Alcohol Use,Drug Use,and Sexual Activity among Pharmacy Students at Three Institutions

ObjectiveTo determine alcohol and drug use and sexual activity among pharmacy students at three colleges of pharmacy.Design and SettingA survey to obtain self-reported information on alcohol and drug use, and sexual activity was administered to professional pharmacy students at the University of Iowa (UI), Massachusetts College of Pharmacy, and Texas Southern University.Main Outcome MeasuresInformation on sexual activity and condom use, alcohol and drug consumption, and the effect of alcohol on unintended sexual activity.Results848 students (50% response rate) completed the survey. Alcohol use was high at all three institutions, and most students had consumed five or more drinks on one or more occasions within the last three months. The extent of drug use among pharmacy students was similar to that reported in other college students. The majority of students were sexually active. More men than women reported having been sexually active with one or more partners. Most students reported having had sexual intercourse without a condom. Significant numbers of students had engaged in unintended sex after alcohol use, especially at UI (χ² = 12.6, p = 0.002). Sexual contact and drinking were strongly correlated (Pearson r = 0.31, p = 0.0001).ConclusionAlcohol consumption among pharmacy students was high. Heavy drinking (five or more drinks on one occasion) was associated with unintended sexual contact. Given low condom use and increased sexual contact, pharmacy students are at an increased risk for HIV infection. Strategies should be developed to reduce alcohol intake and unprotected sexual activity among pharmacy students.     

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

AimsEconomists debate whether changes in availability of alcohol or cannabis are positively or negatively related to changes in use of the other substance. Implicit in these arguments are two competing, individual-level hypotheses—that people use alcohol and cannabis either as complements or substitutes for one another. This is the first study to test these hypotheses using micro-longitudinal data on individuals' alcohol and cannabis use on a given evening.MethodsUnited States college students who use alcohol and cannabis (n = 876) were selected from a larger sample who participated in a 30-day online daily diary study. At baseline, students reported their proclivity to use alcohol/drugs to cope with stress. Each day students reported their level of alcohol use from the prior evening as well as whether they had used cannabis.ResultsEvening levels of alcohol use and mean levels of alcohol use positively predicted the likelihood of evening cannabis use, results indicative of complementary use. This relation, however, was moderated by coping style, such that students who were more likely to use alcohol/drugs to cope were less likely to use cannabis as their evening or mean alcohol use levels increased, results indicative of substitution.ConclusionsSubstance-using college students showed evidence for complementary alcohol and cannabis use at both the within- and between-person levels. Students with a proclivity toward using alcohol/drugs to cope, however, showed evidence of substitution. These findings suggest that studies based on economic theories of substance use should take into account individual differences in substance use motives.     

A test of expectancy-value theory in predicting alcohol consumption*

Background: Research on alcohol-related outcome expectancies has primarily focused on the likelihood of the anticipated effects, while comparatively little attention has been paid to their subjective evaluation. However, according to expectancy-value theory, the expectation that alcohol use will produce certain consequences and the evaluation of those consequences jointly and interactively determine an individual's decision to consume alcohol. Previous research on this issue was hampered by multiple regression strategies that are plagued by measurement error and low statistical power.

Method: To overcome this limitation, we investigated expectancy-value interactions in predicting drinking variables by drawing on latent variable methodology using the five expectancy-value dimensions from the Comprehensive Alcohol Expectancy Questionnaire. Expectancy-value models were tested in a sample of college students (N?=?1053) and a sample of alcohol-dependent inpatients (N?=?699).

Results: Significant expectancy-value interactions emerged concerning social assertiveness among students as well as for aggression and tension reduction among alcohol-dependent inpatients. The relationship between expectancy and drinking was strongest for pronounced (either positive or negative) valuations of the effect. Effect sizes were small, however.

Conclusions: The results are in partial agreement with basic premises of expectancy-value theory. However, this study also identifies limits to the universal validity of expectancy-value theory, given that prediction of alcohol use depends on the effect domains, alcohol outcome measures, and study populations.     

Motives for and impairment associated with alcohol and marijuana use among college students

IntroductionAlcohol and marijuana use are prevalent on college campuses. As recreational marijuana use is legalized, more undergraduate students may use marijuana in combination with alcohol. The motives for, frequency of, and impairment associated with dual use (alcohol and marijuana) compared to alcohol-only use may differ. We examined motives for, frequency of, and impairment associated with alcohol use and dual use at a university in a state where recreational marijuana has been legalized.MethodUndergraduate college students completed an anonymous online survey (N = 430) concerning alcohol and marijuana frequency, motives, and impairment. Students were classified as either alcohol-only users (n = 279) or dual users (n = 151).ResultsAnalyses indicated that among alcohol-only users, social motives predicted more alcohol use, while among dual users, enhancement motives predicted more alcohol and marijuana use and impairment. Coping motives predicted more marijuana use among dual users, but not more alcohol use. Frequency of alcohol and marijuana use predicted more impairment across both the alcohol-only and dual users.ConclusionsFuture research should examine the influence of marijuana use over time to understand how motives may change for previous alcohol-only users.     

Drinking motives and alcohol outcome expectancies as mediators of the association between negative urgency and alcohol consumption

ObjectiveTo determine whether the effects of negative urgency, a unique facet of impulsivity marked by engaging in potentially unhealthy and rash behaviors in order to cope with anxiety or negative moods, on drinking behavior can be explained by positive and negative alcohol outcome expectancies and specific drinking motives (i.e., coping and enhancement).MethodsCollege students (N = 194) completed web-based surveys in exchange for course credit. Students completed measures of negative urgency, comprehensive effects of alcohol, drinking motives, and alcohol use behaviors.ResultsResults of path analysis indicated significant indirect effects of negative urgency and alcohol use through both alcohol outcome expectancies and enhancement motives. The effects of enhancement motives on drinking were mediated by positive alcohol outcome expectancies. The effects of coping motives on drinking were not attributable to negative expectancies.ConclusionsIndividuals high on negative urgency may consume alcohol in order to ameliorate their emotional distress due to strong desires to increase positive and decrease negative experiences associated with drinking. Emotion-focused impulsivity's influence on drinking outcomes can be ascribed to enhancement motives for drinking as well as positive and negative alcohol outcome expectancies. Prevention efforts should target drinking motives and alcohol outcome expectancies among those higher in negative urgency.     

Family history density of substance use problems among undergraduate college students: Associations with heavy alcohol use and alcohol use disorder

PurposeA family history of alcoholism has been found associated with problematic alcohol use among college students, but less research has examined the effects of family history density of substance use problems in this population. This study examined the prevalence of family history density of substance use problems and its associations with heavy alcohol use, negative alcohol consequences, and alcohol use disorder in a college sample.MethodsBased on a secondary analysis of a probability sample, data were analyzed from 606 undergraduate students. Family history density of substance use problems included both first and second degree biological relatives. Heavy alcohol use was the total number of days in which participants drank five/four or more drinks for men/women, negative alcohol consequences were derived from items commonly asked in college student surveys, and an alcohol use disorder was defined as meeting diagnostic criteria for alcohol abuse or dependence. Point prevalence estimated rates of family history density of substance use problems, and negative binomial, ANCOVA, and logistic regression models examined associations between family history density and the alcohol variables while adjusting for sociodemographic variables.ResultsFamily history density of substance use problems was not significantly associated with total days of heavy alcohol use. Having a second degree, a first degree, or both a first and second degree relative(s) with a substance use problem, however, was significantly associated with experiencing negative alcohol consequences. In addition, having both a first and second degree relative(s) with a substance use problem significantly increased the odds of having an alcohol use disorder.ConclusionsFamily history density of substance use problems may play a role in experiencing negative alcohol consequences and in having an alcohol use disorder among undergraduate college students and may be an important risk factor to assess by college health professionals.     

Low rates of alcohol and tobacco use,strong cultural ties for Native American college students in the Southwest

IntroductionCollege attendance is associated with an increased risk for substance use yet we know little about substance use among Native American college students and its regional variation. This study examined alcohol, tobacco, and drug use and their relation to gender, institution, age, and cultural involvement among Native American college students in the Southwest.MethodsNative American community college and university students in a large Southwest city (N = 347) completed an online survey about past-month and lifetime substance use and involvement in cultural activities.ResultsCultural involvement was related to less past-month substance use. In the past month, 43% drank alcohol, 27% binge drank, 20% used drugs, and 13% were current smokers. Males, community college students, and older individuals were more likely to have a positive CAGE-AID and have used drugs more than 100 times. Younger individuals were more likely to use marijuana in the past month.ConclusionsThese findings highlight cultural strengths and comparatively low rates of tobacco and alcohol use among Native American college students in the Southwest.     

Acculturative stress as a moderator of the effect of drinking motives on alcohol use and problems among young adults

BackgroundResearch has demonstrated a strong relationship between drinking motives and alcohol use among young adult populations. Further, there is substantial evidence of the association between psychosocial stressors and greater alcohol consumption. In the present study, we examined whether acculturative stress would moderate the relationship between major drinking motives and alcohol use behaviors and alcohol-related problems, and whether this relationship differs by racial/ethnic group.MethodSix hundred diverse undergraduate students (mean age = 21.50, SD = 2.46; 82.8% female; 40.2% White/Caucasian) completed a series of measures, including demographic information, alcohol use/alcohol problems, and acculturative stress.ResultsFindings showed varying patterns in the moderating effect of acculturative stress on the relationship between drinking motives and alcohol consumption and alcohol-related problems, particularly for self-identified Hispanic, Black, and Asian students. Stronger drinking motives were associated with greater alcohol consumption and alcohol-related problems, and this relationship was stronger among Asian and Hispanic students who reported higher levels of acculturative stress. For Black students, greater acculturative stress was observed to weaken the relationship between coping, enhancement, and conformity motives and alcohol drinking frequency.ConclusionsResults are discussed in terms of incorporating acculturative stress in the development of tailored alcohol use interventions for vulnerable young adults, such as certain ethnic minority and immigrant groups. Clinical implications include screening for acculturative stress in primary care and counseling centers and early intervention programs to identify young adults who may be at-risk for or currently experiencing alcohol problems.     

Alcohol prevention: What can be expected of a harm reduction focused school drug education programme?

Aim: This pilot study investigated what alcohol prevention benefits could be achieved by a harm reduction focused school drug education intervention that addressed all drug use, both licit and illicit.

Method: The study population comprised a cohort of 225 students in three intervention secondary schools and 93 students in a matched control school in Victoria, Australia. A classroom drug education programme, derived from evidence of effective practice and designed to reduce alcohol and other drug harm, was provided to the intervention students during years eight (13–14 year olds) and nine (14–15 year olds) by teachers trained in its delivery. The control students received the drug education programme normally provided by their school.

Findings: The students, who received the intervention, were more knowledgeable about drug use issues, communicated more with their parents about alcohol, drank less, got drunk less, and experienced fewer alcohol related harms. They also remembered receiving more alcohol lessons. They were, however, no less likely to have tried alcohol.

Conclusions: The findings are consistent with other studies that have demonstrated school alcohol education that focuses on harm reduction can be effective in reducing consumption, risk and harm. In this study, this was achieved even though the students were not persuaded against taking up drinking, and the intervention did not focus solely on alcohol. These findings have implications for both the goals and coverage of future school drug education programmes.     

Animal house: University risk environments and the regulation of students’ alcohol use

BackgroundThis article extends the risk environment framework to understand the factors that universities identify as influencing university students’ risky drinking behaviours and universities attempts at managing risky alcohol use on their campuses.MethodsThis article examines data collected as part of qualitative fieldwork on university corporate security services, and others involved in university alcohol policy implementation (e.g., residence services), conducted at five Canadian universities. Interviews (n = 56), fieldnotes from 246 h of observations of university corporate security personnel, and university policy documents (i.e., codes of student behaviour, residence policies) were analysed to understand the influence of risk environments on high-risk alcohol use.ResultsWe identify three risk environments on university campuses in relation to the use and regulation of alcohol: the physical, social, and policy environments. Residence buildings and abutting spaces (physical risk environment) and the university “party” culture (social risk environment) are principal contributors to risk within their risk environments. University policies and practices (policy risk environment) attempt to modify these environments in order to manage risky alcohol use.ConclusionWe suggest current approaches to regulating student alcohol use may not be the best approach to preventing harms (e.g., health problems, legal troubles) to students. Given university policies and practices have the potential to shape and influence risky alcohol use and associated harms we argue it is necessary for university administrators to adopt the best practices of “harm reduction” and seek new ways to address on-campus alcohol use.     

Personality and motivational correlates of alcohol consumption and alcohol-related problems among excessive drinking university students

ObjectivesThe study had three objectives: (1) to assess relationships between personality characteristics and alcohol consumption and alcohol-related problems among university students who drink alcohol excessively; (2) to assess relationships between motivational structure and alcohol consumption and problems among students who consume excessive amounts of alcohol; and (3) to assess how personality characteristics and motivational structure are related to each other and how the two are jointly related to alcohol consumption and problems.DesignPersonality, motivational structure, alcohol use, and alcohol-related problems were assessed among 111 undergraduate students.FindingsMediation analyses showed that both maladaptive motivational structure and novelty seeking predicted participants' alcohol-related problems beyond that predicted by alcohol consumption.ConclusionFuture research should aim to reduce alcohol-related negative consequences by targeting students with a maladaptive motivational structure, while taking into account the role of personality characteristics. Screening and intervention programmes would benefit from addressing novelty seeking and maladaptive motivation.     

Posttraumatic Symptomatology and Alcohol Misuse Among Black College Students: Examining the Influence of Anxiety Sensitivity

Objective: Posttraumatic stress symptoms (PTSS) have been found to be associated with alcohol (mis)use among college students. Anxiety sensitivity has been theoretically and empirically linked to both PTSS and alcohol (mis)use. The goal of the present study was to extend research by examining the relations among PTSS, anxiety sensitivity, and alcohol misuse within a sample of trauma-exposed Black college students. Methods: Participants were 121 Black undergraduate college students who endorsed exposure to a traumatic event (M age = 22.98, 77.7% female). Results: Correlational findings provide support for significant positive relations between PTSS and both anxiety sensitivity and alcohol misuse. Further, analyses revealed a significant indirect effect of anxiety sensitivity on alcohol misuse through PTSS. Specifically, greater anxiety sensitivity was associated with higher levels of PTSS, which, in turn, were associated with higher levels of alcohol misuse. Conclusions: These findings suggest that the assessment of anxiety sensitivity may be useful in identifying trauma-exposed Black individuals who are likely to experience alcohol misuse and the clinical utility of addressing PTSS in this population reporting anxiety sensitivity to possibly prevent alcohol misuse and related negative consequences.     

Drinking,abstinence, and academic motives: Relationships among multiple motivational domains and alcohol use in college students

BackgroundDrinking, abstinence, and academic motives have been previously linked with alcohol consumption in high school and college students; however, little research has examined the impact of such sources of motivations concurrently.ObjectiveDrawing from self-determination theory (SDT; Ryan & Deci, 2000), the current study tested the hypothesis that alcohol-related and academic motives would be associated with one another along internal vs. external focused dimensions. We also examined the relative influence of these motives on alcohol consumption.MethodsCollege students (N = 226) completed self-report measures assessing drinking motives, abstinence motives, academic motives, and alcohol-related outcomes.ResultsFindings suggest that drinking motives are related to abstinence motives but not academic motives. Both forms of alcohol-related motives were related to alcohol use and consequences; no associations between academic motives and alcohol variables were observed.Conclusions/importanceThe lack of associations among academic motives, alcohol-related motives, and alcohol variables departs from previous findings suggesting that academic motives impact alcohol use. The current findings indicate a greater understanding of the interplay of motivational sets related to salient issues for youth, such as academics, is needed in order to expand intervention models for alcohol use in such populations.     

Polydrug use among 15- to 16-year olds: Similarities and differences in Europe

Aims: We describe types of polydrug use among school students across Europe and explore differences between high, medium and low drug prevalence countries.

Method: Analysis is based on survey data from over 70,000 15- to 16-year-old school students in 22 European countries. Polydrug use (defined as the use of two or more listed substances during the last 30 days) is compared across three country clusters based on drug prevalences by hierarchical cluster analysis. Affinity between substances is measured by pairwise associations and regression analysis was used to assess the differences in rate ratio across the country clusters.

Results: A third of all school students had consumed two or more substances. The most common combinations were: alcohol and cigarettes, followed by alcohol or cigarettes combined with cannabis, followed by alcohol or cigarettes, cannabis and at least one other illegal drug. Pairwise associations show that cannabis and cocaine users are more likely to use illegal drugs than the general student populations but least likely to do so in countries with high prevalence levels (p < 0.0005).

Conclusion: Consideration of country differences and objective measures for the concept of normalization could help to inform more holistic prevention initiatives that respond to country-specific contexts.     

The Prospective Effects of Impulsivity on Alcohol and Tobacco Use in a College Sample

Abstract

Alcohol and tobacco use are strongly associated, particularly in younger populations, and concurrent use may encourage progression toward dependence on both substances. Impulsivity has been linked to the use of alcohol and tobacco individually, but has not been studied in terms of its association with use of both. This study tested the hypothesis that the effects of impulsivity (sensation seeking and negative urgency) on smoking initiation in a sample of college students (n = 400) would be mediated by alcohol consumption. We also predicted that sensation seeking and negative urgency would predict alcohol and cigarette use and overlap among initiators.

Sensation seeking and negative urgency both predicted smoking initiation, but only the former effect was mediated by alcohol use. Among initiators, sensation seeking was associated with more frequent alcohol use as well as more frequent overlap between alcohol and tobacco use but not with smoking frequency. Higher negative urgency was associated with more frequent smoking, but not with alcohol use or alcohol/tobacco overlap. Findings are consistent with previous research in college samples and suggest the existence of multiple pathways to alcohol and tobacco use and co-use in college students.     

Adequate sleep moderates the prospective association between alcohol use and consequences

ObjectiveInadequate sleep and heavy alcohol use have been associated with negative outcomes among college students; however, few studies have examined the interactive effects of sleep and drinking quantity in predicting alcohol-related consequences. This study aimed to determine if adequate sleep moderates the prospective association between weekly drinking quantity and consequences.MethodCollege students (N = 568) who were mandated to an alcohol prevention intervention reported drinks consumed per week, typical sleep quantity (calculated from sleep/wake times), and perceptions of sleep adequacy as part of a larger research trial. Assessments were completed at baseline and one-, three-, and five-month follow-ups.ResultsHigher baseline quantities of weekly drinking and inadequate sleep predicted alcohol-related consequences at baseline and one-month follow-up. Significant interactions emerged between baseline weekly drinking quantity and adequate sleep in the prediction of alcohol-related consequences at baseline, one-, three-, and five-month assessments. Simple slopes analyses revealed that weekly drinking quantity was positively associated with alcohol-related consequences for those reporting both adequate and inadequate sleep, but this association was consistently stronger among those who reported inadequate sleep.ConclusionSubjective evaluation of sleep adequacy moderates both the concurrent and prospective associations between weekly drinking quantity and consequences, such that heavy-drinking college students reporting inadequate sleep experience more consequences as a result of drinking. Research needs to examine the mechanism(s) by which inadequate sleep affects alcohol risk among young adults.     

The relationship between situational determinants of use and drinking motives

Objective: Recent research has focused on motives as proximal factors of alcohol use that relate to problematic outcomes. High-risk situations for use are also salient predictors of use and negative consequences, and there is some evidence to suggest that situations of use align with motives for alcohol use. The goal of the current study was to examine whether situational use variables can potentially be a proxy for motives for use by evaluating the relationships between motives, rates of alcohol use, and situational use variables (situations of use, locations of use, use companions).

Methods: We utilized data from a randomized controlled treatment trial of a brief personalized feedback intervention and subsequent online assessments that focused on motives for alcohol use among 303 college students (77.9% female, mean age?=?19.8 years).

Results: Results substantiated several theoretical relationships between Social motives and drinking in positive affect situations with others, Coping motives and drinking alone in negative affect-driven situations, Enhancement and use in positive affective situations, and Conformity and drinking in situations that are not indicative of pleasant emotions. However, we failed to find significant relationships with overall rates of use except for among Enhancement-oriented drinkers.

Conclusion: Results provide insight into the relationships between motives and situations of use. Findings broadly support the use of situational measures as an indicator of motives and suggest future avenues of research and intervention.