Marijuana, but not alcohol, use frequency associated with greater loneliness, psychological distress, and less flourishing among young adults

Is the 21st birthday a turning point for alcohol and cannabis use? A monthly study of young adults

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.

Fatty Acid Amide Hydrolase and Cannabinoid Receptor Type 1 Genes Regulation is Modulated by Social Isolation in Rats

Social isolation is a state of lack of social connections, involving the modulation of different molecular signalling cascades and associated with high risk of mental health issues. To investigate if and how gene expression is modulated by social experience at the central level, we analyzed the effects of 5 weeks of social isolation in rats focusing on endocannabinoid system genes transcription in key brain regions involved in emotional control. We observed selective reduction in mRNA levels for fatty acid amide hydrolase (Faah) and cannabinoid receptor type 1 (Cnr1) genes in the amygdala complex and of Cnr1 in the prefrontal cortex of socially isolated rats when compared to controls, and these changes appear to be partially driven by trimethylation of Lysine 27 and acetylation of Lysine 9 at Histone 3. The alterations of Cnr1 transcriptional regulation result also directly correlated with those of oxytocin receptor gene. We here suggest that to counteract the effects of SI, it is of relevance to restore the endocannabinoid system homeostasis via the use of environmental triggers able to revert those epigenetic mechanisms accounting for the alterations observed.

Differential change in alcohol consumption during the COVID-19 pandemic: the role of loneliness, socialization, and mental well-being

Introduction

The COVID-19 pandemic led to a surge in mental health issues and psychological distress, disruption to work/studying conditions, and social isolation particularly among young adults. Changes in these factors are differentially associated with alcohol use. Moreover, the relationship between these factors are bidirectional and may have fluctuated throughout the different phases of the pandemic. However, studies focusing on young adults had conflicting results, short follow-up periods, and lacked comprehensive data to describe underlying mechanisms.

Methods

1067 young adults participated in repetitive measures termed wave 4 (2021) of the Survey of Adolescent Life in Västmanland Cohort "SALVe" Cohort. Of these, 889 also completed pre-pandemic measurements termed wave 3 (2018). Participants completed the Alcohol Use Disorders Identification Test (AUDIT) to evaluate alcohol consumption and harmful use. Cross-sectional associations between perceived changes in alcohol use and shift in individual, mental health, and work environment factors were examined using Chi-square tests. Logistic regression was utilized to identify pre-pandemic predictors of harmful consumption during the pandemic.

Results

Harmful consumption decreased only in females following the COVID-19 pandemic. Participants who reported increased feelings of depression, anxiety, and loneliness were more likely to increase their alcohol use. Interestingly, the subgroup who felt less lonely and met their friends more often, as well as those who continued working/studying from their regular workplace also had an increased likelihood of higher consumption. Only pre-pandemic ADHD and delinquency symptoms predicted harmful alcohol consumption following the pandemic.

Conclusion

Females reduced harmful alcohol consumption during the COVID-19 pandemic. While those who suffered the burden of social isolation and distress were more likely to increase their alcohol use, young adults who felt less lonely and met their friends more often also had a similar outcome. The relationship between loneliness and alcohol consumption among young adults is influenced by the social factors that may be facilitated by drinking.

Psychological Distress and Cannabis Vaping Among U.S. Adolescents

INTRODUCTION

Cannabis vaping has become increasingly popular among adolescents in recent years. However, research examining mental health determinants of cannabis vaping is scant. This study investigated the relationship between psychological distress and cannabis vaping among a nationally representative sample of U.S. adolescents.

METHODS

Data are from the cross-sectional 2022 National Youth Tobacco Survey, restricted to adolescents ages 11-18 (n=22,202). Psychological distress was categorized as normal, mild, moderate, and severe according to the Patient Health Questionnaire for Depression and Anxiety-4. Cannabis vaping was defined as any use in the past 30 days. To estimate the association between psychological distress and cannabis vaping, logistic regression was performed adjusted for age, biological sex, race/ethnicity, sexual orientation, school grades, family smoking/vaping, nicotine vaping, other tobacco use, and blunt use. Analyses were conducted in 2023.

RESULTS

Nearly 8% of adolescents vaped cannabis in the past 30 days, and 25.6% reported moderate or severe psychological distress. Mild, moderate, and severe psychological distress were associated with cannabis vaping in the unadjusted model. In the adjusted model, the odds of cannabis vaping were higher among adolescents who had severe psychological distress (OR: 1.46, 95% CI: 1.09-1.96), compared to adolescents with no distress. Older age, poor grades, family smoking/vaping, nicotine vaping, other tobacco use, and blunt use were also associated with cannabis vaping.

CONCLUSIONS

Severe psychological distress was associated with past 30-day cannabis vaping among U.S. adolescents. Adolescents experiencing psychological distress need to be screened for cannabis vaping to help prevent and reduce use and promote mental health.

Age-related patterns in high-risk alcohol and cannabis use and their associations with positive and negative affect in young adulthood

OBJECTIVE

We examined age-varying associations between young adult simultaneous alcohol and marijuana/cannabis use (SAM) and heavy episodic drinking (HED) and positive and negative affect to inform harm reduction efforts.

METHODS

Young adults reporting past-year alcohol use (n = 556; ages 19-25) were recruited in a state where alcohol and nonmedical cannabis use was legal for those 21 +. Participants provided 24 repeated monthly assessments. Among those reporting past-month cannabis use on at least one survey, logistic time-varying effect models estimated (1) the age-varying prevalence of and associations between past-month SAM and HED and (2) age-varying unique associations of affect with SAM and HED.

RESULTS

There was a positive age-varying association between HED and SAM over time that was highest at age 19 (OR = 7.56), decreased until age 20.7 (OR = 3.39), increased until age 23.0 (OR = 4.85), and decreased until the association became non-significant by age 25. Negative affect was positively associated with SAM from ages 20.7 to 23.0, peaking at age 21.8 (OR = 1.36). Positive affect was positively associated with HED from ages 19.4 to 20.4 (peak OR = 1.25) and ages 22.5 to 24.5 (peak OR = 1.38). In contrast, positive affect was not uniquely associated with SAM nor negative affect with HED across ages 19-25.

CONCLUSIONS

While HED and SAM were positively associated throughout young adulthood and interventions could target them in tandem, their associations with affect suggest differential etiologic processes. Preventive intervention and harm reduction efforts should attend to psychological context in which these behaviors occur.

General self-efficacy, not musculoskeletal health, was associated with social isolation and loneliness in older adults during the COVID-19 pandemic: findings from the Hertfordshire Cohort Study

BACKGROUND

Social isolation and loneliness are prevalent among older adults. This study investigated factors influencing worsening social isolation and loneliness in community-dwelling older adults during the COVID-19 pandemic, focusing on musculoskeletal conditions, falls, and fractures.

METHODS

We studied 153 participants from the Hertfordshire Cohort Study. Baseline assessments (2019-20) included osteoporosis, clinical osteoarthritis, fractures after age 45 years, falls in previous year, and lifestyle factors. Self-efficacy was assessed using a shortened General Self-Efficacy Scale. Social isolation was assessed using the 6-item Lubben Social Network Scale. Follow-up (2020-21) assessments included social isolation and loneliness using the 6-item De Jong-Gierveld scale for emotional, social, and overall loneliness.

RESULTS

Baseline median age was 83.1 years. A history of smoking predicted worsening social isolation (p = 0.046). Being married (p = 0.026) and higher self-efficacy scores (p = 0.03) predicted reduced social isolation at follow-up. Greater alcohol consumption was associated with higher overall loneliness (p = 0.026). Being married was related to a 36% (95% CI: 3%, 58%) reduction in emotional loneliness (p = 0.037). No musculoskeletal condition was associated with social isolation or loneliness. However, we observed a 22% (14%, 30%; p < 0.001) reduction in emotional loneliness and a 12% (4%, 20%; p = 0.003) reduction in overall loneliness per unit increase in self-efficacy score.

CONCLUSIONS

No musculoskeletal condition was associated with increased social isolation or loneliness, but longitudinal studies in larger samples are required. Greater self-efficacy was associated with reduced social isolation and reduced loneliness. Interventions promoting self-efficacy in older adults may reduce isolation and loneliness in this age group.

Loneliness Is Associated With Problematic Internet Use but Not With the Frequency of Substance Use: A Czech Cross-Sectional Study

Objectives: This study aimed to assess the associations between loneliness and the frequency of substance use and problematic Internet use (PIU) in different age groups. Methods: Data were collected in April 2021 from a sample of 1,293 participants with main characteristics close to a nationally representative sample (mean age = 50.1 ± 15.4 years; 56% male). We measured loneliness with the Three-Item Loneliness Scale (TILS), PIU with the General Problematic Internet Use Scale-2 (GPIUS-2) and the frequency of drugs, alcohol, smoking or caffeine consumption. Spearman's correlation, the t-test, and one-way and multivariate linear regression models were used to analyze the data. Results: In our study, 43.8% of respondents reported moderate to severe levels of loneliness. Loneliness was associated with the severity of PIU [F (3, 1,277) = 15.25, p < 0.001], with higher loneliness corresponding to higher PIU. No significant relationship was found between loneliness and drugs, alcohol, smoking or caffeine consumption. Conclusion: Regardless of age, loneliness is associated with PIU but not with the frequency of substance use. Professional help for lonely people should focus on problematic Internet use in all age groups.

How does loneliness "get under the skin" to become biologically embedded?

Loneliness is linked to declining physical health across cardiovascular, inflammatory, metabolic, and cognitive domains. As a result, loneliness is increasingly being recognized as a public health threat, though the mechanisms that have been studied do not yet explain all loneliness-related health risk. Potential mechanisms include loneliness having 1.) direct, causal impacts on health, possibly maintained by epigenetic modification, 2.) indirect effects mediated through health-limiting behaviors, and 3.) artifactual associations perhaps related to genetic overlap and reverse causation. In this scoping review, we examine the evidence surrounding each of these pathways, with a particular emphasis on emerging research on epigenetic effects, in order to evaluate how loneliness becomes biologically embedded. We conclude that there are significant gaps in our knowledge of how psychosocial stress may lead to physiological changes, so more work is needed to understand if, how, and when loneliness has a direct influence on health. Hypothalamic-pituitary adrenocortical axis disruptions that lead to changes in gene expression through methylation and the activity of transcription factor proteins are one promising area of research but are confounded by a number of unmeasured factors. Therefore, wok is needed using causally informative designs, such as twin and family studies and intensively longitudinal diary studies.

Trajectories of loneliness during COVID-19 pandemic and associations with mental health and substance use

We examined patterns of longitudinal trajectories of loneliness during the COVID-19 pandemic using six time points (January 2020 [pre-pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most-likely loneliness trajectory adjusting for pre-pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre-pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past-month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co-occurring loneliness and cannabis use are needed.

Psychological Distress, Cannabis Use Frequency, and Cannabis Use Disorder Among US Adults in 2020

Using 2020 National Survey on Drug Use and Health data (N = 27,170, age 18+), we examined associations of psychological distress with: (1) cannabis use frequency among all adults, and (2) cannabis use disorder (CUD) among cannabis users. Of all adults, 18.2% reported past-year cannabis use, 12.9% reported mild-moderate psychological distress, and 12.9% reported serious psychological distress. Greater proportions of cannabis users, especially those under age 35, reported psychological distress. Of cannabis users, 28.1% met DSM-5 CUD criteria. Multinomial logistic regression results showed that serious, compared to no, psychological distress was significantly associated with cannabis use at all frequency levels. Both mild-moderate and serious levels of distress were associated with similar elevated CUD risk (RRR = 1.57, 95% CI = 1.15-2.15 for mild-moderate distress; RRR = 1.58, 95% CI = 1.19-2.09 for serious distress) and 2-4 times higher risks of having moderate or severe, compared to mild, CUD and higher odds of having alcohol use disorder. The prevalence of CUD and other substance use/use disorder among cannabis users is concerning as are the significant associations of psychological distress with greater cannabis use frequency, CUD, and other substance use/use disorder. Younger adults especially may benefit from increased behavioral health services given their high prevalence of psychological distress, cannabis use, and CUD.

Prevalence and correlates of cannabis use among individuals with DSM-5 social anxiety disorder: Findings from a nationally representative sample

Cannabis use disorder (CUD) and frequency of use are highly related to social anxiety disorder (SAD). With updates to diagnostic criteria of psychiatric disorders and recent changes in cannabis laws, the present study sought to explore the relationships between cannabis use, CUD, and social anxiety in a large nationally representative sample of individuals with lifetime (N = 1255) and past-year SAD (N = 980). Notably, we found that at the symptom level, at least weekly cannabis use was significantly related to fear or avoidance of social situations interfering with relationships in both samples. Weekly + cannabis use and CUD were significantly associated with lifetime SAD symptom severity, but only weekly + cannabis use was related to SAD severity in the past-year sample. We also found that weekly + cannabis use but not CUD was related to greater odds of seeking treatment for SAD and suicide attempt history. Overall, these data provide an updated examination of cannabis use and SAD using DSM-5 criteria and a large nationally representative sample and also highlight the importance of weekly + cannabis use as a marker of severity and suicide risk in individuals with SAD.

End User Participation in the Development of an Ecological Momentary Intervention to Improve Coping With Cannabis Cravings: Formative Study

BACKGROUND

Cannabis misuse in young adults is a major public health concern. An important predictor of continued use is cannabis craving. Due to the time-varying nature of cravings, brief momentary interventions delivered while cravings are elevated may improve the use of strategies to cope with cravings and reduce cannabis use.

OBJECTIVE

The goal of this manuscript is to describe a formative study to develop coping strategy messages for use in a subsequent intervention.

METHODS

Young adults (aged 19-25 years; n=20) who reported using cannabis >10 of the past 30 days recruited via social media participated in this formative study. Participants rated an initial set of 15 mindfulness and 15 distraction coping strategies on a scale from 1 to 4 (very low degree to very high degree) for clarity, usefulness, and tone. They also provided comments about the content.

RESULTS

Participants found the initial distraction messages slightly clearer than mindfulness (mean 3.5, SD 0.4 and mean 3.4, SD 0.4, respectively), both were comparable in tone (mean 3.2, SD 0.5 and mean 3.2, SD 0.4, respectively), and mindfulness messages were more useful than distraction (mean 3.0, SD 0.5 and mean 2.8, SD 0.6, respectively). Of the 30 messages, 29 received a rating of very low or low (<2) on any domain by >3 participants or received a comment suggesting a change. We revised all these messages based on this feedback, and the participants rated the revised messages approximately 2 weeks later. Participants earned US $10 for completing the first and US $20 for the second survey. The ratings improved on usefulness (especially the distraction items) with very little change in clarity and tone. The top 10 messages of each coping type (mindfulness and distraction) were identified by overall average rating (collapsed across all 3 dimensions: all rated >3.0). The final items were comparable in clarity (distraction mean 3.6, SD 0.4; mindfulness mean 3.6, SD 0.4), tone (distraction mean 3.4, SD 0.4; mindfulness mean 3.4, SD 0.4), and usefulness (distraction mean 3.1, SD 0.5; mindfulness mean 3.2, SD 0.5).

CONCLUSIONS

The inclusion of end users in the formative process of developing these messages was valuable and resulted in improvements to the content of the messages. The majority of the messages were changed in some way including the removal of potentially triggering language. These messages were subsequently used in an ecological momentary intervention.

Smoking Mostly Alone as a Risk Factor for Cannabis Use Disorders and Depressive Symptoms

The empirically grounded etiological models of cannabis use already include a vast range of psychological factors (within an individual), paving the ground for individualized prevention and intervention programs. However, the interpersonal (among individuals) and relational variables influencing the emergence of excessive cannabis use are less understood. Particularly, the impact of consumption context (i.e., smoking alone or with others) on cannabis use intensity in youth remains to be clarified. We evaluated how smoking mostly alone modulates cannabis use disorders (CUD) and depressive symptoms in college students. A sample of 854 individuals from France (568 women, 286 men) who used cannabis in the last 6 months completed self-report questionnaires evaluating cannabis consumption, CUD symptoms, and depressive symptoms. Mostly alone users presented higher current use frequency as well as increased CUD and depressive symptoms compared to mostly social users. Smoking mostly alone remained positively correlated with CUD and depressive symptoms, even when controlling for current use frequency. The association between smoking mostly alone and depressive symptoms was significant before adjustment for symptoms of CUD. The loss of significance of this association after control reflected the mediating effects of symptoms of CUD on the relationship between smoking mostly alone and depressive symptoms. These results suggest that smoking mostly alone constitutes a risk factor for uncontrolled cannabis use and promote the relationship between cannabis use and depressive disorders, potentially through loneliness and social isolation. Longitudinal studies are required to identify the causal mechanisms underlying the links between smoking mostly alone, cannabis use and psychopathological disorders.

Alcohol Use Motives and Cannabis Use among Young Adults: Between- and Within-Person Associations Based on Monthly Data from a Community Sample

Objective: Alcohol use motives may characterize types of drinking that have unique associations with cannabis use and illuminate psychological processes underlying cannabis use. This study examined how alcohol use motives, both on average across two years and in a particular month, were associated with any and frequent cannabis use. Method: A young adult community sample (n = 486; 54% female, age 18-23 at enrollment) who used alcohol and cannabis in the year prior to study enrollment provided two years of monthly data. Multilevel logistic regression models predicting any and frequent (10+ occasions) past-month cannabis use estimated both between- and within-person effects of alcohol use motives, controlling for frequency of alcohol use and demographic covariates. Results: Alcohol use frequency was positively associated with any cannabis use at the between- and within-person levels and frequent cannabis use at the within-person level. Across two years, individuals who had higher average coping drinking motives and lower average social and conformity drinking motives were more likely to use cannabis frequently. Further, between-person variation in social motives was negatively associated with any cannabis use. Within-person, months with greater enhancement and social motives were associated with higher probability of any cannabis use. Conclusions: Using alcohol for coping reasons, rather than other-focused social reasons, indicated greater risk for frequent cannabis use, although drinking for social and enhancement reasons in a particular month signaled slightly increased short-term probability of any cannabis use. Assessment of alcohol motives may help guide targeting and timing of prevention related to cannabis use.

Daily diary study of loneliness, alcohol, and drug use during the COVID-19 Pandemic

BACKGROUND

Research conducted during the COVID-19 Pandemic has identified two co-occurring public health concerns: loneliness and substance use. Findings from research conducted prior to the pandemic are inconclusive as to the links between loneliness and substance use. This study aimed to measure associations of loneliness with three different types of substance use during COVID-19: daily number of alcoholic drinks, cannabis use, and non-cannabis drug use.

METHOD

Data were obtained between October 2020 and May 2021 from 2,648 US adults (Mage  = 38.76, 65.4% women) diverse with respect to race and ethnicity using online recruitment. Participants completed baseline surveys and daily assessments for 30 days. A daily loneliness measure was recoded into separate within- and between-person predictor variables. Daily outcome measures included the number of alcoholic drinks consumed and dichotomous cannabis and non-cannabis drug use variables. Generalized linear multilevel models (GLMLM) were used to examine within- and between-person associations between loneliness and substance use.

RESULTS

The unconditional means model indicated that 59.0% of the variance in the daily number of alcoholic drinks was due to within-person variability. GLMLM analyses revealed that, overall, people drank more on days when they felt a particularly high or particularly low degree of loneliness (positive quadratic effect). There was a negative and significant within-person association between daily loneliness and the likelihood of cannabis use. There was also a positive and significant within-person association between daily loneliness and the likelihood of non-cannabis drug use.

CONCLUSIONS

Associations between loneliness and substance use vary with substance type and whether within- or between-person differences are assessed. These findings are relevant to the persistence of substance use disorders and thus of potential clinical importance. Individuals who do not experience severe loneliness at intake but who show daily increases in loneliness above baseline levels are at heightened risk of alcohol and non-cannabis drug use. Future research could profitably examine just-in-time adaptive interventions that assess fluctuations in loneliness to prevent the development or exacerbation of substance use disorders.

Changes in the clustering of health-related behaviors during the COVID-19 pandemic: examining predictors using latent transition analysis

The COVID-19 pandemic has had a significant impact on daily life, affecting both physical and mental health. Changes arising from the pandemic may longitudinally impact health-related behaviors (HRB). As different HRBs co-occur, in this study, we explore how six HRBs - alcohol (past-week and binge-drinking), tobacco, marijuana, benzodiazepine use, and unhealthy food consumption - were grouped and changed over time during the COVID-19 pandemic. A sample of 1038 university students and staff (18 to 73 years old) of two universities completed an online psychometrically adequate survey regarding their recalled HRB (T0, pre-COVID-19 pandemic) and the impact of COVID-19 on their behaviors during July (T1) and November (T2). Latent Transition Analysis (LTA) was used to identify HRB cluster membership and how clusters changed across T0, T1, and T2. Four clusters emerged, but remained mainly stable over time: ‘Lower risk’ (65.2–80%), ‘Smokers and drinkers’ (1.5–0.01%), ‘Binge-drinkers and marijuana users’ (27.6–13.9%), and ‘Smokers and binge-drinkers’ (5.6–5.8%). Participants who moved from one cluster to another lowered their HRB across time, migrating from the ‘Binge-drinkers and marijuana users’ cluster to ‘Lower risk’. Participants in this cluster were characterized as less affected economically by the COVID-19 pandemic, with lower reported stress levels, anxiety, depression, and loneliness than the other clusters. Our results provide evidence of how HRBs clustered together and transitioned longitudinally during the COVID-19 pandemic. HRB clustering across time offers a valuable piece of information for the tailoring of interventions to improve HRB.

Young Adults' Loneliness and Depression During the COVID-19 Pandemic: A Moderated Mediation Model

Since the outbreak of the COVID-19 pandemic in December 2019, millions of people have been infected with the disease. The COVID-19 pandemic also produced severe mental health problems, such as loneliness and depression. The present study aimed to examine the mediating role of cognitive reappraisal and moderating role of resilience in the relationship between young adults’ loneliness and depression during the pandemic by adopting a cross-sectional research approach. In March 2020, 654 young adults (18–29 years old) were recruited to complete the measures for loneliness, depression, emotion regulation, and resilience. Results found that loneliness was positively and moderately associated with depression (r = 0.531, p < 0.001), and that both loneliness and depression were separately negatively associated with cognitive reappraisal (r = −0.348, p < 0.001; r = −0.424, p < 0.001) and resilience (r = −0.436, p < 0.001; r = −0.419, p < 0.001). The results indicated that both loneliness and depression were not associated with expressive suppression (r = 0.067, p = 0.087; r = −0.002, p = 0.961). The moderated mediation model results revealed that only cognitive reappraisal partially mediated the relationship between loneliness and depression (b = −0.301; Boot 95% CI = −0.388, −0.215). In addition, the results of the moderated mediation model indicated that resilience moderated the association between loneliness and depression (b = 0.035, p < 0.001, Boot 95% CI = 0.014, 0.055), while also moderated the impact of cognitive reappraisal on depression (b = −0.031, p < 0.001, Boot 95% CI = −0.058, −0.005). These findings have practical implications that broaden our understanding of depression in young adults and shed light on how to enhance cognitive reappraisal and resilience as a means of combating depression in this age group during the COVID-19 pandemic.

Using Substances to Cope With the COVID-19 Pandemic: U.S. National Data at Age 19 Years

PURPOSE

To examine predictors of using substances to cope with the COVID-19 pandemic, including pandemic-related isolation, stress, economic hardship, demographics, and prepandemic substance use.

METHODS

A U.S. national sample (N = 1,244) was followed from the 12th grade in Spring 2019 to Fall 2020 (M = 19.6 years) when young adults were asked about their use of marijuana, vaping, drinking, and other drugs to cope.

RESULTS

In Fall 2020, 15.7% reported using marijuana, 8.9% increased vaping, and 8.2% increased drinking to cope with social distancing and isolation. In multivariable analyses controlling for demographics and prepandemic substance use, COVID-related isolation was associated with marijuana use (odds ratio = 1.31, 95% confidence interval = 1.06-1.63) and economic hardship with increased drinking (odds ratio = 1.39, 95% confidence interval = 1.01-1.92). There were few demographic differences. Most (>80%) who reported COVID-related substance use coping used that substance before pandemic.

DISCUSSION

Young people reported using substances to cope with the COVID-19 pandemic, especially if they reported prepandemic use.

Loneliness and multiple health domains: associations among emerging adults

Emerging adults (18–25 years), particularly racially/ethnically diverse and sexual and gender minority populations, may experience loneliness following major life transitions. How loneliness relates to health and health disparities during this developmental period is not well understood. We examine associations of loneliness with physical (self-rated health), behavioral (alcohol/marijuana consequences; nicotine dependence), and health behavior outcomes (weekday and weekend sleep; trouble sleeping), and investigate moderating effects by sex, race/ethnicity, and sexual/gender minority (SGM) status. Adjusted models using cross-sectional data from 2,534 emerging adults, predominantly in California, examined associations between loneliness and each outcome and tested interactions of loneliness with sex, race/ethnicity, and SGM status. Higher loneliness was significantly associated with worse self-rated health, higher marijuana consequences, less weekday sleep, and greater odds of feeling bothered by trouble sleeping. None of the interactions were significant. Findings suggest that interventions to reduce loneliness may help promote healthy development among emerging adults across subgroups.

Prospective effects of loneliness on frequency of alcohol and marijuana use

BACKGROUND

Loneliness is a widespread problem, with demonstrated negative health effects. However, prospective data on the relationship between loneliness and problematic substance use are lacking, and few studies have examined specific commonplace substances, such as alcohol and cannabis. This study used prospective data from a community sample of US adults with problematic alcohol or cannabis use to examine whether loneliness was a predictor of subsequent increased substance use.

METHODS

Participants (N = 210) were recruited between 05/2016-06/2019 from a New York City medical center. At baseline, 3-month, and 6-month follow-ups, participants completed identical computerized questionnaires. We used generalized estimating equations to assess the average effect of past 2-week loneliness on subsequent number of days of alcohol or cannabis use, controlling for baseline days of use, demographic characteristics, and past 2-week DSM-5 depression.

RESULTS

Compared with individuals who were never lonely, participants with moderate or severe loneliness had a significantly higher frequency of alcohol or cannabis use at the subsequent assessment (β = 0.25 95% CI: 0.08-0.42).

CONCLUSION

Individuals experiencing loneliness at least a few times in the past 2 weeks reported more days of subsequent alcohol or cannabis use compared with individuals who were not lonely. This is cause for concern, as national surveys of US adults indicate increasing rates of loneliness, depression and substance use during the COVID-19 pandemic. These results suggest the need for health care providers to screen for feelings of loneliness and potentially harmful coping behaviors such as substance use, and to offer healthier alternative coping strategies.

Young adult simultaneous alcohol and marijuana use: Between- and within-person associations with negative alcohol-related consequences, mental health, and general health across two-years

BACKGROUND

Simultaneous alcohol and marijuana use (SAM) may be linked to both short- and longer-term problems for young adults. Across two years of longitudinal data, we examined between- and monthly within-person associations of alcohol and marijuana use patterns, including SAM, with negative alcohol-related consequences, depressive symptoms, and general health.

METHODS

773 young adults (aged 18-23 at screening; 56% women) who used alcohol in the year prior to study enrollment were surveyed monthly for 24 months. Multilevel models assessed associations of alcohol and marijuana use patterns with outcomes.

RESULTS

Individuals who reported a higher proportion of SAM months had more negative alcohol-related consequences (Rate Ratio [RR] = 1.49, 95% CI: 1.17,1.89). At the within-person level, participants experienced more alcohol-related consequences on months when SAM was reported compared to months of alcohol-only (RR = 1.17, 95% CI: 1.10,1.25) and months of concurrent alcohol and marijuana use without simultaneous use (CAM; RR = 1.20, 95% CI: 1.11,1.29). Compared to alcohol-only, SAM was associated with more depressive symptoms and poorer general health at the between-person level and with more depressive symptoms at the monthly within-person level; however, SAM did not differ substantially from using neither alcohol nor marijuana or CAM for these outcomes at either the between- or within-person level.

CONCLUSIONS

SAM use may indicate risk for negative alcohol-related consequences, both within months of SAM use and across more extended time periods. Individuals who engage in SAM may experience worse mental and physical health than individuals who use alcohol exclusively.

Loneliness and Daily Alcohol Consumption During the COVID-19 Pandemic

Aims

This pilot study aimed to identify associations of loneliness and daily alcohol consumption among US adults during the Coronavirus Disease-2019 pandemic.

Method

Participants completed daily assessments for 30 days.

Results

Results suggest people who feel lonelier on average drink more alcohol, however, people who feel lonelier than usual drink less.

Conclusion

Findings highlight the need to disaggregate within- and between-person components of alcohol use.

Negative evaluation of role transitions is associated with perceived stress and alcohol consequences: Examination of the Transitions Overload Model in young adulthood using two years of monthly data

BACKGROUND

Young adulthood is characterized by transitions into and out of social roles in multiple domains. Consistent with self-medication models of alcohol use, the Transitions Overload Model (J Stud Alcohol Suppl, 14, 2002, 54) hypothesizes that one cause of increased alcohol use during young adulthood may be the stress of navigating simultaneous role transitions. This study examined the simultaneous occurrence of major developmental role transitions in the domains of education, employment, romantic relationships, and residential status and their associations with perceived stress, heavy episodic drinking (HED), and negative alcohol-related consequences. Further, we extended the Transitions Overload Model to explore whether the number of transitions rated as having a negative impact on one's life was related to perceived stress, HED, and alcohol-related consequences.

METHODS

A community sample of young adult drinkers (N = 767, 57% women, ages 18 to 25 years) in the Pacific Northwest provided monthly data across 2 years. Multilevel models were used to assess the average (between-person) and month-to-month (within-person) associations of role transitions with perceived stress, HED, and negative alcohol-related consequences.

RESULTS

Although having more role transitions was positively associated with HED frequency and alcohol-related consequences at both the between- and within-person (monthly) levels, it was not associated with increased stress. The number of transitions rated as having a negative impact on one's life, however, was positively associated with stress. Thus, rather than the total number of transitions, it is the number of negatively perceived major developmental role transitions that is associated with perceived stress and increased risk for negative alcohol-related consequences.

CONCLUSIONS

Contrary to Transitions Overload Model assumptions, more transitions were not a significant predictor of more perceived stress; rather, the evaluation of the transition as negative was associated with stress and negative alcohol-related outcomes. This distinction may help elucidate the etiology of stress and subsequent alcohol consequences and identify individuals at-risk of these effects.

Trends over time in adult cannabis use: A review of recent findings

In the United States, policies regarding the medical and nonmedical use of cannabis are changing rapidly. In 2021, a total of 34 US states have legalized cannabis for adult medical use, and 15 of these states have legalized adult non-medical use. These changing policies have raised questions about increasing prevalences of cannabis use, changing perceptions regarding frequent use, and potentially related outcomes such as comorbid psychiatric illness or driving under the influence of cannabis. Research regarding the correlates of any and frequent cannabis use is also developing quickly. This article reviews recent empirical studies concerning (1) adult trends in cannabis use, (2) state cannabis laws and related outcomes, and (3) emerging evidence regarding how the global coronavirus 19 pandemic may impact cannabis use patterns. We summarize recent findings and conclude with suggestions to address unanticipated effects of rapidly changing cannabis laws and policies.