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Romm KF, Dearfield CT, Berg CJ. Longitudinal patterns of alcohol and cannabis use among US young adults: Correlates and implications for problematic health outcomes. Addict Behav 2024; 158:108123. [PMID: 39127025 DOI: 10.1016/j.addbeh.2024.108123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 06/25/2024] [Accepted: 07/28/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION Alcohol and cannabis use are common during young adulthood. Less is known regarding correlates of alcohol-cannabis use patterns and related problematic health outcomes. METHODS Using longitudinal survey data (Fall 2018, 2019, 2020) from 2,194 young adults (YAs; ages 18-34), bivariate analyses and multivariable logistic regressions examined: (1) Wave 1 (W1) sociodemographics and psychosocial factors (i.e., adverse childhood experiences [ACEs], depressive symptoms, personality traits, parent and peer alcohol and cannabis use) in relation to W3 past-month use group (i.e., use of neither, alcohol only, cannabis only, both/co-use); and (2) W3 use group in relation to W5 problematic alcohol use (Alcohol Use Disorder Identification Test), problematic cannabis use (Cannabis Use Disorder Identification Test), and depressive/anxiety symptoms (Patient Health Questionnaire - 4 item). RESULTS Overall, 42.3% reported W3 alcohol-only use, 34.9% co-use, 17.8% no use, and 5.0% cannabis-only use. Those reporting W3 co-use reported greater W1 extraversion, openness, friend alcohol/cannabis use, and were more likely to report parent cannabis use (vs. no use); reported less conscientiousness, greater friend cannabis use, and were more likely to report depressive symptoms and parent cannabis use (vs. alcohol-only use); and reported greater friend alcohol use, and were more likely to report parent alcohol use (vs. cannabis-only use). W3 co-use was associated with higher odds of W5 problematic alcohol use (vs. alcohol-only use) and problematic cannabis use (vs. cannabis-only use). CONCLUSIONS Substance use messaging and interventions should consider YAs' alcohol-cannabis co-use and the unique correlates of such use.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA.
| | - Craig T Dearfield
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
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Volkow ND, Compton WM, Blanco C, Einstein EB, Han B. Associations of cannabis use, use frequency, and cannabis use disorder with violent behavior among young adults in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 128:104431. [PMID: 38677161 PMCID: PMC11213661 DOI: 10.1016/j.drugpo.2024.104431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Most violent crimes (52 %) are committed by adults aged 18-34, who account for 23 % of the US population and have the highest prevalence of cannabis use and cannabis use disorder (CUD). We examined whether and how associations of cannabis use, use frequency, and CUD with violent behavior (i.e., attacking someone with the intent to harm seriously) vary by sex in U.S. young adults. METHODS Data were from 113,454 participants aged 18-34 in the 2015-2019 US National Surveys on Drug Use and Health, providing nationally representative data on cannabis use, CUD (using DSM-IV criteria), and violent behavior. Descriptive analyses and bivariate and multivariable logistic regression analyses were conducted. RESULTS Among U.S. adults aged 18-34, 28.9 % (95 % CI = 28.5-29.2 %) reported past-year cannabis use (with/without CUD), including 20.5 % (95 % CI = 20.2-20.8 %) with non-daily cannabis without CUD, 4.7 % (95 % CI = 4.5-4.8 %) with daily cannabis use without CUD, 2.1 % (95 % CI = 1.9-2.2 %) with non-daily cannabis use and CUD, and 1.7 % (95 % CI = 1.5-1.8 %) with daily cannabis use and CUD. Past-year adjusted prevalence of violent behavior was higher among males with daily cannabis use but without CUD (2.9 %, 95 % CI = 2.4-2.7 %; adjusted prevalence ratio (PR) = 1.7, 95 % CI = 1.3-2.2) and males with daily cannabis use and CUD (3.1 %, 95 % CI = 2.3-4.0 %; adjusted PR = 1.8, 95 % CI = 1.3-2.4) than males without past-year cannabis use (1.7 %, 95 % CI = 1.6-1.9 %). Adjusted prevalence of violent behavior was higher among females with cannabis use regardless of daily cannabis use/CUD status (adjusted prevalence = 1.6-2.4 %, 95 % CIs = 0.9-3.2 %; adjusted PRs = 1.6-2.4, 95 % CI = 1.3-3.2) than females without past-year cannabis use (1.0 %, 95 % CI = 0.9-1.1 %). CONCLUSIONS Research is needed to ascertain the directionality of the associations between cannabis use and violent behavior and underlying sex-specific mechanism(s). Our results point to complex sex-specific relationships between cannabis use frequency, CUD, and violent behavior and highlight the importance of early screening for and treatment of CUD and of preventive interventions addressing cannabis misuse.
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Affiliation(s)
- Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Emily B Einstein
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
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Guo Y, Dai CL, Ward RM, Mason WA. The Interaction of Cannabis Consumption with Heavy Episodic Drinking and Alcohol-induced Blackouts in Relation to Cannabis Use Consequences Among Recent Undergraduate College Cannabis Users. CANNABIS (ALBUQUERQUE, N.M.) 2024; 6:23-32. [PMID: 38883276 PMCID: PMC11178058 DOI: 10.26828/cannabis/2023/000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Introduction Risky alcohol use patterns, characterized by heavy episodic drinking (HED) and alcohol-induced blackout, are prevalent in college students. However, it is not clear if experiencing HED and blackout among college-attending cannabis users heightens risk for adverse cannabis use consequences. The purpose of this study was to examine whether heavy episodic drinking and blackout episodes moderate the relationship between cannabis consumption and cannabis use consequences among college students. Methods Undergraduate college students (n = 4331) were recruited from a Midwest University in 2021. This analysis used a subset of data from past 6-month cannabis users (n= 772; 17.8% of the full sample). Among cannabis users, 64.5% identified as female and 87.8% were White with an average age of 19.99 (SD=2.88). A linear regression was conducted with two two-way interactions of cannabis consumption and HED frequency as well as cannabis consumption and alcohol-induced blackout episodes. Results Results showed a statistically significant positive association between cannabis consumption and cannabis use consequences (B=0.73, p<.001), adjusting for the other variables in the model. Blackout, but not HED, was a significant moderator (B=0.19, p=.003). Discussion The findings of this study indicate that blackout experiences amplify the relationship between cannabis use and cannabis-related consequences among college students. This underscores that blackouts not only signal a risk of problematic drinking but also exacerbate the association between cannabis use and its negative consequences. Conclusion Findings may inform college campus interventions targeting cannabis and alcohol concurrent-users who experience alcohol-induced blackouts to reduce their additional risk for cannabis-related consequences.
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Shipley JL, Braitman AL. Assessment of simultaneous alcohol and cannabis use and its related consequences and cognitions in college students: A narrative review. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:230-240. [PMID: 38212143 DOI: 10.1111/acer.15258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024]
Abstract
As rates of students using cannabis continue to rise, simultaneous use of alcohol and cannabis (such that their effects overlap; commonly referred to as simultaneous alcohol and marijuana [SAM] use) is prevalent among college students who use both substances. Although research focusing on SAM use and related cognitions and consequences continues to grow, there are no common established measures, as approaches vary across studies. This narrative review identifies current methods for assessing SAM use and measures of SAM-related consequences and cognitions (motives and expectancies) among college students, evaluates how they were developed, identifies gaps in the literature, and provides recommendations for future directions of assessment. We conclude that the assessment of SAM use is limited by difficulties in the assessment of cannabis quantity and potency. However, and the lack of a psychometrically validated measure of SAM consequences. However, measures of SAM motives and expectancies have been published with support from psychometric examinations such as exploratory factor analysis, confirmatory factor analysis, and measurement invariance. Research is needed that incorporates qualitative approaches in the development of SAM use measures so that unique items specific to SAM use rather than single-substance use can be identified. Additionally, validation of these measures is needed across different samples that vary demographically, such as by race and gender or sex. Future research should consider the development of a measure of protective behavioral strategies specific to SAM use to inform interventions that target the reduction of negative consequences of SAM use.
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Affiliation(s)
- Jennifer L Shipley
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Abby L Braitman
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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Buckner JD, Zvolensky MJ, Scherzer CR. Alcohol and cannabis dual use among Black adults: Associations with alcohol use, use-related problems, and race-based discrimination. Am J Addict 2024; 33:65-70. [PMID: 37689991 PMCID: PMC10846665 DOI: 10.1111/ajad.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Black adults who drink alcohol appear at risk for poor alcohol-related outcomes, yet little research has examined whether cannabis use among those who consume alcohol (alcohol-cannabis dual use) is related to worse alcohol-related consequences, as observed in predominantly White samples. Further, it may be that experiencing more race-based discrimination may be related to using multiple substances to cope with such experiences; however, no known studies have examined the impact of race-based discrimination on alcohol-cannabis dual use. METHODS Participants were 270 Black undergraduates who endorsed past-month drinking, 112 of whom endorsed alcohol-cannabis dual use. RESULTS The dual use group reported heavier drinking, more drinking-related problems, and more race-based microaggressions (but not overt racism) than the alcohol-only group. CONCLUSIONS The use of cannabis among Black young adults who drink alcohol was related to heavier drinking and more alcohol-related problems. Further, experiencing more microaggressions may place these individuals at risk for using multiple substances, presumably to cope with these experiences. SCIENTIFIC SIGNIFICANCE Considering models suggesting that the dual use of cannabis may result in less alcohol use, the current study highlights that for Black adults who consume alcohol, cannabis dual use is related to heavier drinking and more alcohol-related problems, which can inform intervention and treatment efforts.
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Affiliation(s)
- Julia D. Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- HEALTH Institute, University of Houston, Houston, TX, United States
| | - Caroline R. Scherzer
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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Morrison M, Hai AH, Bandaru YS, Salas-Wright CP, Vaughn MG. Opioid Misuse and Associated Health Risks among Adults on Probation and Parole: Prevalence and Correlates 2015-2020. Subst Use Misuse 2023; 59:20-28. [PMID: 37735916 PMCID: PMC10754470 DOI: 10.1080/10826084.2023.2257319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
BACKGROUND As state legislatures work to reduce prison populations and increase the use of community-based alternatives, limited knowledge exists about the service needs of those under criminal justice supervision in the community. Preliminary research indicates unusually high rates of disease, disability, and death. Health risks for this population include opioid misuse, a form of substance misuse that has reached epidemic proportions in the U.S. Evidence indicates this may be one of multiple epidemics this population experiences, complicating intervention. METHODS Our study included 5154 individuals on probation or parole. Using 2015-2020 data from the National Survey of Drug Use and Health (NSDUH), we conducted a series of logistic regressions examining associations between opioid misuse and a range of health risks, controlling for sociodemographic variables and survey year. RESULTS Approximately 17% of those on probation or parole indicated past-year opioid misuse, a rate 4 times higher than in the general population. Compared to those on probation and parole who did not misuse opioids, it was associated with higher odds of other health risk behaviors and mental health problems. For example, the odds of marijuana and cocaine use were 4-6 times higher and the odds of substance use disorder were 10 times higher. Similarly, the odds of experiencing major depressive episodes and serious psychological distress were 2-3 times higher. CONCLUSIONS Our findings reveal a markedly high risk for opioid misuse within this population along with associated risks for behavioral and mental health problems. The complex treatment needs of this population require greater policy attention and further research.
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Affiliation(s)
- Maria Morrison
- Saint Louis University, 1 North Grand Boulevard, St. Louis, MO 63103, U.S
| | - Audrey Hang Hai
- Tulane University, 127 Elk Place, New Orleans, LA 70112, U.S
| | | | | | - Michael G. Vaughn
- Saint Louis University, 1 North Grand Boulevard, St. Louis, MO 63103, U.S
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Strzelecki AM, Gipson CD, Childs E, Weafer J. Preliminary evidence of increased alcohol use associated with ethinyl estradiol levels in women using oral contraceptives. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100194. [PMID: 37954868 PMCID: PMC10632661 DOI: 10.1016/j.dadr.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
Alcohol use is highly prevalent in young adult women and rates of alcohol use disorder are rising rapidly in this population. Further, emerging evidence suggests that circulating levels of ovarian hormones influence alcohol consumption, with increased consumption associated with higher estradiol and lower progesterone levels. However, less is known about the influence of synthetic hormones (contained in oral contraceptive (OC) pills) on alcohol use. The current study examined the influence of OC pill phase, ethinyl estradiol (EE) levels, and progestin levels on self-reported alcohol consumption in healthy female drinkers. Young adult female drinkers using OCs (N = 21) reported alcohol use across one OC pill pack using the Timeline Followback and provided blood samples during both pill phases to measure synthetic hormone levels. We compared alcohol use between OC pill phases (active vs. inactive) using linear mixed effects models for repeated measures and examined correlations between alcohol use and EE and progestin levels. Results showed that women with higher EE levels reported increased alcohol consumption (r = 0.56, p = 0.01) and binge drinking (r = 0.45, p = 0.04) in the active pill phase. Progestin levels and pill phase were not significantly associated with alcohol consumption. These findings provide preliminary data suggesting increased levels of EE from OC pills are associated with excessive alcohol consumption in women. Further research is needed to determine if EE plays a causal role in increased alcohol consumption. This line of research could inform female-specific AUD prevention and treatment strategies among the large subpopulation of women using hormonal contraceptives.
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Affiliation(s)
| | - Cassandra D. Gipson
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Emma Childs
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Jessica Weafer
- Department of Psychology, University of Kentucky, Lexington, KY, United States
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, United States
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Salas-Wright CP, Hai AH, Vaughn MG, Hodges JC, Goings TC. Driving under the influence of cannabis and alcohol: Evidence from a national sample of young drivers. Addict Behav 2023; 147:107816. [PMID: 37572491 PMCID: PMC10529886 DOI: 10.1016/j.addbeh.2023.107816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/27/2023] [Accepted: 07/26/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE Driving under the influence (DUI) of psychoactive substances is an important public health and criminal justice issue, impacting the lives of millions of Americans. Although recent research provides up-to-date information regarding DUI among adults, there is a pressing need for research that focuses specifically on younger/underage drivers. We draw from a large, nationally-representative sample to provide up-to-date evidence as to the prevalence and key criminal justice, substance use, and behavioral health correlates of DUI of cannabis and alcohol among drivers ages 16 to 20 in the United States. METHODS We used data from the 2020 and 2021 National Survey on Drug Use and Health (young drivers ages 16-20; N=12,863). All analyses-survey adjusted prevalence estimates, logistic regression-were conducted using Stata SE 17.0 and weighted to account for the study's stratified cluster sampling design. RESULTS The prevalence of DUI-cannabis for the full sample-including those not endorsing past-year use-was 6.3%. Among youth endorsing past-year cannabis use, 24.5% reported DUI of cannabis. In the full sample and among cannabis users, DUI-cannabis risk was elevated among older and male youth. The prevalence of DUI-alcohol was 2.6% among all youth and 6.1% among youth reporting past-year alcohol consumption. CONCLUSIONS Estimates indicate that more than one million young drivers each year are placing their lives and those of others at risk by operating motor vehicles after consuming cannabis and/or alcohol. Findings underscore the importance of prevention efforts targeting underaged cannabis and alcohol-impaired driving.
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Affiliation(s)
| | - Audrey Hang Hai
- School of Social Work, Tulane University, New Orleans, LA, United States
| | - Michael G Vaughn
- School of Social Work, Saint Louis University, St. Louis, MO, United States
| | - James C Hodges
- School of Social Work, Boston College, Chestnut Hill, MA, United States
| | - Trenette Clark Goings
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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