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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 (Apr. 18- Apr. 24)

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

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)

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

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)

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

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)

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

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)

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

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)

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

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)

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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)

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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)

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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)

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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)

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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)

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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)

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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)

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

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)

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

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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