU between 2019 and 2020. We employed multivariable logistic regression analysis that included suicidal ideation as the outcome variable and early onset marijuana use as the explanatory variable, while controlling for demographic factors and mental health treatment status. Approximately 19% of the sample reported suicidal ideation. Early onset marijuana use was reported by 28% of students. Compared to students who never used marijuana, early onset users were three times as likely to report suicidal ideation. In conclusion, early onset marijuana use may place African American young persons at increased risk for suicidal ideation. Marijuana use may be an important malleable risk factor that can be targeted in suicide prevention interventions designed for African American college students. More research is warranted. Read more.

 

Adverse Childhood Experiences and Alcohol Related Negative Consequences Among College Student Drinkers

Despite increasing college campus prevention efforts, and identification of effective strategies to reduce drinking, reducing alcohol-related negative consequences (ARNC, e.g., regrets, blackouts, self- and other- injury, law enforcement exposure, sexual assault, and considering suicide) continues to be a challenge. While college students with a history of adverse childhood experiences are at greater risk for alcohol misuse, research regarding the association between ACE and ARNC remains limited. Data are responses of currently drinking students on the American College Health Association-National College Health Assessment and College Student Health Survey, administered in 2018 to students in California and Minnesota (N = 6,667). On average, students reported one ARNC, although 13 % experienced three or more different types of ARNC in the past year. Every ACE was associated with a 19% to 41% increase in the IRR of ARNC. Students with 1–3 ACE experienced significantly more types of ARNC events than students with no ACE and students with ≥ 4 ACE experienced statistically significantly more types of ARNC events than their peers with 1–3 or no ACE. The ACE-ARNC relationship did not vary by drinking frequency or binge drinking. The consistent ACE - ARNC relationship across drinking behaviors suggests alcohol consumption does not fully explain the association between ACE and ARNC and that early adversity heightens vulnerability for ARNC. Implications for future prevention and intervention efforts are discussed. Read more.

 

Profiles of Alcohol and Cannabis Protective Behavioral Strategies Use Across Two Large, Multi-Site College Student Samples of Concurrent Alcohol and Cannabis Users

Concurrent use of alcohol and cannabis among college students is common and confers greater harms than the use of either of these substances alone. Large and growing bodies of literature have demonstrated the independent utility of behaviors used before, during, after, or instead of alcohol and cannabis use that minimize related harms (i.e., protective behavioral strategies). However, little is known about the relationship between alcohol and cannabis PBS and their joint influence on harms among college students who concurrently use alcohol and cannabis. In the present study, we used data from two large, multi-site samples of college students, and restricted analyses to those who reported at least one episode of alcohol and cannabis use in the past 30 days (Study 1: N = 1,104; Study 2: N = 2,034). A latent profile analysis supported a 4-profile solution that was largely consistent across samples: Profile 1 (low alcohol/cannabis PBS; 8.8–11.9 %), Profile 2 (average alcohol/cannabis PBS; 33.1–37.7 %), Profile 3 (average alcohol PBS/low cannabis PBS; 16.3–25.2 %), and Profile 4 (high alcohol/cannabis PBS; 29.8–37.2 %). Profile 4 reported the least alcohol/cannabis use, fewest negative alcohol-/cannabis-related consequences, and lowest alcohol/cannabis use severity. In contrast, Profile 1 was the opposite for alcohol-related outcomes, and Profile 3 was the opposite for cannabis-related outcomes. These findings are preliminary but may suggest that targeting both alcohol and cannabis PBS in intervention is generally beneficial except some groups at risk for a particular substance may benefit from increased focus on that substance in intervention. Read more.

 

Examining Associations of Coping Strategies with Stress, Alcohol, and Substance Use Among College Athletes: Implications for Improving Athlete Coping

Mental health challenges and substance use are common among college athletes, yet few studies have been conducted to understand substance use as a coping strategy. The pressures of collegiate athletics - including commitments to training, travel, and competition - can contribute to maladaptive coping among college athletes, including alcohol and other substance use. An online survey was completed by 188 college athletes competing across NCAA/NJCAA divisions at six institutions in the United States to examine factors associated with substance use coping and whether specific strategies of coping were associated with risk of substance use. Alcohol and drug use were assessed using the CRAFFT Screening Test, NIDA-Modified ASSIST, and Alcohol Use Disorders Identification Test. Coping was assessed with the Coping Orientation to Problems Experienced Inventory, stress was assessed using an adapted Graduate Stress Inventory, athletics-related anxiety was assessed with the Sport Anxiety Scale, and perceived control of stress was assessed using the Perceived Control Questionnaire. Older athletes, men, and those with higher stress were more likely to use substances to cope. Higher behavioral disengagement, higher substance use coping, and lower religious coping were associated with increased likelihood of binge drinking and substance-related risk behaviors. These findings point to the importance of developing targeted interventions aimed at addressing stress and facilitating healthy coping to reduce problematic drinking and substance use among college athletes. Read more.

 

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Generation COVID: Young Adult Substance Use

This study also focuses on pandemic-linked changes in young adult substance use by summarizing global studies over this issue.  The research team used a longitudinal design and reported declines in alcohol-related harm in an Australian group. This pattern differed for countries across the world. For example, in the Swiss and U.K., studies showed a decreasing pattern in alcohol and cigarette use but heavy drinking had a quicker rebound. Meaning that those with a greater pre-pandemic substance use return to substance use quicker than those with no pre-pandemic substance use. U.S. reported different findings, being an increase in heavy drinking in the first year of the pandemic among college students. College students form a unique cohort for change in substance use. Students that moved back in with their families during the pandemic were found to be most likely to pause past-week tobacco use. On the other hand, another study that sampled 18-20-year-old who misuse prescription drugs had an increase in alcohol and marijuana use in the first two months of the pandemic and reported no change in nicotine use or prescription drug use. The increase in marijuana use was found greatest for those with higher financial strain and marijuana cravings. Nicotine uses increased the most among those with lower loneliness and higher financial strain. Given potential links between surging mental health disorders and substance use, further surveillance and wider dissemination of substance use programming is needed, particularly for vulnerable individuals and settings. Read more.

 

Perceptions of Health Risks and Benefits of Cannabis Use Among College Students: Prevalence and Associations With Cannabis Use

Health decision-making is influenced by perceived health risks and benefits. Greater understanding of these perceptions in college students, a population engaging in high rates of risky cannabis use, is needed. The primary aim of the current study was to examine both perceived risks and benefits of cannabis for short- and long-term health consequences and how these perceptions relate to cannabis use and related problems. Using a large, diverse college sample from 10 institutions across the U.S. (N=2,354), this cross-sectional study assessed health perceptions of cannabis, cannabis use, and related problems. We examined endorsement of various health perceptions by cannabis use status (never, lifetime, current) and other demographic factors. Participants endorsed a number of health risks (e.g., birth defects, memory problems) and benefits (e.g., pain relief, anxiety reduction) associated with cannabis use. Overall, there was stronger endorsement of health risks than benefits, although this relationship was reversed for individuals who currently use. With a few exceptions, perceptions of health risks and benefits did not differ across demographic variables, including state-level legal status of cannabis. Among individuals reporting past month use, benefit perceptions were associated with more frequent use and risk perceptions were associated with less frequent use. Detailed and nuanced understanding of perceived health risks and benefits could be used to identify common beliefs about cannabis and to develop prevention messaging and intervention targets, such as correcting normative beliefs or addressing misconceptions about the health risks and benefits of cannabis. Read more.

 

Alcohol and Cannabis Co-Use: Receptiveness to Treatments and Application to Intervention Planning

Given the prevalence of alcohol and cannabis co-use among college students, prevention for co-use is crucial. We examined hypothetical receptiveness to substance-specific interventions among students who reported co-use. Students who use alcohol and cannabis were more receptive to alcohol interventions than cannabis interventions. Campus prevention experts should consider offering evidence-based, alcohol-focused interventions as a potential pathway for decreasing substance use among college students who engage in co-use. Read more.

 

Are Campus Services Reaching Those in Need? Substance Use and Awareness of University Counseling Services

Help-seeking is uncommon among college students with substance use concerns. Perceived access to services is associated with greater help-seeking behavior. This study identifies substance use-related risk factors associated with awareness of campus counseling services. College students aged 18 to 25 (N = 995) self-administered a web-based survey, reporting their demographics, substance use history, well-being, and counseling services available at their institution. Multiple logistic regression was used to identify factors associated with awareness of services. Overall, 78% of students were aware of counseling services available at their institution. Full-time enrollment and better mental well-being were associated with greater odds of awareness of services. Early initiation of substance use and past month high-intensity drinking were associated with lower odds of awareness of services. Innovative strategies are needed to ensure campus counseling services reach students at risk for substance use-related problems. Read more.

 

Differences in Nonmedical Use of Prescription Stimulants Among Fraternity- and Sorority-Affiliated Students

The current study reviewed data from the 2022 College Prescription Drug Study of 4,967 undergraduate students to examine differences in lifetime and past-year misuse of prescription stimulants, academic motivations and consequences of misuse, and misperceptions of prescription stimulants. Results indicate that fraternity- and sorority-affiliated students are more likely to report misusing a prescription stimulant in their lifetime and within the past year than nonaffiliated students. Fraternity and sorority members are more influenced by academic reasons and social norms than nonaffiliated students, with gender identity further predicting level of risk. Implications for prevention programming for fraternity and sorority members are discussed. Read more.

 

A Mobile-Based Pregaming Drinking Prevention Intervention for College Students: A Pilot Randomized Controlled Trial

Pregaming is among the riskiest drinking behaviors in which college students engage, often leading to elevated blood alcohol levels and negative alcohol-related consequences. Yet, tailored interventions to reduce risk associated with pregaming are lacking. The present study was designed to develop and evaluate the efficacy of a brief, mobile-based intervention targeting heavy drinking during pregaming among college students, called Pregaming Awareness in College Environments. PACE was developed using two innovations to facilitate behavior change: (a) a mobile-based application to increase intervention accessibility and (b) personalized pregaming-specific intervention content delivered using a harm reduction approach with cognitive behavioral skills training. After development and β-testing, we employed a randomized clinical trial with 485 college students who reported pregaming at least once per week in the past month (Mage = 19.98; 52.2% from minoritized racial and/or ethnic groups; 65.6% female). Participants were randomly assigned to PACE (n = 242) or a control condition website (n = 243), which consisted of general information about the effects of alcohol. Analysis assessed intervention effects on pregaming drinking, global drinking, and alcohol-related consequences at 6 and 14 weeks postintervention. Although participants in both conditions reduced drinking, small and significant intervention effects favoring PACE were found at 6-week follow-up for overall drinking days, pregaming days, and alcohol-related consequences. Findings suggest the brief mobile PACE intervention has potential to address risky drinking, but more intensive pregaming-focused efforts may be necessary to achieve stronger and lasting effects among college students. Read more.

 

Hazardous Alcohol Use, Drinking Motives and COVID-19-Related Anxiety in College Students

This study examined the associations of anxiety and drinking motives with hazardous and binge alcohol use among young adults. We recruited young adults (N = 182, mean age 25) between November 2020 and December 2020. Linear regressions were used to evaluate relationships among hazardous alcohol use (US Alcohol Use Disorders Identification Test-C [USAUDIT-C]), binge drinking (Alcohol Intake Questionnaire [AIQ]), PROMIS-Anxiety, COVID-19 related anxiety (CAS), and the drinking to cope with depression and anxiety subscales of the Modified Drinking Motives Questionnaire. Sixty-two percent of participants reported hazardous drinking (USAUDIT-C score > 4). PROMIS Anxiety and CAS scores were 63.7 and 1.0, respectively. Scores were positively associated with drinking patterns. However, the drinking to cope with depression motive significantly mediated these associations. After the onset of the pandemic, hazardous and binge drinking patterns among young adults were associated with drinking to cope with depression rather than anxiety. Read more.

 

How Do Mandated College Student Drinkers Characterize Binge Drinking?

Within the past 30 days, a quarter of U.S. college students reported binge drinking (i.e., consuming ≥ five drinks (male) or ≥ four drinks (female), in about 2 hours). While scholars have refined binge drinking parameters/definitions over time, determining college students’ personal characterization of binge drinking is important as misperceptions can directly impact students’ alcohol use and associated consequences. This study explored differences in college students’ characterization of binge drinking and the effect of overestimating standardized parameters. This study was conducted at a large public university in the Southeast U.S. among college students who violated campus alcohol-use policies (n = 816). Respondents anonymously completed measures of alcohol frequency and quantity, and binge drinking characterization. Analyses explored the relationship between binge drinking parameters and personal alcohol use. Statistically significant differences existed for alcohol consumption between students who underestimated/accurately characterized binge drinking parameters and those who overestimated. Moreover, students who overestimated participated in binge drinking more frequently (p < .001) and were nearly 3.5 times more likely to binge drink than their counterparts. Correcting misperceptions, establishing clear and accurate understandings, and eliminating ambiguity associated with alcohol behaviors and norms should be a priority for college health practitioners and administrators. Read more.

 

Exposure to Media With Alcohol-Related Content Across Young Adulthood: Associations With Risky Drinking and Consequences Among High-Risk 2- and 4-Year College Students

Exposure to media with alcohol-related content is a known risk for alcohol use and related harms among young people. The present study used longitudinal self-report data on exposure to media with alcohol-related content to examine age trajectories across young adulthood and to estimate associations with heavy episodic drinking and negative consequences. Participants were 201 high-risk young adults enrolled in 2- and 4-year colleges (ages 18–25 at screening; 63.7% female). Repeated assessments occurred at four timepoints across a 12-month period. Self-reported exposure to both positively and negatively portrayed alcohol-related media content decreased with age. Between-persons, controlling for alcohol use frequency, exposure to positive alcohol-related media content was positively associated with HED, and exposure to negative alcohol-related media content was inversely associated with HED; no within-person effects on HED were significant. For negative consequences, controlling for alcohol quantity, exposure to positive media content was associated with more negative consequences both between- and within-persons. Unexpectedly, exposure to negatively portrayed media content was positively associated with negative consequences at the within-person level. Trajectories in exposure to media with alcohol-related content showed that relatively younger participants reported greater exposure, highlighting the need for policy and prevention efforts to protect this vulnerable demographic. Findings generally indicated that positive portrayals of alcohol use increase alcohol-related risks. Moreover, increased exposure to negative portrayals in a given assessment was associated with more negative consequences—potentially by normalizing or glorifying high-risk drinking and consequences, though mechanistic/causal research is needed. Read more.

 

Depressive Symptoms, Racism, and School Belonging: Examining Correlates of Substance Use Behaviors Among Black College Students

College is a context in which Black adults are at heightened risk for substance use behaviors and subsequently more harmful consequences. Increasingly, scholars are recognizing that to better understand shifts in patterns of substance use behaviors and health disparities among Black adults, mental health and racism are important factors to consider. Racism is multidimensional; thus, research is needed to investigate its multiple forms. Currently, it is unknown how the occurrence of depressive symptoms and various racism experiences influence patterns of substance use behaviors among Black college students. Further, while school belonging is evidenced to promote better health outcomes during adolescence, research is needed to understand school belonging in relation to substance use among Black college students. Using latent profile analysis, we identify patterns of substance use behaviors among Black college students (N = 152) and examine whether depressive symptoms, racism experiences (i.e., racial discrimination stress, internalized racism, negative police encounters), and school belonging are associated with the unique patterns. Latent profiles included indicators of substance use behavior frequency. Four patterns emerged: 1) low substance use, 2) predominant alcohol use, 3) co-use, 4) high polysubstance use. Depressive symptoms, internalized racism, and negative police encounters were significant correlates of patterns of substance use behaviors. School belonging, specifically, participation in student, cultural, spiritual, and Greek organizations, was also associated with profile membership. Findings suggest a need to integrate a broader understanding of how mental health and racism impacts the lives of Black college students, in addition to processes for supporting school belonging. Read more.

 

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

Previous research cites mindfulness as a protective factor against risky substance use, but the specific association between dispositional mindfulness 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. The present study used latent profile analysis 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. 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. 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. Read more.

 

The Associations of Basic Psychological Need Satisfaction and Need Frustration With Cannabis-Related Outcomes in a Multi-Site Sample of College Students

Psychological need satisfaction and need frustration, proposed by self-determination theory, may serve as conditions that foster health-promoting and health-impairing behaviors related to cannabis use. In the present study, we examined the measurement model of psychological need satisfaction and need frustration and their associations with cannabis protective behavioral strategies use, negative cannabis-related consequences, and cannabis use severity. Data were from 1,394 college students from 10 universities across the U.S. who reported past-month cannabis use. A higher-order factor model representing general psychological need satisfaction and need frustration provided a good fit to the data. Regressing the three observed cannabis outcome variables onto these higher-order latent factors, we found that greater need satisfaction was associated with more frequent cannabis protective behavioral strategies use and fewer negative cannabis-related consequences. Greater need frustration was associated with greater negative cannabis-related consequences and cannabis use severity. Further, an interaction effect between need satisfaction and need frustration emerged for each cannabis outcome such that greater need satisfaction attenuated the associations between need frustration and cannabis outcomes and greater need frustration strengthened the associations between need satisfaction and cannabis outcomes. Implications for the roles of need satisfaction and need frustration in cannabis use and future intervention development are discussed. Read more.

 

Alcohol-Induced Blackouts Among College Student Drinkers: A Multilevel Analysis

The researchers’ objective was to identify factors (manner of drinking, combined alcohol and other substance use, physiology) that are associated with alcohol-induced blackouts over and above estimated blood alcohol concentration. 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. Protective behavioral strategies were associated with decreased odds of AIBs on the daily, weekly, and person-levels. Combined cannabis with alcohol was associated with increased odds of AIBs on the weekly and person-levels. People who more frequently played drinking games, pregamed, and showed higher tolerance showed increased risk of AIBs, over and above eBAC levels. Researchers 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. Read more.

 

"Letting Go and Staying Connected": Substance Use Outcomes From a Developmentally Targeted Intervention for Parents of College Students

Results are presented of a randomized, controlled, efficacy trial of a handbook intervention for parents of first-year college students. The aim of the interactive intervention was to decrease risk behaviors by increasing family protective factors. The handbook, based in self-determination theory and the social development model, provided evidence-based and developmentally targeted suggestions for parents to engage with their students in activities designed to support successful adjustment to college. Researchers recruited 919 parent-student dyads from incoming students enrolled at a university in the U.S. Pacific Northwest and randomly assigned them to control and intervention conditions. Handbooks were sent to intervention parents in June before students’ August matriculation. Research assistants trained in motivational interviewing contacted parents to encourage use of the handbook. Control parents and students received treatment as usual. Participants completed baseline surveys during their final semester in high school (time 1) and their first semester at college (time 2). Self-reported frequency of alcohol, cannabis, and simultaneous use increased across both handbook and control students. In intent-to-treat analyses, odds of increased use were consistently lower and of similar magnitude for students in the intervention condition than in the control condition, and odds of first-time use were also lower in the intervention condition. Contact from research assistants predicted parents’ engagement, and parent and student report of active engagement with handbook predicted lower substance use among intervention than control students across the transition to college. Researchers developed a low-cost, theory-based handbook to help parents support their young adult children as they transition to independent college life. Students whose parents used the handbook were less likely to initiate or increase substance use than students in the control condition during their first semester in college. Read more.

 

Race-Based Traumatic Stress Predicts Risky Drinking, Over and Above Negative Affect, and Non-Race Related Trauma Symptoms in Racial/Ethnic Minority Female College Students

Alcohol misuse remains a major concern in college student populations and rates of risky and problematic drinking are specifically on the rise for women. One important factor that has been shown to be positively associated with substance use/misuse for women from historically marginalized or minoritized racial/ethnic backgrounds is exposure to racial discrimination and possible resulting traumatic stress reactions. Questions remain about the relationship between race-based traumatic stress and risky drinking particularly among diverse female college students who are at greater risk due to their marginalized status in their racial/ethnic and gender groups. The current study examined race-based traumatic stress as a unique predictor of risky drinking when controlling for negative affectivity and general trauma symptoms, additional risk factors for risky drinking in women. Hierarchical linear regressions revealed that race-based traumatic stress made a significant and unique contribution to the amount of variance in risky drinking, above negative affectivity, and general trauma symptoms. These findings highlight the importance of considering experiences of racism as risk factors in substance use prevention and intervention, specifically for female college students from marginalized or minoritized racial/ethnic backgrounds. Read more.

 

Feasibility and Acceptability of the Social Media-Brief Alcohol Screening and Intervention for College Students Intervention

Community college students represent an at-risk population for alcohol use with limited access to campus interventions. The Brief Alcohol Screening and Intervention for College Students is available online, though identifying community college students at risk and connecting them to interventions remains challenging. This study tested a novel approach using social media to identify at-risk students and prompt delivery of BASICS. This randomized controlled trial examined the feasibility and acceptability of Social Media-BASICS. Participants were recruited from five community colleges. Baseline procedures included a survey and social media friending. Social media profiles were evaluated using content analysis monthly for nine months. Intervention prompts included displayed alcohol references indicating escalation of or problematic alcohol use. Participants who displayed such content were randomized into the BASICS intervention or an active control. Measures and analyses assessed feasibility and acceptability. A total of 172 community college students completed the baseline survey, mean age was 22.9 years. Most were female (81%), with many (67%) identifying as White. Among participants, 120 (70%) displayed alcohol references on social media, prompting intervention enrollment. Of randomized participants, 94 (93%) completed the preintervention survey within 28 days of the invitation. The majority of participants reported positive intervention acceptability. This intervention combined two validated approaches: identification of problem alcohol use displays on social media, and provision of the Web-BASICS intervention. Findings demonstrate the feasibility for novel web-based interventions to reach community college populations. Read more.

 

Motives for Nonmedical Use of Prescription Stimulants in Community College Students

The present study identified common motives for nonmedical use of prescription stimulants among community college students and examined behavioral and demographic correlates of certain motives. The survey was completed by 3,113 community college students (72.4% female; 81.7% White). Survey results from 10 community colleges were evaluated. NMUS was reported by 9% (n = 269) participants. The most common motive for NMUS was to “focus on studies or to improve academic performance” (67.5%) followed by to “have more energy” (52.4%). Females were more likely to report NMUS for weight loss, and males were more likely to report NMUS to experiment. The motive “to feel good or get high” was linked to polysubstance use. Community college students report similar motives for NMUS to those commonly endorsed by 4-year university students. These findings may help identify community college students susceptible to risky substance use. Read more.

 

Solitary Cannabis Use and Related Consequences Among College Students During the COVID-19 Pandemic

Solitary cannabis use has been associated with greater cannabis problems than social use and may be increasingly prevalent due to pandemic-related isolation. However, little is known about patterns, correlates, and consequences of solitary cannabis use. This study sought to characterize solitary cannabis use since pandemic onset, examine psychosocial risk factors, and examine interactions between solitary and social cannabis use frequency on cannabis consequences. College students (N = 168) who were lifetime cannabis users at a private, northeastern university in the U.S. completed an online cross-sectional survey in fall of 2020. Past-year solitary cannabis use was common among life-time cannabis users (42% past year, 29% monthly or more), especially among past-year regular cannabis users (85% monthly or more). Solitary use frequency was associated with interpersonal sensitivity and pandemic-related stress. Further, solitary use attenuated associations of social use frequency with cannabis consequences, such that social use frequency was associated with greater consequences only among exclusively social users. In contrast, regardless of social use frequency, solitary users reported greater cannabis consequences than exclusively social users. Findings suggest solitary cannabis use is concurrently associated with greater cannabis consequences, and affective risk factors (interpersonal sensitivity, pandemic stress) should be considered for prevention and intervention strategies. Read more.

 

The Socio-Ecological Context of U.S. College Student Drinking: A Latent Class Analysis

U.S. college student drinking typologies often consider quantity and frequency but not the socio-environmental contexts in which students obtain alcohol and drink. Understanding context could be important for preventive interventions. We used latent class analysis, a person-centered approach to understanding behavior patterns, to identify drinking typologies among 1,390 college student drinkers from a representative survey at two interconnected private colleges in the Northeast. Classes were derived from drinking frequency and quantity as well as how students obtain alcohol, where they drink, and their perceptions of peer drinking. Resulting classes were correlated with demographic and developmental characteristics, participation in campus activities and connectedness, and alcohol consequences and protective behaviors. Four distinct drinking profiles emerged. ‘Tasters’ (n = 290) included infrequent and low quantity drinkers who drank in dorms with alcohol provided by others. ‘Bargoers’ (n = 271) included low quantity and moderate frequency drinkers who purchased their own alcohol and drank at bars. ‘Partiers’ (n = 483) included moderate frequency and quantity drinkers who obtained alcohol from several sources and drank in many locations. ‘Bingers’ (n = 345) included high frequency and quantity drinkers and binge drinkers, who drank in many locations with alcohol obtained from multiple sources. Classes differed in demographics, age of first drink, campus activities and connectedness, alcohol protective behaviors, and alcohol problems. Heterogeneous patterns of drinking based on quantity, frequency and social/environmental context emerged and suggested the need for different tailored interventions. Read more.

 

Who Persists and Who Desists? A Prospective Study of Prescription Stimulant Misuse in College Graduates

Prescription stimulant misuse has been studied extensively in college populations, but few studies have examined how PSM changes after graduation. We used a longitudinal design to follow individuals at risk for PSM 2 years after college graduation to document PSM prevalence, motives, and predictors of PSM persistence. Participants from two small, private colleges completed online surveys focused on intrapersonal, interpersonal, and sociocultural predictors of PSM. Overall, PSM declined over time. Lack of premeditation, perceived peer norms, positive expectancies, media exposure, and other substance use were associated with continued PSM; however, only lack of premeditation, descriptive norms, and other substance use predicted PSM in a multivariate model. This preliminary study suggests dispositional and behavioral risk factors may help to explain why PSM persists after college. Interventions that enhance decision-making skills, correct misperceptions about peers’ PSM, and reduce polysubstance use may be effective in curbing PSM in college graduates. Read more.

 

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Health Literacy: Major Factor in Preventing Youth Cannabis Use

Amelia Arria, Ph.D., has focused her research on the impact of substance use and untreated mental health problems among college students specifically, and more broadly, on adolescents. Speaking at this month's annual leadership meeting of Community Anti-Drug Coalitions of America, Arria, a professor in the school of public health at the University of Maryland, talked about the widespread misperceptions of cannabis among college students. Read more.

 

High Spirits? Exploring "Halloweekend" Alcohol and Cannabis Use Among Heavy-Drinking College Students

Specific events are associated with heavier and riskier substance use behaviors among college students, including holidays like Halloween that may include several days of themed parties/events (“Halloweekend”). The current study compared drinking, pregaming (i.e., fast-paced drinking prior to going out for the night), cannabis use, same-day alcohol and cannabis co-use, and negative alcohol-related consequences over Halloweekend compared to two adjacent non-Halloween weekends among a sample of heavy-drinking university students. Participants (N = 228; 65% female) provided 28 days of daily diary data. We used a 3-level generalized linear mixed model approach estimating zero-inflated Conway-Maxwell Poisson regressions to assess the effect of weekend and specific weekend day on number of overall drinks, number of pregaming drinks, and negative alcohol-related consequences. Proportions tests assessed for differences in any cannabis use and daily co-use between Halloweekend and non-Halloween weekends. Zero-inflated portions of the GLMMs indicated general drinking, pregaming, and negative consequences were most prevalent on Halloweekend and Fridays and Saturdays. Count portions of the models indicated general drinking quantity was highest during these periods, and participants experienced a greater number of negative consequences on Halloweekend compared to the weekend prior; no differences were observed in the quantity of pregaming drinks consumed across weekends or days. No significant differences in cannabis use or co-use were observed between weekends. Given risk associated with Halloweekend compared to weekends immediately prior to and after, interventions targeting alcohol use and pregaming on Halloweekend may be beneficial to reduce related harm for heavy-drinking students. Read more.

 

Exposure to Pro and Anti-Cannabis Social Media Messages and Teens' and College Students' Intentions to Use Cannabis

Content analyses have documented that posts about cannabis are increasingly common on social media. The relationship between the cannabis-related content to which teens and college students are exposed on social media and how such content may be associated with intentions to use and use of cannabis is less known, however. We conducted an online survey with teens (N = 350) who lived in Washington state using online survey panel participants in June 2018 and with college students (N = 966) in a Washington statewide university system in February and March 2019. Participants in both samples reported seeing both pro-cannabis and anti-cannabis messages on social media platforms. Exposure to pro-cannabis messages on social media was associated with an increased intention to use cannabis. Exposure to anti-cannabis messages on social media was indirectly associated with decreased intentions to use cannabis through negative outcome beliefs of cannabis use and, among college students, through perceived norms. Among college students specifically, exposure to pro-cannabis messages on social media was also associated with more frequent cannabis use. Health communicators could focus anti-cannabis messaging on negative outcome beliefs among teens and college students as well as norms among college students to potentially influence constructs associated with intentions and use. Read more.

 

Eating Disorders and Substance Use: Examining Associations Among U.S. College Students

The study’s objective was to investigate associations between reported eating disorder diagnosis and substance use disorder diagnosis, substance misuse, and illicit drug use among U.S. college students. Data consisting of 414,299 students' responses to the National College Health Assessment survey conducted by the American College Health Association between fall 2015 and spring 2019 were utilized for this study. Unadjusted and adjusted odds ratios were used to determine the association of reported ED diagnosis with reported SUD diagnosis, misuse of cigarettes, e-cigarettes, alcohol, marijuana, cocaine/methamphetamine, sedatives, hallucinogens, opiates, inhalants, MDMA, and other club drugs, as well as illicit use of prescription pain killers, prescription sedatives, and prescription stimulants. A sensitivity analysis investigating associations between reported anorexia nervosa, bulimia nervosa, and each substance use outcome was also conducted. Among all in our analytic cohort, 7.15% reported receiving an ED diagnosis or being treated for an ED in the last 12 months. Students with ED indications were significantly more likely to report each of the substance use outcomes investigated in this study, including SUD diagnosis, opiate misuse, and misuse of other club drugs than peers without reported EDs. Both AN and BN were associated with an increased likelihood of SUD diagnosis. These findings demonstrate strong associations between EDs and the most extensive list of substance use outcomes explored in the context of college setting ED research to date. Read more.

 

Cannabis Use Disorder Uniquely Predicts Educational Impairment in College Students Over and Above Other Mental Health Disorders

The impact of cannabis use disorder on education functioning and GPA was examined within the context of co-occurring alcohol use disorder, major depressive disorder, and post-traumatic stress disorder. Undergraduates (N = 210) who reported using cannabis within the past six months were recruited. Hierarchical multiple regression analyses were used to determine whether CUD symptom severity and presence of probable CUD diagnosis predicted educational impairment and current GPA, over and above other mental health conditions. CUD symptom severity, but not probable CUD, significantly predicted greater educational impairment, over and above probable PTSD and MDD, which were also significant predictors. CUD symptom severity, but not probable CUD, significantly predicted lower GPA. In addition to other common mental health conditions, CUD may be an important area of assessment and intervention for university counseling centers to foster student academic success. Read more.

 

Post-Traumatic Stress, Alcohol Use, and Alcohol Use Motives Among Non-Hispanic Black/African American College Students: The Role of Emotion Regulation

The associations between posttraumatic stress disorder symptom severity, alcohol use, and alcohol use motives are well-established. Emotion regulation difficulties have been implicated in the association between PTSD symptoms and alcohol use. A dearth of empirical work, however, has examined these associations among Black/African American college students, a population with high prevalence of exposure to potentially traumatic events, PTSD symptomatology, and alcohol-related consequences. This study examined PTSD symptoms, emotion regulation difficulties, and alcohol use severity and motives among a sample of Black/African American trauma-exposed college students (N = 282; 77.4% identified as female; M age = 22.36, SD = 4.71). PTSD symptom severity was related to alcohol use and coping and conformity motives for alcohol use through heightened emotion regulation difficulties. Findings were significant above and beyond the effects of trauma load (i.e., number of potentially traumatic event types experienced). This study extends past work to an understudied population and contributes to groundwork for culturally informed interventions. Read more.

 

Associations Between Alcohol and Cannabis Use Order, Frequency, Quantity, and Consequences in a College Sample of Individuals Who Co-Use Alcohol and Cannabis

Using both alcohol and cannabis (either at the same time or at different times) is common among college students, and is called “co-use.” Using these substances simultaneously, such that their effects overlap, is thought to be an especially risky co-use pattern. Gaining a better understanding of how co-use patterns relate to substance use and consequences could aid prevention and intervention efforts. We examined college students (N = 401) who reported using both alcohol and cannabis at least once in the past 30 days. Path analysis was used to explore relations among co-use patterns (number of days in a typical week that participants used both alcohol and cannabis; the number of days using alcohol first, cannabis first, alcohol last, and cannabis last; the number of days of simultaneous use), past-30-day alcohol and cannabis consequences, use frequency, and typical quantities used. Each additional day of using alcohol first was associated with fewer past-30-day cannabis consequences. Each additional day of using cannabis first was associated with fewer alcohol-related consequences. Each additional day of using alcohol and cannabis on the same day and each additional day of simultaneous use were both associated with less cannabis used and alcohol consumed in a typical week. This study is among the first to identify associations between alcohol and cannabis order and outcomes (i.e., consequences and consumption). Results suggest that modifying which substance is used first on a given day could be a practical intervention strategy for individuals who co-use alcohol and cannabis. Read more.

 

Increases in Cannabis Use and Negative Emotions During COVID-19 Pandemic Among College Students With Cannabis Use Disorder

Using cross-sectional baseline measurements from a longitudinal cohort study, we evaluated the perceived impact of the Coronavirus Disease 2019 pandemic on cannabis use and emotional well-being among college students meeting cannabis use disorder criteria (N = 150). Compared to before the pandemic, participants retrospectively reported an increase in cannabis use during the first phase of the pandemic when stay-at-home orders occurred, which was correlated with a greater number of CUD symptoms and cannabis use-related consequences since the pandemic began. Reporting greater frequency of cannabis use during the pandemic was associated with greater frequency of using amphetamine-type drugs and consumption of cannabis by dabbing since the pandemic began. There were significant differences in cannabis use-related outcomes as a function of negative emotions (e.g., feeling lonely/stressed/anxious/depressed) experienced during the pandemic. The findings elucidate the impact of the pandemic on cannabis use among college students with CUD and can inform prevention/intervention efforts in this population. Read more.

 

Exploring the Role of Social Networking Sites in Alcohol Consumption among College Students; Which Platforms Have the Greatest Influence?

Excessive alcohol use among college students is associated with a host of deleterious physical, mental, and academic outcomes. Social Networking Sites are thought to influence norms around alcohol consumption, leading to increased college student drinking. We utilized a sample of 330 college students to investigate the effects of Facebook, Instagram, Twitter, and Snapchat on college student drinking behavior. Only Snapchat use was associated with college student drinking even while controlling for confounders such as the amount of time spent on SNS. Interventions attempting to lower college student drinking should focus on Snapchat to have the most effective platform. Read more.

 

Risk Factors Associated with Driving After Marijuana Use among US College Students During the COVID-19 Pandemic

To assess the sociodemographic and behavioral risk factors associated with driving after marijuana use among U.S. college students. A secondary analysis used the fall 2020 and spring 2021 American College Health Association-National College Health Assessment III and the dataset was restricted to college students ≥ 18 years of age who reported recent driving and marijuana use. Associations between risk factors and driving after marijuana use were estimated using multivariable logistic regression. A total of 29.9% (n=4,947) of the respondents reported driving after marijuana use. Males, non-Hispanic Black, sexual minorities, individuals with an alcohol or substance use disorder, anxiety, higher suicidality, and those who also drank and drove had a higher risk of driving after marijuana use. Future research should focus on increasing awareness of driving after marijuana use and prevention programs and/or strategies on college campuses regarding driving after marijuana use for these groups to reduce this risky behavior. Read more.

 

 

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Bouncing Back From COVID-19: The Role of Resilience in Depression, Substance Use, and Loneliness in College Students Amidst the Pandemic

To assess the influence of specific COVID-19 impacts on college student depression, loneliness, and alcohol and cannabis use, and to investigate if resilience moderates these relationships. Data were collected from students (N = 1849, 80.9% white, 66.6% female) at a midwestern university during the 2021 winter/spring semester. Data were gathered cross-sectionally through an online survey platform. COVID-19 impacts and resilience’s relationships with mental health variables were analyzed with multiple regression analysis. Moderation analyses were conducted using PROCESS. The COVID-19 impacts measured in this study were significantly related to student depression and cannabis use. Resilience moderated the association between COVID-19 impacts and (a) depression and (b) cannabis use. Resilience may mitigate the effect of pandemic-related impacts on depression and cannabis use in college students, but not loneliness and alcohol use. These findings hold important implications for further research and practice. Read more.

 

Factors That Influence Cannabis Vaping Habits of College Students: A Qualitative Study

The purpose of this study is to examine the attitudes and perceptions of college undergraduates regarding cannabis vaping. Participants: Twenty-one, predominantly male (71.4%; Mage = 22, SD = 2.09), undergraduate college students who reported vaping cannabis in the past 30 days. Participants were interviewed to determine their attitudes and perceptions regarding cannabis vaping. Thematic analysis uncovered six primary themes and eighteen subthemes. Main themes included (1) Convenience, (2) Discreetness, (3) Mood-Altering Experience, (4) Social Acceptability, (5) Health and Safety, and (6) COVID-19 Pandemic Impact. College students who use cannabis tend to both vape and use combustible methods, depending upon social and physical environment. This population tends to vaporize cannabis for its perceived mood-altering properties. Additional research is needed to further examine the behaviors and attitudes surrounding cannabis vaping among college undergraduates, as well as the development of interventions specific to this demographic. Read more.

 

Sexuality and Gender Identity Inequities in Substance Use Disorder and Its Treatment among American Indian, Alaska Native, and Native Hawaiian College Students

The aim of this study was to investigate inequities in substance use disorder diagnosis, opioid misuse, marijuana misuse, SUD treatment utilization, and utilization of university mental health services among sexual and gender minority American Indian, Alaska Native, and Native Hawaiian college students. Data consisting of 8,103 AI/AN/NH students’ responses to the American College Health Association’s National College Health Assessment survey from fall 2015 through spring 2019 were utilized for this study. Multivariable logistic regression models were used to compare the odds of SUD diagnosis, opioid misuse, and marijuana misuse in SGM AI/AN/NH students to cisgender, heterosexual peers. Unadjusted odds of SUD treatment utilization and utilization of university mental health services were also evaluated. Compared to cisgender females, transgender and gender diverse students had significantly higher odds of SUD diagnosis. Similarly, significantly higher odds of SUD diagnosis were observed among sexual minorities, including gay/lesbian and bisexual students compared to heterosexual peers. Sexual minority students had significantly higher odds of utilizing university mental health services than heterosexual peers. Odds of opioid misuse and marijuana misuse were also significantly increased among sexual minority students. AI/AN/NH college students who identify as SGM have higher odds of SUD diagnosis, opioid misuse, and marijuana misuse than their cisgender, heterosexual peers. These findings highlight the need to consider tailored programming for SGM AI/AN/NH students in substance use prevention and intervention efforts in U.S. college settings. Read more.

 

Who's at Greatest Risk? Latent Profiles of Alcohol and Cannabis Use and Related Consequences Among College Students

There is significant heterogeneity in alcohol and cannabis use patterns among college students, with some engaging in use patterns that heighten their risk for adverse consequences. Person-centered approaches can help identify those subgroups of students with riskier use patterns. Latent Profile Analyses were conducted to identify subgroups based on alcohol and cannabis use frequency and quantity, to explore demographic covariates and to examine mean differences across subgroups on alcohol- and cannabis-related consequences, simultaneous use, and other substance use. Participants were 2,423 college students (Mage = 20.1; 72  % female) recruited from seven U.S. universities who endorsed past-month alcohol and cannabis use and completed an online survey of substance use behaviors. A four-profile solution was the best fitting model. Profile 1 represented “light, infrequent alcohol and cannabis use” (73.8 %), Profile 2 represented “heavy, infrequent alcohol and moderate, frequent cannabis use” (15.9 %), Profile 3 represented “moderate, frequent alcohol and cannabis use” (5.6 %) and Profile 4 represented “very heavy, frequent alcohol and heavy, frequent cannabis use” (4.7 %). Students who identify as male, White non-Hispanic, and/or Greek-affiliated were more likely to be in the heavy alcohol use profiles. Profiles 3 and 4 represent high-risk profiles, with both having a higher likelihood of simultaneous use, Profile 3 endorsing more cannabis consequences, and Profile 4 endorsing more alcohol consequences. Results suggest that heavy alcohol or heavy co-use heightens risk for serious adverse consequences. Read more.

 

Substance Use Behaviors Among College Students in the Food Service Industry

Food service employment is associated with substance use, risk of substance use disorders, and various negative consequences. Previous research has not examined the substance use patterns of students employed in food service positions. During fall of 2018, 276 undergraduates completed an anonymous online survey regarding current employment status and substance use. Compared to students employed in other positions, students in food service positions reported higher levels of drinking to cope with negative affect, negative urgency, workplace substance use, marijuana use, marijuana-related problems, and motives. Food service employment was also a significant predictor of marijuana use and related consequences. Students in food service positions, relative to other employment positions, report elevated substance use behavior, risk factors, and negative consequences. Food service employment also contributed variance to models accounting for marijuana use and related consequences. Prevention and intervention strategies should be investigated to mitigate risk for this population. Read more.

 

Student Pharmacists' Attitudes, Perceptions, and Knowledge Regarding Opioid Use, Misuse, and Overdose: Four Years of Data

The American Association of Colleges of Pharmacy has urged pharmacy faculty to commit to actions to reduce the public health threat from opioid use and misuse. Optimizing student pharmacist training necessitates understanding changes in their attitudes and perceptions over time. This study assessed student attitudes, perceptions, and understanding of addiction, opioid use and misuse, and opioid overdose over four sequential years, from 2016 to 2019. The participants were third-professional year doctor of pharmacy students enrolled in a required course. Participants voluntarily completed a 27-statement survey to determine student attitudes, perceptions, and understanding. A total of 452 participants completed the survey (response rate = 76.5%). Of the 27 survey items, five survey statements showed year on year positive increases in specific student attitudes towards addiction, hopefulness for its treatment, and confidence to use and train opioid overdose reversal agents. These yearly changes did not appear to be related to any changes in the academic aptitude of the students. The 22 remaining statements showed positive and stable attitudes towards self-perceived understanding of opioid use and misuse, hopefulness for its treatment, and the role of pharmacists. To our knowledge, this is the first large multiyear assessment of student pharmacists' attitudes, perceptions, and understanding of opioid use, misuse, and overdose. The data indicate favorable and improving attitudes. Knowledge of student attitudes, perceptions, and understanding regarding opioid use, misuse, and overdose will aid in the development of effective training programs for students in our, and other colleges of pharmacy. Read more.

 

Race- and University-Specific Norms Associated With Alcohol Use Among Black College Students

Approximately one-third of college students engage in heavy episodic drinking. Although White students drink more than Black students, White individuals are more likely to mature out of heavy drinking, whereas Black individuals drink more as they age and experience disproportionate alcohol-related consequences. Compared to their White counterparts, limited research has examined factors associated with alcohol use among Black college students. Descriptive drinking norms based on the typical college student are strong predictors of college student drinking, but previous research found that this association was weaker for Black college students. Therefore, the current study is a preliminary examination of perceived drinking norms (descriptive) and approval (injunctive) based on race for Black college students. Further, we explored likelihood of excessive drinking around other Black students. The current study included survey responses of 192 Black college students from a large southeastern U.S. university. Results indicated that university and race-specific descriptive norms, but not university- and race-specific injunctive norms, were associated with more drinks per week. These findings suggest that descriptive norms with Black students at the participant’s university as the normative reference group are associated with alcohol use among Black students. Further, greater likelihood of drinking excessively around peers who share the same racial identity may impact alcohol consumption for this population. Current prevention programs for college student drinking are tailored by gender rather than race; however, preliminary findings from the current study suggests that tailoring by race may be an effective way to prevent alcohol misuse among Black college students. Read more.

 

Compounding Privilege, Resilience, and Nonmedical Prescription Stimulant Use Among College Students

In this study, we examined why non-Hispanic White cisgender men are more likely than other subgroups to misuse prescription stimulants in college. The objective of the current study was to use a strength-based framework to examine intersectional demographic predictors. We examined gender and race/ethnicity as predictors of nonmedical prescription stimulant use among college students. We also investigated resilience as a moderator. This report uses data from an online multisite study conducted at seven universities with 4,764 undergraduate students (70.1% women and 52.0% People of Color). We found that college students who were cisgender men and non-Hispanic White used NPS significantly more than students who identified as another gender and as People of Color. There was also a buffering effect of resilience between race/ethnicity and NPS, such that resilience predicted lower NPS for People of Color, but not non-Hispanic White people 28% of the time. It may be that Students of Color are more resilient than non-Hispanic White students, and this resilience is protective of NPS use in college. Importantly, a compounding-privilege and/or intersectional approach to identity is crucial to fully understanding behavior (in this case NPS) in a diversity of college students; future studies should continue to use and develop such approaches. Read more.

 

In Harm's Way: Do College Students' Beliefs About Cannabis Put Them at Risk for Use?

This study describes beliefs held by college students about cannabis use and examines the association between three specific cannabis beliefs and likelihood of use. Participants were 3,720 undergraduate students ages 18 to 25 attending 10 colleges in one state. Data were gathered via online survey. The majority (80%) of the sample was unsure or believed that cannabis was an effective way to reduce stress; 67% were unsure or believed that cannabis was not related to an increased risk for mental health problems; and 62% were unsure or believed that students who use cannabis are not more academically disengaged. Holding these beliefs, which are not supported by scientific evidence, was associated with a greater likelihood of cannabis use, even after statistically adjusting for covariates. These findings suggest that beliefs unsupported by scientific evidence are widespread among college students. Dispelling misinformation about cannabis might hold promise for reducing use. Read more.

 

Simultaneous Alcohol and Marijuana Use Among College Students in the United States, 2006-2019

Objective: Simultaneous alcohol and marijuana use exposes college students to a myriad of adverse consequences. However, there is no recent nationally representative study on SAM use among college students in the United States. To provide an update to the literature, the present study aimed to examine the trends, prevalence, and correlates of SAM use among U.S. college students between 2006 and 2019, using nationally representative data. Method: We used data from the 2006-2019 National Survey on Drug Use and Health and the analytic sample was limited to the 55,669 full-time college student respondents (ages 18-22). Using logistic regression analysis, we assessed trends in SAM use prevalence and examined sociodemographic and psycho-social-behavioral correlates of SAM use. Results: The proportion of U.S. college students who reported SAM use increased significantly from 8.13% (2006-2010) to 8.44% (2015-2019). However, examination by race/ethnicity revealed that the increasing trend was largely driven by Black college students, whose SAM use prevalence increased significantly from 5.50% (2006-2010) to 9.30% (2015-2019), reflecting a 69.09% increase. SAM use rates did not change significantly among other racial/ethnic groups. Conclusions: This study uncovered an upward trend and prevalence of SAM use among U.S. college students, calling for more research and public health interventions in this area. At-risk subgroups that warrant more attention include college students who are Black, female, above the legal drinking age, have a lower than $20,000 household income, and reside in small metropolitan areas. Read more.

 

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Encountering Overdose: Examining the Contexts and Correlates of US College Students' Overdose Experiences

As overdose rates increase, it is critical to better understand the causes and contexts of overdose, particularly for college students who exhibit high rates of alcohol and drug use. The purpose of this study was to examine the social contexts of U.S. college students’ overdose experiences (their own, witnessed, and family’/friends’), and to assess the correlates of personal overdose. A cross-sectional survey containing open- and closed-ended questions about overdose encounters was completed by undergraduate students at a southeastern American university (n = 1,236). Descriptive frequencies assessed prevalence, substance involvement, and fatalities associated with different encounter types. A content analysis of open-ended responses examined the social contexts of encounters. Multivariate logistic regression was used to assess the correlates of personal overdose. Forty-one percent of respondents reported at least one type of overdose encounter and witnessed overdose was most common. Substances involved varied across encounter type and 20-40% of respondents reported overdose-related fatalities. Students who encountered overdose often reported multiple experiences and many attributed overdoses to mixing substances. Respondents commonly encountered overdose as intervening bystanders and overdose events were often perceived to be intentional or the result of using substances to cope with stress/mental health concerns. Personal overdose was significantly associated with having ever mixed alcohol with prescription drugs, been diagnosed with a mental disorder, witnessed an overdose, and had a family member/friend overdose. Findings suggest a need for future research into the contexts and consequences of students’ overdose encounters to more effectively tailor overdose prevention/response initiatives within college communities. Read more.

 

Racial/Ethnic Discrimination, ADH1B*3, and Coping-Motivated Drinking Among Black College Students

Discrimination due to race and/or ethnicity can be a pervasive stressor for Black college students in the United States beyond general negative life events and has demonstrated associations with adverse health and alcohol outcomes. Genetics may confer individual differences in the risk of drinking to cope with discrimination-related stress. This study tested whether associations of racial/ethnic discrimination with coping drinking motives and alcohol use differ as a function of a well-documented variant in the alcohol dehydrogenase 1B gene (ADH1B*3). Cross-sectional data were obtained from 241 Black students (Mage = 20.04 [range = 18–53]; 66% female) attending a predominantly White university in the northeastern United States. Participants provided a saliva sample for genotyping and self-reported on their racial/ethnic discrimination experiences, coping drinking motives, and past-month total alcohol quantity. Path models demonstrated that associations of discrimination with alcohol quantity directly or indirectly through coping drinking motives did not differ as a function of ADH1B*3, after controlling for gender, age, negative life events, and potential confounding interactions of covariates with model predictors. Regardless of ADH1B*3, greater experience of negative life events was associated with higher coping drinking motives, which in turn were associated with greater alcohol quantity. Findings represent a novel investigation into gene–environment interplay in associations of alcohol use with racial/ethnic discrimination. Findings demonstrate coping-motivated drinking associated with negative life events within Black college drinkers regardless of ADH1B*3. Future research should leverage longitudinal designs to characterize associations of genetics, stressful experiences, and coping-motivated drinking over time. Read more.

 

A Longitudinal Examination of Relations Between Competitive Athletic Participation, Drinking Norms, Impulsivity, and Sensation-Seeking and Binge-Drinking Throughout College

College athletes are a high-risk group for heavy drinking and related risky behaviors and consequences. However, most prior work examining drinking behavior in college athletes has been cross-sectional. Drinking norms predict drinking among athletes, but other potential risk factors, including personality traits have received limited attention. Using data from a large sample (n = 2,245) of college students, we examined athletic participation, high-risk personality traits (i.e., impulsivity, sensation seeking), and perceptions of peer drinking behavior (descriptive and injunctive norms) as predictors of binge drinking from prior to college entry through 2 years postcollege. Negative binomial latent growth models were used to examine these predictors of patterns of drinking across the college years. Binge drinking increased through the first 3 years of college before leveling off and decreasing postcollege. Controlling for significant effects of sensation seeking and perceptions of peer attitudes and drinking behaviors, athletic participation at T1 was associated with greater binge drinking at matriculation and greater athletic participation was associated with greater risk across the college years. Normative perceptions and sensation seeking also predicted concurrent drinking in Year 4 of college and impulsivity emerged as an additional predictor. Sensation seeking emerged as a significant predictor of greater postcollege binge drinking. Athletic participation in Year 4 of college indicated no significant risk for greater binge drinking during Year 4 or following graduation. Early participation in competitive athletics was associated with risk for binge drinking, even when accounting for several social and personality factors. Future studies using momentary assessment may be fruitful for identifying within-subject pathways of risk, including athlete specific factors. Read more.

 

Social Networks and Sexual and Gender Minority Disparities in Alcohol Use and Consequences Among First-Year College Students

In this work, we investigate the association between social relationships and alcohol use and the related consequences of sexual and gender minority (SGM) college students, and we highlight the importance of SGM social networks as a potential protective factor among SGM college students. The study used data from 1,340 students (47.2% White and non-Hispanic, 55.4% assigned female at birth, 16.3% SGM), which were collected during the 2016 fall semester of the first year of college at one university. The study collected information about alcohol use and related consequences and about the social networks of participants through a peer nomination survey. Regardless of SGM status, students who nominated at least one SGM peer reported significantly lower drinks per week and heavy drinking frequency after adjusting for relevant covariates including peer drinking. SGM participants showed a significantly stronger negative association between having an SGM peer and heavy drinking frequency and alcohol-related consequences than their cisgender heterosexual counterparts. These findings highlight the importance of SGM social networks as a potential protective factor for reducing alcohol use and related consequences among SGM college students. College campuses should identify ways to support connections among SGM students. Read more.

 

Social Norms and Club Drug Use of Young Adult College Students During Music Week

Young adult college students have high rates of substance use, theoretically related to social norms. Behavioral norms refer to the quantity of substances that students think others use, and attitudes refer to how much students or others approve of substance use. Prior research has shown a relationship between behavioral norms, student attitudes, and perceived parental attitudes and alcohol and marijuana use. However, the relationship between social norms and use of club drugs (e.g., MDMA) has not been studied. The purpose of this cross-sectional study was to expand knowledge about young adult college student social norms and club drug use. 200 young adult undergraduates (Women = 97, 49%) were recruited from a campus recreational facility on a large private Southeastern university in April 2019. Students self-reported behavioral norms, student attitudes, parental perceived attitudes, club drug use during a typical week and during music week, and substance use consequences. Logistic and negative binomial regressions showed that student attitudes were significantly related to club drug use in a typical week, during music week, and consequences of use, but behavioral norms and perceived parental attitudes were not. Findings build on social norms research with alcohol and marijuana use. Attitudes may be more important to consider than behavioral norms or perceived parental attitudes for interventions to reduce club drug use. Read more.

 

A Brief Intervention on E-Cigarette, Regular Cigarette, and Marijuana Use Results in Generalization Effects: Lateral Attitude Change among College Students

We hypothesized (1) perceived harm beliefs and intention to use e-cigarette attitudes will become more negative post-exposure to the intervention (2) this change will generalize to more negative beliefs and intention toward regular cigarettes and marijuana. MANOVAs of students’ perceptions of harm beliefs and intention toward the use of e-cigarettes and regular cigarettes, and marijuana were performed to ascertain change in harm beliefs before (t1) to after the intervention (t2) for 188 nonwhite Hispanic and White college students who viewed educational material (informational text + video), the intervention, during an online experimental survey. E-cigarettes, regular cigarettes, and marijuana were perceived more harmful for one’s health and for the health of others at t2. Respondents were less likely to use any of the substances if their best friend offered at t2. Intent for future use was also reduced at t2. A brief intervention potentiated favorable change in harm beliefs and intention to focal object (e-cigarettes) and lateral objects (regular cigarettes and marijuana). Read more.

 

Defining Belonging and Its Association to Binge Drinking among College Students

This study investigated the relationship between the students’ combined belonging and binge drinking. Combined belonging was defined as a combination of both subjective (perceived belonging) and objective (participation in school activities) measures of belonging. The sample included 33,360 college students enrolled in U.S. States collegiate institutions. Data were obtained from an online survey through the Healthy Minds Study from 2018 to 2019. Logistic regression models estimated odds ratios and corresponding 95% confidence intervals. Overall, 39.3% of students met criteria for binge drinking. Combined belonging had the highest odds of binge drinking compared to their counterparts. Being 21 and 22 years of age was the strongest risk factor for binge drinking. Interventions should be tailored to include objective and subjective measures of belonging to effectively reduce college binge drinking. Read more.

 

Evaluating Non-Response Bias in a Parent-Based College Alcohol Intervention

The purpose of this study was to address a dearth in the literature on non-response bias in parent-based interventions by investigating parenting constructs that might be associated with whether a parent volunteers to participate in a no-incentive college drinking PBI. Incoming first-year students (N = 386) completed an online questionnaire that included items assessing plausible predictors of participation in a PBI (students’ drinking, perceptions of parents’ harm-reduction and zero-tolerance alcohol communication, whether parents allowed alcohol, and changes in parents’ alcohol rules). Four months later, all parents of first-year students at the study university were invited to join the PBI, which was described as a resource guide to teach them how to help their student navigate the college transition and prepare them for life at their university. Parents who signed up for the intervention used greater harm-reduction communication than those who did not sign up, were more likely to have allowed alcohol use, and signing up was significantly associated with student reports that fathers became less strict toward drinking after high school. Students’ drinking and zero-tolerance communication did not significantly differ between the groups. Results indicate that non-response bias can be an issue when utilizing a real-world, non-RCT recruitment approach to invite parents into a PBI (i.e., non-incentivized, inviting all parents). Findings suggest that more comprehensive recruitment strategies may be required to increase parent diversity in PBIs. Read more.

 

Independent and Concurrent Cannabis Use With Alcohol, Cigarettes, and Other Substances Among College Students: Rates and Consequences

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 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. Substance use, academic-related outcomes, and measures of Cannabis Use Disorder severity and problems were obtained in an online survey. 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, but only the latter reported greater CUD severity, problems, and poorer academic outcomes. College student polysubstance users may be at increased risk for poorer outcomes compared to cannabis-only users and other groups. Read more.

 

Drinking Among College Student Athletes During the COVID-19 Pandemic

The objective was to investigate demographics, sport type, athletic identity, and COVID-19 sport season cancelation in relation to alcohol consumption among college student athletes shortly after the pandemic emerged. Survey data were collected from 5,915 college student athletes in April/May 2020. Being female, Latinx, and in a relationship were associated with lower alcohol consumption. Among males, team sport participation was related to greater alcohol consumption. Among females, athletic identity was inversely related to drinking, which was moderated by sport type, such that alcohol consumption was lower as athletic identity strengthened in individual (vs. team) sport athletes. However, we did not find a relationship of COVID-19 sport season cancelation with drinking. Our gender-specific findings are novel and generalizable based on a large, national sample of college student athletes, and may inform strategies for alcohol consumption education among college team sport athletes. Read more.

 

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Effectiveness of Mandated Interventions for Cannabis-Using US College Students: A Systematic Review

This review analyzed the effectiveness of mandated substance use interventions in reducing future cannabis or other illicit drug use. Findings indicated that early decreases in cannabis and other drug use are commonly reported among students participating in mandated interventions. The longer time elapses post-intervention, the more likely recidivism will occur. Universities are in a unique position to provide support for students who use cannabis by employing some of the effective methods discovered in this review. Read more.

 

Prevalence and Correlates of Appearance- and Performance-Enhancing Drugs and Substances Use Among a National Sample of College Students Aged 18–30

To identify the lifetime prevalence and correlates of appearance- and performance-enhancing drugs and substances use among a national sample of US college and university students. Student participants from the 2020–2021 Healthy Minds Study (N = 7,401; ages 18–30 years). Lifetime prevalence of five forms of APEDS was estimated. Modified Poisson regression analyses were conducted to determine the sociodemographic correlates of protein and creatine supplement use. Lifetime protein (23.8%) and creatine (7.7%) supplement use were most common among the sample. Older age within young adulthood, male sex, perceiving oneself to be normal weight or somewhat overweight, any athletics participation, and 2–3 or ≥ 5 h/week of exercise were associated with greater likelihood of lifetime protein and creatine supplement use. Awareness and prevention efforts on the potential harms of APEDS use are needed on campuses, particularly among males and those who participate in athletics and high-frequency exercise. Read more.

 

Negative Consequences Related to Nonmedical Prescription Stimulant Use: Development and Psychometric Validation of the Prescription Stimulant Consequences Questionnaire

Nonmedical prescription stimulant use is prevalent among undergraduates and associated with several negative consequences. However, no validated measures exist assessing NPS-related consequences. The present study aimed to develop and psychometrically validate a Prescription Stimulant Consequences Questionnaire for use among college students. A multisite sample of college students endorsing NPS (N = 715, 68.4% female) completed the PSCQ and measures of NPS frequency and correlates of NPS via an online survey. Exploratory factor analysis supported a 27-item measure, with three factors (i.e., Compulsive Behavior, Risky Behaviors, and Physical and Mental Health) and a total score. Each PSCQ factor and total score demonstrated good internal consistency, and were significantly positively associated with all NPS frequency indicators, route of administration, alcohol-related problems, sleep problems, and depressive/anxiety symptoms. Findings demonstrate support for the psychometric validity and reliability of the newly developed PSCQ, which may demonstrate potential as a screening and outcome measure for intervention. Read more.

 

Defining Belonging and Its Association to Binge Drinking among College Students

This study investigated the relationship between the students’ combined belonging and binge drinking. Combined belonging was defined as a combination of both subjective (perceived belonging) and objective (participation in school activities) measures of belonging. The sample included 33,360 college students enrolled in U.S. collegiate institutions. Data were obtained from an online survey through the Healthy Minds Study from 2018 to 2019. Logistic regression models estimated odds ratios and corresponding 95% confidence intervals. Overall, 39.3% of students met criteria for binge drinking. Combined belonging had the highest odds of binge drinking compared to their counterparts. Being 21 and 22 years of age was the strongest risk factor for binge drinking. Interventions should be tailored to include objective and subjective measures of belonging to effectively reduce college binge drinking. Read more.

 

The Association Between Vaping and Health Behaviors Among Undergraduate College Students in the United States

To examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Sociodemographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Of all participants (n = 1,775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults. Read more.

 

Motives, Frequency, and Consequences of Cannabis Use Among College Students

We investigated profiles of cannabis use motives among current cannabis-consuming college students. Then we assessed profile differences in demographic characteristics, social contexts of use, regulatory environment, alcohol use, negative affect, negative consequences, and cannabis use. Participants (N = 1, 213) were from three universities in states with different cannabis legislation. Six profiles emerged: Low Motives, Low to Moderate Enhance, High Enhance, High Enhance & Social + Moderate Expand, High Enhance & Cope, and High Motives. Profiles differed in social contexts of use, sex, alcohol use, negative affect, and regulatory environment. Profiles endorsing high and multiple motives had higher cannabis use and negative consequences, relative to profiles with low or fewer motives. Profiles characterized by high avoidance motives (i.e., coping) had the highest cannabis use and consequences. Interventions targeting types and intensity of motives for cannabis-use may help reduce use and related consequences among college students who use cannabis. Read more.

 

Upstream Approaches to Addressing Prescription Stimulant Misuse and Diversion: Exploring Perspectives of College Students Who Misuse and Divert

We interviewed college students who engage in prescription stimulant misuse and diversion to better understand perspectives on prevention and intervention strategies.

Trained student researchers at one southern California university completed 32 face-to-face interviews with students who had a history of misuse and/or diversion. Participants provided insights on programs, policies, and practices that have the potential to deter behavior. Data were analyzed inductively via thematic analysis.

Students were often misinformed or unaware of existing programs, policies, and practices. Additionally, some students felt their behaviors would not be detected, whereas other students felt the fear of being detected would lead them to change their behaviors. Harm reduction and treatment-based approaches to address misuse were also recommended.

Our findings emphasize the importance of better educating students about, and enforcing, existing policies. In addition, the need to better inform students of existing campus programs is warranted.  Read more.

 

Use of Protective Behavioral Strategies and Blackout Experience Among Mandated College Students

Alcohol-induced blackouts are experienced by approximately half of college students who drink. People who use protective behavioral strategies tend to experience fewer alcohol-related consequences of drinking, but the relationship between PBS and blackouts is unknown. This study examines the associations among the use of protective behavioral strategies and blacking out. 

Participants were 484 college students, aged 18–22 (56% male, 51% first-year), who were mandated to complete alcohol education following an alcohol violation. Before the intervention, participants completed questionnaires that included questions about past month peak consumption, alcohol-related consequences, marijuana use frequency, and frequency of PBS use. Logistic regression analyses were conducted to evaluate how use of PBS was related to the odds of experiencing a blackout, controlling for consumption and other risk factors. 

Participants endorsing greater overall use of PBS had decreased odds of having experienced a blackout. However, this association depended on the type of PBS being used. Participants endorsing greater use of PBS regarding manner of drinking and stopping/limiting drinking had decreased odds of having experienced a blackout, but those who endorsed greater use of PBS relating to serious harm reduction did not. This study adds nuance to the idea that PBS protect against adverse alcohol-related consequences. Only PBS that serve to limit or slow consumption appear to be protective against experiencing blackouts. Research on specific associations between types of PBS and consequences may lead to improved outcomes in interventions that incorporate PBS. Read more.

 

Alcohol Use and Alcohol-Related Consequences Based on Gender and Sexual Orientation Among College Students

Research has not yet investigated how the association between alcohol and alcohol-related consequences differs across cisgender heterosexual women (CHW), cisgender heterosexual men (CHM), and sexual and gender minority (SGM) college students. Participants were 754 college students (34.5% CHW [n = 260]; 34.5% CHM [n = 260]; 31.0% SGM [n = 234]) between the ages 18 and 25 who completed a survey on sexual orientation, gender identity, alcohol use (i.e., average drinks per week), and alcohol-related consequences. Among individuals who reported alcohol use, CHM reported significantly more drinks per week compared to CHW and SGM. The logistic model of a zero-inflated negative binomial regression indicated that excess zeros in the alcohol-related consequences were more likely among (1) nondrinkers and (2) SGM compared to CHM. The count portion of the model indicated that, among drinkers, there was a positive association between drinks per week and alcohol-related consequences. Estimated alcohol-related consequences per drink were 1.90% higher among CHW than CHM and 2.76% higher among SGM than CHM. Exploratory analyses did not find significant differences in outcomes between cisgender female and male sexual minority students. Findings suggest that although CHW and SGM students consume less alcohol than CHM, these students experience more alcohol-related consequences per drink. This study advances the field's knowledge of alcohol use patterns and consequences among SGM college students. There is a need for alcohol education programming that is tailored to the unique experiences, identities, and minority stressors of SGM college students. Read more.

 

Alcohol and Marijuana Use, Consequences, and Perceived Descriptive Norms: Differences Between Two- and Four-Year College Students

Among two-year college students, alcohol and marijuana use, related consequences, and risk factors for use are not well understood. We examined differences between two- and four-year students in alcohol and marijuana use, consequences, and perceived descriptive norms, and explored whether two-year status moderated associations between norms and use. Data were drawn from a cross-sectional subsample of two- and four-year students aged 18–23 (n = 517) participating in a longitudinal study on alcohol use. Four-year students reported greater alcohol use and consequences than two-year students; two-year students reported greater marijuana use than four-year students. Perceived alcohol and marijuana norms were positively related with use; two-year status did not moderate these associations. Perceived alcohol and marijuana norms function similarly for two- and four-year students in terms of associations to actual use. Adapting normative interventions for two-year students may be an effective strategy for reducing high-risk use among this underserved population. Read more.

 

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Effective Prevention Programming for Reducing Alcohol-Related Harms Experienced by First Year College Students: Evaluation of the Expectancy Challenge Alcohol Literacy Curriculum (ECALC)

Prevention programs may have contributed to modest declines in alcohol use among college students in recent years, but negative consequences continue to be pervasive. First year college students are particularly vulnerable, and there is clearly a need for more effective methods to reduce risk. Meta-analyses focused on expectancy challenge have found this approach to be effective, but “experiential” EC that includes a drinking exercise is not suitable for most FYCS, many of whom are underage. A nonexperiential alternative, the Expectancy Challenge Alcohol Literacy Curriculum, is practical for widespread implementation. ECALC has been effective with mandated students and members of fraternities, and in the present study, we focused on evaluating effects with FYCS. In a group randomized trial, 48 class sections of a course designed for FYCS received either ECALC or an attention-matched control presentation. ECALC was associated with significant changes on six expectancy subscales of the Comprehensive Effects of Alcohol Scale. Structural equation modeling was used to examine the mediated effects of the intervention on alcohol-related harms via alcohol expectancies. There were significant indirect effects from condition to alcohol use and alcohol harms. This model accounted for 54% of the variance in alcohol use and 46% of the variance in alcohol-related harms. These findings suggest ECALC is an effective, single session group-delivered program that can be incorporated into classroom curricula. Read more.

 

Changes in College Students’ Health Behaviors and Substance Use After a Brief Wellness Intervention During COVID-19

College students exhibit low levels of physical activity, high levels of sedentary behavior, poor dietary behaviors, sleep problems, high stress, and increased substance use. On-campus resources offering programs to improve college students’ health have been limited during the pandemic. The purpose of this study was to test a brief intervention to improve multiple health behaviors among United States college students. The intervention was a single arm repeated measures study conducted over 12 weeks, utilizing the Behavior Image Model. The intervention involved three components: a survey, a 25-minute wellness specialist consult with a peer health coach, and a 15-minute goal planning session. Follow-up measures were completed at 2-, 6-, and 12-weeks post session to assess changes in wellness behaviors. Linear mixed effects models for repeated measures were used to analyze the association between intervention implementation on within-subject changes in physical activity, sedentary behavior, diet, general health, emotional wellness, and substance use. A total of 121 participants enrolled in the study and 90 (74.4%) completed the health coach session (71% female). At first follow-up, statistically significant increases were observed in vigorous physical activity days/week, moderate physical activity days/week, general health, and emotional wellness. Statistically significant decreases in cannabis use and alcohol consumption were observed. Many of these changes were sustained at second and third follow-up. This brief wellness intervention shows promise to positively influence multiple health behaviors in college students. Read more.
 

Meaning in Life and Stress-Related Drinking: A Multicohort Study of College Students During the COVID-19 Pandemic

During the COVID-19 pandemic, college students have experienced heightened stressors and reported stress-related drinking. To identify potential protective factors among college students, we investigate the possibility that finding meaning and purpose in one’s life may lessen the strength of the association between stress and alcohol consumption in a multicohort sample of college students (N = 694; 64.8% women) recruited between November 2019 and September 2021. Consistent with expectations, negative binomial regressions revealed significant interactions, such that higher stress was only associated with more past-month alcohol use among individuals who reported low levels of meaning in life. The buffering role of meaning in life appeared to be robust; interaction results held when investigating both general perceived stress and COVID-specific stress, and did not vary by cohort. Although longitudinal and experimental research are needed, findings indicate that finding meaning and purpose in one’s life may help college students to navigate heightened periods of stress with more adaptive coping strategies that do not result in drinking to cope. Findings highlight the potential utility of meaning-promoting strategies in college alcohol interventions. Read more.

 

Drinking Motives Among College Student-Athletes

Research has shown that college student-athletes participate in higher alcohol consumption (frequency and quantity) compared to non-athletes. Some common reasons to help explain these drinking patterns include drinking to cope, drinking to conform or fit in, drinking for social reasons, drinking to enhancement to a positive mood and drinking among fraternities and sororities. We hypothesized that males would have a higher Total AUDIT score, and there would be gender differences among the drinking motives. A cross-sectional sampling method was used to collect data (DMQ-R SF and AUDIT) from student-athletes (N = 225, male = 92, female = 133) who engaged in alcohol consumption behavior. No gender differences for Total AUDIT score were detected at the p < .05 significance level. Regression analyses found the “coping” motive as a significant predictor of Total AUDIT and Hazardous Drinking for both genders combined. When genders were modelled separately, “coping” was again a significant predictor, with the addition of “social” and “enhancement” motives for females on Total AUDIT score. The use of DMQ-R SF and AUDIT instruments can provide information to guide health promotion practitioners during alcohol intervention design. Results from this study indicate that “coping” information should be incorporated into the messaging to assist with managing progression to hazardous drinking among student-athletes. In addition, the identification of “social” and “enhancement” motives among females only supports a need to provide gender-specific messaging in alcohol consumption interventions when differences are identified. Read more.

 

Depressive Symptoms and Drinking to Cope in Relation to Alcohol Use Outcomes Among White and Black/African American College Students

Prior research shows that Black/African American adults experience more negative alcohol use consequences than White adults, despite lower alcohol consumption. Research also shows that Black/African Americans experience higher rates of depression, which can increase risk for alcohol consumption and alcohol use disorder through drinking to cope. We examined associations between depressive symptoms and drinking to cope with alcohol consumption and AUD symptoms among White and Black/African American college students. Participants completed an online survey during the fall and spring semester of their first year of college (N = 2,168, 62.8% female, 75.8% White). Path analyses were conducted to examine whether depressive symptoms and drinking to cope mediated the association between race/ethnicity and alcohol use outcomes, and whether race/ethnicity moderated the associations between depressive symptoms, drinking to cope, and alcohol use outcomes. Results indicated that Black/African Americans had lower levels of depressive symptoms, which were associated with lower drinking to cope, and in turn associated with lower alcohol consumption and AUD symptoms. Multigroup analysis indicated that the pattern of associations between depressive symptoms, drinking to cope, and alcohol use outcomes were largely similar between White and Black/African American college students and between males and females, except that the association between depressive symptoms and drinking to cope appeared to be stronger for Whites than for Black/African American students. Depressive symptoms and drinking to cope are risk factors in relation to alcohol use outcomes among White and Black/African American college students and partially account for the link between race/ethnicity and alcohol use outcomes. Read more.

 

Unplanned Versus Planned Simultaneous Alcohol and Cannabis Use in the Daily Lives of a Predominantly White College Student Sample: What Are the Motives, Contexts, and Outcomes?

Simultaneous alcohol and cannabis use is common among college students and associated with more consumption and consequences compared to single-substance use. This study examined occasions of simultaneous use and compared planned occasions to unplanned occasions with respect to motives, contexts, consumption, and consequences. College student simultaneous users (N = 341; 53% women; 74% White) completed five daily surveys for 54 days. Mixed-effects models examined motives and contexts of simultaneous use occasions as a function of whether alcohol and cannabis use were (a) both planned versus (b) unplanned, no use planned, or (c) unplanned, single-substance use planned and whether alcohol and cannabis consumption and negative simultaneous use-related consequences varied across planned versus unplanned occasions. Social and enhancement motives were related to planned simultaneous use; offered and coping motives were associated with planned single-substance use that became simultaneous use (vs. planned simultaneous use). Compared to unplanned use, planned simultaneous use was negatively associated with using at home or alone, and positively associated with using with others, more intoxicated people, and more people using cannabis. Planned simultaneous use was associated with more alcohol and cannabis consumption. No significant differences were found for negative consequences. Planned simultaneous use was motivated by social and enhancement reasons, whereas planned single-substance use that became simultaneous use was more likely motivated by offers or for coping. Planned simultaneous use resulted in greater consumption, but not negative consequences. Results provide specific motives and contexts associated with unplanned and planned simultaneous use to be incorporated into real-time interventions. Read more.

 

A National Study on Drinking Game Behaviors and Related Consequences Among NCAA Student-Athletes: Racial/Ethnic and Sex Differences

Research indicates that college student-athletes report more alcohol use and negative drinking consequences than non-student-athletes. One drinking practice that has been linked to heavy alcohol use and related consequences is playing drinking games. In the present study, we investigated which segment of the student-athlete population is most at risk for frequent drinking game participation, elevated alcohol consumption while playing drinking games, and negative drinking game consequences. We examined sex and racial/ethnic differences in behaviors and consequences associated with drinking games in a national sample of White, Hispanic, Black, and Asian American/Pacific Islander student-athletes. A total of 11,839 student-athletes (51.4% women) from 165 National Collegiate Athletic Association member institutions who endorsed lifetime participation in drinking games completed a confidential online survey. Hierarchical linear modeling revealed that being a White (vs. Black or Hispanic) student-athlete was associated with more frequent drinking game participation, and among AAPI and Black (but not White or Hispanic) student-athletes, men played drinking games more frequently than women. Being a Black (vs. White) student-athlete was associated with more drinking game consumption; no sex differences in drinking game consumption were found among Black student-athletes. Among White, AAPI, and Hispanic student-athletes, being a male student-athlete was associated with more drinking game consumption. Finally, female student-athletes had a higher likelihood of experiencing one or more negative consequences from drinking games than did male student-athletes. The association between drinking game participation and negative drinking game consequences was also stronger for women compared with men. Student-athletes are heterogeneous with regard to drinking game behaviors and related consequences. Knowing who is at greatest risk for drinking game participation and related outcomes is an important first step in developing targeted intervention approaches for student-athletes. Read more.

 

Changes in Cannabis Consumption Among College Students During COVID-19

College campuses closed in March 2020 because of the COVID-19 pandemic, disrupting the lives of students. The goal of the present study was to examine whether cannabis use changed from before campus departures prompted by COVID-19 to after campus departures and after the semester ended--and if living situation explained observed changes. We also examined changes in specific formulations of cannabis and self-reported reasons for perceived changes in use frequency. A sample of 223 college student cannabis users (61% female) from three universities completed two online surveys (one in May 2020 assessing cannabis use pre-campus closure [pre-closure] and since campus closed [post-closure-1], and another in September 2020 assessing cannabis use since remote classes ended [post-closure-2]). Any use of cannabis and use of each specific formulation (leaf, edibles, concentrates) declined from pre-closure to post-closure-1, whereas the frequency of use did not change. Any cannabis use declined for those who stayed living dependently or moved to dependent living. Leaf use declined for all groups, concentrate use declined only for those who moved from independent to dependent living, and edible use declined only for those who stayed living dependently or moved to dependent living. Cannabis use did not change between post-closure-1 and post-closure-2, regardless of living situation stability or transition. Overall, among a sample of cannabis-using college students, the prevalence of any cannabis use, but not frequency of use, was reduced during the pandemic. Living with parents appears to be protective against frequent cannabis use. Read more.

 

Effort-Related Decision Making and Cannabis Use Among College Students

Cannabis exerts an indirect effect on dopamine output in the mesolimbic projection, a circuit implicated in reward processing and effort expenditure, and thus may be associated with aberrant effort-based decision making. The "amotivation syndrome" hypothesis suggests that regular cannabis use results in impaired capacity for goal-directed behavior. However, investigations of this hypothesis have used divergent methodology and have not controlled for key confounding variables. The present study extends these findings by examining the relation between cannabis use and effort-related decision making in a sample of college students. Cannabis using (n = 25; 68% meeting criteria for Cannabis Use Disorder) and noncannabis using (n = 22) students completed the Effort Expenditure for Rewards Task. In generalized estimating equation models, reward magnitude, reward probability, and expected value predicted greater likelihood of selecting a high-effort trial. Furthermore, past-month cannabis days and cannabis use disorder symptoms predicted the likelihood of selecting a high-effort trial, such that greater levels of both cannabis use days and symptoms were associated with an increased likelihood after controlling for Attention Deficit/Hyperactivity Disorder symptoms, distress tolerance, income, and delay discounting. The results provide preliminary evidence suggesting that college students who use cannabis are more likely to expend effort to obtain reward, even after controlling for the magnitude of the reward and the probability of reward receipt. Thus, these results do not support the amotivational syndrome hypothesis. Future research with a larger sample is required to evaluate possible associations between cannabis use and patterns of real-world effortful behavior over time. Read more.

 

Thirty Years of BASICS: Dissemination and Implementation Progress and Challenges

The first clinical trial of the Brief Alcohol Screening and Intervention for College Students (BASICS) was launched at the University of Washington in 1990. Since that time, multiple trials have demonstrated the efficacy of BASICS and related approaches in a variety of young adult populations and this information has been widely disseminated. However, in practice BASICS implementation varies considerably, including formats and mediums (e.g., group, telehealth, written/electronic feedback alone) not studied in the original research. Even if delivered in an individual in-person format, implementation can stray substantially from the original design. Adaptations may be necessary to address campus resource constraints or other barriers to implementation but can have unknown impacts on intervention effectiveness. Thus, despite wide-scale efforts to disseminate and implement BASICS, challenges remain, and there are several critical research gaps that need to be addressed to support campuses in implementing BASICS successfully. The current manuscript reviews several ways in which BASICS has been adapted to address these challenges, and provides recommendations for best implementation practices as well as future research needed to improve implementation and effectiveness of BASICS going forward. Read more.

 

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Stressors Experienced During the COVID-19 Pandemic and Substance Use Among US College Students

The COVID-19 pandemic caused numerous stressors that may have been linked to substance use among college students. We analyzed data from the Fall 2020 Healthy Minds Study (N = 15,995), a non-probability sample of students attending one of 28 universities, who completed an online survey during the COVID-19 pandemic (September – December 2020). Using multivariable logistic regression, we examined the associations between COVID-19 stressors (concern, racial/ethnic discrimination, financial distress, infection, illness of loved one, death of loved one, caregiving) and substance use (alcohol, cigarette, marijuana), adjusting for age, gender, race/ethnicity, and international student status. All COVID-19 stressors were included in the same weighted logistic regression models. About 46.89% of the sample reported drinking any alcohol (in the past 2 weeks), 7.38% used any cigarettes, and 16.87% used any marijuana over the past month. Multivariable logistic regression models showed that infection and caregiving were significantly associated with alcohol use; racial/ethnic discrimination and financial distress were associated with smoking cigarettes; and concern and infection were associated with marijuana use. COVID-19 stressors were related to substance use, though the strength and significance of the associations varied depending on the stressors and the type of substance. Read more.

 

The Role of Resilience in Alcohol Use, Drinking Motives, and Alcohol-Related Consequences Among Hispanic College Students

Hispanic college students experience minority stressors and are therefore at greater risk of experiencing alcohol-related consequences. Resilience may protect against problem drinking and related consequences, yet its relationship to drinking motives remains unexplored. Given that drinking motives precede both alcohol use and its consequences, investigating the role of resilience in such associations may inform interventions to reduce alcohol-related health disparities. The current study investigated whether greater resilience predicted fewer drinking motives, lower alcohol consumption, and reduced the negative impact of drinking motives on alcohol consequences among Hispanic college students. Resilience, drinking motives, and alcohol consequences were assessed among 443 students living on the U.S./Mexico border recruited via e-mail (68% female; Mage = 22.6 years, SD = 5.09). Linear regressions assessed whether drinking motives (i.e., coping, conformity, social, enhancement) and resilience predicted alcohol consumption. A linear regression also assessed resilience, drinking motives, and alcohol consumption as potential predictors of alcohol consequences. Lastly, linear regressions tested the moderating effects of resilience between each drinking motive and alcohol consumption as well as alcohol consequences. Greater resilience predicted fewer alcohol-related consequences. Additionally, resilience moderated the relationships social and enhancement drinking motives had with alcohol consequences. Higher social and enhancement motives were not associated with alcohol consequences among resilient individuals. Strengthening resilience among Hispanic students whose drinking is motivated by a desire for socialization or mood enhancement may protect against alcohol-related consequences. Read more.

 

Prescription Stimulant Misuse and Diversion Events Among College Students: A Qualitative Study

Prescription stimulant misuse and diversion are interrelated behaviors: diversion increases the availability of stimulants for misuse, and persons who misuse are also more likely to divert. To date, research has examined these behaviors using a primarily quantitative lens. We led a qualitative investigation to better understand misuse and diversion events. Data are from a diverse southern California campus where we interviewed students who misuse and/or divert prescription stimulants (32 total interviews: 16 interviews with students who had a history of misuse, and 16 different interviews with students who had a history of diversion). We analyzed interview data inductively. We identified the following themes about misuse and diversion events, several of which intersected during interviews: medication surplus, diversion and misuse hubs, ease of behavior performance, academic stress, and other drugs commonly involved. For diversion, altruism and monetary gain were juxtaposed themes. Across themes, friends and family were influential figures. Implications for prevention, intervention, and future research directions are discussed. Read more.

 

College Students’ Receptiveness to Intervention Approaches for Alcohol and Cannabis Use

Addressing high-risk alcohol and cannabis use represent major challenges to institutions of higher education. A range of evidence-based treatment approaches are available, but little is known concerning students’ receptiveness to such approaches. Prior work identified that students were most open to individual therapy and self-help options for reducing alcohol use, but less open to medication. The current study examines student receptiveness to intervention approaches across a wider range of intervention approaches (e.g., remote/telehealth), and extends to evaluate cannabis intervention receptiveness. Undergraduate students reported on alcohol and cannabis use, motives for and reasons against use, and openness to an array of interventions for reducing alcohol and cannabis use. Informal options (self-help, talking with family/friends), individual therapy, and appointments with a primary care provider (PCP) were endorsed most frequently. Group therapy and medication were less commonly endorsed, though medication was endorsed at a higher prevalence than in prior studies. Women generally expressed higher receptiveness than men. Lower alcohol consumption was associated with increased receptiveness to some approaches. Students at high risk for alcohol and/or cannabis dependence were less receptive to many treatment options. College students were open to a wide variety of approaches for reducing their alcohol and cannabis use. These results can inform selection, implementation, and availability of campus-wide services, especially as low-cost technological-based approaches are expanding. Further attention to existing services (e.g., PCP) for addressing alcohol and cannabis use may be considered, given students’ receptiveness to such approaches. Read more.

 

Moderated Mediation of the ECHECKUP TO GO College Student Cannabis Use Intervention

Cannabis use rates are rising among college students, creating a need for effective and accessible intervention options. One such intervention, the Marijuana eCHECKUP TO GO (eCTG) program, has relatively few studies investigating mechanisms of change and related outcomes. This intervention provides users with personalized normative feedback to adjust user’s normative perceptions and use patterns. The current study tested moderated mediation of program effects between the eCTG intervention condition and a healthy stress management (HSM) control condition in a college student sample of near-daily cannabis users. Protective behavioral strategies (PBS) were measured among the eCTG condition. Data were analyzed from a sample of 227 students who were randomly assigned to the eCTG intervention condition or HSM control condition. Change in cannabis use frequency was measured by re-administering the baseline survey at a six-week follow-up. Multi-group moderated mediation path analysis tested the effects of the eCTG intervention on change in cannabis use frequency through PBS, descriptive norms, and injunctive norms, with multi-group categories defined by sex. Direct effects indicated the intervention predicted reduced descriptive norm perceptions and cannabis use frequency. An indirect effect was found for the intervention condition on reducing cannabis use frequency through change in descriptive norms in males. Similarly, an indirect effect was seen for intervention condition on reducing cannabis use frequency through change in injunctive norms for females. Findings suggest changes in descriptive norms played a sex-specific mediating role in the mechanisms of change for the eCTG intervention on reductions in cannabis use frequency. Read more.

 

Nuanced Relations Between Simultaneous Alcohol and Cannabis Use Motives and Negative Consequences Among College Students: The Role of Multiple Product Use

Simultaneous alcohol and marijuana (SAM) use is common, but it exacerbates negative consequences. Individuals use alcohol and cannabis products in different ways and have distinct reasons for use. The present study examines day-level effects of motives on consequences on SAM-use days, accounting for consumption, and tests whether using multiple alcohol (e.g., beer + liquor) and/or cannabis (e.g., concentrate + leaf) products on the same day mediates these relations. College students engaging in SAM use at least once in the past month (N = 281) completed two bursts of 28 consecutive days of data collection. We examined within-person effects of motives (effect-enhancement, social, offered [it was offered], coping) on number of negative consequences and on experiencing hangover, nausea, or blackout; and indirect effects via two concurrent mediators: using multiple alcohol products and multiple cannabis products. Total effect models showed effect-enhancement motives were related to nausea, social motives to number of total consequences and hangover, and coping motives to blackout. Effect-enhancement, social, and offered motives evinced significant indirect effects on consequence outcomes via multiple alcohol, but not cannabis, product use. Coping motives did not exhibit significant indirect effects, and were related to multiple cannabis, but not alcohol, product use, although all other motives were related to both mediators. Findings support recent work demonstrating within-person relations between social motives and negative consequences on SAM-use days. Limiting the number of alcohol products consumed on SAM-use days may be beneficial, particularly for young adults using to enhance intoxication or for social reasons. Read more.

 

Outcomes and Predictors of Stimulant Misuse in College Students With and Without ADHD

In recent years, rates of prescription stimulant misuse have increased among young adults ages 18 to 25 along with increases in dispensing rates of these medications. Preliminary studies suggest that college students with Attention-Deficit Hyperactivity Disorder may be more likely to misuse their stimulant medication than their non-ADHD peers. Research is needed to further explore possible rates, correlates, and outcomes of prescription stimulant misuse among college students with and without ADHD. Data regarding study strategies, psychological functioning, stimulant misuse, and GPA were collected from students from universities within the U.S. (N = 144), showing significantly higher rates of misuse among college students with ADHD. With depression and anxiety entered into the predictive model, inattentive symptoms were the only significant predictor of misuse in the full sample. The present findings have implications for academic interventions aimed at supporting the success of college students with and without ADHD and inform academic outcomes of prescription stimulant misuse. Read more.

 

Psychosocial Functioning Associated With Prescription Stimulant and Opioid Misuse Versus Illicit Drug Use Among College Students

College students’ prescription stimulant and opioid misuse (PSM and POM) share psychosocial risks with other substance use. We sought to extend a prior study of these issues. National College Health Assessment (2015–2016) participants ages 18–24 years (n = 79,336) reporting 12-month PSM (defined as use of a drug not prescribed to them), 30-day other illicit drug use (non-cannabis), both, or neither, were compared on other substance use, psychopathology, academic adjustment, attention deficit hyperactivity disorder, and chronic pain. Models were repeated for POM. Relative to those who only misused the prescription drug, those who used other illicit drugs had lower odds of chronic pain and academic problems, but higher odds on nearly every other outcome especially if they also misused the prescription drug. Findings suggest PSM and POM are on a continuum of risk shared with illicit drug use, but also are linked to outcomes specific to these drugs’ perceived medical purposes. Read more.

 

Brief Alcohol Screening and Intervention for Community College Students (BASICCS): Feasibility and Preliminary Efficacy of Web-Conferencing BASICCS and Supporting Automated Text Messages

The Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff et al., 1999) is an evidence-based approach to reduce high-risk drinking and associated harms; however, implementation may present challenges for community colleges (CC) that have limited budgets and mostly nonresidential students. We examined feasibility, acceptability, and efficacy of BASICS for CC students (BASICCS) delivered remotely via web-conferencing with supporting automated text messages. Participants included 142 CC students who reported exceeding National Institute on Alcohol Abuse and Alcoholism weekly low-risk drinking recommendations and/or heavy episodic drinking. Participants were randomized to BASICCS or assessment-only control (AOC) and completed 1- and 3-month follow-up assessments. Most students liked the personalized information in the program and found the web-conferencing platform useful, however intervention completion rate was 56%. Significant differences were found between BASICCS and AOC. At 1-month, individuals in BASICCS had 33% fewer alcohol consequences than those in AOC. At 3-month follow-up, individuals in BASICCS had lower estimated peak blood alcohol concentration, 29% fewer drinks per week, 62% fewer episodes of HED, and 24% fewer consequences than those in AOC. BASICCS showed evidence of being acceptable and the technology proved feasible, although the intervention completion rate in the non-treatment-seeking volunteer sample was modest. Preliminary evidence does suggest BASICCS shows promise in reducing alcohol use and consequences. Technology-based platforms could be a viable prevention solution for CC students. Read more.

 

 

Online Personalized Feedback Intervention Reduces Cannabis-Related Problems Among College Students With High Problem Distress

Despite experiencing problems related to using cannabis, very few undergraduate cannabis users are interested in treatment for cannabis-related problems or benefit from cannabis-focused online personalized feedback interventions. Thus, it may be important to determine whether individuals perceive their problems as distressing, as only those who are distressed by their problems may be motivated to change their cannabis use or benefit from cannabis-related interventions. The current study examined cannabis-related problem distress, its relation to motivation to change cannabis use, and whether problem distress impacted outcomes of a problem-focused online PFI. Past-month cannabis-using undergraduates who endorsed experiencing at least one cannabis-related problem in the past 3 months were randomized to a PFI (n = 102) or a personalized normative feedback-only condition (n = 102). Problem distress was robustly related to readiness, importance, and confidence to change cannabis use at baseline. Among those with high levels of problem distress at baseline, those in the PFI condition reported a greater decrease in problems than those in the PNF-only condition. This was not the case among those with lower levels of problem distress. Further, the number of cannabis-related problems did not moderate intervention outcomes. Cannabis users who perceive their problems as more distressing may be more motivated to change their cannabis use and more likely to benefit from a problem-focused PFI relative to a PNF-only intervention. Results have implications for the personalization of cannabis-focused interventions to maximize the impacts of interventions and decrease cannabis-related problems. Read more.

 

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Gender Differences in the Risk and Protective Factors of Marijuana Use Among US College Students

Gender differences in the risk and protective factors of marijuana use among college students were explored by analyzing online survey responses from 464 undergraduates. Women perceived higher risk and used marijuana less than men, with no gender difference in peer disapproval. In addition, women had higher objective knowledge regarding the health effects of marijuana, although they exhibited lower confidence in their knowledge. In subsequent regression analyses, health knowledge, confidence in knowledge, perceived risk, and peer disapproval predicted women’s marijuana use, whereas only confidence in knowledge and perceived risk predicted men’s use. These findings can help devise effective intervention strategies. Read more.

 

Changes in Alcohol Use and Drinking Context Due to the COVID‐19 Pandemic: A Multimethod Study of College Student Drinkers

In spring 2020, U.S. universities closed campuses to limit the transmission of COVID‐19, resulting in an abrupt change in residence, reductions in social interaction, and in many cases, movement away from a heavy drinking culture. The present mixed‐methods study explores COVID‐19‐related changes in college student drinking. We characterize concomitant changes in social and location drinking contexts and describe reasons attributed to changes in drinking. We conducted two studies of the impact of the COVID‐19 pandemic on drinking behavior, drinking context, and reasons for both increases and decreases in consumption among college students. Study 1 (qualitative) included 18 heavy‐drinking college students (Mage = 20.2; 56% female) who completed semi‐structured interviews. Study 2 (quantitative) included 312 current and former college students who reported use of alcohol and cannabis (Mage = 21.3; 62% female) and who completed an online survey. In both studies, COVID‐19‐related increases in drinking frequency were accompanied by decreases in quantity, heavy drinking, and drunkenness. Yet, in Study 2, although heavier drinkers reduced their drinking, among non‐heavy drinkers several indices of consumption increased or remained stable. Both studies also provided evidence of reductions in social drinking with friends and roommates and at parties and increased drinking with family. Participants confirmed that their drinking decreased due to reduced social opportunities and/or settings, limited access to alcohol, and reasons related to health and self‐discipline. Increases were attributed to greater opportunity (more time) and boredom and to a lesser extent, lower perceived risk of harm and to cope with distress. This study documents COVID‐19‐related changes in drinking among college student drinkers that were attributable to changes in context, particularly a shift away from heavy drinking with peers to lighter drinking with family. Given the continued threat of COVID‐19, it is imperative for researchers, administrators, and parents to understand these trends as they may have lasting effects on college student drinking behaviors. Read more.

 

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

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. 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. 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. 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. Read more.

 

A Novel Approach to Assess Descriptive and Injunctive Norms for College Student Marijuana Use

Descriptive and injunctive norms are traditionally assessed using different metrics. Following an innovation in the alcohol field, we examined a novel measure of perceived descriptive and injunctive marijuana norms (i.e., Marijuana Norms Grid, MNG) to characterize how these normative perceptions relate to one's own use of marijuana. The present study addressed three research questions: (1) Do college students overestimate descriptive/injunctive marijuana norms of typical college students and close friends? (2) Are descriptive/injunctive norms uniquely related to marijuana frequency and quantity? (3) Are injunctive norms related to marijuana frequency and quantity above and beyond how injunctive norms are traditionally assessed? College students (n = 7,000) were recruited from nine universities throughout the U.S., including 2,077 past month marijuana users. Participants completed an online, cross-sectional survey that included measures assessing marijuana use, marijuana consequences, and descriptive and injunctive marijuana norms using traditional and novel assessments, among other assessments. The results revealed robust self-other discrepancies using the MNG such that participants overestimated how often and how much college students use marijuana. We also found that both descriptive and injunctive norms related uniquely to one’s own marijuana use. The MNG injunctive norms explained about 19% of additional variability in marijuana outcomes beyond injunctive norms assessed using the traditional method. The findings of the present study support the utility of the novel assessment of injunctive marijuana norms. Implications for norms-based interventions are discussed. Read more.

 

Past Year High-Intensity Drinking Moderates the Association Between Simultaneous Alcohol and Marijuana Use and Blackout Frequency Among College Students

The role of simultaneous alcohol and marijuana (SAM) use in the experience of blackouts among college students is unclear. To clarify discrepancies, the current study evaluated whether the association between SAM user status and blackouts was moderated by high-intensity drinking (HID). College students (N = 1,224; 63.7% female) reported on their past year experiences of blackout, marijuana use, SAM use, and HID (i.e., drinking at least twice the binge threshold). SAM users had more past year blackouts than non-SAM users, but this effect was only significant among SAM users who had engaged in HID in the past year. Effects of SAM user status on the experience of alcohol-related blackouts may be limited to individuals who engage in HID. Read more.

 

Changes in College Student Alcohol Use During the COVID-19 Pandemic: Are Perceived Drinking Norms Still Relevant?

With widespread concern for increased alcohol use during the COVID-19 pandemic, there is a pressing need to examine changes in young adults’ alcohol use and to identify antecedents of increased use. We tested the hypothesis that self-reported changes in alcohol use during the pandemic (frequency, quantity, heavy episodic drinking) would relate to perceptions of peers’ changes in alcohol use. In April of 2020, 507 college students self-reported changes in their alcohol use and perceived changes in use for typical students at their university (i.e., norms). Most students in our sample reported decreased alcohol use and perceived decreases in peers’ alcohol use. Perceptions of peers’ changes in alcohol use behavior strongly related to changes in students’ own alcohol use. Findings provide strong support for norms-based strategies that can correct normative misperceptions by highlighting the fact that most college students are not in fact engaging in heavier alcohol use during the COVID-19 pandemic. Read more.

 

Changes in Alcohol Use and Drinking Context Due to the COVID‐19 Pandemic: A Multimethod Study of College Student Drinkers

In spring 2020, U.S. universities closed campuses to limit the transmission of COVID‐19, resulting in an abrupt change in residence, reductions in social interaction, and in many cases, movement away from a heavy drinking culture. The present mixed‐methods study explores COVID‐19‐related changes in college student drinking. We characterize concomitant changes in social and location drinking contexts and describe reasons attributed to changes in drinking. We conducted two studies of the impact of the COVID‐19 pandemic on drinking behavior, drinking context, and reasons for both increases and decreases in consumption among college students. Study 1 (qualitative) included 18 heavy‐drinking college students (Mage = 20.2; 56% female) who completed semi‐structured interviews. Study 2 (quantitative) included 312 current and former college students who reported use of alcohol and cannabis (Mage = 21.3; 62% female) and who completed an online survey. In both studies, COVID‐19‐related increases in drinking frequency were accompanied by decreases in quantity, heavy drinking, and drunkenness. Yet, in Study 2, although heavier drinkers reduced their drinking, among non‐heavy drinkers several indices of consumption increased or remained stable. Both studies also provided evidence of reductions in social drinking with friends and roommates and at parties and increased drinking with family. Participants confirmed that their drinking decreased due to reduced social opportunities and/or settings, limited access to alcohol, and reasons related to health and self‐discipline. Increases were attributed to greater opportunity (more time) and boredom and to a lesser extent, lower perceived risk of harm and to cope with distress. This study documents COVID‐19‐related changes in drinking among college student drinkers that were attributable to changes in context, particularly a shift away from heavy drinking with peers to lighter drinking with family. Given the continued threat of COVID‐19, it is imperative for researchers, administrators, and parents to understand these trends as they may have lasting effects on college student drinking behaviors. Read more.

 

Associations Between Opioid Misuse and Social Relationship Factors Among American Indian, Alaska Native, and Native Hawaiian College Students in the US

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. 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. 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, difficult social relationships, family problems, and intimate partner violence were significantly more likely to misuse opioids than students who did not report experiencing these relationship problems. 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. Read more.

 

Risk for Alcohol Use/Misuse Among Entering College Students: The Role of Personality and Stress

Excessive alcohol use among 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. 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. Data were collected during the first eight weeks of the first semester at college. Overall, domain-level Neuroticism was not associated with alcohol use/misuse above and beyond perceived levels of stress and other Big Five domains. Notably, the depression facet of Neuroticism, 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. 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. Read more.

 

Sex‐Specific Risk Profiles for Substance Use Among College Students

Growing evidence indicates sex and gender differences exist in substance use. Framed by a lifecourse perspective, we explored prospectively by sex the effects of distal and proximal factors on the initiation of drug use in college. College students without prior drug use (n = 5,120 females; n = 2,951 males) were followed longitudinally across 4 years. Analyses were estimated as a multigroup survival analysis separately by sex within a latent variable SEM framework with illicit drug use (6 or more times in past year) as the latent factor. More males initiated drug use (8.5%) than females (6.4%), but less so for Black males and females. Students initiating drug use more likely included students smoking cigarettes at baseline, using alcohol, or having cannabis using peers. Impulsivity domain associations differed by sex and sensation seeking. History of unwanted/uncomfortable sexual experience predicted drug use for males and females, but physical assault only for females. Mood symptoms predicted drug use only for males. Risk factors for initiating drug use during college differ by sex. As substance use during early age predisposes one for addiction, sex‐ and gender‐informed interventions for young adults are needed. Read more.

 

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Binge Drinking Before and After a COVID-19 Campus Closure Among First-Year College Students

The COVID-19 pandemic is associated with reports of increased substance use. College students are a population of concern for high risk binge drinking and their behavior may be particularly impacted by COVID-19 campus closures. Therefore, we examine first-year college students’ binge drinking soon after their university’s pandemic-related suspension of in-person operations. Students from a single campus (N=741; age: M=18.05, SD=0.22) completed one assessment in April-May 2020 post-campus closure (March 2020) including theoretically-informed measures (e.g., drinking motives, norms) and two items of self-reported pre- and post-closure binge drinking frequency, the focus of these analyses. About half of students consistently reported not binge drinking pre- and post-closure; 6.75% reported a consistent frequency of binge drinking pre- and post-closure. Many (39.41%) reported lower 30-day binge drinking post-campus closure compared to their pre-closure reports; few (4.18%) reported higher 30-day binge drinking frequency post-campus closure. Students reporting lower binge drinking post-closure showed differences in coping, social, and enhancement drinking motives and isolation. Students reporting greater post-closure binge drinking reported higher perceived drinking norms and were more likely to be in Greek life. This study demonstrates self-reported patterns in binge drinking among first-year college students at the point of COVID-19 campus closures. Pandemic-related college closures may have been a temporary environmental intervention on this high-risk behavior for some students. Although many students were not binge drinking, some continued binge drinking after closure and may benefit from preventive interventions. Read more.

 

Parental Concerns About Students’ Transition Into College: Substance Use and Sexual Assault

Parents play an important role in the development of their college-bound children, including engagement in risk behaviors and associated consequences. Still, few studies have investigated parental concerns about their children’s transition into college. The aim of this study was to describe parental concerns about substance use and sexual assault and to test differences between parents of sons and parents of daughters in their levels of concern and communication. Data are from 450 parents of incoming students to a large, midwestern university. Parents responded to questions regarding their concerns about substance use and sexual assault. Results found that parents of sons are more concerned about substance use while parents of daughters are more concerned about sexual assault. Parents of daughters also communicate more about sexual assault than parents of sons. Finally, there was a positive relationship between relationship quality and communication about sexual assault. Implications for future research and the development of parent-based prevention are explored. Read more.

 

Mechanisms of Change in an Adapted Marijuana E-CHECKUP TO GO Intervention on Decreased College Student Cannabis Use

The objective of this study was to test indirect effects of the Marijuana e-CHECKUP TO GO program on college students' frequent marijuana use through decreased use in specific social and academic activities. This study randomly assigned college students who reported frequent marijuana use (i.e., approximately five times per week) in fall 2016 to receive Marijuana e-CHECKUP TO GO or healthy stress management strategies. The final baseline sample included 298 participants. Path analyses tested direct program effects on marijuana use at six-week posttest, as well as the indirect effect via use within four activities frequently participated in by college students: socializing, being physically active, studying, and being in class. Direct Marijuana e-CHECKUP TO GO effects on reductions in frequent use were transmitted by decreased marijuana use while studying and no use while socializing, being physically active, or in class. Marijuana e-CHECKUP TO GO may be most effective at reducing use of marijuana among college students while studying. Read more.

 

Students Who Turn To Adderall To Cram For Tests May Be Hurting Their Developing Brain

Students cramming for exams often turn to Adderall — a drug approved for the treatment of attention deficit hyperactivity disorder, according to a 2018 study that looked at how college students use the prescription drug. What students don’t realize is that this behavior can actually hurt their performance in the long-run, experts say. 

“If you want to have a successful company, you have to have a good CEO,” said Lina Begdache, a professor at Binghamton University who studies Adderall abuse, who says the prefrontal cortex is like the brain’s CEO.

“It’s the last part of the brain that matures. So when people abuse Adderall, they’re actually decreasing the maturity of the brain,” she said. Read more.

 

Consequences of Alcohol and Marijuana Use Among College Students: Prevalence Rates and Attributions to Substance-Specific Versus Simultaneous Use

College students who use alcohol and marijuana often use them simultaneously, so that their effects overlap. The present study examined whether negative consequences experienced by simultaneous alcohol and marijuana (SAM) users vary from those experienced by individuals who use alcohol and marijuana concurrently but not simultaneously (CAM) or single-substance users. We considered 9 types of consequences: cognitive, blackout, vomiting, academic/occupational, social, self-care, physical dependence, risky behaviors, and driving under the influence. Further, we examined whether consequences experienced by SAM users are attributed to using alcohol, marijuana, or both simultaneously. The sample included past-year alcohol and marijuana users age 18–24 (N = 1,390; 62% female; 69% White; 12% Hispanic) recruited from 3 U.S. college campuses. SAM users experienced a greater overall number of consequences than CAM or alcohol-only users, even controlling for frequency and intensity of alcohol and marijuana use and potentially confounding psychosocial and sociodemographic factors. Experiencing specific consequences differed between simultaneous and concurrent users, but after adjusting for consumption and other covariates, only blackouts differed. In contrast, SAM users were more likely to experience each consequence than alcohol-only users, with strongest effects for DUI, blackouts, and cognitive consequences. Among SAM users, consequences were most likely to be attributed to alcohol and were rarely attributed to simultaneous use. Being a user of both alcohol and marijuana and using alcohol and marijuana together so that their effects overlap each contribute to risk, suggesting there is value in targeting the mechanisms underlying type of user as well as those underlying type of use. Read more.

 

Increased Mood Disorder Symptoms, Perceived Stress, and Alcohol Use Among College Students During the COVID-19 Pandemic

The COVID-19 pandemic caused significant disruption during the spring of 2020. Many college students were told to leave campus at spring break and to complete the semester remotely. This study evaluates effects of this disruption on student well-being. A sample of 148 students (86.5% female, 49.3% White) completed measures of psychological symptoms, perceived stress, and alcohol use during the spring 2020 semester at a university in the southeastern U.S. Their results were compared to those of 240 students (87.9% female, 64.2% White) who completed the same measures in the fall 2019 semester. Participants in spring 2020 reported more mood disorder symptoms, perceived stress, and alcohol use than did pre-pandemic participants. Worry about COVID-19 was negatively associated with well-being in multiple domains. Additionally, White students reported a greater effect of the pandemic on well-being than did African American students. Young adults appear to be less vulnerable to the most serious medical complications associated with COVID-19 but nonetheless experience psychological effects from the pandemic. Universities and practitioners who work with college students can help young adults manage their symptoms and avoid behaviors like risky alcohol use when confronted with stressors such as the COVID-19 pandemic. Read more.

 

Study Finds Student Drinking Habits Changed Due to COVID‐19

When college and university campuses closed in spring 2020 due to the COVID‐19 pandemic, the amount of alcohol consumed by underage students decreased according to a new report in the Journal of Studies on Alcohol and Drugs. The report speculates that the decrease in underage drinking may be due to students moving back in with their parents, compared to the relative freedom for unsupervised activities when living on a college campus. Read more.

 

Cannabis Use in College: Genetic Predispositions, Peers, and Activity Participation

Among adult college students in the U.S., cannabis use is common and associated with considerable negative consequences to health, cognition, and academic functioning, underscoring the importance of identifying risk and protective factors. Cannabis use is influenced by genetic factors, but genetic risk is not determinative. Accordingly, it is critical to identify environments that reduce risk among those who are at elevated genetic risk. This study examined the impact of polygenic scores for cannabis initiation, various forms of social activity participation, and peer deviance on recent cannabis use. Our aim was to test whether these environments moderate genetic risk for cannabis use. Data came from a longitudinal sample of undergraduate college students of European American (EA; NEA = 750) and African American (AA; NAA = 405) ancestry. Engagement with church activities was associated with lower probability of cannabis use. Peer deviance was associated with higher probability of cannabis use. Engagement with community activities moderated the influence of the polygenic risk score in the EA sample, such that PRS was associated with recent cannabis use among those who never engaged in community activities. This effect did not replicate in AAs, which may have been due to the portability of PRS based on EA discovery samples. Results suggest that community activities may limit the influence of genetic risk, as associations between PRS and cannabis use were only observed among individuals who never engaged in community activities. Read more.

 

Preliminary Impact of the COVID-19 Pandemic on Smoking and Vaping in College Students

We examined tobacco use changes in young adult college students in the context of the COVID-19 pandemic, focusing on smoking and vaping. First, we evaluated changes in tobacco use from pre- to post-campus closure focusing on smoking and electronic nicotine vaping frequency (days) and quantity (cigarettes/cartridges per day). Also, given the potential protective effects of pausing (temporarily or permanently discontinuing) smoking or vaping, we evaluated its predictors. We hypothesized that generalized anxiety and moving home would increase the odds of pausing. We also explored effects of COVID-related news exposure and seeking on tobacco use. We re-contacted young adults two years after they completed a study on alcohol and marijuana co-use. A subset (N = 83; 26.6% of the 312 respondents) were enrolled in college and reported use of cigarettes (n = 35) and/or e-cigarettes (n = 69) in the week prior to their campus closing (PC). Paired sample t-tests compared smoking and vaping frequency and quantity PC to past-week use since closing (SC). Both smoking and vaping frequency decreased from PC to SC; however, decreased frequency did not correspond to reduced quantity. Twenty-four participants (28.9%) paused past-week use SC. Higher anxiety and moving home (versus living independently) were related to increased odds of pausing, whereas COVID-19-related news exposure and seeking were related to decreased odds of pausing. Characterizing COVID-19 related tobacco use change provides insights into how college students respond to novel health threats and informs potential interventions. Read more.

 

Changes in Alcohol Consumption Among College Students Due to COVID-19: Effects of Campus Closure and Residential Change

It is well established that college students increase their drinking when they leave home. This study examined changes in drinking as a result of campus closure due to coronavirus disease 2019 (COVID-19), focusing on the influence of living situation. A sample of 312 college students (mean age = 21.2 years; 62% female; 67% White) responded to an online survey regarding their drinking behavior before and after university closures because of COVID-19. Those participants who lived with peers pre-closure and moved home to live with parents post-closure were compared with those who remained living with peers or remained living with parents in terms of changes in frequency and quantity of drinking. A comparison of pre- to post-closure drinking indicated significant decreases in the typical number of drinks per week (from 11.5 to 9.9) and maximum drinks per day (from 4.9 to 3.3) and a slight increase in typical drinking days per week (from 3 to 3.2). Patterns of change significantly varied across groups. Those who moved from peers to parents showed significantly greater reductions in drinking days (from 3.1 to 2.7), number of drinks per week (from 13.9 to 8.5), and maximum drinks in one day (from 5.4 to 2.9) than those who remained living with peers or with parents. In contrast, the latter two groups significantly increased their frequency (from 3.0 to 3.7 days and 2.0 to 3.3 days, respectively). Participants reduced their quantity of drinking during the COVID-19 pandemic. Returning to live with parents during emerging adulthood may be protective for heavy drinking. Read more.

 

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How Do College Students Use Their Free Time? A Latent Profile Analysis of Leisure Activities and Substance Use

College is a critical period of transition to independence and the substantial amount of time that students have to participate in leisure activities may be conducive to substance use. However, little is known about the associations between leisure activities and substance use over time, or whether these associations differ by residential status (i.e., living with parents vs. on their own). Using latent profile analysis, this study found six distinct profiles of leisure activity participation in a racially/ethnically diverse sample of college students (N = 1,207). Overall, profiles with medium levels of leisure activity participation were associated with more alcohol use, heavy drinking, and marijuana use one year later; whereas profiles with the lowest levels of leisure activity participation were associated with more cigarette use 1 year later. Identifying mechanisms through which leisure activities influence substance use can help inform prevention efforts to either reduce risks associated with participation or support protective effects. Read more.

 

Childhood Trauma and Prescription Drug Misuse in a College Population

Adverse childhood experiences predict health-compromising behaviors such as substance use. However, few studies have examined the association between ACE and prescription drug misuse among young adults—a growing public health concern. College students are especially vulnerable to prescription drug misuse due to social and academic stressors. This study investigated associations between ACE and prescription drug misuse (e.g., antidepressants, opiates, sedatives, and stimulants) among a diverse college population, as well as gender and racial/ethnic variations in these associations. Data are from the 2018 American College Health Association’s National College Health Assessment II (N = 3,899) at a large, diverse university in California. Logistic regression models assessed the association between ACE and prescription drug misuse adjusting for gender and race/ethnicity and explored gender and racial/ethnic differences in the ACE/prescription drug misuse association. ACE was associated with misuse of all prescription drugs. This study contributes to the mounting evidence regarding the importance of ACE screening and the use of campus-based prevention programs. This study also suggests programs should be tailored to address cultural variation. Read more.

 

US College Students’ Marijuana Information Sources, Confidence in Knowledge, and Objective Knowledge

In recent years, marijuana use on U.S. college campuses reached the highest point while the perceptions of risk and social disapproval registered the lowest since the early 1980s. However, little attention has been paid to the sources of the marijuana-related messages and their relationships with marijuana knowledge and confidence in knowledge, proximate protective/risk factors. To fill this gap, a convenience sample of students (N = 249) on a campus located in a U.S. recreational marijuana legal state were surveyed to identify their marijuana information sources and explore the relationships among the sources, confidence in marijuana knowledge, and objective knowledge. Peers/media were the most important sources and they were used more than other sources. Use of peers/media sources was related to lower health knowledge and higher confidence in knowledge. Although students named parents and education/science sources as important, these were less frequently used than siblings, the sources they named as the least important. This study advanced our understanding of the various sources of marijuana information used by U.S. college students and the relationships between the information sources and confidence in knowledge and objective knowledge, two emerging risk/protective factors in the era of marijuana deregulation. Read more.

 

Predictive Factors of College Student Willingness to Alter Substance Use Behavior: An Investigation of the Role of Parental Relationships

Substance use, specifically alcohol use, among college students is concerning. Despite the pervasive influence of a peer culture that promotes and supports drinking, young adults are also connected to other sources of socialization that inform their risk behaviors, including parents. Family dynamics have an appreciable influence on risk behaviors like substance use. The purpose of the present study was to further examine the degree of effect a parent has on the stability or change in college students’ substance use behavior. Using a non-clinical convenience sample of college students (n = 649), binary logistic regression was used to identify the factors that contributed to whether participants believed that their parents’ concern about their substance use would motivate them to change their substance use behavior. Substance use, consequences of drinking, and parental attachment significantly predicted propensity to change behavior. Read more.

 

Helicopter Parenting and Drinking Outcomes Among College Students: The Moderating Role of Family Income

Helicopter parenting, a form of overcontrol defined by intense levels of monitoring and supervision, has been linked to an increase in risky behaviors in emerging adults. However, the context may modify how helicopter parenting operates on adjustment in this population. The current study sought to better understand the contextualizing role of family income on the relations between helicopter parenting and drinking behaviors during college. Undergraduates (N = 171; 49% female; M age = 18.82; 68% White; M family income = $60,001–$75,000) completed measures of helicopter parenting, income, and multiple indices of alcohol consumption and problematic drinking. To accommodate the zero-inflated data for the outcome variable, two-part regression modeling was used to examine whether the interaction among (maternal or paternal) helicopter parenting and income was significant. Although the interaction was not significant for the binary models, the interaction generally predicted the magnitude of drinking. For low-income college students, increased helicopter parenting from mothers and fathers deterred most drinking behaviors. For high-income college students, increased maternal and paternal helicopter parenting was associated with a greater degree of average number of drinks consumed per day and drinking to intoxication. Overall, the results suggest that considering the economic conditions of families is important when examining the influence of parenting behaviors on young adult drinking patterns. While helicopter parenting might not be adaptive for high-income families, this form of parenting might serve a different function in low-income families by reducing risky behaviors of undergraduates. Read more.

 

The Moderating Role of Positive Peers in Reducing Substance Use in College Students

Young adulthood (18–25) is the peak age for substance use, but friends who engage in positive behaviors may be protective. The present study examined the direct relation between positive peer affiliation and substance use, and whether positive peer affiliation moderated the relation between self-reported sensation-seeking, future orientation, self-regulation, and substance use. Participants were 382 college students. Participants completed questionnaires assessing substance use, peer affiliation, sensation-seeking, future orientation, and self-regulation. In structural equation models, positive peer affiliation was negatively associated with drunk driving, cigarette use, and marijuana use; and moderated relations between sensation-seeking and substance use, but not cognitive control in the predicted direction. Substance use remains a salient public health concern for college students, but the current study found that having friends who generally engage in positive activities is an important buffer against socioemotional risk. Read more.

 

Study Strategies and “Study Drugs”: Investigating the Relationship Between College Students’ Study Behaviors and Prescription Stimulant Misuse

The current study examined the regular use of study strategies between college students who misused prescription stimulants and college students who did not misuse prescription stimulants in an undergraduate sample. Participants were 334 college students at a large, Midwestern university. Using logistic regression, we examined whether students who misused prescription stimulants did so to compensate for poor study strategies and/or a lack of study strategies overall. We hypothesized that regularly spacing studying, using more study strategies, and using more effective study strategies would predict lower odds of prescription stimulant misuse among students. In contrast, we hypothesized that using more ineffective study strategies would predict higher odds of prescription stimulant misuse. Results indicated that a greater number of total study strategies and effective study strategies, and higher importance of school predicted higher odds of prescription stimulant misuse. Thus, students may not be misusing prescription stimulants as a substitute for effective studying but, rather, to augment effective study habits. Read more.

 

Reducing Heavy Episodic Drinking Among College Students Using a Combined Web and Interactive Text Messaging Intervention

Heavy episodic drinking is associated with numerous negative consequences among U.S. college students. A number of universities have turned to web-based interventions to reduce heavy episodic drinking. Despite their efficacy, the magnitude of intervention effects tends to be relatively modest. The current project examined the potential utility of a combined interactive text messaging + web-based intervention for heavy drinking college students. In Study 1 (N = 30), effect sizes were estimated for the combined intervention versus an assessment only control on frequency of HDEs and alcohol-related consequences at one-month follow-up. In Study 2 (N = 79), the effect of the combined intervention compared to a web-intervention alone on past-month HDEs and alcohol-related consequences was assessed using negative binomial regression analyses. Results indicated that the combined intervention had a medium to large effect on HDEs compared to Assessment Only (Study 1) and a significant incremental effect on HDEs compared to the web-based intervention alone (Study 2). Cognitive-motivational process variables were also examined in each study to identify potential mediational mechanisms to be explored in the future work. Findings suggest a combination web-based intervention + interactive text messaging may be an efficacious approach for addressing heavy episodic drinking among risky drinking college students. Read more.

 

Social Media, Marijuana, and Sex: An Exploratory Study of Adolescents’ Intentions to Use and College Students’ Use of Marijuana

Recreational marijuana continues to be legalized in U.S. states, with popular media discussing connections between cannabis and the facilitation of sexual activity. We conducted two surveys with adolescents and college students in Washington state to examine the role of viewing social media and pro-marijuana content on sex-related marijuana expectancies and intentions to use. In Study 1, among adolescents (N = 350), we found connections between social media use, exposure to pro-marijuana content, and sex-related marijuana expectancies, with boys’ sex-related marijuana expectancies predicting intentions to use marijuana. In Study 2, we expanded this research to college students (N = 966), with the addition of frequency of marijuana use as an outcome. For men, sex-related marijuana expectancies were negatively associated with marijuana use. Sex-related marijuana expectancies were not associated with intentions to use or use of marijuana among adolescent girls and college women. Our findings highlight how social media use is associated with increased exposure to pro-marijuana content for adolescents and college students, and how such content is associated with sex-related marijuana expectancies. The mixed relationships in our data between sex-related marijuana expectancies and intentions and use highlight potential gender and developmental differences. Read more.

 

Prevalence of Vaping and Behavioral Associations of Vaping Among a Community of College Students in the United States

We investigated the prevalence of vaping among college students in South-central Appalachia in the United States and explored factors which were associated with and could predict vaping among the college students. A sample of 498 enrolled students voluntarily completed a self-report REDCap health survey questionnaire in 2018. Outcome variable was use of electronic cigarettes categorized as yes/no. Independent variables included risky behaviors such as texting or emailing while driving, riding in a car with someone who had been drinking, history of protected and unprotected sexual intercourse, age at first intercourse, and type of contraceptive used. Covariates were age, gender, ethnicity/race and high school location. The first category was used as reference. Binary logistic regression was used to identify factors associated with and predicting vaping. Mean age of participants was 20.93, 62.9% were female, a majority (76.5%) were non-Hispanic White, and 43.2% reported vaping at some point in their lives. Vaping was highly prevalent (43.2%) among our participants. Gender, location of high school, texting/emailing while driving, and seat belt usage are predictors of vaping among these students. Read more.

 

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Self-Esteem, Acculturative Stress, and Marijuana Use Among Hispanic College Students

Previous research has found mixed results regarding the association between acculturation and substance use in Hispanic populations. Additional research is warranted to examine relations among facets of acculturation, particularly acculturative stress, and marijuana use. The purpose of this study was to examine whether self-esteem mediates the relation between acculturative stress and a lifetime history of marijuana use among a sample of Hispanic college students. Hispanic college students (N = 204; Mean age = 20.3 years) from a large southwestern university participated in an online study and reported on lifetime marijuana use, self-esteem, and acculturative stress. We evaluated the hypothesis that self-esteem would mediate the relation between acculturative stress and the likelihood of reporting a history of marijuana use, utilizing Hayes’ SPSS macro, which provides estimates of boot-strapped confidence intervals for the indirect effect. Results showed that self-esteem did not significantly mediate the relation between acculturative stress and likelihood of marijuana use [b = .157, 95% CI (−.003, .017)]. Future studies might examine other facets of acculturation in relation to substance use, utilizing a longitudinal approach to better understand these associations. Read more.

 

Who Takes the Trip? Personality and Hallucinogen Use Among College Students and Adolescents

Research examining hallucinogen use has identified potential benefits, as well as potential harms, associated with use. The acute effects of hallucinogen use can be intense, disorienting, cognitively impairing, and may result in perceptual changes mimicking aspects of temporary psychosis. Hallucinogen use may also lead to the onset of more chronic issues, such as Hallucinogen Persisting Perception Disorder, which impairs daily functioning even when sober. However, research on factors that predict who will misuse hallucinogens is an understudied area. In particular, while sensation seeking, impulsivity, and emotion dysregulation have all been shown to be predictive of problematic substance misuse, there is almost no research on how these personality variables predict hallucinogen use. The present study assessed how these personality traits predicted hallucinogen use in a sample of college undergraduates (N = 10,251) and a sample of adolescents in an inpatient residential psychiatric hospital (N = 200). Results indicated that facets of sensation seeking, impulsivity, and emotion dysregulation positively predicted ever having used hallucinogens, earlier initiation of use, and lifetime use among college students. Findings also indicated that facets of sensation seeking, impulsivity, and emotion dysregulation positively predicted having ever used hallucinogens in the adolescent inpatient sample. Results highlight the need for more research on who is likely to misuse hallucinogens. If confirmed in future research, the findings presented herein indicate viable personality variables as predictors. This is especially important as there has been a recent explosion of research on the positive benefits of therapeutic hallucinogen use. Read more.

 

Characteristics Associated With Marijuana Use in Latinx College Students

While marijuana use rates are significantly high within college students, less is known about use patterns and correlates in Latinx groups. This study assessed the relationships between ever use and frequency of use of marijuana, polysubstance use, expectancies, motives, and mental illness symptoms among Latinx college students (n = 345). Results indicated more frequent marijuana use was positively associated with enjoyment, celebration, social anxiety, low risk, sleep, and availability, and was negatively associated with experimentation, boredom, altered perception, and anxiety. Other dual use with tobacco expectancies were also observed. These constructs should be explored prospectively and inform prevention and intervention efforts. Read more.

 

Cannabis Use in Civilian College Students and College Student Service Members/Veterans: The Moderating Effect of Anxiety

Cannabis is the most commonly used illicit drug on college campuses. Research suggests that Student Service Members/Veterans (SSM/V) may be more likely to use alcohol than civilian students, but little research has focused on cannabis use in these two samples. The purpose of the current study was to compare cannabis use frequency, cannabis use disorder (CUD) symptoms, and cannabis-related problems between civilian students and SSM/V. A second aim was to determine if group differences in these outcomes were moderated by symptoms of depression, stress, or anxiety. The sample included 164 college SSM/V (80.4% female, 19.6% male) and 456 civilian (78% female, 22% male) college students. Participants completed an online survey assessing demographics, number of days of past month cannabis use, cannabis-related problems, CUD symptoms, and a measure of anxiety, depression, and stress. Negative binomial regressions indicated no significant differences in number of days of past-month cannabis use or past-year cannabis-related problems between civilian students and SSM/V, although SSM/V reported more past-year CUD symptoms. Moderation analyses revealed that at elevated levels of anxiety, SSM/V students used cannabis more frequently than civilian students. These findings indicate that when experiencing elevated levels of anxiety, SSM/V use cannabis more frequently than civilian students, suggesting that anxiety may be a more prominent risk factor for frequency of cannabis use for SSM/V compared to civilian students. Education, prevention, and intervention efforts specifically addressing anxiety in this demographic are needed. Read more.

 

Prescription Opioid Misuse Among University Students: A Systematic Review

Misuse of prescription opioids has substantially increased in the past decade among the general population, including among university students. Relative to the literature concerning opioid misuse among the general population, little information is available regarding the college student population. The purpose of the present study was to conduct a systematic review of the literature concerning the prevalence of prescription opioid misuse among the university student population. The lifetime estimate for prescription opioid misuse among general populations of students ranged from 4% to 19.7%, with higher estimates for special student populations. Students most at risk for misuse of prescription opioids are those who report higher rates of psychological distress, depression, and suicidal thoughts and behaviors, and white, male students who use alcohol and illicit drugs. Findings from this study underscore the need for opioid prevention and intervention programs on university campuses. Read more.

 

Examining the Relationship Between Ethnic Identity, Depression, and Alcohol Use Among Students at Historically Black Colleges/Universities

Alcohol abuse among college populations is a serious public health issue and is associated with many negative consequences; however, few studies have examined the drinking behavior of African American students at Historically Black Colleges/Universities. Alcohol abuse, including binge drinking, has historically been lower among African American than Caucasian college students; however, recent studies indicate that HBCU undergraduates are reporting increased rates of alcohol consumption, raising the question of which potential risk and protective factors are associated with alcohol consumption in this population. Ethnic identity has been identified as one protective factor for ethnic minorities, yet the processes that facilitate this relationship are little known. This study sought to further investigate the relationship between ethnic identity, depression, and alcohol use in a sample of 171 African American HBCU students. Participants were tightly clustered toward the desirable end on all measures, which restricted variability and thus attenuated correlational analyses to evaluate the relationships between study variables. There was a consistent pattern of high ethnic identification, minimal mental health distress, and low alcohol and substance use. Results suggest HBCU students are maintaining lower rates of alcohol consumption and binge drinking compared to nationally-stratified samples of undergraduates. Furthermore, these findings suggest African Americans attending HBCUs score highly on ethnic identity and resiliency. Cultural and social norms at HBCUs may help explain low rates of substance and alcohol misuse among HBCU students. Recommendations for culturally-informed alcohol use prevention and intervention strategies and for future research are provided. Read more.

 

Study Strategies and “Study Drugs”: Investigating the Relationship Between College Students’ Study Behaviors and Prescription Stimulant Misuse

The current study examined the regular use of study strategies between college students who misused prescription stimulants (N = 36) and college students who did not misuse prescription stimulants (N = 298) in an undergraduate sample. Using logistic regression, we examined whether students who misused prescription stimulants did so to compensate for poor study strategies and/or a lack of study strategies overall. We hypothesized that regularly spacing studying, using more study strategies, and using more effective study strategies would predict lower odds of prescription stimulant misuse among students. In contrast, we hypothesized that using more ineffective study strategies would predict higher odds of prescription stimulant misuse. Results indicated that a greater number of total study strategies and effective study strategies, and higher importance of school predicted higher odds of prescription stimulant misuse. Thus, students may not be misusing prescription stimulants as a substitute for effective studying but, rather, to augment effective study habits. Read more.

 

Characterizing Symptoms of Cannabis Use Disorder in a Sample of College Students

Since the legalization of marijuana in several U.S. states in 2012, there has been concern about increases in the development of cannabis use disorder. The current study examined rates of CUD in Colorado college students who reported regular marijuana use and assessed a range of factors associated with CUD symptoms, including coping motives, concentrate/dab use, mental health concerns (depression, anxiety), age of regular marijuana use, and alcohol use. College students were recruited from a mid-sized university and completed a baseline assessment that included a marijuana urine screen. Participants reported a median of five CUD symptoms and 90% met criteria for CUD. After adjusting for covariates, the age of regular marijuana use was negatively associated with the number of CUD symptoms, while the average daily alcohol drinks was positively associated with the number of symptoms. Prevention and intervention efforts at the university level should be increased to reduce negative outcomes associated with problem marijuana use. Read more.

 

Assessment of Prescription Stimulant Misuse Among College Students Using the MMPI-2-RF

Prescription stimulant misuse (PSM) is a growing concern on college campuses and more research is needed to validate clinical measures commonly used for the assessment of risk for PSM among college students. The present study examined correlations between scores on the Minnesota Multiphasic Personality Inventory–Second Edition–Restructured Form (MMPI-2-RF) and self- and peer-reported misuse of prescription stimulants and other drugs in a sample of 96 pairs of undergraduate students. Nearly half of the participants (48%) reported that they had been offered prescription stimulants and one quarter (26%) reported trying someone else's prescription stimulant medications, often to perform better academically. Scores on the MMPI-2-RF scales designed to measure general substance misuse and related behavioral or externalizing constructs, were correlated positively with both self- and peer-reported prescription stimulant misuse, as well as with problematic use of other drugs. MMPI-2-RF scales designed to measure constructs in the domains of Emotional/Internalizing, Somatic/Cognitive, and Thought Dysfunction, as well as Interpersonal Functioning, had weaker correlations with misuse of prescription stimulants and other drugs. These results provide support for the convergent validity of the MMPI-2-RF with regard to the assessment of prescription stimulant misuse and general drug misuse among college students. Read more.

 

Prescription Stimulant Diversion on a College Campus: Intrapersonal, Interpersonal, and Environmental Correlates

Prescription stimulant diversion is a behavior that increases the availability and accessibility of prescription stimulants for purposes such as misuse. As such, we aimed to develop a theory-guided understanding of diversion correlates. Data are from a probability sample of 499 undergraduate college students attending one California university. Participants completed a 100-item survey related to prescription stimulant misuse and diversion. We first calculated prevalence of diversion and associations with demographic variables. Next, to examine intrapersonal, interpersonal, and environmental correlates of diversion, we estimated three separate nested logistic regression models. Prescription stimulant diversion during college was reported by approximately 10% of the sample. In the nested logistic analyses, diversion was found to be associated with intrapersonal, interpersonal, and environmental variables. These findings highlight the importance of examining a comprehensive set of correlates to identify subgroups of students at risk for engaging in sharing and/or selling of prescription stimulants. Read more.

 

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The Role of Past and Current Medical Use on Nonmedical Use of Prescription Drugs Among College Students: Exploring Same-Drug and Cross-Drug Class Associations

Understanding the role that medical use of prescription drugs plays in nonmedical use of prescription drugs can inform prevention efforts. In order to understand fully the potential risk that medical use of prescription drugs conveys for nonmedical use of prescription drugs, the current study explored the simultaneous associations between the medical use of several classes of prescription drugs with current nonmedical use of the same and other prescription drug classes, and whether the associations depended upon past or current medical use. Data came from a cross-sectional survey of 1,686 college students, which assessed past and current medical use and current nonmedical use of stimulants, sedatives/anxiolytics, and opioid analgesics. Logistic regression analyses revealed that both past and current medical use of sedatives/anxiolytics and opioid analgesics predicted the current nonmedical use of the same drug class, whereas past medical use of stimulants predicted the current nonmedical use of stimulants. In addition, current medical use of stimulants predicted current nonmedical use of sedatives/anxiolytics and past medical use of sedatives/anxiolytics predicted current nonmedical use of opioid analgesics. This study provides a broader examination than past research of simultaneous same-drug class and cross-drug class associations between medical and nonmedical prescription drug use, as well as the role of past and current medical use in these associations. Overall, the results suggest that efforts to prevent nonmedical use of a prescription drug class should move beyond targeting only those who have or who are using the same drug class medically. Read more.

 

A Qualitative Examination of College Students’ Perceptions of Cannabis: Insights into the Normalization of Cannabis Use on a College Campus

This study aimed to qualitatively examine how perceptions of cannabis differ among college students in an effort to better understand the changing landscape of cannabis on college campuses. Forty-six predominantly male college students attending a border state university (i.e., a state that has not yet legalized cannabis but borders a state that has) engaged in facilitated focus group discussions (N = 5) about cannabis-related issues. Thematic analysis uncovered three primary themes and six subthemes. Main themes included user heterogeneity and identity, relative benefits and harms of cannabis, and social position of cannabis on campus culture. Cannabis has quickly integrated into the college social environment, with social stigmatization and identification with cannabis impacting decisions to use. Findings inform existing college health programs on how to approach conversations about cannabis with students. Read more.

 

Motives for Alcohol and Marijuana Use as Predictors of Use and Problem Use Among Young Adult College Students

This study examined differences between alcohol-only users and alcohol–marijuana co-users and motives for use in relation to alcohol and marijuana use and problem use. Spring 2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use measured 4 months later. Controlling for covariates, alcohol use frequency correlated with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives, but lower Conformity alcohol use motives; greater Coping and Self-enhancement alcohol use motives predicted problem alcohol use. Marijuana use frequency correlated with greater Coping and Expansion marijuana use motives; greater Expansion marijuana use motives predicted problem marijuana use. College-based substance use interventions should target Coping and Self-enhancement alcohol use motives and Expansion marijuana use motives. Read more.

 

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

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. 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. 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. 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. Read more.

 

Marijuana Knowledge, Confidence in Knowledge, and Information Efficacy as the Protective and Risk Factors of Marijuana Use Among College Students

This study explored the relationships between marijuana knowledge, confidence in knowledge, and information efficacy and marijuana use. Furthermore, the effects of the knowledge-related variables were examined on intention to use, resistance efficacy, and intention to vote for legalization. Undergraduate students (N = 215) were surveyed in Fall 2018. Data were collected online and analyzed through a series of regression analyses. Higher knowledge was related to less use via higher perceived risk whereas higher confidence in knowledge was related to more use. Marijuana use was related to higher future intention to use, lower resistance self-efficacy, and intention to vote for legalization. Information efficacy was related to intention to vote for legalization only. Students with more knowledge were less likely to use marijuana, whereas students who considered themselves well-informed were more likely to use it. Future intervention efforts will benefit from counteracting students’ misplaced confidence in their knowledge. Read more.

 

Marijuana Use Trends Among College Students in States With and Without Legalization of Recreational Use: Initial and Longer-Term Changes From 2008 to 2018

Young adult college students in the United States are likely to be affected by marijuana liberalization trends. However, changes in students' marijuana use following recreational marijuana legalization (RML) have not been examined in more than one RML state at a time, or beyond 1-2 years post-legalization. Participants were undergraduates aged 18-26 years attending college in U.S. states that did (n = 234,669 in seven states) or did not (n = 599,605 in 41 states) enact RML between 2008 and 2018. Measurements were self-reported marijuana use (past 30 days) and individual and contextual covariates, institution-provided institutional and community covariates, and publicly available dates when states enacted RML. Adjusting for covariates, state differences and state-specific linear time trends (accounting for pre-RML trends), prevalence of 30-day marijuana use increased more among students exposed to RML than among non-RML state students throughout the same time-period; the results were similar for frequent use (≥ 20 days). In U.S. states that enacted recreational marijuana legislation from 2012 to 2017 there was evidence for a general trend toward greater increases in marijuana use by college students and differential impact by gender, legal using age, and campus residence. Read more.

 

High-Risk Alcohol Use Behavior and Daily Academic Effort Among College Students

It is not well understood whether heavy drinking interferes with academics on specific days or if this relationship simply reflects between-student differences. 736 college students completed 14 consecutive daily assessments during 7 semesters. Days were classified as nondrinking, moderate drinking, heavy episodic drinking only (HED-only), or high-intensity drinking (HID) days. Students were more likely to skip class after engaging in HED-only or HID the previous day. On weekdays, students spent more time on schoolwork when they did not drink the previous day and spent less time on schoolwork when they engaged in HED-only and HID the previous day. On weekends, students spent less time on schoolwork after HED-only days. Heavy drinking is associated with lower academic effort the next day, highlighting the need for college programs targeting heavy alcohol use prevention and daily decision making. Read more.

 

Alcohol and Marijuana Co-Use: Consequences, Subjective Intoxication, and the Operationalization of Simultaneous Use

Alcohol and marijuana are frequently co-used with overlapping effects. However, the absence of consistent operational definitions delineating simultaneous alcohol and marijuana use (SAM) from concurrent use (CAM) challenges consistent inferences about these behaviors. This study first examined whether daily alcohol and marijuana co-use predicted substance-use related consequences and subjective intoxication; and then evaluated whether competing operationalizations of SAM and CAM were associated with differences in these outcomes on co-use days. A sample of 341 young adult college students who reported past-month use of both alcohol and marijuana “at the same time so that their effects overlapped” completed a two-wave survey with paired 28-day daily experience sampling bursts examining alcohol and marijuana co-use. Participants reported more negative consequences on co-use days versus marijuana-only days and greater subjective intoxication relative to alcohol or marijuana-only days. Co-use days involve greater risk than alcohol-only or marijuana-only days. Although there was no evidence of additional daily risk from simultaneous use regardless of the timeframe used to operationalize it, investigating these effects remains challenging due to the generally small timeframe between substances on co-use days in this sample. Read more.

 

Preventing College Student Nonmedical Prescription Stimulant Use: Development of Vested Interest Theory-Based Persuasive Messages

Vested interest theory (VIT) predicts that perceived importance and hedonic relevance of an expected behavioral outcome affects attitude-behavior consistency. Applied to college students’ nonmedical use of prescription stimulants (NUPS), the theory posits that persuasive information that weakens vested perceptions regarding assumed advantages of stimulant use will reduce usage intentions. The current study developed and experimentally assessed persuasive messages that targeted perceptions of vested interest (VI), and examined if message effectiveness varied as a function of users’ risk status. Appeals that focused on the physical harms of misuse served as the comparison condition. College student participants were randomly assigned to one of four message conditions. Analyses showed that messages focused on lowering VI by convincing students that NUPS did not enhance cognitive functioning of non-ADD/ADHD students reduced perceived vested interest. In vulnerable nonusers, these messages also decreased NUPS intentions. The effect of exposure to the physical harm communication was not significant. Findings support the potential of VIT-guided messages in NUPS prevention, and the lack of effect of messages focused on physical consequences of misuse. Read more.

 

Electronic Screening and Brief Intervention to Reduce Cannabis Use and Consequences Among Graduate Students Presenting to a Student Health Center: A Pilot Study

This pilot study sought to test the feasibility of screening and delivering a web-based intervention to reduce marijuana use and consequences among graduate student presenting to a student health center (SHC). Graduate students completed a 9-item electronic health screening instrument during their visit to the SHC. Those who reported monthly or greater marijuana use were eligible for participation in the pilot trial. Forty-nine students completed baseline assessments and were randomly assigned to an electronic screening and brief intervention (eSBI) for marijuana or a control condition (CTL) that consisted of minimal general health information. Participants completed measures of marijuana use frequency and negative consequences at baseline, 3-, and 6-months. Results suggest that BI may hold promise as a method to reduce marijuana use among graduate students who present to primary care settings. Future research should test the efficacy of this approach in a full-scale randomized controlled trial. Read more.

 

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Does Cannabis Use Predict More Severe Types of Alcohol Consequences? Longitudinal Associations in a 3‐Year Study of College Students

Prior research shows that negative drinking outcomes among young adults may be exacerbated by cannabis use. However, to date, there have been few longitudinal studies of associations between cannabis use and negative alcohol‐related consequences. This study examined longitudinal within‐person associations between cannabis use and several domains of negative alcohol consequences among young adults and explored the moderating role of sex. We analyzed data from N = 997 students assessed 4 times per year over the first 3 years of university. At each time point, participants completed measures of past‐month cannabis use frequency, typical weekly number of drinks, and 8 domains of negative alcohol consequences. Findings suggest that within‐person changes in cannabis use frequency among young adults are associated with corresponding changes in some domains of alcohol consequences (but not others) when examined over the course of several years. Results may inform targeted harm reduction interventions for young adult drinkers who use cannabis, although future research is needed to clarify the mechanisms of the observed associations. Read more.

 

Self-Esteem and Non-Medical Use of Prescription Drugs Among College Students: Coping as a Mediator 

Nonmedical use of prescription drugs (NMUPD) has become a threat to public health. In the United States, NMUPD is especially common in young adults (aged 18-25). Self-esteem is a robust psychosocial factor of substance use. The substance use literature also documents that self-esteem is associated with alcohol use through other cognitive factors, such as coping. Given the important role of coping in substance use intervention, it is important to understand how coping alters mechanisms underlying the effects of self-esteem on NMUPD. However, little research has explored mediational mechanisms among self-esteem, coping, and NMUPD. The current study sought to examine a hypothesized mediation model among self-esteem, coping, and NMUPD in college students. Data were collected online from 1,052 undergraduates (aged 18 to 25; 723 females) in a large public university in Virginia. Participants reported their past-three-month NMUPD (i.e. opioids, sedatives, anxiolytics, and stimulants), self-esteem, and coping (13 domains; e.g. active coping and self-blame). Self-esteem appears to be a protective factor for NMUPD in college students, and its relationship with NMUPD is mediated by two types of coping. Future interventions targetting NMUPD among college students should attend to self-esteem and coping. Read more.

 

Substance Use and Interpersonal Violence: Exploring Potential Threats to Underrepresented Minority Students’ Academic Success

College dropout has been described as an epidemic, with underrepresented minority (URM) students having the highest dropout rates at colleges and universities. This study examines interpersonal violence and substance use as potential threats to the academic success of URM students. This study is a secondary data analysis of the National College Health Assessment. Significant decreases for grade point average in African American students were associated with physical violence and marijuana use. For Hispanic/Latinx students, physical violence, marijuana use, and methamphetamine use were significantly associated with decreases in GPA. American Indian, Alaska Native, or Native Hawaiian students’ decreases in GPA were significantly associated with marijuana use. Results of the study indicated that substance use and interpersonal violence are associated with decreases in GPA for various groups of URM. These findings are disconcerting and relay the importance for colleges and universities to undertake strategies to increase the retention of URM students. Read more.

 

Effects of Frequent Marijuana Use on Risky Decision-Making in Young Adult College Students

Marijuana is the most widely used illicit substance among adolescents and young adults. Frequent MJ use has been associated with impairments in cognitive flexibility and inhibition, both of which play important roles in decision-making. However, the impact of frequent MJ on decision-making performance is mixed and not well understood. The current study examined the influence of frequent MJ use on risky decision-making in college students, 18–22 years old. From 2017 to 2019, data was collected from young adult college students (n = 65) consisting of 32 healthy controls (HC) and 33 frequent marijuana users (MJ+). Participants completed the Iowa Gambling Task, a measure of risky decision-making, and net IGT scores (advantageous-disadvantageous decisions) were used as a measure of optimal decision-making. The main finding indicated there was a significant effect of group on net IGT scores, which remained significant when sex was included in the model. These findings highlight potential differences in risky decision-making between MJ+ and healthy controls, but it is uncertain whether these differences are pre-existing and increase vulnerability for frequent MJ use or if they are related to the effects of frequent MJ use on decision-making. Read more.

 

E-Cigarette Use Is Prospectively Associated With Initiation of Cannabis Among College Students

E-cigarettes have dramatically increased in popularity among youth. Coincident with expanded legalization, young adults’ use of cannabis (marijuana) has also steadily increased in recent years. Use of tobacco products can increase the chances of later cannabis initiation among youth. However, most longitudinal investigations of tobacco and cannabis use patterns have focused on tobacco cigarettes, included adolescents as opposed to young adults, and have only employed two timepoints. The current study examined prospective associations between e-cigarette and cannabis use in a large, diverse college sample assessed over four timepoints (freshman – senior year; N = 4,670). The current findings suggest that the association of e-cigarette use and cannabis use is likely bidirectional, with stronger support for the link from e-cigarette use to later cannabis use, above and beyond cigarette use. As e-cigarettes gain further hold of the tobacco product market share and cannabis legalization continues to expand, data such as these will be critical for informing regulatory decisions for e-cigarettes and cannabis, particularly involving their accessibility to youth and young adults. Read more.

 

Illicit Drug Use Among College Students: The Role of Social Norms and Risk Perceptions

This study’s purpose was to examine the prevalence and correlates of college student use of illicit substances including cocaine, designer drugs, and nonmedical use of prescription stimulants and opioids, and to identify how different drug-related perceptions are related to past year use of these substances. Data were analyzed from a cross-sectional anonymous web-based survey among a sample (n = 1345, 81% female) of students attending a mid-sized liberal arts college in the U.S. Findings suggest that future college student drug prevention efforts should more directly target current marijuana users since they are most at risk of using other illicit substances. Additionally, findings indicate that injunctive norms may be an important consideration for education-focused drug prevention programs. However, findings should be interpreted in light of limitations of the sample, which is predominantly female. Read more.

 

Disordered Eating Is Associated With Non-Medical Use of Prescription Stimulants Among College Students

Disordered eating behaviors are associated with non-medical use of prescription stimulants for weight and appetite-related purposes. Yet, estimates of the prevalence and types of disordered eating associated with non-medical use vary. Additionally, little is known about the association between medical use of prescription stimulants and disordered eating. Data were collected from 87,296 college students at 127 institutions that participated in the Healthy Minds Study. Non-medical use of prescription stimulants (NMUPS) was reported by 2.8% (n = 2,435) of the sample. One-third of students using prescription stimulants non-medically reported two or more disordered eating attitudes and behaviors. Disordered eating was a significant predictor of non-medical, but not medical use of prescription stimulants. The risk for NMUPS increases with disordered eating symptomatology. There is a need to assess for NMUPS among college students presenting with disordered eating. Read more.

 

Psychosocial Functioning Among College Students Who Misuse Stimulants versus Other Drugs

The misuse of prescription stimulants (e.g., Ritalin, Adderall) is a large and growing problem on college campuses. Emerging research examines not only the demographic predictors of stimulant misuse but also the potential role that stimulant misuse plays in a college student’s overall functioning and mental health. To better understand the experiences specifically linked with stimulant misuse rather than substance use more broadly, we tested whether psychosocial functioning differed across four groups of college students: those who do not misuse stimulants or other hard drugs; those who misuse both stimulants and other hard drugs; those who misuse stimulants but not other hard drugs; and those who misuse other hard drugs but not stimulants. Those who misused stimulants reported higher levels of impulsivity, as well as substance use consequences, than those who did not use any hard drugs. However, these differences were exacerbated among those who misused stimulants and other hard drugs. Taken together, these findings suggest that stimulant misuse typically occurs in a broader pattern of substance use, and that stimulant misusers generally fall along a continuum of substance use severity in terms of psychosocial functioning. Read more.

 

A Day in the Life: A Daily Diary Examination of Marijuana Motives and Protective Behavioral Strategies Among College Student Marijuana Users

This study examined marijuana-use motives and protective behavioral strategies (PBS) as within- and between-subject predictors of marijuana-related outcomes. Furthermore, we explored differences between a specific marijuana-related event (i.e., 4/20) compared with typical weekend/weekday use. Forty-three college student marijuana users (31 females) completed daily surveys for 12 days (April 15–April 26, 2016). Four motives (coping, conformity, enhancement, and social) were associated with more negative consequences within-subjects. Enhancement and conformity motives were also associated with a higher number of use sessions, and expansion motives were associated with higher subjective high. Marijuana PBS use (total score) was associated with fewer sessions and lower subjective high within-subjects. Social motives were higher, whereas PBS use and coping motives were lower on 4/20 compared with other days. Our findings support PBS and certain use motives as promising intervention targets for college student marijuana users. Read more.

 

Reasons for Transition From Electronic Cigarette Use to Cigarette Smoking Among Young Adult College Students

Longitudinal studies indicate that e-cigarette use among youth and young adults is associated with cigarette smoking initiation. The purpose of this study was to identify reasons why nonsmoking young adults transition from e-cigarette use to cigarette smoking. The study used concept mapping (CM), a mixed-method participatory approach. Fifty-five college students who endorsed initiation of e-cigarettes before cigarettes completed at least one part of the study. In an online program, participants brainstormed statements describing reasons for transition from e-cigarette use to cigarette smoking, sorted statements into conceptually similar categories, and rated how true each statement was for them. Results suggest that tailored prevention efforts aimed at reducing cigarette smoking uptake among college students who use tobacco as a means for psychological coping or social facilitation may be warranted. Furthermore, regulatory decisions aimed at limiting cigarette appeal, reinforcing effects, and accessibility may be relevant to reducing transition. Read more.

 

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Recreational Prescription Opioid Misuse Among College Students in the USA: An Application of the Theory of Planned Behavior

Young adults aged 18-25 are at elevated risk for prescription drug misuse compared to other age groups. The purpose of the current study was to utilize the Theory of Planned Behavior (TPB) to predict the intention to engage in recreational prescription opioid misuse (RPOM) among college students while identifying specific salient beliefs that underlie this behavior. A random sample of college students in the USA completed an electronic survey measuring TPB constructs, salient beliefs, RPOM, and demographic items. The beliefs identified by this study may benefit interventions aimed at preventing prescription opioid misuse among this population. Further, targeting global perceptions of peer behavior, as well as, attitudes toward recreational use of prescription opioids may be particularly efficacious. Read more.

 

Trends in College Students’ Alcohol, Nicotine, Prescription Opioid, and Other Drug Use After Recreational Marijuana Legalization: 2008-2018

Young adult college students may be particularly sensitive to recreational marijuana legalization (RML). Although evidence indicates the prevalence of marijuana use among college students increased after states instituted RML, there have been few national studies investigating changes in college students’ other substance use post-RML. The cross-sectional National College Health Assessment-II survey was administered twice yearly from 2008-2018 at four-year colleges and universities. Participants were 18-26 year old undergraduates attending college in states that did or did not implement RML by 2018. In the context of related research showing national increases in college students’ marijuana use prevalence and relative increases following state RML, researchers observed decreases in binge drinking and increases in sedative use that both depended on age. Findings support some specificity in RML-related changes in substance use trends and the importance of individual factors. Read more.

 

Tobacco and Marijuana Use Among US College and Noncollege Young Adults, 2002–2016

This research’s objective was to assess trends and behavioral patterns of marijuana and cigarette and/or cigar (i.e., smoked tobacco) use among 18- to 22-year-old U.S. young adults who were in or not in college. Data were from the 2002–2016 National Survey on Drug Use and Health. Past-30-day and past-12-month use of marijuana and smoked tobacco were assessed by college enrollment status. Exclusive marijuana use is increasing among young adults overall, whereas exclusive smoked tobacco use is decreasing: faster rates are seen among college students. Exclusive marijuana use is higher among college students, whereas exclusive smoked tobacco use is higher among noncollege individuals. Surveillance of tobacco and marijuana use among young people is important as the policy landscape for these products evolves. Read more.

 

Frequent Marijuana Use and Cognitive Flexibility in Young Adult College Students 

Frequent marijuana use has been associated with deficits in executive functioning, but few studies have examined the contribution of recent and lifetime MJ use to the magnitude of EF impairment in young adults. Researchers examined cognitive flexibility in 18- to 22-year-old college students, who were heavy marijuana users or healthy controls. Researchers hypothesized heavy marijuana users would have poorer cognitive flexibility compared to healthy controls, which would be related to earlier age at first MJ use, and greater past 30-day and lifetime MJ use. Heavy marijuana users had a significantly lower EF-composite score compared to healthy controls, and this was related to greater past 30-day MJ use Impaired cognitive flexibility in heavy marijuana users and greater recent MJ use may contribute to the maintenance of MJ use, making it difficult to choose alternatives to reduce MJ use. Read more.

 

Educational Intervention Changes College Students’ Attitudes toward Prescription Opioid Drug Use

More than 47,000 people in the United States died from opioid drug overdoses in 2017. Among college students, opioid drugs are the second most abused drug. This study aimed to examine if an educational intervention affected college students’ attitudes toward prescription opioid drugs. Two hundred forty-two participants (72 males, 21 ± 3 years) from an American university participated. After collecting demographic data, investigators recited a narrative in which the protagonist was injured and prescribed opioid drugs. Next, participants rated their agreement on 10 Likert prompts and two visual analog scales before and after an educational intervention, then noted which topics were most or least influential in any changed responses. Educational intervention topics related to risk were most influential and topics related to alternative therapies were least influential. Educational interventions may be beneficial for college students. Any interventions that are employed should focus on risks associated with prescription opioid drug use. Read more.

 

Achievement Goal Orientation and Stimulant Misuse in College Students

The prevalence of stimulant medication misuse is rising in college students. Motivations to use stimulant medications differ from motivation to use other substances such as alcohol or cannabis. However, no previous research has examined the impact of achievement goal orientation on stimulant misuse in college students. 309 college students (mean age = 18.9; 117 males) without an ADHD diagnosis were invited to participate. Participants completed an online research questionnaire that assessed factors associated with stimulant medication misuse as well as achievement goal orientations (Learning and Performance Orientations). Approximately 12% endorsed a history of stimulant misuse within the past year. More males (17.1%) than females (9.4%) reported stimulant misuse. Those with and without a history of stimulant misuse differed on Performance Orientation (misuse > no misuse) yet were comparable on Learning Orientation. Having a higher Performance Orientation independently predicted stimulant misuse. Read more.

 

College Attendance Type and Subsequent Alcohol and Marijuana Use in the US

College attendance is a risk factor for frequent and heavy drinking and marijuana initiation but less is known about the extent to which risk varies by type of college attendance and across age. Using panel data of young adults who were high school seniors in 1990-1998 from the Monitoring the Future study (n = 13,123), we examined the associations between college attendance at age 19/20 (4-year college full-time, other college, and non-attendance) and subsequent alcohol and marijuana use at age 21/22, 25/26, 29/30, and 35. College attendance may confer elevated risk of substance use post-college. The magnitude and duration of risk vary by type of college attendance and substance. Read more.

 

Trajectories of Prescription Drug Misuse During the Transition From Late Adolescence Into Adulthood in the USA: A National Longitudinal Multicohort Study

Prescription drug misuse is most prevalent during young adulthood (ages 18–25 years). We aimed to identify prescription drug misuse trajectories for three drug classes (opioids, stimulants, and sedatives or tranquilizers) from adolescence into adulthood, assess the extent to which different trajectories are associated with symptoms of substance use disorder, and identity factors associated with high-risk prescription drug misuse trajectories. Five prescription drug misuse trajectories were identified and the defining characteristic that differentiated the five trajectories was the age when past-year prescription drug misuse high frequency peaked. Prescription drug misuse trajectories are heterogeneous, and any high-frequency prescription drug misuse is a strong risk factor for development of substance use disorders during adulthood, especially later-peak prescription drug misuse trajectories. These findings might help practitioners identify individuals at greatest risk for substance use disorders and target intervention strategies. Read more.

 

College Students’ Using Marijuana to Sleep Relates to Frequency, Problematic Use, and Sleep Problems

Given the rising rates of insufficient sleep and the popularity of marijuana, the researchers investigated using marijuana as a sleep aid, marijuana use frequency, problematic marijuana use, and sleep problems. Participants included a convenience sample of college students who endorsed using marijuana in the past year from May to December 2013. Path analyses investigated if using marijuana to sleep predicted: (1) marijuana use outcomes and (2) sleep problems; and if sleep problems predicted marijuana use outcomes. Using marijuana to sleep was related to increased use and problematic use, as well as worse sleep efficiency. Daytime dysfunction related to sleepiness was associated with elevated levels of marijuana use and problematic use. Similar associations were found across sex and race. College students should be informed of the potential misconceptions between marijuana and improved sleep and provided with evidence-based alternatives to improve their sleep. Read more.

 

Teaching About Nonmedical Use of Prescription Drugs Among College Students

The misuse of prescription medications has emerged as a national public health concern. Epidemiological studies suggest that college students are at an elevated risk to engage in nonmedical use of several medications, including stimulants and central nervous system depressants. Teachers can easily integrate material related to the nonmedical use of prescription drugs (NMUPD) into undergraduate psychology and statistics courses. Presenting this information provides an opportunity for teachers to address fundamental topics in ways that students tend to find interesting and personally relevant. We use this article to introduce a definition of NMUPD, present statistics on prevalence and a wide range of physical and psychological correlates among college students, and discuss risk and protective factors and motives for use. We also present a number of concrete examples of how teachers can use the material to illustrate basic concepts often included in statistics, research methods, and other psychology courses. Read more.

 

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Risks Associated With Alcohol and Marijuana Use Among College Student Athletes: The Case for Involving Athletic Personnel in Prevention and Intervention

This study’s purpose was to describe alcohol and marijuana use patterns and related consequences among student athletes. A total of 12,510 students (n=1,233 athletes) completed four cross-sectional online annual surveys as part of a multi-site campus initiative. Chi-square tests of independence, t-tests, and regression models evaluated differences in alcohol and marijuana use between athletes and non-athletes. The prevalence of binge drinking and high intensity drinking was significantly higher among student athletes than non-athletes, even after controlling for demographic characteristics. Thirteen percent of student athletes experienced an alcohol-related injury during the past year; this was more common among binge drinkers than non-binge drinkers. Among student athletes, past-month binge drinking and past-year marijuana use were significantly associated with lowered GPA. Skipping class was twice as prevalent among student athletes who used marijuana as compared with athletes who did not use marijuana, but no differences were found related to binge drinking. Components for a training for athletic personnel to reduce risks for alcohol-related injury and academic consequences that are associated with alcohol and marijuana use among student athletes are described. Involving athletic personnel might be an important strategy to identify and intervene with high-risk student athletes. Read more.

 

Assessing Marijuana Use, Anxiety, and Academic Performance Among College Students

This article examines the relationship between marijuana use and anxiety symptoms among college students, with a secondary focus on marijuana use and grade point average. A secondary analysis was conducted on data obtained from the American College Health Association–National College Health Assessment. Results indicated that marijuana use was negatively associated with GPA among students with current anxiety and no formal treatment. The relationships between these variables may be more complex than previously thought. Read more.

 

Systematic Review: Nonmedical Use of Prescription Stimulants: Risk Factors, Outcomes, and Risk Reduction Strategies

To review all literature on the nonmedical use (NMU) and diversion of prescription stimulants to better understand the characteristics, risk factors, and outcomes of NMU and review risk-reduction strategies. NMU of stimulants is a significant public health problem, especially in college students, but variations in the terms used to describe NMU and inconsistencies in the available data limit a better understanding of this problem. Further research is needed to develop methods that detect NMU, identify individuals at greatest risk, study routes of administration, and devise educational and other interventions to help reduce occurrence of NMU. Colleges should consider including NMU in academic integrity policies. Read more.

 

Cannabis and Alcohol Use for Sleep Aid: A Daily Diary Investigation

Objective: One in 5 college students use substances such as cannabis and/or alcohol to help sleep. Despite this high prevalence of sleep aid use, there remains a lack of research on the potential day-to-day sleep- and substance-related consequences. The current study examined associations of cannabis and alcohol sleep aid use with subsequent sleep and substance use consequences among college students. Of a baseline sample of 217 college students endorsing past-month cannabis and/or alcohol use, 83 students endorsing past-month cannabis and/or alcohol use for sleep aid completed online questionnaires for 14 consecutive days to report daily sleep, substance use, and negative substance consequences. Multilevel models demonstrated that nights of cannabis sleep aid use predicted longer same-night sleep duration, shorter same-night wake time after sleep onset, and greater next-day daytime fatigue within person, after controlling for daily cannabis frequency. Results highlight daytime fatigue as a potential adverse short-term outcome of cannabis sleep aid use, despite its proximal sleep-related benefits. Read more.

 

Online Personalized Feedback Intervention for Cannabis-Using College Students Reduces Cannabis-Related Problems Among Women

There is growing evidence that college cannabis use is associated with use-related problems, yet efforts to reduce cannabis-related problems via online personalized feedback interventions (PFIs) have had limited success in significantly reducing risky cannabis use among college students. However, men and women may respond differently to such interventions and failure to examine effects of gender may obfuscate intervention effects. Thus, the current study tested intervention effects (moderated by gender) of an online, university-specific PFI for high-risk cannabis users (i.e., past-month cannabis users with at least one recent cannabis-related problem) who were randomly assigned to an online PFI or an online personalized normative feedback-only condition. Men in the PFI condition did not significantly differ from men in the PNF-only condition on use-related problems at follow-up. Cannabis PFIs may be efficacious for reducing cannabis use-related problems among undergraduate women (but not men) and women may benefit from online interventions that include problem-focused components. Read more.

 

Association Between Prescription Opioid Misuse and Dimensions of Suicidality Among College Students

Suicide rates among young adults have increased in recent years. Prescription opioid misuse is not only associated with depression onset but also misuse has been reported as a means to manage existing depressive symptoms. College students are at increased risk for psychological distress compared to other populations. The current cross-sectional study aimed to fill a literature gap by examining a relationship between prescription opioid misuse and 3 dimensions of suicidality among a large sample of college students. Among this sample 38.8% reported suicidal ideation, 11.6% reported making a plan to kill themselves, and 7.8% reported at least one suicide attempt in the past 12 months. Past year prescription opioid misuse was common (21.6% of participants) and significantly associated with each dimension of suicidality. Though the relationships were attenuated, past year prescription opioid misuse remained significantly associated with suicidal ideation, planning, and attempts following covariate adjustment. At a local level, university health promotion specialists should give particular consideration to individuals exhibiting prescription opioid misuse as this may serve as an indicator of underlying psychological distress and possible suicidality. Read more.

 

Are Co‐Users of Alcohol and Marijuana More Willing to Experience Consequences From Drinking? A Longitudinal Examination Among First‐Year College Students

Alcohol and marijuana co‐users are at heightened vulnerability for experiencing a variety of negative alcohol use outcomes including heavier alcohol use and driving under the influence. The current study explored willingness to experience negative consequences as a potential factor underlying the association between co‐user status and negative consequences in an effort to guide future intervention work. The current study was the first to compare co‐users of alcohol and marijuana to alcohol‐only users on willingness to experience consequences, and examine the role of willingness as a mediator between co‐user status and consequences experienced. Co‐users were more willing to experience adverse effects from drinking, in turn predicting more consequences. Intervention work targeting consequences may be less effective for co‐users; thus, additional work is needed to identify other potential mechanisms for change for this at‐risk group. Read more.

 

Alcohol Use and Consequences in Matriculating US College Students by Prescription Stimulant/Opioid Nonmedical Misuse Status

U.S. college students have elevated prescription opioid and stimulant misuse rates, with frequent alcohol use and alcohol-related consequences (ARCs). To date, though, no research has examined relationships between opioid and/or stimulant misuse and alcohol quantity/frequency or ARC variables in college students. The 2016–17 AlcoholEDU for College™, a web-based alcohol prevention program, provided data (n = 491,849). Participants were grouped into past 14-day: (1) no misuse; (2) opioid misuse only; (3) stimulant misuse only; and (4) combined misuse. Using multilevel logistic regressions, groups were compared on 14-day alcohol use odds, and among those with use, odds of any ARCs and specific ARCs (e.g., hangover). College students engaged in 14-day stimulant and/or opioid misuse had higher odds of 14-day alcohol use, higher levels of alcohol use, and a greater likelihood of ARCs, versus students without misuse. These findings suggest that college students with any prescription misuse need alcohol screening, although those with poly-prescription misuse may not need more intensive alcohol interventions. Read more.

 

Understanding the Drug-free Schools and Communities Act, Then and Now 

Higher education institutions are known to have been lax in their compliance with the Drug-Free Schools and Communities Act Amendments of 1989 (DFSCA), and until recently, the U.S. Department of Education did not seem to notice. Now, the Department regularly investigates colleges and issues hefty fnes for violations. No case provides better insights into the pitfalls of DFSCA compliance than the Department’s review of Penn State University published in 2016. In this article, we analyze the Penn State and other recent program reviews against the DFSCA’s original statute, regulations, Department handbooks, and guidance letters. We fnd that over time, DFSCA compliance has grown increasingly complex, and the stakes for institutions are higher than ever. To higher education attorneys and administrators, we ofer advice on how to improve compliance with the Drug-Free Schools and Communities Act. Read more.

 

If Everyone Is Doing It, It Must Be Safe: College Students’ Development of Attitudes toward Poly-Substance Use

While binge drinking on college campuses has been a topic of concern for decades, especially among fraternity and sorority members, recreational drug use is on the rise and mixing alcohol and drugs is now more of a concern than ever. Social learning theory was used as a framework for understanding how students develop attitudes regarding the possible risks and rewards of various behaviors such as binge drinking and drug use. This research reports the results of 13 focus group discussions with 63 college students. A thematic approach was used and revealed several themes: participating in college culture, experimenting is expected, ignoring risk-taking, and resisting peer pressure. Participants felt as if it was expected that college students would experiment with alcohol and drugs, and that it was just “part of going away to college.” Students reported ignoring the known risks of mixing alcohol and drugs use despite prior education efforts. The findings of this study suggest that alcohol and drug use on college campuses is, at least in part, driven by a perception of college culture and a poor balancing of the risks and rewards associated with these behaviors. Read more.

 

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Simultaneous Alcohol and Marijuana Use Among College Students: Patterns, Correlates, Norms, and Consequences

Alcohol and marijuana users often engage in simultaneous alcohol and marijuana (SAM) use (i.e., using the 2 substances together so that their effects overlap), which can result in more negative consequences than using either substance alone. Nevertheless, little is known about SAM use among contemporary college students to aid in the development of preventive interventions. This study examined SAM use patterns, demographic correlates of SAM use, and normative influences on SAM use and related negative consequences among college students. About three‐fourths of participants reported at least 1 occasion of SAM use in the past year with an average frequency of twice per month among SAM users. There were significant differences in SAM use prevalence and frequency by sociodemographic characteristics controlling for past‐year alcohol and marijuana frequency. Students in a state with decriminalized recreational marijuana use reported higher frequency of past‐year SAM use than students in states with legalized or criminalized use. There were significant demographic differences in perceived norms regarding SAM use among close friends and same‐gender peers. SAM users endorsed significantly higher perceived peer and friend norms than nonusers. Also, higher perceived norms predicted more frequent SAM use and more negative consequences of use. Results indicate a need for prevention programs on college campuses that address SAM use. Interventions that use personalized normative feedback may be effective. Read more.

 

Personality Traits and Negative Consequences Associated With Binge Drinking and Marijuana Use in College Students 

Binge drinking is common in college students and many drink in quantities greater than the standard definition of bingeing. Combined use of additional substances, particularly marijuana, is also common. Increased impulsivity and sensation seeking are risk factors for bingeing, and this study was designed to characterize their association with extreme compared to standard bingeing, as well as with combined bingeing and marijuana use. Negative consequences of alcohol use were also investigated. Self-report personality measures and a measure of the negative consequences of alcohol use were given to a sample of 221 college students (109 females) sorted into a control and 4 binge groups based upon their patterns of bingeing and marijuana use. Standard bingers did not differ from non-bingeing controls on either impulsivity or sensation seeking, whereas extreme bingers had significantly higher impulsivity and sensation seeking scores than controls and also significantly higher sensation seeking than standard bingers. Impulsivity, sensation seeking, and disinhibition are significant associates of substance use patterns and the negative consequences of use in college students. Read more.

 

Cocaine Use Declining in Emerging Adults in Relation to College Enrollment

A recent study attempted to observe trends in cocaine use among young adults, and describe differing trends based on college enrollment. In this study, data from the National Survey on Drug Use and Health from 2002-2016 was used to measure cocaine use, prevalence of use, and college enrollment. The data showed that overall cocaine use and cocaine use disorders have declined in the past 15 years in those aged 18-22. Overall, although cocaine use remains prevalent in emerging adults, use has decreased since the early 2000s in those aged 18-22. College enrollment may put young adults at risk for short-term use, but non-college young adults experience more prevalence of use disorders. Read more.

 

Substance Use Among College Students

U.S. college campuses have witnessed a national increase of cannabis, stimulant, and illicit drug use among students over the past decade. Substance use among college students is associated with numerous negative outcomes including lower academic performance, a higher probability of unemployment after graduation, and an increased risk of committing and experiencing sexual assault. Several risk factors for substance use are specific to this population, including an affiliation with Greek life, perception of high academic pressure, and peer pressure. Students with problematic substance use also face unique challenges in planning treatment, including aspects of confidentiality, financial constraints, and potential university oversight and involvement. This article highlights the prevalence of substance use on college campuses and describes some of the specific challenges and approaches to treatment in this population, including screening tests and interventions for specific substances used on college campuses and evidence-based substance use programming for college students. Read more.

 

Brief Intervention to Reduce Problem Drinking in College Students With ADHD

Despite gaining admission to college, many students with attention-deficit/hyperactivity disorder (ADHD) struggle to achieve academic, social, and occupational success. Additionally, college students with ADHD experience higher rates of problem drinking and comorbid psychology (e.g., depression). This paper describes the development of the Students Understanding College Choices: Encouraging and Executing Decisions for Success (SUCCEEDS) program for college students diagnosed with ADHD who are engaging in problem drinking. SUCCEEDS combines ADHD psychoeducation, behavioral activation, and brief motivational intervention treatment elements to help college students with ADHD achieve healthier and more fulfilling lifestyles. SUCCEEDS aims to decrease problem drinking by increasing substance-free, goal-directed behavior allowing for success in college. The iterative treatment development process, two SUCCEEDS illustrative case examples, and reliable change indices are presented. Preliminary results suggest that SUCCEEDS may be effective in reducing problem drinking and functional impairment in areas relevant to college students (e.g., academics). Read more.

 

Evaluation of the Psychometric Properties of the Cannabis Use Disorders Identification Test - Revised Among College Students

Cannabis use is common among college students and is associated with a variety of negative consequences. The Cannabis Use Disorders Identification Test Revised (CUDIT-R) is an 8-item screening instrument designed to identify potentially problematic or harmful recent cannabis use. The current study’s purpose was to evaluate the internal consistency and validity of the CUDIT-R in a sample of college students who reported recent cannabis use (past 30 day). Overall, the CUDIT-R appears to be a reliable and valid screening measure when used to identify college students at risk for cannabis-related problems. Future research should further evaluate the sensitivity and specificity of the CUDIT-R threshold scores with more rigorously established DSM-5 diagnoses, and across a range of populations. Research on the utility of using the CUDIT-R for measuring treatment outcomes is also warranted. Read more.

 

Synthetic Cannabinoid Use Among College Students

Synthetic cannabinoid use is associated with severe problems, including psychosis, kidney failure, and death. Given that young adults are especially vulnerable to using synthetic cannabinoids, the current study sought to identify factors and consequences related to use within this population. 1,140 undergraduates completed an online survey of synthetic cannabinoid use, consequences, and related constructs. The prevalence of lifetime synthetic cannabinoid use was 7.9 percent, 15.6 percent of which were regular users, meaning they used once a year or more often. Synthetic cannabinoid users reported multiple adverse effects (e.g., anxiety, paranoia, tachycardia, lightheadedness) and 16.7 percent of users said they considered or did go to the emergency room while using synthetic cannabinoids. In the entire sample, participants believed their friends and students in general use synthetic cannabinoids more than they do. Read more.

 

Alcohol, Tobacco, and Marijuana Use During the Initial Transition to College

Many studies have highlighted the public health concern of substance use among college students. A new study specifically examined the transition period between high school and college and surveyed students during this time period to understand changes in substance use. In this study, a cohort of students was surveyed one week before they moved into campus housing and started their first year of college. This survey assessed their health-related attitudes, demographic information, and substance use behaviors. After one week of the academic semester had passed, each student completed a brief survey each morning for 10 days. Each day they responded if they had engaged in alcohol, tobacco, or marijuana use the previous night. They were also asked about sleep patterns and class attendance. The data showed that alcohol was the most commonly used substance, with 54 percent of students reporting that they had used alcohol in the past 30 days at the baseline survey and 43 percent reporting use during the 10 day period of surveys. 31 percent of students reported having used marijuana at baseline, and during the period of being surveyed 9 percent reported use. As for tobacco use, about 30 percent reported that they had used tobacco before beginning college. No tobacco use was reported during the time frame of the surveys, perhaps because of the short length of data collection. A strong relationship existed between alcohol and tobacco use, with over 70 percent of students who had used tobacco before college reporting alcohol use within the 10-day period. Previous use of any of the substances correlated with continued use when the students began college, and this association was seen most strongly with alcohol and marijuana. Also, out of students who reported no previous substance use, 13.8 percent reported using alcohol while transitioning to college. Read more.

 

Graduate Degree Completion: Associations With Alcohol and Marijuana Use Before and After Enrollment

Research has shown that alcohol and marijuana use are associated with academic performance difficulties, but the relationship to completion of a graduate degree has not been explored. Undergraduate students (n = 1253) were assessed during their first year of college and annually thereafter until age 29. Among the subset of the original sample who enrolled in graduate school (n = 520), measures of alcohol and marijuana use were averaged separately for the time periods before and after graduate school enrollment.  The majority of drinkers (70 percent) drank an average of twice a week or less each year, and 62 percent of marijuana users used marijuana once a month or less each year. After adjusting for demographic and program characteristics, marijuana use frequency after graduate school enrollment was negatively associated with odds of graduate degree completion. Alcohol use frequency before graduate school enrollment was positively associated with odds of graduate degree completion. Results add to the growing body of literature on marijuana use and decreased academic achievement, but results should be interpreted with caution given the small, but significant, effect sizes found. The positive association between alcohol use frequency and degree completion might be attributed to engagement in the academic environment. Future studies should examine the potential mechanisms through which alcohol and marijuana use are related to the academic achievement of graduate students. Read more.

 

The Impact of Marijuana Legalization on Law Enforcement in States Surrounding Colorado

Since the legalization of recreational marijuana occurred in Colorado, politicians, academics, and the public have been paying close attention to what impact, if any, the legalization of recreational marijuana has on crime, substance use and abuse, and state revenue gains. However, research has not identified the potential impact that marijuana legalization has had on law enforcement officers in neighboring states. This study used survey methodology to explore how the legalization of recreational marijuana in Colorado has affected law enforcement officers and their duties in states that border Colorado. Results indicate that law enforcement officers view Colorado’s legalization of recreational marijuana as having a negative impact on their enforcement duties. Respondents note an increase in potency, perceived juvenile use, and strain on their resources as major issues they are now having to deal with. Analysis indicates that departments further away from Colorado perceive less of an impact than counties closer to Colorado’s border. Compared with Nebraska and Kansas, respondents from Wyoming perceived a larger impact on enforcement, but these differences were diminished when controlling for personal perceptions of marijuana. Read more.

 

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University Students’ Self-Reported Reasons for Abstinence From Prescription and Non-Prescription Stimulants and Depressants

No previous publication has evaluated whether the importance of university students’ reasons for abstinence differ among prescription stimulants, prescription opioids, and two illicit forms of those medications (cocaine and heroin). In response to a recruitment email sent to all enrolled undergraduates at a large public university, 768 students who reported no prior recreational use of these four substances rated the importance of 17 reasons for lifelong abstention from each of the four drugs. Based on factor analyses, 16 of the 17 reasons comprised four subscales (Negative Consequences, Difficult to Acquire, Not Enjoyable, Social Disapproval). With few exceptions, importance ratings for each of the four subscales and the single non-loading reason (Against My Beliefs) were highest for heroin, followed in descending order by cocaine and the two prescription medications. Each type of reason was rated a more important influence on abstention from street drugs than from comparable prescription drugs. Reasons reflecting harmful consequences were rated most important and reasons reflecting acquisition difficulties were rated least important for each drug. To the degree that importance ratings are associated with continued abstinence, education and prevention messages could emphasize negative consequences as one means to reinforce continued abstinence from these drugs. Read more.

 

Examining the Relationship Between Strain and the Use of Nonmedical Prescription Drugs Among College Students

The study of nonmedical prescription drug use (NMPDU) on college campuses is of importance, as college students tend to engage in NMPDU more often than their same-age peers not attending college. Typical correlates of NMPDU include need for alertness, perception of peer use, desire to get high, and use of other drugs including alcohol and marijuana. Few studies have explored the relationship between strain, depression, and NMPDU among college students. Using general strain theory as the theoretical framework, the current study aims to add to the literature on NMPDU by exploring the role that strain and depression play in the prevalence of nonmedical prescription stimulant, tranquilizer/sedative, and pain reliever use at a midsize university. Results support the relationship proposed by strain theorists for both nonmedical use of prescription pain relievers and tranquilizers/sedatives, but not stimulants. Policy implications and future areas of research are discussed. Read more.

 

Marijuana Use Is Associated With Alcohol Use and Consequences Across the First 2 Years of College

College entry is associated with marijuana initiation, and co-use of alcohol and marijuana is associated with problematic outcomes, including alcohol-related consequences. The present study explored if: use of marijuana on a given day would be associated with greater alcohol use within the same day; use of marijuana within a given week would be associated with increased alcohol-related consequences in that same week; and the association between marijuana use and alcohol consumption and consequences varies across time or by precollege level of problematic alcohol use. Analyses revealed daily marijuana use predicted greater number of daily drinks and estimated breath alcohol concentration; weekly marijuana use predicted more weekly positive and negative alcohol consequences; the effect of daily marijuana use on alcohol use strengthened over time, while the effect of weekly marijuana use on positive alcohol consequences reduced over time; and precollege level of problematic alcohol use moderated the association between daily marijuana and alcohol use and weekly marijuana use and negative consequences. This study provides the first longitudinal evidence of the association between marijuana use and greater alcohol use and consequences in college students. Future research examining event-level measurement of alcohol and marijuana co-use is important for the prevention of alcohol-related consequences. Read more.

 

Prescription Opioid Medication Misuse Among University Students

Prescription opioid misuse is an established problem in the United States. Less information is known regarding the clinical and cognitive characteristics of prescription opioid misusers, specifically in a college age population. This study sought to characterize individuals who misuse prescription opioids and the differences between current, past, and non‐misusers. This study found prescription opioid misusers to be more likely to live off campus, have a lower GPA, and exhibit increased impulsivity. Prescription opioid misusers were also more likely to report earlier age of sexual activity and were less likely to use barrier protection during sexual activity. This study identifies a number of risk factors for those misusing prescription opioids that can be used to develop and refine prescription opioid misuse screening tools for university health centers. It also identifies a number of concurring behaviors that can simultaneously be addressed when prescription opioid misusers are identified. Read more.

 

ADHD, Depression, and Substance Abuse Risk Among Beginning College Students

This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants included 1,748 students with and without history of ADHD. ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use, and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties. Read more.

 

Marijuana's Effects on Brain Structure and Function: What Do We Know and What Should We Do? A Brief Review and Commentary

The recent Federal Drug Administration approval of the marijuana constituent cannabidiol as safe and effective for treatment of two rare forms of epilepsy has raised hopes that others of the 500 chemicals in marijuana will be found to be therapeutic. However, the long-term consequences of street marijuana use are unclear and recent studies raise red flags about its effects. Changes in brain maturation and intellectual function including decreases in intelligence quotient have been noted in chronic users and appear permanent in early users in most but not all studies. These studies suggest that at a minimum, regular marijuana use should be discouraged in individuals under the age of 21. Read more.

 

Oregon Recreational Marijuana Legalization: Changes in Undergraduates’ Marijuana Use Rates From 2008 to 2016

There have been few studies of marijuana use before and after recreational marijuana legalization (RML) in affected states. Researchers tested whether marijuana use rates increased more among college students in Oregon than in non-RML states following Oregon RML in July 2015. Changes in marijuana use after RML did not differ significantly for participants under and over age 21 years. Some study limitations would be addressed with higher survey response rates, inclusion of other Oregon institutions, and controls for marijuana and other substance policies. Still, findings are consistent with an effect of RML on rates of marijuana use among young adult college students, which may have important public health implications. Read more.

 

Marijuana eCHECKUPTO GO: Effects of a Personalized Feedback Plus Protective Behavioral Strategies Intervention for Heavy Marijuana-Using College Students

Marijuana use is common among U.S. college students. Liberalization of marijuana use policies is hypothesized to decrease social norms discouraging use, which protects against marijuana use. This may increase the importance of protective behavioral strategies to reduce marijuana use harm. Results demonstrate preliminary support for the adapted Marijuana eCHECKUPTO GO in reducing marijuana use for “heavy college-aged users.” Future research should test adapted Marijuana eCHECKUPTO GO sustained effects over time, and examine whether program effects on harm reduction manifest after sustained (e.g., booster) program implementation. Read more.

 

Motives for and Impairment Associated With Alcohol and Marijuana Use Among College Students

Alcohol and marijuana use are prevalent on college campuses. As recreational marijuana use is legalized, more undergraduate students may use marijuana in combination with alcohol. The motives for, frequency of, and impairment associated with dual use (alcohol and marijuana) compared to alcohol-only use may differ. We examined motives for, frequency of, and impairment associated with alcohol use and dual use at a university in a state where recreational marijuana has been legalized.  Analyses indicated that among alcohol-only users, social motives predicted more alcohol use, while among dual users, enhancement motives predicted more alcohol and marijuana use and impairment. Coping motives predicted more marijuana use among dual users, but not more alcohol use. Frequency of alcohol and marijuana use predicted more impairment across both the alcohol-only and dual users.Future research should examine the influence of marijuana use over time to understand how motives may change for previous alcohol-only users. Read more.

 

Simultaneous Alcohol and Marijuana Use Among Underage Young Adults in the United States

The current study examines the prevalence, stability, and correlates of simultaneous alcohol and marijuana (SAM) use among underage US young adults, a population at high risk for participating in this behavior. SAM use among young adults aged 19/20 in the US is relatively common, but especially so for those who began such use by age 18, highlighting the early onset and stability of this behavior. Among underage drinkers, SAM risk varies by sex, race/ethnicity, college status, and living arrangements. Read more.

 

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Prescription Drug Use, Misuse and Related Substance Use Disorder Symptoms Vary by Educational Status and Attainment in US Adolescents and Young Adults

Prescription drug misuse (PDM) rates are highest in adolescents and young adults. Little research in these high-risk groups has examined PDM differences by educational status or attainment. This investigation attempted to further our understanding of adolescent and young adult prescription drug use and misuse through examining PDM type (i.e., nonmedical misuse, medical misuse, and mixed misuse) and substance use disorder (SUD) symptoms from PDM by educational status/attainment. In adolescents and across medication classes, the highest rates of any use, PDM, medical misuse, nonmedical misuse, and presence of two or more SUD symptoms were seen in those with poor school adjustment or not in school. In young adults, opioid-PDM and related outcomes were more prevalent in those not in school, especially high school dropouts. For stimulants, rates were highest in full-time college students and college graduates. Read more.

 

Prescription Drug Use, Misuse and Related Substance Use Disorder Symptoms Vary by Educational Status and Attainment in US Adolescents and Young Adults

Prescription drug misuse (PDM) rates are highest in adolescents and young adults. Little research in these high-risk groups has examined PDM differences by educational status or attainment. This investigation attempted to further our understanding of adolescent and young adult prescription drug use and misuse through examining PDM type (i.e., nonmedical misuse, medical misuse, and mixed misuse) and substance use disorder (SUD) symptoms from PDM by educational status/attainment. In adolescents and across medication classes, the highest rates of any use, PDM, medical misuse, nonmedical misuse, and presence of two or more SUD symptoms were seen in those with poor school adjustment or not in school. In young adults, opioid-PDM and related outcomes were more prevalent in those not in school, especially high school dropouts. For stimulants, rates were highest in full-time college students and college graduates. Read more.

 

A Mediated Multigroup Model Examining Marijuana Use Consequences by Sexual Orientation in US College Students

Marijuana use holds a curvilinear relation to sexual orientation, whereby bisexual individuals reporter higher frequency of use than exclusively hetero- or homosexual individuals. This relation differs by gender, with more pronounced differences among women. Bisexual individuals are at greater risk for negative consequences of marijuana use, such as dependence. To mitigate potential risks, individuals employ protective behavioral strategies (PBS). While differences in use are known, research has yet to examine if consequences and PBS use vary by sexual orientation. This study seeks to address the relations between sexual orientation, consequences, gender, and PBS. It was hypothesized that orientation would be associated with consequences, mediated by PBS, and these relations would vary by gender. Results indicated a curvilinear relation between sexual orientation and consequences among men, however not women. Moreover, PBS use mediated the relation between orientation and consequences among men, and negatively predicted consequences among women. Conclusions include that mixed sexual orientation men experience higher consequences through lower PBS use. For women, PBS use buffers against consequences. These findings reflect a general effectiveness of PBS use for mitigating negative marijuana-related consequences. The implications of these results are discussed. Read more.

 

Stimulant Use Among Undergraduate Nursing Students

Research reveals a decade-long increase in prescription drug misuse (PDM) of stimulant medication used to treat attention deficit hyperactivity disorder, and college students in particular are at the highest risk for these behaviors. However, PDM has not been specifically studied in undergraduate nursing students, and thus, this study fills a gap in our knowledge of PDM of stimulants. This descriptive study used a cross-sectional, convenience sample of undergraduate nursing students (N = 249) attending a large midwestern university. The study’s purpose was to examine the medical use, medical misuse, nonmedical use, and diversion of attention deficit hyperactivity disorder stimulant medications as well as to compare CRAFFT scores among these four groups of stimulant users. Results showed that 10.4 percent of respondents used prescription stimulants non-medically in the past 12 months, and over half (51.5 percent) of respondents screened positive on the CRAFFT, an indication of possible alcohol and drug misuse behaviors. In addition, there was a strong association between medical misuse and nonmedical use and positive CRAFFT scores. The high percentage of positive CRAFFT scores is a concern and indicates a pressing need for nursing faculty to evaluate and address substance use by nursing students. Read more.

 

Why Not Pot?: A Review of the Brain-Based Risks of Cannabis

In this review, researchers provide a historical perspective on marijuana, and survey contemporary research investigating its potential negative effects on the brain. The researchers discuss the evidence regarding cannabis dependence, driving under the influence of cannabis, underachievement, inducing (or worsening) certain psychiatric conditions, and the potential for progression to use of more dangerous drugs-summarized by the acronym DDUMB, a cognitive tool that may help healthcare providers in their risk/benefit discussions with patients who use cannabis. The researchers also review and discuss the impact of marijuana use on target populations, including adolescents (who are at increased risk of harm); heavy users; and people suffering from-or at high risk of-mental illness. While cannabis presents certain subjective, health-related, and pecuniary benefits to users, growers, and other entities, it is also associated with several brain-based risks. Understanding these risks aids clinicians and their patients in making informed and balanced decisions regarding the initiation or continuance of marijuana use. Read more.

 

Hookah Use Among College Students: Recent Use, Knowledge of Health Risks, Attitude, and Reasons for Use

Notwithstanding the efforts of health educators and other health professionals regarding tobacco and smoking cessation, research indicates that hookah smoking among college students remains a health concern. Research shows an upward trend in college students’ hookah use. The purpose of this study was to identify and describe potential patterns/differences in college students’ hookah use, and the relations among attitudes toward and knowledge about hookah use and use of this drug. Results indicated increased prevalence rates (53.8 percent) among participants of this study. Participants’ recent hookah use was consistent with that of current research. Study findings supports current research, which found that college students have low negative perceptions of the health risks (addictive and detrimental properties) of hookah use. Analyses also determined that college students’ attitudes toward hookah was associated with use of this drug. Regarding reasons why students may use hookah, data analysis indicated statistical significance in lifetime hookah use based on reasons for use. Study provide information for health educators creating hookah risk awareness educational programs aimed at reducing rates of hookah smoking among college students. Read more.

 

Reefer Madness or Much Ado About Nothing? Cannabis Legalization Outcomes Among Young Adults in the United States

In 2012, Colorado became one of the first two U.S. states to legalize cannabis for recreational use for adults 21 and older. Given that cannabis use holds potential physical and mental health risks, particularly among adolescent users, concerns have grown regarding changes in use following this change in policy. Based on past literature, two hypotheses were made for this study. First, college student cannabis use would increase after recreational legalization, however just for those 21 years old and older. Second, there would be a positive relation between the influence of cannabis legislation on out-of-state student’s decision to attend a Colorado university and their cannabis use. Data from 5,241 undergraduate students was available to test study hypotheses using Pearson’s Chi-square, negative binomial regressions, and path analysis. Results indicated that cannabis use increased since recreational legalization for all students, but more so for those over 21 years. No differences in past month use frequency were found between pre- and post-legalization. Influence of cannabis laws on non-resident student’s decision to attend a Colorado college predicted lifetime and past 30-day use. Additionally, out-of-state students reported higher past 30-day use than in-state students. These findings may help inform other states considering recreational legalization of potential outcomes, as well as potential interventions. Read more.

 

Poor Mental Health, Peer Drinking Norms, and Alcohol Risk in a Social Network of First-Year College Students

College students with anxiety and depressive symptomatology face escalated risk for alcohol-related negative consequences. While it is well-established that normative perceptions of proximal peers' drinking behaviors influence students' own drinking behaviors, it is not clear how mental health status affects this association. In the current study, researchers examined cross-sectional relationships between anxiety and depressed mood, perceived drinking behaviors and attitudes of important peers, and past month alcohol consumption and related problems in a first-semester college student social network. Read more.
 

 

How Collegiate Fraternity and Sorority Involvement Relates to Substance Use During Young Adulthood and Substance Use Disorders in Early Midlife: A National Longitudinal Study

This study’s purpose was to assess how social fraternity involvement (i.e., membership and residence) in college relates to substance use behaviors and substance use disorder symptoms during young adulthood and early midlife in a national sample. National longitudinal data confirm binge drinking and marijuana use are most prevalent among male fraternity residents relative to non-members and non-students. The increased risk of substance-related consequences associated with fraternity involvement was not developmentally limited to college and is associated with higher levels of long-term AUD symptoms during early midlife. Read more.

 

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Policy Implications and Research Recommendations: A Review of Hookah Use Among US College Students

The rate of hookah use among college students during the last decade is about 30 percent. Although college students perceive hookah use as a safer alternative to conventional cigarettes, hookah use increases the risk of disease and nicotine dependence, and therefore remains an area of concern. This review attempts to assess empirical literature relating to hookah use while focusing on the consequences for regulatory policy. College students who use hookah are generally not aware of the increased risks for tobacco-related diseases as it relates to their behavior. In addition, few public health messages target college-age adults with anti-hookah messages. A lack of information regarding the dangers and potential harms of hookah use may be misinterpreted as a sign of “safety” which inadvertently may imply a suggestion of no need for safety measures. Hence, a research agenda that would inform about health policy actions has been proposed. Read more.

 

College Party Culture and Sexual Assault

This paper considers the degree to which events that intensify partying increase sexual assault. Estimates are based on panel data from campus and local law enforcement agencies and an identification strategy that exploits plausibly random variation in the timing of Division 1 football games. The estimates indicate that these events increase daily reports of rape with 17-24 year old victims by 28 percent. The effects are driven largely by 17- to 24-year- old offenders and by offenders unknown to the victim, but the researchers also found significant effects on incidents involving offenders of other ages and on incidents involving offenders known to the victim. Read more.

 

Low Rates of Alcohol and Tobacco Use, Strong Cultural Ties for Native American College Students in the Southwest

College attendance is associated with an increased risk for substance use, yet we know little about substance use among Native American college students and its regional variation. This study examined alcohol, tobacco, and drug use and their relation to gender, institution, age, and cultural involvement among Native American college students in the Southwest. Read more.

 

How Collegiate Fraternity and Sorority Involvement Relates to Substance Use During Young Adulthood and Substance Use Disorders in Early Midlife: A National Longitudinal Study

The purpose of this research was to assess how social fraternity involvement (i.e., membership and residence) in college relates to substance use behaviors and substance use disorder symptoms during young adulthood and early midlife in a national sample. National longitudinal data confirm binge drinking and marijuana use are most prevalent among male fraternity residents relative to non-members and non-students. The increased risk of substance-related consequences associated with fraternity involvement was not developmentally limited to college and is associated with higher levels of long-term AUD symptoms during early midlife. Read more.

 

A Longitudinal Study of Risk Perceptions and E-Cigarette Initiation Among College Students: Interactions With Smoking Status

Recent data suggest that lower perceived risks of e-cigarettes are associated with e-cigarette use in young adults; however, the temporality of this relationship is not well-understood. The researchers explore how perceptions of harmfulness and addictiveness of e-cigarettes influence e-cigarette initiation, and specifically whether this association varies by cigarette smoking status, in a longitudinal study of tobacco use on college campuses. Read more.

 

Using Deviance Regulation Theory to Target Marijuana Use Intentions Among College Students

Several large epidemiological studies have shown increasing trends on a number of indices of marijuana use among college age samples. This may be due to changing attitudes about marijuana use linked to legalization efforts. Interventions that can target problematic use on a broad scale are lacking. Recent research has shown that deviance regulation theory (DRT) can be used to design effective Web-based substance use interventions. DRT relies on the interplay between perceived norms and an appropriately framed message about the given behavior. The current study examines the use of DRT to change marijuana use intentions. Participants completed measures of marijuana use and marijuana use norms. They were then assigned to receive a positively framed message about marijuana abstainers or a negatively framed message about marijuana users. Following the manipulation, participants rated intentions to use marijuana over the next three months. Consistent with DRT, there was an interaction between message frame and marijuana use norms. The positive frame attenuated the association between marijuana use norms and use intentions. A negative frame resulted in the lowest levels of use intentions among those with low use norms. Results suggest that DRT may be used to modify use intentions in college students, a population that has shown increasing rates of use. Read more.

 

Does Social Context Matter? An Ecological Momentary Assessment Study of Marijuana Use Among College Students

Past research has shown that marijuana use occurs commonly in social situations for young adults, though few studies have examined the association between immediate social context and marijuana use patterns and associated problems. The current study examined the impact of demographics, marijuana use and problem use, alcohol use, craving, and social context on the likelihood of using marijuana with others via ecological momentary assessment (EMA). Cannabis dependence, more time using marijuana in the moment, and using for social facilitation purposes were positively associated with using marijuana in the context of being with others. Daily users had more variability in terms of the social context of their use. This study illustrates the complex relationship between social context and marijuana use. Read more.

 

Drug Overdose Deaths in the United States, 1999–2016

This report uses the most recent data from the National Vital Statistics System (NVSS) to update trends in drug overdose deaths, describe demographic and geographic patterns, and identify shifts in the types of drugs involved. Read more.

 

Sports Involvement, Injury History, and Non-Medical Use of Prescription Opioids Among College Students: An Analysis With a National Sample

To more effectively deal with the devastating outcomes associated with non-medical use of prescription opioids (NUPO), research is needed to identify populations at increased risk. The current research builds on a small number of studies that have shown that adolescents involved in competitive sports are more likely to report NUPO. Specifically, we examine the relationship between athlete status, injury history, and NUPO among college students. Looking at factors individually, having an injury, being a varsity athlete, and being male were all significantly associated with NUPO. By combining these factors together we were able to determine that male athletes, athletes with injuries, and male athletes with injuries were at the greatest risk for NUPO, after controlling for relevant covariates. Read more.

 

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College Students' Perceived Benefit-to-Risk Tradeoffs for Nonmedical Use of Prescription Stimulants: Implications for Intervention Designs

Few studies have examined the benefit-to-risk tradeoffs undergraduate students perceive when engaging in the nonmedical use of prescription stimulants (NPS). This study examined the variation in college students' perceived risks and benefits for NPS. These findings identify subgroups of college NPS users that could have vastly different trajectories in terms of future drug use and college performance. Given this heterogeneity among students regarding perceived risks and benefits of NPS, interventions should be designed to assess motives and provide personalized feedback. Further research is needed with larger, more diverse samples and to assess the prospective stability of perceived risks and benefits. Read more.

 

Correlates of Cannabis Vape-Pen Use and Knowledge Among U.S. College Students

The proliferation of electronic devices, such as vape-pens, has provided alternative means for cannabis use. Research has found cannabis-vaping (i.e., vape-pen use) is associated with lower perceived risks and higher cannabis use. Knowledge of these products may increase likelihood of subsequent use. As policies for cannabis shift, beliefs that peers and family approve of this substance use increase and there has been an increase in vape-pen use among young adults (18–35 year olds); however, correlates thereof remain unknown. Young adults often engage in cross-substance use with cannabis and alcohol, making alcohol a potential correlate of cannabis vape-pen use and knowledge. Therefore, researchers examined alcohol use and other potential correlates of vape-pen use and knowledge among a sample of university students. Alcohol use was correlated with cannabis vape-pen use and knowledge. Frequency of cannabis use, peer injunctive norms, and positive expectancies were associated with increased likelihood of vape-pen use. Lack of premeditation, a facet of impulsivity, was associated with cannabis vape-pen knowledge. Given the unknown nature and consequences of cannabis vape-pens, the present findings offer valuable information on correlates of this behavior. Further, correlates of knowledge of vape-pens may point to areas for education and clinical intervention to prevent heavy cannabis vape-pen use. Read more.

 

Association Between Nonmedical Use of Prescription Drugs and Sleep Quality in a Large College Student Sample

Poor sleep and nonmedical use of prescription drugs (NMUPD) are both common among college students. Since lack of sleep adversely influences academic performance, this study examined the association between NMUPD and subjective sleep quality among college students. Any NMUPD, nonmedical use of stimulants specifically, and nonmedical use of painkillers specifically were associated with getting fewer days of Enough Sleep, more days of Early Awakening, Daytime Sleepiness, and Difficulty Falling Asleep. Nonmedical use of sedatives was significantly associated with Daytime Sleepiness, more days of Early Awakening, and Difficulty Falling Asleep. NMUPD is associated with poor sleep among college students. Therefore, behavioral medicine screening and treatment of this vulnerable population should consider sleep health, NMUPD, and the potential that these problems may be comorbid. Read more.

 

Marijuana Use and Associated Motives in Colorado University Students

Marijuana is the most commonly used illicit drug among college students, with heavy use leading to negative outcomes. Use of marijuana for medical and recreational purposes in select U.S. states has been controversial, with concerns surrounding increased prevalence rates and harm. The current exploratory study aimed to assess marijuana use in college students in Colorado, demographic differences in frequency of use, and motives for using. Prevalence rates of marijuana use were high in this sample of college students in a state with legal recreational marijuana use. Particular students (eg, students who use marijuana to cope) may be at higher risk for problem marijuana use. Developing effective, tailored interventions for university students is warranted. Read more.

 

Empirical Profiles of Alcohol and Marijuana Use, Drugged Driving, and Risk Perceptions

The present study sought to inform models of risk for drugged driving through empirically identifying patterns of marijuana use, alcohol use, and related driving behaviors. Findings suggest that college students’ perceived dangerousness of driving after using marijuana had greater influence on drugged driving behaviors than alcohol-related driving risk perceptions. These results support targeting marijuana-impaired driving risk perceptions in young adult intervention programs. Read more.

 

The Use of Substances Other Than Nicotine in Electronic Cigarettes Among College Students

Electronic cigarettes have grown in popularity, especially among youth and young adults. Although e-cigarettes were originally intended to vaporize a liquid mixture containing nicotine, there appears to be an increasing trend in other substance use in e-cigarettes (OSUE). Little is known regarding the health effects of cannabis and cannabis derivatives delivered through e-cigarettes. Concern may also be warranted regarding the potential dangers of this young population using substances more dangerous than cannabis in e-cigarettes. Knowledge is limited regarding the public health impact of vaping cannabis or other illicit substances among college student populations. This study stresses the need for continued research regarding the vaping of cannabis and other illicit substances among college students. Read more.

 

Nonmedical Use of Over-the-Counter Medications Is Significantly Associated With Nonmedical Use of Prescription Drugs Among University Students

This study’s objective was to examine the association between nonmedical use of over-the-counter medications (NMUOTC) and nonmedical use of prescription drugs (NMUPD).  The majority of respondents were women, undergraduate, Caucasian, and not affiliated with Greek life. NMUPD and NMUOTC were reported by 21.4 percent and 11.2 percent of students, respectively. Secondary analyses showed a relationship between over-the-counter (OTC) cough medication misuse and NMUPD, OTC stimulant misuse and prescription stimulant misuse, and OTC sleep aid misuse with prescription depressant misuse. Results suggest the importance of both measuring the prevalence of OTC misuse and incorporating its misuse into assessments of polydrug use in the university population. Read more.

 

A Culturally Sensitive Approach to Substance Use Counseling on Campus

This article presents an integrated approach for counselors providing substance use counseling to college students with sensitivity to the students' gender, culture, development, and readiness and motivation to change. Incorporating the use of relational–cultural therapy and motivational interviewing, the author organizes these complementary modalities along the Transtheoretical Model of behavior change and discusses practical implications for counselors to reduce harm in the context of the college environment. A case illustration is included. Read more.

 

The Case for Implementing the Levels of Prevention Model: Opiate Abuse on American College Campuses

Opiate abuse in the United States is on the rise among the college student population. This public health crisis requires immediate action from professionals and stakeholders who are committed to addressing the needs of prospective, current, and recovering opiate users using comprehensive prevention methods. Such approaches have been used to deliver primary, secondary, and tertiary intervention to alcohol and other drug users but are underutilized in the case of opiate abuse among college students in the United States. There is a definite need for involving college campus faculty, staff, students, and others in efforts to prevent opiate abuse at all levels. Our recommendations include specific strategies to address this imminent issue using an innovative application of the traditional Levels of Prevention Model. Read more.

 

Perceived Academic Benefit Is Associated With Nonmedical Prescription Stimulant Use Among College Students

College students are at higher than average risk for nonmedical use of prescription stimulants (NPS). A commonly identified motive among students who engage in NPS is to improve grades. Several research studies have observed that NPS most likely does not confer an academic advantage, and is associated with excessive drinking and other drug use. This study documents the proportion of the general college student population who believe that NPS will lead to improvements in academic performance. Read more.

 

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Academic Doping: Institutional Policies Regarding Nonmedical use of Prescription Stimulants in U.S. Higher Education

Academic integrity policies at 200 institutions of higher education (IHEs) were examined for the presence of academic prohibitions against the nonmedical use of prescription stimulants (NMUPS) or any other cognitive enhancing drug (CED). Researchers used online search tools to locate policy handbooks in a stratified random sample of IHEs drawn from the Integrated Postsecondary Education Data System database, searching for NMUPS/CED use as violations of either academic integrity or alcohol and other drug (AOD) policies. Of 191 academic integrity policies found online, NMUPS/CED prohibitions were present in only one. However, NMUPS was addressed in all but two of the 200 IHE AOD policies, often with language referencing IHE adherence to federal or state law. NMUPS/CED prohibitions are predominantly absent in IHE academic integrity policies, raising questions about whether colleges and universities are concerned about the use of enhancement drugs as a form of cheating. Implications for fairness, health promotion, and future research are discussed. Read more.

 

Drug-Free Schools and Communities Act Compliance at Michigan Community Colleges

This study analyzed public reports from Michigan community colleges to evaluate compliance with the Drug-Free Schools and Communities Act and to examine their alcohol and drug programs. The study’s author provides a rationale for why colleges should invest in improving compliance and the quality of alcohol and drug programs, and offers seven recommendations to community college administrators on how to do so. Read more.

 

University Student Perceptions About the Motives For and Consequences of Non-Medical Use of Prescription Drugs

The current study’s purpose was to increase qualitative understanding of student motives for and consequences associated with nonmedical use of prescription drugs. Qualitative findings extend previous research by suggesting differences in students' perceived motives for using and consequences associated with the different classes of prescription drugs. These findings provide implications for development of preventive interventions. Read more.

 

Freshman Year Alcohol and Marijuana Use Prospectively Predict Time to College Graduation and Subsequent Adult Roles and Independence

This study examined how freshman year substance use prospectively predicted time to college graduation, and whether delayed graduation predicted postponed adoption of adult roles and future substance use. Results indicated that frequent binge drinking and marijuana use during freshman year predicted delayed college graduation. Those who took longer to graduate were more likely to have lower incomes and were less likely to obtain a graduate degree. Taking 5-6 years to graduate was associated with greater likelihood of alcohol-related problems. Read more.

 

Mobile Health Interventions Helped Young Adults Reduce Alcohol Use

Young adults who received educational information via mobile technologies successfully reduced heavy drinking days, decreased risky single-occasion drinking and increased the percentage of days avoiding alcohol, according to an AHRQ-funded literature review. The use of mobile phones and other wireless technologies in health care – known as mHealth – is a strategy for engaging young adults who may not be reached by in-person interventions. The review examined 12 research articles, most of which focused on adults between the ages of 18 and 25. Researchers analyzed the use of mHealth apps that included motivational and educational materials, support tools and instruments to track alcohol use. Eleven studies indicated mHealth interventions are most useful when apps maintain regular contact, do not require the participant to initiate contact, vary messages and provide feedback. The study was published in the May issue of Journal of Health Communication. Read more.

 

Longitudinal Influence of Alcohol and Marijuana Use on Academic Performance in College Students

Alcohol and marijuana are the two most abused substances in U.S. colleges. However, research on the combined influence (cross sectional or longitudinal) of these substances on academic performance is currently scant. This study validates and extends the current literature by providing important implications of concurrent alcohol and marijuana use on academic achievement in college. Read more.

 

Alcohol-Related Blackouts, Negative Alcohol-Related Consequences, and Motivations for Drinking Reported by Newly Matriculating Transgender College Students

Many transgender college students struggle with identity formation and other emotional, social, and developmental challenges associated with emerging adulthood. A potential maladaptive coping strategy employed by such students is heavy drinking. Prior literature has suggested greater consumption and negative alcohol-related consequences (ARCs) in transgender students compared with their cisgender peers, but little is known about their differing experiences with alcohol-related blackouts (ARBs). This study examined the level of alcohol consumption, frequency of ARBs and other ARCs, and motivations for drinking reported by the largest sample of transgender college students to date. Read more.

 

The Influence of College Attendance on Risk for Marijuana Initiation in the United States: 1977 to 2015

This study examines a potential increase in marijuana initiation among U.S. college students as compared with their age peers not in college before and after 2013, a watershed year for increasing tolerance of marijuana use in the United States. Read more.

 

Marijuana and College Students: A Critical Review of the Literature

The purpose of this study was to evaluate existing literature on the associated effects of marijuana use on U.S. college students’ academic success, including conduct/legal issues, negative outcomes, normative perceptions, and physical/mental health. Read more.

 

Magnitude and Trends in Heavy Episodic Drinking, Alcohol-Impaired Driving, and Alcohol-Related Mortality and Overdose Hospitalizations Among Emerging Adults of College Ages 18–24 in the United States, 1998–2014

This article estimates percentages of U.S. emerging adults ages 18-24 engaging in past-month heavy episodic drinking and past-year alcohol-impaired driving, and numbers experiencing alcohol-related unintentional injury deaths and overdose hospitalizations between 1998 and 2014. Read more.

 

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