PROFILES OF ALCOHOL AND MARIJUANA USE AMONG SIMULTANEOUS ALCOHOL AND MARIJUANA USERS: INDIVIDUAL DIFFERENCES IN DEMOGRAPHICS AND SUBSTANCE USE

Assessment of simultaneous alcohol and cannabis use and its related consequences and cognitions in college students: A narrative review

As rates of students using cannabis continue to rise, simultaneous use of alcohol and cannabis (such that their effects overlap; commonly referred to as simultaneous alcohol and marijuana [SAM] use) is prevalent among college students who use both substances. Although research focusing on SAM use and related cognitions and consequences continues to grow, there are no common established measures, as approaches vary across studies. This narrative review identifies current methods for assessing SAM use and measures of SAM-related consequences and cognitions (motives and expectancies) among college students, evaluates how they were developed, identifies gaps in the literature, and provides recommendations for future directions of assessment. We conclude that the assessment of SAM use is limited by difficulties in the assessment of cannabis quantity and potency. However, and the lack of a psychometrically validated measure of SAM consequences. However, measures of SAM motives and expectancies have been published with support from psychometric examinations such as exploratory factor analysis, confirmatory factor analysis, and measurement invariance. Research is needed that incorporates qualitative approaches in the development of SAM use measures so that unique items specific to SAM use rather than single-substance use can be identified. Additionally, validation of these measures is needed across different samples that vary demographically, such as by race and gender or sex. Future research should consider the development of a measure of protective behavioral strategies  specific to SAM use to inform interventions that target the reduction of negative consequences of SAM use.

Sex and Gender Differences in Simultaneous Alcohol and Cannabis Use: a Narrative Review

Purpose of Review

The aim is to review recent literature on sex and gender differences in patterns of use, motives, pharmacological effects, and consequences of simultaneous alcohol and cannabis use (SAC).

Recent Findings

Men engage in SAC more frequently than women. Women may have more substance-specific motives for use, while men tend to consistently endorse social/enhancement motives for both alcohol and cannabis. Regarding pharmacological effects, women experience the same subjective effects as men do at lower levels of use, with some evidence that women modulate cannabis use during simultaneous use episodes to avoid greater subjective intoxication. Finally, women appear more vulnerable to experiencing a range of positive and negative consequences from SAC relative to men.

Summary

Research has identified several important sex/gender differences in SAC and its correlates and consequences. However, research has primarily focused on white and cisgender populations, with a need for more research among racial/ethnic and gender minorities.

"What was the vibe you were going for?" SAM Behaviors and Socialization During the COVID-19 Pandemic, a Qualitative Approach

Introduction

Marijuana use is at historic highs amongst college-aged adults, who are more likely to engage in simultaneous alcohol and marijuana use (SAM) than other age cohorts. For college students, the COVID-19 pandemic is a unique transitory phenomenon that led to isolation, as well as changes in socialization, academic environments, and substance use. This exploratory qualitative study aims to understand SAM socialization and motivation behaviors among college students.

Methods

Semi-structured qualitative interviews (N=32) were conducted across the United States from January 2021-April 2021via Zoom. Interviews were then transcribed, then a thematic analysis was conducted in Atlas.ti.

Results

The sample was primarily college juniors (mage=21). Since the pandemic, half of the participants increased SAM, whereas the other half decreased SAM. SAM was reported in different categories including primarily with friends, but, much less with partners and with roommates. More than half of the sample indicated that they used SAM alone. Motivations to engage in SAM included relaxing, socializing, offsetting stressors specific to the COVID-19 pandemic, and relieving general stress, anxiety and boredom.

Conclusion

The COVID-19 pandemic impacted college students' substance use in interesting ways. Understanding the behaviors of SAM in the context of the COVID-19 pandemic is crucial due to the legalization of marijuana in many states. This understanding has significant implications for prevention strategies and potential policy interventions. Our study yielded findings regarding the impact of socialization on SAM. We discovered that not only does socialization affect SAM, but the specific contexts and motivations behind these behaviors also play a crucial role, which adds to our developing understanding of SAM behavior.

Reasons for not drinking among young adults with simultaneous alcohol and cannabis use: A latent class analysis applied to daily diary data

Simultaneous alcohol and cannabis use (i.e., simultaneous use) is prevalent among young adults and often associated with negative consequences. Understanding reasons for not drinking (RND) may provide insight into a key intervention target for reducing negative consequences associated with simultaneous use. RND may vary on a day-to-day level, and multiple RND may be endorsed on a given day. Latent class analysis (LCA) of daily diary data is a nuanced approach that can identify complex patterns of daily RND as well as its day- and person-level covariates. The current study was a secondary data analysis of daily diary data from young adults who engaged in heavy drinking and recent simultaneous use (n = 154). We aimed to: (1) characterize daily RND, (2) use LCA to classify day-level patterns of RND, and (3) compare latent classes on same-day variables (i.e., positive and negative affect, day of the week), previous-day variables (i.e., substance use, intoxication level, consequences), and person-level characteristics (i.e., age, sex, baseline substance use frequency, simultaneous use motives). Participants completed up to 14 consecutive diaries. Multilevel LCA identified four classes of heterogeneous daily RND profiles. Daily RND classes significantly differed in terms of day of the week, previous day quantity of cannabis use, and several baseline variables (age, typical substance use, simultaneous use motives). Study findings offer preliminary support for heterogeneous RND classes among young adults engaging in simultaneous use and suggest multiple avenues for future research.

Educational Attainment and Differences in Patterns of Alcohol, Cannabis, and Tobacco Use Among Young Adults

Multigroup latent profile analysis examined whether patterns of alcohol, cannabis, and tobacco use varied between college student and nonstudent young adults ( N = 745), and profiles were characterized by alcohol- and drug-related problems, psychological distress, and perceived stress. Findings supported three profiles (high use across substances, primarily high tobacco use, and low use across substances) among students. Students in the high use group, relative to other groups, experienced the highest number of problems and psychological distress. Among nonstudents, two profiles emerged (high use across substances and primarily high tobacco use), and noncollege participants in the high use group experienced the highest problems, psychological distress, and perceived stress. Students, compared to nonstudents, reported more variability in their substance use profiles, as a low substance use group was not observed among nonstudents. Prevention and intervention efforts should target nonstudents, which could aid in reducing negative health outcomes based on disparities in education.

Who's at greatest risk? Latent profiles of alcohol and cannabis use and related consequences among college students

BACKGROUND

There is significant heterogeneity in alcohol and cannabis use patterns among college students, with some engaging in use patterns that heighten their risk for adverse consequences. Person-centered approaches can help identify those subgroups of students with riskier use patterns. Latent Profile Analyses (LPA) were conducted to identify subgroups based on alcohol and cannabis use frequency and quantity, to explore demographic covariates and to examine mean differences across subgroups on alcohol- and cannabis-related consequences, simultaneous use, and other substance use.

METHODS

Participants were 2,423 college students (Mage = 20.1; 72  % female) recruited from seven US universities who endorsed past-month alcohol and cannabis use and completed an online survey of substance use behaviors.

RESULTS

A four-profile solution was the best fitting model. Profile 1 represented "light, infrequent alcohol and cannabis use" (73.8 %), Profile 2 represented "heavy, infrequent alcohol and moderate, frequent cannabis use" (15.9 %), Profile 3 represented "moderate, frequent alcohol and cannabis use" (5.6 %) and Profile 4 represented "very heavy, frequent alcohol and heavy, frequent cannabis use" (4.7 %). Students who identify as male, White non-Hispanic, and/or Greek-affiliated were more likely to be in the heavy alcohol use profiles. Profiles 3 and 4 represent high-risk profiles, with both having a higher likelihood of simultaneous use, Profile 3 endorsing more cannabis consequences, and Profile 4 endorsing more alcohol consequences.

CONCLUSION

Results suggest that heavy alcohol or heavy co-use heightens risk for serious adverse consequences.