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Learn more about the latest and most up-to-date research in the field of AOD misuse prevention and recovery!

Latest Research (November 14 – November 20)

*Click on the article title to open link to full research article.

For Native American college students, victimization and substance use have a perceived impact on academic performance

A recent study examined the rates of victimization and substance use among Native American students in comparison to other students and assessed the perceived impact of these experiences on academics. A secondary analysis of data was conducted from data collected as part of the American College Health Association (ACHA) and National College Health Assessment (NCHA). Participants (N = 2,103) included a sample of Native American undergraduate students. A series of chi-square analyses were used to (a) examine rates of victimization among Native American college students compared with students of other ethnicities; (b) explore the various types of victimization experienced by Native American college students; (c) examine rates of substance use among Native American college students compared with students of other ethnicities; and (d) determine whether victimization and substance use have a perceived impact on academic performance for Native American students. Results showed Native American students had the highest rates of being physically assaulted (8.1%), verbally threatened (30.4%), and stalked (11.7%). Furthermore, Native American students, Black students, and biracial or multiracial students all reported the highest rates of rape (2.3%). Substance use, including alcohol use, marijuana use, and other drug use, differed significantly by ethnic group. Native American students reported the second highest rates of other drug use (6.5%), following biracial or multiracial students (7.9%), and the third highest rates of alcohol use (59.9%) and marijuana use (15.6%). Males and females reported similar rates of alcohol use and other drug use within the past 30 days across all ethnicities; however, males had the highest rates of marijuana use within the past 30 days in comparison to females, regardless of ethnicity. Furthermore, Native American students were most likely to report that alcohol use (6.1%), physical assaults (1.6%), and sexual assaults (1.8%) adversely affected their academics. They also reported the second highest rates of drug use having a negative impact on academics (2.1%), following biracial or multiracial students (2.8%). Across all ethnicities, males and females reported similar rates of alcohol use affecting their academics. Results of regression analyses indicated a significant perceived impact of drug use on academics among Native American males (p < .05). They also indicated a significant perceived impact of alcohol use on academics among Native American females (p < .05). In both cases, it is the perception that drug and alcohol use negatively impacts academics that predicts GPA, rather than the actual drug and alcohol use variables.

Take away: Native American students reported the second highest rates of other drug use and the third highest rates of alcohol and marijuana use. In addition, Native American students perceived their experiences with substance use as an impediment to their academic performance.

Fish, J., Livingston, J. A., VanZile-Tamsen, C., & Wolf, D. A. P. S. (2017). Victimization and Substance Use Among Native American College Students. Journal of College Student Development58(3), 413-431.

Brief online interventions linked to less alcohol use and alcohol related consequences among American college students studying abroad

Previous research has documented increased and problematic alcohol use during study abroad experiences for college students. A new randomized controlled trial was designed to prevent increased and problematic alcohol use abroad by correcting misperceptions of peer drinking norms abroad and by promoting positive and healthy adjustment into the host culture (i.e., sojourner adjustment) through brief online personalized feedback interventions. Participants (N = 343) were recruited through the study abroad office at one large university in the northwest United States. Participants completed a pre-departure survey and the following information was obtained. First, participants provided information about alcohol use and consequences over the past month by completing the Daily Drinking Questionnaire (DDQ). Second, participants shared perceptions of peer and host national drinking behavior within the study abroad environment by completing a Drinking Norms Rating Form (DNRF). Third, aspects of the cultural adjustment process among students temporarily living abroad were assessed through the Sojourner Adjustment Measure (SAM). Participants were randomly assigned to 1 of 4 intervention conditions including a personalized normative feedback intervention (PNF), a sojourner adjustment feedback intervention (SAF), a combined PNF SAF intervention, and an assessment-only control condition. If randomized to one of the three intervention conditions, participants immediately received feedback based on their responses. Their personalized feedback was also resent during the first week of their trip via email. The same participants also completed follow-up surveys with similar content during their first and last months abroad. The authors conducted primary analyses using generalized estimating equations (GEEs). The results showed that among the three covariates of age, gender and location, only location of study abroad was predictive of drinking. Studying in a European country was associated with more drinking over time as those who studied abroad in Europe, drank 1.49 times more than those who studied elsewhere. Furthermore, PNF participants drank 30% fewer drinks per week than control participants during the follow-up period. PNF participants who reported drinking eight or fewer drinks per week at baseline reported fewer drinks per week abroad compared with control. Although heavier drinkers in the PNF condition drank at approximately the same level abroad as control, heavier baseline drinkers receiving SAF in addition to PNF drank more than control. There was no observed SAF baseline drinking interaction; however, those in the SAF condition drank the most abroad regardless of their baseline drinking. As for alcohol-related consequences, those who studied in Europe experienced 1.47 times more consequences than those who studied elsewhere. There were no significant main effects of any intervention condition on preventing consequences compared with control. However, PNF participants with fewer baseline consequences reported fewer consequences abroad compared with control. Also, combined PNF + SAF condition participants with varying levels of pre-departure consequences reported comparatively less consequences abroad than their control counterparts.

Take away: Combined SAF + PNF intervention appears beneficial for study abroad students reporting more alcohol-related consequences at pre-departure, while PNF intervention alone may be sufficient to reduce the level of drinking abroad for lighter pre-departure drinkers.

Pedersen, E. R., Neighbors, C., Atkins, D. C., Lee, C. M., & Larimer, M. E. (2017). Brief online interventions targeting risk and protective factors for increased and problematic alcohol use among American college students studying abroad. Psychology of Addictive Behaviors31(2), 220.

Study finds that perceived academic benefit is linked to nonmedical prescription stimulant use among college students

A new study documented the prevalence of perceived academic benefit of the nonmedical use of prescription stimulants (NPS) among college students for improving grades and to examine the association between such belief and NPS. Participants (N = 6962) included full-time undergraduate students from nine different universities who indicated that they had never been diagnosed with ADHD. The reason for excluding students with an ADHD diagnosis was that their perceptions about NPS might differ from other students due to taking ADHD medications for their diagnosis. Participants received an online survey, which measured NPS, perceived academic benefit of NPS, alcohol use and marijuana use frequency. For the NPS measure, participants were asked about the number of days they had used prescription stimulants non-medically during the past six months. For perceived academic benefit of NPS, participants were asked to rate the degree to which they agree to statements such as “prescription stimulants will help people without a prescription get better grades.” For alcohol use, the total number of drinks consumed in a typical week during the past six months was computed from responses to the Daily Drinking Questionnaire (DDQ). Lastly, for the marijuana use frequency measure, participants were asked about the number of days they had used marijuana during the past six months. The authors computed descriptive statistics for the overall sample and within the subsets of students who did and did not engage in NPS during the past six months. A multivariate logistic regression model was developed with NPS as the binary dependent variable and included the three hypothesized explanatory variables of perceived academic benefit, alcohol use, and marijuana use as well as the control variables of gender, race, ethnicity and school. Results showed that 11.2% of participants engaged in NPS during the past six months. Furthermore, 28.6% of participants agreed or strongly agreed that NPS could help students earn higher grades and an additional 38% were unsure. Among the students who had engaged in NPS over the past six months, 64.9% endorsed the academic benefit of NPS, while 24.1% of non-users endorsed such beliefs. It is important to note that even though the endorsement was higher among NPS users, the perceived academic benefit was still relatively high among non-users. The logistic regression model found that all three of the hypothesized variables were significantly and positively associated with NPS (all ps < .001). In addition, students with higher perceived academic benefit of NPS were significantly more likely to engage in NPS (p < 0.001).

Take away: College students with the highest perceived academic benefits of NPS were more likely to report use. Students who were more likely to report use, agreed with the academic benefits of NPS at higher rates than non-users.

Arria, A. M., Geisner, I. M., Cimini, M. D., Kilmer, J. R., Caldeira, K. M., Barrall, A. L., & Lee, C. M. (2018). Perceived academic benefit is associated with nonmedical prescription stimulant use among college students. Addictive Behaviors76, 27-33.

Latest Research (November 7 – November 13)

*Click on the article title to open link to full research article.

Study finds that changes in the composition of social networks influences an individual’s alcohol use during the transition to college

A new study examined the extent to which personal social networks change during the transition from high school to college and how changes in the composition of these networks are related to alcohol use. Participants (N = 374) were part of a longitudinal study of incoming college students from three different universities and were recruited before the beginning of their first year. The baseline data (T1) consisting of assessments were obtained before student’s arrival on campus. At the end of the first year (T2), participants completed the second assessments. Other than the demographic characteristics obtained at baseline, the following information was obtained during both assessment points. Graduated Frequency for Alcohol, which derived the maximum number of drinks consumed in the past year, frequency of drinking several different quantities of alcohol and number of drinking and heavy drinking days per month. Young Adult Alcohol Problems Screening Test (YYAPST), from which total number of negative consequences experienced in the past year was derived. Important People and Activities Instrument, in which participants filled in people who were important to them during the past year, demographic characteristics along with first name and last initials, type and length of their relationship as well as drinking frequency and maximum drinking quantity of each network member. The authors conducted dependent samples t-tests and chi-square tests to examine the differences in network composition from T1 to T2. Correlations were calculated for respondents’ alcohol use, the composition of social networks and network turnover between T1 and T2. Mann-Whitney tests were conducted to examine the differences in personal alcohol use between participants who named at least one parent from those who did not. In addition, regression analyses were conducted to examine the interaction between the number of unique members in the network and their alcohol use on participant alcohol use. Overall, results indicated that alcohol use increased from T1 to T2 (all ps <.001). The total number of people identified in the network from T1 to T2 did not differ, (p = .36) however, parents were less likely than friends to be listed as network members at T2 compared to T1 (p < .001). Furthermore, the number of friends in the network at T1 was negatively associated with participant number of drinking days (p < .05) and heavy drinking days during that time (p< .05), however, the number of friends T1 was positively associated with greater maximum alcohol consumption at T2 (p < .05). Also, participants at T1 without a parent in their network had a greater number of heavy drinking days in the past month and had higher maximum quantities than those who named at least one parent in their network. There were no cross-sectional differences in drinking and alcohol consequences between those at T2 who had a parent in their network and those who did not. In addition, respondent alcohol use was unrelated to the number of carryover, number dropped, and number added at both time points. However, the number of members added was negatively related to the number of alcohol related consequences at T1 (p< .05) but positively related to the changes in the number of alcohol consequences at T2 (p < .05).

Take away: This study found that heavy drinking in high school is associated with retaining more friends during the transition to college, but once in college, adding more people who drink heavily in one’s social network is associated with higher alcohol use risk.

Citation: Meisel, M. K., & Barnett, N. P. (2017). Protective and Risky Social Network Factors for Drinking During the Transition From High School to College. Journal of Studies on Alcohol and Drugs78(6), 922-929.

Alcoholic beverage preference is a factor influencing alcohol cue reactivity among heavy-episodic-drinking college students

Previous studies have shown that reactivity to alcohol use may play a role in both heavy episodic drinking (HED) and alcohol use disorder (AUD) risk. A new study examined whether alcoholic beverage preferences affect event-related potential (ERP) indices of cue reactivity to different types of alcohol images among heavy episodic drinkers. Participants were HED students (N = 16) ages 21-35 and were recruited form TX State. Students with a history of past-year regular drinking and at least one past-month HED episode were included. Participants completed questionnaires and provided their demographics, drinking history including HED and beverage preferences. They also completed quantity-frequency index (QFI), measuring the ounces of absolute ethanol consumed per day over the past 6 months. Participants attended trials, which consisted of a fixation (400 ms) followed by an alcohol or control image (1,500 ms or until the response) and feedback. There were four blocks of 240 trials, each block was broken into two runs consisting of 90 unique preferred alcohol images designated as Go stimuli and 30 unique control images as No-Go stimuli. Participants were seated in front of a monitor in a soundproof, radiofrequency-shielded chamber. Before each block, they were informed of target (Go) stimuli and instructed to press a specific key on a computer keyboard as quickly as possible when a target appeared. EEG data was sampled and ERPs, including N2 and P3 amplitudes, were recorded for the trials. The authors used t-tests to compare demographic and drinking variables as well as separate repeated-measures analysis of variance (RM-ANOVA) with trial type, condition and image type to analyze behavioral and ERP data. Results showed no sex differences for age, age at first drink, total QFI or days since last drink. For preferred beverages the majority of men chose beer, while the majority of women chose wine. Furthermore, larger N2 amplitudes for preferred alcohol versus control images (p = .032) were observed, but amplitudes for non-preferred alcohol did not differ from those for control images (p = .111). In addition, amplitudes for preferred alcohol were enhanced versus non-preferred alcohol images (p = .004). P3 amplitudes and latencies were not sensitive to preferences, but latencies were delayed and amplitudes for No-Go trials were larger than those for Go trials (p = .001).

Take away: In this study, N2 cue reactivity was observed for preferred alcohol images in comparison to control and non-preferred alcohol images, indicating increased attention capture among HED college students.

Citation: Thurin, K., Ceballos, N. A., & Graham, R. (2017). Alcohol Preferences and Event-Related Potentials to Alcohol Images in College Students. Journal of Studies on Alcohol and Drugs78(6), 916-921.

For students with social anxiety disorder, fear of negative evaluation may predict fewer alcohol-related negative consequences

College students with social anxiety disorder (SAD) experience more alcohol-related negative consequences, regardless of the amount of alcohol they consume. A new study examined within-group differences in alcohol-related negative consequences of students who met or exceeded clinically indicated social anxiety symptoms. More specifically, the study tested a sequential mediation model of the cognitive (i.e., fear of negative evaluation) and behavioral (protective behavioral strategies) mechanisms for the link between social anxiety disorder subtypes (i.e., interaction and performance-type) and alcohol-related negative consequences. Participants were college students (N = 412), who were aged 18 to 24 years and received credit for partial fulfillment of a class research requirement. In order to be included, participants had to have consumed alcohol in the past month and endorsed clinically indicated levels of SAD (SIAS ≥ 34 and/or SPS ≥ 24). Measures included Social Interaction Anxiety Scale (SIAS) to assess interaction SAD, Brief Fear of Negative Evaluation Scale (BFNE-S) to measure evaluation fears, Protective Behavioral Strategy Scale-revised (PBSS) to assess protective behavioral strategies (PBS), Rutgers Alcohol Problem Index (RAPI) to assess negative drinking consequences and the Daily Drinking Questionnaire (DDQ) was used to assess typical weekly alcohol consumption. To test within-group differences in the relationship among SAD, fear of negative evaluation, PBS, and alcohol-related negative consequences, while controlling for alcohol consumption, all variables were treated as continuous and a sequential mediation analysis was performed through a structural equation model framework using Mplus 7.11. Results showed that interaction SAD predicted alcohol-related negative consequences (p < 0.05). Furthermore, fear of negative evaluation and serious harm reduction PBS independently mediated the relationship between interaction SAD and alcohol-related negative consequences. Specifically, fear of negative evaluation (p < 0.05) accounted for 41% of the mediated effect and serious harm reduction PBS (p < 0.05) accounted for 42% of the mediated effect. Additionally, fear of negative evaluation and serious harm reduction PBS sequentially mediated the relationship between interaction SAD and alcohol-related negative consequences (p = 0.11), accounting for 13% of the variance. Interaction SAD predicted more fear of negative evaluation (p < 0.001), which predicted more serious harm reduction PBS (p = 0.05), which predicted fewer alcohol-related negative consequences (p < 0.001).

Take away: College students with more severe social anxiety symptoms, of the interaction subtype, reported more fear of negative evaluation, which was related to more serious harm reduction strategies, which in turn predicted fewer alcohol-related negative consequences.

Citation: Villarosa-Hurlocker, M. C., Whitley, R. B., Capron, D. W., & Madson, M. B. (2017). Thinking while drinking: Fear of negative evaluation predicts drinking behaviors of students with social anxiety. Addictive Behaviors.

Latest Research (October 31 – November 6)

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Study examines role of marijuana use, expectancies on sexual risk taking among college students

A new study investigated whether smoking marijuana acutely increased sexual risk on a behavior decision-making task (SRT) and whether sex-related marijuana outcome expectancies influenced sexual risk decisions after marijuana consumption. The study used a 2×2 factorial design to assign participants to one of four groups in which they received a dose of marijuana with 2.8% THC or a placebo and were informed they were given THC or a placebo. Participants (n = 126) were selected from a larger study of the effects of marijuana and impulsivity. Inclusion criteria were age (between 18 and 30 years old) and marijuana use at least weekly in the past month and at least 10 times in the past six months. Exclusion criteria included history of substance use treatment, intent to quit or receive treatment for cannabis misuse, history of certain mental illnesses, and smoking 20 or more cigarettes per day. Participants who reported exclusive homosexual status on the Kinsey scale were also excluded, because the SRT was designed for use with heterosexuals. At baseline, participants’ number of sexual partners, number of new sexual partners, sex-related marijuana expectancies, and intent to engage in sexual risk-reduction behavior (i.e., condom use) were assessed. Total sex-related marijuana expectancy scores were calculated for each participant. The SRT was used to assess participants’ likelihood of having sex without a condom with both a “steady partner” and a “new partner” using filmed, gender-specific scenarios. After smoking marijuana or a placebo and viewing the videos, participants reported their likelihood of using a condom using a six-point scale. The authors used bivariate correlations to examine associations between baseline measures of intent to engage in safe sex, sex-related marijuana expectancies, and post-smoking likelihood of engaging in unprotected sex with a new or steady partner. Multiple regression was used to investigate sex-related marijuana expectancy effects on the likelihood of using a condom on the SRT. For men and women, baseline behavioral intentions were positively correlated with post-smoking ratings of likelihood of unprotected sex, across both types of partners (rs = 0.30 – 0.57, ps < 0.05). For men, sex-related marijuana outcome expectancies were significantly positively correlated with likelihood of having sex without a condom (r = 0.28, p < 0.01). For women, expectancies were positively correlated with this likelihood for a steady partner (r = 0.33, p < 0.05). There was a significant interaction effect observed for marijuana expectancies and drug manipulation observed on the SRT with a new partner (p = 0.02), but, for women, more salient expectancies were associated with increased likelihood of sex without a condom with a steady partner (p = 0.033).

Take away: In this study, the pharmacologic effects of THC did not influence sexual decision making on a sexual risk behavior decision-making task, but sex-related marijuana expectancy outcomes did. These effects were different for men and women.

Citation: Skalski LM, Gunn RL, Caswell A, et al. (2017). Sex-related marijuana expectancies as predictors of sexual risk behavior following smoked marijuana challenge. Experimental and Clinical Psychopharmacology, 25(5), 402-411 doi: 10.1037/pha0000138

Study of off-campus tobacco retailers finds types of tobacco products sold and advertised varies by store type, changes over time

Nationally, the number of colleges with tobacco-free campus policies is rising; however, students may still be still exposed to tobacco products off campus. A recent study assessed availability, marketing, and promotion of tobacco products (cigarettes, snus, and smokeless tobacco [SLT]) among communities surrounding 11 college campuses in North Carolina and Virginia. Trained observers completed 481 total point-of-sale assessments at 334 unique tobacco retailers, including convenience stores, pharmacies, and supermarkets, over a three-year period. There were three waves of data collection. A repeated cross-sectional design was used to select and observe up to 15 tobacco retailers within a one-, two- or five-mile radius of each campus. Each observation took about 10-15 minutes to complete; data were recorded in the field by trained study team members. Measures included store type, availability of each type of tobacco product, counts of advertising inside the store, counts of advertising outside of the store on its premise, and the presence of product promotions (i.e., buy-one-get-one, multi-pack discounts). Results indicated cigarettes were the most widely available tobacco product and were available at all stores in the sample and over 80% of stores sold SLT products each year. Convenience stores and supermarkets were among the types of stores most likely to sell SLT products, whereas pharmacies were the least likely type. To compare the prevalence of selling each product by year across different types of stores, the researchers used Pearson’s chi-square tests; Fisher’s Exact Tests were applied in small sample size comparisons. The authors did not find any statistically significant changes in the number of stores that sold SLT products over time; however, snus availability decreased from 80.4% of retailers in 2012 to 58.6% of retailers in 2011 (p < 0.001). 70-75% of retailers offered product promotions each year, most commonly for cigarettes. Significant increases in the number of promotions for SLT products were observed among convenience stores (without gas) (3.1% in 2011 to 23.3% in 2013, p = 0.02), as well as for convenience stores with gas for cigarettes (65.4% in 2011 to 72.8% in 2013, p = 0.04). Nearly all (94-96%) stores displayed interior tobacco product advertisements and 61-65% displayed exterior advertisements. There were no significant changes in exterior advertising for any product during the study, but the number of stores with interior advertising for snus decreased from 80.1% in 2011 to 53.1% in 2013 (p < 0.0001).

Take away: In this sample of 481 observations of campus-community tobacco retailers, the proportion of stores selling and advertising snus decreased significantly over time. Most stores displayed interior and exterior tobacco product advertisements and promotions for cigarettes and smokeless tobacco products significantly increased during the study period.

Citation: Wagoner KG, Song E, King JL, et al. (2017). Trends in point-of-sale tobacco marketing around college campuses: Opportunities for enhanced tobacco control efforts [published online ahead of print October 11 2017], Journal of American College Health doi: 10.1080/07448481.2017.1389734

Motivations to quit smoking cigarettes vary by frequency of smoking, past quit attempts, and discounting among sample of Canadian young adults

Previous research suggests motivations to quit smoking vary across age groups. A new study examined the importance of reasons to quit in young adult smokers. In addition, this study also examined whether smokers who discounted the importance of long-term health risks associated with smoking (‘discounters’) differed from those who acknowledged these risks. Participants (N = 1,294) were part of the Nicotine Dependence in Teens (NDIT) Study, for which they were recruited during seventh grade in 1999-2000 from 10 high schools in Canada. Data for the current study were collected via self-report questionnaires administered six years after participants graduated from high school. A modified version of the Adolescent Reasons for Quitting Smoking Scale (ARFQ) was used to assess participants’ concerns about the short-term consequences of smoking, social disapproval of smoking, and long-term concerns about smoking. Scores for each of these three subscales were calculated for each participant. Responses to 15 individual items, including past-month daily smoking, age at smoking initiation, previous quit attempts, cravings and withdrawal symptoms, and other tobacco use behaviors were also collected. Participants were categorized as discounters or non-discounters based on their levels of agreement with a statement about the importance of long-term health concerns related to tobacco use. The authors analyzed the three ARFQ subscale scores using Mann-Whitney U-tests and Kruskal-Wallis tests from the 311 participants who reported they were current smokers. Half (51.4%) of these individuals reported being daily smokers who consumed 12.3 cigarettes per day, on average, and 36.5% of smokers reported a past-year quit attempt. Results showed this group ranked long-term concerns as the most important reason to quit and social disapproval as the least important. Rankings on ARFQ subscales did not differ by sex or education and the rankings on individual items did not differ by sex. Daily smokers (Mdn (IQR) = 3.0 (2.0–3.0)) rated the importance of long-term concerns as more important than did nondaily smokers (2.5 (1.5–3.0)). Smokers who attempted to quit in the past year rated long-term concerns as more important than smokers who did not attempt to quit (3.0 (2.5–3.0) vs. 2.5 (1.5–3.0), respectively), as did smokers to expressed strong motivation to quit. The authors classified 45 smokers (14.5% of participants) as discounters and the remaining 266 smokers as non-discounters. Discounters smoked less frequently and in smaller quantities and were less likely to report a quit attempt, report difficulty quitting, or express strong motivation to quit compared to non-discounters. The authors recommended using this insight to tailor quit interventions by smoker characteristics.

Take away: Over 70% of current cigarette smokers in this study rated long-term concerns (i.e., health risks) about smoking as being very important. 15% of participants did not acknowledge long-term consequences of smoking and were classified as discounters. This group tended to smoke less frequently and consume fewer cigarettes per day than non-discounters.

Citation: Wellman RJ, O’Loughlin EK, Dugas EN, et al. (2017). Reasons for quitting smoking in young adult cigarette smokers [published online ahead of print September 20 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.09.010

Latest Research (October 24-October 30)

*Click on the article title to open link to full research article.

Study finds variability in construct reliability of multi-item alcohol use measure over time and across demographic variables

Measurement invariance is desirable in population studies because non-invariance may cause statistical bias, which could lead researchers to make misguided recommendations. A new study examined patterns of alcohol use from adolescence to adulthood across key demographic variables. This study analyzed data from three waves of the National Longitudinal Study of Adolescent to Adult Health, which used a three-item measure to assess alcohol use, to determine whether this measure demonstrated invariance across racial/ethnic, sexual identity, and education groups. Three types of measurement invariance (configural, metric, and scalar) were examined.   Participants (N = 11,715) were a representative sample of U.S. 7th – 12th graders who completed surveys at baseline, five to six years later (at ages 18-24 years), and 13-14 years (at ages 24-32 years). Within-wave results showed there was metric and scalar invariance in alcohol use measurement across racial/ethnic and sexual identity groups, but not across any of the college education subgroup comparisons. Longitudinally, Black and gay/bisexual males were the only male groups to display metric invariance across all waves, but no male groups displayed scalar invariance across all waves. Similarly, only Black females demonstrated metric invariance across all longitudinal comparisons and no female group displayed scalar invariance across all waves. Non-invariance was greater from adolescence to adulthood (from Wave 1 to 3) compared to across adulthood (Wave 3 to 4). The authors stated the results suggested greater variability in drinking behaviors over time for women than for men. Based on the results of this study, the authors cautioned the multi-item alcohol use measure may introduce biased parameter estimates if models do not account for invariance, especially for comparisons across subgroups.

Take away: Measurement invariance is desirable in population models, especially when subgroups are compared. This study found a three-item alcohol use measure from a nationally representative longitudinal study was non-invariant, which can lead to statistical bias and misguided recommendations.

Citation: Fish JN, Pollitt AM, Schulenberg JE, et al. (2017). Measuring alcohol use across the transition to adulthood: Racial/ethnic, sexual identity, and educational differences [published online ahead of print October 12 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.10.005

Self-reported prevalence of water pipe tobacco smoking increased among emerging adults from 2012-2015

Previous research has shown water pipe (i.e., hookah) tobacco smoking (WTS) is highest among 18- to 24-year-olds, the age group known as emerging adults. A new study examined the prevalence and correlates of current WTS among U.S. emerging adults. Participants were respondents of the 2012-2013 (N = 3,577) and 2014-2015 (N = 4,439) National Adults Tobacco Surveys (NATS) who were aged 18 to 24 years. Measures included current water pipe tobacco use (dependent variable), cigarette smoking, other tobacco product use, e-cigarette use, and sociodemographic characteristics. Results showed 18.3% of emerging adults reported current WTS in 2012-2013, compared to 20.1% in 2014-2015. Prevalence rates of other tobacco use during each respective wave were 22.2% and 20.6% for current cigarette use, 7.2% and 6.9% for smokeless tobacco use, and 9.6% and 13.5% for e-cigarette use. Multivariable analyses showed current users of cigarettes (OR: 2.37, CI: 1.73, 3.26 in 2012-2013 and OR: 1.65, CI: 1.25, 2.18 in 2014-2015), cigars/cigarillos (OR: 2.83, CI: 2.07, 3.86 and OR: 2.79, CI: 2.15, 3.63), pipes (OR: 3.93, CI: 2.31, 6.68 and OR: 4.38, CI: 2.69, 7.13), and e-cigarettes (OR: 2.51, CI: 1.64, 3.86 and OR: 4.16, CI: 3.20, 5.42) were more likely to be current water pipe smokers than non-current users, controlling for the effects of covariates. Emerging adults aged 22-24 years old and self-identified African Americans were less likely to engage in WTS, while self-identified Hispanics, sexual minorities, and participants who attended or completed college were more likely to engage in WTS.

Take away: The prevalence of self-reported current water pipe tobacco smoking among a national sample of emerging adults increased from 18.3% in 2012-2013 to 20.1% in 2014-2015. Current users of cigarettes, cigars/cigarillos, pipes, and e-cigarettes had higher odds of current water pipe smoking than non-current users of these products.

Citation: Kates FR, Haider MR & Laberge M (2017). Prevalence and determinants of water pipe tobacco and polytobacco use among 18- to 24-year-old emerging adults in the United States [published online ahead of print September 4 2017], Emerging Adulthood doi: 10.1177/2167696817728177

In Colorado, marijuana legalization associated with decrease in opioid-related deaths

The state of Colorado legalized recreational marijuana in 2013 and began retail sales in 2014. A new study investigated the relationship between recreational marijuana legalization and opioid-related deaths within the state from 2000 to 2015. This study used an interrupted time-series design and included opioid-related deaths in two other states (Nevada, in which medical marijuana is legal, and Utah, in which all cannabis use remains illegal) as covariates. Colorado implemented a prescription drug monitoring program during the study period, which could have affected opioid-related death rates. The authors controlled for this variable in their analysis, although it remained a potential confounder. Counts of opioid-related deaths were collected from CDC WONDER. These deaths and other variables were compared before and after January 1, 2014 using three separate segmented regressions. The authors defined the total effect of recreational marijuana legalization as the percent change at the end of the follow-up period (December 2015). Results indicated there was a statistically significant reduction in trend in opioid-related deaths in Colorado following recreational marijuana legalization laws. When the authors controlled for comparison state trends and Colorado’s prescription drug monitoring program, opioid-related deaths decreased by approximately 0.7 deaths per month, compared to during the baseline period (b = -0.68, CI: -1.34, -0.03). The authors estimate there was a 6.5% reduction in deaths following recreational marijuana legalization. Additional studies in other states with legalized recreational cannabis are needed in order to draw conclusions about the relationship between marijuana legalization and the rate of opioid-related deaths.

Take away: Following recreational marijuana legalization in Colorado in 2014, opioid-related deaths decreased by an estimated 6.5%, relative to before legalization.

Citation: Livingston MD, Barnett TE, Delcher C, et al. (2017). Recreational cannabis legalization and opioid-related deaths in Colorado, 2000–2015 [published online ahead of print October 11 2017], American Journal of Public Health doi: 10.2105/AJPH.2017.304059

Latest Research (October 17-October 23)

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Study provides insight into variables associated with using substances other than nicotine in e-cigarettes among college students

Although electronic cigarettes (e-cigarettes) were designed to vaporize a liquid mixture containing nicotine, previous research has shown the prevalence of other substance use in e-cigarettes (OSUE) is rising among certain groups. A new study examined OSUE among undergraduate students at one U.S. university (N = 5,429) who reported lifetime use of e-cigarette use (N = 1,542). Participants completed a cross-sectional, online survey and reported their demographic characteristics, tobacco use (cigarette and smokeless), e-cigarette use and perceived harm of use, reasons for e-cigarette use, and OSUE. The authors computed descriptive statistics to examine demographic information across all e-cigarette users, e-cigarette users reporting OSUE, and e-cigarette users not reporting OSUE. Chi square analysis was used to determine whether covariates significantly differed between OSUE and no OSUE groups and binomial logistic regression was used to predict OSUE. Results showed the sample was 55.3% women and 88.6% White. 87.0% of respondents reported no Greek affiliation. Nearly half of participants (45.3%) reported they had never smoked tobacco, but 37.7% reported they were current smokers and 17.0% identified as former smokers. Almost 7.0% of e-cigarette users reported OSUE. Men were significantly more likely to report OSUE than women. Average perceived harm of e-cigarette use was lower among participants who reported OSUE, but not significantly. Students who reported past-month alcohol (p = 0.02), marijuana (p < 0.0005), ecstasy (p < 0.0005) use and prescription pain medication misuse (p = 0.001) were significantly more likely to report OSUE than other participants. E-cigarette users who did not report OSUE cited experimentation, friends’ use, and greater perceived safety of e-cigarettes (compared to traditional cigarettes) as their top three reasons for using e-cigarettes. Among the OSUE group, these reasons were greater perceived safety, experimentation, and friends’ use. 77.9% of the OSUE group reported using cannabis in e-cigarettes, while 16.4% of this group refused to report or did not know what substance they used. Results of the binomial logistic regression showed women were less likely to report OSUE compared to men (OR: 0.60, CI: 0.39-0.91), former smokers were more likely to report OSUE than never smokers (OR: 0.1.87, CI: 1.16-3.04), and e-cigarette users who used e-cigarettes for “trendy or cool” reasons were more likely to report OSUE (OR: 2.89, CI: 1.53-5.45). Unexpectedly, Greek affiliation was not associated with OSUE. The authors believe this may be because this study contained relatively few fraternity/sorority members.

Take away: In this sample, almost 7.0% reported using a substance other than nicotine in e-cigarettes, most commonly cannabis (77.9%). Male sex, former smoker status, and motivation to use e-cigarettes to look “trendy or cool” were associated with higher odds of using other substances in e-cigarettes.

Citation: Kenne DR, Fishbein RL, Tan ASL, et al. (2017). The use of substances other than nicotine in electronic cigarettes among college students [published online ahead of print October 4 2017], Substance Abuse: Research and Treatment doi: 10.1177/1178221817733736

Text messaging intervention promising for correcting college student misperceptions of drinking norms, reducing risky drinking

A new study tested the feasibility, acceptability, and preliminary efficacy of a social norms text messaging intervention to correct misperceptions in drinking norms and reduce risky drinking among college students. Participants were 68 second-year U.S. college students who met the NIAAA criteria for risky drinking and used text messaging at least weekly. Individuals were excluded from this study if they disclosed they were in treatment for alcohol use disorder or scored 20 or higher on the alcohol use disorders identification test (AUDIT). All participants completed a baseline survey, on which they reported their demographic information, number of drinks consumed per drinking day in the past month, past-month frequency of heavy episodic drinking (HED), estimated past-month peak blood alcohol concentration (BAC), and past-month alcohol-related consequences. Participants were also asked to estimate the number of drinks a typical student of their own gender consumed per drinking day (descriptive norm), as well as the level of approval or disapproval they believed their peers had for drinking, drinking 5 or more drinks on one occasion, and getting drunk (injunctive norms). Participants were then randomly assigned to either the experimental group (in which they received daily text messages regarding injunctive and descriptive norms for drinking, alcohol consequences, and protective behavioral strategies) or a control group (in which participants received a daily fun fact text message). Both groups received daily text messages for 28 days and then completed a follow-up survey of normative perceptions and drinking behaviors. Participants also reported their levels of interest in each text message and their overall satisfaction with the intervention. The authors used t-tests to analyze between-group differences and within-group changes in outcomes. ANCOVAs with baseline levels of the outcome as a covariate were used to compare pre- and post-test means. Results indicated control group participants rated the fun facts as more interesting than experimental group participants rated their text messages, but both groups reported overall satisfaction with the program. ANCOVAs revealed no significant group differences at follow-up. Within-group t-tests showed significant reductions in experimental group reported frequency of HED, estimated peak BAC, and reported consequences. Both groups significantly reduced in injunctive drinking norms and the control group significantly reduced in drinking norms. Between-group effect sizes showed the experimental group reported larger reductions in frequency of HED, estimated peak BAC, alcohol consequences, and injunctive norms, while the control group reported larger reductions in typical number of drinks consumed per drinking day and descriptive norms. The authors believed there was contamination between the groups caused by participants sharing the text messages with friends.

Take away: In this small, randomized controlled trial of a text message intervention to correct descriptive and injunctive drinking norms, all participants found the program to be acceptable and satisfactory. Although no between-group differences in drinking behaviors were observed at follow-up, participants in the experimental group showed significant reductions in risky drinking behaviors and injunctive drinking norms from baseline to follow-up.

Citation: Merrill JE, Boyle HK, Barnett NP, et al. (2017). Delivering normative feedback to heavy drinking college students via text messaging: A pilot feasibility study [published online ahead of print October 5 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.10.003

Proportion of ecstasy/MDMA users with a college degree increased by over 100% between 2007 and 2014

A recent study examined trends in ecstasy/MDMA use among 12- to 34-year-olds (N = 332,560) from 2007-2014. Data from the National Survey on Drug Use and Health, a nationally representative, cross-sectional study, were analyzed. Measures included self-reported past-year substance use and demographic characteristics, including education level, gender, and race/ethnicity. The authors collapsed years into pairs (e.g., 2011/12) to increase power to detect linear trends and estimated the prevalence of ecstasy/MDMA use. Demographic and other substance use characteristics were analyzed among the subsample of self-reported ecstasy/MDMA users and linear trends were examined over time using Taylor series estimation methods. Results showed the annual prevalence of self-reported ecstasy/MDMA use ranged from 2.2% to 2.6% and did not significantly change over time. The majority of ecstasy/MDMA users identified as non-Hispanic White. Among ecstasy/MDMA users (N = 7,979), the most common age group was 18 to 25 –year-olds; this also remained consistent over time. The proportion of users aged 12-17 years increased decreased by 42.9% between 2007/08 and 2013/14 (p < 0.001), while the proportion of users aged 26-34 years increased by 31.5% (p = 0.027). The proportion of users with a college degree increased by 113.0% among the latter age group, from 11.5% in 2007/08 to 24.5% in 2013/14 (ps < 0.001). Nearly all (94.6%) ecstasy/MDMA users reported using at least one other substance in the past year. The proportion of users who also disclosed nonmedical opioid use decreased significantly between 2007/08 and 2013/14 (p < 0.001), while the proportion of users who disclosed past-year DMT/AMT/Foxy use increased significantly (p < 0.001) during the same period. The authors postulate the availability of ecstasy/MDMA may be increasing among college students; however, perceived availability of this substance was not assessed in this study.

Take away: Although the prevalence of self-reported ecstasy/MDMA use remained stable and relatively low from 2007-2014 (about 2.5%), the proportion of users with college educations increased by 113%. Polysubstance use was common among ecstasy/MDMA users.

Citation: Palamar JJ, Mauro PM, Han BH, et al. (2017). Shifting characteristics of ecstasy users ages 12–34 in the United States, 2007–2014 [published online ahead of print October 6 2017], Drug and Alcohol Dependence doi: 10.1016/j.drugalcdep.2017.09.011

Latest Research (October 10-October 16)

*Click on the article title to open link to full research article.

For college students, exposure to anti-binge drinking messages, message framing, and drinking behaviors associated with intention to avoid binge drinking

A new study used prospect theory and exemplification theory to investigate whether presenting anti-binge drinking campaign messages using different framing and evidence types influenced college students’ intentions to binge drink. Participants (n = 156) were undergraduate students at one U.S. university. The sample was 74% female. 84% (n = 134) of the sample identified as binge drinkers. Participants were randomly assigned to one of four experimental groups or a control group that did not view any messages. The study used a 2×2 factorial design to present each group with one of four possible combinations of framing and evidence messages. Before and/or after viewing the messages, participants reported their perceptions of message framing and evidence type, drinking behaviors, attitudes toward drinking and toward the message, and intention to avoid binge drinking. Messages were either loss-framed (e.g., binge drinking will “increase your change of experiencing negative health consequences”) or gain-framed (e.g., not binge drinking will “increase your chance of experiencing positive health consequences”). Evidence was presented in narrative or statistical form. The authors used the General Linear Model procedure to analyze results and test for interaction effects. Results showed participants reported a higher level of behavioral intention to avoid binge drinking in the near future when they were exposed to a loss-framed message compared to the control group, regardless of evidence type (all ps < 0.07). However, the authors found a significant difference was only detected among non-binge drinkers for framing (p < 0.01) and evidence type (p < 0.05). There was no evidence of a relationship (p > 0.05) between evidence type and behavioral intention. Participants had a more favorable attitude toward the message when it was loss-framed than gain-framed, as well as a more favorable attitude toward the message when evidence was presented statistically. Results also indicated participants’ attitude toward drinking was less favorable after they were exposed to a loss-framed message than a gain-framed message. There was no evidence of a significant effect of message faming or interaction effect on intention to avoid binge drinking (all ps > 0.05), nor was there evidence participants’ attitudes toward drinking were affected by their exposure to anti-binge drinking messages. One limitation of this study is behavioral intention does not always predict behavior.

Take away: Participants who were exposed to loss-framed anti-binge drinking messages reported higher levels of intention to avoid binge drinking in the near future than participants who did not view any messages; this effect occurred mainly among non-binge drinkers. There was no significant relationship observed between message evidence type (statistical vs. narrative) and intention to avoid binge drinking.

Citation: Kang H & Lee MJ (2017). Designing anti-binge drinking prevention messages: Message framing vs. evidence type [published online ahead of print September 27 2017], Health Communication doi: 10.1080/10410236.2017.1372046


Gender identity, drinking intention, and ‘predrinking’ influence young adults’ weekend alcohol consumption

According to the theory of planned behavior, behavioral intentions play an important part in predicting future behavior. Previous research suggests young adults may be likely to deviate from their intended drinking behavior over the course of a drinking occasion, typically by drinking more than planned. A new study examined drinking intentions for a given evening among young adults and explored the individual and situational factors that contribute to deviations from initial intentions. Participants were recruited between 9pm and 12am by a field research team over a one-month period in popular nightlife areas in two Swiss cities, Lausanne and Zurich. Inclusion criteria were being between 16 and 25 years of age, owning an Android smartphone, having consumed alcohol at least once in the past month, and having been out in the city at least twice in the past month. Participants (n = 241) were asked to install the Youth@Night app, which documents event-level nightlife behaviors using questionnaires, pictures, videos, GPS, accelerometers, and other sensors. Participants were asked to use this app to report the types of drinks they consumed and characteristics of the locations they attended for at least 10 Friday or Saturday nights (including nights when they did not go out or did not drink) over seven consecutive weeks. A baseline questionnaire assessed monthly frequency of going out, monthly frequency of ‘predrinking’ or ‘pregaming,’ and monthly alcohol consumption. Between 5pm and 8pm on weekend nights, the app prompted participants to report the number of drinks they planned to consume that night. From 8pm until the end of the night, participants were asked to report the number of friends who were present each time they had another drink and each type of location where they drank (i.e., bar, private place). The following morning, participants were prompted to report the number of drinks they consumed the previous night. Deviation from drinking intention was measured by subtracting the number of drinks a participant intended to consume from the number actually consumed. The analytic sample consisted of 757 drinking intention and total consumption questionnaires and 356 consumption before 8pm questionnaires. On average, each participant had 4.3 fully documented nights (SD = 3.1), with 6.1 questionnaires per night (SD = 2.2). The authors used a series of multilevel regression models to investigate individual- and night-level predictors of intentions and deviation from intentions, respectively. At the night level, results showed alcohol consumption occurred on 79% of weekend nights and drinking began before 8pm on 45.2% of nights, during which participants consumed about two drinks each. On average, men intended to drink 3.1 alcoholic drinks (with intention to binge drink on 27.6% of nights) and women 1.8 (with intention to binge drink on 18.6% of nights), but men reported actually drinking 4.6 drinks (binge drinking 43.6% of nights) and women 2.9 (binge drinking 31.2% of nights). Thus, male participants drank more than intended on 51.0% of occasions and women on 44.1% of occasions. At the individual level, results found month frequency of predrinking for both genders and monthly alcohol consumption for men predicted high drinking intentions. For men and women, lower drinking intentions were associated with higher deviation from intention, and vice-versa, at both levels. Drinking early in the night was associated with a +0.42 drink deviation from intention for men and a +1.37 drink deviation for women for each drink consumed over and above the person’s usual consumption before 8pm. The effects of the gender of friends with whom participants drank and the locations at which drinking occurred varied by gender.

Take away: Overall, participants drank more than intended on nearly half of all nights and binge drank twice as often as planned. At both individual and occasion levels, the frequency of predrinking and number of drinks consumed before 8pm were significantly associated with heavier-than-intended drinking.

Citation: Labhart F, Anderson KG & Kuntsche E (2017). The spirit is willing, but the flesh is weak: Why young people drink more than intended on weekend nights—an event-level study [published online ahead of print October 2 2017], Alcoholism: Clinical and Experimental Research doi: 10.1111/acer.13490


New study identifies predictors of short-term drinking behavior changes following alcohol intervention for mandated college students

Brief motivational interventions (BMIs) have been shown to reduce problematic drinking for some, but not all, college students. A new study attempted to identify students who may be less responsive to these interventions and identify predictors of reduced alcohol use and problems one month after the BMI. Participants were students at a U.S. university who were mandated to complete an alcohol education program following an alcohol-related violation. This study, which included a BMI and one-month follow-up, was offered to mandated students as an alternative to a BASICS-like program. 568 students consented to the study and completed the baseline assessment. The BMI utilized motivational interviewing and provided students with a personalized feedback sheet that included weekly consumption, social norms data, estimated blood alcohol concentration (BAC) levels, alcohol-related consequences and risk, as well as goal setting and tips for safer drinking. Participants reported their demographic characteristics, typical number of drinks consumed per week, typical number of drinks consumed per day in the past month (used to estimate BAC levels), alcohol-related consequences, descriptive drinking norms and perceived injunctive drinking norms, impulsivity, behavioral inhibition and activation, decisional balance, distress, and perceived centrality of alcohol to college life. 98.6% (n = 560) of participants returned for the one-month follow-up; multiple imputations were used to replace missing data. The authors used t-tests to examine differences between baseline and follow-up and latent change scores (LCS) to examine changes in alcohol consumption and alcohol use consequences. LCS models for consumption and consequences were created separately. Results indicated participants were mostly male (72%) and White (84%). Male sex, White race, fraternity/sorority membership, descriptive norms, costs of change, and beliefs about the centrality of drinking to college life predicted baseline consumption. Change in consumption between baseline and follow-up was predicted by male sex (p = 0.001), higher fun-seeking (p < 0.01), and greater costs associated with reducing alcohol use (p = 0.01). Participants who reported more consequences at baseline decreased their consequences more over the one-month follow-up than participants with fewer consequences at baseline (p < 0.001). Controlling for this effect, participants who reported more benefits to changing their drinking had larger reductions in consequences (p < 0.05), while those with stronger centrality beliefs reported smaller decreases in consequences over the follow-up period (p = 0.05). The authors included suggestions for tailoring BMIs to improve them for specific groups of students. Limitations of this study are the lack of a comparison group and lack of diversity among the sample.

Take away: Participation in a brief motivational intervention reduced reported alcohol-related consequences and problems at one month among the sample. Predictors of these outcomes included demographic characteristics, beliefs about the centrality of alcohol in college life, and perceived costs of changing drinking behavior.

Citation: Carey KB, Merrill JE, Walsh JL, et al. (2017). Predictors of short-term change after a brief alcohol intervention for mandated college drinkers [published online ahead of print September 28 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.09.019

Latest Research (October 3-October 9)

*Click on the article title to open link to full research article.

For college students involved in Greek life, alcohol intervention program outcomes linked to gender, perceived benefit of program

Previous studies have demonstrated college students who belong to fraternities or sororities engage in high-risk drinking at higher rates than the general student population. A new study examined Greek students’ perceptions of a novel alcohol invention program. Participants were Greek new members at one U.S. college (N = 276) were invited to complete surveys during two consecutive semesters. 85.5% (n = 236) participants attended at least one session of the program and completed both surveys. Program components included two facilitated discussions: One on the effects of alcohol and one on the relationship between alcohol and sex. Participants were segregated by gender for the latter component. They reported their demographic characteristics, year in school, and risky drinking behaviors (measured using the AUDIT-C, on which a higher score means greater risk). The authors used the survey data to calculate participants’ changes in perception of high-risk drinking before and after attending the program and used ANOVA to test whether these changes differed significantly by gender. General linear model repeated measure analyses were used to test for differences in AUDIT-C scores based on program attendance and perceived program benefit. Overall, results indicated 61.0% of participants who attended the first discussion and 74.2% of those who attended the second discussion reported the program changed their perception of high-risk drinking. Women were more likely to report a change in risk perception on both surveys than men. For women, AUDIT-C scores were not significantly different between those who only attended the first discussion and those who attended both (p = 0.169). The same was true for men (p = 0.221). Men who perceived the program as beneficial had significantly lower AUDIT-C scores after the training (p < 0.000), whereas men who did not find the program helpful did not experience a significant change (p < 0.631). There was no significant interaction between AUDIT-C scores and program perception observed for women.

Take away: Participation in a novel, two-part alcohol intervention program was associated with decreased risky drinking behaviors among fraternity men who perceived the program as beneficial, but not among those who did not. This interaction was not observed among sorority participants.

Citation: Brown-Rice K, Furr S & Hardy A (2017). Determining the effectiveness of an alcohol intervention program with Greek college students [published online ahead of print September 21 2017], Journal of Addictions & Offender Counseling doi: 10.1002/jaoc.12031


For college students, mental health status predicts tobacco product use

A new study investigated the relationship between mental health status and tobacco use among young adults. In fall 2010, a sample of first-year U.S. college students completed an initial screener survey (N = 10,528) about their college experiences and substance use. Of these, a cohort of 3,146 students completed the baseline survey for the present study. This group oversampled smokeless tobacco ever users, current smokers, and males. The cohort was resurveyed each semester until fall 2013 (wave 6); 2,500 participants completed the wave 6 survey, for a retention rate of 79.5%. At wave 6, participants reported whether they had received one or more mental health diagnoses in the past six months, past 30-day perceived stress levels, past-week depressive symptoms, and ever tobacco use. Tobacco use was defined as any use of 15 types of tobacco products, including cigars, cigarettes, e-cigarettes, waterpipes, or smokeless tobacco. Participants who endorsed tobacco use indicated the interval in which they had used each product (e.g., past week, past month). Participants were also asked to report their sociodemographic characteristics. The analytic sample consisted of the 2,370 cohort members who reported tobacco use. The authors used logistic regression models predicting tobacco use that were fit for each product and mental health predictor separately. Multiple imputations by chained equations were used to handle any missing covariate data. Results indicated 27.3% of participants reported past-month tobacco use and the three most commonly used products were cigarettes, waterpipe, and e-cigarettes. 10.5% (n = 249) of the analytic sample reported a mental health diagnosis, most frequently depression, ADHD, and anxiety. Of these 249 students, 18.5% reported having two or more diagnoses. Participants who reported a past-six month mental health diagnosis had greater odds of reporting past 30-day cigarette use (AOR = 1.55, CI = 1.01, 2.27), controlling for age, sex, race, ethnicity, and mother’s education. The authors observed a dose-response relationship, in which participants who reported more than one mental health diagnosis had greater odds for reporting cigarette use (AOD = 3.16, CI = 1.58, 6.33) and any tobacco use (AOD = 2.76, CI = 1.14, 6.71) than their peers with no mental health diagnoses. Higher perceived stress score was associated with increased odds for cigarette, waterpipe, e-cigarette, and any tobacco use, controlling for demographics and past 30-day use. Higher depression symptoms were associated with increased odds of cigarette, e-cigarette, or any tobacco use, controlling for the same covariates. A limitation of this study is its reliance on self-reported tobacco use, mental health diagnoses, and mental health symptoms.

Take away: In this study, self-reported mental health diagnoses received in the past six months, past-month perceived stress levels, and past-week depressive symptoms were positively associated with odds of using at least one type of tobacco product.

Citation: King JL, Reboussin BA, Spangler J, et al. (2017). Tobacco product use and mental health status among young adults [published online ahead of print September 23 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.09.012


Sustained heavy drinking associated with accelerated loss of gray matter in college students’ brains

A new study provides evidence of the longitudinal effects of heavy alcohol use on the brain. Participants were a cohort of first-year U.S. college students who were recruited into the Brain and Alcohol Research in College Students (BARCS) study. A representative subsample was classified as either sustained abstinent/light drinkers (n = 55) or sustained heavy drinkers (those who met criteria for binge drinking or alcohol abuse at both time points; n = 84), based on self-report. History of ADHD, family history of alcoholism, and mental illness diagnosis were also assessed at baseline and follow-up. Participants in both groups underwent MRI imaging at baseline and 24 months; volumetric changes in gray matter at these two time points were computed for each participant. Chi-square tests and independent sample t-tests were used to compare demographic variables and covariates between groups. Results showed groups did not differ by age, smoking, family history for alcoholism, or mental illness diagnosis, but groups differed significantly by sex (chi-square = 4.47, p = 0.03). Maps of participants’ volumetric changes in gray matter were analyzed separately by group using a 1-sample t-test. Results indicated significant gray matter volumetric (GMV) loss occurred in both drinking groups; however, this result was expected because of the cortical pruning that typically occurs during late adolescence. GMV loss was significantly greater (p < 0.05) among heavy drinkers than among light drinkers/abstainers. Areas of the brain in which GMV loss was accelerated among heavy drinkers included regions responsible for emotion, memory, and decision-making. The authors detected no group-by-sex or group-by-sex-by-time interactions at the whole brain level.

Take away: College students who reported sustained heavy drinking over a two-year period had significantly greater losses of gray matter than their peers who reported sustained light drinking or no drinking. Areas in which this loss was accelerated included regions responsible for emotion, memory, and decision-making.

Citation: Meda SA, Dager AD, Hawkins KA, et al. (2017). Heavy drinking in college students is associated with accelerated gray matter volumetric decline over a 2 year period [published online ahead of print September 29 2017], Frontiers in Behavioral Neuroscience doi: 10.3389/fnbeh.2017.00176

Latest Research (September 26-October 2)

*Click on the article title to open link to full research article.

Substance use linked to likelihood of engaging in impaired driving during and after college

Previous research has identified college students as a population at high risk for alcohol and other drug (AOD)-involved driving. A new study investigated the continuity of AOD-involved driving four years beyond college. Participants were a subset of the College Life Study, a prospective study of 1,253 individuals who were recruited as first-year college students in 2004. Most analyses in the present study included only individuals who reported having access to car in the past year. Students who screened positive for illicit drug use or prescription drug misuse at least once during high school were oversampled. Participants completed eight annual personal interviews throughout the study; AOD-involved driving behaviors were retrospectively assessed in Years 2-8. Measures of interest included past-year frequency of AOD-involved driving (driving while intoxicated [DWI], driving after drinking [DAD], and drugged driving [DD]), substances used during AOD-involved driving episodes, and past-year frequency of alcohol and marijuana use. Importantly, the researchers did not specify the distinction between DWI and DAD and students were left to subjectively interpret these terms. The authors used statistical weights to generalize findings from the sample to the general college student population. Trends were evaluated using a series of logistic models. Results found the prevalence of DAD increased significantly during college, then plateaued around Year 5. DAD was the only behavior that showed no significant declines throughout the study period; both DAD and DD peaked at modal age 21 (Year 4). Among the 863 individuals with complete data through Year 8, an estimated 43% reported DWI at least once, an estimated 63% reported DAD and an estimated 23% reported DD. Among participants who reported engaging in binge drinking, the probability of DWI peaked at 41% in Year 6, but among moderate-to-light drinkers, there was a stable trend of around 10% during Years 2-3, followed by a second stable trend at around 18% throughout Years 4-8. Among marijuana users, likelihood of DD exhibited an inverted U-shaped trend, with a significant decline from 46.2% in Year 5 to 37.0% in Year 8 (p = 0.029). The prevalence of binge drinking and marijuana use both stabilized at the beginning of the study period, then declined steadily. In any given year, the majority of participants who engaged in AOD-involved driving persisted in this behavior during the following year. The proportion of DWI drivers who also engaged in DD ranged from 54.9% in Year 2 to 32.8% in Year 8, while 45.8% – 58.8% of DD drivers engaged in DWI.

Take away:  Although the reported prevalence of substance use declined over time, participants’ likelihood of driving while intoxicated (DWI) depended on their drinking patterns and did not necessarily decrease. Reported past-year drugged driving was common among participants who engaged in DWI, and vice-versa, across all years.

Citation: Caldeira KM, Arria AM, Allen HK, et al. (2017). Continuity of drunk and drugged driving behaviors four years post-college, Drug and Alcohol Dependence, 180, 332-339 doi: 10.1016/j.drugalcdep.2017.08.032


Drinking, other activities during first year of college predict involvement during third and fourth years

Previous research has established the transition to college as an important period for students’ academic and personal successes throughout their college careers. A new longitudinal study examined first-year college students’ time use and their engagement in high-impact activities during their third and fourth years of study. Participants were U.S. undergraduate students who were in their first semester of college, under 21 years of age, U.S. citizens or permanent residents, and lived within 25 miles of campus. The study utilized a longitudinal burst design, in which participants completed a baseline survey, followed by 14 consecutive daily surveys for seven consecutive semesters. At baseline, the response rate was 65.6% (n = 744) and final analytic sample (those who responded at semesters 5, 6, or 7) contained 652 individuals. Self-reported measures at baseline included the number of hours participants spent volunteering, attending campus events, going to bars or parties, and engaging in passive entertainment (i.e., watching TV) each day. Participants also reported whether they wanted to get drunk and the number of drinks consumed each day for 14 consecutive days in the first and second semesters. Other measures included socioeconomic characteristics at baseline and levels of civic engagement, course decisions, participation in study abroad programs, and appointment to leadership positions in philanthropic organizations in later semesters. Results showed first-year students reported spending more time engaged in passive activities (i.e., napping, watching TV) than volunteering, attending clubs and events, and engaging in political activism. The authors conducted linear regression analyses, which found the ways in which students spent their time during the first year of college predicted their participation in selected high-impact activities during their third and fourth year of college, controlling for age and parent education. Studying abroad was predicted by spending more time volunteering and more time going to bars and parties, while holding a leadership position in a philanthropic organization was predicted by spending more time napping, watching TV, playing video games, and going to bars and parties. In their discussion, the authors hypothesized both studying abroad and leadership positions may attract social students, who enjoy spending time at parties and bars. A limitation of this study is that preexisting characteristics, such as proclivity for risk-taking, may drive students to study abroad or drink, rather than first-year drinking behaviors.

Take away: In this longitudinal study, the amount of time first-year students spent going to bars and parties, as well as the time they spent engaged in other activities, predicted their involvement in high-impact activities two to three years later.

Citation: Small ML, Waterman E, & Lender T. (2017). Time use during first year of college predicts participation in high-impact activities during later years, Journal of College Student Development, 58(6) 954-960 doi: 10.1353/csd.2017.0075


NCAA tournament participation associated with increases in college student drinking, binge drinking, and drunk driving episodes

A new white paper from the National Bureau of Economic Research examined the impact of the NCAA Men’s Basketball Tournament on college student drinking behavior. Data from the Harvard School of Public Health College Alcohol Study, a nationally representative sample of four-year, full-time college students, from the 1993, 1997, 1999, and 2001 basketball seasons were analyzed. Forty-four participating institutions competed in the NCAA Division I. Survey data from these colleges were compared to data from non-participating (control) schools in the same years; there were 25,977 responses in the final analytic sample. Drinking behaviors of interest included binge drinking in the past two weeks and drunk driving or riding with someone who had been drinking. Survey demographic measures for individuals included gender, race, age, membership in Greek life, and marital status. Demographic measures at the institutional level included men’s basketball regular season win percentage and athletic conference. The authors used a difference-in-differences model, in which they exploited both time differences (whether a respondent’s survey covered the time period for the tournament) and between-institution differences. Results indicated students at tournament schools were more likely to have reported consuming alcohol and reported, on average, engaging drinking and binge drinking at higher frequencies during the same time period, compared to their peers at control institutions. Participants whose surveys covered the period in which their institution played a tournament game had a lower probability of drinking, but reported greater rates of binge drinking and total drinking. Results from the primary regression analysis showed respondents who attended tournament colleges and whose surveys covered the tournament reported increased binge drinking occasions by 20%, on average, although total drinking among these students decreased by 4%. This implies there was greater alcohol consumption among those who were already drinking. Among students at tournament schools, there was no evidence drinking before the tournament decreased in the months leading up to and after the tournament. Other findings included larger amounts of alcohol consumed by Greek students and decreased likelihood of drinking, but greater likelihood of binge drinking among first-year students. Men reported consuming an additional seven drinks when their college team participated in the tournament. For women, the probability of any drinking declined, but binge drinking and number of drinks did not. “Dosage” (the number of tournament rounds in which a team competed) was also found to influence student drinking: When participants’ surveys covered more tournament games, they reported engaging in more total drinking and binge drinking. Both men and women at tournament schools were found to experience a four percentage point increase in the probability of engaging in drunk driving or riding with an intoxicated driver.

A major limitation of this study is that the dates on which respondents completed their surveys were unknown; only the dates on which surveys were processed were known. This means the period for which students retrospectively reported their drinking behaviors may not have coincided with the NCAA tournament. The authors assumed all surveys were processed four weeks after they were completed by students.

Take away: In a nationally representative sample, college students who attended an institution that participated in an NCAA basketball tournament in the 1990s or early 2000s reported a 20% increase in binge drinking and a 4% increase in drunk driving episodes. These increases were larger among males than among females.

Citation: Wooten J., White DR & Cowan BW (2017). March madness: NCAA tournament participation and college alcohol use. http://www.nber.org/papers/w23821.pdf



Latest Research (September 19-September 25)

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Undergraduate students ambivalent about nonmedical use of prescription stimulants

A new, qualitative study provides insight on college students’ perceptions of prescription stimulant misuse. Participants (n = 35) were undergraduate students at one selective U.S. liberal arts college who completed semi-structured interviews with research personnel. Based on their prior prescription stimulant use, participants were classified as prescribed users (who had ADHD diagnoses and used stimulants as prescribed), combined users (who had ADHD diagnoses and used stimulants both as prescribed and illicitly), illicit users (who lacked a diagnosis and a prescription), and nonusers (who lacked diagnoses and had never used prescription stimulants).  One major theme of the interviews was students’ neoliberal logic with respect to the purpose of attending college. Students viewed college as a multiyear competition and aimed to optimize their investments of time and labor for future gain. Students also shared that using prescription stimulants both with and without a prescription was common on campus and there was no stereotypical stimulant user. One combined user reported it was easy for him to stockpile stimulant pills by taking less than his prescribed dosage or skipping doses altogether. Participants were asked whether they thought non-medical use of prescription stimulants (NMPS) was a form of academic cheating. Students were divided on this issue: 48% thought NMPS was cheating, while 43% did not. Students in the former group described the medications as “cognitive enhancers” that gave users abilities they did not deserve; several compared NMPS to steroid use in athletics. Students reported this was an unfair advantage in a college environment where they were competing to outperform each other. Only about one-third of this group acknowledged students who engage in NMPS might have a therapeutic need for medication, such as undiagnosed ADHD. Students who had never misused prescription stimulants were very likely to view NMPS as a form of cheating. All of the participants who did not believe NMPS was a form of cheating reported using stimulants at least once. Some claimed prescription stimulants were not “magic pill[s]” and; therefore, did not confer unfair academic advantage to users. They compared NMPS to caffeine use and reported academic “pressures” could push students to engage in NMPS. In addition, 40% of participants reported NMPS was morally problematic; most of them also agreed that NMPS was a form of cheating. A few students described NMPS as evidencing positive cultural values, such as highly valuing academic success.

Take away: This study found disagreement among students as to whether nonmedical use of prescription stimulants was immoral or a form of cheating. Most participants viewed the purpose of attending college through neoliberal logic, which may have influenced their opinions about stimulant use.

Citation: Cooper A & McGee L. (2017). “At such a good school, everybody needs it”: Contested meanings of prescription stimulant use in College academics, Ethos, 45(3), 289–313 doi:10.1111/etho.12167


Smartphone apps to manage drinking are widely downloaded, but user tailoring is limited

A new study analyzed the content of smartphone apps for managing drinking. Researchers downloaded publically available Android apps that were designed to support recovery or prevent problematic alcohol use from the Google Play Store between late 2014 and mid-2015. The final analytic sample consisted of 266 apps. The number of downloads and user rating were recorded for each app and used as a proxy to measure user engagement, although correlation between these two indices was very low (r = – 0.02). Apps were then rated on three domains: Basic descriptors, functionality, and use of dynamic features. Univariate regression models were used to identify qualities of the apps that were associated with popularity and user-rated quality. Overall results found the apps were designed target to multiple audiences, including current and former drinkers, and goals of the apps included drinking more safely (55%), stopping drinking (40%) and remaining sober (40%). Some apps contained advertising, grammatical errors, or tutorials. Only 3% of apps included information on national drinking guidelines. 25% of apps were downloaded over 10,000 times. The average rating was 3.8 stars (SD = 0.9). The most common app functions were blood alcohol concentration (BAC) calculators (37%) and providing general information on drinking (37%). 24% of apps included tracking calculators and 21% included motivational messages or features; 28% provided support to users during intoxication by reminding them to drink water or asking them to perform reaction time tests to assess intoxication. Most tailoring occurred within the context of BAC calculators and tracking calendars, but 38% of apps described users’ alcohol consumption and 33% provided information based on user demographics. Two percent of apps or fewer included tailored information on variables known to be important to behavior change, such as self-efficacy, triggers, and goal-setting. Results of the univariate regression found variables from all three domains were related to app popularity and user-rated quality. Apps were more likely to have over 10,000 downloads if they were free (OR = 3.13 [1.57-6.21]) or provided some form of tailoring (OR = 2.41 [1.30-4.46]). Apps were more likely to be highly rated if they were larger, included guidance on their use, or included tracking calendars. The authors claim this may indicate users prefer relatively complicated apps that can provide a greater degree of tailoring.

Take away: Among publically available smartphone apps, tailoring to manage drinking was positively associated with user-rated quality, but the degree to which apps were tailored to users was limited. Very few apps included tailored information on variables known to be important to behavior change, such as self-efficacy.

Citation: Hoeppner BB, Schick MR, Kelly LM, et al. (2017). There is an app for that – Or is there? A content analysis of publicly available smartphone apps for managing alcohol use [published online ahead of print September 12 2017], Journal of Substance Abuse Treatment doi: 10.1016/j.jsat.2017.09.006


Strength of social bonds over time influences likelihood of engaging in nonmedical prescription drug use in adulthood

Previous research on the impact of social bonds upon substance use has been mostly cross-sectional. A new study investigated the longitudinal impacts of social bonds on nonmedical prescription drug use (NMPDU). Data were obtained from the National Longitudinal Study of Adolescent to Adult Health, which contained four waves of data collection. Participants were aged 14-16 years at Wave 1 and 28-30 years at Wave 4. At each wave, they reported their NMPDU since the previous wave. Social bond measurements included the marital bond, parent-child bond, education bond, religious bond, and several others. Participants were grouped into trajectories based on their responses for each bond at each wave. The authors used group-based latent trajectory modeling as the main analytical tool, as well as multiple imputation technique to handle missing data. Results showed 5.8% of the sample reported NMPDU at baseline and 18.6% reported NMPDU at Wave 4. Overall, self-reported relationship with parents declined in quality at Wave 3, but rose back to baseline levels at Wave 4. Most participants were enrolled in an educational institution at Waves 1 and 2. There were three trajectories for religious bond: 34% of the sample consistently attended church with high frequency, 43.2% gradually decreased attendance (“high decrease” group), and 22.8% never really frequented church, but increased attendance slowly over time (“low increase” group). Model 1 used “constantly high level” trajectories as the reference group. It showed the “low increase” and “high decrease” religious bond groups were more likely to engage in NMPDU (both ps < 0.001). Similar trajectories were created for other bonds. The “low increase” trajectory of familial bond had elevated risk of NMPDU at Wave 4 (p< 0.001), but such risk was not observed in the “high decrease” trajectory. Delayed marriage was found to have a protective impact on likelihood of NMPDU, while enrollment in higher education or training may be a possible risk factor. Baseline NMPDU was associated with a significantly higher likelihood of NMPDU in at Wave 4 (p < 0.001). In Model 2 (which used “low initial” as the reference group) for most types of social bond, people in the “constant high” trajectories were significantly less likely to report NMPDU than their counterparts in all other trajectories. This implies cumulative level of social bond is important and the initial bonding strength may not matter as much as the contemporaneous bonding strength.

Take away: In this nationally representative sample, people who belonged in a constant and high-level trajectory of social bond were significantly less likely to report nonmedical use of prescription drugs in their late twenties than all others.

Citation: Yang XY & Yang T (2017). Nonmedical prescription drug use among adults in their late twenties: The importance of social bonding trajectories, Journal of Drug Issues, 47(4), 665-678 doi: 10.1177/0022042617722563

Latest Research (September 12-September 18)

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Perceived parental permissibility of college students’ alcohol consumption is dynamic, predicts student drinking behaviors throughout college

Prior research has linked perceived parental approval of alcohol consumption to earlier alcohol initiation and higher quantities consumed by high school and college students. A new study investigated the relationship between perceived parental permissibility of alcohol use (PPP) and college students’ drinking quantity and likelihood of binge drinking across multiple years of college. Data from the University Life Study, a longitudinal study of U.S. college students’ daily lives and risk behaviors, were analyzed. Participants (N = 744) completed a longer, web-based survey followed by 14 consecutive daily web-based surveys for seven semesters. Participants were first-year students under 21 years of age at baseline. The sample was racially and ethnically diverse and 51% female. Students were asked to estimate the maximum amount of alcohol they believed their parents would deem acceptable for them to consume on one occasion when they were in 12th grade and at multiple time points in college. Students also annually reported their past-month frequency of binge drinking and maximum number of drinks consumed on one occasion. Generalized linear mixed models (GLMMs), estimated using Poisson distributions, were used to determine whether PPP changed over time and whether mean PPP levels predicted drinking outcomes over time. Using k-cluster analysis, students were sorted into one of four clusters representing different patterns of PPP change. Two additional GLMMs were estimated using Poisson distribution to predict drinking outcomes using PPP cluster membership as a predictor. Results showed the average student engaged in binge drinking between one and three times and drank between five or six drinks on their past-month heaviest drinking occasion. The amount the average male and female students reported their parents would approve them consuming increased from about one drink to less than three drinks over time (quantities were greater for males than females, but rates of change did not significantly differ by sex). Each one-unit increase in mean PPP was associated with a 29% greater number of past-month binge drinking occasions. The average annual increase in females’ peak drinking was 12%; the rate of increase for males did not significantly differ. Patterns of PPP change were non-linear and differed among families. Each one-unit increase in mean PPP was associated with a 24% greater number of drinks consumed on the past-month heaviest drinking occasion. Cluster membership predicted the rate of increase in the number of drinks on students’ heaviest drinking occasion through the fourth year of college.

Take away: Perceived parental permissibility of alcohol use (PPP) increased across college; between-person differences in mean PPP were positively associated with binge drinking frequency and peak drinking. Through the fourth year of college, patterns of PPP change differentially predicted both drinking outcomes.

Citation: Calhoun BH, Maggs JL, & Loken E. (2017) Change in college students’ perceived parental permissibility of alcohol use and its relation to college drinking [published online ahead of print August 31 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.08.025


Cannabis use patterns in early adulthood may have distinct risk profiles

A new study prospectively identified risk profiles associated with patterns of problematic cannabis use in early adulthood. Participants were 1,229 individuals in the Great Smoky Mountain study. Between 1993 and 2015, they were assessed yearly from ages 9 to 16 years, as well as every 2-5 years from ages 19 to 30 years. This sample was representative of western North Carolina, except for oversampling American Indians. Problematic cannabis use was defined as either daily use or meeting full criteria for DSM-5 Cannabis Use Disorder (CUD). Patterns of problematic use included 1) non-problematic use in late adolescence (ages 19-21) and early adulthood (ages 26-30), 2) limited problematic use in late adolescence only, 3) persistent problematic use in late adolescence and early adulthood, and 4) delayed problematic use in early adulthood only. At each data collection point, participants were assessed for symptoms of psychiatric disorders and high-risk behaviors and were asked to report their cannabis use within the past three months. The authors ran multinomial logistic regression models to create relative risk ratios (RRRs) of risk factors between all patterns. Then, interaction models were used to test whether the effects of risk factors in the prediction of developmental patterns varied by race/ethnicity and sex. Results indicated 6.7% of the sample was classified as persistent problematic use (group #3 above), 13.3% as limited problematic use (group #2), and 3.7% as delayed problematic use (group #4). The persistent problematic use group was characterized by higher prevalence of anxiety disorders across development and more DSM-5 CUD symptoms during adolescence, compared to the limited problematic use group. The limited group had higher prevalence of externalizing disorders, maltreatment, and peer bullying in childhood, compared to the non-problematic use group, and greater childhood family instability and dysfunction than the persistent use group. There were no significant race/ethnicity or sex interactions observed.

Take away: In this sample, problematic cannabis use patterns during early adulthood had distinct risk profiles across development, with respect to psychiatric disorder symptoms and high-risk behaviors. There was no evidence of significant interactions of sex and race/ethnicity.

Citation: Hill S, Shanahan L, Costello EJ, et al. (2017) Predicting persistent, limited, and delayed problematic cannabis use in early adulthood: Findings from a longitudinal study [published online ahead of print September 01 2017], Journal of the American Academy of Child & Adolescent Psychiatry


For young adults, solitary drinking may predict alcohol problems

According to previous studies, approximately 15% of emerging adults engage in solitary drinking. A new study examined solitary drinking (compared to normative social drinking) as a predictor of alcohol-related problems in early adulthood, as well as the role hazardous drinking as a potential mediator between solitary drinking and specific alcohol problems. Data were collected from a larger alcohol-related study of full-time students aged 18 to 25 years who reported drinking at least one, but fewer than 35, drinks per week. This sample contained 118 Canadian undergraduate students (68% female) who completed questionnaires on their drinking behaviors and harms. Measures included drinking contexts (how often they drank alone, at parties, and at bars within the past six months), alcohol problems (measured using the Young Adult Alcohol Consequences Questionnaire), and hazardous drinking (adopted from the AUDIT). Alcohol problems were organized into eight domains: social-interpersonal, impaired control, diminished self-perception, poor self-care, risky behavior, academic/occupations, physical dependence, and blackout drinking.  Data were analyzed using path modeling to test the unique associations between drinking contexts (predictors) and alcohol problem domains (outcomes), with hazardous drinking as a mediator. Robust maximum likelihood estimation was used to correct for non-normal distributions of variables. Results indicated this sample had comparable levels of hazardous drinking, slightly fewer alcohol problems, and similar means for solitary and social drinking, compared to previous undergraduate samples. The model was found to be an excellent fit. Confidence intervals (CIs) showed solitary drinking was a positive predictor of hazardous drinking, but did not support associated between social (parties and bars) drinking and hazardous alcohol use. CIs also showed hazardous drinking was a positive predictor of all eight domains of alcohol problems. Analysis of indirect effects using CIs found solitary drinking positively predicted all domains of alcohol problems via hazardous drinking. Effect sizes showed drinking alone was an especially important predictor of domains involving risky behaviors and blackout drinking; solitary drinking accounted for over 20% of the variance in these outcomes. There was no evidence of indirect effects from social drinking at bars to alcohol problems via hazardous drinking, but smaller indirect effects were observed for drinking at parties in four problem domains.

Take away: The results of this study support hazardous drinking as a mediator of the effects of drinking alone on alcohol problems. For alcohol problems in risky behavior and blackout drinking domains, solitary drinking accounted for 20% of the variation in outcomes.

Citation: Keough MT, O’Connor RM & Steward SH. (2017) Solitary drinking is associated with specific alcohol problems in emerging adults [published online ahead of print August 31 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.08.024

Latest Research (September 6-September 11)

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Skipping class found to mediate relationships between alcohol, marijuana use and GPA

A recent study investigated the relationship between alcohol and marijuana use among college students, as well as the role of skipping class on the relationship between substance use and GPA. Participants were undergraduate students at one U.S. university whose names were listed in the institution’s directory. Of the 8,471 undergraduates contacted, 13% (n = 1,104) responded and completed an online survey. The final analytic sample consisted of 946 students. Survey measures included self-reported GPA, past-year alcohol and marijuana use, demographic characteristics, and frequency of skipping class (options ranged from ‘never’ to ‘all of the time’). Results showed the average GPA for the sample was 3.21 (higher than the university-wide average), 90% reported past-year alcohol use (with 40% reported using on 40 or more occasions), and nearly half of respondents reported past-year marijuana use. The authors used bivariate correlation, ordinary least squares (OLS) regressions, and mediational analyses to examine the relationships of interest. They found both alcohol and marijuana use were significantly negatively correlated with GPA (r = -0.16, p < 0.001 and r = -0.20, p < 0.001, respectively). Respondents who reported skipping class less frequently were more likely to report having higher GPAs than those who reported skipping class frequently. Results of the OLS regressions found alcohol use significantly predicted GPA (p = 0.004), even when controlling for other variables. Male sex (p < 0.001) and non-White race (p < 0.001) both had a significant negative relationship with GPA. Results for an OLS regression with marijuana use were similar: Marijuana use alone was significantly negatively associated with GPA (p < 0.001) and marijuana use accounted for 12.7% of the variance in GPA. A third OLS regression model that included both alcohol use and marijuana use found only marijuana use was a significant predictor of GPA (p = 0.01), with a negative association between frequency of use and GPA. In this model, frequency of skipping class was the most important predictor of GPA. Results of the mediation analyses found marijuana use mediated the relationship between alcohol use and GPA, accounting for nearly half of the total effect. Skipping class was found to partially mediate the relationship between alcohol use and GPA, accounting for about 40% of the total effect. Results for marijuana use were similar: It had a significant indirect effect on GPA through the frequency of skipping class, accounting for about 35% of the total effect.

Take away: In this sample, both marijuana use and alcohol use were significantly negatively associated with GPA. Skipping class was found to partially mediate the relationships between alcohol and marijuana use on GPA, accounting for approximately one-half and one-third of the respective total effects.

Citation: Bolin RM, Pate M & McClintock J (2017) The impact of alcohol and marijuana use on academic achievement among college students [published online ahead of print August 30 2017], The Social Science Journal doi: 10.1016/j.soscij.2017.08.003


Following legalization, frequency of marijuana use higher among CO college students, linked to alcohol use

In 2012, Colorado became the first state to legalize recreational marijuana use; the first retail stores opened in 2014. A new article examined the effects of recreational marijuana legalization (RML) on college students in Colorado. Data on self-reported marijuana and alcohol use were collected from current college students or recent graduates in four waves (N = 1,413; ns ranged from 256 to 424) over a 17-month period (before and after RML). Snowball sampling was used to recruit new participants. The overall sample was mostly female (77%) and mostly White (76%). Participants completed online surveys on which they reported the frequency, severity, and method of their marijuana and alcohol use. The authors used independent t-tests and ANOVA to analyze changes in frequency of alcohol and marijuana use over time, independent t-tests to compare Colorado data to national data, and logistic regression and Pearson’s correlation to analyze patterns in alcohol and marijuana use in each wave. Participants were sorted into groups, based on their reported frequency of alcohol and marijuana use: No/Infrequent use, use every 2-5 months, use 1-3 times per month, and weekly use. One-way ANOVA was used to explore differences in GPA among these groups. Results indicated a significantly higher proportion of Colorado college students had ever tried marijuana, compared to results from the National College Health Assessment (NCHA) (71% v. 39%, p < 0.001). The average amount of daily or near daily marijuana users was significantly higher in the sample than in NCHA results (25% v. 2%, p < 0.001). No significant differences in frequency of marijuana use were found across waves. Mean GPA for the no/infrequent use group was 0.429 points higher than the weekly use group (p < 0.05). The authors also investigated the relationship between alcohol use and marijuana use at each wave. Moderate positive correlations between frequency of alcohol and marijuana use were observed at all waves, but the strength of these correlations diminished over time. In waves I and II, all three alcohol use groups were significantly different from weekly drinkers, with respect to marijuana use; however, in waves III and IV, only two use groups were significantly different from weekly drinkers. Overall, binge drinking increased the likelihood of using marijuana since RML (ORs at each wave ranged from 2.012 to 6.128, compared to students who did not report binge drinking).

Take away: Following recreational marijuana legalization in Colorado, frequency of marijuana use among college students was significantly higher than the national average, especially for daily or near daily users. There were moderate positive correlations between frequency of marijuana use and frequency of alcohol use; binge drinking increased the likelihood of using marijuana.

Citation: Jones J, Jones KN & Peil J (2017 The impact of the legalization of recreational marijuana on college students [published online ahead of print August 31 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.08.015


Exclusive e-cigarette use predicted cigarette initiation among cohort of college students

A new study prospectively examined the role of electronic nicotine delivery systems (ENDS; also known as e-cigarettes) in initiating cigarette use among young adults. Participants were 2,558 U.S. college students involved in the first four waves of the Marketing and Promotions across Colleges in Texas project (Project M-PACT) who were between 18 and 25 years of age and reported never having used cigarettes at baseline. Variables examined in this study included age at first cigarette use, number of cigarettes smoked in lifetime, socio-demographic characteristics, cigarette use susceptibility, interpersonal factors (family-of-origin tobacco use and friend cigarette use), lifetime other tobacco use, and lifetime ENDS use. During the study period, 213 participants dropped out. The authors concluded students who remained in the study were more likely to be Asian and enrolled in a four-year university (versus a two-year school), and less likely to use other tobacco products and to be susceptible to other tobacco use. Two multivariable, multi-level discrete-time hazard models were used to evaluate whether ENDS use predicted cigarette initiation during the study period. Overall, results indicated 11% (n = 282) of participants reported cigarette use by wave 4. A significantly higher proportion of wave 1 ENDS users reported initiating cigarette use by wave 4, compared to wave 1 non-ENDS users (p < 0.001). Individuals who initiated cigarette use by wave 4 were more likely to be susceptible to cigarette use at wave 1, have a family member who used tobacco, have at least one friend who used cigarettes at wave 1, use at least one other type of tobacco at wave 1, and report ever using ENDS at wave 1, compared to participants who did not initiate cigarette use. The first model found lifetime ENDS use at wave 1 was associated with a 1.36 times greater odds of cigarette initiation, but the second model found a significant two-way interaction with other tobacco use. The authors interpreted this to mean that among students who used no other tobacco products at wave 1, ENDS use predicted greater odds of cigarette initiation (OR = 2.26, CI: 1.35-3.76), but among users of other tobacco products, ENDS use was not a significant predictor (OR = 1.13, CI: 0.81-1.58).

Take away: At baseline, students in this sample who reported only using electronic nicotine delivery systems (ENDS) had increased risk of cigarette initiation up to 1.5 years later, compared to non-tobacco users.

Citation: Loukas A, Marti CN, Cooper M, et al. (2017) Exclusive e-cigarette use predicts cigarette initiation among college students [published online ahead of print August 31 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.08.023




Latest Research (August 29-September 5)

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Among recent college graduates, drinking behavior during college predicted likelihood of full-time employment at graduation

A new study prospectively examined the relationship between drinking behaviors during college and employment immediately after graduation. Participants were 827 graduating seniors from four U.S. universities who completed surveys during their last semester/quarter of college and one month after graduation. Respondents reported their average number of drinks a typical week (modal quantity of consumption) and the number of days on which they drank within the past 30 days (modal frequency), as well as number of times they engaged in heavy episodic drinking (HED) within the past 30 days. Participants also reported whether they were employed full-time, part-time, or unemployed at follow-up; those who reported part-time work were excluded from the analysis. Results indicated non-White graduates were 0.66 times less likely to be employed full-time (vs. unemployed), relative to White graduates and participants with any loan debt were 1.49 times more likely to be employed full-time than their peers without loan debt. Next, the authors ran a series of multiple logistic regressions using maximum likelihood estimation. After controlling for race, loan debt, career indecision, and financial stress, results indicated neither modal quantity nor frequency of consumption were significantly related to full-time employment after graduation (p = 0.16 and 0.84, respectively); however, HED frequency significantly predicted employment status at follow-up (p < 0.05). Each additional episode of HED per month corresponded to a 1.4% reduction in the odds of being employed full-time (vs. unemployed) one month after graduation. This meant students who engaged in HED once or twice per week were about 10% less likely to be employed full-time, relative to students who abstained from HED.

Take away: In this sample, the frequency at which college students reported engaging in heavy episodic drinking significantly predicted full-time employment at graduation. Each additional episode of heavy episodic drinking per month was associated with a 1.4% decrease in the likelihood of full-time employment one month after graduation.

Citation: Bamberger PA, Koopman J, Wang M, et al. (2017) Does college alcohol consumption impact employment upon graduation? Findings from a prospective study [published online ahead of print August 242017], Journal of Applied Psychology doi: 10.1037/apl0000244


From 2013-2014, smokeless tobacco use was highest among college-aged adults

Smokeless tobacco (SLT) products include snus (a type of moist snuff tobacco), dip, chewing tobacco, and dissolvable tobacco. A recent article shares findings from the Population Assessment of Tobacco and Health (PATH) study wave 1, which was conducted between 2013 and 2014. Participants were 32,320 adults aged 18 years or older who completed audio computer-assisted self-interviews in English and Spanish. Young adults (aged 18 to 24 years), African Americans, and adult tobacco users were oversampled during this wave. Participants reported whether they used any tobacco product or any SLT product, which product(s) they used, and frequency of use. Other measures included number of days on which participants used SLT in the past month, number of snus pouches used per day, age at first use, age at first regular use of a given product, frequency of cigarette use, and demographic characteristics. Use of other tobacco products (i.e., hookah, e-cigarettes) was also assessed. Overall, SLT use was most common among men, young adults, non-Hispanic Whites, and respondents in nonurban areas. Among participants aged 18 to 24 years, 4.0% reported using any SLT and 1.0% reported using pouched snus. 35.9% of young adults reported using both pouched snus and at least one other type of SLT product. Results of the PATH study wave 1 were used to estimate the prevalence of SLT use among all U.S. adults: These estimates were 16.5% for ever using any type of SLT and 2.9% for current established use of SLT.

Take away: Results from this large-scale study found smokeless tobacco (SLT) use was most common among men, young adults aged 18 to 24 years, and respondents in nonurban areas. Using more than one type of tobacco product was common among respondents who reported SLT use.

Citation: Cheng Y-C, Rostron BL, Day HR, et al. (2017) Patterns of use of smokeless tobacco in US adults, 2013–2014 [published online ahead of print August 82017], American Journal of Public Health doi: 10.2105/AJPH.2017.303921


Feminine norms may have direct, indirect effects on binge drinking, alcohol-related problems among collegiate women

Previous research has shown alcohol consumption among women has increased over the past three decades. There is also evidence feminine norms (“socially constructed beliefs about what it means to be a woman”) influence women’s drinking behavior. A new study examined the relationships among multidimensional feminine norms, binge drinking, and alcohol-related problems among collegiate women. The authors used Mahalik, et al.’s (2005) set of norms (focus on thinness, investment in appearance, sexual fidelity in a committed relationship, maintaining relationships, being sweet and nice, valuing romantic relationships, modesty, upholding domestic roles, and caring for children) to test whether these norms would account for differential alcohol-related outcomes, controlling for sorority membership, descriptive norms, and alcohol expectancies. Participants were 1,190 U.S. undergraduate women, 58.3% of whom identified as Asian American and 23.2% of whom belonged to a sorority. They reported their frequency of binge drinking within the past three months, alcohol-related problems, conformity to feminine norms, perceived peer alcohol consumption (descriptive norms), positive and negative alcohol expectancies, and demographic characteristics via a web-based survey. Respondents reported binge drinking, on average, 2.59 (SD = 5.49) times in the past three months and having 4.80 (SD = 7.76) alcohol-related problems in the past year. The authors analyzed survey data using negative binomial regression to create incidence rate ratios (IRRs), which were interpreted as a one-unit increase in the predictor representing a one-unit increase binge or alcohol-related problems. The model showed sorority membership (IRR = 1.63, p < 0.001), descriptive norms (IRR = 3.24, p <0.001), and positive alcohol expectancies (IRR = 1.03, p < 0.01) were significantly associated with binge drinking. After controlling for covariates, the norms of sexual fidelity (IRR = .87, p <.001), being sweet and nice (IRR = .93, p < .001), and upholding domestic roles (IRR = .96, p <.05) were negatively associated with binge drinking. The norms of importance of relationships (IRR = 1.09, p <.002) and investment in appearance (IRR = 1.08, p <. 001) were positively associated to the outcome. A second model revealed the norms of sexual fidelity (IRR = .91, p <. 001) and being sweet and nice (IRR = .96, p < 0.01) were negatively related to the probability of past-year alcohol-related problems, whereas the norm of investment in appearance (IRR = 1.06, p < 0.001) was positively related. Endorsement of these feminine norms was also found to have indirect effects on alcohol-related problems through binge drinking.

Take away:  After controlling for covariates, endorsement of the norm of investment in appearance was positively related to binge drinking and alcohol-related problems, while endorsement of the norms of sexual fidelity and being sweet and nice were negatively associated with these outcomes.

Citation: Iwamoto DK, Corbin W, Takamatsu S, et al. (2017) The association between multidimensional feminine norms, binge drinking and alcohol-related problems among young adult college women [published online ahead of print August 24 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.08.016

Latest Research (August 15-August 28)

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College students’ personal approval of intoxicated behaviors lower than perceived peer approval; approval linked to sex and race/ethnicity

Previous drinking norms literature has found college students tend to overestimate their peers’ consumption and approval, relative to their own consumption and approval, which may influence students’ drinking behaviors. These discrepancies are called self-other differences (SODs). A recent study examined SODs for college students’ ratings of the approval of intoxicated behaviors and whether gender and race/ethnicity moderated these differences. Participants were a convenience sample of 233 U.S. college students; this sample was mostly female and mostly White. Participants were presented with a list of 44 intoxicated behaviors (i.e., slurring speech, walking with difficulty) and rated how acceptable each behavior was to them personally using a Likert scale. These ratings were then used to measure injunctive norms: Participants were asked to rate how acceptable a “typical student at the university” thought each behavior was. Participants also reported their demographic characteristics (age, sex, year in school, race/ethnicity, etc.) and drinking behaviors (average number of drinks consumed per week and number of binge-drinking occasions in the past month). Results found 84% (n = 195) of the sample reported past-month drinking, 83% of whom (n = 161) reported binge drinking, and the average number of drinks consumed per week was 9.86 (SD = 8.57). The authors performed paired t-tests to compare the means from personal approval ratings and perceived others’ ratings for each behavior. All but two of the means were significantly different. The average personal approval rating (closest to slightly unacceptable) and the average perceived others’ approval score (closest to slightly acceptable) were significantly different (p < 0.0001). All SOD scores were positive, meaning students rated others as more approving of intoxicated behaviors than they rated themselves. After controlling for weekly alcohol consumption, women rated intoxicated behaviors to be less personally acceptable than men (p < 0.001), but there were no significant differences with respect to perceived others’ approval. Because only 30% of the sample identified as a racial or ethnic minority, all of these participants were combined into one group for analysis. Minority respondents reported significantly less accepting attitudes toward intoxicated behaviors and significantly higher perceived peer approval of these behaviors compared to White respondents, controlling for consumption.

Take away: In this convenience sample, students rated their peers’ perceived approval as significantly higher than their personal approval for 42 of 44 intoxicated behaviors. On average, women rated behaviors as less personally acceptable than men and students of color rated behaviors as less personally acceptable and more acceptable to their peers.

Citation: Lowery AD, Merrill JR & Carey KD. (2017). How acceptable are intoxicated behaviors? Discrepancy between personal versus perceived approval [published online ahead of print August 17 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.08.021


From 2006-2015, racial/ethnic differences in past-month adolescent marijuana use diminished, were influenced by school context and state marijuana laws

A new study examined longitudinal trends in marijuana use in adolescence by race/ethnicity in the U.S. using a socioecological perspective. Data from the Monitoring the Future study (MTF), a nationally representative sample of eighth-, 10th-, and 12th-grade students, from the years 2006 through 2015 were examined (N > 390,000). Measures included in this analysis were self-reported past 30-day marijuana use, individual factors (race/ethnicity, gender, highest level of parental education), as well as school context (class size, public vs. private status) and state context (level medical marijuana laws, state-level demographic characteristics). The authors used multilevel logistic regression to model the prevalence of marijuana use among respondents within each state by year and grade, then used difference-in-difference models to estimate whether the differences in log odds of respondents reporting past-30 day marijuana use differed by race/ethnicity and whether differences by race also differed by individual, school, and state factors. Results indicated there were no differences in log odds of past 30-day marijuana use over time among eighth graders, but significant differences by race/ethnicity were observed for 10th and 12th graders. Across all years, 10th-graders who identified as multiracial had the highest prevalence of marijuana use, while those who identified as Asian had the lowest. In 12th grade, multiracial students had the highest prevalence of use across most years, but rates among Black and Hispanic students increased over time and eventually converged with those of multiracial students. Non-Hispanic Whites were significantly more likely to use marijuana than Hispanic students from 2006-2010; however, after 2010 there was no significant differences in use for any year. For 10th-graders, significant interactions between race/ethnicity (Black vs. White and Hispanic vs. Non-Hispanic White) and class size were observed. Among 12th-graders, the increase in marijuana use for Black students compared to White students was greater in states with a medical marijuana law enacted before 2006 (p = 0.02).

Take away: Monitoring the Future data indicate U.S. adolescents of color had a greater prevalence of past-month marijuana use than their White peers; however, these differences diminished to convergence by 2015. Class size and state-level medical marijuana laws were also found to influence adolescent marijuana use.

Citation: Keyes KM, Wall M, Feng T, Cerda, et al. (2017) Race/ethnicity and marijuana use in the United States: Diminishing differences in the prevalence of use, 2006–2015 [published online ahead of print August 18 2017], Drug and Alcohol Dependence doi: 10.1016/j.drugalcdep.2017.07.027


Review: Alcohol screening and brief intervention is effective but underutilized, may prevent alcohol-related cancers

In addition to potential social, professional, and other health-related harms, excessive alcohol use is a risk factor for multiple types of cancer. A new report reviews the link between alcohol and cancer, describes the components of alcohol screening and brief intervention (SBI) programs, and uses life course theory to consider the need for increased implementation of these programs with young adults. According to the authors, young adulthood (ages 18 – 44 years) presents a unique window for intervention, because it is the period in which past-year alcohol use and past-month binge drinking are highest. Previous studies have established a link between alcohol use and cancers of the breast, liver, colon, rectum, and esophagus. The article also reviews current dietary guidelines and recommendations for lower-risk alcohol consumption and data on the current prevalence of excessive drinking in the U.S. The authors also describe the evidence for the effectiveness of alcohol SBI, its components (including validated screening tools), and CDC guidelines for implementing alcohol SBI as part of a routine practice. The U.S. Preventive Services Task Force recommends alcohol SBI as a grade B clinical preventive service and it is covered by most insurance policies. Data on the prevalence of alcohol SBI implementation suggest it is underutilized: Among a representative sample of U.S. adults aged 18 to 24 years, only 36% of those who reported drinking or being drunk more than six times in one month to their physicians were asked to reduce their drinking. One study of college students found awareness of the link between alcohol and various cancers ranged from 86% for liver cancer to only 3% for breast cancer. Other evidence suggests health care providers may be able to effectively educate patients on the harms of excessive alcohol consumption.

Take away: Alcohol screening and brief intervention (SBI) is an evidence-based clinical preventive service that is currently underutilized. The authors argue health care providers should implement alcohol SBI with young adults in order to reduce future risk of cancer.

Citation: McNight-Eily LR, Henley SJ, Green PP, et al. (2017). Alcohol screening and brief intervention: A potential role in cancer prevention for young adults American Journal of Preventive Medicine, S55-S62 doi: 10.1016/j.amepre.2017.04.021

Latest Research (August 8-August 14)

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Energy drink consumption throughout college linked to risk of substance use at age 25

A new study examined the trajectories of energy drink (ED) consumption among college students and substance use outcomes at age 25. Participants were 1,099 undergraduate students at one U.S. university who completed a baseline survey before the start of freshman year and at least one annual assessment four to eight years later (n = 863 in final analytic sample; modal ages at follow-up were 21 to 25 years). Measures included past-year ED consumption, other caffeine consumption, past-year alcohol use, DSM-IV criteria for alcohol use disorder (AUD), other substance use, and psychological risk factors (impulsive sensation-seeking, behavioral dysregulation, and conduct problems). Participants’ ED consumption frequencies were used to classify them into categories: Frequent (≥52 days), occasional (≥12 days and <52 days), and infrequent (≥1 days and < 12 days) patterns of use. The authors used statistical weights to estimate annual ED consumption prevalence and adjust for attrition and sampling design. The prevalence of ED consumption ranged from 62.5% in Year 4 to 49.1% in Year 8. Infrequent users comprised roughly one-quarter of the sample in any given year, whereas frequent users declined from 11.7% in Year 4 to 5.9% in Year 8. The authors used statistical software to model four trajectories based on the probability of ED consumption. These groups were Non-Use, Persistent (consistently high probability), Intermediate, and Desisting (steadily declining probability). The probability of past-year ED consumption significantly declined over time in the Persistent group (p < 0.003), but not in any other groups. Infrequent users represented substantial proportions of all groups but Non-Use. Moderate and frequent users were more likely to be in the Persistent trajectory group. Males and non-Hispanic Whites were over-represented in the Persistent group and all three psychological risk factors were positively associated with higher probability of ED consumption. At Year 8, AUD risk, cocaine use, and prescription stimulant misuse were significantly associated with ED trajectory group membership, after controlling for potential confounders. Individuals in the Persistent group were at significantly higher risk for AUD, prescription stimulant misuse, and cocaine misuse (all ps < 0.05), compared to non-users. Members of the Desisting group were not found to be at elevated risk for any of the substance use behaviors investigated, relative to non-users.

Take away: In this study, patterns of energy drink (ED) consumption established during college were generally sustained throughout early adulthood. ED consumption trajectories suggest individuals with higher probabilities of using EDs may be at elevated risk for cocaine use, alcohol use disorder, and prescription stimulant misuse.

Citation: Arria AM, Caldeira KM, Bugbee BA, Vincent KB & O’Grady KE. (2017). Trajectories of energy drink consumption and subsequent drug use during young adulthood [published online ahead of print August 7 2017] doi: 10.1016/j.drugalcdep.2017.06.008




College students who endorse one DSM-5 alcohol use disorder criteria may have distinct drinking pattern, risks

The term “diagnostic orphan” (DO) refers to an individual who endorses only one substance use disorder criterion from the DSM (the manual used to diagnose substance use disorders). DOs do not receive a diagnosis, but they may still be at risk for substance-related harms. A recent study examined characteristics of alcohol use disorder (AUD) DOs in a college sample. Participants were 396 U.S. undergraduate students aged 18 to 30 years who reported drinking at least once in the past three months. This sample was 60% White and 52% male. The authors created 13 items to reflect the content of DSM-5 AUD criteria. Participants answered these items, as well as measures of their own substance use, alcohol-related consequences, temptation to drink and attempts to control alcohol use, emotional dysregulation, self-control, and mindful awareness. Those who endorsed only one AUD criterion (24%) were classified as DOs. Results showed 58.9% of DOs were White, 63.2% were freshmen, and 50.5% were female. The majority of DOs were full-time students and lived on campus. 46.25% of DOs reported using marijuana in the past three months. No significant differences with respect to sex, race/ethnicity, class rank, Greek membership, current residence, or employment status were found between DOs and their peers who endorsed either no DSM-5 criteria or two or more criteria. Participants who endorsed two or more AUD criteria reported significantly higher alcohol consumption and drinking frequencies than the other two groups. DOs reported significantly more alcohol-related consequences and social and enhancement drinking motives than participants who did not endorse any AUD criteria. Compared to those who endorsed two or more AUD criteria, DOs reported significantly less frequent drinking, less alcohol consumed, fewer consequences, fewer social, coping, and enhancement motives, less emotional dysregulation, and less drinking restraint.

Take away: “Diagnostic orphans” who endorsed only one DSM-5 alcohol use disorder criterion reported significantly more alcohol-related consequences and social and enhancement drinking motives than their peers who did not endorse any criteria. Compared to their peers who endorsed more than one criterion, diagnostic orphans consumed less alcohol, drank less often, and experienced fewer consequences.

Citation: Hagman BT. (2017) Characteristics of DSM-5 Alcohol Use Disorder diagnostic orphans in college: An overlooked group of drinkers [published online ahead of print 31 July 2017], Addictive Disorders & Their Treatment doi: 10.1097/ADT.0000000000000116



Probability of using marijuana, frequency of use increased among Washington state college students following legalization of recreational marijauna 

Recreational marijuana use was legalized in Washington state in 2012. A new study explored the relationship between legalization and marijuana use among students at Washington State University (WSU). Cross-sectional data on self-reported marijuana and other substance use were collected from the National College Health Assessment (NCHA), which was administered at WSU in seven different years, with a mean of 2,069 students surveyed per year. The sample was representative of the WSU undergraduate population, except for an oversampling of White and Asian students. Participants were randomly selected from all survey years except for 2012 and 2014; in these years, survey invitations were sent to all WSU undergraduates. To compare changes in reported past-month marijuana use before and after recreational marijuana legalization, the authors compared WSU data to NCHA national data and the National Survey on Drug Use and Health (NSDUH). (Note: Both of these data sets were ‘contaminated’ with data from students in Washington and Colorado, where recreational marijuana was legalized.) The authors used logit regression to estimate the probability of a student choosing to use a substance and used ordinary least squares regression to estimate the number of days a student used marijuana, controlling for age, sex, race, and year in school. After controlling for a small, predicted increase in marijuana use each year, results of the analysis indicated marijuana use among WSU students increased between 2.0 and 3.5 percentage points each year after legalization and remained higher through 2015. The authors found no evidence legal sales had an additional impact on the proportion of marijuana users. Other findings included a decreasing likelihood of marijuana use after age 20, greater likelihood of use among first-year and Greek students, and positive correlations between marijuana use and other drug use. There were no observed differences in increases in use between underage students and those who could legally purchase marijuana. Use rates among Black and Hispanic students and female students increased the most following legalization. Frequency of marijuana use increased by a small, but significant, number of days per month following legalization, but no significant changes were observed following legal sales. Using difference-in-difference comparisons to national data, the authors estimated the effect of legalization was an increase of 8.6 percentage points (NCHA) to 9.6 percentage points (NSDUH) in likelihood of using marijuana.

Take away: Following legalization of recreational marijuana in Washington state, probability of marijuana use and frequency of marijuana use increased among Washington State University undergraduates. Black and Hispanic students and female students had the largest increases in probability of use.

Citation: Miller AM, Rosenman R & Cowan BW. (2017). Recreational marijuana legalization and college student use: Early evidence [published online ahead of print August 03 2017], SSM – Population Health doi: 10.1016/j.ssmph.2017.08.001

Latest Research (August 1 -August 7)

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Relationship between risky sexual behaviors and alcohol consumption influenced by drinking motives in college students

A recent study examined how drinking motives interact with alcohol use to predict risky sexual behaviors (i.e., not using condoms) among college students. Participants were a mostly White, mostly female sample of U.S. undergraduate students aged 18 to 24 years (n = 98) who reported both past-month alcohol use and lifetime penetrative sex and completed weekly questionnaires on their alcohol consumption, drinking motives, and risky sexual behaviors. The authors used drinking motive categories identified by Cooper, et al. (1994): Social, enhancement, coping, and conformity. Participants provided data on the above measures for a final sample 403 drinking episodes. Data were analyzed using Generalized Estimating Equations with a model for each drinking motive. Results showed participants consumed an average of 5.38 drinks per occasion. Risky sexual behaviors, which occurred on 22.2% of days, were more likely to occur during drinking days than on non-drinking days. The most commonly reported motive for drinking was social, closely followed by enhancement. Very few participants reported drinking to cope. For the social drinking motives model, the authors found participants were 10.4% more likely to engage in risky sexual behavior with every one-unit increase in their typical social motives on a given day. There was a significant interaction between enhancement motives and quantity of alcohol consumed: Individuals with strong enhancement motives had greater odds of engaging in risky sex, regardless of their level of alcohol consumption, but among participants with weaker enhancement motives, these odds depended on the quantity of alcohol consumed. The coping drinking motives model found a marginally significant positive relationship between level of alcohol consumption and odds of engaging in risky sex, but no significant main effect of coping motives. Results of the conformity drinking motives model were similar: A marginally significant effect for level of alcohol consumption on odds of engaging in risky sex, but no significant main effect of conformity motives.

Take away: This study found only marginally significant effects of alcohol use on risky sex for two of the four drinking motives models. The level of alcohol consumed on drinking occasions may only play a role in predicting risky sex when college students are drinking for certain reasons.

Citation: Kilwein TM & Looby A (2017). Predicting risky sexual behaviors among college student drinkers as a function of event-level drinking motives and alcohol use [published online ahead of print 24 July 2017], Addictive Behaviors doi: 10.1016/j.addbeh.2017.07.032


For American Indian youth, doctor-prescribed stimulants, perceived peer use linked to increased odds of stimulant misuse

A new study investigated prescription stimulant misuse among American Indian (AI) youth. Participants were a school-based sample of AI individuals in grades 7th – 12th who lived on or near reservations between 2009 and 2012 (N = 3,498). This sample was not randomly selected, nor was it nationally representative. Participants completed a modified version of The American Drug and Alcohol survey, which included self-report measures on prescribed stimulant use, frequency of stimulant misuse to get high, school performance, perception of peer substance use, and parental monitoring. Results showed 7% of the sample had been prescribed stimulants in the past and 32% of this group reported using stimulants to get high. Among students who were not prescribed stimulants, only 4% misused stimulants to get high. The authors used a multilevel analytic approach to interpret survey data. They found positive bivariate relationships between both peer modeling and having ever been prescribed stimulants and both lifetime stimulant misuse and frequency of past-month stimulant misuse. Logistic multilevel analysis found students from the Upper Great Lakes region had three times greater log odds of ever using stimulants to get high, compared to students in the Southwest (p = 0.001). The log odds of stimulant misuse were nearly nine times greater among students who were prescribed stimulants than their peers who were not (p < 0.001). Perception of peer substance use was positively related to log odds of lifetime stimulant use (p < 0.001) and parental monitoring was negatively related (p = 0.020). Perception of peer substance use and being prescribed stimulants in the past were both associated with increased frequency of past-month misuse (p < 0.001 and p = 0.011, respectively).

Take away: Among this school-based sample of American Indian (AI) youth, lifetime and past-month odds of prescription stimulant misuse were much higher than among youth who were not prescribed stimulants. AI youth in the Upper Great Lakes region had three times greater log odds of misusing stimulants to get high than their peers in the Southwest.

Citation: Spillane NS, Weyandt, L, Oster D, et al. (2017). Social contextual risk factors for stimulant use among adolescent American Indians [published online ahead of print 25 July 2017], Drug and Alcohol Dependence doi: 10.1016/j.drugalcdep.2017.06.032


From late 1990s to 2014, heavy episodic drinking, drunk driving declined, but alcohol-related nontraffic deaths, overdose hospitalizations increased among U.S. emerging adults

A new report provides updated data on the percentages of U.S. emerging adults aged 18 to 24 years who engaged in past-month heavy episodic (binge) drinking and past-year alcohol-impaired driving, as well as the magnitude of alcohol-related unintentional injury deaths and overdose hospitalizations, between 1998 and 2014. Longitudinal data were collected from the National Highway Traffic Safety Administrations’ Fatality Reporting System, CDC WISQARS, a meta-analysis of death certificate data, the U.S. Census Bureau, the Nationwide Inpatient Sample, and the National Survey on Drug Use and Health. The authors integrated these data sets and used statistical software to estimate the counts and proportions of 18- to 24-year-olds and college and noncollege respondents who experienced the events of interest. Results showed the proportion of emerging adults who engaged in past-month heavy episodic drinking (HED) increased from 31.7% in 1999 to 43.1% in 2005 (p = 0.03), then declined to 38.8% in 2014 (p > 0.05). Overall, individuals aged 21 to 24 years were more likely to engage in HED than those aged 18 to 20 years and college students aged 18 to 20 years were more likely to engage in HED than their noncollege peers. From 1999 to 2005, the proportion of emerging adults who drove after drinking increased significantly, but decreased proportionately by 37% (p < 0.01) from 2005 to 2014. A greater proportion of 21-to 24-year-olds than 18- to 20-year-olds engaged in this behavior (p < 0.05). Alcohol-related unintentional deaths were estimated to have increased slightly from 1998 to 2005, then decreased proportionately by 29% from 2005 to 2014. Alcohol-related unintentional traffic deaths proportionately declined 43% from 1998 to 2014. The estimated number of college students who died in these events decreased from 1,266 in 1998 to 967 in 2014.  Overall alcohol-related unintentional nontraffic deaths increased 21% from 1998 to 2014 and alcohol-related poisoning death rates increased 254% during the same period. An estimated 22,219 college students were hospitalized for an alcohol overdose in 2014. Alcohol-related overdose hospitalization rates rose by 26% between 1998 and 2014. Combined alcohol and opioid overdose hospitalization rates increased by 197% and combined alcohol and sedatives rates rose by 241% during this period.

Take away: Between 1999 and 2005, rates of reported heavy episodic drinking and driving under the influence increased, then decreased by 37% and 41%, respectively, between 2005 and 2014. Alcohol-related traffic deaths also decreased, but alcohol-related nontraffic deaths increased by 21% between 1998 and 2014. Alcohol poisoning deaths more than doubled during this period.

Citation: Hingson R, Zha W & Smyth D (2017). Magnitude and trends in heavy episodic drinking, alcohol-impaired driving, and alcohol-related mortality and overdose hospitalizations among emerging adults of college ages 18–24 in the United States, 1998–2014 [published online ahead of print 26 July 2017], Journal of Studies on Alcohol and Drugs doi: 10.15288/jsad.2017.78.540

Latest Research (July 25 – July 31)

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Latest Research (July 18 – July 24)

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Marijuana review videos easily accessible, more likely to be viewed by medical marijuana users

A new study investigated consumers’ exposure to and content within product reviews about marijuana. Researchers conducted two investigations: A systematic study of the content of user-generated Youtube videos of marijuana product reviews (n = 83) and an online survey of young adult marijuana users (n = 742). Results of the first investigation found only 13% of videos were age-restricted, 87% of videos depicted someone consuming marijuana, 87% of videos reviewed a specific form of marijuana, and 93% of videos contained positive reviews. The most common benefit/health claim of the product reviewed was getting the user very high (44%), followed by facilitating relaxation (35%). Participants in the second investigation were members of the SurveyMonkey Audience aged 18 to 34 years who reported past-month or current marijuana use and completed an online survey about their exposure to marijuana advertisements in the past 30 days. After statistical analyses, results showed 57% of the sample used marijuana for recreational purposes alone and 34% of current marijuana users either viewed or sought a marijuana product or dispensary review in the past month. Individuals who lived in a state in which recreational marijuana use was legal were significantly more likely to seek out reviews than their counterparts in states in which it was illegal. Respondents who reported using marijuana only for recreational reasons were significantly less likely to view or seek reviews than respondents who reported using only for medical reasons.

Take away: Online marijuana review videos are easily accessible and typically share favorable experiences with specific products. Messages on marijuana prevention and potential harms of marijuana may be needed to balance the pro-marijuana messages delivered in review videos.

Citation: Cavazos-Rehg PA, Krauss MJ, Sowles SJ, et al. (2017). Exposure to and content of marijuana product reviews [published online ahead of print July 5 2017], Prevention Science doi: 10.1007/s11121-017-0818-9


College student drinking patterns influence effectiveness of fear-based and humor-based persuasive messages

Previous literature has established the effectiveness of emotional appeals at promoting intention to change behavior. A new study investigated whether fear appeals or humor appeals in anti-alcohol abuse campaigns were more effective at generating interest, creating awareness of drinking-related risks, and promoting readiness to change. The study employed a factorial design: (Fear vs. Humor) x (Non-binge vs. Binge drinkers). Participants were 94 U.S. college students (81% of whom were older than 21 years of age) who completed a survey on their drinking behavior, watched either four humor appeal ads, four fear appeal ads, or no ads (control group), and completed post-surveys to measure the constructs listed above. The authors found participants who watched the fear ads showed higher interest than those who watched the humor ads (p<0.01), participants preferred humor ads to fear ads (p = 0.05), and fear appeal exhibited a higher level of risk perception than humor appeal (p<0.05). In addition, there was a significant interaction between type of appeal and drinking behavior. Participants who reported binge drinking in the humor condition reported greater intent to change their drinking behavior compared to their counterparts in the fear condition (p = 0.08). Participants who did not report binge drinking who were in the fear condition reported greater intent to change than participants who reported binge drinking who were in the humor condition (p < 0.05).

Take away: When planning interventions to risky drinking among college students, the target audience’s drinking patterns should be considered. Fear appeals may not be successful among binge drinkers; humor appeals may be a promising solution.

Citation: Lee MJ. (2017). College students’ responses to emotional anti–alcohol abuse media messages: should we scare or amuse them? [published online ahead of print July 14 2017], Health Promotion Practice doi: 10.1177/1524839917711639


Drinking identities linked to risky drinking among college students

A recent study used latent class analysis to examine the relation between drinking identity and drinking behaviors. Participants were 456 first- or second-year U.S. college students aged 18 to 20 years. 53% identified as White and 20% were members of a fraternity or sorority. These students completed a survey on their past-month drinking behaviors, alcohol-related consequences, and symptoms of alcohol dependence. The following latent classes were created based on survey responses: Lifetime non-drinker (37.5%), recent non-drinker/past risk, light drinker, moderate drinker, and heavy drinker (nearly 20%). Implicit drinking identity was assessed using a modified version of the Implicit Association Test and explicit drinking identify was assessed using the Alcohol Self-Concept Scale. Explicit and implicit drinking identity and Greek membership were found to be significant predictors of overall class membership. Stronger implicit and explicit drinking identities were associated with membership in the heavy drinker class. Results also suggest students who drink at low levels may not have significantly different drinking identities than their peers who abstain from alcohol and drinking identity may be more strongly influenced by risky past drinking events than by recent drinking without consequences.

Take away: In this sample, implicit and explicit drinking identities significantly predicted overall membership in drinking classes created by the researchers. Although more research is needed, drinking identities may present additional opportunities for interventions to risky drinking.

Citation: Ramirez JJ, Fairlie AM, Olin CC, et al. (2017). Implicit and explicit drinking identity predict latent classes that differ on the basis of college students’ drinking behaviors [published online ahead of print July 11 2017], Drug and Alcohol Dependence doi: 10.1016/j.drugalcdep.2017.06.010


College students may be unable to accurately estimate whether they are above legal limit to drive after drinking

Adults aged 21 to 24 years are at elevated risk of driving after drinking in the U.S.; tolerance and external factors (e.g., number of drinks consumed) may make it difficult for individuals to accurately assess their own levels of intoxication. A new field research study compared self-estimates and objective measures of breath alcohol concentration (BrAC) levels among 510 bar patrons near universities in Florida and Texas. Participants were asked to estimate their BrAC levels using a graphic scale, report the number of drinks consumed, perceived intoxication levels, and other data. After recording this information, research assistants measured participants’ BrAC levels and provided feedback on their current levels of intoxication. Results showed only 38.6% of participants accurately estimated their BrAC levels within 0.02g/dl and 23.5% underestimated their BrAC levels by more than 0.04 g/dl. Nearly one-fifth of the 62.9% of participants who had BrAC levels at or above 0.08g/dl believed they were below the legal driving limit. After statistical analyses, the authors concluded participants with measured BrAC levels over 0.10 g/dl tended to underestimate their BrAC levels, especially those with measured BrAC levels of 0.20 g/dl or higher. Reported number of drinks consumed and perceived drunkenness were positively associated with BrAC self-estimates.

Take away: This study offers further evidence that intoxicated individuals are unable to accurately estimate their breath alcohol concentration (BrAC) levels. Individuals in this sample with measured BrAC levels above the legal limit to drive tended to underestimate their levels of intoxication.

Citation: Rossheim ME, Barry AE, Thombs DL, et al. (2017). Factors associated with self-estimated breath alcohol concentration among bar patrons [published online ahead of print July 6 2017], Alcoholism: Clinical and Experimental Research doi: 10.1111/acer.13428

Latest Research (July 4 – July 10)

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Academic involvment mediates the relationship between binge drinking and academic performance

A new study examined the relationship between binge drinking and academic performance in college. The authors used longitudinal data from three cohorts of first-year U.S. college students in the Wabash National Study of Liberal Arts Education (n = 8,475). Multiple imputation was used to handle missing values. Measures included academic performance, academic involvement (academic motivation, study group participation, relationships with other students, and class participation), and frequency of binge drinking. Ordinary least squares and binary mediation were used to analyze the relationships among variables. Results showed students who engaged in binge drinking at least once per week tended to have lower GPAs than students who did not drink, even after controlling for pre-college characteristics, fraternity/sorority membership, on-campus residence, and other potential confounders. Binge drinking once per week was associated with a 0.139-point decrease in GPA and binge drinking three or more times per week was associated with a 0.218-point decrease in GPA, relative to GPAs of students who did not binge drink. The authors also found 20%-30% of the influence of binge drinking on academic performance was due to changes in students’ academic involvement. Evidence that the mediating effects of academic involvement differ by gender was mixed.

Take away: This study provides additional evidence that binge drinking negatively influences academic performance among first-year students. This is concerning, as first-year GPAs are important for future academic success, graduation, and retention.

Citation: An BP, Loes CN & Trolian TL. (2017). The relation between binge drinking and academic performance: Considering the mediating effects of academic involvement. Journal of College Student Development, 492-508


Review: Marijuana legalization may lead to higher prevalence of cannabis use disorders

A new study reviews evidence legalization of recreational and/or medical marijuana at the state level may be associated with higher prevalence of cannabis use disorders (CUDs) among residents. The authors identified three “risk factor” areas: Pharmacology of drug effects, access/availability of cannabis, and environmental influences. As cannabis legalization spreads, the potency of cannabis products may increase, as manufacturers create edibles and other products with high THC concentrations, as well as new delivery methods. This could lead to earlier initiation of cannabis use among youth, a risk factor for future CUD. Access/availability of cannabis may also be related to incidence of CUD: As the number of retail/medicinal marijuana outlets increases, the unit price of cannabis products is likely to decrease and residents’ frequencies of cannabis use and CUD-related hospitalizations may rise. Additionally, home cultivation of cannabis can be difficult to regulate and more research is needed to develop effective marijuana taxation policies. Environmental influences on CUDs include marketing of cannabis products (which is not tightly regulated in some states) and social norms. As acceptability of marijuana use increases, individuals may perceive cannabis as less harmful, thus leading to increased marijuana use and risk of CUDs.

Take away: Cannabis legalization may increase the prevalence of cannabis use disorders, because it is associated with stronger products, increased availability, greater social acceptance of marijuana use, and aggressive marketing. States should consider implementing public health policies similar to those regulating alcohol and tobacco to minimize these risks.

Citation: Budney AJ & Borodovsky JT. (2017). The potential impact of cannabis legalization on the development of cannabis use disorders [published online ahead of print June 29 2017], Preventive Medicine doi: 10.1016/j.ypmed.2017.06.034


Motives, delivery methods, and state policy predict marijuana concentrate use

Marijuana concentrates (i.e., dabs, hash oil, wax) typically contain 40% – 80% THC and produce a stronger high than smoking marijuana herb/flower. A new study provides insights on characteristics of marijuana concentrate users, motives for use, usage patterns, perceived risk, and predictors of daily/near daily use. Participants were 673 individuals in the U.S. who completed an anonymous, online survey on a drug use discussion website. Results showed the sample consisted of mostly male and non-Hispanic Whites. Almost all (99%) of respondents reported lifetime herbal/flower marijuana use, 40% reported using this form of marijuana daily or near daily, 80% reported using resin or edibles, and over 66% reported using marijuana concentrates. Multivariable logistic regression was used to identify state policy, socio-demographic, and drug use characteristics associated with marijuana concentrate use and daily/near daily concentrate use in the past year. The authors found living in a state in which recreational marijuana use was legal was the strongest predictor of lifetime marijuana concentrate use (Adjusted OR = 4.91, p = 0.001, relative to states in which all marijuana use was illegal). Living in a state in which medical marijuana use was legal was also associated with higher odds of concentrate use (Adjusted OR = 1.87, p = 0.014). Reported use of marijuana concentrates for therapeutic purposes and reported use of vape pens were both significant predictors of daily/near daily concentrate use. Over 25% of concentrate users reported they had made their own concentrates, most commonly (70%) using butane extraction, which carries a risk of fire and/or injury.

Take away: In this convenience sample, 66% of respondents reported using marijuana concentrates. Predictors of frequency of concentrate use included living in a state in which medical or recreational marijuana use was legal, using concentrates for therapeutic purposes, and using vape pens.

Citation: Daniulaityte R, Lamy FR, Barratt M, et al. (2017). Characterizing marijuana concentrate users: A web-based survey [published online ahead of print June 29 2017], Drug and Alcohol Dependence doi: 10.1016/j.drugalcdep.2017.05.034


Current university policies regarding alcohol use may have unintended, harmful effects 

Risk environments are areas in which multiple factors interact to influence substance use and risky behaviors. A new qualitative study used risk environment theory to investigate the relationship among physical, social, and policy environments and use and regulation of alcohol on college campuses. The physical environment included residence halls and the surrounding spaces; the social environment included “party culture” and social norms about drinking.  Data were collected through interviews with 56 security personnel or staff members at five Canadian universities, 246 hours of field observation, and examination of university documents (e.g., student codes of conduct). Themes that emerged from the interviews and observations indicate current university policies may not be the best approach to preventing harms. For example, university policies that prohibit drinking in residence halls may result in students engaging in heavy drinking off-campus, where they may be less likely to receive medical attention in the event of an alcohol-related emergency. Other insights included the identification of spaces within and near residence halls in which students congregated to engage in high-risk drinking, normalization of risky drinking practices, and negative academic or legal consequences for students who violate policies.

Take away: The authors argue current university approaches to regulating alcohol consumption may not be the best approach to preventing harms. Universities should consider adapting harm reduction policies that aim to make small changes in student alcohol consumption, rather than dramatic changes in heavy drinking patterns, and involve students in the formation of these policies.

Citation: Wilkinson B & Ivsins A. (2017). Animal house: University risk environments and the regulation of students’ alcohol use, International Journal of Drug Policy, 18-25

Latest Research (June 27 – July 3)

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Daily text messages may be effective at reducing problem drinking among adults

‘Problem drinking’ refers to heavy alcohol consumption that is associated with moderate to severe harms, but not with serious co-occurring drug use or mental health disorders. Recent evidence suggests text messaging may be an effective supplement to in-person interventions to reduce problem drinking; however, little literature on the efficacy of text messaging as a stand-alone intervention exists. A new single-blind randomized control pilot study attempted to fill this gap by comparing the effects of four different types of alcohol-reduction-themed texts on alcohol consumption. Participants were 157 adults aged 21-65 years who were recruited through online alcohol screening and help-seeking sources and drank between 13 (women) or 15 (men) and 45 drinks per week. They were randomly assigned to receive daily tailored motivational messages with alcohol content (groups included gain-framed, loss-framed, statically tailored, or adaptively tailored messages), daily non-tailored messages without alcohol content, or weekly control mobile alcohol assessment only messages for 12 weeks. All participants completed assessments at baseline, 4 weeks, and 12 weeks, in which they reported their past-month substance use and alcohol-related consequences. Results showed participants in all treatment groups, except for gain-framed messaging, reported greater reductions in weekly alcohol consumption and number of heavy drinking days and larger increases in number of non-drinking days than control group participants. No treatment group was found to be significantly more effective than the others. There were no significant differences in types of severity of consequences between the control and treatment groups. Retention in all groups was very high (94%).

Take away: Results of this study support the efficacy of daily text messaging at significantly reducing drinking frequency and quantity more than weekly self-tracking messages alone. None of the five treatment conditions (gain-framed, loss-framed, statically tailored, adaptively tailored messages, or non-tailored motivational messages without alcohol content) were found to work significantly better than the others.

Citation: Muench F, van Stolk-Cooke K, Kuerbis A, et al. (2017). A randomized controlled pilot trial of different mobile messaging interventions for problem drinking compared to weekly drink tracking, PLoS ONE doi:10.1371/journal.pone.0167900


College students’ prescription drug misuse motivated by desires for fun, improved academic performance, influenced by other drug use, social approval

A new study used social learning theory and general strain theory to investigate predictors of instrumental (e.g., to enhance academic performance) and recreational (e.g., to get high) nonmedical prescription drug use (NMPDU) among college students. Participants were a convenience sample of U.S. university students (n = 2,458) who completed questionnaires on their drug use behaviors. Multiple imputation was used to correct for missing data. Results showed 10.2% of respondents reported using prescription stimulants with a physician’s approval and 4.4% reported using benzodiazepines with a physician’s approval, yet 15% reported NMPDU of stimulants and 4% reported NMPDU of benzodiazepines within the past 30 days. 32.5% of respondents reported lifetime NMPDU of stimulants and nearly 19% reported other NMPDU. 31.8% reported lifetime NMPDU to improve academic performance, while 15% reported NMPDU to get high. The perceived efficacy of specific stimulants to improve academic performance varied. The authors concluded there was a lack of support for strain theory in predicting NMDU, but found support for social learning theory: Increased peer and parental approval of NMPDU was positively associated with both types of NMPDU. In addition, marijuana use, illicit drug use, and possession of a relatively low academic ethic positively predicted both types of NMPDU. Membership in Greek life significantly predicted instrumental, but not recreational, NMPDU.

Take away: Nearly half of respondents in this sample reported lifetime nonmedical prescription drug use (NMPDU) and almost one-third of these reported engaging in NMPDU to improve their academic performance. Positive predictors of either instrumental or recreational NMPDU included marijuana use, illicit drug use, possession of a low academic ethic, and approval from parents and/or peers.

Citation: Pino NW, Tajalli H, Smith CL, et al. (2017). Nonmedical prescription drug use by college students for recreational and instrumental purposes: Assessing the differences, Journal of Drug Issues, 1-16


Alcohol use common among college students with disabilities, who report higher rates of binge drinking than their peers without disabilities

Students with disabilities (SWD) comprise roughly 11% of U.S. college population, yet little is known about their drinking behaviors. A new study explored alcohol use and binge drinking among a national sample of students aged 18 years and older who had registered disabilities with their respective institutions. Participants (n = 2,440) were selected using a random, stratified, multistage cluster sampling technique and completed a survey with validated items about alcohol and other drug use, type of disability, and demographic information. Respondents were classified as binge drinkers if they had engaged in heavy episodic drinking (consumption of at least five drinks in one sitting by males and four drinks in one sitting by females) within the past year and non-binge drinkers if they had consumed alcohol in the past year, but did not meet binge drinking criteria. The authors used multiple logistic regression to identify compare potential correlates of alcohol use between these two groups. Results of this analysis showed 10% (n = 128) of respondents reported at least one episode of binge drinking within the past two weeks and 70% of respondents (n = 715) reported binge drinking in the past year, compared to the national college student average of less than 40%. SWDs who reported using marijuana or amphetamines were significantly more likely (OR = 1.60 and 1.74, respectively) to binge drink. Spending more than two hours per day socializing was also positively associated with binge drinking (OR = 1.17).

Take away: In this sample, 70% of students with disabilities (SWDs) engaged in past-year binge drinking, compared to only 40% of general college student population. Using other drugs and socializing were positively associated with binge drinking among SWDs.

Citation: West SL, Graham CW & Temple P. (2017). Rates and correlates of binge drinking among college students with disabilities, United States, Public Health Reports, 1-9

Latest Research (June 20 – June 26)

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Smaller next-day classes linked to reduced alcohol demand among college students

A new study used behavioral economic principles to examine the effects of next-day class characteristics on alcohol demand among college students. In the first experiment, participants were 59 U.S. undergraduates who were randomly assigned to read one of three scenarios and report the number of drinks they would consume across a range of prices. The control scenario did not include information about next-day class and the two experimental scenarios included a lower-level class or an upper-level class at 10 a.m. the following morning. Results indicated higher prices for drinks and the presence of a next-day class were both associated with significantly lower reported demand for alcohol, but class level was not. The second experiment involved 57 different undergraduate students. The control scenario remained the same, but the experimental scenarios were changed to include a 30-person class or a 12-person class at 10 a.m. the next morning. As before, participants indicated they would consume fewer drinks when drinks cost more. Students who read the 12-person class scenario reported they would drink less than those in the 30-person class scenario; both groups reported less demand for alcohol than participants in the control group.

Take away: This study provides evidence that students’ demand for alcohol is negatively associated with higher prices per drink and the presence of a next-day class. Smaller next-day classes were found to lower alcohol demand, but higher-level next-day classes were not.

Citation: Berman HL & Martinetti MP. (2017). The effects of next-day class characteristics on alcohol demand in college students, Psychology of Addictive Behaviors, 488-496


For Oregon college students who drank heavily, legalization of recreational marijuana associated with higher rates of marijuana use

Recreational marijuana legalization (RML) went into effect in the state of Oregon in 2015. A recent study compared changes in rates of marijuana use among college students in Oregon before and after RML to rates of use among college students in states where RML did not occur. Data on self-reported past-month marijuana use and frequency of heavy alcohol use were collected from the Healthy Minds Survey (HMS). Participants in the experimental group were students at a public Oregon university who completed the HMS in 2014 (n = 588) and in 2016 (n = 1,115). Participants in the control group (n = 9,221) were students at six U.S. universities in states were recreational marijuana was illegal who completed the HMS in 2016 and at least once between 2012 and 2015. Average participation rates for the pre- and post-RML HMS were 31.2% and 26.3%, respectively. Results indicated overall past-month marijuana use rates increased from 21.7% to 23.8% (p = 0.03) throughout the study period, although use rates varied by campus, while rates of heavy drinking decreased (p = 0.005). Among Oregon students who reported recent heavy alcohol use, RML was associated with 73% greater odds of past-month marijuana use, adjusting for secular trends in use, correlation, and potential covariates. This relationship was not observed for Oregon students who did not report heavy alcohol use.

Take away: Past-month marijuana use rates significantly increased following the legalization of recreational marijuana among Oregon college students, but only among those who reported recent heavy alcohol use.

Citation: Kerr DCR, Bae H, Phibbs S, et al. (2017). Changes in undergraduates’ marijuana, heavy alcohol, and cigarette use following legalization of recreational marijuana use in Oregon [published online ahead of print June 14 2017].  Addiction. doi: 10.1111/add.13906


College students’ motives, perceived consequences for misusing prescription drugs vary by type of drug

Previous studies indicate about 12.5% of university students reported engaging in any non-medical use of prescription drugs (NMUPD).  A new qualitative study provided insight on student motives for NMUPD and the perceived consequences associated with this behavior. Participants were 61 U.S. college students who reported NMUPD within the past three months and attended a focus group. This sample was predominantly White and male. 93.1% of participants reported misusing prescription stimulants and the majority of these (83%) reported doing so at least once per month. Participants disclosed they diverted prescription drugs by selling their own medications and identified friends/peers and physicians as common sources of prescription drugs. Motives for misusing prescription stimulants included studying and improving grades. Motives for misusing benzodiazepines included partying and blacking out. The primary motivation for misusing opioids was the sensation. Participants reported the intoxication caused by combining prescription drugs with alcohol or other drugs was desirable, but risky; however, they felt they were not personally at risk for harms. Participants perceived addiction as a potential consequence of misusing any of the three classes of prescription drugs. Other negative consequences included extreme fatigue after use (stimulants), blacking out and having poor judgment (benzodiazepines), and cost and fatigue after use (opioids).

Take away: Student motives and perceived consequences of non-medical use of prescription drugs (NMUPD) vary by type of drug. NMUPD in combination with alcohol or other drug use is common.

Citation: Parks KA, Levonyan-Radloff K, Przybyla SM, et al. (2017). University student perceptions about the motives for and consequences of non-medical use of prescription drugs (NMUPD) [published online ahead of print June 15 2017].  Journal of American College Health. doi: 10.1080/07448481.2017.1341895


Freshman year substance use predicts time to graduation, influences achievements, alcohol-related problems in adulthood

In 2007, only 34% of U.S. college students graduated with a bachelor’s degree in four years or less. A new longitudinal study investigated whether binge drinking, marijuana use, and illicit drug use during the first semester of freshman year of college were related to (1) time to graduation and alcohol-related problems in adulthood and (2) achievements in young adulthood. Participants (n = 2,050 for the first research question and n = 575 for the second) were U.S. college students aged 17 to 19 years in 2004 who participated in a larger longitudinal study and completed a follow-up survey between 2012 and 2015. Measures at follow-up included employment status, income, home ownership, marriage, graduate education, and alcohol-related problems. Results of statistical modeling and path analysis indicated marijuana use and binge drinking were significantly associated with a longer time to graduation, while use of other drugs was not. Results showed that by follow-up, respondents who graduated in five to six years had 48% lower odds of achieving milestones in young adulthood, 53% lower odds of obtaining a graduate degree, and were more likely to have higher levels of alcohol-related problems, compared to those who graduated in four years or less. Those who graduated in seven or more years had 40% lower odds of living independently and 31% lower odds of obtaining a graduate degree, compared to their peers who graduated within four years. Time to graduation significantly predicted future income.

Take away: In this study, frequent binge drinking and marijuana use during freshman year of college predicted delayed graduation, which was associated with lower financial achievement and greater likelihood of future alcohol-related problems. Substance use interventions during freshman year of college may promote timely graduation and success in adulthood.

Citation: Wilhite ER, Ashenhurst JR, Marino EN, et al. (2017). Freshman year alcohol and marijuana use prospectively predict time to college graduation and subsequent adult roles and independence [published online ahead of print June 15 2017].  Journal of American College Health. doi: 10.1080/07448481.2017.1341892

Latest Research (June 13 – June 19)

*Click on the article title to open link to full research article.

Statewide collaboration to address problematic drinking on campus successfully implements evidence-based interventions

The Maryland Collaborative to Reduce College Drinking and Related Harms was launched in 2012, with the goal of implementing evidence-based individual- and environmental-level strategies to address risky drinking among college students. A new article describes the formation of the initiative, data collection, and findings. Environmental interventions implemented by participating institutions included identifying and intervening at “hot spots”  where staff believed high-risk drinking was occurring (most campuses selected off-campus parties), enforcing existing laws, establishing civil social host ordinances, restricting access to dangerous products (i.e., grain alcohol and powdered alcohol). Individual-level interventions included screening and brief interventions that used motivational interviewing and the design and implementation of a website to help parents of college students talk about alcohol use with their children. Key findings from the collaborative were (1) the importance of supportive campus leaders, (2) the need for annual data collection on student drinking behaviors, safety, and academic performance, (3) addressing the problem at the state level may be more effective than a campus-by-campus approach; and (4), direct technical assistance by experts is critical, especially when employing new strategies.

Take away: The Maryland Collaborative to Reduce College Drinking and Related Harms “exemplifies a real-world ongoing example of how state resources can be used efficiently to address a serious public health problem” on college campuses and the surrounding communities.

Citation: Arria AM & Jernigan DH. (2017). Addressing college drinking as a statewide public health problem: Key findings from the Maryland Collaborative [published online ahead of print June 5 2017].  Health Promotion Practice. doi: 10.1177/1524839917711399


Adolescent marijuana use associated with small declines in intelligence scores over time

Previous studies of the relationship between adolescent marijuana use and adult intelligence have yielded mixed results. A new study attempted to shed light on this association by examining data from the first three waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health), which followed a nationally representative sample of U.S. adolescents for six years. The first wave began when participants were aged 12 – 21 years and the second and third waves were administered one and six years later, respectively. To control for potential confounding from the effects of marijuana use prior to wave I, only participants who reported never using marijuana were selected into the study (99.2% of the sample at wave I, 88.0% at wave II, and 30.3% at wave III). Constructs measured were verbal intelligence, lifetime marijuana use, and past-month marijuana use. Verbal intelligence change scores between waves and ordinary least squares (OLS) regression models were used to determine if either lifetime or past-month marijuana use were associated with changes in intelligence scores, adjusting for age, sex, race, socioeconomic status, and personality traits. Findings included a significant association between lifetime marijuana use at wave II and a decrease in intelligence scores between waves I and III; this decrease was 2.1 points, relative to abstainers. Lifetime marijuana use at wave III was associated with a 1.1-point decrease in intelligence scores between waves I and III, relative to abstainers. There was no evidence past-month marijuana use at waves II or III was significantly associated with changes in intelligence scores.

Take away: Results of this study show ever trying marijuana during adolescence is associated with small, but significant, declines in intelligence scores over time; however, there was no evidence of a dose-dependent relationship between adolescent marijuana use and adult intelligence scores.

Citation: Boccio CM & Beaver KM. (2017). Examining the influence of adolescent marijuana use on adult intelligence: Further evidence in the causation versus spuriousness debate [published online ahead of print June 6 2017].  Drug and Alcohol Dependence, 199-206


Review: E-Cigarettes emit hazardous chemicals, are not recommended as smoking cessation aid

A new article reviews the potential hazards of electronic cigarettes (e-cigarettes), including their components and byproducts, exposure concerns, disposal issues, and current regulatory status. E-cigarettes pose second- and third-hand exposure concerns. Contrary to what may be popular belief among college students, e-cigarettes emit hazardous chemicals (including glycerin, nicotine, diacetyl, and ultrafine particles), in addition to water vapor. In addition, components of e-cigarettes are considered to be hazardous and several instances of explosions or fires involving e-cigarettes have been reported. Occupational health and safety agencies recommend against permitting e-cigarette use in the workplace. Because of the known hazards and lack of thorough evaluation of these products, the authors caution against the recommendation of e-cigarettes as a smoking cessation device or safer alternative to traditional cigarettes.

Take away: Although more research on e-cigarettes is needed, they are known to emit harmful substances and pose disposal hazards. For these reasons, e-cigarettes should not be regarded as a smoking cessation tool or safer alternative to other forms of tobacco.

Citation: Marcham CL & Springston JP. (2017). E-cigarettes: A hazy hazard. Professional Safety, 46-51

Latest Research (June 6 – June 12)

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Review of collegiate recovery programs: Theory, initial outcomes, and a case study

A recent article reviewed the available literature on collegiate recovery programs (CRPs) and provided a case study on the development of a theory-based CRP at the University of North Carolina at Greensboro (UNCG). The authors viewed substance abuse among college students within a social ecological system and applied social cognitive theory to explain the process through which students in recovery navigate this system. They argued recovery-oriented systems of care and peer support are important supports for students in recovery. CRPs are unique to the campuses on which they are located, which makes it difficult to evaluate their effectiveness, yet they have been associated with higher grade point averages (GPAs), retention rates, and graduation rates than the general student body, as well as reduced relapse rates. The article details the development of UNCG’s CRP and provides examples of its services at the individual, interpersonal, institutional, and community levels. Initial outcomes of this program are promising: UNCG CRP members (n = 19) had higher mean GPAs, retention rates, and graduation rates, in addition to increased social connections to the university and their peers in recovery. The authors also described their experiences developing and implementing a recovery ally training program. Participants in this program reported significant gains in desired knowledge and behavioral intentions.

Take away: Collegiate recovery programs are a promising strategy to support students in recovery from substance use disorder. This article reviews existing literature and provides a guide to developing and implementing one such program.

Citation: Beeson ET, Whitney JM & Peterson HM. (2017). The development of a collegiate recovery program: Applying social cognitive theory within a social ecological framework [published online ahead of print May 19 2017].  American Journal of Health Education. doi: 10.1080/19325037.2017.1317304


College students justify misusing prescription painkillers with perceived safety, enabling by parents and health care providers

A new qualitative study used neutralization theory to explore the justifications college students use to defend their nonmedical use of prescription painkillers. Participants were 76 college students aged 18-26 years who reported nonmedical prescription drug use within the past year and completed semi-structured interviews with the research team. Some participants were self-pronounced drug addicts, whereas others were novice users. About half of the participants disclosed misusing of prescription painkillers (i.e., Oxycontin, Percocet, and Vicodin). Common themes included students believing prescription drugs were relatively safe (especially when compared to alcohol) and could be used “responsibly” without harming anyone (e.g., taking two Vicodin to treat a headache and fall asleep), students comparing their own perceived “safe” use of these drugs with riskier use among their peers, enabling by doctors who readily prescribe large numbers of painkillers, and enabling by parents who encouraged students to use leftover prescription drugs for ailments. Interestingly, all prescription painkillers as were not perceived as equally safe:  Several students shared they abstained from misusing Oxycontin because they had witnessed friends experience harms from this particular drug.

Take away: College students may justify their misuse of prescription painkillers by claiming they are relatively safe and easily available from parents and health care providers.

Citation: Cutler K & Kremer J (2017). Safety, generous doctors, and enabling parents: A perfect recipe of justifications for college students’ nonmedical use of prescription painkillers [published online ahead of print June 6 2017]. Journal of Drug Issues. doi: 10.1177/0022042617710953


Patterns of cigarette use may be established by age 21

The implementation of tobacco control policies in the past decade has resulted in changed patterns of cigarette use among young adults. For many of these individuals, light or intermittent smoking has replaced smoking multiple packs per day. Little research exists on the age at which patterns of cigarette use stabilize. A new study attempted to fill this gap by examining data from the Truth Initiative Young Adult Cohort Study, a nationally representative sample of young adults aged 18-34 years. The researchers used survey data from baseline and 6 waves of follow-ups, which occurred every six months. The average completion rate was 60.3% and the cumulative average response rate across waves was 5.7%. Although this is a low response rate, the authors argue it is still representative. Participants were 9,791 survey respondents, 64.4% (n =6,305) of whom provided data at two or more time points. They were sorted into one of three categories: Daily smokers, non-daily smokers, and never-smokers/those who smoked, but not within the past 30 days (these two groups were combined into a single category). After analysis, three classes of smokers were identified: “Rapid escalators” (11.3%), “dabblers” (9.4%), and “never or ever triers” (79.3%). Rapid escalators had the greatest estimated probability of daily smoking (~80%), while the other two classes had low probabilities. Dabblers had the greatest estimated probability of non-daily smoking (~50%) and the other categories had low probabilities. The estimated probability of never smoking was nearly 100% among never-smokers, while this probability decreased over time among dabblers. Low socioeconomic status and parental smoking during childhood were identified as risk factors associated with cigarette use progression. Smoking patterns were found to be stable by age 21.

Take away: Intervening prior to age 21 may disrupt progression to established daily or occasional smoking. These findings offer support for the effectiveness of policies that raise the minimum age for purchasing tobacco products to age 21.

Citation: Hair E, Bennett M, Williams V, et al. (2017). Progression to established patterns of cigarette smoking among young adults [published online ahead of print May 29 2017].  Drug and Alcohol Dependence. doi: 10.1016/j.drugalcdep.2017.03.040


For mandated college students, marijuana use not associated with changes in effectiveness of alcohol interventions, alcohol interventions not associated with changes in marijuana use

Alcohol use is common among college students who use marijuana. A recent study investigated whether marijuana use reduces the effectiveness of alcohol interventions delivered within a stepped-care approach, as well as the impact of such interventions upon marijuana use. Participants were 530 mandated U.S. undergraduate students. All students received a didactic Brief Advice (BA) session facilitated by a peer counselor and completed an online follow-up assessment six weeks later. Students who screened as higher-risk on this assessment were randomly assigned to receive either a Brief Motivational Intervention (BMI) (n = 211) or assessment only (n = 194). All students completed follow-up assessments at three, six, and nine months. Self-reported past-month marijuana use, heavy drinking episodes, estimated peak blood alcohol content (BAC), and alcohol-related consequences were collected at all time-points. 44.2% (n = 234) of the sample reported using marijuana at baseline. The authors analyzed the impact of each type of intervention upon alcohol and marijuana use among marijuana users and non-marijuana users. Marijuana use at baseline was not associated with changes in the frequency of heavy drinking episodes, estimated peak BAC, or alcohol-related consequences after the BA intervention. Marijuana users were more likely to have engaged in heavy episodic drinking at greater frequencies than non-users; however, marijuana use was not associated with any changes in the frequency of heavy drinking episodes during any follow-up period. Following the BMI, there were no significant interactions between marijuana user status and the frequency of heavy drinking episodes. Additionally, receiving a BMI was not associated with changes in marijuana use frequency during any follow-up period.

Take away: Among high-risk drinkers, there was no evidence receiving a Brief Motivational Intervention (BMI) was more or less effective for marijuana users than non-users, nor was receiving the BMI associated with any changes in marijuana use. Marijuana-focused interventions may be needed to change college student marijuana use.

Citation: Yurasek AM, Merrill JE, Metrik J, et al. (2017). Marijuana use in the context of alcohol interventions for mandated college students [published online ahead of print May 31 2017].  Journal of Substance Abuse Treatment. doi: 10.1016/j.jsat.2017.05.015

Latest Research (May 31 – June 5)

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College students believe driving after using marijuana is more acceptable, less dangerous than driving after drinking 

Previous studies have found 1 in 6 college students reported driving under the influence of a substance other than alcohol in the past year. A recent study examined associations among college student beliefs about driving under the influence of marijuana, beliefs about driving under the influence of alcohol, behaviors associated with driving under the influence of marijuana, and marijuana and alcohol use. The researchers administered an online survey to 280 U.S. undergraduate students to measure these constructs. 39.9% of respondents reported smoking marijuana at least once and 19.6% reported they had driven within two hours of smoking marijuana in the past year. 17.8% of respondents believed, in general, using marijuana would not affect a person’s driving at all or would make driving slightly harder; yet, 80.8% of respondents believed smoking marijuana within one hour of driving would make a person much more likely or somewhat more likely to cause an accident. Overall, 93.2% of respondents believed it was completely unacceptable for a person to drive under the influence of alcohol, compared to only 46.6% for marijuana. Respondents who had never used marijuana were significantly more likely to believe driving after smoking marijuana was just as dangerous as driving after drinking alcohol and driving within one hour of smoking marijuana were unacceptable behaviors.

Take away: In this sample, 1 in 5 college students had driven within one hour of smoking marijuana in the past year. Driving under the influence of marijuana may be much more acceptable to college students than driving under the influence of alcohol; public health campaigns are likely needed to change this belief.

Citation: Davis S & Sloas K (2017). Driving while high: College student beliefs and behaviors [published online ahead of print April 19 2017].  Journal of Addictive Behaviors, Therapy & Rehabilitation. doi: 10.4172/2324-9005.1000164


Alcohol-related problems linked to suicidality, intimate partner abuse among college students 

Abusive relationships, problematic alcohol use, and suicidality are issues of serious concern in college health. A recent study modeled the role of alcohol problems in the association between intimate partner abuse (including physical, sexual, and psychological abuse) and suicide-related behaviors (self-harm, ideation, and attempt) among college students. Researchers used data from the National College Health Assessment II (NCHA-II) (n = 88,568). Their findings suggest alcohol-related problems (which include doing something regrettable, memory loss, and getting in trouble with the police) partially mediate the relationship between intimate partner abuse and suicidality in both men and women.

Take away: College students experiencing intimate partner abuse may be at increased risk of developing suicidality, especially if they are experiencing alcohol-related problems. Clinicians should consider screening students for problematic alcohol use and history of abusive relationships as a means to reduce suicidality.

Citation: Sunami N, Hammersley J & Keefe K (2017). The role of alcohol problems in the association between intimate partner abuse and suicidality among college students [published online ahead of print April 27 2017]. Psychology of Violence. doi: 10.1037/vio0000122


Consumption of caffeinated alcoholic beverages linked to greater alcohol consumption, harms among college students

Caffeinated alcoholic beverage (CABs) include alcohol mixed with energy drinks and alcohol mixed with cola. CAB consumption has been linked to alcohol-related harms. A new study examined this relationship using daily online diary entries from 122 U.S. college students. Measures included alcohol use, type of CAB mixer, and drinking-related outcomes. The researchers also controlled for impulsivity. Participants were moderate to heavy drinkers who reported consuming CABs at least once in the past week. 76.2% of participants completed diary entries for at least 12 of the 14 days during the data collection period and 389 total entries were collected. Results showed CAB consumption was significantly associated with heavier alcohol use and more alcohol-related harms, such as blacking out and hangovers. Participants also drank significantly more on occasions on which they consumed energy drinks and alcohol, compared to alcohol and cola. No differences were found for alcohol-related harms by type of CAB mixer.

Take away: Caffeinated alcoholic beverage consumption may be risky, especially when alcohol is mixed with energy drinks.

Citation: Linden-Carmichael A & Lau-Barraco C (2017). A daily diary examination of caffeine mixed with alcohol among college students [published online ahead of print May 22 2017].   Health Psychology. doi: 10.1037/hea0000506

Latest Research (May 23- May 30)

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Prescription stimulant misuse associated with impaired neuropsychological functioning in college students

A new study assessed differences in neuropsychological functioning in college students who misused prescription stimulants prescribed for attention-deficit/hyperactivity disorder (ADHD), compared to their peers who did not misuse prescription stimulants. Neuropsychological functioning was assessed by validated self-report and objective measures. Participants were 100 individuals who reported misusing prescription stimulants at least once and 198 controls. All participants were undergraduate students aged 18-28 years. Results showed stimulant misusers were more likely to report higher levels of dysfunction in executive cognitive operations, such as planning/organizing, working memory, and inhibition, than non-misusers. These differences were statistically significant, even when controlling for ADHD. The researchers also found a significant, positive correlation between greater lifetime frequency of buying or trading prescription stimulants and self-reported executive dysfunction. Overall, there were few differences between groups on objective measures, after controlling for ADHD.

Take away: Misuse of prescription stimulants may be associated with impaired neuropsychological functioning in college students.

Citation: Wilens T, Carrellas N, Martleton M, et al. (2017) Neuropsychological functioning in college students who misuse prescription stimulants. American Journal on Addictions, 379-387


After legalization, most CO marijuana users tried new products, over half experienced unexpected high

Recreational marijuana use has been legal in Colorado since 2012. A new study examined the relationship between trying new marijuana or hashish products, including edibles, and experiencing unexpected highs (stronger or longer highs than expected) during the first year of legal retail marijuana sales. Respondents were a convenience sample of 634 Colorado adults who reported past-year marijuana use. In an online survey, 71.4% of respondents reported using new cannabis products and 53.6% reported consuming edibles in the past year. Over half of respondents (55.4%) reported experiencing an unexpected high, during which 44.3% of them felt paranoid, 23.2% had a panic attack, 21.6% had a hallucination, and 8.1% went to a hospital, clinic, or emergency room. The most common response to an unexpected high was going to sleep (87.9% of respondents). The odds of experiencing an unexpected high more than doubled among those who had tried a new product, compared to those who had not. Use of edibles was associated with a 1.5 times greater odds of experiencing an unexpected high.

Take away: During the first year of legal retail marijuana sales, 70% of past-year marijuana users tried a new cannabis product and half used an edible, both of which were associated with significantly greater odds of experiencing an unexpected high. Colleges in states that recently legalized retail marijuana sales should prepare for students trying new products and potentially having adverse experiences while high.


Citation: Allen J, Davis K, Duke J, et al. (2017) New product trial, use of edibles, and unexpected highs among marijuana and hashish users in Colorado. Drug and Alcohol Dependence, 44-47


Friends, siblings are important influences on college student tobacco, alcohol, and marijuana use

A new study investigated associations between the use of cigarettes, alternative tobacco products (e.g., cigars/cigarillos, hookah, e-cigarettes), alcohol, and marijuana within the college population. Participants were 3,418 U.S. undergraduate students who completed an online survey about their substance use behaviors, as well as the substance use behaviors of their parents, siblings, and five closest friends within the past 30 days and past four months. The researchers used a structural equation model (SEM) approach to determine the effects of parent, friend, and sibling use on participants’ own use. Results showed that the prevalence of past 30-day use of alcohol was 63.5%, past 30-day use of marijuana was 19.7%, and past 30-day use of most tobacco products was about 13%; however, cigar use ranged from 8.4% – 11.3%, depending on the type of cigar. For alcohol and tobacco products, the odds of college students using a particular substance roughly doubled if either parents or siblings used it. For marijuana, these odds more than tripled. The odds of college students using alcohol and tobacco products were six to nine times greater if friends used these substances. The odds of students using marijuana were over 21.0 times greater if their friends used it.

Take away: For college students, friends (and, to a lesser degree, siblings) may significantly influence substance use behaviors. This relationship is true for alternative tobacco products, tobacco products, alcohol, and marijuana.

Citation: Windle M, Haardörfer R, Lloyd S, et al. (2017) Social influences on college student use of tobacco products, alcohol, and marijuana. Substance Use & Misuse, 1-9

Latest Research (May 16- May 22)

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Peer group norms, drug sources, and desire for fun influence frequency of prescription drug misuse in young adults

A new study examined the mechanisms that shape prescription drug misuse behaviors in young adults. Study participants were 440 New York City residents aged 18 to 29 years who reported misusing prescription painkillers, stimulants, or sedatives at least three times during the past six months, including at least once in the past three months. Participants completed quantitative surveys about their drug use and peer groups. Additionally, the authors conducted 214 qualitative interviews with participants and analyzed 70 of these interviews. Quantitative results indicated for every additional source of drugs, participants’ frequency of misuse increased by 16% and the desire to have a pleasant time with others was significantly positively associated with frequency of misuse. Neither peer pressure nor obtaining drugs from friends were significant predictors of frequency of misuse in the final model. Analysis of the qualitative interviews indicated peers are a key source of prescription drugs, which are often provided for free as gifts or favors, as well as liaisons to a wider network of prescription drug sources. Participants reported prescription drug misuse was normalized within their friend groups, even among peers who did not misuse drugs themselves, and misusing these drugs was a common way to have a good time. Comments on the influence of peer pressure were mixed.

Take away: For young adults, peers are important influencers of prescription drug misuse. Drug sources, peer group norms, and a desire to enhance social experiences may be important factors in the frequency of engaging in this behavior.

Citation: Kelly B, Vuolo M & Marin A. (2017). Multiple dimensions of peer effects and deviance: The case of prescription drug misuse among young adults. Socius, 1-18


College attendance has increased as a risk factor for first marijuana use

2013 was the first full year after which two U.S. states legalized recreational marijuana use. A recent study used data from the Monitoring the Future study to examine college enrollment as a risk factor for initiation of marijuana use before and after 2013. Among respondents who reported never using marijuana by 12th grade (64% of the entire sample), the prevalence of marijuana use between the ages of 19 to 22 was lowest for individuals who were not enrolled in college. From 1977 – 2012, the prevalence of marijuana use among college students aged 19 to 22 years was 13% – 17%, compared to 17% – 22% among non-college students. Between 2013 and 2015, the prevalence of marijuana use increased to 18% – 21% for college students, yet remained stable for non-college students. The researchers calculated the probability of marijuana use for college students was 31% higher than for non-college students in 2013, 41% higher in 2014, and 51% higher in 2015. Increased marijuana use among college students is likely related to its perceived level of harm, which decreased to its lowest recorded level among college students in 30 years in 2015.

Take away: Since 2013, marijuana initiation has increased among college students, but not among their peers who were not enrolled in college.

Citation: Miech R, Patrick M, Patrick M, et al. (2017) The influence of college attendance on risk for marijuana initiation in the United States: 1977 to 2015. American Journal of Public Health, 996-1002


College students may stockpile, improperly dispose of prescription and OTC medications

A new study examined college student over-the-counter (OTC) and prescription medication purchasing, use, and disposal practices in order to better understand the behaviors that result in pharmaceutical pollution in surface waters. The researchers administered an online survey to a convenience sample of 358 U.S. university students. Female students reported purchasing more OTC and prescription drugs than male students and 61% of students reported having leftover drugs of any kind (27% reported leftover prescription medications and 51% reported leftover OTC drugs). Reasons for leftover medication included more medicine came in the package than was needed and stopping the medication because it was not working. 31% of students reported they kept leftover prescription medication, 13% said they disposed of it, and 2% of students reported they gave prescription painkillers or stimulants to a friend or family member. 55% of students reported they kept leftover OTC drugs, 8% reported throwing them away, and 6% reported giving them to a friend or family member. The most commonly reported method of disposal was trash (13% for prescriptions and 18% for OTC medications) and the most frequently reported reason for disposal was no longer needing the medication. Only 24% of respondents reported they had heard of National Drug Take-Back Day and only 4% of respondents reported they had actually used this service.

Take away: College students may be storing a large volume of unused medications that could potentially be misused or diverted. When students do dispose of unused drugs, they most often throw them away, which could potentially contribute to pollution and drug misuse.

Citation: Vatovec C, Van Wagoner E & Evans C. (2017) Investigating sources of pharmaceutical pollution: Survey of over-the-counter and prescription medication purchasing, use, and disposal practices among university students. Journal of Environmental Management, 348-352


PTSD symptoms and alcohol-related consequences may increase after graduation among students who have experienced trauma

The transition out of college is associated with changes in drinking behavior among many students; however, students with trauma histories may be at greater risk for experiencing negative alcohol outcomes. Previous research found individuals with posttraumatic stress disorder (PTSD) are more likely to experience negative alcohol-related consequences than their peers. A new study examined changes in drinking patterns and changes in PTSD symptomology among 283 U.S. college students who reported experiencing trauma. The researchers collected data on past-month PTSD symptoms, alcohol use, and alcohol-related consequences during the fifth year after students matriculated into college. Participants were assigned to one of three groups, based on their college transition status at baseline: Still in college, starting graduate studies, or graduated and transitioned to the post-college environment. Results showed average levels of alcohol use and alcohol consequences were higher among students who transitioned to graduate school and students who transitioned out of the college environment than among individuals who remained in undergraduate studies. There were no significant associations among college transition status, alcohol use, and PTSD symptomology, although, on average, men who reported higher levels of PTSD symptoms also reported lower levels of alcohol use throughout the data collection period. The researchers found students who had transitioned out of a college environment had a significantly greater likelihood of experiencing negative alcohol consequences during periods in which their self-reported PTSD symptoms increased, but this was not true for students who had just started graduate school or were still completing their undergraduate studies.

Take away: Transitioning out of the college environment after graduation may exacerbate PTSD-associated drinking outcomes among students with trauma histories. Colleges should consider implementing a brief motivational intervention for graduating students shortly before this transition.

Citation: Read J, Radomski S & Wardell J. (2017) Posttraumatic stress and problem drinking at the transition out of college. Prevention Science, 440-449

Latest Research (May 2- May 15)

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Text messaging may be a valuable addition to risky drinking interventions

A new study examined the effectiveness of three interventions to risky drinking among undergraduate students:  An assessment alone, a web-based intervention, and a web-based intervention plus text messaging. Participants were 111 U.S. college students from an introductory psychology course who completed questionnaires on drinking outcomes, typical drinking behaviors, past 30-day heavy episodic drinking, and alcohol-related consequences. Participants were randomly assigned to one of the three interventions and measures were collected at baseline, three months, and a one-month follow-up. Students in the web-based intervention plus text messaging group received text messages designed to reinforce topics covered during the online intervention that were delivered at high-risk times for heavy drinking episodes, as well as educational text messages about general health behaviors. The researchers found participants in the web-based intervention plus text messaging group consumed significantly fewer drinks per weekend occasion than those in the assessment only or web intervention-only groups at three months. There was no evidence that group assignment was associated with fewer alcohol-related consequences at follow-up.

Take away: The results of this study provide partial support for the utility of text messaging as an adjunct to web-based interventions to reduce alcohol consumption among college students.

Citation: Tahaney K & Palfai T. (2017) Text messaging as an adjunct to a web-based intervention for college student alcohol use: A preliminary study, Addictive Behaviors, 73:63-66


Self-efficacy linked to college students’ likelihood to intervene in alcohol-related emergencies

According to Bandura’s social cognitive theory, self-efficacy (one’s confidence in their ability to accomplish a specific task) is a major component of the decision to intervene on behalf of another person; someone with the skills to intervene may not choose to do so if they have low self-efficacy. A new study examined the relationship between self-efficacy and bystander behavior in alcohol-related emergencies among 1,095 U.S. undergraduate students. Participants completed an online survey about their alcohol consumption and related behaviors as part of a larger project on alcohol consumption. Items on the survey measured past witnessing of and past intervention in an alcohol-related emergency and likelihood of future intervention in such emergencies. Participants also reported their levels of confidence in their own abilities to intervene in emergencies. These responses were summed to create a general self-efficacy score for intervening in social situations. The researchers found approximately half of the respondents had witnessed at least one alcohol-related emergency in the past. Previous witnessing was not significantly associated with likelihood of intervening in the future, but previous intervening and self-efficacy were both significantly positively associated with likelihood of future intervening. Previous intervening was significantly positively associated with self-efficacy. The analysis also suggested self-efficacy is a partial mediator of the relationship between past and future intervening.

Take away: The results of this study indicate it may be useful for colleges to develop materials to enhance students’ abilities to identify dangerous alcohol-related situations and increase self-efficacy for intervening. The authors suggest providing students with role-playing opportunities in simulated alcohol-related emergencies as a potential mechanism to increase these skills.

Citation: Krieger H, Serrano S & Neighbors C. (2017). The role of self-efficacy for bystander helping behaviors in risky alcohol situations, Journal of College Student Development, 58:451-456


Student veterans report greater alcohol-related consequences than their peers

A recent study examined data on alcohol consumption and alcohol-related consequences from the National College Health Assessment – II (NCHA-II). These data were collected from 44 U.S. colleges; the median response rate across colleges was 19%. The researchers compared responses between students with military services histories and those without, as well as between students aged 18 to 24 years and students 25 years and older. The researchers found military service history was associated with a nearly two-fold increase in odds of police encounters as a consequence of alcohol consumption, in addition to increased odds of experiencing nonconsensual sex and engaging in unprotected sex for both age groups. There were no significant differences in alcohol consumption between veteran and non-veteran students, nor between the two age groups.

Take away: Student veterans appear to have greater odds of experiencing adverse alcohol-related events. Additional research is needed to explore the reasons behind this disparity and effective prevention strategies.

Citation: Mitchell M, Blosnich J, Gordon A & Matukaitis Broyles L. (2017). College students with military experience report greater alcohol-related consequences, Military Psychology, 29,234-243.

Latest Research (Apr. 25- May 1)

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Ads aimed at reducing risky drinking succeed when they include long-term health effects, drinking guidelines

Success of mass-media campaigns to reduce alcohol harm varies widely and those that feature a good reason for change appear to be more successful, a new study found. Researchers set out to identify those advertisements that viewers find most successful. They studied 2,174 Australians who drink weekly. They were recruited from an online panel. Participants were randomly assigned view three of 83 English-language alcohol harm reduction ads. Each ad was viewed by an average of 79 people. After the participants watched the ads, they reported the extent to which they felt motivated to reduce their drinking. Then the researchers compared the characteristics of the top-ranked 15 percent of ads with the middle 70 percent and the bottom 15 to look for trends. An ad about the link between cancer and alcohol proved most motivating. One that encouraged drinking water instead of beer was least motivating to the participants. Overall, the top-ranked ads were more likely than others to feature a “why change” message and less likely to carry a “how to change” message, the study found. The successful ads also were more likely to address long-term harms, more likely to be aimed at the general adult drinking population and more likely to include drinking guidelines. This was true regardless of the age, gender, and alcohol risk level of the study participant.

Take away: The researchers concluded that “The effectiveness of alcohol harm reduction campaigns may be improved by directly communicating alcohol’s long-term harms to the general adult population of drinkers along with drinking guidelines.”

Citation: Wakefield M, Brennan E, Dunstone K, Durkin S et al. (2017) Features of alcohol harm reduction advertisements that most motivate reduced drinking among adults: an advertisement response study, British Medical Journal, 7:1-13


Young adults with ADHD more prone to unhealthy decisions about substance use

Young people with ADHD face additional challenges in making healthy decisions about substance use and misuse due to a lack of positive role models, new research concludes. The study of 60 participants with and without ADHD evaluated decision-making about alcohol and drugs and found a significant difference in the groups. The ADHD participants reported fewer social advantages to avoiding substances in addition to having fewer positive role models in their lives. Substance use and misuse are more common in youth with ADHD, according to previous research. ADHD may pose these risks due to impulsivity and inattention, but there are a host of other factors that contribute, the researchers point out. Little research has examined whether or how these risk factors predict individuals’ decisions to abstain, initiate, persist or stop substance use and misuse. This study used data from a larger longitudinal study that originally recruited children when they were 7 to 10 years old. This research was based on their responses to questions asked when the participants were about 24 or 25 on average.

Take away: Young adults with ADHD may be more prone to substance use and misuse due to fewer beliefs in the benefits of abstinence or moderation, and a lack of positive role models and support, among other things. These findings could present an opportunity for interventions specific to young adults with ADHD

Citation: Jensen P, Yuki K, Murray D et al. (2017) Turning Points in the Lives of Youth of With/Without ADHD: Are They Linked to Changes in Substance Use?, Journal of Attention Disorders, 1-11


Mobile app shows promise for speedy screening, intervention and referral

Citing difficulty translating knowledge and skills learned in the classroom into clinical practice, researchers evaluated the use of a screening, brief intervention and referral to treatment (SBIRT) approach. Though this technique is high-promoted, routine use of these interventions has lagged, the researchers noted. Their study described the development, pilot testing and trial protocol of a mobile app based on the theory of planned behavior. The mobile app has three primary functions – to review skills about SBIRT, to apply skills with patients and to report performance data. The app includes depression and anxiety screening tools as well as those directly related to substance use. Testing with 22 advanced practice nursing students found that the app and its assessment tools were acceptable and useful. But they also found room for improvement that led to app modifications prior to a subsequent clinical trial.

Take away: If the subsequent testing of the app proves effective, this approach could improve SBIRT implementation, fidelity and clinical outcomes, the researchers concluded.

Citation: Satre D, Ly K, Wamsley M, Curtis A, Satterfield J (2017) A Digital Tool to Promote Alcohol and Drug Use Screening, Brief Intervention, and Referral to Treatment Skill Translation: A Mobile App Development and Randomized Controlled Trial Protocol, JMIR Research Protocols,

Latest Research (Apr. 18- Apr. 24)

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Use of tobacco, marijuana and other drugs linked to higher severe mental illness scores

College students who score higher on a mental illness screening scale are more likely to use drugs, marijuana and smoke cigarettes, a new study has found. The researchers did not find an association between alcohol use and high scores on the K6 screening test for mental illness, but did find an association between problematic alcohol behaviors and mental health problems. The research included 11,216 participants in the 2013 Texas College Survey of Substance Use. The students were 18 to 26 years old and a majority attended large four-year schools. Students from 45 colleges participated. The researchers classified participants into three mental-health groups: those likely to have severe mental illness (9 percent of participants), those with some mental health problems (36 percent of the students) and those without mental health issues (the remaining 55 percent.) The K6 screening scale used to evaluate mental health is a well-validated standardized six-item scale. The researchers compared those results to self-reported use of alcohol, marijuana and drugs. The students likely to have severe mental illness reported more occasions when they used drugs than the other groups. Marijuana was the most frequently used drug by all groups, but more frequent use was reported among those in the severe mental illness group. Stimulants were the second-most-used drug in the study and including medications such as Adderall and Ritalin. When the researchers looked at stimulants and eight other categories of drugs, they found that those with severe mental illness scores had the highest use and those with no evidence of mental health problems had the lowest use. Tobacco use was also highest in the severe mental illness group. Students’ exposure to and use of substances could affect mental illness manifestation, the researchers note.

Take away: The researchers concluded that students’ proximity to university mental health resources and involvement in the college community makes it possible for interventions to be targeted to positively affect their recovery from mental illness. “If substance use is found at a higher rate among college and university students with diagnosed mental illness, these groups should be identified so resources can be allocated to help limit risks,” they wrote.

Citation: Shafer A, Koenig J, Becker E (2017) Relation of Mental Health to Alcohol and Substance Use Among Texas College Students, Texas Medicine, 113(4)


Mobile interventions for alcohol and drug misuse show promise, but room for improvement

Mobile health technologies – including phone-based interventions to prevent alcohol and substance misuse – have shown promise as a viable resource in preventing, treating and supporting those with substance misuse disorders, a new review has found. Furthermore, researchers found, mobile technologies (referred to as mHealth in the study) are currently the most accepted and effective communication mode of connecting with youth and adult populations, which highlights its use as an intervention for high-risk behaviors. The analysis of 12 previous studies found that overall, participants found messages motivating and interesting. But it appears that mHealth interventions are used less and less with time unless there is regular contact with the participant, include prompts, the researchers found. Interventions that include static information or rely heavily on users’ initiative to access them see declining use in a week or two. The review found mixed results from existing studies in terms of alcohol consumed and alcohol-related outcomes. The researchers suggest that it might be valuable to increase the frequency and personal relevance of contact, including increasing response rates to text messages.

Take away: “The current review supports the mounting evidence that mHealth technology is a promising means to address substance use and warrants further development and study,” the researchers wrote.

Citation: Kazemi D, Borsari B, Levine M et al. (2017) A Systematic Review of the mHealth Interventions to Prevent Alcohol and Substance Abuse, Journal of Health Communication, 1-20


No links between binge drinking and anxiety or depression, study finds

A study of 201 college students – most of whom engaged in in hazardous drinking – found no associations between hazardous drinking and depression or hazardous drinking and anxiety. The study used the Alcohol Use Disorders Identification Test (AUDIT) to assess alcohol use. According to AUDIT scores, 93 percent of the students in the study engaged in hazardous drinking and almost 39 percent were binge drinkers. Though the researchers did not find a link between drinking and depression or anxiety, they did find a significant relationship between amount of drinking and negative consequences. Men in the study were more likely to binge drink than females. Most students who reported binge drinking experienced memory loss. Students of both genders reported taking foolish risks and impulsivity while drinking. The researchers wrote that, “despite the application of comprehensive evidence-based interventions and policies specifically designed to effectively address and curb the problem of (binge drinking) among the college student population, campuses across the United States continue to struggle with this pestilent issue.” In this study, the researchers found that 3.5 percent of students were in need of counseling or monitoring and that 3.5 percent could be classified as alcohol dependent.

Take away: In light of past conflicting study results concerning anxiety and depression and their possible relationship to binge drinking, this study helps clarify the relationship, or lack thereof. It also reinforces the need to continue focusing on binge drinking on college campuses.

Citation: Nourse R, Adamshick P, Stoltzfus J (2017) College Binge Drinking and Its Association with Depression and Anxiety: A Prospective Observational Study, East Asian Archives of Psychiatry, 27, 18-24


Mindfulness plays role in protective strategies to curb over-drinking, negative consequences

To better understand the relationship between mindfulness and alcohol consumption and subsequent negative consequences, researchers looked at the role of Protective Behavioral Strategies, or PBS. The researchers had 239 college students at a large South Central university report measures of demographics, alcohol use and consequences, use of PBS and trait mindfulness. They found that both mindfulness and using more PBS were linked to decreased alcohol consumption and negative consequences after drinking. Students with higher levels of mindfulness were more likely to use protective strategies and those who used those strategies drank less per week overall and were less likely to experience alcohol-related consequences. Protective behavioral strategies including extra ice in drinks, not taking shots, and pacing drinking have been repeatedly shown to be effective in college students in other studies, the researchers point out. But PBS has yet to be integrated into a specific theoretical framework, they wrote. Mindfulness – being nonjudgmentally aware and attentive to the present moment – is related to both self-control and goal achievement. It’s also negatively associated with impulsivity, which is related to facets of drinking. PBS use while drinking, the authors wrote, can be thought of as maintaining awareness and self-control while drinking.

Take away: The authors conclude that “Interventions that incorporate a mindfulness component along with specific strategies to target PBS use may be beneficial. Mindfulness is a skill that can be practiced and improved upon.”

Citation: Brett E, Leffingwell T, Leavens E (2017) Trait mindfulness and protective strategies for alcohol use: Implications for college student drinking, Addictive Behaviors, 1-30

Latest Research (Apr. 11- Apr. 17)

*Click on the article title to open link to full research article.

Disadvantage may predict negative consequences of marijuana use in young adulthood

Many young adults use marijuana and some of them experience relatively few negative consequences. But others experience heightened substance-related problems and risk of substance use disorders. To examine the role of community disadvantage in amplifying the effects of marijuana use, researchers studied young black men who live in rural Georgia and found a robust effect between the frequency of marijuana use and related problems. In less-disadvantaged communities, they didn’t find the same association. Their conclusion:  Increases in social disengagement mediated the influence of marijuana use on substance use problems in the context of community disadvantage. The three-year longitudinal study included 505 black men 18 to 25 years old. Three waves of data were collected in participants’ homes or community settings. The men completed computer-assisted self-interviews concerning substance use, engagement in conventional roles and relationships, community characteristics and substance use problems. The researchers say their study suggests that residence in stressful low socioeconomic community environments “may help to determine why some young men who use marijuana have difficulty maturing out of substance use.”

Take away: “For young Black men, residence in a disadvantaged neighborhood appears to amplify the impact of marijuana use on substance use problems. This effect appears to be a consequence of increases in social disengagement,” the researchers wrote. While this study was community-based, it could inform efforts on college campuses, particularly those aimed at helping students from low SES communities acclimate to and succeed in college.

Citation: Kogan S, Cho J, Brody G and Beach S (2017) Pathways linking marijuana use to substance use problems among emerging adults: A prospective analysis of young Black men, Addictive Behaviors, Vol. 72, 86-92


Heavy drinking in young adulthood raises risk of becoming overweight later by 41 percent


Heavy drinking during young adulthood may contribute to excess weight and/or obesity later in life, found authors of a new study. It is the first study to evaluate the association between heavy episodic drinking during early adulthood and the transition to overweight/obese status five years later. The researchers used data from the U.S. Longitudinal Study of Adolescent to Adult Health. Participants were aged 18-26 years old and 24-32 years old during the data collection periods used in this research. The study included 7,941 participants. Heavy episodic drinking was linked to a 41 percent higher risk of transitioning from normal weight to overweight and a 36 percent higher risk of transitioning from overweight to obese compared to study participants who didn’t drink heavily. Individuals were classified as heavy episodic drinkers if they reported their typical quantity of alcohol consumption was in excess four or more drinks in one setting for women and five or more for men and that they drank once per month or more in the past year.

Take away: Though the researchers write that “Obesity prevention efforts should address heavy drinking as it relates to caloric content and risk of transitioning to an unhealthy weight class,” there could be implications for those in substance-misuse prevention programs as well. As risks of excess consumption are shared with students, obesity risk could be included.

Citation: Fazzino T, Fleming K, Sher K, Sullivan D and Befort C (2017) Heavy Drinking in Young Adulthood Increases Risk of Transitioning to Obesity, American Journal of Preventive Medicine, 1-7


New measurement tool could help assess how social norms color college marijuana use

A new measure of college students’ perceptions of marijuana use could open the door to a promising target for marijuana interventions, researchers found. Their study of 8,141 college students attending 11 universities examined the psychometric properties of a new measure called the “Perceived Importance of Marijuana to the College Experience Scale.” The scale is based on the idea that college students’ use of substances is colored by a perception of social normal – that the substance is an integral part of the college experience. The eight-item PIMCES proved a good model. It was consistent and correlated with marijuana user status, frequency of marijuana use, marijuana consequences and injunctive norms. “The PIMCES can serve as a possible mediator of the effects of personality and other factors on marijuana-related outcomes and may be a promising target for marijuana interventions,” the researchers wrote.

Take away: Perceived social norms could play a role in the likelihood a student will use marijuana and an eight-item scale could help intervention specialists better understand that role.

Citation: Pearson M, Kholodkov T, Gray M, et al. (2017) Perceived Importance of Marijuana to the College Experience Scale (PIMCES): Initial Development and Validation, Journal of Studies on Alcohol and Drugs, 78(2), 319-324

Latest Research (Apr. 4- Apr. 10)

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Themed and Greek-hosted parties, shots and drugs increase percentage of intoxicated students at college bashes

College students who drink shots at parties have five times the risk of intoxication as those who do not and the overall likelihood of intoxication climbs when the party has a theme, is hosted by a sorority or fraternity or if there are illicit drugs on hand, a new study has found. Furthermore, women at college parties are significantly more likely to be drunk at theme parties – 75 percent had an alcohol blood concentration above 0.08 compared to 35 percent at non-themed parties. Somewhat surprisingly, the study found that those who engaged in drinking games were 74 percent less likely to have a blood-alcohol level above the U.S. legal limit of 0.08. The study included 112 attendees at 29 parties. The researchers drove and walked a route to identify parties primarily on Thursdays, Fridays and Saturdays between 9 p.m. and 1 a.m. during the academic year. They randomly sampled parties and asked hosts’ permission to enter. Study participants completed a brief survey and gave a breath sample. Researchers made an attempt to follow up with the participants after the party as well. The researchers controlled for demographic characteristics. The findings in this study differed from a previous similar study, prompting the researchers to conclude that risks might differ from campus to campus.

Take away: “Prevention programs should target unique risk identified on each campus, and respond to problematic party behaviors with comprehensive programming rather than policy-level bans.

Citation: Croff J, Leavens E and Olson K (2017) Predictors of breath alcohol concentrations in college parties, Substance Abuse Treatment, Prevention, and Policy. 12:10


Links found between e-cigarette use and alcohol, illicit drug use

E-cigarette use among young adults is linked to increased use of alcohol, marijuana, cocaine, amphetamines, inhalants, hallucinogens, ecstasy and misuse of over-the-counter and prescription medications, new research has found. Though e-cigarette harms remain largely unknown, this study shows they could be a risk factor for misuse of other substances, the researchers wrote. Participants in the study included an ethnically diverse sample of young adults participating in an ongoing longitudinal study of health and risky behaviors. This study included 662 participants who were mostly in college or working. Their average age was 20 years old. They were asked about past year use of e-cigarettes, traditional cigarettes and a variety of substances. Hispanic, white and male participants were more likely to use e-cigarettes and many reported that they did so as a substitute for cigarettes in places where they aren’t allowed. Other reasons cited included to avoid exposing others to second-hand smoke, to avoid smelling like tobacco smoke, to cut down on cigarettes smoked, to help quit smoking, to save money and because they found the taste preferable to that of regular cigarettes.

Take away: “Substance use prevention programs should target the reduction of e-cigarette use with particular attention to addressing their taste appeal,” the researchers concluded.

Citation: Temple, J. R., Shorey, R. C., Lu, Y., Torres, E., Stuart, G. L. and Le, V. D. (2017), E-cigarette use of young adults motivations and associations with combustible cigarette alcohol, marijuana, and other illicit drugs. Am J Addict. doi:10.1111/ajad.12530


Lesbian, gay and bisexual students more likely to misuse prescription drugs

Lesbian, gay and bisexual college students are significantly more likely than heterosexual students to misuse prescription drugs, pain medications and sedatives, a new study has found. The data come from the 2015 College Prescription Drug Study, which surveyed 3,389 students from nine 4-year public and private colleges and universities across the United States using an anonymous online survey. Measures assessed demographic information, prevalence of non-medical use, frequency of use, where the drugs were obtained, reasons for use and consequences of use. Overall, 23 percent of participants – 26 percent of the men and 22 percent of the women – reported non-medical use of prescription drugs. By contrast, 33 percent of lesbian, gay and bisexual students said they’d misused prescription drugs of any kind. They were also more likely to report nonmedical use of pain medications (16 percent vs. 9 percent) and sedatives (16 percent vs. 8 percent.) The researchers did not find statistically significant differences in the use of prescription stimulant use – a third category they measured.

Take away: Students who are gay, lesbian or bisexual might benefit from specific efforts to decrease misuse of prescription drugs. “Although sexual minority students are more likely to report nonmedical use, students overall use prescription medications for similar reasons, with the exception of painkillers,” the researchers wrote.

Citation: Faedra R. Dagirmanjian, Anne E. McDaniel & Richard Shadick (2017): Sexual Orientation and College Students’ Reasons for Nonmedical Use of Prescription Drugs, Substance Use & Misuse, DOI: 10.1080/10826084.2016.1268631

Latest Research (Mar. 28-Apr. 3)

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Drinkers down vodka faster when mixed with energy drinks

A small, double-blinded, placebo-controlled study aimed to find out if young people drink alcohol faster when it’s mixed with energy drinks. Previous research has shown an association between alcoholic beverages containing energy drinks and binge drinking and impaired driving. In this study, 16 participants who were social drinkers attended four sessions each in which they consumed vodka and energy drinks, alone and in combination. The participants were between 21 and 30 years old. Those with substance misuse disorders were excluded. On each test day, the participants were given two hours and a possible 10 cups of drinks to consume. The participants consumed the alcohol combined with an energy drink 16 minutes faster than vodka combined with a caffeine-free mixer. The researchers also gauged the participants’ reaction times after drinking and found that they were faster after the caffeine-infused beverages. In the discussion, the study authors say their work adds to a growing body of literature showing that although caffeine is generally safe, the high levels in energy drinks are not safe when combined with alcohol.

Take away: In this small study, drinkers drank faster when alcohol was mixed an energy drink. “Alcohol consumers should be made aware that rapid drinking might occur for (alcohol and energy drink) beverages, thus heightening alcohol-related safety risks,” the researchers wrote.

Citation: Marczinski CA, Fillmore MT, Maloney SF and Stamates AL (2017) Faster self-paced rate of drinking for alcohol mixed with energy drinks versus alcohol alone, Psychology of Addictive Behaviors, 31(2), 154-161


Drinking patterns, perception of peer alcohol use similar for whites, Native Americans

Native American college students and their non-Hispanic white peers have similar drinking patterns, found a new study. Furthermore, students in both groups overestimate how much their peers drink – something the study authors say is worrisome because estimates of friends’ alcohol consumption are good predictors of individual alcohol use and negative consequences. Researchers already knew that college students who overestimate peer drinking have higher personal alcohol use, but they did not know if that held true for Native American students. Their study included 147 Native American and 246 non-Hispanic white undergraduates. Participants completed on online survey. The researchers wanted to know more about native college students because, though they comprise a small part of undergraduates in the U.S., as a group they tend to consume alcohol at a younger age than other racial and ethnic groups and experience a higher incidence of drinking-related consequences. Overall, participants consumed an average of 3.4 drinks per week and most did not have concerning scores on the commonly used AUDIT test.

Take away: “Given that we found similar low rates of alcohol use between (non-Hispanic whites) and (Native Americans) in the present study, further research with similar samples could contribute to a strengths-based approach to the prevention of heavy drinking,” the researchers wrote in their discussion.

Citation: Hagler K, Pearson M, Venner K and Greenfield B (2017) Descriptive drinking norms in Native American and non-Hispanic White college students, Addictive Behaviors, 72, 45-50.


Most college prescription-drug misuse not for purposes of getting high, review finds

In an effort to determine what motivates college students to misuse stimulants, analgesics, tranquilizers and sedatives, researchers conducted a review of the literature and found that desire to enhance performance in sports and academics is the most prevalent motive. Their review included 29 studies conducted from 2002 to 2015. They found some trends among the studies in each category of prescription drug misuse. For stimulants, students were primarily concerned with academic pursuits and staying awake. Others used them to experiment and get high, while other yet sought to lose weight, enhance sports or self-medicate. Most analgesic use was linked to pain reduction, but they were also used to get high. The main motives for use of tranquilizers was to reduce anxiety and offer self-medication. Less frequently, students reported using tranquilizers to get high or go to sleep. Sedatives, such as sleeping aids, were almost entirely used for their intended purpose, though some students used them to reduce anxiety or get high.

Take away: Fewer than half the students in studies reviewed said they were involved in prescription drug misuse for pleasure, the researchers point out. This information might be useful in guiding intervention strategies and providing education to students about risks associated with misuse of these drugs.

Citation: Bennett T and Holloway K (2017) Motives for illicit prescription drug use among university students: A systematic review and meta-analysis, International Journal of Drug Policy, 12-22.


Adolescent opioid use: medical use and subsequent misuse often linked

Like older adults, adolescents given prescription opioids for medical reasons may be more likely to misuse the drugs, putting themselves at risk, according to a new study looking at trends in the last four decades. The study authors point out that most U.S. studies of medical and nonmedical use of opioids have focused on adults. They used data from the Monitoring the Future study, which included forty cohorts of nationally representative samples of high school seniors. Lifetime medical use of prescription opioids in this group peaked in both 1989 and 2002, was stable for years, then declined from 2013 through 2015. Misuse of the drugs was highly correlated with medical use of opioids, the researchers found. “Long-term trends indicate that one-fourth of high school seniors self-reported medical or nonmedical use of prescription opioids,” they wrote.

Take away: The researchers say sociodemographic differences and risky patterns involving both medical and nonmedical use should be taken into consideration in clinical practice. This study could also inform those who are working in prevention with young adults, as the transition from prescribed use to misuse – or to continue misuse into the college years — is likely common in this population.

Citation: McCabe S, West B, Veliz P, McCabe V, Stoddard S and Boyd C (2017) Trends in Medical and Nonmedical Use of Prescription Opioids Among US Adolescents: 1976-2015, Pediatrics

Latest Research (Mar. 21-Mar. 27)

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Stimulant misuse more common in students who use other substances; motivation for use linked to negative outcomes


Prescription stimulant misuse is prevalent on college campuses, and the study authors aimed to evaluate characteristics of users and their motives for taking prescription stimulants. The study of 199 college students from a southeastern U.S. university. Included evaluations of motives for use, consequences associated with use, perceptions of risk and social norms. The researchers sought out participation from students who misuse prescription stimulants. Of the 199 students in the study, 86 said they had misused the drugs in the past 60 days. The researchers found that students who misused the drugs also used more alcohol and other drugs. They also saw stimulants use as more commonplace and perceived the drugs as lower-risk than those students who did not misuse prescription drugs. The researchers also looked for connections between the students’ motivation to use the drugs and negative consequences and found links when the misuse arose from a desire for enhancement, social gains and weight loss.

Take away: “Motives for prescription stimulant use and user characteristics may provide insight into prevention and treatment,” the authors wrote, calling for additional work to replicate the findings. It could also be beneficial to consider during alcohol and other drug prevention efforts that stimulant misuse often goes hand-in-hand with the other behaviors.

Citation: Blevins C, Stephens R and Abrantes A (2016) Motives for Prescription Stimulant Misuse in a College Sample: Characteristics of Users, Perception of Risk, and Consequences of Use, Substance Use & Misuse, 52, 555-561


Evaluating cutoffs for “risk” on online tests can be tricky, study of AUDIT-C finds


As the abbreviated Alcohol Use Disorder Identification Test for Consumption (AUDIT-C) becomes more widely used, this study aimed to determine thresholds that indicate risky drinking among those who seek help over the internet. Researchers obtained AUDIT-C scores from 3,720 adults searching the internet for help with alcohol misuse. The information was collected during a pilot phase of the “Down Your Drink” trial, which randomized participants to a web-based intervention or an information-only site. Most of the participants were from the United Kingdom. Cutoff data for various recommendations in AUDIT-C was set based on expert opinion, and this study aimed to provide data to validate appropriate cutoffs. The study found that an optimal cut-off score for the 12-point test (if graded on sensitivity and specificity) was greater than or equal to 8 for both men and women. But in order to reach the highest proportion of individuals at high risk, the cutoff should be greater than or equal to 4 for women and 5 for men. Because of the significant difference found in this study, the researchers caution that those seeking to prevent problem drinking or intervene through online tools carefully consider cutoff scores they use to identify those who need help.

Take away: “Early identification of people drinking at risky levels followed by brief intervention is the key individual-level intervention approach for reducing alcohol to safer levels,” the researchers wrote. Those interventions can happen in a range of settings, including the workplace and within higher education. But as online tools, particularly AUDIT-C, grow in popularity, it is important to understand that the cutoff numbers applied in different populations.

Citation: Khadjesari Z, White I, McCambridge J, Marston L, Wallace P et al. (2017) Validation of the AUDIT-C in adults seeking help with their drinking online, Addiction Science & Clinical Practice, 12:2


Smoking increases odds of relapse in those who stop substance misuse


Continuing to smoke cigarettes or starting to smoke cigarettes increases the chance a person with a substance misuse disorder will suffer a relapse, a new study has found. The analysis was done based on data collected from 5,515 respondents to the National Epidemiologic Survey on Alcohol and Related Conditions. Historically, many have thought that quitting cigarette smoking while also addressing drug treatment would be too difficult, and that smoking was unrelated to long-term outcomes of substance use treatment or abstinence, the authors wrote. Smoking cessation is not typically offered alongside other treatments. The authors found that smoking adults with remitted substance use disorders who continued smoking three years later had increased odds of substance use and relapse compared to those who quit. Those who were nonsmokers and started smoking after they stopped using substances also had increased odds of relapse compared to those who never took up smoking. The authors suggest that research should examine how smoking prevention and cessation could be integrated into substance use treatment, in the interest of preventing relapse.

Take away: In this study, smoking appears to be connected to a return to substance misuse in people who have quit drinking and using other substances. The authors suggest that “Incorporating smoking cessation and prevention efforts into substance abuse treatment may improve long-term substance use outcomes for adult smokers with SUDs.”

Citation: Weinberger A, Platt J, Esan H, et al. (2017) Cigarette Smoking is Associated with Increased Risk of Substance Use Disorder Relapse: A Nationally Representative, Prospective Longitudinal Investigation, The Journal of Clinical Psychiatry, Feb;78(2):e152-e160. doi: 10.4088/JCP.15m10062

Research (Mar. 14-Mar. 20)

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College students who drink and use marijuana may see grades suffer more than those who just drink


Citing little published science on the combined influence of alcohol and marijuana on academic performance, researchers studied data on 1,142 college students who completed monthly marijuana and alcohol surveys. The students were grouped into three categories: Those who consumed little or no alcohol and marijuana, those classified as medium-high consumers of alcohol and “no-low” users of marijuana and those who were medium-high users of both. The analysis suggests that at the outset of the two-year study, students using moderate to high levels of alcohol and low amounts of marijuana had lower GPAs compared to sober peers. But over time, that difference became insignificant. But those who consumed both substances at moderate-to-high levels scored significantly lower at the start of the study and throughout the two-year study period. The researchers’ follow-up analysis found that when students curtailed their substance use over time they had significantly higher GPAs compared to those whose drinking and marijuana use remained stable. The researchers adjusted for a variety of sociodemographic and clinical factors that could influence their results. “Overall, our study validates and extends the current literature by providing important implications of concurrent alcohol and marijuana use on academic achievement in college,” they wrote.

Take away: College students who consume moderate to high amounts of both marijuana and alcohol have been shown to have lower GPAs. Decreased use over time during college appeared to have a favorable effect on grades.

Meda SA, Gueorguieva RV, Pittman B, Rosen RR, Aslanzadeh F, Tennen H, et al. (2017) Longitudinal influence of alcohol and marijuana use on academic performance in college students. PLoS ONE 12(3)


Alcohol screening at health centers rare for college women, despite frequent hazardous drinking


Researchers looking to assess screening for alcohol and tobacco use among college women examined self-reported data from 615 female students in their senior year of college at two four-year universities. They found that though drinking was especially common, screening rates for both alcohol and tobacco use were relatively low. The data in this secondary analysis came from a web-based survey in which women were asked about alcohol and tobacco use and about screening experiences in college health centers. Nearly 90 percent (550) of the women said they drank in the last three months. More than two-thirds of them (370) met the “hazardous drinking” definition set by the U.S. Centers for Disease Control and Prevention – the consumption of three or more alcoholic beverages in a day. However, only about 22 percent (56) reported being screened for alcohol use. Only about 20 percent (52) were screened for tobacco use. (About 5 percent of the women reported recent tobacco use.)  More than half of the women visited a student health center in the three months prior to completing the survey. “Screening and providing interventions for alcohol misuse are the first steps to prevent many negative health consequences and are essential parts of prevention strategies in the college health setting,” the researchers wrote. 

Take away: The researchers concluded that screening and assessment of health issues among college students needs to match the risk behaviors of those students.  Alcohol screening, in particular, could present an opportunity to address health prevention and promotion.

Angelini K, Sutherland M, Collins Fantasia H (2017) Reported Alcohol and Tobacco Use and Screening Among College Women, Journal of Obstetric, Gynecologic & Neonatal Nursing, 1-8


Compared with other drugs, opportunity to use marijuana abundant in college, declines after


A study looking at the drugs college students have the opportunity to use and which ones they do use has found marijuana is far more available than other drugs, but that that opportunity declines over time. The researchers analyzed data on eight categories of drugs that are mostly illegal and on non-medical use of prescription medications. They looked at data from a longitudinal cohort study of 1,253 first-year college students who were followed for seven years. The study participants attended a large, public university. Drug categories included marijuana, hallucinogens, inhalants, cocaine, ecstasy, amphetamines, methamphetamine and heroin. In the prescription drug category, the researchers examined non-medical use of prescription stimulants, analgesics, and tranquilizers. Opportunity for both drugs other than marijuana and prescription medications consistently declined, while use given the opportunity remained relatively stable over time. Previous research has established a strong link between exposure opportunity and drug use. An established connection also exists between opportunity and use of marijuana and subsequent use of other drugs, including hallucinogens and cocaine.

Take away: The researchers wrote that “These findings suggest that changes in drug use are driven by changes in opportunity to use, even during the post-college years. Greater opportunity to use and use of all drugs during the college years in comparison with the post-college years confirms the high-risk nature of the college environment.”

Allen H, Caldeira K, Bugbee B et al. (2017) Drug involvement during and after college: Estimates of opportunity and use given opportunity. Drug and Alcohol Dependence, 1-31


One in five undergraduates misusing prescription stimulants, study finds


A study looking at college-age misuse of prescription stimulants found that those who used the drugs were motivated by academic drivers, in particular a desire to improve focus during school work. They also were motivated by a desire to experiment. The study of 554 randomly sampled undergraduates at a northern California university also found that those who abstain from prescription stimulant use do so primarily because of concerns about health risks, ethics and breaking the rules. In the study, about 17 percent of students reported recreational use of prescription stimulants during college. And the frequency of use per academic term ranged from less than once to 40 or more times. Most users reported taking the drugs orally and most said they received the drug for free, usually through friends. The authors point out that illicit use of prescription stimulants is a potentially addictive behavior that has grown in prevalence on college campuses. Cardiomyopathy, myocardial infarction and psychosis are among the risks of misuse. “We conclude that characteristics of misuse are a cause for concern, and correlates of the behavior are multifaceted,” the researchers wrote.

Take away: “A number of prevention approaches are plausible, such as a social norms campaign that simultaneously corrects exaggerated beliefs about prevalence while also illustrating why abstainers, in their own words, choose to abstain,” wrote the authors. They also suggested that young people who do have prescriptions for these drugs be closely monitored for signs they might be selling or giving away the medication.

Bavarian N, McMullen J, Flay BR et al. (2017) A Mixed-Methods Approach Examining Illicit Prescription Stimulant Use: Findings From a Northern California University, Journal of Primary Prevention, 1-21

Research (Mar. 7-Mar. 13)

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Frequency of energy drink use corresponds to misuse of alcohol and drugs


Those who consume a lot of energy drinks are more likely to use drugs, misuse alcohol and experience poorer wellbeing, new research has found. The researchers called energy drink use “part of a complex interplay of drug use, alcohol problems, and poorer personal wellbeing.” They also cautioned that frequent use of energy drinks could be a flag for current or future signs of misuse of drugs and alcohol. The Australian study looked at data from 74,864 people who use drugs and participated in the online Global Drug Survey 2014. Almost 70 percent of the group reported some past consumption of energy drinks; 25 percent said they used caffeine tablets and another 5 percent said they used caffeine spray. The researchers found a greater frequency of energy drink consumption among male study participants and those under 21 years old. Previous research has found an association between energy drink consumption and increased intake of alcohol, tobacco, prescription drugs and illicit drugs. “Prospective research is required exploring where (energy drink) use fits within the trajectory of other alcohol and drug use,” the authors of the new paper wrote.

Take away: High consumption of energy drinks could correspond to misuse of drugs and alcohol and should be considered by those seeking ways to prevent problematic substance use among young people.

Peacock A, Bruno R, Ferris J and Winstock A (2017) Energy drink use frequency among an international sample of people who use drugs:  Associations with other substance use and well-being, Drug and Alcohol Dependence, 1-33


Where and with whom you drink could influence strategies to curb consumption


To better understand how drinking context may promote or hinder use of protective behavioral strategies, researchers examined data on where and with whom college drinkers consume alcohol and compared it with the level of consumption and self-reported problems. The study of 284 college-aged drinkers, 69 percent of them women, focused on two dimensions of protective behavioral strategies: Limiting consumption and avoiding alcohol in general or specific situations. They tallied daily drinking by having the study participants complete a weekly diary. On days where participants drank at bars and parties, they used fewer strategies designed to limit their consumption and risk level such as predetermining the number of drinks to consume, never leaving a drink unattended and eating before or while drinking, the researchers found. They concluded that some social (who) and environmental (where) contexts represent elevated risk for higher alcohol consumption and related problems. And select types of protective behavioral strategies for reducing harm are more effective in some environmental contexts, whereas other contexts are more resistant to using protective behaviors.

Take away: “College student drinking interventions may benefit from a focus on increasing the use of PBS within potentially risky drinking environments to help reduce problematic alcohol use,” the researchers wrote.

Braitman AL, Linden-Carmichael AN and Henson JM (2017) Behavioral Strategies as a Context-Specific Mediator: A Multilevel Examination of Within- and Between-Person Associations of Daily Drinking, Experimental and Clinical Pyschopharmacology


Support for legalized marijuana has grown among all ages; younger Americans’ support coincides with belief that pot is safe


To better understand changing attitudes toward marijuana legalization, researchers looked at three large, nationally representative surveys of high school 12th graders, college students and adults. By analyzing surveys conducted between 1968 and 2015, the researchers were able to determine that Americans became significantly more supportive of legal marijuana starting in the mid-1980s. Support steadily rose from the 1980s to the 2010s. Their models showed that this was largely due to changing perceptions over time, rather than because of generational or age differences. In other words, it was not just one generation carrying forth support. In fact, Americans of all ages became more supportive. Among 12th graders, they found that support for legalization was closely linked to their perceptions of marijuana safety. “Perceptions of risk and support for legalization move in tandem, with high perceived risk linked to low support for legalization and low perceived risk linked to high support of legalization,” they wrote.

Take away: As support for legalized marijuana grows on college campuses and elsewhere, it could be beneficial to recognize that many young people who are in favor of legalized recreational marijuana use have come to this decision in large part because they believe that it is safe.

Campbell W, Twenge J and Carter N (2017) Support for Marijuana (Cannabis) Legalization: Untangling Age, Period, and Cohort Effects, Collabra: Psychology, 3(1)

Research (Feb. 28-Mar. 6)

*Click on the article title to open link to full research article.

Brief intervention before spring break can increase use of alcohol harm-prevention strategies

In an effort to assess prevention strategies for minimizing problems related to excessive drinking during spring break, researchers studied 62 women going on spring break in 2015. The women completed initial screening, a brief online pre-break intervention, and a post-break assessment. The college students were randomized to either a positively-framed message or a negatively-framed message about individuals who use protective behavioral strategies to reduce negative outcomes related to drinking. Protective behavioral strategies fall into three categories – stopping or limiting drinking after a certain amount, drinking more slowly and reducing harm through techniques such as designating a sober driver. Overall, the study showed that the intervention worked to increase use of the strategies and that both interventions were successful on certain women. Previous research has established that drinking during certain events – 21st birthdays, homecoming and spring break, for instance – has a higher association with problematic outcomes. Those can include anything from hangovers and minor injuries to impaired driving, unwanted sexual interactions, serious injury, and death. For women, the researchers on the new paper point out, the risks may be even greater.

Take away: The researchers write that their study adds support to simple interventions such as this and helps illustrate which women respond better to negative framing and which to positive framing about protective strategies. 

Dvorak RD, Kramer MP, Stevenson BL et al. (2017) An Application of Deviance Regulation Theory to Reduce Alcohol-Related Problems Among College Women During Spring Break, Psychology of Addictive Behaviors, 1-12


Study Shows Association between Drug Use and Dating Violence

An analysis of data from the International Dating Violence Study found a strong association between problematic drug use and physical victimization, injury, severe physical victimization, severe psychological victimization and severe injury. The study of 4,162 students from 19 U.S. colleges included 69.1 percent women and 30.9 percent men. When the researchers looked for an overall potential relationship between problematic alcohol use and victimization, they did not find one. But problematic alcohol use was associated with the victimization of men. According to previous research cited in the paper, 20 to 30 percent of college couples experience physical aggression, as many as 90 percent experience psychological aggression and 3 to 20 percent experience sexual aggression each year.

Take away: The researchers write: “Programs addressing dating violence on campuses are urged to include discussions on drug use and victimization of men.” It is possible that substance misuse prevention specialists could work in tandem with those focused on dating violence.

Sabina C, Schally J, Marciniec L (2017) Problematic Alcohol and Drug Use and the Risk of Partner Violence Victimization among Male and Female College Students, Journal of Family Violence, 1-12


Black students’ unique stressors could contribute to risky drinking

A study that examined the relationship between multiple stressors affecting black college students and high-risk drinking found a positive relationship between race-related stress and risky drinking. The correlation has previously been found in other marginalized groups. Acculturative stress – culture shock, in lay terms – accounted for a significant amount of high-risk drinking beyond general-life and race-related sources of stress, the researchers found. They emphasized a need to better understand the influence of acculturative stress on risky drinking and point out that the population in their paper is understudied in the alcohol-use literature. Participants included 148 black American college students who were part of a larger study exploring stress and coping behaviors. The students ranged in age from 18 to 25. Participants completed questionnaires and a were assessed using four methods of measuring stress and high-risk drinking behaviors. Nearly 71 percent of participants drank at least monthly. This study found no association between general life stress and institutional race-related stress and risky drinking. But it did find a correlation between drinking and three other types of stress: cultural race-related, individual race-related and acculturative.


Take away: The researchers say that outreach workers on college campuses should encourage black students to participant in alcohol awareness events and consider programming tailored to this group.

Pittman DM, Cho Kim S, Hunter CD, Obasi EM (2017) The Role of Minority Stress in Second-Generation Black Emerging Adult College Students’ High-Risk Drinking Behaviors, Cultural Diversity and Ethnic Minority Psychology, 1-11


Perceptions of alcohol, drug risk different among undergraduates pursuing clinical, non-clinical degrees


Students’ perceptions of substance use may be influenced by their legal perceptions, personal values and social norms. And use patterns differ among undergraduates pursuing clinical degrees, such as medicine or dentistry, and other students, new research has found. The researchers write that heavy use of alcohol and illicit drugs has been documented among medical and dental professionals and that educational programs often exist to reduce misuse of substances in clinical undergraduates. The study found that more clinical (72.5 percent) than non-clinical (66 percent) drink regularly. Both groups consider ecstasy, cocaine and ketamine to be “high risk” drugs. Almost half of non-clinical students said they’d consider changing their behavior if illicit substances were legalized, compared to 32 percent of clinical students. In the study, more than a third of both types of students said they support legalization of illicit drugs. The study, conducted in the U.K., included 107 undergraduates, about half of whom were pursuing medicine or dentistry. Almost half of the clinical students considered alcohol high risk, compared with less than a third of the non-clinical students. The clinical students were less likely to consider marijuana, nitrous oxide and tobacco high risk and more likely to consider ecstasy and ketamine high risk.

Take away: Students on the track for careers in medicine and dentistry may have different perceptions regarding drug and alcohol use than their non-clinical undergraduate peers and this information could help shape the understanding of why some clinical students continue to misuse substances regardless of possible consequences, the researchers write.

Puryer J, Rowley A, Saimbi J and Waylen A (2017) The legal and moral perceptions of clinical and non-clinical undergraduates regarding substance use: a pilot project, British Dental Journal, 222, 198-204

Research (Feb. 20-Feb. 27)

*Click on the article title to open link to full research article.

College students who served in military more likely to report nonconsensual sex, police encounters after drinking


A large national study of military experience and alcohol use has found that college students who served in the military report more negative consequences associated with drinking, including police encounters and rape. The study included 27,249 students and found no differences between students with and without a military history in three areas: past-month history of alcohol use, binge drinking in the last two weeks and drinking and driving in the last 30 days. But there were several differences in the groups when the researchers analyzed the students’ self-reported consequences of drinking. Among those students 18 to 24 years old, those who served in the military had nearly twofold increased odds of police encounters and even greater odds of experiencing nonconsensual sex. The military veterans also reported greater odds of having unprotected sex as a consequence of drinking than their peers who did not serve. This study was a secondary data analysis of the National College Health Assessment – II. Of the students in the study, 2.6 percent (702) reported military service history. They were more likely to be male, married or partnered compared to students who were not in the military.

Take away: The researchers call for more study to determine why alcohol results in more negative consequences of students with military service history. Those in prevention and intervention roles might consider particular efforts to reach veterans on campuses.

Mitchell M, Blosnich J, Gordon A, Matukaitis Broyles L (2017) College Students with Military Experience Report Greater Alcohol-Related Consequences, Military Psychology, 1-11


Students expect more from 21st birthday celebrations than other drinking occasions


To better understand how college students’ expectations about 21st birthday drinking differ from typical expectations about alcohol consumption, researchers surveyed 585 students who were turning 21 within a week and planned to drink at least four drinks if they were women and five drinks if they were men. The researchers asked about both negative expectancies, such as impairment, risk and aggression. They also asked about positive expectations, including social benefits, liquid courage and sex. In almost all cases, both good and bad expectations of what would happen during drinking were greater for 21st birthday celebrations than for typical outings where students consume alcohol. The only expectation that was not greater was tension reduction. This is the first study to look at how drinking expectations differ when a student is anticipating a 21st birthday celebration.

Take away: The researchers conclude that interventions aimed specifically at 21st birthday drinking could be effective at lowering negative alcohol-related events.

Geisner I, Rhew I, Ramirez J et al. (2017) Not all drinking events are the same: Exploring 21st birthday and typical alcohol expectancies as a risk factor for high-risk drinking and alcohol problems, Addictive Behaviors


E-cigarettes seen as beneficial, low-risk among college-aged users


In an attempt to evaluate how young adults perceive the use of e-cigarettes, researchers recruited 734 undergraduate students at a large southern university. Survey questions asked about demographic information, current and past smoking behaviors, and perceptions of risks and benefits related to e-cigarettes and similar devices. A majority of the participants were women (78 percent) and white (76 percent) and their average age was 20. Thirty-seven percent of those surveyed said they’d tried an e-cigarette at least once; 7.5 percent of them had used one in the last month. Thirty-eight people reported current daily use of conventional cigarettes. The survey results indicated that college students who use e-cigarettes perceive benefits associated with them and don’t acknowledge negative health consequences of the devices. E-cigarette use includes inhaling nicotine, may lead to smoking traditional cigarettes and represents a public health concern, the study notes.   While other recent studies have shown that daily cigarette smoking among young people is declining, e-cigarette use is growing in popularity, other studies have shown.


Take away: E-cigarette use among college students could have negative health consequences, but users of the devices don’t perceive much harm associated with them. The researchers write: “The current results indicate a need for health education and cessation-oriented interventions among this population.”

Copeland A, Peltier M, Waldo K (2017) Perceived risk and benefits of e-cigarette use among college students, Addictive Behaviors


College students appear to favor energy drinks mixed with alcohol in certain settings


Citing limited research examining the context in which young people consume alcohol mixed with energy drinks, researchers collected data from 122 heavy-drinking college students, mostly women.

The link between harm and alcohol combined with energy drinks is well-established, the researchers write. The new study used a two-week daily diary to compare days in which the beverages were consumed and days where other types of alcoholic drinks were consumed. The researchers collected data across 389 drinking days, 40 of which included consumption of alcohol mixed with energy drinks. The study found that the odds of drinking the beverages was higher on days where students drank at a bar or club and drank at home relative to other locations. In addition, odds of pre-gaming were higher on days when energy drinks entered the picture. The researchers found that days when energy drinks were mixed with alcohol, odds were lower that the student would participate in drinking games. Overall, the researchers concluded that these type of drinks appear to be consumed in potentially risky contexts.

Take away: Identifying the social and environmental characteristics of use may illuminate whether alcoholic mixed with energy drinks is used in settings that could increase the likelihood of engaging in risky behaviors or experiencing harms, the researchers write.

Linden-Carmichael A, Lau-Barraco C (2017) Alcohol mixed with Energy Drinks: Daily Context of Use, Alcoholism: Clinical & Experimental Research

Research (Feb. 11-Feb. 20)

*Click on the article title to open link to full research article.

Mixing alcohol with nicotine, marijuana and other drugs increases negative consequences


A new effort to evaluate the risks associated with young adults combining alcohol and other substances has found a significant correlation between combining substances and negative consequences. The study of 461 college students examined alcohol, tobacco and drug consumption and consequences on four weekends (including Thursday, Friday and Saturday) during the academic year. The analysis found students who typically combine alcohol and other substances experience more consequences on occasions when they use multiple substances compared to students who only drink. Alcohol combined with nicotine, or marijuana, or ADHD medications or cocaine all were positively related to increased consequences. The researchers, from Pennsylvania State University, found consistent evidence that combination of substances is prevalent among college students and that it puts them at higher risk of problems. To be part of the study, students had to report alcohol use and use of another substance in the past year. The participants, who were 20 years old on average and primarily white, completed surveys reporting substance use. They also reported on which of 45 possible consequences they encountered on each occasion. Examples of consequences include “I had heart palpitations” and “I felt dizzy.” The substances most commonly used in conjunction with alcohol were marijuana, nicotine and ADHD medications

Take away: Young people experience more negative consequences when they combine alcohol with other substances. Prevention specialists could use this information to better educate young people about the risks associated with mixing alcohol and other drugs.

Mallett K, Turrisi R, Hultgren B et al. (2017) When Alcohol Is Only Part of the Problem:  An Event-Level Analysis of Negative Consequences Related to Alcohol and Other Substance Use, Psychology of Addictive Behaviors, 1-8


Risky drinking, use of other substances increases likelihood of impaired driving, riding with an impaired driver


A study of teens and young adults seen in emergency departments found that those who reported previous risky alcohol use and marijuana use in the past year were at increased risk of driving while drink and riding with a drunken driver. This was true for both male and female participants in the study of 3,418 young people recruited at the University of Michigan. Participants, who were 18 years old on average, completed a self-administered 15-minute screening questionnaire. Most were being seen in the emergency department for medical reasons other than injuries. Of those who agree to the screening, 2,150 reported past-year alcohol use. Motor vehicle crashes are the leading cause of death for 1-24 year olds and drinking and driving is a significant factor, the researchers wrote. Furthermore, those who’ve ridden with a driver who has been drinking are more likely to drive after drinking themselves and vice versa. In the study, the researchers found that odds of drinking and driving or riding with an impaired driver went up if young people had used substances in the past. Marijuana use was a strong predictor, with odds of drinking and driving increased by 2.3 times for females and 1.7 times for males. Prescription drug misuse was also associated with impaired driving for females and with riding with an impaired driver for both genders.

Take away: Teens and young adults who drink and use other substances are more likely to put themselves in risky situations on the road, including driving themselves and riding with an impaired driver.

Buckley L, Bonar E, Walton M et al. (2017) Marijuana and other substance use among male and female underage drinkers who drive after drinking and ride with those who drive after drinking, Addictive Behaviors, 1-16


Family alcohol misuse history and student risk goes beyond parents


New research examined the prevalence of family history density of substance misuse and potential links to heavy drinking, negative consequence of alcohol consumption and alcohol use disorder among college students. Though much research has examined the link between a family history of alcoholism and problematic alcohol use in this age group, less is known about the effects of family history density of substance misuse, the researchers write. A secondary analysis of 606 undergraduate students evaluated potential connections between substance misuse in extended families (beyond parents) and students’ behavior. The density of family history of substance use problems was not significantly associated with participants’ total days of heavy alcohol use. But having a second-degree relative or first-degree relative with a substance use disorder – or having both—was associated with students experiencing negative consequences related to alcohol. Having a first-degree and second-degree relative with a substance use problem also was linked to increased odds of having an alcohol use disorder.

Take away: Efforts to prevent problem drinking among college students might include an acknowledgment that parental alcohol use disorders aren’t the only family history that could contribute to increased risk for a young adult.

Powers G, Berger L, Fuhrmann D, Fendrich M (2017) Family history density of substance use problems among undergraduate college students: Associations with heavy alcohol use and alcohol use disorder, Addictive Behaviors, 1-18

Research (Jan. 28-Feb. 10)

*Click on the article title to open link to full research article.

Review finds mixed results from tobacco-control efforts on campuses, calls for more research


Anti-smoking efforts on college campuses show mixed, but promising, results and more research is needed to establish how policies effect student tobacco use, a review of 11 studies has found. Researchers searched the literature for studies of smoking bans and other tobacco-control efforts on college campuses and identified 11 studies conducted between 1990 and 2016. A majority evaluated 100 percent smoke-free or tobacco-free campus policies. Others looked at different efforts to curb tobacco use on campus. This new effort is the first to systematically review anti-smoking policies and smoking behaviors on U.S. college campuses. It found mixed results, and evidence that stricter policies and those that include prevention and cessation efforts produce better results. The researchers concluded that more research is needed, specifically longitudinal studies. The design of the studies in the review varied. Sample sizes ranged from 36 to more than 13,000. Young adults continue to have the highest prevalence of cigarette smoking in the United States, and although most smokers start in adolescence, the early-adult years are when smokers transition into regular use and become dependent on nicotine, the researchers point out. Furthermore, smokers who quit before 30 almost eliminate risk of death from smoking-related causes, previous research has shown.

Take away: In their conclusion, the researchers write: “This review may be of particular interest to college or universities in the process of making their own antismoking policies. The combined results of the existing studies on the impact of anti-smoking policies on smoking behaviors among U.S. college students can help colleges and universities make informed decisions. The existing research suggests that stricter policies produce better results for smoking behavior reduction.”

Bennett B, Deiner M, and Pokhrel P (2017) College anti-smoking policies and student smoking behavior; a review of the literature, Tobacco Induced Diseases, 15:11


Feedback on online marijuana use assessment need not be lengthy to do most good, study finds


Brief online feedback for marijuana users proved more effective than an extended, more-detailed feedback option in a study of 287 Australian participants. The researchers tested the online assessment tool, called “Grassessment,” in two formats. Participants had a median age of 26 and were self-selected based on a desire to reduce or quit use of cannabis. They joined the study between 2012 and 2013. All of them completed the “Grassessment” evaluation, which includes questions about past-month marijuana use, motives for using it, positive and negative consequences of use, severity of dependence and other related issues. Then they received feedback, either in a brief format or in a more-detailed extended format. A month later, 194 participants completed a one-month follow up. Analysis showed that those who had brief feedback about their questionnaire results saw a significant decrease in past-month quantity and frequency of marijuana use and lower severity of dependence scores. Those with extended feedback also reported much less marijuana use but no significant changes in severity of dependence.

Take away: The study supports efforts to help people reduce marijuana use through brief online self-completed interventions such as “Grassessment” and shows that lengthier efforts did not provide superior outcomes.

Copeland J, Rooke S, Rodriguez D et al. (2017) Comparison of brief versus extended personalized feedback in an online intervention for cannabis users:  Short-term findings of a randomized trial, Journal of Substance Abuse Treatment, 1-6


Students expect more social benefits, tension reduction when they drink with strangers


New research may help explain established links between drinking with unfamiliar individuals – at large parties and bars, for instance — and higher incidence of excessive drinking. In two studies that included a total of 507 undergraduate college students, researchers explored the intersection of drinking, social familiarity with drinking companions and psychological factors. They found evidence that subjects believed that drinking will lead to greater social enhancement and tension reduction when it’s done in the company of strangers as opposed to people they know. The researchers said they’ve found the first evidence that drinkers believe they will gain more reward from drinking when they drink among unfamiliar, versus familiar, people. Participants in both studies were asked to read scenarios, imagine themselves sin the scenarios and report on the effects they thought alcohol would have in that situation.

Take away: Those working to curb substance misuse and abuse on college campuses might tailor their messages to take into account the evidence that when students drink in groups of people they don’t know, they expect the alcohol to lead to more social enhancement, tension reduction and, to an extent, mood enhancement than when they drink with friends.

Fairbairn C, Bresin K (2017) The Effects of Contextual Familiarity on Alcohol Expectancies, Experimental and Clinical Psychopharmacology, Vol. 25, No. 1, 13-23


Text messages could help in effort to drink less, and less often


A pilot study looking at text messages as an intervention for those with alcohol use disorders found promising evidence that text messages help people reduce drinking frequency and quantity. The study included 152 participants, aged 21 to 65, who were divided into five groups. A control group tracked their own drinking and four other groups received text messages for 12 weeks. Those in the intervention groups received different types of text messages designed to help them reduce their drinking. The participants in all but one of the messaging groups reduced the number of drinks consumed per week and the number of heavy drinking days compared to the control participants. Only two groups showed a significant difference in the overall number of drinking days. Almost 80 percent of individuals in the study wanted to continue receiving messages for another 12 weeks at the end of the initial participation period. The study, which took place in 2014 and 2015, included women who consumed at least 13 standard drinks per week and men who drank at least 15 standard drinks per week.

Take away: Text message support programs for those seeking to reduce alcohol consumption could be a valuable tool, and this study suggests some approaches could be more successful than others.

Muench F, van Stolk-Cooke K, Kuerbis A et al. (2017) A Randomized Controlled Pilot Trial of Different Mobile Messaging Interventions for Problem Drinking Compared to Weekly Drink Tracking, PLOS ONE, 12(2)

Latest Research (Jan. 21-Jan. 27)

*Click on the article title to open link to full research article.

Race, gender plays a role in college students’ misuse of prescription stimulants


A new study found significant racial and gender differences in use of stimulants on college campuses. White students were more likely to have prescriptions for the drugs. Asians and Latinos in the study were more likely to engage in smoking prescription stimulants, which can alter the rate of release, absorption, bioavailability and reinforcing effects of the drug, which could increase vulnerability for dependence. The researchers also found that Asians and Latinos were more likely to pay more for the pills than white students. Whites were more likely to take the drugs to party longer or to improve concentration. The only gender difference was the motivation to lose weight. Women were more likely to use the stimulants for that purpose. The researchers used data collected at two California universities from 1,053 undergraduate students. The students were asked to self-report use without a prescription; use for nonmedical purposes, such as to stay awake; use in excess of what was prescribed; frequency of use; and first use. Amphetamines, such as Adderall; dextroamphetamines, including Dexedrine; and methylphenidates, such as Ritalin are commonly prescribed to treat attention-deficit hyperactivity disorder. With rising rates of ADHD-diagnosed students attending college, the availability of these stimulants has increased and paralleled a rise in illicit use of the drugs. When people take these drugs recreationally, it can lead to substance use disorders, addiction, dependence, psychosis, seizures, heart problems and even death. In this study, the researchers characterized illicit use of prescription stimulants as use in excess of what is prescribed, use without or prescription or use for non-medical reasons.

Take away: Illicit use of prescription stimulants is increasing on college campuses and there appear to be important differences in how these drugs are used by different racial groups. It’s possible that targeted interventions among Asian and Latino students could focus on the additional risks associated with smoking the drugs. Those working with young women may wish to address the use of these drugs as a weight-loss tool.


Cruz S, Sumstine S, Menendez J, Bavarian N (2017) Health-compromising practices of undergraduate college students: Examining racial/ethnic and gender differences in characteristics of prescription stimulant misuse, Addictive Behaviors, 68, 59-65.


Marketing campaigns can change norms when it comes to underage drinking, study finds


This Australian study reports on a novel, community-based social marketing intervention designed to correct misperceptions that excessive adolescent drinking is the norm. The effort targeted adolescents, parents of adolescents and the broader community. The study found that shifts in community social norms are possible and suggests that this approach could be used more widely to support the positive trends in youth alcohol consumption and parental supply. Using the social norms approach – the notion that people are motivated to conform to the behavior of others – the campaign included more than 2,600 advertising posters, 5,000 booklets on underage drinking and tips for parents and 20,000 items for kids, including hacky sacks, highlighters, magnets and coffee cups. The effort also included paid advertising, media coverage and website traffic. A survey of 397 people in the community found that 86 percent had seen or heard the messages about underage drinking. More than half recalled the main message, “Kiama Doesn’t Support Underage Drinking.” After a year, the researchers were able to identify several community changes. They found a drop in the perceived prevalence of youth drinking and an increase in the average age people thought it was acceptable for people to drink. Among parents, perceptions of the acceptability of supplying alcohol to a 16-year-old changed in the desired direction.

Take away: Social campaigns can be effective at changing long-held perceptions about underage drinking. While this study was in younger adolescents, it is possible that those seeking to reduce on-campus underage drinking could employ some of the tactics used here.


Jones S, Andrews K, Francis K (2017) Combining Social Norms and Social Marketing to Address Underage Drinking: Development and Process Evaluation of a Whole-of-Community Intervention, PLOS ONE, 12(1), 1-14.


Study finds no association between college-related stress and drinking, binge drinking


School spillover occurs when the education-related obligations and pressures faced by college students extend into other aspects of their lives through shared behaviors or stress. The researchers surveyed 250 students between the ages of 18 and 29 at the University of North Dakota, a mid-sized Midwestern university, to better understand how school spillover effects mental and behavioral outcomes, including drinking and binge drinking. There were slightly more women (62 percent) than men in the study. Most of the participants were full-time students. The average age was almost 21. Contrary to past studies, the degree of pressure from college studies was not associated with alcohol consumption or with binge drinking. The researchers did, however, find a significant association with all the mental health outcomes they considered – nervousness, restlessness, worthlessness, depression and hopelessness. They also found that more-stressed students slept less and had more sex partners.

Take away: In contrast to previous studies, the researchers did not find an association between higher levels of school-related stress and alcohol consumption or binge drinking. Prevention specialists might consider this finding as they consider how best to focus prevention efforts.


Pedersen D, Swenberger J, Moes K (2016) School Spillover and College Student Health, Sociological Inquiry, 1-23


More female Israeli students are drinking, but fewer get behind the wheel after alcohol


Researchers examined alcohol use, binge drinking and other behaviors of Israeli university students, citing little data about alcohol use and related behavior in that group. They hypothesized that the discipline the women were studying (“helping” versus “non-helping” disciplines) would predict whether they’d engage in drinking and other activities. But they found few differences in the groups. The research team sampled 473 female undergraduates from a major university in Israel in 2015. Respondents included social work students, nursing students, and students from other disciplines including engineering and natural sciences. No men were included in the analysis. The 31-item Substance Use Survey Instrument (SUSI) was used to collect the data. Respondents ranged from 19 to 52 years old. Most were single and full-time students. Though they didn’t find that the area of study was associated with more or less alcohol use, the researchers did establish some changes over time when they compared the current study to one done at the same university 20 years prior. They saw a considerable rise of beer, wine and hard liquor consumption in those years. However, students today reported drinking and driving less frequently – 7.5 percent compared to 21 percent in 1996.

Take away: Women college students in Israel are reporting much more drinking than women at the same university 20 years ago, but drinking and driving is less prevalent. The area of study did not make a difference when it came to whether a female student was a drinker or binge drinker. Prevention and intervention specialists should consider the possibility that women are drinking more, and be aware that choice of study program does not appear to affect the likelihood a female student will drink.


Isralowitz R, Sarid O, Dagan A, Grinstein-Cohen O, Reznik A (2017) Alcohol Consumption among Female University Students in Israel: A Cross Sectional Study of Background Characteristics and Drinking Patterns, International Journal of Mental Health Addiction, 1-8

Research (Jan. 14-Jan. 20)

*Click on the article title to open link to full research article.

Brief intervention, referral to treatment linked to drops in substance use


To evaluate the effectiveness of the U.S. Substance Abuse and Mental Health Services Administration’s “Screening, Brief Intervention and Referral to Treatment” program, researchers compared substance use prior to the intervention with substance use six months after participants received intervention. The grant project, referred to as SBIRT, began in 2003 to screen patients in medical settings for substance use disorders. Depending on outcomes, the program includes brief intervention, brief treatment or referral to treatment. Evaluating a sample of 17,575 patients treated in healthcare facilities, the researchers found large and statistically significant decreases for almost every measure of substance use following SBIRT intervention. After six months, alcohol-use prevalence fell by almost 36 percent, heavy drinking by 43 percent and illicit drug use by 76 percent. The greater the intensity of intervention, the larger the decreases in substance use. The researchers wrote that they can’t document a causal link between SBIRT and estimated decreases, but that there does appear to be an association between the intervention and improved outcomes. They point out several caveats, including the absence of a control group for comparison.

Take away: Asking questions about and providing brief interventions and referrals in the medical setting could make a significant difference in subsequent substance use. Prevention and intervention experts on college campuses could partner with affiliated medical centers and others in the community to encourage such interventions.

Aldridge A, Linford R, Bray J (2017) Substance use outcomes of patients served by a large US implementation of screening, brief intervention and referral to treatment (SBIRT), Addiction, 112, 43-53


Binge drinking leads to spike in alcohol-related injuries in college-age men and women


Researchers in Spain evaluated the effects of heavy episodic drinking, or binge drinking, on the incidence of alcohol-related injuries among college students. Overall, they found that self-reported binge drinking raised the likelihood of alcohol-related injuries. Among women, they found that a high frequency of binge drinking and use of marijuana increased the risk of injury and that the risk dropped when the women were 23 or older. The open-cohort study of 992 women and 371 men was conducted within the framework of a study of neurocognitive and social consequences of alcohol use. The study ran from 2005 to 2015 and included students from 33 universities. Women participants’ highest prevalence of binge drinking was at 18, while men reached a peak at 22. Among the female participants, 91 cases of alcohol-related injuries were found. Among the men, there were 36. The researchers concluded that their analysis suggests about a third of alcohol-related injuries among women could be avoided in the absence of heavy episodic drinking, or HED. For this study, six or more drinks in a single occasion was defined as HED. In Spain, a standard drink corresponds to 10 grams of alcohol. In the U.S., a standard drink has 14 grams of alcohol. The participants also reported on their marijuana use and rate and injuries to themselves or to others that were attributable to their drinking. This study’s results were most robust for women. 

Take away: Efforts to discourage binge drinking and educate college students on its potential outcomes could include details about increased chances of students injuring themselves or others. Additionally, prevention experts might consider focusing efforts more heavily on younger female students and older male students, given the gender difference in peak binge drinking found in this study. In their discussion, the study’s authors suggest that motivational interventions for college freshmen could be helpful.

Caamano-Isorna F, Moure-Rodriguez L et al. (2017) Heavy episodic drinking and alcohol-related injuries: An open cohort study among college students, Accident Analysis and Prevention, 100, 23-29


College “Molly” use more common earlier in evening, linked to sexual contact and other drug use later


Molly, a powdered form of ecstasy or MDMA, is most often used by college students to “pregame” before parties and other outings and is linked to behaviors that could put those students at risk, found a new study. Researchers collected data from 151 students who drink alcohol, 18 to 25 years old, in 2014 and 2015. Study participants provided information about alcohol and drug use and about sexual behaviors.   The researchers write that many young people who use Molly may perceive it to be relatively safe, but that it has been shown to cause various harms. In this study, 21.5 percent of participants reported using Molly each week in the three months prior. The weekly users said they did an average of 2 hits over the course of 1.25 days in an average week. The drug was most commonly used between 8 p.m. and 10 p.m. Sixty percent reported engaging in at least one sexual behavior after their most recent use. Only a quarter of the participants reported using Molly without other substances in their most recent use and the most commonly reported other substances used were alcohol and marijuana.

Take away: “Efforts aimed at reducing Molly use among college students may also want to educate about the harms from using combinations of multiple drugs,” the researchers wrote in their discussion. Furthermore, those seeking to educate students about these risks might focus their efforts on places where students gather prior to going out rather than considering Molly to be primarily a drug of use at raves, festivals and other larger gatherings.

Stamates A, Linden-Carmichael A et al. (2017) An examination of the most recent episode of molly use among college students, Journal of Drug Issues, 1-8


Marijuana use, peer and parental influences and other factors influence transition to alcohol use disorders


To better understand the development of alcohol use disorder, researchers looked at four transitions in a large, ethnically diverse sample of adolescents and young adults. They found several significant influences on development of a disorder, including marijuana use and peer and parental influences. Having a mother with an alcohol use disorder was especially linked to initiation of drinking and some later transitional stages. While initiation of drinking has been given much attention, all stages of development of a disorder have not been well-studied, the authors wrote. They studied young people at higher risk based on family history, using the Prospective Study of the Collaborative Study on the Genetics of Alcoholism, or COGA, which began in 1989 at multiple U.S. sites. At baseline, the study included 3,573 adolescents and young adults who were 16 years old on average. Data collected from those adolescents and young adults over the years were used to study four transitions:  Time to first drink, first drink to first problem, first drink to first diagnosis and first problem to first diagnosis. Then they compared associations of parental alcohol use disorder, parental separation, peer substance use, marijuana use, trauma exposures and internalizing and externalizing psychopathology across those transitional periods. Transition risks were elevated for those who had ever used cannabis, those who attributed substance use to their peers, those with externalizing disorders and those with parents with alcohol use disorder. Trauma that did not include an assault was associated only with early initiation. Assaultive trauma was not linked to any transition, which came as a surprise to the researchers, they wrote. 

Take away: Prevention and intervention efforts should take into consideration risk factors that elevate the chances higher-risk individuals will develop a disorder. In particular, the relationship between marijuana use and development of alcohol use disorders should be considered:  The researchers wrote that, “in light of the increasingly permissive legal and social stances toward cannabis in the United States, the marked elevations of all alcohol outcomes observed for cannabis use underscore the importance of studying the underpinnings of this relationship.”

Bucholz K, McCutcheon V, Agrawal A et al. (2017) Comparison of Parent, Peer, Psychiatric, and Cannabis Use Influences Across Stages of Offspring Alcohol Involvement:  Evidence from the COGA Prospective Study, Alcoholism:  Clinical and Experimental Research, 1-16


A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions


To evaluate opportunities to improve youth engagement in prevention and treatment interventions for mental health and substance use, researchers undertook a literature review of 40 papers. They analyzed various strategies to engage young people and grouped them by themes into six overarching categories. The categories included youth empowerment through participation in program development; engagement through parental relations; engagement through technology; engagement through the medical or mental health clinic; engagement through school; and engagement through social marketing. The researchers identified various characteristics that improve the likelihood of success in various types of programs and discuss a broad range of tools in their review of best practices.

Take away: Prevention, diagnosis and treatment programs targeting individuals 11 to 29 years old vary widely and this literature review aims to identify best practices that can help providers use evidence to make decisions about program design, delivery and funding.

Dunne T, Bishop L, Avery S, Darcy S (2017) A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions, Journal of Adolescent Health,  1-72

Research (Dec 3.-Jan. 13)

*Click on the article title to open link to full research article.

Marijuana linked to increase in sex partners among lesbian, gay and bisexual youth


A recent study examining marijuana use and sex habits of lesbian, gay and bisexual youth found that those who used marijuana were significantly more likely to engage in sex with multiple partners. The researchers were interested in this because sex with multiple partners is an important contributing factor for contracting sexually transmitted infections, or STIs. The study included surveys of 694 youth in the National Longitudinal Study of Adolescent to Adult Health (Add Health.) The researchers examined the relationship between marijuana use and sex with multiple partners among adolescents and young adults. Researchers used generalized estimating equations (GEE) logistic regression analyses to look for relationships between reported drug use and sex with multiple partners. They adjusted for other substance use, current depression, the relationship between the young person and his or her mother, and for socioeconomic variables. Marijuana use was both concurrently and prospectively associated with increased odds of sex with multiple partners, both among adolescents and young adults. The researchers concluded that two theories might be at play. First, marijuana use may increase risk for sex with multiple partners by impairing users’ decision-making or judgment. Secondly, marijuana use and sex with multiple partners may both be influenced by shared risk factors, including stress.

Take away: Efforts to reduce marijuana use could impact prevention of transmission of HIV and other sexually-transmitted disease in a higher-risk population of adolescents and young adults. Substance-use prevention specialists might make a special effort to communicate these risks to LGBT students on campus.

Zhang X and Wu L (2017) Marijuana use and sex with multiple partners among lesbian, gay and bisexual youth: results from a national sample, BMC Public Health, 17:19


Online relapse prevention tool appears to help young people


A new, internet-based relapse prevention program used to supplement traditional outpatient substance abuse treatment appears to motivate young addicts, found a new study. The program, “Navigating my Journey,” included 12 core lessons delivered over three months. Each lesson was designed to teach evidence-based relapse prevention skills and was accompanied by short video clips of young adults sharing true stories about their personal challenges and successes. The randomized controlled trial of 129 participants ages 13 to 23 included an intervention group who received the online coaching and a control group who viewed wellness articles at their discretion. Participants were recruited through a job corps program in California. Researchers collected data from participants four times:  at the start of the study, one month in, three months in and after six months. The researchers used a linear mixed modeling approach to look for difference in the participants. When they compared participant responses, the researchers found that the young people who used the program reported a significantly greater increase in motivation to reduce use of drugs or not misuse drugs at both the three-month and six-month intervals, compared to the control group. Participants in the program also reported less drug use at three months compared to their peers who didn’t use the online program. When the researchers looked at results based on age, they concluded that the intervention may be more effective for older adolescents and young adults. 

Take away: Those working with young adults in the outpatient substance abuse setting might employ this online program, or a similar effort, to increase the likelihood that those who abuse drugs and/or alcohol will be more likely to stick with efforts to stop or curtail their use.

Trudeau, KJ, Black, RA, Kamon, JL et al. (January 2017) A Randomized Controlled Trial of an Onine Relapse Prevention Program for Adolescents in Substance Abuse Treatment, Child Youth Care Forum, 1-18.


Dating violence more likely for those who use alcohol, drugs


In an effort to better understand the relationships between dating violence and risk behaviors, including substance use, researchers in Belgium analyzed survey responses from 466 participants, who were 16 to 22 years old (mean age 17.8 years) and were in a relationship. The data came from a larger effort, called the Teen Digital Dating Survey. Adolescents who consume alcohol at a younger age, use marijuana or were involved in vandalism had a higher probability of becoming victims of dating violence than those not involved in those behaviors, the researchers found. Additionally, they linked dating violence victimization and symptoms of depression and low self-esteem. The researchers used logistic regression analyses to assess the associations between well-being, risk behaviors and dating violence victimization. They controlled for gender, age and whether the respondent lived with his or her parents. In the six months prior to the survey, 23 percent of the adolescents surveyed were victims of dating violence. The researchers point out that dating-violence victimization has been found to predict subsequent substance abuse, risky sexual behaviors, fighting, antisocial behaviors, depression and suicide. The findings in this study departed from previous research in that alcohol use at a young age was linked with a higher risk of victimization but no other associations between alcohol use and victimization were found.

Take away:  In their discussion, the researchers suggest that knowledge of connections between dating violence and risk behaviors including drug and alcohol use, can be used to help young people in both prevention and intervention efforts. Those who have used alcohol at a young age or who use marijuana could be at higher risk for sexual assault and other violence.

Van Ouytsel J, Ponnet K, Walrave M (2017) The associations of adolescents’ dating violence victimization, well-being and engagement in risk behaviors, Journal of Adolescence, 55, 66-71

Research (Nov. 19-Dec. 2)

*Click on the article title to open link to full research article.

Experiences of Students in Recovery on a Rural College Campus: Social Identity and Stigma

The increase in rates of substance abuse among young adults creates a growing number of college students in recovery from addiction. Over one million youth and young adults received substance abuse treatment in 2012, of which many entered active recovery before or during college. Substance use has become common on college campuses, making recovery a difficult task for college students in recovery. Collegiate Recovery Programs (CRPs) have been developed to combat these difficulties by providing campus-based support to students in recovery. The purpose of this study is to examine the social experiences (e.g. identity reconstruction and social stigma) of students in recovery attending a rural college. Interviews were conducted with 12 students participating in the CRP at a rural public university. Students were asked set questions related to their social experiences with substance use and treatment prior to college, with the initial transition to campus, and with coping skills/resources they used during those times. Students were also asked questions about the role the CRP played in their coping and identity on campus. Five themes were identified from the interviews conducted. The first 3 themes involved the experience of campus life: returning to college after treatment, feelings of exclusion, and disclosure. The other two themes related to the role of the CRP: in relation to social support, and in relation to identity. With regard to returning to college after treatment, many of the students felt it was difficult readjusting to life after treatment and it was particularly challenging to remain sober on a campus that had high rates of alcohol and drug use. The students also described feelings of exclusion because most social events served alcohol so they “missed out” on many experiences and felt set apart from their peers due to their abstinence. Disclosing identity as a student in recovery was also discussed by many students during the interviews. Some students had a positive experience with disclosure, but others struggled with a fear of being judged, making decisions about whom to tell and when, and bracing for the reactions of others. Students described the CRP as an important source of social support by providing a safe, comforting place for students in recovery to relax, make friendships, and feel a sense of community. The CRP also provided students with support during the formation of a recovery identity because it providing recovery-based activities, friends, and social settings.

Take away: Students in recovery often experience feelings of uncertainty about fitting in and question their identity when transitioning out of treatment and into college. These feelings are further complicated by the pervasiveness of substance use on campus. The CRP provided students in recovery with the support and resources to cope with these challenges. It also assisted students in establishing positive identities as students in recovery. Members of the CRP also exhibited better academic achievement compared to non-CRP students. Additional studies are needed to examine identity and stigma issues in relation to relapse, academic success, and other indicators of well-being.

Scott, A., Anderson, A., Harper, K., & Alfonso, M.L. (2016). Exeriences of Students in Recovery on a Rural College Campus: Social Identity and Stigma. SAGE Open, 6(4). doi:10.1177/2158244016674762


Patterns of Waterpipe Tobacco Smoking Among U.S. Young Adults, 2013−2014

While cigarette smoking has become less prevalent among college-aged young adults, alternative tobacco use has increased. Waterpipe smoking (also known as hookah) is a common tobacco product with particularly high rates on college campuses. Waterpipe smoking is often perceived as less harmful than cigarettes; however evidence shows it poses the same risks as other tobacco products. Although it is common, waterpipe smoking use patterns have not been well studied. The Population Assessment of Tobacco and Health (PATH) study is a national study on tobacco use that provides an opportunity to understand these patterns. This study used baseline data from PATH to examine waterpipe smoking patterns among young adults (aged 18-24), in addition to their use of other tobacco products. The study included data on 9,116 young adults (18-24 years) that answered questions related to past use of waterpipe, cigarettes, and e-cigarettes. Participants were also asked about patterns of use in relation to age of initiation, smoking frequency, average length of a smoking session, usual place of smoking, ownership of smoking devices, and use of flavored tobacco. Among the individuals surveyed, 44.2% reported ever smoking a waterpipe and 10.7% reported past 30 day use. For participants that reported past-30 day waterpipe use, the average age at initiation was 17.4 years. Of these users, 37.5% reported less than monthly use, 36.2% reported monthly, 22.9% reported weekly, and 3.4% reported daily smoking. Daily smokers were more likely to be black than white, whereas weekly smokers were more likely to be Hispanic/Latino than white. Average length of smoking sessions were reported as less than 30 minutes (20.8%), 30 to 60 minutes (45.7%), 1 to 2 hours (26.5%), and greater than 2 hours (2.6%). Participants reported their usual place to smoke was at home or a friend’s house (35%), at a hookah bar/café (22.7%), or both in homes and at bars/cafes (42.1%). Flavored tobacco was used during the first time of smoking for 92.9% of participants, and 38.4% owned a waterpipe. About 30% of participants did not use other tobacco products in the past 30 days. Cigarette use (15.6%), e-cigarette use (5.9%), both cigarette and e-cigarette use (9%), and other poly tobacco use (40.3%) were reported by participants.

Take away: The results of this study confirm that waterpipe smoking is common among this age group and smokers typically spend greater than 30 minutes per session, exposing them to greater health risks. About half of past 30 day users had not smoked cigarettes prior to waterpipe use, indicating that waterpipe smoking may be a gateway to cigarette smoking. The health consequences associated with waterpipe and other tobacco use create a need for regulation. Understanding these patterns is crucial to informing effective control strategies.

Salloum, R.G., Thrasher, J.F., Getz, K.R., Barnett, T.E., Asfar, T. & Maziak, W. (2016) Patterns of Waterpipe Tobacco Smoking Among U.S. Young Adults, 2013−2014. American Journal of Preventive Medicine, In Press.


Alcohol consumption among university students: a typology of consumption to aid the tailoring of effective public health policy

The national rise in alcohol consumption on college campuses warrants effective public health policies to tackle this issue. Current measures of alcohol consumption on college campuses categorize individuals based on consumption alone, overlooking the heterogeneity of this population and making it difficult to tailor effective interventions. One solution to this is the use of typologies to better understand societal phenomenon and identify patterns. Other typology studies have identified abstainers, light drinkers, social drinkers, hedonistic drinkers, heavy alcohol consumers, and problem alcohol users as distinct types. This study was conducted to expand on these by developing descriptive typologies among university students. Using Q-methodology, 43 Irish university students completed interviews and sored 36 statement cards into three groups: agree, disagree, and neither agree nor disagree. They also sorted the statements on a continuum from ‘least describes me’ to ‘most describes me’ and completed a questionnaire about their alcohol consumption. The study identified four groups of alcohol consumers: the guarded drinker, the calculated hedonist, the peer-influenced drinker, and the inevitable binger. The guarded drinker individuals were characterized by cautious drinking, careful spending, and controlled enjoyment. These drinkers enjoy socializing but tend to follow the rules and make a conscious decision to be a light drinker. However, almost 40% of these drinkers exhibited signs of risky drinking. The calculated hedonists described drinking as a way to maximize pleasure and have fun with disregard for the negative consequences of drinking. Almost 54% of these drinkers are risky or hazardous drinkers. Peer-influenced drinkers consumed alcohol as part of a group or at a party and are motivated to drink because it will help them feel a part of the group and adds social confidence. The inevitable bingers were characterized by having a loss of control and drinking until the alcohol was gone. These drinkers were aware of the dangerous situations they put themselves in, believed they were failing to reach their potential, and identified their consumption as problematic rather than fun.

Take away: This study identifies four distinct profiles of alcohol consuming university students and creates a better understanding of drinking patterns in order to develop appropriate public health interventions. These typologies provide university and health professionals with the insight needed to tailor motivational interventions to students.

Davoren, M.P., Cronin, M., Perry, I.J., & O’Connor, K. (2016) Alcohol consumption among university students: a typology of consumption to aid the tailoring of effective public health policy. BMJ Open, 6(11).

Research (Nov. 12-Nov. 18)

*Click on the article title to open link to full research article.

Online Personalized Normative Alcohol Feedback for Parents of First-Year College Students

While efforts are typically focused on the delivery of interventions directly to students, this study takes a different approach at collegiate alcohol prevention by intervening at the parental level. Research indicates that parents remain influential to their children, even throughout college. Research also suggests that parents (like students) have many misperceptions about their college-aged children’s alcohol use. Correcting these alcohol-related misperceptions may motivate parents to communicate more with their college-aged children about drinking. This study uses social norms theory to develop and test an online parent-based personalized normative feedback intervention for parents of incoming first-year college students. A total of 399 student-parent dyads participated in the study and received either the control or the intervention condition. In the intervention condition, parents received statistics on the proportion of students who reported drinking prior to college and those who drank before the legal drinking age. They were then provided with personalized feedback on their perceptions of how much their own child would drink in college and how much the typical student reports drinking.   Parents also received feedback regarding their approval of their child’s alcohol use compared to parents of other same-college students. Lastly, feedback was provided with regard to the proportion of parents who talk about their alcohol-related expectations with their children and the frequency they discuss the consequences of drinking. The control condition received norms related to student exercise, diet, and sunscreen use. Students and parents were surveyed at baseline, one month into college, and six months into college. Students were asked about their alcohol use, negative alcohol-related consequences, communication frequency with their parents, and whether or not their parent had discussed the intervention materials with them. Parents were asked how much they though their child would drink in college, their estimated proportion of other parents who had spoken to their children about alcohol expectations, whether they planned to change how they approached alcohol-related conversations with their child, and whether they planned to have those conversations more often. The majority of parents (82.7%) reported they planned to talk to their child more often about alcohol and 75.7% would change the way they talked about it. Parents’ perceptions of their student’s maximum drinking increased from pre to posttest for the parents that received the intervention. Parents in the intervention group also increased their perception of the proportion of parents who talk to their children about alcohol. For all of the student outcomes, there were no significant effects on alcohol use or consequences, and communication frequency decreased over time regardless of condition received. Nearly half of students in both conditions reported their parents discussed the materials with them. Of the intervention students, 26.3% reported their parents conveyed permissive messages about alcohol and only 12.6% reported their parents conveyed disapproving messages focused on abstinence.

Take away: This parent-based intervention was successful at motivating parents to engage in conversations about alcohol, but may have inadvertently encouraged more permissive communication between parents and their college-aged children. The normative information provided may have conveyed to parents that their child would inevitably drink, resulting in more conversations about drinking safely as opposed to abstinence messages. Similar interventions should include information on how to talk to students about alcohol and the most effective messages for influencing outcomes.

Napper, L.E., LaBrie, J.W., & Earle, A.M. (2016). Online Personalized Normative Alcohol Feedback for Parents of First-Year College Students. Psychology of Addictive Behaviors


Preliminary Development of a Brief Intervention to Prevent Alcohol Misuse and Enhance Sport Performance in Collegiate Athletes

Researchers set out to address the growing concern of alcohol consumption, heavy drinking episodes, and alcohol-related consequences among college student athletes. Past literature has indicated that successful alcohol misuse interventions incorporate components such as individualized feedback and goal-setting. This study was conducted to develop and test an intervention using support systems, brief assessment, goal construction, and contingency management. Incoming college freshman athletes (n=201) participated in the study and were randomly assigned to receive the intervention or control condition. Participants assigned to the intervention were to identify a supportive other that would attend with them (parent, significant other, etc.). Baseline measurements included the Sport Interference Checklist (SIC) to identify troublesome behaviors that interfere with sport performance and the Alcohol Use Disorders Identification Test (AUDIT) to detect harmful levels of alcohol consumption. Participants and their supportive others met with a performance coach for the intervention program. They were provided feedback and performance-oriented goals based on their alcohol use and troublesome behaviors identified at baseline. Supportive others were instructed to contingently reward goal achievement.  At the 2-month follow-up, alcohol consumption (measured by AUDIT scores) had significantly reduced for participants in the intervention condition compared to those the control condition. Academic problems during training, injury concerns during training, and dysfunctional thoughts/stress during competition were also significantly lower at 2 month follow-up for those that received the intervention.

Take away: The results of this study indicate that brief assessment, goal development, contingency management, and the involvement of student’s significant others are potentially effective components to include in alcohol prevention interventions for college student athletes. Future research should also explore the influence of coaches, peers, teammates, and other relationships in the development of prevention programs.

Donohue, B., Loughran, T., Pitts, M., Gavrilova, Y., Chow, G., Nevarez, A.S., & Schubert, K. (2016). Preliminary Development of a Brief Intervention to Prevent Alcohol Misuse and Enhance Sport Performance in Collegiate Athletes. Journal of Drug Abuse, 2(3:26)


Deficits in Access to Reward Are Associated with College Student Alcohol Use Disorder

Research has shown that alcohol use disorder (AUD) symptoms are more likely to occur in college students than in their non-college peers. Some research has shown that substance use is common when access to alternative sources of reward is restricted. This study was conducted to investigate the relationship between reward deprivation (lack of access to or inability to experience enjoyment from natural rewards) and AUD symptoms by examining reward availability, reward experience, depression, and problematic alcohol use among college drinkers. First and second year undergraduate students who reported a minimum of 2 heavy drinking episodes in the last month (n=392) participated in the study. Participants completed a computerized assessment that measured alcohol consumption, AUD symptoms, alcohol related consequences, reward deprivation, and depression. Of the participants in this study, 83.7% of participants reported experiencing 1 or more AUD symptom in the past year, of which 31.6% reported 2 or 3 symptoms, 19.5% reported 4 or 5 symptoms, and 13.9% reported 6 or more AUD symptoms. The average depression score was 8.43 meaning “normal”, however 31.1% of participants scored above a level of mild depression. The study also found that reward deprivation was significantly related to alcohol-related problems and AUD symptoms. More specifically, environmental suppressors (i.e. low reward availability) were significantly related, while reward probability (i.e. reward experience) was not.

Take away: The findings of this study indicate that individuals more likely to experience reward will experience fewer alcohol-related problems and AUD symptoms. Addressing factors that influence environmental suppression of reward is a promising approach to reduce the alcohol-related problems on college campuses. These factors could include poor social skills, limited socialization and recreational opportunities, difficulties integrating into the campus environment, uncertainty related to school or career goals, and living situations.  Addressing any of these factors may improve reward availability and decrease alcohol consumption and related problems as a result.

Joyner, K.J., Pickover, A.M., Soltis, K.E., Dennhardt, A.A., Martens, M.P., & Murphy, J.G. (2016). Deficits in Access to Reward Are Associated with College Student Alcohol Use Disorder. Alcoholism: Clinical and Experimental Research

Research (Oct. 29-Nov. 11)

*Click on the article title to open link to full research article.

Substance Use Trajectories From Early Adolescence Through the Transition to College

Young adults experience many changes during the transition to college, including changes to their substance use risk factors and patterns.  While there are often high rates of use during late adolescence and young adulthood, individuals’ substance use varies over time. This has lead researchers to believe that including these adolescent years in substance use trajectories could provide information about how substance use patterns change during the transitional period from early adolescence through emerging adulthood. This study examines the progression of alcohol, marijuana, and hard drug use from age 13 through the junior year of college. First-year college students (N = 526) were selected to participate in the study and were assessed for 3 years. Participants retrospectively reported their substance use from age 13 to the present, then past-year use was assessed during the second and third years. Impulsive personality traits, delinquency, and violence were also assessed in the third year of the study. The majority of students reported alcohol use (94.8%), 60.3% reported marijuana use, 24.7% reported misuse of prescription stimulants, and 20.5% reported opiate use. Alcohol use was divided into five groups, while marijuana and hard drug use were divided into four groups. Nil to low drinkers had modest use throughout college. Moderate drinkers had relatively stable use throughout college. Experimenters had a peak in alcohol use during the end of high school/beginning of college. Late-onset drinkers had peak increases just before college entry and had continued increases throughout college. Early-onset drinkers escalated their use though high school and maintained a high level of drinking through college. Occasional marijuana users initiated low marijuana use during high school which gradually decreased through college. Moderate marijuana users had steady use with a peak in high school, followed by a decline throughout college. High marijuana users initiated marijuana use much earlier (around age 13) with steep increases throughout high school and subtle decreases during college. Hard drug experimenters had steep increases in polydrug use up to college entry that declined to almost no use during the third year. Late-onset heavy users of hard drugs increased polydrug use from freshman to junior year. Early-onset hard drug users used more than one type of drug during high school, with subtle declines throughout college.

Take away: This study identifies five trajectories for alcohol use, four for marijuana use, and four for hard drug use that provide useful information about the progression of substance use over time. Some of these trajectories and patterns of alcohol and substance use are time limited and unique to a certain period. For example, experimenters have escalated use up until college entry. These findings can influence the development of campus prevention and intervention strategies targeting these specific groups. Addressing more than one of these trajectories could serve as a promising multi-tiered intervention.

Derefinko, K.J., Charnigo, R.J., Peters, J.R., Adams, Z.W., Milich, R., & Lynam, D.R. (2016). Substance Use Trajectories From Early Adolescence Through the Transition to College. Journal of Studies on Alcohol and Drugs, 77(6), 924–935.


Patterns of Change in Weekend Drinking Cognitions Among Non–Treatment-Seeking Young Adults During Exposure to a 12-Week Text Message Intervention

Excessive alcohol use is common among young adults and is associated with many consequences. Although in-person interventions have been effective at reducing alcohol consumption, researchers were looking to create an intervention that could have wide-scale population effects through the use of technology. One unique way of delivering a computerized intervention is through the use of text messaging (short message service [SMS]), which has been an effective strategy in addressing other health issues. Texting to Reduce Alcohol Consumption (TRAC) is an SMS intervention that has been effective at reducing alcohol consumption among at-risk young adults. This study was conducted to examine response patterns to TRAC texts with a focus on weekend drinking cognitions such as drinking plans and willingness to commit to a low consumption goal. Text responses from 12 weeks of intervention were reviewed and changes over time were examined. Participants of this study were 384 individuals that had been randomized to receive the TRAC intervention in a previously conducted randomized clinical trial. Participants were 18-25 years old hazardous drinkers that were not seeking treatment for substance use. Individuals received SMS queries on Thursday and Sunday for 12 weeks. On Thursdays, participants were asked if they planned on drinking that weekend and whether they were likely to have more than 3 or 4 (women/men) drinks. They were then asked if they were willing to commit to a goal of consuming less than 4/5 drinks (women/men) per occasion that weekend. Feedback messages were sent to participants that expressed support for low consumption or encouraged reflection on not setting a consumption goal. Participants reported the number of drinks they had each Sunday at noon, and received additional feedback messages. Drinking cognitions were divided into three groups of individuals: those that planned not to drink, those that were willing to limit drinks, and those not willing to limit drinks. Not surprising, those that planned not to drink reported fewer heavy drinking episodes in the first week and had the greatest reduction in prevalence over the 12 weeks (24% reported heavy drinking during the first week, then 6% after the intervention). The group of individuals not willing to limit drinks had a high, relatively unchanged rate of heavy drinking episodes throughout the twelve weeks. The group willing to limit drinks had intermediate values ranging from 55% to 31% reporting a heavy drinking episode.

Take away: Together, the “planned not to drink” and “willing to limit drinking” groups (88% of participants) reduced their weekend drinking and increased their willingness to commit to limiting alcohol consumption, even after the intervention. Sending these text messages to individuals with no intention to drink may be reinforcement for later weeks. This intervention was most successful for individuals that planned not to drink, had a moderate effect on those willing to limit drinking, and was least effective for those not willing to limit alcohol consumption. Similar interventions should be designed with content targeting these different groups.

Suffoletto, B., & Chung, T. (2016). Patterns of Change in Weekend Drinking Cognitions Among Non–Treatment-Seeking Young Adults During Exposure to a 12-Week Text Message Intervention. Journal of Studies on Alcohol and Drugs, 77(6), 914–923.


College Student Marijuana Involvement: Perceptions, Use, and Consequences across 11 College Campuses

Marijuana use on college campuses is a commonly discussed issue as prevalence continues to rise. Researchers set out to examine different marijuana use rates and consequences, and to compare users and non-users at 11 universities. Participants at these universities included 8141 college students that completed a survey measuring marijuana use, consequences, descriptive and injunctive norms, availability, internalized norms, beliefs about marijuana users, marijuana identification, protective behavioral strategies, motives, and policies and impacts of use. Across the 11 universities, an average of 53.3% of students reported lifetime use, 26.2% reported past month use, and 5.8% reported near daily use.  These rates are similar to nationally representative samples. Users reported experiencing an average of 8 negative consequences from marijuana use in the past month. About one in ten users did not report any consequences, and one in ten reported experiencing 19 or more consequences. The most commonly reported consequences were driving a car while high, saying or doing something embarrassing, using on nights when planned not to use, and feeling sluggish/tired/dazed the morning after use. The least commonly reported consequences were injuring someone, getting into physical fights, having unprotected sex, and doing something disruptive. Students that used marijuana reported they perceived typical college students consumed marijuana more frequently compared to themselves. On a scale of 1-5, students reported marijuana availability was 3.55, between fairly difficult and fairly easy to obtain, but thought that others were able to obtain it more easily than themselves. Compared to non-users, lifetime users perceived others to be more approving of marijuana, had more positive beliefs about marijuana users, and were more likely to identify with being a marijuana user. Users also had more support for legalization, recreational use, and decriminalization of marijuana.

Take away: The number of consequences students experience highlights the importance of distinguishing between problematic and non-problematic marijuana use in order to develop safe use guidelines, similar to those used for safe alcohol consumption. The normative misperceptions and self-other discrepancies found in this study highlight the need for additional research that identifies the best factors and behaviors to target for normative feedback interventions.

Pearson, M.R., Liese, B.S., & Dvorak, R.D. (2016). College Student Marijuana Involvement: Perceptions, Use, and Consequences across 11 College Campuses. Addictive Behaviors—In Press

Research (Oct. 22-Oct. 28)

*Click on the article title to open link to full research article.

How Strong is the “Fake ID Effect?” An Examination Using Propensity Score Matching in Two Samples

Research has found that a bidirectional relationship exists between heavy drinking and possession of a fake ID, indicating that heavy drinking predicts one’s subsequent obtainment of a fake ID, while possession of a fake ID predicts subsequent heavy drinking. However, what is unclear is whether the fake ID is serving as a vehicle to subsequent harm (known as “the fake ID effect”) or whether those harms and outcomes are instead driven by an individual’s level of phenotypic or propensity risk. To investigate the strength of the fake ID effect, this study compared students with and without fake IDs using propensity score matching. Two samples of students were examined; the first was a cross-sectional sample of 1,454 underage college students from a large Southeastern university. The second sample was a prospective replication sample of 3,720 undergraduates under the minimum legal drinking age from a large Midwestern university, surveyed over a period of 4 years. Students in both samples completed self-report surveys that collected information with regard to frequency of binge drinking, alcohol-related problems, alcohol-related arrest/citation, marijuana use, hard drug use, and ownership of a fake ID. A number of other variables (such as demographics and exposure to substance use) were used to assess traits and risk factors for propensity scores. In the cross-sectional sample, 38.5% of students owned a fake ID. Ownership rates varied over time for the prospective sample, with a peak during students’ third year of college (39%). Prior to propensity score matching, students with fake IDs were more often binge drinkers and had greater alcohol-related problems than non-fake ID owners. After matching however, the differences were no longer significant. Alcohol-related arrests and hard drug use were associated with fake ID possession both before and after matching. Alcohol related problems, marijuana use, and frequent binge drinking differences were significant in the prospective sample, but not the cross-sectional sample.

Take away: This study supports previous findings that students with fake IDs are at higher risk for alcohol-related problems, alcohol-related arrests, and other substance use. However, this study indicates that some outcomes are largely the result of individuals’ risk traits rather than the fake ID effect. Potential interventions to address these factors may be specifically aimed at decreasing the likelihood that at-risk students obtain a fake ID. Another approach may be to incorporate fake ID intervention components into other interventions that address individuals’ traits and behaviors.


Stogner, J., Martinez, J.A., Miller, B.L., Sher, K.J. (2016) How Strong is the “Fake ID Effect?” An Examination Using Propensity Score Matching in Two Samples. Alcoholism: Clinical and Experimental Research


Perceived Friends’ Use as a Risk Factor for Marijuana Use Across Young Adulthood

Marijuana use is increasingly common among teens and young adults, but the prevalence and risk factors may vary throughout an individual’s young adulthood.  One factor that often predicts adolescent and college student marijuana use is the presence of marijuana-using peers and perceived social norms. This study was conducted to evaluate this relationship at different ages, which may inform age-appropriate interventions. The study examines how the associations between perceived friends’ marijuana use and own marijuana use change from age 18 to 30 using longitudinal data from a study that has been ongoing since 1976 (the Monitoring the Future study). Participants were enrolled and surveyed during their senior year of high school and completed follow-up surveys biennially. Variables collected include demographics, marijuana use, and perceived friends’ use of marijuana. The prevalence of marijuana use was stable from ages 18 to 20 and declined more rapidly after age 21. Perceived friends’ use was an average of 2.5 friends and decreased to 2. This study found a significant, positive, and increasing effect of perceived friends’ use on marijuana use across ages through age 30, with an increase in odds of past 12-month use associated with a one-unit increase in perceived friends’ use. The effect of perceived friends’ use on odds of marijuana use was significantly stronger for males compared with females from ages 19 to 24 and ages 27 to 30. Blacks, Hispanics, Other races had significantly lower odds of marijuana use than Whites across all ages. Participants with parents that have at least some college education had significantly higher odds of marijuana use compared to those with less educated parents.

Take away: The findings of this study indicate that the association between perceived friends’ marijuana use and an individual’s own use of marijuana strengthens with age and is strongest around age 28.  These findings suggest that peer selection and peer influence are persistent factors of substance use into an individual’s late twenties. Intervention strategies that acknowledge the roles of peers and their effect on substance use are needed beyond alcohol initiation and adolescence.


Patrick, M. E., Kloska, D. D., Vasilenko, S. A., & Lanza, S. T. (2016, October 13). Perceived Friends’ Use as a Risk Factor for Marijuana Use Across Young Adulthood. Psychology of Addictive Behaviors. Advance online publication.


Social Media and College Student Risk Behaviors: A Mini-Review

Social media posts related to risk behaviors are common and have been linked to negative outcomes. This review was conducted in order to assess the current literature examining social media as a popular forum for college students to share their engagement in risk behaviors, as well as the associations between college students’ social media use and engagement in risky behaviors. The studies examined have found that 60-85% of college students’ Facebook profiles include alcohol-related content. Students who viewed a profile with alcohol content had greater perceived peer norms of alcohol use. Individuals posting alcohol-related photos are up to 2.34 times more likely to report engaging in excessive alcohol use than individuals that don’t post alcohol-related photos. Alcohol-related posts were also associated with multiple motives, predicted alcohol use, and alcohol-related problems. Alcohol advertising on social media is also common. One study found that college students who viewed or interacted with alcohol marketing on social media reported drinking more frequently, consuming more alcohol, and experiencing drinking problems. Studies have also found other risk behaviors are often normalized on social media. 87% of hookah-related posts and 54% of marijuana-related posts portrayed the behaviors as normal or typical behaviors on social media. Another study found 39% of social media profiles contained references to tobacco and 10% to illicit drugs.

Take away: These findings support the social norms theory as a framework to explain the connection between social media use and risky behaviors. Because social media clearly influences college students’ health risk behaviors, it should be considered as a useful avenue for alcohol and substance-related prevention and intervention efforts targeting college students. Such efforts could include the distribution of information, debunking myths, promoting responsible behaviors, screening for problematic alcohol use, and delivering targeted communications.


Groth, G. (2016, October 21). Social Media and College Student Risk Behaviors: A Mini-Review. Addictive Behaviors, In Press.

Research (Oct. 8-Oct. 21)

*Click on the article title to open link to full research article.

The Influence of Social Media on Addictive Behaviors in College Students

With nearly 90% of college-aged young adults utilizing social media, researchers were interested in reviewing the literature that explored the relationship between social media and substance use. Substance use posts on social media (including alcohol, tobacco, and illicit substances) are increasingly common among college students.  Recent research has indicated that social media posts of substance use content are predictive of a poster’s usage and problems. These substance use-related posts are often glamorized and the behaviors are endorsed by peers. In many cases, alcohol is depicted in photos rather than text, while being shown in a positive context highlighting drinking in a sociable and affirmative light. Positive social validation for these posts is likely to increase the frequency and intensity of students’ substance use-related behaviors over time. Positive reinforcement for these posts is also likely to encourage risky behaviors. One study found that students posted about alcohol 40% more by the end of their freshman year than prior to entering college. In addition to the impact that these posts have on the poster, they are also influencing the norms of others who view the posts and may increase the viewers’ consumption. Two studies have shown that viewing alcohol-related social media content significantly predicted positive attitudes and drinking norms towards consumption, as well as greater intentions to drink.

Take away: The use of social media has created a new source of social influence that research suggests contributes to increases in substance use. Researchers and prevention specialists should consider developing interventions that target substance use posts and misperceptions in an effort to reduce consumption rates among college students who post the content, as well as their social networking peers who view the content.

Steers, M.N., Moreno, M.A., & Neighbors, C. (2016) The Influence of Social Media on Addictive Behaviors in College Students. Current Addiction Reports.


Daily Relations Among Affect, Urge, Targeted Naltrexone, and Alcohol Use in Young Adults

Recent research suggests that naltrexone may be an effective intervention to reduce heavy drinking in young adults. Naltrexone is an opioid antagonist medication that has also approved for the treatment of alcohol dependence. Researchers are finding that this medication may be effective for reducing the number of drinks consumed in a day, and reducing the number of drinking days with a blood alcohol concentration meeting the legal limit of intoxication among young adults. This study examines whether targeted (as-needed) naltrexone influences within-person relations among mood, urge, and alcohol use among 127 young adults ages 18-25 that reported at least 4 heavy drinking days in the past 4 weeks. The study was a double-blind placebo-controlled trial in which participants were assigned to receive either placebo or naltrexone (25mg daily + 25mg targeted). Participants were instructed to take the targeted dose as needed prior to drinking in addition to their daily dose. Participants completed a daily web-based diary for 8 weeks that assessed their current mood, as well as their desire to drink and number of drinks consumed the previous day. Negative affect was not significantly related to urge or drinking outcome, while positive affect and urge were significantly related to an increase in drinking. Compared to the participants taking naltrexone, those taking the targeted placebo dose were associated with greater odds of having blood alcohol concentration greater than the legal limit of intoxication. The effects of urge and positive affect on drinking outcome were significant in the placebo group but not the naltrexone.

Take away: The findings of this study indicate that taking targeted naltrexone buffers against the indirect effects of positive affect and urge on drinking to the point of intoxication. This provides evidence that naltrexone may be utilized to reduce heavy drinking in college-aged young adults. These results also suggest that heightened positive affect and urge are signals for alcohol use, which can be used to inform risk reduction strategies for this population.

Bold, K. W., Fucito, L.M., Corbin, W.R., DeMartini, K.S., Leeman, R.F., Kranzler, H.R., & O’Malley, S. S. (2016) Daily Relations Among Affect, Urge, Targeted Naltrexone, and Alcohol Use in Young Adults. Experimental and Clinical Psychopharmacology, 24(5).


Patterns of the co-use of alcohol, marijuana, and emerging tobacco products in a national sample of young adults

Marijuana, alcohol, and tobacco are commonly used by young adults, and co-use of these substances often occurs. Yet, little is known about the prevalence of the different ways in which individuals are co-using these substances. Researchers conducted this study in order to better understand which products and methods of co-use are most common. Using a national sample of 3,940 young adults ages 18-24, past 30-day alcohol use, marijuana use, and tobacco use (including cigarettes, cigars, LCCs, electronic cigarettes, hookah, and “others”) were assessed in waves from 2011 to 2015. Estimates across all waves indicate the following top 10 patterns: no past 30-day use (42.4%); alcohol use alone (31.1%); cigarette and alcohol use (5.4%); alcohol and marijuana use (4.0%);  cigarette use alone (2.5%); cigarette, alcohol and marijuana use (2.1%); hookah and alcohol use (.9%); cigar and alcohol use (.9%); marijuana use alone (.9%); and other tobacco and alcohol use (.7%). This study identifies the most popular ways in which young adults are co-using alcohol, marijuana, and tobacco products. Alcohol, cigarette, and marijuana use (in different cominations) are in the top for most popular patterns across all years of assessment. Alcohol co-use occurred in the majority of patterns suggesting prevention efforts focused on addressing alcohol use may prevent use of additional substances. Multi-product targeted interventions could have even greater benefit.

Take away: These patterns can inform intervention and educational efforts targeted toward reducing substance use by focusing on the different product combinations identified in this study.

Cohn, A.M., Johnson, A.L., Rath, J.M., & Villanti, A.C. (2016) Patterns of the co-use of alcohol, marijuana, and emerging tobacco products in a national sample of young adults. The American Journal on Addictions.

Research (Sept. 30-Oct. 7)

*Click on the article title to open link to full research article.

Energy Drink Use Patterns Among Young Adults: Associations with Drunk Driving

Highly caffeinated energy drinks are commonly consumed and are often highly appealing to college-aged individuals. One trend among college students is the consumption of energy drinks with alcohol, either mixed as a cocktail or consumed during the same session. A typical reason a student may mix energy drinks with alcohol is to combat the sedative effects of alcohol or to extend the duration of a drinking session. Studying energy drink usage is important because of its association with risk-taking behaviors and alcohol related problems such as increased risk for alcohol dependence among college students. The consumption of alcohol mixed with energy drinks (AmED) and general energy drink consumption have been linked to drunk driving. The purpose of this study was to examine the patterns of energy drink (ED) consumption with and without alcohol among college students and to examine those in relation to drunk driving. This study included 969 students that completed the sixth-year assessment of a 10-year prospective longitudinal study and reported consuming alcohol during the past year. ED consumption patterns were measured, as well as drunk driving frequency, alcohol use patterns, caffeine consumption, and demographic characteristics. Of the students that participated, 57% consumed ED at least once during the past year. Of those, 56% drank alcohol mixed with ED (AmED) and also drank ED alone, 27% drank alcohol and ED alone but not mixed and 15% drank alcohol mixed with ED but not ED alone. Drunk driving was significantly associated with the consumption of ED both with and without alcohol.

Take away: In this study, more frequent AmED use lead to heavier alcohol use which lead to more frequent drunk driving. Also, more frequent ED use without alcohol still contributed directly to more frequent drunk driving. These findings suggest that college students who consume energy drinks may be an audience for targeted drunk driving prevention interventions. Further research is needed, but ED consumption could be viewed as a marker for such high-risk behaviors.

Arria, A.M., Caldeira, K.M., Bugbee, B.A., Vincent, K.B., O’Grady, K.E. (2016) Energy Drink Use Patterns Among Young Adults: Associations with Drunk Driving. Alcoholism: Clinical and Experimental Research.


Sedentary College Student Drinkers Can Start Exercising and Reduce Drinking After Intervention

Students often avoid seeking help due to perceived stigma, so researchers wanted to examine exercise as a potentially nonstigmatizing, substance-free intervention for heavy drinking students. Exercise may alter student’s drinking habits by decreasing the urge to drink, improving mental health, and improving self-regulation. This randomized clinical trial enrolled 70 college students that were sedentary (having exercised less than 2 days per week in the last 2 months), reported 4 or more heavy drinking episodes during the past 2 months, and met criteria related to hazardous drinking. Participants completed baseline assessments and were randomized to one of two exercise intervention conditions for 8 weeks. The first intervention consisted of motivational interviewing plus exercise contracting (MI + EC), which reinforced participants for attending the exercise contracting sessions (regardless of exercise activity completion). This intervention involved a therapist meeting with the participant to develop an exercise contract, reviewing the previous week’s contract and the participant’s exercising, resolving any barriers, and creating a new contract for the next week. Participants in the MI + EC group received $5 for each of the 8 sessions they attended. The second intervention was motivational interviewing plus contingency management of exercise contracts (MI + CM) which reinforced participants only for completion of verified exercise activities.  Participants in this intervention received drawings from a prize bowl for every exercise they completed. The prize bowl contained 80 slips of paper, half of which stated “Good job!” and the other half were associated with prizes ranging in value from $1 to $100. Both groups had similar rates of participation and reported similar satisfaction. Students in both interventions significantly increased their exercise frequency, with participants in the MI + CM group having a greater increase in exercise frequency than those who received MI + EC. There was a statistically significant reduction in the number of binge drinking episodes among the students that participated and there were no differences between the two interventions. However, the reduction does not appear to be clinically significant with reductions of less than one episode per week and endorsement of one or two fewer consequences over time.

Take away: The findings of this study indicated changes in exercise were not predictive of changes in drinking. This could be explained by factors such as the benefits of exercising having differential impact on drinking, or because the interventions did not directly link exercise with drinking outcomes. Addressing both heavy drinking and exercise simultaneously under one intervention may be an appropriate method in addressing these two behaviors. The findings and limitations of this study are useful in examining exercise as an intervention for addictive behaviors.

Weinstock, J., Petry, N.M., Pescatello, L.S., & Henderson, C.E. (2016) Sedentary College Student Drinkers Can Start Exercising and Reduce Drinking After Intervention. Psychology of Addictive Behaviors.

Research (Sept. 17-Sept. 29)

*Click on the article title to open link to full research article.

College students’ perceptions and knowledge of hookah use

The prevalence of hookah use among college students is increasing. However, while one hookah session can expose an individual to over 40 times the amount of smoke compared to smoking a cigarette, the health consequences associated with hookah use are not widely known. Researchers aimed to determine if college students are aware of the tobacco and nicotine content in hookah, and how their knowledge and perceptions influence their hookah use. Undergraduate students age 18-29 years old (N = 5451) completed online surveys. Students were asked about their hookah and other tobacco/nicotine use and intensity of use during the last 30 days. They were also asked to report whether or not they think hookah contains tobacco and nicotine, as well as their perceptions of hookah’s harmfulness and addictiveness. About half of the students reported ever using hookah, while 16.8% reported current (past 30 days) hookah use. Current users were more likely to be younger and used a greater number of other tobacco products. Of the sample, 26.9% reported hookah does not contain tobacco, and 38.1% reported hookah does not contain nicotine. Non-current users were more likely to believe hookah did not contain tobacco, while no difference between users and non-users was found with regard to nicotine. Findings of this study indicate that college students’ knowledge that hookah contains tobacco is associated with increased odds of current hookah use, while greater perceptions of harm were associated with decreased odds of current use and lower intensity of use.  The results indicated there was no association between knowledge of nicotine or perceptions of addictiveness and hookah use, although increased perceptions of addictiveness were associated with higher intensity among users.

Take away: Given that almost 40% of students did not know that hookah contains nicotine and almost 30% did not know it contains tobacco, college prevention programs and warning labels are needed that include messages to educate both college users and non-users of hookah contents and health consequences.

Creamer, M.R., Loukas, A., Li, X., Pasch, K.E., Case, K., Crook, B., & Perry, C.L. (2016) College students’ perceptions and knowledge of hookah use. Drug and Alcohol Dependence, 168, 191-195.


Pre-drinking motives in Canadian undergraduate students: Confirmatory factor analysis of the Prepartying Motivations Inventory and examination of new themes

The act of consuming alcohol before going to an event where more alcohol may be consumed, termed pre-drinking, is becoming increasingly common among college students. Studies in the United States have found that between 50% and 60% of students and 80% of student drinkers engage in pre-drinking. Pre-drinking is problematic because it is associated with higher blood alcohol levels, risky behaviors, and more alcohol-related consequences. One potential reason for pre-drinking is because underage students cannot purchase alcohol at bars and events. Researchers examined pre-drinking in Canada, where the drinking age is 19, to determine whether pre-drinking exists independently from the legal drinking age in the U.S.  Undergraduate students in Ontario completed an online survey (n = 276), all of which reported consuming alcohol and 89.9% reported engaging in pre-drinking. Participants were asked about their reasons for pre-drinking using the Prepartying Motivations Inventory (PMI) that included 16 different motives in 4 categories (interpersonal enhancement, situational control, intimate pursuit, and barriers to consumption). Among the predefined motives on the PMI, interpersonal enhancement was the most highly endorsed reason for pre-drinking. Monetary concern was identified by more than half of participants and 31% of participants identified socialization with close friends as a reason for pre-drinking. Additionally, 11% reported peer influence as a reason for pre-drinking. Barriers to consumption were only reported as a motive by 4% of participants. Take away: This study provides evidence that pre-drinking is not primarily a function of being underage, given that the majority of the students surveyed were of legal drinking age in Ontario. Because pre-drinking is so prevalent among college students and has been shown to lead to greater alcohol-related consequences, campuses should develop alcohol intervention programs that directly address motives for pre-drinking.

O’Neil, A.I., Lafreniere, K.D., & Jackson, D.L. (2016) Pre-drinking motives in Canadian undergraduate students: Confirmatory factor analysis of the Prepartying Motivations Inventory and examination of new themes. Addictive Behaviors, 60, 42-47.


Exploring the Relationship Between the Misuse of Stimulant Medications and Academic Dishonesty Among a Sample of College Students

Researchers conducted a study to examine the relationship between misuse of prescription stimulant medications (MPS) and academic dishonesty (AD), two behaviors that often result from a student’s desire to succeed academically. The study was done in order to assess potential differences in the frequency of AD between those who do engage in MPS and those who do not. Undergraduate students from three US colleges completed surveys that assessed prescription stimulant status, MPS, misuse of other prescription medications, energy drink use, and frequency of 7 different forms of AD (n = 974). Of the students surveyed, 18.3% reported MPS during the last 12 months. The results of the study indicated that increased frequency of AD was associated with past-year MPS. Participants were also more likely to report MPS if they misuse prescription painkillers, antidepressants or sedatives, filled at least one prescription for stimulants, consumed at least one energy drink in the last 30 days, reported a lower GPA, and were affiliated with a Greek organization. 65% of the students reported engaging in AD during the past year. Students who indicated past-year misuse of prescription stimulants reported they more frequently copied off of someone else’s homework, allowed others to copy their homework, and used the internet improperly when compared to non-users.

Take away: Further research is needed to explore the relationship between AD and MPS among college students, as well as students’ attitudes and beliefs regarding these behaviors. This study shows that MPS is associated with student’s academic pursuits. College programs aimed at reducing MPS may reduce AD and other behaviors, and vice versa.

Gallucci, A.R., Martin, R.J., Hackman, C., & Hutcheson, A. (2016) Exploring the Relationship Between the Misuse of Stimulant Medications and Academic Dishonesty Among a Sample of College Students.  J Community Health. doi:10.1007/s10900-016-0254-y

Research (Sept. 10-Sept. 16)

*Click on the article title to open link to full research article.

Directions of the relationship between substance use and depressive symptoms from adolescence to young adulthood

Because both depression and substance use are prevalent among adolescents and are often comorbid, researchers explored the longitudinal relationship between the two from adolescence into young adulthood. A total of 12,288 adolescents in grades 7-12 were sampled in 1994 and were interviewed in waves until 2009. The Center for Epidemiologic Studies Depression scale (CES-D) was used at each interview wave to capture depressive symptoms and frequency.  Substance use and frequency of alcohol binge drinking, cigarettes, and marijuana were also assessed at each interview. Increases on the CES-D predicted an average increase in male monthly marijuana use by 1 day, and an increase in monthly cigarette smoking frequency by 2 days for females. In other words, depressive symptoms were associated with later increases in smoking frequency for females and marijuana use frequency for males. Smoking was also associated with later increases in depressive symptoms for both males and females. These findings support the self-medication hypothesis that individuals are self-medicating depressive symptoms with the use of marijuana and cigarettes. However, there is also a reverse pathway that indicates an increase in smoking frequency is significantly associated with later increases in depressive symptoms among both genders. Interestingly, this study found no evidence supporting the idea that individuals self-medicated with binge drinking, which could be a function of the measures used.

Take away: The findings of this study indicate a bidirectional relationship between depressive symptoms and substance use among adolescents. This research shows that screening for both depression and substance use in this population is important. Interventions and prevention strategies involving depression could benefit from having a substance use component, and vice versa.

Wilkinson, A.L., Halpern, C.T., & Herring, A.H. (2016) Directions of the relationship between substance use and depressive symptoms from adolescence to young adulthood. Addictive Behaviors, 60, 64-70.


Do drinking motives distinguish extreme drinking college students from their peers?

Several studies have shown that some youth drink far more than the traditional binge drinking criteria of 5+ drinks for men and 4+ for women. As a result, researchers are moving beyond the heavy episodic binge drinking criteria and focusing instead on more extreme levels of drinking in order to identify at-risk college students. Unfortunately, there has been little research on extreme drinking and what motivates it. This study included previously collected data from an integrative data analysis on 3518 students that were drinkers at baseline. Follow-up assessments were conducted over 12 months post-baseline. Students reported their alcohol use frequency including the maximum number of drinks they’d had on one occasion, the number of drinking days per typical week, and the total number of drinks per typical week. Students also reported their reasons for drinking on the Drinking Motivations Questionnaire-Revised, of which four subscale scores of social, enhancement, coping, and conformity motives were computed. Men were classified as extreme drinkers if they consumed 10+ drinks on one occasion and women were classified as extreme drinkers if they had 8+ drinks. Of the students sampled, 43.1% were extreme drinkers.  Extreme drinkers in this study were more likely to be male, white, later-year (non- first-year students), and members of a fraternity or sorority. This study found that extreme drinkers were more likely to drink for social, enhancement, and coping motives when compared to their non-binge and binge drinking peers. This relationship was linear and showed greater endorsement as drinking quantities increased. Increases in social and enhancement motives were associated with becoming an extreme drinker, while reductions in enhancement and coping motives were associated with cessation of extreme drinking.

Take away:  Findings of this study indicate that the typical heavy episodic drinking measures may not be sufficient for identifying college students at greatest risk for experiencing alcohol problems. It is critical to target these extreme drinking students most at risk in order to reduce the harms of drinking. As such, colleges may benefit from developing interventions that focus on enhancement, social, and coping motives while targeting students in this extreme drinking category.

White, H.R., Anderson, K.G., Ray, A.E., and Mun, E.Y. (2016). Do drinking motives distinguish extreme drinking college students from their peers? Addictive Behaviors, 60, 213-218.


Potential Opportunities for Peer Feedback Interventions

Typical peer-delivered feedback interventions have been promising at reducing heavy drinking on college campuses, yet often pose challenges with respect to the training and resources needed to implement them. One correspondence published in the Journal of Studies on Alcohol and Drugs describes an alternative  approach to peer feedback interventions that focuses on delivering an intervention requiring minimal training. Researchers conducted preliminary testing on a peer-delivered feedback intervention that influences alcohol pouring amounts in order to reduce overall consumption and prevent related harms. 36 college students were instructed to pour the amount of alcohol that they would typically pour for themselves into a 16 ounce cup. They then received feedback from a peer (using a standardized written protocol) about whether the amount they poured was a standard serving, was too little, or was too much. The control group received no feedback. Students were then asked to pour a second time 30 minutes after the feedback and again 1 month later. At the first pour, 27 students poured an amount larger than a serving; 17 of those students received the feedback intervention and were told they had poured too much. Compared with the students that received no feedback, those that did receive feedback decreased their pour amounts after 30 minutes and at the 1-month follow-up.

Take away: This unique, single-action peer feedback intervention showed lasting effects in preliminary testing. The intervention was successful at reducing the amount of alcohol students poured, and thus could reduce risky behaviors such heavy drinking. Similar single-action interventions could yield promising results for a sustainable peer intervention that shows efficacy without the use of a great deal of resources.

Martinez, J.A., & Mallet, K.A. (2016). Potential Opportunities for Peer Feedback Interventions. Journal of Studies on Alcohol and Drugs, 77(5), 842–843.

Research (Aug. 27-Sept. 9)

*Click on the article title to open link to full research article.

Expectancies for and use of e-cigarettes and hookah among young adult non-daily smokers

Are young adults’ expectancies for alternative nicotine and tobacco products predictors of their use of e-cigarettes and hookah? With the increasing prevalence of these alternative nicotine and tobacco products (ANTPs) and the little research on the use of such products, one study set out to determine the relationship between ANTP expectancies and usage among young adults. Outcome expectancies are an individual’s beliefs regarding consequences of substance use based on their experiences and observations of the consequences of specific substance using behaviors. This cognitive process has been extensively researched and found to be associated with the use of multiple substances such as tobacco, but there is little research examining its predictive relationship to ANTP use. This study enrolled 377 young adults aged 18-24 that have smoked cigarettes monthly for the previous six months, but have never smoked daily for one month. ANTP expectancies were measured by questions related to products’ harmfulness to health, affect regulation (e.g. stress relief), social facilitation, and substitution for cigarettes (e.g. improves coping with cravings). Of the participants surveyed regarding their behaviors in the past 14 days, 33.4% reported hookah use, 34% reported e-cigarette use, and 18% reported using both.  More positive expectancies predicted more frequent use of both e-cigarettes and hookah. Participants with more expectation that the ANTPs would improve affect, socialization, or cigarette craving relief were more likely to use them in the past two weeks. Interestingly, expectancies for health consequences were not associated with ANTP use.

Take away: These findings indicate that ANTP expectancies do predict whether or not a young adult cigarette smoker will also use these products. This study suggests a need for prevention and intervention programs tailored specifically to ANTP use. Also, because affect regulation was the most consistent predictor of ANTP use, affect regulation components are strongly needed in intervention programs.

Doran, N. & Brikmanis, K. (2016). Expectancies for and use of e-cigarettes and hookah among young adult non-daily smokers.  Addictive Behaviors, 60, 154-159.


Alcohol and cannabis use among college students: Substitutes or complements?

Researchers aimed to settle the economic debate of whether alcohol and cannabis act as substitutes or complements to one another. If substitutes, factors that limit availability of one substance lead to increased use of the other. For example, increased pricing of alcohol may lead individuals to use cannabis as a substitute. On the other hand, a complementary relationship is one in which factors that influence the availability of one substance has a parallel effect on the use of another substance. An example of this relationship would be an increase in alcohol consumption as a result of cannabis decriminalization.  Researchers recruited 876 college students that use alcohol and cannabis to participate in the daily diary study and report their proclivity to use alcohol or drugs to cope with stress, as measured by the 60-item COPE Inventory. The study found that levels of evening alcohol use were positively associated with the likelihood of cannabis use, indicating a complementary relationship between the two. However, individuals with stronger alcohol/drug coping tendencies showed a negative relation between evening alcohol use and cannabis use, having used alcohol and cannabis as substitutes rather than complements.

Take away: This relationship is important to understand as it is a key in developing public health interventions and policies that influence substance use. Higher levels of alcohol consumption predict higher odds of cannabis use in the college student population—unless the student is using alcohol as a coping mechanism, in which case the opposite effect occurs. This is important to keep in mind because policies or interventions developed with the intent to curb alcohol consumption might produce unintended results in certain groups of people, and could in fact drive an increase in cannabis consumption among students that use alcohol and cannabis as substitutes.

O’Hara, R.E., Armeli, S., & Tennen, H. (2016). Alcohol and cannabis use among college students: Substitutes or complements? Addictive Behaviors, 58, 1-6.


A parent-based intervention reduces heavy episodic drinking among first-year college students

Researchers are turning to parent-based interventions in order to leverage parents’ protective influence that seemingly shapes their children’s drinking behaviors well into college. Typical parent-based interventions have been somewhat successful, but have failed at reducing heavy episodic drinking (HED). As a result, resources are focused instead toward peer influence interventions. Although the basic parent-based interventions fall short, expanding on these interventions by engaging parents further and utilizing social norms may yield promising results. Researchers developed the “Parent Feedback Intervention Targeting Student Transitions and Alcohol Related Trajectories” (Parent FITSTART) in hopes of delaying alcohol initiation and reducing HED among first-year college students.  In short, they hoped the intervention would increase parents’ disapproval of drinking and their communication with their children about alcohol, ultimately influencing student alcohol behaviors. 385 students from a private university participated and had at least one parent participate with them. The intervention took place during scheduled parent-only orientation programming for one group, while an information technology session was presented to another group of parents to serve as a control for the study. Parents answered questions and discussed their perceptions of student drinking, their normative beliefs with regard to parent alcohol acceptability, and their beliefs with regard to parent-child alcohol-related communication. During the intervention session, parents were also educated on research that demonstrates parents’ influence on their children’s alcohol use decisions during the transition to college, and strategies for communicating with their children about alcohol use. Students completed a baseline survey prior to the parent intervention and a follow-up survey 4 months later.  Results of this study found that students of parents assigned to the intervention consumed 30% fewer drinks per week than students in the control group. Predicted HED was also significantly reduced for those that received the intervention.

Take away: Parents continue shaping their children’s drinking behaviors well into college, which makes parents a promising avenue for interventions in order to reach students at risk for heavy drinking during the transition to college. This study also supports social-norms-based college drinking interventions, whether applied to parents or peers. Colleges may consider adapting their orientation programs to incorporate alcohol use as a topic presented to parents of first-year college students.

LaBrie, J.W., Earle, A.M., Boyle, S.C., Hummer, J.F., Montes, K., Turrisi, R., and Napper, L.E. (2016) A parent-based intervention reduces heavy episodic drinking among first-year college students. Psychology of Addictive Behaviors, 30(5), 523-535.

Research (Aug. 20-26)

*Click on the article title to open link to full research article.

Diversion of prescription stimulants among college students: An initial investigation of injunctive norms

With the recent increase in use of prescription stimulants, the high rate of prescription stimulant diversion among college students,  and the concurrent dearth of research examining stimulant use among college students, one study aims to examine the normative beliefs about nonmedical use of prescription stimulants (NMUPS) among a sample of this population. Undergraduate college students that reported having a current prescription for a stimulant were surveyed in this study (n=121). The injunctive norms examined were related to frequency and motives of NMUPS across diversion status among the sample. These students completed questions related to diversion of their stimulant medications during their lifetime, their approval of behaviors related to NMUPS, as well as their presumed levels of approval from their close friends, parents, and a typical university student. Findings of this study revealed that nearly 44% of participants indicated they had diverted their prescription at least once. Only 7.5% reported never being approached to divert their prescription. Compared with those that indicated never diverting, those that had diverted reported their close friends were significantly more approving of their NMUPS across all motives and were actually less approving of the act of refraining from NMUPS. With regard to parent and typical university students, diverting students reported more approval of NMUPS for motives related to educational reasons such as studying, increased concentration, and staying awake.

Take away: Students who divert their medications perceive higher levels of NMUPS approval than students without a history of diverting. These students are more likely to rate their close friends as more approving of NMUPS for various motives, while viewing more distal groups (i.e. parents and other students) as more approving of NMUPS for educational purposes. This study shows that future interventions should focus not only on reducing medication diversion, but also on correcting students’ misperceptions about NMUPS approval from close friends, parents, and peers.


Alcohol and sexual assault victimization: Research findings and future directions

While we know alcohol use is associated with at least half of all sexual assault cases, the relationship (and directionality) between sexual assault and alcohol use by victims and/or offenders is unclear. As such, one literature review focuses on this relationship between sexual assault, drinking, and post assault outcomes among individuals in both community and college student populations by examining studies from 2000 to the present. The review found that alcohol-related sexual assault is more prevalent among college women than comparable non-college women. The literature indicated that the relationship between sexual assault and alcohol can be explained by the effects of alcohol, risky situations and behaviors, and assault history. Physiological changes involving altered perception can lead to increased miscommunication about sexual interest, aggressive behaviors, and risk taking or decreased self-protection. Exposure to risky situations due to the social settings in which alcohol is consumed can also place individuals at higher risk. For example, settings that encourage excessive drinking, risky behaviors, close interaction, and little to no supervision place individuals at a heightened risk because there may be more motivated offenders and fewer trained bystanders. The review also found that alcohol use and sexual assault often have a cyclical relationship. For example, victimization can lead to the continuation or increase in post-assault alcohol consumption in order to cope with sexual assault, which then places an individual at risk for experiencing subsequent assaults.

Take away: This review summarizes findings from a number of studies examining the link between alcohol consumption and sexual assault. There is no clear explanation for the association between alcohol and sexual assault, but the responsibility for sexual assault lies primarily with offenders. Current studies show there are differences in alcohol-related sexual assault experiences between student and non-student populations. There are various factors and characteristics involved in sexual assault and post-assault experiences; therefore there is a need for research on alcohol- and non-alcohol involved assault for comparison. This review also demonstrates a need for post-assault interventions targeted specifically for victims of alcohol-related sexual assault.


The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes

Recognizing the prevalence of nonmedical use of prescription stimulants (NMUPS) among college students, researchers set out to examine factors that may predict NMUPS among college students in the United States. One cognitive factor that may increase a student’s risk for NMUPS is executive functioning deficits such as difficulties with planning, organization, self-motivation, and interference control. College students often report academic enhancement as a motive for NMUPS. Executive functioning deficits often result in decreased academic performance and increased risk behavior, therefore students with these deficits may engage in NMUPS to enhance their academic performance. A convenient sample of 314 college students participated in the study by completing the Stimulant Survey Questionnaire (a 40-item questionnaire that measures NMUPS in college students) and the Barkley Deficits in Executive Functioning Scale (a scale with higher scores representing higher executive functioning deficits).  Of the individuals sampled, 18.8% reported NMUPS during their lifetime. Students with clinically significant executive functioning deficits had significantly higher scores on the prescription stimulant misuse questionnaire compared to those with no deficits.

Take away: The findings of this study suggest that students with executive functioning deficits are at increased risk for NMUPS than students without executive functioning deficits. This may help identify students at risk for NMUPS and has important implications for prevention and intervention policies on college campuses. The effects of NMUPS on overall functioning of students with these deficits are unknown, thus further research on this relationship is needed.

Research (July 23 – July 29)

*Click on the article title to open link to full research article.

Young People’s More Permissive Views About Marijuana: Local Impact of State Laws or National Trend?

Do state medical marijuana laws influence young people’s views about the risks of using marijuana?  A recent study investigated this question by analyzing 10 annual waves of the US National Survey on Drug Use and Health (2004-2013) submitted by young people [stratified as: middle-school aged youth (12-14yo; 111,100), high-school aged youth (15-17yo; n=114,000), and young adults (18-25yo; n=225,200)].  Results indicated that young people living in medical marijuana states was associated with more permissive views regarding marijuana—such as believing monthly and weekly use is not of great risk, marijuana is easy to obtain, and parents and friends would not disapprove of its use.  However, this association became non-statistically significant after controlling for state level differences.  Instead, data indicated a national trend over time toward more permissive attitudes, which was more pronounced among young adults. For example, young adults in 2013 had 2.4 times higher odds of reporting weekly marijuana use is “not of great risk” than young adults did in 2004.

Take Away: this study’s findings support that a national trend toward young people’s more permissive views on marijuana use is emerging independently of any policy changes within states.  Given that young adults experienced the greatest shift in attitudes, campus prevention specialists may consider discussing the role of public policy in shaping our attitudes about marijuana use in their prevention programs.


A text message intervention for alcohol risk reduction among community college students: TMAP

In an effort to reduce heavy alcohol use and alcohol-related consequences among community college students, a recent study assessed the efficacy of a Text Message Alcohol Program (TMAP).  Study participants included community college students (18-28yo) that reported 1 binge drinking day in the previous two weeks.  All participants completed an online survey at baseline, week six (end of intervention), and week 12 (follow-up) that self-reported alcohol use and experience of alcohol-related consequences. Participants assigned the TMAP intervention received six text messages per week for six weeks (n=31).  Message content included facts about alcohol, strategies to limit alcohol use and alcohol-related risks, and motivation messages.  Participants assigned the control condition received motivational texts unrelated to alcohol use (n=29).  Results indicated that at week 6, TMAP participants were less likely than control participants to report heavy drinking and alcohol-related consequences.  Unlike control participants, TMAP participants also demonstrated increased self-efficacy to resist drinking in high-risk situations at week 6 compared with baseline.  These findings were maintained through week 12 (follow-up).

Take Away: This study’s findings support that text messages focused on harm-reduction techniques may be an effective approach toward reducing heavy alcohol use and alcohol-related consequences among young adults.  Future studies may consider conducting a larger trial at both community and 4-year colleges, as well as evaluating the mechanism mediating the positive intervention effects.


Do college students improve their grades by using prescription stimulants nonmedically?

Can misusing a pill improve academic performance?  Many college students misperceive that misusing prescription stimulant medication may improve grades and academic performance.  In an effort to address this misperception, a recent study investigated the association between the nonmedical use of prescription stimulants (NPS) and a change in annual GPA (from Year 2 to Year 3 in college).  Study participants included undergraduates not diagnosed with ADHD (n=898) that self-reported past-year misuse of prescription stimulants during their second and third year.  Based on their responses, participants were categorized as: Abstainers (misused neither year; 68.8%), Initiators (misused Year 3 but not Year 2; 8.7%), Desisters (misused Year 2 but not Year 3; 5.8%), and Persisters (misused both years; 16.7%).  Results indicated that after controlling for sex and Year 2 GPA, there was no significant association between NPS group membership and change in GPA.  The average change in GPA was lowest for Persisters and Initiators, whereas Abstainers experienced a small but significant increase in GPA.

Take Away: This study concluded that while one cannot rule out the possibility that misusing prescription stimulants prevented declines in GPA, participants whom chose to misuse prescription stimulants showed no increase in their annual GPA.  Campus prevention specialists may consider discussing in their prevention programs the increasing body of research demonstrating that misusing prescription stimulants does not improve grades or academic performance.  Instead, encourage students to brainstorm and share healthy and sustainable habits for long-term academic and professional success.

Research (July 16 – July 22)

*Click on the article title to open link to full research article.

Prevalence, Correlates and Patterns of Heroin use among Young Adults in the United States 

Given the rise in heroin use in the United States, a recent study analyzed data from the 2011-2013 National Survey on Drug Use and Health to determine the prevalence, correlates, and patterns of heroin use among young adults in the United States.  Study participants included young adults (18-25 years old) that self-reported lifetime, past-year, and past-month heroin use (n=55,940).  A brief summary of this study’s findings include:


  • Lifetime use, 18.4 per 1,000; Past-year use, 7.3 per 1,000; Past-month use, 3.3 per 1,000 (suggests 2% of study participants reported ever using heroin)

Patterns and Attitudes:

  • The mean age of heroin use initiation was 18-19 years old
  • The majority of heroin users reported concurrent use of other substances
  • The majority of lifetime (61.9%), past-year (80.6%), and past-month (93.6%) heroin users indicated it was fairly or very easy to access heroin


  • Young adults that smoked cigarettes, misused prescription opioid pain relievers, used illegal drugs, or had been arrested and booked for breaking the law had higher odds of using heroin.

Take Away:  This study analyzed national data that assessed heroin use by young adults (18-25 years old) in the United States.  This study concluded that young adult heroin users initiated heroin use at an early age (18-19 years old), and the majority of heroin users were also polysubstance users.  As a result, campus prevention specialists may consider specifically targeting first-year college students with prevention programming.


Associations between tobacco and nicotine product use and depressive symptoms among college students in Texas

Research supports an association between cigarette smoking and clinical depression.  Given the high prevalence of alternative tobacco and nicotine product (ATP) use among college students, a recent study examined if ATP use by college students also associated with clinical depression.  Study participants included young adults attending one of twenty-four universities in Texas (n=5,438).  Participants completed an online survey where they self-reported past 30-day use of cigarettes and ATPs as well as past 7-day experience of depressive symptoms.  Findings indicated that only e-cigarette use positively associated with depressive symptoms.

Take Away: In this study, e-cigarette use by college students positively associated with past 7-day depressive symptoms.  The authors suggest future studies evaluate whether e-cigarette use elevates risk for depressive symptoms or vice versa, as well as re-examine this association with college students actually diagnosed with clinical depression.

Research (July 9 – July 15)

*Click on the article title to open link to full research article.

Associations between tobacco and nicotine product use and depressive symptoms among college students in Texas

Research supports an association between cigarette smoking and clinical depression.  Given the high prevalence of alternative tobacco and nicotine product (ATP) use among college students, a recent study examined if ATP use by college students also associated with clinical depression.  Study participants included young adults attending one of twenty-four universities in Texas (n=5,438).  Participants completed an online survey where they self-reported past 30-day use of cigarettes and ATPs as well as past 7-day experience of depressive symptoms.  Findings indicated that only e-cigarette use positively associated with depressive symptoms.

Take Away: In this study, e-cigarette use by college students positively associated with past 7-day depressive symptoms.  The authors suggest future studies evaluate whether e-cigarette use elevates risk for depressive symptoms or vice versa, as well as re-examine this association with college students actually diagnosed with clinical depression.


Prevalence, Correlates and Patterns of Heroin use among Young Adults in the United States

Given the rise in heroin use in the United States, a recent study analyzed data from the 2011-2013 National Survey on Drug Use and Health to determine the prevalence, correlates, and patterns of heroin use among young adults in the United States.  Study participants included young adults (18-25 years old) that self-reported lifetime, past-year, and past-month heroin use (n=55,940).  A brief summary of this study’s findings include:


  • Lifetime use, 18.4 per 1,000; Past-year use, 7.3 per 1,000; Past-month use, 3.3 per 1,000 (suggests 2% of study participants reported ever using heroin)

Patterns and Attitudes:

  • The mean age of heroin use initiation was 18-19 years old
  • The majority of heroin users reported concurrent use of other substances
  • The majority of lifetime (61.9%), past-year (80.6%), and past-month (93.6%) heroin users indicated it was fairly or very easy to access heroin


  • Young adults that smoked cigarettes, misused prescription opioid pain relievers, used illegal drugs, or had been arrested and booked for breaking the law had higher odds of using heroin.

Take Away:  This study analyzed national data that assessed heroin use by young adults (18-25 years old) in the United States.  This study concluded that young adult heroin users initiated heroin use at an early age (18-19 years old), and the majority of heroin users were also polysubstance users.  As a result, campus prevention specialists may consider specifically targeting first-year college students with prevention programming.

Research (July 1 – July 8)

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A successful high-visibility enforcement intervention targeting underage drinking drivers

In an effort to reduce underage drinking and driving, a recent study developed, conducted, and evaluated a high-visibility enforcement (HVE) program targeting zero tolerance violators (i.e. underage drinking drivers).  The HVE program (termed “intervention”) consisted of increased high-visibility enforcement of drinking and driving laws, featuring the use of passive alcohol sensors by police, along with a coordinated publicity campaign in two college towns.  Evaluation of this program included weekend roadside surveys measuring breath alcohol concentrations (BrAC; n=6,825) as well as online surveys administered to college students in the targeted communities (n=2,061).  Both surveys asked participants to self-report drinking behavior, drinking history, and perceptions of risk and awareness of special impaired driving enforcement.  Findings from the roadside surveys revealed a significant reduction in drivers with BrAC ≥ 0.08g/dl during the intervention and follow-up periods.  Findings from the online surveys indicated that college students under age 21 reported significantly less driving after drinking during the intervention and follow-up periods, as well as an increase in their perceived risk of being stopped after 3 drinks or while driving drunk.

Take Away: The HVE campaign implemented in this study appeared to reduce both underage drinking after driving among college students, as well as drunk driving among young adults.  Substance use prevention specialists may consider partnering with police and media specialists to model this campaign on their campus or in their community.  The authors also encourage others to consider HVE campaigns that incorporate messaging which effectively reduces both drunk driving and driving under the influence of other drugs.


Alcohol attitudes, motives, norms, and personality traits longitudinally classify nondrinkers, moderate drinkers, and binge drinkers using discriminant function analysis

In an effort to reduce problematic drinking among college students, a recent study applied multiple risk factors to determine the extent that such measures distinguished college nondrinkers, moderate drinkers, or binge drinkers.  Study participants included male (n=155) and female (n=351) college students.  At baseline, participants completed an online survey that measured personality traits, alcohol attitudes, drinking motives, and social norms.  One month later, participants reported the number of drinks typically consumed per occasion during the past month, which determined drinking type.  Discriminant function analyses indicated that risk factors such as alcohol attitudes, social drinking motives, and close friend norms contributed to status as nondrinker, moderate drinker, or binge drinker.  Additional statistical analyses revealed mean differences in risk factors across drinker types, with stronger effects observed in alcohol attitudes, social motives, enhancement motives, and close friend norms.

Take Away: This study concluded that risk factors such as alcohol attitudes, drinking motives, and social norms tended to be more important than personality traits in distinguishing college drinker types.  As such, campus professionals that target problematic drinking may consider addressing these identified risk factors in their prevention efforts—the authors suggest specific ideas in the Discussion section.

Research (June 24 – June 30)

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Evaluation of the Overdose Education and Naloxone Distribution Program of the Baltimore Student Harm Reduction Coalition

An increasing number of states are passing laws that enable third-party prescriptions for naloxone, a prescription medication that reverses opioid overdoses. As such, the Baltimore Student Harm Reduction Coalition overdose education and naloxone distribution program is a state-authorized, community-based training program that distributes naloxone to third-parties.  A recent report evaluated this training program by asking trainee participants (n=113) to complete a pre- and post-test written survey that assessed knowledge, attitudes, and self-efficacy surrounding opioid overdoses. In addition, trainee participants completed a follow-up telephone survey that assessed overdose- and naloxone-related experiences during the 8-12 months following training (n=35). Results indicated significant gains in knowledge, as well as improved attitudes and self-efficacy immediately following the training. For participants that completed the follow-up survey, most shared their knowledge of overdose prevention with others (86%) or had told others that they possessed naloxone (83%). However, many trainees stated they kept naloxone at home (67%) versus carrying it on them (22%), citing concerns of heat sensitivity during the summer. Other third-party naloxone distribution programs may consider directly addressing this concern in order to maximize probability of naloxone use. Lastly, three participants reported reversal of an opioid overdose after administering naloxone received at the training.

Take Away: This report summarizes findings of a third-party naloxone distribution program led primarily by college students. Program staff consisted of undergraduate and graduate students that provided third-party community members valuable education on substance use and overdose prevention, appropriate procedures for naloxone administration, as well as emotional support for family members and friends. As such, this program may provide a model for university campuses to engage college students in community health through a mutually beneficial manner.


Preference for Gain- or Loss-Framed Electronic Cigarette Prevention Messages

E-cigarettes remain popular among youth and young adults. In an effort to develop effective e-cigarette interventions, a recent study assessed student preferences for e-cigarette prevention messages. Participants included middle-school (n=1,166) and high school (n=3,614) students that completed a written survey, as well as college students (n=625) that completed an online survey.  Participants reported cigarette and e-cigarette use, as well as preferences for loss- or gain-framed e-cigarette prevention messages focused on one of four themes (financial costs, health risks, addiction potential, and social labeling). Loss-framed messages emphasize the costs of engaging or not engaging in a behavior (e.g. “You spend more money if you use e-cigarettes”). Gain-framed messages emphasize benefits of engaging or not engaging in a behavior (e.g. “You save money by not using e-cigarettes”).  Regardless of grade level, loss-framed messages were preferred for themes related to health risks, addiction potential, and social labeling, while gain-framed messages were preferred for the theme related to financial costs.  In addition, lifetime e-cigarette users preferred loss-framed health risk and social labeling messages relative to never e-cigarette users.

Take Away:  Findings from this study may help campus prevention specialists compose effective e-cigarette prevention messages for dissemination through social media or other digital platforms. When discussing health risks, addiction potential, and social labeling, consider developing prevention messages related to the costs of using e-cigarettes. When discussing financial costs, consider composing prevention messages related to the benefits of not using e-cigarettes.


Normative Influences on the Nonmedical Use of Prescription Stimulants Among College Students

Do perceived social norms impact prescription stimulant misuse by college students? A recent study investigated this question by asking college students to self-report lifetime and past-year prescription stimulant misuse, as well as self-approval and perceived social norms for prescription stimulant misuse (n=959). Results indicated that participants overestimated prevalence for lifetime (perceived, 50%; actual, 29.7%) and past-year (perceived, 44.3%; actual, 22.9%) misuse, and this overestimation was greater for past-year prescription stimulant misusers relative to non-misusers. In addition, past-year misusers also reported greater self-approval, as well as perceived approval by close friends, parents, and the typical college student relative to non-misusers.

Take Away:  Findings from this study support that college students overestimate the rate of prescription stimulant misuse on their campus, with past-year prescription stimulant misusers perceiving greater use, self-approval, and perceived approval than non-misusers. Although the majority of college students do not misuse prescription stimulants, this study suggests that social norm campaigns may be an effective approach to prevent prescription stimulant misuse on college campuses.

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