Prevalence and trends of alcohol use and misuse among adolescents and young adults in the Netherlands from 1993 to 2000

This study presents an overview of Dutch studies on prevalence of alcohol use and adds findings from our own study on prevalence of drinking among adolescents and young adults aged 12-30 years in the Netherlands. Data were collected as part of a longitudinal study by the Netherlands Twin Register in 1993 (n=3885), 1995 (n=4814), 1997 (n=3772) and 2000 (n=4090). Measures included lifetime alcohol use, frequency of drinking, quantity of drinking, lifetime drunkenness, frequency of drunkenness and problem drinking. The main findings are: (a) alcohol use increased with age until the age of 25, after which it decreased; (b) males exceeded females on all aspects of alcohol use, with exception of the youngest age group and lifetime alcohol use; (c) time trends indicated an increase in frequency and quantity of drinking among 12-15-year-old adolescents during the 1990s; and moreover, (d) 21-25-year-old females drank more frequently, consumed more drinks a week, had more experience with lifetime drunkenness and were drunk more often in 2000 than in 1993. Among 21-25-year-old males, an increase of drunkenness and problem drinking was displayed during the 1990s.     

Tobacco use, heavy use, and dependence among adolescents and young adults in the United States

Tobacco involvement among US youth was investigated in a national survey conducted in 2005-2007 of 2,274 respondents aged 14-21, including those not in school. Logistic regressions predicted tobacco involvement. Males had higher rates of tobacco use than females, but males and females had equal rates of heavy use and dependence. Tobacco involvement increased with age. Whites were more tobacco involved than minorities. Tobacco involvement declined with increasing socioeconomic status. Reduced tobacco use was associated with being married and with being a student. Smokeless tobacco use was associated with being male, older, white, and lower socioeconomic status. The implications of these results are discussed.     

Alcohol use, condom use and partner type among heterosexual adolescents and young adults

OBJECTIVE: The present study examined the links between alcohol use and condom use, and the nature of the sexual relationship in which these behaviors occurred, and tested the notion that partner type suppresses the negative, direct effects of alcohol use on condom use. METHOD: Data were collected as part of face-to-face interviews conducted with 1,417 (54% female) randomly selected young adults (aged 18-25 years) who had had sex in the past 6 months. RESULTS: Using within-subjects analytic procedures, results showed that both drinking and condom use were more common with casual than with serious sexual partners, as expected. Moreover, consistent with the suppression hypothesis, the relationship between alcohol use and condom use became significant and negative only after controlling for partner type. CONCLUSIONS: These findings suggest that the interrelationships among partner type, alcohol use and condom use are complex and that the processes linking each pair of variables are best understood as part of a larger system of interconnected variables.     

Understanding the motivations for recreational marijuana use among adult Canadians

The Canadian Special Senate Committee on Illegal Drugs (2003) noted that little ethnographic research had been devoted to exploring why people use marijuana recreationally or the social contexts in which it is used. The purpose of this exploratory qualitative research is to better understand both of these neglected topics through interviews conducted with 41 adult Canadian users between 2005 and 2006. The participants' ages ranged from 21 to 61 and included 25 males and 16 females whose consumption patterns ranged from sporadic use to regular daily use. They were predominantly middle class, employed in a wide range of occupations, and used marijuana recreationally to enhance relaxation and concentration while engaged in leisure activities. Implications for drug laws and policies are discussed. The study's limitations are noted.     

Religiosity, refusal efficacy, and substance use among African-American adolescents and young adults

Research points toward multiple pathways (i.e., psychosocial domains) through which religiosity influences substance use behaviors. This study examined whether refusal efficacy mediated the relationship between religiosity and substance use in African-American adolescents and young adults. Four hundred thirty-five urban and rural African-Americans, aged between 12 and 25, completed measures of private and public religiosity, refusal efficacy, and substance use (i.e., tobacco, alcohol, marijuana, and other illicit drug use). Tests for mediation were computed with private and public religiosity as independent variables, drug refusal efficacy as mediator, and substance use as the criterion. Results show that drug refusal efficacy mediated the relationship between private religiosity and tobacco, marijuana, and other illicit drug use, but not for alcohol use. Refusal efficacy also mediated the relationship between public religiosity and alcohol use, but not for other licit and illicit substances. The findings provide support for the unique impact of public religiosity when considering its role in preventive intervention. Future research should consider examining other psychosocial domains which may mediate the effect of religiosity on substance use behaviors among African-American adolescents.     

Heroin use in adolescents and young adults admitted for drug detoxification

Purpose: To examine heroin use and associated morbidity in young adults undergoing drug detoxification. Methods: A retrospective chart review of all persons (ages 18–25) admitted to either of the two state-funded detoxification facilities in Rhode Island was conducted between June 1998 and June 1999. Only those reporting heroin as a primary drug were included in this study (N=201). Results: Clients were largely male (64%), and white (79%), with a mean age of 22. Of those that reported heroin as their primary drug, 62% used primarily by injection. Mean age of initiation for heroin use was 18.3 years. Twenty-two percent reported a psychiatric diagnosis, and 80% reported a substance-abusing family member. Injection, previous overdose, and a mother with a history of substance use were associated with early initiation of heroin use. Conclusions: The majority of young adults with heroin addiction undergoing detoxification began using heroin during late adolescence. Cooccurrence of psychiatric and medical diagnoses with heroin addiction was common, and may contribute to the severity of drug use. Efforts to identify risk factors for heroin and other injection drug use in adolescents and young adults will be critical for the design of effective interventions to prevent injection drug use and its associated morbidities.     

Relationship between extent of cocaine use and dependence among adolescents and adults in the United States

The relationships between intensity of cocaine use, route of administration and past year dependence were investigated in a nationally representative sample of past year cocaine users aged 12 and over (N = 2,349) from three aggregated surveys (1991-1993) of the National Household Survey on Drug Abuse (NHSDA). An approximate measure of DSM-IV dependence criteria was developed from self-reported symptoms of dependence and drug-related problems. The model and the data provided no basis for rejecting the hypothesis that the logit of the probability of dependence increased linearly with the logarithm of the frequency of cocaine use in the past year and with quantity of cocaine use in the past 30 days. The associations between frequency and quantity of cocaine use and cocaine dependence varied significantly by an age-by-gender interaction and race/ethnicity. African-American users, who had higher rates of cocaine dependence than whites, used cocaine more frequently, used it by more addictive routes (smoking or injection), and were more likely to use crack. Adolescent females, who reported higher rate of cocaine dependence than males, used cocaine more frequently and reported more symptoms at low doses of cocaine use. Multivariate logistic regressions indicated that frequency and quantity of use, as well as route of administration, retained unique associations with cocaine dependence. Implications of the findings for the epidemiological study of cocaine use and dependence are discussed.     

Mediational relations of substance use risk profiles,alcohol-related outcomes,and drinking motives among young adolescents in the Netherlands

Aim

To examine the mediation by drinking motives of the association between personality traits (negative thinking, anxiety sensitivity, impulsivity, and sensation seeking) and alcohol frequency, binge drinking, and alcohol-related problems using a sample of students (n = 3053) aged between 13 and 15, who reported lifetime use of alcohol.

Method

Structural equation modeling was used to examine the relationship between personality traits and alcohol-related outcomes. The Model Indirect approach was used to examine the hypothesized mediation by drinking motives of the association between personality traits and alcohol-related outcomes.

Results

In this study among young adolescents, coping motives, social motives and enhancement motives played a prominent mediating role between personality and the alcohol outcomes. Multi-group analyses revealed that the role of drinking motives in the relation between personality and alcohol outcomes were largely similar between the sexes, though there were some differences found for binge drinking. More specifically, for young males, enhancement motives seems to play a more prominent mediation role between personality and binge drinking, while for young females, coping motives play a more mediating role between personality and binge drinking. Few mediation associations were found for conformity motives, and no relationships were found between anxiety sensitivity and drinking motives.

Discussion

Already in early adolescence, personality traits are found to be associated with drinking motives, which in turn are related to alcohol use. This study provides indications that it is important to intervene in early adolescence with interventions focusing on personality traits in combination with drinking motives.     

Reliability of use, abuse, and dependence of four types of inhalants in adolescents and young adults

Inhalants, as a class of drugs, consists of heterogeneous substances that increase the probability of many serious illnesses and death. Research on inhalant abuse has lagged behind other drugs partly because of the need for a diagnostic instrument of different types of inhalants. This study was conducted to obtain reliability estimates for the new Substance Abuse Module DSM-IV inhalants diagnoses for four types of inhalants: aerosols, gases, nitrites, and solvents as well as different diagnostic configurations of inhalant-related criteria. Participants were 162 community sample adolescents or young adults (mean age=20.3 years, S.D.=2.4). Two-thirds of the sample was male and 83.3% was Caucasian. Kappas and intraclass correlation coefficients were computed to estimate test-retest reliabilities. Results suggested (a) abuse was more common than dependence (34.6% versus 12.3%), (b) reliabilities of abuse criteria and diagnosis were good to excellent across subtypes, and (c) reliabilities of dependence criteria and diagnoses were poor to good across subtypes. Alternative configurations of DSM-IV criteria that were consistent with previous research on adolescents provided excellent reliabilities across subtypes of inhalants. Moreover, 11.1% of participants experienced inhalants withdrawal.     

Relations between dissociative experiences,borderline personality disorder symptoms and cannabis use in adolescents and young adults

The aim of the study was to evaluate the relations between cannabis use, dissociative experiences and borderline personality disorder symptoms. A convenient sample of 212 subjects composed of high school students completed questionnaires assessing cannabis use frequency, the symptoms of dependence, the symptoms of dissociation and borderline personality disorder using the Dissociative Experience Scale (DES) completed by a subscale measuring hyper-personalization/hyper-realization experiences and the Borderline Personality Inventory (BPI), respectively; 114 (54%) were cannabis users. Multiple regression analyses showed that the frequency of cannabis use was negatively predicted by the frequency of spontaneous experiences of absorption and imaginative involvement and positively predicted by the frequency of experiences of absorption and hyper-personalization and hyper-realization linked to cannabis use. Cannabis dependence was predicted only by borderline personality symptoms. Positive dissociative experiences appear to be an important element in the understanding of cannabis use in adolescents and young adults.     

Drinking styles of adolescents and young adults

Drinking among adolescents and young adults has received more attention during the recent past, but little research has focused on the drinking styles that might characterize younger people. A typology of drinking behavior has special relevance for this group, since the adolescent years and young adult years are formative in the development of drinking habits. This study used a model that had been applied to "normal" drinking behaviors of adults. However, the set of drinking variables was expanded to cover a wider range of activities, and a second set of behaviors, intended to reflect potential "problem" drinking, were derived from the National Council on Alcoholism criteria for the diagnosis of alcoholism. The set of 55 "normal" drinking behaviors was factor analyzed, yielding a six-factor structure. The first four factors were quite similar to previous work on adult drinking styles, and the remaining two factors clearly related to the drinking of younger people. The "problem" drinking variables yielded a two-factor structure, one set consisting of serious but uncommon experiences and the second set consisting of less serious and more common experiences. Several of the "normal" drinking factors were significant predictors of the "problem" drinking scores, suggesting that certain styles of drinking are more likely than others to lead to later problems.     

Trends in use of electronic nicotine delivery systems by adolescents

Electronic nicotine delivery systems (ENDS) have been gaining in popularity. The few prevalence studies in adults have found that most ENDS users are current or former smokers. The objectives of this study were to estimate the prevalence of ENDS usage in adolescents, and examine the correlates of use. Self-administered written surveys assessing tobacco use behaviors were conducted in multiple waves as part of a larger intervention study in two large suburban high schools. The prevalence of past-30 day ENDS use increased from 0.9% in February 2010 to 2.3% in June 2011 (p = 0.009). Current cigarette smokers had increased odds of past-30 day ENDS use in all study waves. When adjusted for school, grade, sex, race and smoking status, students in October 2010 (Adjusted OR 2.12; 95% confidence interval (CI): 1.12–4.02) and June 2011 (Adjusted OR 2.51; 95% CI: 1.17–4.71) had increased odds past-30 day ENDS use compared to February 2010. The prevalence of ENDS use doubled in this sample of high school students, and current cigarette smoking is the strongest predictor of current use. Continued monitoring of ENDS is needed to determine whether it increases the likelihood of cigarette smoking initiation and maintenance in youth.     

A comparison of motivations for use among users of crack cocaine and cocaine powder in a sample of simultaneous cocaine and alcohol users

This study examined the motivations for using cocaine and alcohol comparing those who primarily smoked crack and those who primarily used cocaine powder when using simultaneously with alcohol. Motivations examined included: 1) to cope with a negative affect, 2) enhancement, 3) to be social and 4) to conform. The research design was a cross-sectional study in which clients in treatment for cocaine and alcohol problems completed a self-administered questionnaire about their substance use. Among those who primarily smoked crack or snorted cocaine when also using alcohol (n = 153), there were 93 participants who reported primarily snorting cocaine and 60 participants who primarily reported smoking crack. Bivariate analyses found that those who primarily smoked crack reported lower social motivations to use alcohol and cocaine. When adjusting for other covariates in a multivariate analysis, social motivation was still significantly different between groups. Additionally, those who primarily smoked crack were more likely to be older, report higher cocaine dependence severity, be unemployed and were less likely to have completed some post-secondary education, than those who primarily snorted cocaine. No differences were found in enhancement, coping or conformity motivations between the two groups. These results suggest that simultaneous cocaine and alcohol use may have social importance to those who primarily snort cocaine, but that this importance is less evident to those who smoke crack. Consequently, future studies examining motivations for simultaneous cocaine and alcohol use should distinguish between different routes of cocaine administration.     

The interaction of alcohol and tobacco use in adolescents and young adults: Bogalusa Heart Study

Alcohol and tobacco usage patterns were assessed in 1,811 children and young adults, 12-24 years of age. The prevalence of cigarette smoking and alcohol consumption increased with age in all race and sex groups. Smokeless tobacco use (chewing tobacco and snuff) was primarily seen in white males with the highest prevalence rates in 12-15 year olds. Among white males who reported smokeless tobacco usage, 44% of the 12-17 year olds and 80% of the 18-24 year olds reported concurrent alcohol use. There was a significant interaction between alcohol consumption and cigarette smoking in all four race-sex groups (p less than 0.001). Given the potential synergistic relationship between ethanol and tobacco products on oral and upper gastrointestinal tract cancer, as well as between smoking and cardiovascular disease, the long term effects from these behaviors could be troublesome. Since healthy lifestyles are established in youth, early intervention on alcohol and tobacco use is needed to prevent the future morbidity and mortality from cancer and cardiovascular disease.     

Alcohol, cannabis, ecstasy and cocaine: drugs of reasoned choice amongst young adult recreational drug users in England

This paper describes the current drugs consumption patterns of a cohort of English young adults who have been tracked, longitudinally, since they were fourteen. It compares their tobacco, alcohol and illicit drugs consumption at 22 years (n=465) with when they were 18 years (n=529) using self-report questionnaires and in-depth interviews (n=86). It further explores whether, as a very drugwise/experienced sample of adolescents, this cohort are now beginning to settle down and reduce their substance use. The results suggest that any reductions in recreational drug use are likely to be delayed beyond traditional markers. The cohort have largely maintained their consumption habits with rates for current tobacco smoking (35.5%), regular drinking (82.3%), on-going drug involvement (past year, any drug, 52.1%) and more regular use (past month, any drug, 31.2%) being almost identical to their rates at 18 years. Current drug involvement is increasingly dominated by cannabis however. A minority continue to use ecstasy. LSD and amphetamine use have declined but cocaine trying (lifetime prevalence 5.9% at 18 years up to 24.6%) and use have increased dramatically. Mixing and combining substances is commonplace. Hedonistic motives for these substance use patterns remain but are now joined by the need to use psycho-active repertoires ‘sensibly’ to relax and reduce the stresses of the working week. This style of recreational drug use by generally conforming adults offers a severe challenge to current national drugs strategy.     

Genetic influences on quantity of alcohol consumed by adolescents and young adults

OBJECTIVE: To examine genetic and environmental influences on drinking in a nationally representative study of genetically informative adolescents followed into young adulthood. METHOD: The average quantity of alcohol used per drinking episode during the past year was analyzed in 4432 youth assessed during adolescence (mean age of 16) and then 1 and 6 years later. The variance of quantity of alcohol consumed was decomposed into three components: additive genetic (a2), shared environmental (c2), non-shared environmental (e2). Four candidate genes were tested for association. RESULTS: Wave 1 a2-0.52e2-0.48, Wave 2 a2-0.28e2-0.72, Wave 3 a2-0.30e2-0.70. Genetic correlations between Waves 1 and 2 were 0.85, Waves 1 and 3 were 0.34. The DAT1 440 allele was associated at Wave 1 (p=0.007). DRD2 TaqI A1/A2 was associated at Wave 3 (p=0.007). DRD4 and 5HTT were not associated. The DAT1 and DRD2 polymorphisms accounted for 3.1% and 2.0% of the variation, respectively. CONCLUSION: Genetic influence on drinking behavior was common in adolescents longitudinally assessed 1 year apart, but was less correlated between these adolescents and their assessment as young adults at a subsequent time point. Polymorphisms in genes of the dopaminergic system appear to influence variation in drinking behavior.