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Rhew IC, Gilson MS, Fleming CB, Walukevich-Dienst K, Guttmannova K, Patrick ME, Lee CM. Is the 21st birthday a turning point for alcohol and cannabis use? A monthly study of young adults. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:955-966. [PMID: 38558408 PMCID: PMC11260108 DOI: 10.1111/acer.15307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/04/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND An important life-course event with respect to alcohol and cannabis use is turning 21 years of age, which may be associated with increases in use of these substances due to celebrations during the month and easier access to them on and following this birthday. We examined the trajectories of alcohol and cannabis use behaviors in the months leading up to, during, and following the 21st birthday month. We also examined whether the use trajectories vary by college status and baseline levels of use. METHODS We used data from 203 young adults recruited from the Greater Seattle region who turned 21 during the course of the study. Surveys were administered each month for 24 consecutive months. Measures included the typical number of drinks per week for the past month, the frequency of heavy episodic drinking, the number of cannabis use days, and any simultaneous alcohol and cannabis use. Multilevel spline models were run that estimated linear slopes over time at four intervals: (1) up to 1 month before the 21st birthday month; (2) from 1 month before to the month of the 21st birthday; (3) from the 21st birthday month to 1 month following; and (4) from 1 month following the 21st birthday month through all following months. RESULTS Alcohol use, generally, and simultaneous alcohol and cannabis use showed sharp increases from the month before the 21st birthday month to the 21st birthday month and decreases following the 21st birthday month. For cannabis use, there were significant increases in the months leading up to the 21st birthday and no other significant changes during other time intervals. Patterns differed by baseline substance use and college status. CONCLUSIONS Findings from the current study have implications for the timing and personalization of prevention and intervention efforts. Event-specific 21st birthday interventions may benefit from incorporating content targeting specific hazardous drinking behaviors in the month prior to the 21st birthday.
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Affiliation(s)
- Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Michael S. Gilson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Charles B. Fleming
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | | | - Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Christine M. Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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2
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Hall W, Stjepanović D, Dawson D, Leung J. The implementation and public health impacts of cannabis legalization in Canada: a systematic review. Addiction 2023; 118:2062-2072. [PMID: 37380613 PMCID: PMC10953418 DOI: 10.1111/add.16274] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/15/2023] [Indexed: 06/30/2023]
Abstract
AIMS We provide a narrative summary of research on changes in cannabis arrests, cannabis products and prices, cannabis use and cannabis-related harm since legalization. METHODS We systematically searched for research on the impacts of cannabis legalization in Canada in PubMed, Embase, Statistics Canada and government websites and Google Scholar, published between 2006 and 2021. RESULTS Cannabis legalization in Canada has been followed by substantial reductions in cannabis-related arrests and cannabis prices. It has also increased adults' access to a diverse range of cannabis products, including edibles and extracts. The prevalence of cannabis use among young adults has increased, but there have been no marked increases or decreases in use among high school students or changes in the prevalence of daily or near-daily use. Legalization has been associated with increased adult hospital attendances for psychiatric distress and vomiting, unintentional ingestion of edible cannabis products by children and hospitalizations for cannabis use disorders in adults. There is conflicting evidence on whether cannabis-impaired driving has increased since legalization. There is suggestive evidence that presentations to emergency departments with psychoses and cannabis use disorders may have increased since legalization. CONCLUSIONS Legalization of cannabis in Canada appears to have reduced cannabis arrests and increased access to a variety of more potent cannabis products at lower prices. Since 2019, recent cannabis use in Canada has modestly increased among adults but not among adolescents. There is evidence of increased acute adverse effects of cannabis among adults and children.
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Affiliation(s)
- Wayne Hall
- National Centre for Youth Substance Use ResearchThe University of QueenslandBrisbaneAustralia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use ResearchThe University of QueenslandBrisbaneAustralia
| | - Danielle Dawson
- National Centre for Youth Substance Use ResearchThe University of QueenslandBrisbaneAustralia
| | - Janni Leung
- National Centre for Youth Substance Use ResearchThe University of QueenslandBrisbaneAustralia
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3
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Boyle HK, Singh S, López G, Carey KB, Jackson KM, Merrill JE. A qualitative examination of positive and negative consequences young adults experience from simultaneous alcohol and cannabis use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:639-650. [PMID: 36301269 PMCID: PMC10133411 DOI: 10.1037/adb0000886] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Alcohol and cannabis are two of the most commonly used substances among young adults, and most individuals who use both substances use them simultaneously, that is, on the same occasion such that their effects overlap. Given the high prevalence of simultaneous alcohol and cannabis use, it is important to understand the relationship between simultaneous use and consequences. This study presents a qualitative examination of positive and negative consequences of simultaneous use. METHOD We conducted individual interviews among 36 young adults who engage in simultaneous use (23 women, 12 men, 1 trans man). Interviews included open-ended questions examining negative and positive consequences of simultaneous use and how simultaneous use differed from single substance use (alcohol only use, cannabis only use). Interviews were analyzed using applied thematic analysis. RESULTS Young adults reported numerous negative and positive consequences of simultaneous use, many overlapping with single substance use. Yet, they also reported unique combinations of positive consequences not experienced by single substance use. Young adults discussed patterns of use that were sometimes approached intentionally (e.g., quantity of substances used, order) that influenced consequences. CONCLUSIONS Together these findings provide further insight into young adults' simultaneous use experiences. Next steps should include quantitative exploratory research to identify and determine the frequency of specific consequences experienced during simultaneous use and examine the relationship between simultaneous use consequences and particular patterns of use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Holly K Boyle
- Center for Alcohol and Addiction Studies, Brown University
| | - Samyukta Singh
- Center for Alcohol and Addiction Studies, Brown University
| | - Gabriela López
- Center for Alcohol and Addiction Studies, Brown University
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University
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Hai AH, Carey KB, Vaughn MG, Lee CS, Franklin C, Salas-Wright CP. Simultaneous alcohol and marijuana use among college students in the United States, 2006-2019. Addict Behav Rep 2022; 16:100452. [PMID: 36106094 PMCID: PMC9465098 DOI: 10.1016/j.abrep.2022.100452] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/23/2022] [Accepted: 08/28/2022] [Indexed: 11/28/2022] Open
Abstract
US college students’ simultaneous alcohol and marijuana (SAM) use rate was rising. There was an upward trend of SAM use among Black college students (2006–2019). Hispanic and Asian American/Pacific Islander students’ trend remained stable.
Objective Simultaneous alcohol and marijuana (SAM) use exposes college students to a myriad of adverse consequences. However, there is no recent nationally representative study on SAM use among college students in the United States (US). To provide an update to the literature, the present study aimed to examine the trends, prevalence, and correlates of SAM use among US college students between 2006 and 2019, using nationally representative data. Method We used data from the 2006–2019 National Survey on Drug Use and Health (NSDUH) and the analytic sample was limited to the 55,669 full-time college student respondents (ages 18–22). Using logistic regression analysis, we assessed trends in SAM use prevalence and examined sociodemographic and psycho-social-behavioral correlates of SAM use. Results The proportion of US college students who reported SAM use increased significantly from 8.13% (2006–2010) to 8.44% (2015–2019). However, examination by race/ethnicity revealed that the increasing trend was largely driven by Black college students, whose SAM use prevalence increased significantly from 5.50% (2006–2010) to 9.30% (2015–2019), reflecting a 69.09% increase. SAM use rates did not change significantly among other racial/ethnic groups. Conclusions This study uncovered an upward trend and prevalence of SAM use among US college students, calling for more research and public health interventions in this area. At-risk subgroups that warrant more attention include college students who are Black, female, above the legal drinking age, have a lower than $20,000 household income, and reside in small metropolitan areas.
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Affiliation(s)
- Audrey Hang Hai
- School of Social Work, Tulane University, 127 Elk Place, New Orleans, LA 70112, USA
- Corresponding author at: Tulane University School of Social Work, New Orleans, LA, USA.
| | - Kate B. Carey
- Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Providence, RI 02903, USA
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, 121 South Main Street, Providence, RI 02903, USA
| | - Michael G. Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, 1 N. Grand Blvd., St. Louis, MO 63103, USA
- Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Christina S. Lee
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, 264 Bay State Rd, Boston, MA 02215, USA
| | - Cynthia Franklin
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, USA
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5
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Terry-McElrath YM, Patrick ME, O'Malley PM, Johnston LD. Self-reported perceived negative consequences of marijuana use among U.S. young adult users, 2008-2019. Addict Behav 2022; 124:107098. [PMID: 34521066 PMCID: PMC8562780 DOI: 10.1016/j.addbeh.2021.107098] [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: 04/05/2021] [Revised: 08/02/2021] [Accepted: 08/23/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE This study estimated self-reported perceived negative marijuana use consequences among a national sample of U.S. young adults, examining consequence prevalence differences by use frequency, college attendance, living situation, employment, sex, and race/ethnicity; and use frequency/sociodemographic characteristic interactions. METHODS A subsample of 1,212 respondents from the 2004-2018 class cohorts of 12th grade students participating in the nationally-representative Monitoring the Future study was surveyed up to two times from modal ages 19 through 22 (in 2008-2019). Respondents self-reported negative consequences related to their own past 12-month marijuana use. Bivariate and multivariable models examined subgroup differences in consequence prevalence. RESULTS Approximately 60% of those using frequently (20+ use occasions in the past 30 days) and 35% of those using non-frequently reported negative consequences. Among all young adult marijuana users, 31.1% reported emotional/physical consequences, 12.9% performance/financial consequences, and 12.3% relational consequences. Use frequency was positively associated with consequence likelihood, excluding regret and unsafe driving. Among college students, frequent use was more strongly associated with any and performance/financial consequences. Controlling for use frequency, men reported more performance/financial consequences; relational consequences were higher among Hispanic (vs. White) respondents, and those living with parents, employed full-time, and not attending 4-year colleges. CONCLUSION Young adults using marijuana reported a wide range of negative use consequences; likelihood of most consequences increased with higher use frequency. Perceived consequences varied by college attendance, living situation, employment, sex, and race/ethnicity. Efforts to reduce negative marijuana consequences may be strengthened by recognizing and addressing the different types of negative consequences users perceive.
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Affiliation(s)
- Yvonne M Terry-McElrath
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106, USA.
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106, USA.
| | - Patrick M O'Malley
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106, USA.
| | - Lloyd D Johnston
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106, USA.
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Castillo-Carniglia A, Rivera-Aguirre A, Calvo E, Queirolo R, Keyes KM, Cerdá M. Trends in marijuana use in two Latin American countries: an age, period and cohort study. Addiction 2020; 115:2089-2097. [PMID: 32196789 PMCID: PMC7502472 DOI: 10.1111/add.15058] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/09/2019] [Accepted: 03/16/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Uruguay and Chile have the highest levels of marijuana use in Latin America, and have experienced consistent increases during the last two decades. We aim to calculate separate age-period-cohort (APC) effects for past-year marijuana use in Uruguay and Chile, which have similar epidemiologica, and demographic profiles but diverging paths in cannabis regulation. DESIGN APC study in which period and cohort effects were estimated as first derivative deviations from their linear age trend, separately by country and gender. SETTING Uruguay and Chile. PARTICIPANTS General population between 15 and 64 years. MEASUREMENTS Past-year marijuana use from household surveys with five repeated cross-sections between 2001 and 2018 in Uruguay (median n = 4616) and 13 between 1994 and 2018 in Chile (median n = 15 895). FINDINGS Marijuana use prevalence in both countries peaked at 20-24 years of age and increased consistently across calendar years. Period effects were strong and positive, indicating that increases in use were evident across age groups. Relative to 2006 (reference year), Chilean period effects were approximately 48% lower in 1994 and approximately four times higher in 2018; in Uruguay, these effects were approximately 56% lower in 2001 and almost quadrupled in 2018. We observed non-linear cohort effects in Chile and similar patterns in Uruguay for the overall sample and women. In both countries, marijuana use increased for cohorts born between the mid-1970s and early 1990s, even in the context of rising period effects. Prevalence was consistently larger for men, but period increases were stronger in women. CONCLUSIONS Age-period-cohort effects on past-year marijuana use appear to have been similar in Chile and Uruguay, decreasing with age and increasing over time at heterogeneous growth rates depending on gender and cohort. Current levels of marijuana use, including age and gender disparities, seem to be associated with recent common historical events in these two countries.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Santiago, Chile,School of Public Health, Universidad Mayor, Santiago, Chile,Department of Population Health, New York University Grossman School of Medicine. New York, NY, United States,Correspondence to: Alvaro Castillo-Carniglia, Society and Health Research Center, Universidad Mayor, Chile. Badajoz 130, room 1306, Las Condes, Santiago, Chile. Phone: +56.2.2518.9826.
| | - Ariadne Rivera-Aguirre
- Department of Population Health, New York University Grossman School of Medicine. New York, NY, United States
| | - Esteban Calvo
- Society and Health Research Center, Universidad Mayor, Santiago, Chile,School of Public Health, Universidad Mayor, Santiago, Chile,Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University. New York, NY, United States,Laboratory on Aging and Social Epidemiology, Universidad Mayor, Santiago, Chile
| | - Rosario Queirolo
- Department of Social and Political Sciences, Universidad Católica Uruguay, Montevideo, Uruguay
| | - Katherine M. Keyes
- Society and Health Research Center, Universidad Mayor, Santiago, Chile,Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University. New York, NY, United States
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine. New York, NY, United States
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Hall W, Lynskey M. Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World Psychiatry 2020; 19:179-186. [PMID: 32394566 PMCID: PMC7215066 DOI: 10.1002/wps.20735] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The sale of cannabis for adult recreational use has been made legal in nine US states since 2012, and nationally in Uruguay in 2013 and Canada in 2018. We review US research on the effects of legalization on cannabis use among adults and adolescents and on cannabis-related harms; the impact of legalizing adult recreational use on cannabis price, availability, potency and use; and regulatory policies that may increase or limit adverse effects of legalization. The legalization of recreational cannabis use in the US has substantially reduced the price of cannabis, increased its potency, and made cannabis more available to adult users. It appears to have increased the frequency of cannabis use among adults, but not so far among youth. It has also increased emergency department attendances and hospitalizations for some cannabis-related harms. The relatively modest effects on cannabis use to date probably reflect restrictions on the number and locations of retail cannabis outlets and the constraints on commercialization under a continued federal prohibition of cannabis. Future evaluations of legalization should monitor: cannabis sales volumes, prices and content of tetrahydrocannabinol; prevalence and frequency of cannabis use among adolescents and adults in household and high school surveys; car crash fatalities and injuries involving drivers who are cannabis-impaired; emergency department presentations related to cannabis; the demand for treatment of cannabis use disorders; and the prevalence of regular cannabis use among vulnerable young people in mental health services, schools and the criminal justice system. Governments that propose to legalize and regulate cannabis use need to fund research to monitor the impacts of these policy changes on public health, and take advantage of this research to develop ways of regulating can-nabis use that minimize adverse effects on public health.
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Affiliation(s)
- Wayne Hall
- University of Queensland Centre for Youth Substance Abuse Research, Brisbane, Australia
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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8
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Jackson KM, Sokolovsky AW, Gunn RL, White HR. Consequences of alcohol and marijuana use among college students: Prevalence rates and attributions to substance-specific versus simultaneous use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:370-381. [PMID: 31944787 PMCID: PMC7064425 DOI: 10.1037/adb0000545] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
College students who use alcohol and marijuana often use them simultaneously, so that their effects overlap. The present study examined whether negative consequences experienced by simultaneous alcohol and marijuana (SAM) users vary from those experienced by individuals who use alcohol and marijuana concurrently but not simultaneously (CAM) or single-substance users. We considered 9 types of consequences: cognitive, blackout, vomiting, academic/occupational, social, self-care, physical dependence, risky behaviors, and driving under the influence (DUI). Further, we examined whether consequences experienced by SAM users are attributed to using alcohol, marijuana, or both simultaneously. The sample included past-year alcohol and marijuana users age 18-24 (N = 1,390; 62% female; 69% White; 12% Hispanic) recruited from 3 U.S. college campuses. SAM users experienced a greater overall number of consequences than CAM or alcohol-only users, even controlling for frequency and intensity of alcohol and marijuana use and potentially confounding psychosocial and sociodemographic factors. Experiencing specific consequences differed between simultaneous and concurrent users, but after adjusting for consumption and other covariates, only blackouts differed. In contrast, SAM users were more likely to experience each consequence than alcohol-only users, with strongest effects for DUI, blackouts, and cognitive consequences. Among SAM users, consequences were most likely to be attributed to alcohol and were rarely attributed to simultaneous use. Being a user of both alcohol and marijuana and using alcohol and marijuana together so that their effects overlap each contribute to risk, suggesting there is value in targeting the mechanisms underlying type of user as well as those underlying type of use. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Kristina M Jackson
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | - Alexander W Sokolovsky
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | - Rachel L Gunn
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | - Helene R White
- Center of Alcohol Studies, Rutgers, The State University of New Jersey
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Hall W, Stjepanović D, Caulkins J, Lynskey M, Leung J, Campbell G, Degenhardt L. Public health implications of legalising the production and sale of cannabis for medicinal and recreational use. Lancet 2019; 394:1580-1590. [PMID: 31657733 DOI: 10.1016/s0140-6736(19)31789-1] [Citation(s) in RCA: 184] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/11/2022]
Abstract
We assess the current and describe possible future public health impacts of the legalisation of cannabis production, sale, and use in the Americas. First, we describe global patterns of cannabis use and their most probable adverse health effects. Second, we summarise evidence regarding the effectiveness of cannabinoids for medicinal use and describe approaches that have been used to regulate the use of medicinal cannabis and how these approaches might have affected medicinal and recreational use and harms (eg, road crashes). Third, we describe how jurisdictions that have legalised recreational use have regulated production and sale of cannabis. Fourth, we evaluate the effects of cannabis legalisation on cannabis use and harms and on the use of alcohol, tobacco, and other drugs. Fifth, we use alcohol and tobacco policy examples to identify possible long-term public health effects of cannabis legalisation. Finally, we outline policy approaches that could minimise harms to public health arising from the legalisation of a commercial cannabis industry.
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Affiliation(s)
- Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia; National Addiction Centre, King's College London, London, UK.
| | - Daniel Stjepanović
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | | | - Michael Lynskey
- Addictions Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia; The National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Gabrielle Campbell
- The National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Louisa Degenhardt
- The National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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10
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Terry-McElrath YM, O’Malley PM, Johnston LD, Schulenberg JE. Young adult longitudinal patterns of marijuana use among US National samples of 12th grade frequent marijuana users: a repeated-measures latent class analysis. Addiction 2019; 114:1035-1048. [PMID: 30614105 PMCID: PMC6510630 DOI: 10.1111/add.14548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/08/2018] [Accepted: 01/02/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Long-term frequent marijuana use is associated with significant negative outcomes, yet little is known about the longitudinal course of marijuana use among those who start frequent use during adolescence. Objectives are (a) to identify latent patterns of within-person marijuana use from ages 19-30 years among 12th graders reporting frequent marijuana use, (b) to examine if membership in identified patterns has changed across historical time and (c) to examine if key covariates differentiate class membership. DESIGN, SETTING, PARTICIPANTS Longitudinal, national US panel data from 4423 individuals [53.4% of the eligible sample; 2744 (62%) males] who reported frequent marijuana use in 12th grade (modal age 18 years; senior year cohorts 1976-2006) followed biennially from ages 19/20 to 29/30. MEASUREMENTS Self-reported past 30-day marijuana use (frequent use defined as use on 20+ occasions), demographics, college graduation, marriage and parenthood. FINDINGS Repeated-measures latent class analysis (RMLCA) identified five latent classes of past 30-day marijuana use from ages 19/20 to 29/30: continued frequent users (estimated membership 23.4%); frequent to non-frequent users (15.5%); consistent non-frequent users (18.4%); non-frequent users to discontinuers (19.5%); and discontinuers (23.2%). In multivariable models, membership in the highest-risk latent class (continued frequent users) versus one or more of the lower-risk latent classes was more likely for recent cohorts (P = 0.038 to <0.001), as well as those who did not marry (P = 0.039 to < 0.001) or become parents (P = 0.001) by modal age 29/30. CONCLUSIONS Nearly one in four 12th grade (modal age 18 years) frequent marijuana users in the US continues to report high frequency use to age 30; the proportion continuing high frequency use across young adulthood has increased among more recent cohorts.
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Affiliation(s)
- Yvonne M. Terry-McElrath
- Institute for Social Research, University of Michigan, Ann Arbor, MI,Corresponding author: Yvonne Terry-McElrath, Institute for Social Research, University of Michigan, 426 Thompson St., PO Box 1248, Ann Arbor, MI 48106-1248. Telephone: 734-647-9142. Fax: 734-936-0043.
| | | | - Lloyd D. Johnston
- Institute for Social Research, University of Michigan, Ann Arbor, MI
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