Substance use (SU) can result in a number of negative personal and public health consequences including emotional regulation deficits, poor academic performance, and economic strain. SU often peaks during young adulthood and is a particular risk among young adults in college. Past research has also demonstrated a link between SU and suicide ideation (SI) which is also prevalent among college students. One possible explanation for this association is that SU is a method of coping with intolerable emotional pain and highly distressing events. SU may also be influenced by peer perceptions and social motives. This study examines the impact of the suicide ideation-distress-peer perception interaction on substance use among college students.  

The study’s sample consisted of 3,608 undergraduate students from eleven college campuses in North Dakota. Students were asked to report past-month use of alcohol, tobacco, electronic cigarettes, cannabis, amphetamines, opioids, non-medical use of prescription drugs, and other illicit drugs. Participants were also asked about past 12-month SI, past-month distress, and perceived peer substance use. Data was analyzed using regression analyses to examine for relationships between SI, general distress, perceived peer SU and past-month SU.  

Results of the data analysis showed there was a main effect of perceived peer use on past 30-day use of alcohol, tobacco, electronic cigarettes, and cannabis. In addition, SI predicted past 30-day use of electronic cigarettes and cannabis. The three-way interaction of SI, distress, and peer perceptions of SU predicted frequency of past month tobacco and illicit drug use. The interaction between perceived tobacco use and SI predicted past 30-day tobacco use at high levels of distress (scores > 2.06). Perceived peer cannabis use aggravated the effects of SI on past 30-day cannabis use and distress lessened the effects of SI on past 30-day cannabis use. In regards to past 30-day illicit drug use, perceived peer illicit drug use exacerbated the effects of SI and distress on SU. In addition, the interaction effect of perceived peer drug use and SI was dependent on either low or high levels of distress.  

Takeaway: Heightened distress and perceived peer substance use may impact the suicide ideation- substance use relationship among college students.  

O’Loughlin CM, Park Y, Ammerman BA. Suicide Ideation, Distress, and Peer Perceptions as Predictors of Substance Use. Substance Use & Misuse. 2023;58(4):560-569. doi:10.1080/10826084.2023.2177964