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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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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-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.
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 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.
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.
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.
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.
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.
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.
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 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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Despite gaining admission to college, many students with attention-deficit/
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 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,
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.
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.
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.
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.
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.
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 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.
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.
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.
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 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.
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.
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.
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 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.
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.
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.
Under National Collegiate Athletic Association (NCAA) rules, all Division I and II student-athletes are subject to year-round drug testing. In addition to these NCAA-mandated tests, the NCAA encourages each member school to establish its own drug testing policy. Drug testing has been studied frequently, often from the legal, athlete motivation, or economic perspectives. Yet, on the collegiate level, it is unclear the extent to which drug testing policies vary across institutions and divisions. Therefore, the purpose of this study was to compare the drug testing policies of high- and low-performing athletic programs to determine whether student-athletes competing on successful teams in revenue-generating sports are held to different standards than those participating on less successful athletic teams. Drug testing policies were collected from “high-performing” Division I and II athletic programs (i.e., those ranked in the top 25 in football, men’s basketball, or women’s basketball between 2012–2017); these policies were compared with those of “low-performing” athletic programs (i.e., those ranked in the bottom 50 of the Directors’ Cup between 2012–2017). The results indicate several contrasts between high- and low-performing athletic departments in how they penalize athletes for positive drug penalties, particularly at the Division I level. Read more.
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.
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.
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.
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.
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.
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.
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.
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.
This study aimed to explore the relationship between substance use and abuse, delinquency, and risky sexual behaviors among college students at a Historically Black University (HBCU). This study recruited a total of 150 participants ages 18-24 from a Historical Black College in the Mid-Atlantic. This study implemented a cross-sectional and quantitative design utilizing survey research to assess relationships between the independent variables under investigation. Results revealed that there was a significant positive relationship between substance use, dependency, and delinquency. Results also revealed there was a significant positive relationship between risky sexual behavior and delinquency and between substance use/dependency and risky sexual behavior. Given the increase in opioid use among this population there is a need for further research. Read more.
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.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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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