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Lewis MA, Zhou Z, Fairlie AM, Litt DM, Geusens F, Parks KA, McCabe SE. Examining within-person associations between alcohol and cannabis use and hooking up among adolescents and young adults in the United States. Addict Behav 2024; 155:108040. [PMID: 38657402 DOI: 10.1016/j.addbeh.2024.108040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study examined daily associations between alcohol use, cannabis use, and simultaneous alcohol and cannabis/marijuana (SAM) use with the likelihood of hooking up (uncommitted sexual encounter that may or may not include intercourse). METHOD We used a longitudinal measurement burst ecological momentary assessment (EMA) design with 3-week EMA bursts with daily measurements repeated quarterly across 12 months. 1,009 (57 % female, Mean age = 20.00 [SD = 3.21]) Texan adolescents and young adults ages 15-25 participated in the study. Mixed effects logistic regression models were estimated using maximum likelihood estimation to evaluate the associations between substance use and hooking up. RESULTS Within-person results indicated that participants were more likely to hook up on days with alcohol use and on days with cannabis use, but not on days with SAM use. Participants were also more likely to hook up on drinking days with higher-than-usual alcohol use. Between-person results indicated that participants who used alcohol more often or cannabis more often on average were more likely to hook up, and participants who tended to drink more on drinking days were more likely to hook up. CONCLUSIONS Given the significant daily-level associations between alcohol and cannabis use and hooking up behavior, public health initiatives should focus on developing interventions to reduce alcohol and cannabis use and promote safer hooking up behavior among adolescents and young adults.
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Affiliation(s)
- Melissa A Lewis
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States.
| | - Zhengyang Zhou
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Anne M Fairlie
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, United States
| | - Dana M Litt
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Femke Geusens
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 752 37 Uppsala, Sweden; Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Kathleen A Parks
- Department of Psychology, College of Arts and Sciences, The State University at New York at Buffalo, Park Hall, Buffalo, NY 14226, United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building Ann Arbor, MI 48109, United States
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Broman MJ, Grekin E, Resko SM, Agius E. Demographic, substance use, and mental well-being correlates of high-intensity drinking among college students and non-college young adults: implications for intervention. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38564777 DOI: 10.1080/07448481.2024.2334071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To assess demographic, substance use, and mental wellbeing factors associated with high-intensity drinking (HID; 10+ drinks on one occasion) among college- and non-college young adults, to inform prevention and intervention efforts. PARTICIPANTS A total of 1,430 young adults (819 in college and 611 not attending college) in a Midwestern state who reported trying alcohol at least once. METHODS Participants were recruited via social media between November 2019 and February 2020 to complete a web-based survey assessing demographics, substance use, and mental well-being. Logistic regression was conducted to assess relationships between these measures and HID among (1) college students and (2) non-college young adults. RESULTS About 14.0% of participants reported past-month HID. Among both college- and non-college young adults, men, those who perceived slight or no risk of harm from binge drinking, and those who used alcohol and marijuana simultaneously in the past year had greater odds of reporting past-month HID. Among students, past-year prescription drug misuse was also associated with HID. CONCLUSIONS High intensity-drinking is concerning given potential adverse consequences. Campus programming should address norms that may promote such drinking and other high-risk substance use associated with HID.
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Affiliation(s)
- Michael J Broman
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
| | - Emily Grekin
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Stella M Resko
- School of Social Work & Merrill, Palmer Skillman Institute, Wayne State University, Detroit, Michigan, USA
| | - Elizabeth Agius
- Center for Social Work Research, Wayne State University, Detroit, Michigan, USA
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Glenn D, Lau-Barraco C, Goings K. Simultaneous Substance Use With Alcohol in a Community-Based Sample of Young Adults. J Dual Diagn 2024:1-12. [PMID: 38560886 DOI: 10.1080/15504263.2024.2330633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective: Simultaneous substance use is associated with worse outcomes than concurrent use. Further investigations into simultaneous use are warranted because there is limited knowledge about the co-use of substances other than alcohol and cannabis. Study aims were to examine: (1) the prevalence of simultaneous use of substances with alcohol, (2) the extent to which use patterns are related to key correlates (i.e., psychological functioning, sensation seeking), and (3) differences by college status. Methods: Participants were 623 young adult drinkers who were recruited online to complete a one-time survey. Results: Cannabis (54.3%), tobacco (53.7%), and stimulants (46.5%) were most frequently used with alcohol. Moderation analyses showed the positive association between simultaneous use and psychological distress was stronger for students whereas the positive association with sensation seeking was stronger for nonstudents. Conclusions: Results highlight the need for future research and intervention efforts that consider the link between simultaneous use and psychological wellbeing while acknowledging that educational attainment may differentially influence these factors.
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Affiliation(s)
- Douglas Glenn
- Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Cathy Lau-Barraco
- Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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Jaume-Feliciosi N, Benca-Bachman CE, Holliday E, Palmer RH. Individual Differences in Substance Use Motives, Trauma, and Stress Among College-Based Polysubstance Users. Subst Use Misuse 2024; 59:1228-1239. [PMID: 38544304 PMCID: PMC11157642 DOI: 10.1080/10826084.2024.2330911] [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: 04/26/2024]
Abstract
Background: Co-use of alcohol and other drugs within a certain time frame (i.e., polysubstance use) has become increasingly prevalent, particularly among college-aged individuals, but understanding motives for co-use remains limited. Polysubstance use has been associated with a higher likelihood of negative health consequences as compared to single substance use. Objectives: The current study examined associations between motivations for using alcohol, tobacco, and cannabis among college students who use multiple substances versus students using only one substance or no substances. Additionally, we examined the effect of trauma and daily stress on polysubstance use in self-report data from individuals (N=134) participating in the MAPme Study. Results: First, the observed prevalence of polysubstance use was greater than expected by chance, with most individuals co-using alcohol and cannabis. "Alcohol and Other Drug Users" were more frequently motivated to drink for social (β=0.27, CI=[0.07, 0.44]), enhancement (β=0.26, CI=[0.01, 0.42]) and coping (β=0.21, CI=[0.06, 0.47]) reasons compared to individuals who consumed alcohol alone. Conclusions: Individual differences in motivations for use were partly explained by frequency of alcohol use and alcohol problem severity, but not by history of trauma or stress. Finally, while patterns of correlations among motivations for use across substances suggested a general tendency to be motivated to use substances for similar reasons, this was not supported by confirmatory factor models. Overall, shared motives may inform potential behavioral patterns for co-use of substances during college and might advise future treatment efforts.
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Affiliation(s)
- N Jaume-Feliciosi
- Behavioral Genetics of Addiction Laboratory, Department of Psychology at Emory University, Atlanta, GA, USA
| | - C E Benca-Bachman
- Behavioral Genetics of Addiction Laboratory, Department of Psychology at Emory University, Atlanta, GA, USA
| | - E Holliday
- Neuropsychology of Emerging Adulthood, Addiction, Recovery and Related Disorders Lab, Department of Psychology at Kennesaw State University & Center for Young Adult Addiction and Recovery, Kennesaw, GA, USA
| | - R H Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology at Emory University, Atlanta, GA, USA
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Lyons VH, Myers MG, Cunningham RM, Zimmerman MA, Carter PM, Walton MA, Goldstick J. Experiencing violence and other predictors of within-person same-day use of multiple substances in youth: a longitudinal study in emergency settings. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:218-228. [PMID: 38563511 DOI: 10.1080/00952990.2024.2307546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/06/2024] [Indexed: 04/04/2024]
Abstract
Background: Although experiencing violence is a risk factor for substance use among youth, its association with same-day use of multiple substances (a form of polysubstance use) and mitigating factors is less well understood.Objectives: To identify whether prosocial factors modified the effect of experiencing violence on the frequency of same-day use, and examine gender-specific risk/protective factors for same-day use.Methods: We analyzed longitudinal data from a cohort of youth who use drugs aged 14-24 (n = 599; 58% male) presenting to an urban emergency department between 2009-2011 and assessed biannually for two years. Using Poisson-generalized linear models with person-level fixed effects, we estimated within-person associations between self-reported experiencing violence and same-day use and analyzed gender and peer/parent support as effect modifiers. We adjusted for negative peer influence, parental drug and alcohol use, family conflict, anxiety and depression, and age.Results: Overall, positive parental support corresponded to lower rates of same-day use (rate ratio [RR]:0.93, 95% CI:0.87-0.99) and experiencing violence was associated with higher rates of same-day use (RR:1.25, 95% CI:1.10-1.41). Violence exposure was a risk factor among males (RR:1.42, 95% CI:1.21-1.66), while negative peer influences and parental substance use were risk factors among females (RR:1.63, 95% CI:1.36-1.97 and RR:1.58, 95% CI:1.35-1.83, respectively). Positive peer support reduced the association between violence exposure and same-day use among males (RR:0.69, 95% CI:0.57-0.84, p < .05).Conclusions: Tailored interventions may address gender differences in coping with experiencing violence - including interventions that promote parental support among males and reduce influence from parental substance use among females.
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Affiliation(s)
- Vivian H Lyons
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Firearm Injury & Policy Research Program, Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
- Social Development Research Group, University of Washington, Seattle, WA, USA
| | - Matthew G Myers
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca M Cunningham
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Prevention Research Center of Michigan, University of Michigan, Ann Arbor, MI, USA
| | - Patrick M Carter
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Maureen A Walton
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Jason Goldstick
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
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Warmingham J, Petrenko C, Rockhold M, Alto M, Manly JT, Toth S. Investigating the associations between prenatal exposure to substances and intergenerational maltreatment and symptoms of psychopathology for adolescent girls from families with low income. CHILD ABUSE & NEGLECT 2024; 147:106594. [PMID: 38086214 PMCID: PMC10843548 DOI: 10.1016/j.chiabu.2023.106594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/21/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Adolescent girls whose families experience poverty are more vulnerable to psychopathology, and it is vital to investigate biopsychosocial factors contributing to mental health functioning. OBJECTIVE To test associations between prenatal exposure to substances, intergenerational maltreatment, and adolescent mental health symptoms. PARTICIPANTS AND SETTING Baseline data were used from a randomized controlled trial testing the efficacy of Interpersonal Psychotherapy (IPT-A) for depression among girls with and without maltreatment exposure. Adolescents (Aged 13-16; 63.5 % Black/African-American, 21.0 % White, 15.57 % other racial identity; 12.57 % Latina/x) were recruited from families experiencing financial adversity (income <200 % poverty threshold). METHODS Adolescent maltreatment status was determined by using multiple sources (child protective service records, parental report, and adolescent report). Mothers reported on prenatal substance exposure, experiences of maltreatment in their own childhood, and rated adolescent internalizing and externalizing symptoms. Latent Class Analysis was used to determine common patterns of prenatal substance exposure (tobacco, alcohol, marijuana, and cocaine). Structural Equation Modeling was used to evaluate associations between maltreatment in two generations, prenatal exposure to substances, and adolescent mental health symptoms. RESULTS Two profiles of prenatal substance exposure emerged: one typified by low substance exposure (92.8 %), and one with moderate to high substance exposure (7.2 %). Both prenatal substance exposure and maternal history of maltreatment were associated with adolescent maltreatment, which in turn, was associated with greater adolescent externalizing symptoms. Parental history of maltreatment was directly associated with greater adolescent internalizing symptoms. CONCLUSION Prenatal exposure to substances and intergenerational maltreatment each confer risk for mental health symptoms in adolescent girls.
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Affiliation(s)
- Jennifer Warmingham
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America.
| | - Christie Petrenko
- Mt. Hope Family Center, University of Rochester, Rochester, NY, United States of America.
| | - Madeline Rockhold
- Mt. Hope Family Center, University of Rochester, Rochester, NY, United States of America
| | - Michelle Alto
- Baker Center for Children and Families, Boston, MA, United States of America
| | - Jody Todd Manly
- Mt. Hope Family Center, University of Rochester, Rochester, NY, United States of America
| | - Sheree Toth
- Mt. Hope Family Center, University of Rochester, Rochester, NY, United States of America
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Goodhines PA, Rathod K. Substance use and sleep health in young adults: Implications for integrated treatment and harm reduction. Sleep Med Rev 2023; 70:101811. [PMID: 37423096 DOI: 10.1016/j.smrv.2023.101811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
In their systematic review and meta-analysis, Meneo and colleagues document distinct substance-sleep effects reported by young adults (ages 18-30) across multidimensional sleep health and different substances used in the naturalistic environment, including alarming rates of self-medication for sleep aid. Key innovations of Meneo et al.'s review include (a) a multidimensional approach to defining sleep health and (b) robust inclusion of various substances commonly used in young adults. Although future research will be essential to clarifying transdiagnostic risk mechanisms, interplay of co-used substances, and the role of expectancies in risk processes, the developing literature reviewed herein may inform much-needed clinical recommendations. This work by Meneo et al should prompt an emphasis on approaching young adult substance use and self-medication through a harm reduction lens, highlighting recommendations for integrated behavioral sleep treatment tailored to stage of change using motivational interviewing.
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Han DH, Elam KK, Quinn PD, Huang C, Seo DC. Within-person associations of escalated electronic nicotine delivery systems use with cigarette, alcohol, marijuana and drug use behaviors among US young adults. Addiction 2023; 118:509-519. [PMID: 36367333 PMCID: PMC10098511 DOI: 10.1111/add.16082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022]
Abstract
AIMS Most extant evidence has addressed between-person differences, short-term or cross-sectional associations of electronic nicotine delivery systems (ENDS) use with other substance use, the majority focusing on current rather than escalated use. The present study aimed to examine within-person changes in escalated ENDS use and their associations with individual and combined substance use over a 6-year period. DESIGN, SETTING AND PARTICIPANTS This study used a longitudinal cohort design with US young adults. A generalized linear mixed-model approach was employed to fit a series of weighted logistic regression models. Data were drawn from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) study in the United States. Of the 9110 young adults at baseline, aged 18-24 years, a total of 5042 individuals had matched data across all five waves of assessments. MEASUREMENTS Escalated ENDS use was computed by subtracting the number of days of ENDS use within the past 30 days at wave w - 1 from that at wave w and coded as 1 = escalated, if the value was greater than zero (otherwise, coded as 0 = not escalated). FINDINGS Escalated ENDS use gradually decreased over time, with the lowest prevalence at wave 4 (4.0%) but sharply increasing at wave 5 (8.4%). Escalated ENDS use was associated with increased odds of using each substance (binge drinking, marijuana use, marijuana vaping, prescription and illicit drugs) and different combinations of polysubstance use between cigarette smoking, binge drinking and marijuana use (Ps < 0.05). In addition, sweet/fruit flavor use (versus menthol/mint) was associated with increased likelihood of reporting co-use of cigarettes and marijuana. CONCLUSIONS In the United States, the prevalence of young adults using electronic nicotine delivery systems appears to have increased steadily between 2013 and 2019, although the rate of increase may have started to accelerate in recent years. Escalated electronic nicotine delivery systems use and time-lagged established electronic nicotine delivery systems use appear to be prospectively associated with individual and combined substance use, particularly between cigarettes, alcohol and marijuana. Among established electronic nicotine delivery systems users, sweet/fruit flavor appears to be associated with increased risk of co-using cigarettes and marijuana.
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Affiliation(s)
- Dae-Hee Han
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kit K Elam
- School of Public Health, Indiana University, Bloomington, IN, USA
| | - Patrick D Quinn
- School of Public Health, Indiana University, Bloomington, IN, USA
| | - Chunfeng Huang
- Department of Statistics, Indiana University, Bloomington, IN, USA
| | - Dong-Chul Seo
- School of Public Health, Indiana University, Bloomington, IN, USA
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9
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Gooding NB, Williams JN, Williams RJ. The Differences Between Gamblers and Substance Users Who Seek Treatment. CANADIAN JOURNAL OF ADDICTION 2023. [DOI: 10.1097/cxa.0000000000000171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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10
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Galano MM, Stein SF, Hart N, Ramirez JI, Cunningham RM, Walton MA, Eisman AB, Ngo QM. Nonpartner Violence Perpetration Among Emerging Adults: Associations With Polysubstance Use and Trait Mindfulness. PSYCHOLOGY OF VIOLENCE 2023; 13:64-73. [PMID: 37593112 PMCID: PMC10430878 DOI: 10.1037/vio0000448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Objective Violence is a leading cause of death among individuals ages 18-25, with alcohol misuse consistently linked with violence perpetration. However, the association between polysubstance use and violence perpetration is less clear, despite the frequency of use of alcohol with other drugs. Additionally, protective factors such as mindfulness that may reduce violence perpetration among emerging adults have been understudied. This cross-sectional study examined the association between substance use, trait mindfulness, and violence perpetration outside of romantic relationships, utilizing a compensatory model of resilience. Methods Data were drawn from a sample of 665 emerging adults ages 18-25, recruited from an urban Emergency Department (68% men). Participants self-administered a computer survey that assessed non-partner violence perpetration (NPV), alcohol use, marijuana use, prescription drug misuse, and trait mindfulness. Fifteen percent reported non-partner violence perpetration over the past six months. Results Multivariate logistic regression tested associations between violence perpetration, substance use, trait mindfulness, and demographic characteristics. Results showed that alcohol use alone (OR= 3.04), prescription opioid use alone (OR = 3.58), alcohol and marijuana use (OR = 3.75), and use of all three substances (OR= 7.78) were positively associated with violence perpetration. Post-hoc contrasts demonstrated the polysubstance use significantly increased risk over single substance use. Trait mindfulness (OR= 0.97) was negatively associated with violence perpetration after controlling for substance use. Conclusions Findings suggest that polysubstance use may increase risk for violence. Interventions that address polysubstance use, potentially including mindfulness, could reduce non-partner violence perpetration among emerging adults and requires further study.
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Affiliation(s)
- Maria M. Galano
- University of Massachusetts Amherst, Department of Psychological and Brain Sciences
| | - Sara F. Stein
- University of Michigan School of Public Health
- University of Michigan, Department of Psychiatry
| | - Nyla Hart
- University of Michigan, Department of Psychiatry
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11
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Stevens AK, Gunn RL, Sokolovsky AW, Colby SM, Jackson KM. Examining the heterogeneity of polysubstance use patterns in young adulthood by age and college attendance. Exp Clin Psychopharmacol 2022; 30:701-713. [PMID: 33970653 PMCID: PMC8578597 DOI: 10.1037/pha0000472] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Substance use in young adulthood and polysubstance users (PSU), in particular, pose unique risks for adverse consequences. Prior research on young adult PSU has identified multiple classes of users, but most work has focused on college students. We examined PSU patterns by age and college attendance during young adulthood in two nationally representative samples. Using National Epidemiological Survey on Alcohol and Related Conditions (NESARC) Wave 1 and NESARC-III data sets, multigroup latent class analysis (MG-LCA) was employed to examine PSU patterns based on age (18-24 vs. 25-34) and determine whether solutions were similar (i.e., statistically invariant) by college attendance/graduation. Classes were estimated by binary past-year use of sedatives, tranquilizers, opioids/painkillers, heroin, amphetamines/stimulants, cocaine, hallucinogens, club drugs, and inhalants, and past-year frequency of alcohol, cigarette, and cannabis use. PSU patterns are largely replicated across waves. Model fit supported 3-class solutions in each MG-LCA: Low frequency-limited-range PSU (alcohol, cigarettes, and cannabis only), medium-to-high frequency limited-range PSU (alcohol, cigarettes, and cannabis only), and extended-range PSU (ER PSU; all substances). Apart from one model, MG-LCA solutions were not invariant by college attendance/graduation, suggesting important differences between these groups. Except for alcohol, cannabis, and cigarette use frequency, results showed that probabilities of illicit and prescription drug use declined in the older age group. Findings also supported examining college and noncollege youth separately when studying PSU. ER PSU may be uniquely vulnerable to coingesting substances, particularly for nongraduates, warranting future research to classify patterns of simultaneous PSU and identify predictors and consequences of high-risk combinations (e.g., alcohol and opioids). (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Angela K Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Rachel L Gunn
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | | | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
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12
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Stevens AK, Boyle HK, Sokolovsky AW, White HR, Jackson KM. Nuanced relations between simultaneous alcohol and cannabis use motives and negative consequences among college students: The role of multiple product use. Exp Clin Psychopharmacol 2022; 30:593-608. [PMID: 33705200 PMCID: PMC8433268 DOI: 10.1037/pha0000454] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Simultaneous alcohol and marijuana (SAM) use is common, but it exacerbates negative consequences. Individuals use alcohol and cannabis products in different ways and have distinct reasons for use. The present study examines day-level effects of motives on consequences on SAM-use days, accounting for consumption, and tests whether using multiple alcohol (e.g., beer + liquor) and/or cannabis (e.g., concentrate + leaf) products on the same day mediates these relations. College students engaging in SAM use at least once in the past month (N = 281; Mage = 20.17) completed two bursts of 28 consecutive days of data collection. We examined within-person effects of motives (effect-enhancement, social, offered [it was offered], coping) on number of negative consequences and on experiencing hangover, nausea, or blackout; and indirect effects via two concurrent mediators: using multiple alcohol products and multiple cannabis products. Total effect models showed effect-enhancement motives were related to nausea, social motives to number of total consequences and hangover, and coping motives to blackout. Effect-enhancement, social, and offered motives evinced significant indirect effects on consequence outcomes via multiple alcohol, but not cannabis, product use. Coping motives did not exhibit significant indirect effects, and were related to multiple cannabis, but not alcohol, product use, although all other motives were related to both mediators. Findings support recent work demonstrating within-person relations between social motives and negative consequences on SAM-use days. Limiting the number of alcohol products consumed on SAM-use days may be beneficial, particularly for young adults using to enhance intoxication or for social reasons. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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13
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Howe LK, Bailey AJ, Ingram PF, Finn PR. An exploration of multivariate symptom clusters of cannabis use disorder in young adults. Addict Behav 2022; 135:107465. [PMID: 35995015 DOI: 10.1016/j.addbeh.2022.107465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/01/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022]
Abstract
AIMS Since the release of the DSM-V, CUD has been understood as a unidimensional construct. However, continued research has identified separate symptom clusters relating to consumption, loss of control, and withdrawal within substance use disorder criteria that may pose separate risk factors and functional difficulties. The current study aims to examine how symptom clusters commonly manifest in young adults that use cannabis using a latent class analysis (LCA) and explore how these clusters are related to co-occurring psychological constructs. METHODS 1174 (aged 18-34) participants completed a battery of assessments on substance use and other psychological constructs. LCA was conducted on 17 symptoms corresponding with DSM-V CUD criteria. Multinomial regressions were used to examine class membership and commonly co-occurring psychopathology and psychological constructs. RESULTS LCA results identified a 'No problems' class, a 'Moderate consumption' class characterized by moderate probability of endorsing consumption items, a 'Consumption with Moderate Loss of Control' class, characterized by endorsing consumption and loss of control items but minimal endorsement of withdrawal items, a 'Consumption with Moderate Withdrawal' class characterized by moderate probability of endorsing all item types, and 'High Consumption, Loss of Control, Withdrawal' class characterized by high probability of endorsing all items. Multinomial regressions indicated some class differences in psychological constructs. CONCLUSIONS Symptom clusters differed in terms of CUD criteria, especially for those in our sample with moderate/severe problems. Findings suggest intervention efforts may benefit from treatment targeted at various presentations of CUD.
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Affiliation(s)
- Lindy K Howe
- Department of Psychological & Brain Sciences, Indiana University Bloomington, IN 47405, USA.
| | - Allen J Bailey
- Department of Psychological & Brain Sciences, Indiana University Bloomington, IN 47405, USA
| | - Polly F Ingram
- Department of Psychological & Brain Sciences, Indiana University Bloomington, IN 47405, USA
| | - Peter R Finn
- Department of Psychological & Brain Sciences, Indiana University Bloomington, IN 47405, USA
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14
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Waddell JT, Jager J, Chassin L. Maturing out of alcohol and cannabis co-use: A test of patterns and personality predictors. Alcohol Clin Exp Res 2022; 46:1603-1615. [PMID: 35994040 PMCID: PMC10325930 DOI: 10.1111/acer.14898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Reductions in substance involvement into adulthood are thought to represent a normative maturing out of substance use. However, patterns and predictors of maturing out of alcohol and cannabis co-use remain largely unstudied. Therefore, the current study tested developmental trajectories of alcohol and cannabis use from late adolescence into adulthood and whether late adolescent personality traits predicted trajectory class membership. METHODS Data come from a longitudinal study of family history of alcohol disorder (N = 458). Age bands were created to model trajectories of drinking quantity, negative alcohol consequences, and cannabis use frequency from late adolescence (age 18-22) to young adulthood (age 23-28) and adulthood (age 29-36). Participants reported on their sensation seeking, conscientiousness, and neuroticism during late adolescence and their typical drinking quantity, negative alcohol consequences, and cannabis use frequency at each age band. RESULTS Three trajectory classes were derived from an initial Parallel Process Growth Mixture Model: (1) low-risk maturing out of alcohol-only use, (2) high-risk maturing out of co-use, and (3) high-risk switchers who increased their cannabis use into adulthood. Late adolescent sensation seeking was associated with higher odds of being in both co-use trajectories, whereas a lack of conscientiousness was associated with higher odds of being a co-use switcher. CONCLUSIONS We identified heterogeneity in trajectories of co-use, which suggests that a lack of maturing out of alcohol involvement may be accompanied by increased cannabis use. Moreover, late adolescent personality traits may predispose individuals toward riskier developmental trajectories of substance use into adulthood.
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Affiliation(s)
- Jack T Waddell
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Justin Jager
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Laurie Chassin
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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15
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Bailey AJ, Ingram PF, Howe LK, Finn PR. Is lower severity alcohol use disorder qualitatively different than more severe manifestations? An evaluation of multivariate symptom clusters. Addiction 2022; 117:1598-1608. [PMID: 34935218 PMCID: PMC9081272 DOI: 10.1111/add.15785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Alcohol use disorder (AUD), since the release of DSM-V, is conceptualized and studied as a unidimensional construct. However, previous research has identified clusters of AUD symptoms related to excessive consumption/tolerance, loss of control/social dysfunction and withdrawal/craving that have shown differential genetic risks, personality associations and predictive ability. Although past 'variable-centered' (e.g. factor-analytic) studies have demonstrated the importance of these clusters, the current study aimed to examine how these clusters commonly manifest using a 'person-centered' approach (e.g. latent class). DESIGN Cross-sectional in-person assessment. SETTING Indiana, USA. PARTICIPANTS A convenience sample of 1390 young adults (mean age = 21.43, SD = 2.47) recruited for an over-representation of alcohol problems (65% with AUD). MEASUREMENTS Latent class analysis (LCA) was conducted on 23 criteria from the Semi-Structured Interview on the Genetics of Alcoholism (SSAGA) that align with DSM-V AUD symptoms. Identified latent classes were characterized using multinomial regressions to examine the association of class and measures of alcohol use, other externalizing psychopathology, internalizing problems and personality. FINDINGS LCA results identified a 'Low Problems' class (34% of sample), a 'Heavy Consumption' class (26%) characterized by high endorsement probabilities of essentially only consumption/tolerance symptoms, a 'Consumption and Loss of Control' class (31%) characterized by endorsing consumption/tolerance and loss of control/social dysfunction symptoms, and finally a 'Consumption, Loss of Control and Withdrawal' class (9%) characterized by high endorsement probabilities of all symptom clusters. Multinomial regression results indicated an increasing spectrum of severity in terms of psychological impairment. CONCLUSIONS AUD appears to manifest as different clusters of symptoms at different severity levels.
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Affiliation(s)
- Allen J Bailey
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - Polly F Ingram
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - Lindy K Howe
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - Peter R Finn
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
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16
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Powers JM, Lape EC, LaRowe LR, Hooker JE, Heckman BW, Ditre JW. Initial Validation of the Intentions to Co-Use Alcohol and Opioids Scale. J Psychoactive Drugs 2022:1-9. [PMID: 35574916 PMCID: PMC9761858 DOI: 10.1080/02791072.2022.2075713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Co-use of alcohol and prescription opioid medication increases risk for harmful and potentially fatal health effects (e.g., overdose). Behavioral intentions (i.e., the immediate antecedent of corresponding behavior according to the Theory of Planned Behavior) are important in prediction of substance use, and a valid measure assessing intentions to co-use alcohol and opioids is needed to identify individuals at-risk for harmful substance use. The goal of the current study was to develop and conduct the psychometric validation of a six-item Intentions to Co-Use Alcohol and Opioids (ICAO) scale. Participants included 261 (Mage = 38; 64% male) past-month drinkers with a current opioid prescription and chronic musculoskeletal pain who completed a targeted online survey. Confirmatory factor analysis indicated that a single-factor structure provided good model fit (Bollen-Stine bootstrap p = .121). Moreover, the ICAO demonstrated high internal consistency (α = .96) and was correlated with measures of alcohol and opioid use/co-use. These findings provide support for the single-factor structure, reliability, and concurrent/convergent validity of the ICAO among individuals who endorse alcohol use, opioid use, and chronic musculoskeletal pain. The ICAO may offer clinical utility as a tool to identify individuals at greater risk of potentially fatal co-use of alcohol and opioid medications.
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Affiliation(s)
| | - Emma C. Lape
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Lisa R. LaRowe
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Julia E. Hooker
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Bryan W. Heckman
- Psychiatry & Behavioral Sciences, Meharry Medical College, Nashville, TN, USA
| | - Joseph W. Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, USA
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17
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Applying network analysis to investigate substance use symptoms associated with drug overdose. Drug Alcohol Depend 2022; 234:109408. [PMID: 35306394 PMCID: PMC9018556 DOI: 10.1016/j.drugalcdep.2022.109408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/17/2022] [Accepted: 03/10/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Drug overdose deaths have been increasing over the last several decades. While single substance classes, such as opioids, have been implicated in this rise, less is known about the contributions of polysubstance use (PSU) and other combinations of specific substances and symptoms that may be a risk factor for drug overdose. METHODS Symptoms of alcohol, cannabis, and other drug use disorders, as well as co-substance use indicators, were assessed and then examined via network analysis in a sample of young adults (N = 1540). Features of the estimated symptom network were investigated, including topology and node centrality, as well as bridge centrality, which further examines node centrality while accounting for the nodes belonging to discrete communities. RESULTS Individual symptoms were more strongly associated with other symptoms within the same substance class than across substance classes. Tolerance and withdrawal symptoms were the most central items in the network. However, when accounting for symptoms belonging to discrete substance classes, drug overdose emerged as a strong bridge symptom, among others. CONCLUSIONS As a strong bridge symptom, drug overdose had many connections with a variety of substances and symptoms, which might suggest that risk for drug overdose may be a function of overall substance use severity. Altogether, examining alcohol and substance use symptoms using a network analytic framework provided novel insights into the role PSU might play in conferring risk for drug overdose.
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18
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Survey of substance use among adolescent drug offenders referred from juvenile courts in Taiwan: Clinical epidemiology of single versus multiple illicit substance use. J Formos Med Assoc 2022; 121:2257-2264. [PMID: 35484001 DOI: 10.1016/j.jfma.2022.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Substance use during adolescence might cause substantial health burden. Little is known regarding profiles of multiple illicit substance users compared to single illicit substance users in adolescent population in Taiwan. METHODS We enrolled 106 adolescent illicit drug users who received addiction treatment referred by juvenile courts in Taiwan between September, 2016 and September, 2021. We divided them into two groups: single versus multiple illicit drug users, and further compared their socio-demographic characteristics, psychiatric and substance comorbidities. The independent t test or Mann-Whitney U test was used for continuous variables and Pearson's chi-square test for nominal variables. Multivariate logistic regression was used to examine the suicide and violence risk among adolescents. RESULTS 71.7% of participants were multiple illicit drug users while 28.3% of them were single drug users. Multiple illicit substance users were more likely to use methamphetamine (p = 0.005), ketamine (p < 0.001), new psychoactive substance (NPS) (p < 0.001), MDMA (p = 0.003), and nitrous oxide (p < 0.001) compared to single illicit substance users. In addition, multiple illicit drug users were more likely to have ADHD (p = 0.030), major depressive disorder (p = 0.050), and lifetime suicidal attempts (p = 0.048) compared to single illicit drug users. In further analysis (NPS vs. traditional drugs), we found NPS users tended to use larger numbers of illicit drugs (p < 0.001) and were more likely to have substance-induced psychotic disorder (p = 0.008), ADHD (p = 0.011), suicidal attempts (p = 0.020). CONCLUSION Our findings highlight the distinct profiles of multiple illicit drug users compared to single illicit drug users among adolescent population. High suicidality and high psychiatric comorbidities in multiple illicit drug users call for special need for suicide screening and a more integrated care incorporating psychiatric and substance treatment.
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19
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Brgdar A, Gharbin J, Elawad A, Yi J, Sanchez J, Bishaw A, Taha ME, Ameyaw EE, Allen N, Prafulla M. Effects of Substance Use Disorder on In-Hospital Outcomes of Young Patients Presenting With a Cardiovascular Event: A Nationwide Analysis. Cureus 2022; 14:e22737. [PMID: 35386479 PMCID: PMC8969757 DOI: 10.7759/cureus.22737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
Background Substance use is widely prevalent among young adults and is associated with increased cardiovascular morbidity and mortality such as sudden cardiac arrest, acute coronary syndrome, arrhythmias, and cardiomyopathy. However, they are limited studies analyzing the impact of substance use disorder on in-hospital outcomes among young patients with cardiovascular events. Methods All patients aged 18-39 years admitted primarily for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, cardiac arrest, acute ischemic stroke, and venous thromboembolic events in 2019 were identified in the National Inpatient Sample database. They were then categorized into those with and without concomitant substance use disorder (SUD). The primary outcome was in-hospital mortality. Unadjusted and adjusted analysis was performed on appropriate variables of interest. Results Of 57,985 hospitalizations with cardiac events, 12,115 (20%) of young adults had concomitant SUD. SUD was significantly associated with cardiac arrest (OR 3.3; CI 2.4-4.4), atrial fibrillation (OR 1.5; CI 1.3-1.7), AMI (OR 1.3; CI 1.2-1.6), heart failure (OR 2.6; CI 2.4-3.0) (all p<0.05) despite a lower prevalence of traditional cardiovascular risk factors than non-users. Logistic regression showed acute kidney injury (aOR 1.5; CI 1.3-1.8; p<0.001) and inpatient mortality (aOR 1.6; CI 1.2-2.2; p<0.001) were also significantly higher in young patients presenting with cardiac events and concomitant SUD. There was no difference in the length of stay or incidence of gastrointestinal bleed between the two groups. Conclusion In young patients presenting with a cardiovascular event, concurrent substance use disorder was associated with increased in-hospital mortality despite significantly lower comorbidities.
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20
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Konefal S, Sherk A, Maloney-Hall B, Young M, Kent P, Biggar E. Polysubstance use poisoning deaths in Canada: an analysis of trends from 2014 to 2017 using mortality data. BMC Public Health 2022; 22:269. [PMID: 35144586 PMCID: PMC8830122 DOI: 10.1186/s12889-022-12678-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Over the past decade, rates of drug poisoning deaths have increased dramatically in Canada. Current evidence suggests that the non-medical use of synthetic opioids, stimulants and patterns of polysubstance use are major factors contributing to this increase. Methods Counts of substance poisoning deaths involving alcohol, opioids, other central nervous system (CNS) depressants, cocaine, and CNS stimulants excluding cocaine, were acquired from the Canadian Vital Statistics Death Database (CVSD) for the years 2014 to 2017. We used joinpoint regression analysis and the Cochrane-Armitage trend test for proportions to examine changes over time in crude mortality rates and proportions of poisoning deaths involving more than one substance. Results Between 2014 and 2017, the rate of substance poisoning deaths in Canada almost doubled from 6.4 to 11.5 deaths per 100,000 population (Average Annual Percent Change, AAPC: 23%, p < 0.05). Our analysis shows this was due to increased unintentional poisoning deaths (AAPC: 26.6%, p < 0.05) and polysubstance deaths (AAPC: 23.0%, p < 0.05). The proportion of unintentional poisoning deaths involving polysubstance use increased significantly from 38% to 58% among males (p < 0.0001) and 40% to 55% among females (p < 0.0001). Polysubstance use poisonings involving opioids and CNS stimulants (excluding cocaine) increased substantially during the study period (males AAPC: 133.1%, p < 0.01; females AAPC: 118.1%, p < 0.05). Conclusions Increases in substance-related poisoning deaths between 2014 and 2017 were associated with polysubstance use. Increased co-use of stimulants with opioids is a key factor contributing to the epidemic of opioid deaths in Canada. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12678-z.
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Affiliation(s)
- Sarah Konefal
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada.
| | - Adam Sherk
- Canadian Institute for Substance Use Research, Victoria, B.C., Canada
| | | | - Matthew Young
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada.,Gambling Research Exchange Ontario, Guelph, Ontario, Canada.,Department of Psychology, Carleton University , Ottawa, Ontario, Canada
| | - Pam Kent
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Emily Biggar
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
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21
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Boileau-Falardeau M, Contreras G, Gariépy G, Laprise C. Patterns and motivations of polysubstance use: a rapid review of the qualitative evidence. Health Promot Chronic Dis Prev Can 2022; 42:47-59. [PMID: 35170930 PMCID: PMC8935897 DOI: 10.24095/hpcdp.42.2.01] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
INTRODUCTION Polysubstance use-the use of substances at the same time or close in time-is a common practice among people who use drugs. The recent rise in mortality and overdose associated with polysubstance use makes understanding current motivations underlying this pattern critical. The objective of this review was to synthesize current knowledge of the reasons for combining substances in a single defined episode of drug use. METHODS We conducted a rapid review of the literature to identify empirical studies describing patterns and/or motivations for polysubstance use. Included studies were published between 2010 and 2021 and identified using MEDLINE, Embase, PsycINFO and Google Scholar. RESULTS We included 13 qualitative or mixed-method studies in our analysis. Substances were combined sequentially to alleviate withdrawal symptoms or prolong a state of euphoria ("high"). Simultaneous use was motivated by an intention to counteract or balance the effect(s) of a substance with those of another, enhance a high or reduce overall use, and to mimic the effect of another unavailable or more expensive substance. Self-medication for a pre-existing condition was also the intention behind sequential or simultaneous use. CONCLUSION Polysubstance use is often motivated by a desire to improve the experience based on expected effects of combinations. A better understanding of the reasons underlying substance combination are needed to mitigate the impact of the current overdose crisis.
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Affiliation(s)
- Michèle Boileau-Falardeau
- Public Health Agency of Canada, Montréal, Quebec, Canada
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Geneviève Gariépy
- Public Health Agency of Canada, Montréal, Quebec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Quebec, Canada
| | - Claudie Laprise
- Public Health Agency of Canada, Montréal, Quebec, Canada
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montréal, Quebec, Canada
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22
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Lee CM, Calhoun BH, Abdallah DA, Blayney JA, Schultz NR, Brunner M, Patrick ME. Simultaneous Alcohol and Marijuana Use Among Young Adults: A Scoping Review of Prevalence, Patterns, Psychosocial Correlates, and Consequences. Alcohol Res 2022; 42:08. [PMID: 35548267 PMCID: PMC9059839 DOI: 10.35946/arcr.v42.1.08] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Alcohol and marijuana are commonly used by young adults, and use of both substances, particularly at the same time, is prevalent among this population. Understanding the prevalence, patterns, correlates, and consequences of simultaneous alcohol and marijuana (SAM) use is important to inform interventions. However, this literature is complicated by myriad terms used to describe SAM use, including use with overlapping effects and same-day co-use. OBJECTIVES This scoping review identifies and describes the peer-reviewed literature focused on SAM use by young adults and distinguishes simultaneous use from same-day co-use of alcohol and marijuana. This review also provides a narrative summary of the prevalence of SAM use, patterns of SAM and other substance use, psychosocial correlates, and consequences of SAM use. ELIGIBILITY CRITERIA This review is limited to papers written in English and published in peer-reviewed journals between January 2000 and August 2021. It includes papers assessing simultaneous use or same-day co-use of alcohol and marijuana among young adults ages 18 to 30. Review papers, qualitative interviews, experimental lab studies, policy work, toxicology or medical reports, and papers focused on neurological outcomes are excluded. SOURCES OF EVIDENCE PubMed, PsycINFO, and Web of Science databases were searched. Databases were selected and the search strategy developed in consultation with an information specialist. CHARTING METHODS A data charting form was utilized to specify which information would be extracted from included papers. Eight categories of data were extracted: (1) research questions and hypotheses; (2) sample characteristics; (3) study procedures; (4) definition of SAM use; (5) prevalence of SAM use; (6) patterns of SAM and other substance use; (7) psychosocial correlates of SAM use; and (8) consequences of SAM use. RESULTS A total of 1,282 papers were identified through initial search terms. Through double-blind title/abstract screening and full-text review, the review was narrowed to 74 papers that met review inclusion criteria. Review of these papers demonstrated that SAM use was prevalent among young adults, particularly among those who reported heavier quantities and more frequent use of alcohol and marijuana. Enhancement-related motives for use were consistently positively associated with SAM use. SAM use was associated with greater perceived positive and negative consequences of alcohol and/or marijuana use. Inconsistencies in prevalence, patterns, correlates, and consequences were found between studies, which may be due to large variations in measurement of SAM use, populations studied, methodological design (e.g., cross-sectional vs. intensive longitudinal), and the covariates included in models. CONCLUSIONS The literature on simultaneous use and same-day co-use of alcohol and marijuana has expanded rapidly. Of the 74 included papers (61 on SAM use; 13 on same-day co-use), 60 papers (47 on SAM use; 13 on same-day co-use) were published within the last 5 years. Future research focusing on the ways in which SAM use confers acute risk, above and beyond the risks associated with separate consumption of alcohol and marijuana, is needed for understanding potential targets for intervention.
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Affiliation(s)
- Christine M. Lee
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Brian H. Calhoun
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Devon Alisa Abdallah
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Jessica A. Blayney
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Nicole R. Schultz
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Meg Brunner
- Addictions, Drug, and Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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23
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Stevens AK, Drohan MM, Boyle HK, White HR, Jackson KM. More Reasons, More Use and Problems? Examining the Influence of Number of Motives on Consumption and Consequences Across Alcohol-Only, Cannabis-Only, and Simultaneous-Use Days. J Stud Alcohol Drugs 2021; 82:782-791. [PMID: 34762038 PMCID: PMC8819619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/12/2021] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Alcohol and cannabis use as well as their simultaneous use are common among U.S. college students. Reasons for use are proximal predictors of consumption and consequences. Little research has examined possible adverse effects of endorsing multiple motives on a given use day. We examined the effects of the number of motives on consumption and negative consequences for alcohol-only, cannabis-only, and simultaneous-use days. METHOD College students (N = 341; 53% women; mean age = 19.79 years) who reported past-month simultaneous alcohol and cannabis use completed 54 days of data collection. We used generalized linear mixed-effects models to examine the effects of endorsing multiple motives on consumption and consequences. RESULTS Across models, endorsing more motives than typical on a given use day (within person) and more motives in general (between person) was related to greater alcohol and cannabis consumption. Endorsing more alcohol-only motives and cannabis-only motives than typical resulted in greater odds of experiencing a negative consequence when accounting for consumption. This within-person effect was not statistically significant for simultaneous-use motives/consequences. Endorsing a greater number of motives across the study (i.e., between person) was not significantly related to consequences beyond consumption. CONCLUSIONS Research has documented the robust effects of specific motives on substance use outcomes. Our novel findings extend this work by demonstrating the risks associated with endorsing multiple motives on a given use day. In addition to motive type, we recommend that the number of motives endorsed on a given day be considered as a potential risk factor to be targeted to reduce harms associated with substance use.
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Affiliation(s)
- Angela K. Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Megan M. Drohan
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Holly K. Boyle
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Helene R. White
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
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Scott ML, Murnane KS, Orr AW. Young at heart? Drugs of abuse cause early-onset cardiovascular disease in the young. Heart 2021; 107:604-606. [PMID: 33589426 DOI: 10.1136/heartjnl-2020-318856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Matthew L Scott
- Department of Pathology, LSU Health Shreveport, Shreveport, Louisiana, USA
| | - Kevin S Murnane
- Departments of Pharmacology, Toxicology and Neuroscience and Psychiatry, LSU Health Shreveport, Shreveport, Louisiana, USA
| | - Anthony Wayne Orr
- Departments of Pathology, Cellular Biology and Anatomy, and Molecular and Cellular Physiology, LSU Health Shreveport, Shreveport, Louisiana, USA
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25
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Ford JA, Schepis TS, McCabe SE. Poly-prescription drug misuse across the life course: Prevalence and correlates across different adult age cohorts in the U.S. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 88:103017. [PMID: 33227640 PMCID: PMC8005409 DOI: 10.1016/j.drugpo.2020.103017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Most research on prescription drug misuse (PDM) focuses on the misuse of specific classes of psychoactive prescription drugs among adolescents or young adults. The current research addressed important gaps in the literature by assessing poly-prescription drug misuse (poly-PDM), the misuse of more than one class of psychoactive prescription drug, across different adult age cohorts. METHODS We used the 2015-2018 National Survey on Drug Use and Health to examine the prevalence of past-year poly-PDM and specific combinations of PDM. Multinomial logistic regression was used to identify demographic, health-related factors, and substance use behaviors that were significantly associated with poly-PDM. RESULTS The prevalence of poly-PDM decreases with age and is common among individuals who engage in PDM. Slightly more than one in four respondents in age cohorts 18-25 (31.66%, 95% CI = 30.35, 33.00) and 26-34 (29.92%, 95% CI = 25.82, 30.12) who engage in PDM, misused more than one class of prescription drug. Additionally, poly-PDM was identified as a high-risk type of PDM as roughly 60% of adults younger than 65 who endorse poly-PDM reported having a substance use disorder (SUD). While certain characteristics (i.e., race/ethnicity, marital status, depression, suicidal ideation, illegal drug use, and SUD) were consistently associated with poly-PDM across age cohorts, other characteristics (i.e., sexual identity, income, and justice involvement) varied across age cohorts. Finally, a comparison of poly-PDM to single PDM showed, in all age cohorts, that having an SUD was associated with an increased likelihood of poly-PDM, while Black adults were less likely than whites to report poly-PDM. CONCLUSIONS By identifying prevalence and correlates of poly-PDM across adult age cohorts, the current research has significant implications. Understanding stability and heterogeneity in the characteristics associated with poly-PDM should inform interventions, identify at-risk groups, and shape public health approaches to dealing with high-risk substance use behavior.
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Affiliation(s)
- Jason A Ford
- Department of Sociology, University of Central Florida, Orlando, FL United States.
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, TX United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, United States; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, United States; Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
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Howe LK, Fisher LR, Atkinson EA, Finn PR. Symptoms of anxiety, depression, and borderline personality in alcohol use disorder with and without comorbid substance use disorder. Alcohol 2021; 90:19-25. [PMID: 33232791 DOI: 10.1016/j.alcohol.2020.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/13/2020] [Accepted: 11/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Alcohol use disorder (AUD) is highly comorbid with other substance use disorders (SUDs) as well as other psychiatric disorders, such as anxiety, depression, and Borderline Personality Disorder (BPD). However, studies of persons with AUD rarely account for its comorbidity with other SUDs. Some research suggests that BPD symptoms reflect an important connection between internalizing disorders and SUDs. The current study investigated: 1) the levels of trait anxiety and symptoms of depression and BPD in persons with an AUD as a function of comorbid SUDs (cannabis use disorder - CUD) and other substance use disorder (oSUD), and 2) the influence of BPD on the association between severity of overall lifetime SUD symptoms (AUD + CUD + oSUD) and both trait anxiety and symptoms of depression. METHOD Trait anxiety and symptoms of depression and BPD were assessed in 671 young adults (351 men; 320 women; mean age 21 years) separated into four groups: Controls (n = 185), AUD-only (134), AUD + CUD (n = 210), and AUD + oSUD (n = 142). RESULTS Trait anxiety and symptoms of depression and BPD were elevated in all AUD groups compared with controls, and in the AUD + oSUD group compared with all other groups as well. Structural models also indicated that BPD symptoms accounted for all of the variance in lifetime SUD symptoms associated with Trait Anxiety, and a significant portion of the variance in lifetime SUD symptoms associated with depression symptoms. CONCLUSION Results indicate that when AUD is comorbid with oSUD, it is associated with more severe AUD symptoms and higher levels of trait anxiety and symptoms of both depression and BPD. The results also indicate that BPD symptoms account for the majority of the variance in SUD symptoms associated with both trait anxiety and depression, suggesting that a considerable amount of the internalizing symptomatology in AUD/SUDs is associated with BPD psychopathology.
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Martínez-Loredo V, Macipe V, Errasti Pérez JM, Al-Halabí S. Clinical symptoms and personality traits predict subpopulations of treatment-seeking substance users. J Subst Abuse Treat 2021; 125:108314. [PMID: 34016301 DOI: 10.1016/j.jsat.2021.108314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/09/2020] [Accepted: 01/25/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND The heterogeneity of treatment-seeking substance users represents a challenge, as most studies include participants having problems with specific substances or merge polysubstance users into the same category without considering differences between profiles. Considering the inconsistent literature on predictors of treatment outcomes, this study aimed to identify subpopulations of individuals with substance use disorders (SUDs) and analyze the association among class membership, previous relapses, and treatment retention. METHODS The study recruited a total of 159 participants (mean age = 40.60, SD = 8.70; 85.5% males) from two treatment facilities (outpatient daycare and inpatient residential centers). The baseline assessment gathered lifetime and current substance use, and personality and psychopathology measures. The study performed a latent class analysis to identify subpopulations of substance users and explored predictors of class membership using a multinomial regression analysis. RESULTS The study found six different classes of substance users based on their diagnosis and pattern of substance use: class 1 (6.92% of participants): individuals with cannabis as primary substance, alcohol/cocaine as secondary substance and additional use of stimulants or other drugs; class 2 (30.82%): cocaine as primary substance, alcohol as secondary and additional cannabis use; class 3 (20.13%): alcohol as primary substance, cocaine as secondary and additional cannabis use; class 4 (17.61%): cocaine as primary substance, cannabis as secondary and additional alcohol/other drugs use; class 5 (16.35%): alcohol as primary and cannabis as secondary substance; class 6 (8.18%): heroin as primary substance, cocaine as secondary and additional alcohol use. Several traits and clinical symptoms predicted distinct class memberships. Participants pertaining to class 6 presented the highest number of relapses (M = 2.54, SD = 1.56). CONCLUSIONS These results have several clinical implications. Belonging to class 6 was associated with a greater number of previous relapses. Also, specific psychopathological symptoms and personality traits may impact SUD treatment response, which may help clinicians to guide initial assessment and treatment allocation.
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Affiliation(s)
- V Martínez-Loredo
- Department of Psychology, University of Oviedo, Oviedo, Asturias, Spain; Department of Psychology and Sociology, University of Zaragoza, Teruel, Aragón, Spain.
| | - V Macipe
- Department of Psychology, University of Oviedo, Oviedo, Asturias, Spain
| | - J M Errasti Pérez
- Department of Psychology, University of Oviedo, Oviedo, Asturias, Spain
| | - S Al-Halabí
- Department of Psychology, University of Oviedo, Oviedo, Asturias, Spain
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Preadult polytoxicomania-strong environmental underpinnings and first genetic hints. Mol Psychiatry 2021; 26:3211-3222. [PMID: 33824432 PMCID: PMC8505259 DOI: 10.1038/s41380-021-01069-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 11/09/2022]
Abstract
Considering the immense societal and personal costs and suffering associated with multiple drug use or "polytoxicomania", better understanding of environmental and genetic causes is crucial. While previous studies focused on single risk factors and selected drugs, effects of early-accumulated environmental risks on polytoxicomania were never addressed. Similarly, evidence of genetic susceptibility to particular drugs is abundant, while genetic predisposition to polytoxicomania is unexplored. We exploited the GRAS data collection, comprising information on N~2000 deep-phenotyped schizophrenia patients, to investigate effects of early-life environmental risk accumulation on polytoxicomania and additionally provide first genetic insight. Preadult accumulation of environmental risks (physical or sexual abuse, urbanicity, migration, cannabis, alcohol) was strongly associated with lifetime polytoxicomania (p = 1.5 × 10-45; OR = 31.4), preadult polytoxicomania with OR = 226.6 (p = 1.0 × 10-33) and adult polytoxicomania with OR = 17.5 (p = 3.4 × 10-24). Parallel accessibility of genetic data from GRAS patients and N~2100 controls for genome-wide association (GWAS) and phenotype-based genetic association studies (PGAS) permitted the creation of a novel multiple GWAS-PGAS approach. This approach yielded 41 intuitively interesting SNPs, potentially conferring liability to preadult polytoxicomania, which await replication upon availability of suitable deep-phenotyped cohorts anywhere world-wide. Concisely, juvenile environmental risk accumulation, including cannabis and alcohol as starter/gateway drugs, strongly predicts polytoxicomania during adolescence and adulthood. This pivotal message should launch more effective sociopolitical measures to prevent this deleterious psychiatric condition.
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Stevens AK, Aston ER, Gunn RL, Sokolovsky AW, Padovano HT, White HR, Jackson KM. Does the Combination Matter? Examining the Influence of Alcohol and Cannabis Product Combinations on Simultaneous Use and Consequences in Daily Life. Alcohol Clin Exp Res 2021; 45:181-193. [PMID: 33242220 PMCID: PMC8142286 DOI: 10.1111/acer.14494] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/20/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Alcohol and marijuana/cannabis are frequently used simultaneously (i.e., SAM use). SAM use is complex, and the ways in which alcohol and cannabis are simultaneously used may reveal differential effects. The purpose of this study was to examine day-level effects of distinct alcohol and cannabis product combinations on simultaneous use and consequences on that day. METHODS College student SAM users (N = 274; 50% women; Mage = 19.82 years) were recruited to complete 54 days of data collection, including 5 repeated daily surveys each day. We identified 12 distinct product combinations reported during SAM-use days. We tested 4 reference groups, with one reflecting the most common use pattern and 3 potentially risky use patterns. We considered 3 outcomes (negative consequences, number of drinks, and number of cannabis uses) and used generalized linear mixed-effects models disentangling within- from between-person effects in all analyses. RESULTS Using multiple products (≥2) of alcohol was consistently linked to higher odds of experiencing a negative consequence. Combining beer with only one cannabis product (leaf or concentrate) was consistently associated with lower odds of a consequence. Combining cannabis with multiple alcohol products was associated with heavier alcohol consumption. Using dual cannabis products also was associated with heavier cannabis consumption, but this pattern was not significantly different than using concentrate only on a given day. CONCLUSION This is the first study to examine day-level influences of distinct alcohol and cannabis product combinations on consumption and consequences among young adult SAM users. Findings suggest that mixing alcohol products confers greater risk for negative consequences and heavier consumption, whereas there is little difference in cannabis consumption when using concentrate only vs. 2 cannabis products on a given day, except for concentrate + beer. Our findings support existing protective strategies of not mixing alcohol products and avoiding use of cannabis concentrate for SAM use as well.
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Affiliation(s)
- Angela K. Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Rachel L. Gunn
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Alexander W. Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Helene R. White
- Center of Alcohol and Substance Studies, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
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Wheeler PB, Stevens-Watkins D, Dogan JN, McCarthy D. Polysubstance use among frequent marijuana users: an examination of John Henryism Active Coping, psychiatric symptoms, and family social support among African American incarcerated men. J Ethn Subst Abuse 2020; 21:553-569. [PMID: 32697626 DOI: 10.1080/15332640.2020.1793861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Incarcerated African American men who use marijuana are vulnerable to polysubstance use, which is associated with greater risk for negative health and psychosocial outcomes than marijuana use alone. It is imperative to understand risk and protective factors for polysubstance use among this vulnerable population to inform the development of culturally tailored substance use interventions. The current study examined the association between John Henryism Active Coping (JHAC), family social support, psychiatric symptoms, and polysubstance use among African American incarcerated men who frequently use marijuana. Results indicated that higher John Henryism Active Coping (JHAC) is associated with decreased likelihood of engaging in polysubstance use, while psychiatric symptoms are associated with increased likelihood of polysubstance use. Incorporating elements of JHAC into concurrent mental health and substance use treatment may reduce risk for overdose and reincarceration among African American incarcerated men upon release into the community.
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Affiliation(s)
- Paris B Wheeler
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
| | - Jardin N Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
| | - Daniel McCarthy
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
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Bailey AJ, Finn PR. Examining the Utility of a General Substance Use Spectrum Using Latent Trait Modeling. Drug Alcohol Depend 2020; 212:107998. [PMID: 32362437 PMCID: PMC7293921 DOI: 10.1016/j.drugalcdep.2020.107998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Polysubstance use (PSU; lifetime use of multiple substances) is common among individuals with problematic alcohol/substance use and is associated with poor prognosis and poor physical/mental health. Furthermore, simultaneous co-use of substances, such that drug effects overlap, is also common and related to unique risks (e.g. overdose). Despite the importance of PSU, current diagnostic systems continue to conceptualize problems with alcohol/substances as class-specific constructs (e.g. Stimulant Use Disorder), which essentially ignore many unique PSU processes. METHODS The current study modeled problems with alcohol, cannabis, stimulants, sedatives, opiates, and simultaneous co-use of these substances as a manifestation of a general substance use continuum versus as correlated class-specific constructs in a sample of young-adults(n = 2482) using confirmatory factor analysis. Utility of the models was evaluated by examining associations between the general substance use spectrum and class-specific latent factors with measures of anxiety, ADHD, adult antisocial problems, borderline symptoms, neuroticism, and intelligence in a subset of the sample(n=847). RESULTS Findings supported the conceptualization of problems with all substances, including co-use of substances, as being manifestations of a general substance use spectrum, as class-specific constructs were not differentially associated with other measures of psychological dysfunction. Examination of this general substance use spectrum indicated that all substances, separately and co-use, were robustly informative of this spectrum, but tended to discriminate between different severity levels. DISCUSSION The general substance use spectrum allows for integration of information from the use and co-use of all substances to provide better assessment of overall problems with substances compared to class-specific constructs.
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Affiliation(s)
- Allen J Bailey
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA; Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA.
| | - Peter R Finn
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA; Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA.
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