Demographic, substance use, and mental well-being correlates of high-intensity drinking among college students and non-college young adults: implications for intervention

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.

Experiences of Healthcare and Substance Use Treatment Provider-based Stigma Among Patients Receiving Methadone

Background

Medications for Opioid Use Disorder (MOUD) are efficacious, however only one-third of individuals with an opioid use disorder (OUD) enter into treatment. Low rates of MOUD utilization are partially due to stigma. This study examines provider-based stigma toward MOUD and identifies factors associated with experiencing stigma related to MOUD from substance use treatment and healthcare providers among people receiving methadone.

Methods

Clients receiving MOUD at an opioid treatment program (N = 247) were recruited to complete a cross-sectional computer-based survey assessing socio-demographics, substance use, depression and anxiety symptoms, self-stigma, and recovery supports/barriers. Logistic regression was used to examine factors associated with hearing negative comments about MOUD from substance use treatment and healthcare providers.

Results

27.9% and 56.7% of respondents reported they sometimes/often hear negative comments about MOUD from substance use treatment and healthcare providers, respectively. Logistic regression results indicate that individuals who experience more negative consequences resulting from their OUD (OR=1.09, p=.019) had greater odds of hearing negative comments from substance use treatment providers. Age (OR=0.966, p=.017) and treatment stigma (OR=1.42, p=.030) were associated with greater odds of hearing negative comments from healthcare providers.

Conclusions

Stigma can be a deterrent to seeking substance use treatment, healthcare, and recovery support. Understanding factors associated with experiencing stigma from substance use treatment providers and healthcare providers is important as these individuals may act as advocates for those with OUD. This study highlights individual factors associated with hearing negative comments about methadone and other MOUD and point to areas for targeted education.

Inconsistency in Self-Reporting the Use of Substances over Time

The reliability of reporting the use of substances has important implications for researchers, policymakers, treatment providers, and other stakeholders. Recanting, defined as endorsing use of a particular substance initially and later denying it, threatens such reliability. Methods: Data from the National Longitudinal Study of Adolescent to Adult Health are utilized. This is a longitudinal nationally representative study of the U.S. individuals who have participated in five waves of interviews, starting in adolescence in 1994 and 1995 (Wave 1) and ending with the most recent wave (2016-2019) where respondents were aged 33-44 (Wave 5). Results: We found substantial recanting across years. From 2 to 17% of respondents recant over time. Misuse of prescription drugs is the most commonly recanted substance use behavior, at 16.8%. After this, alcohol use, and smoking are the most recanted substances. Race-ethnicity and education have a widespread association with recanting the various substances, and age and gender are also of importance. Conclusion: In the present study, we examined the issue of recanting of substance use over duration of up to 18 years. This extends the previous work on recanting by examining this phenomenon over a considerably longer period of time. We found substantial recanting across years, and that race-ethnicity and education are of significance in association with recanting.