Age at First Use of Energy Drinks Associated With Risky Alcohol-Related Motor Vehicle Behaviors Among College Students

Age at first use has been extensively studied in various substances, but remains unexplored in energy drinks. Recent studies suggest adolescent energy drink consumption is linked to alcohol misuse and high-risk motor vehicle behaviors. This study examined energy drink age at first use and high-risk motor vehicle behaviors among a sample (N = 468) of college students. Consumption of energy drinks at an earlier age predicted high-risk motor vehicle behaviors including driving after having too much alcohol, driving with a perceived blood alcohol content above the .08 limit, and knowingly choosing to ride with someone who had consumed too much alcohol. However, when controlling for various 30-day drinking behaviors, age at first energy drink use significantly predicted only driving with a perceived blood alcohol content above the .08 limit (p < .05), while number of days drunk during the past 30 days was shown to be a stronger predictor (p < .05) for all three high-risk driving behaviors.     

Daily Reports of Positive and Negative Affect and Alcohol and Marijuana Use Among College Student and Nonstudent Young Adults

Background: Daily affect and substance use covary among college students, but little is known about these associations among young adults not in college. Objectives: The current pilot study examines associations between positive and negative affect and alcohol and marijuana use, with a focus on differences between college student and nonstudent young adults. Methods: High school seniors completed a baseline survey during the spring of 2012 and were then randomly selected to participate in an intensive measurement follow-up. Participants in the follow-up (N = 72, 40.3% men, 77.8% White, 66.7% full-time college students) completed up to 14 consecutive web-based daily surveys during the fall after high school completion. Multilevel models in which days (Level 1) were nested in persons (Level 2) were estimated. Results: Weekend days were associated with increased alcohol use among all young adults, increased marijuana use among college students, and decreased marijuana use among nonstudents. For young adults not in college, greater daily positive affect was associated with increased likelihood of binge drinking, consuming a greater number of drinks, and lower odds of marijuana use; greater daily negative affect was associated with lower odds of alcohol use and lower odds of binge drinking for non-students. For college students, greater daily negative affect was associated with lower odds of marijuana use. Conclusions/Importance: Daily affect and alcohol and marijuana use covary among young adults, though these associations differ between students and non-students. Results highlight the need to examine predictors of alcohol and marijuana use among young adults who do not attend college.     

Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects

BackgroundNegative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship.ObjectivesExplore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions.MethodsA convenience sample of 2953 residents of New South Wales, Australia completed an online survey. N = 731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects.ResultsThere were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates.ConclusionsAmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels.     

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.     

Difficulties regulating positive emotions and alcohol and drug misuse: A path analysis

IntroductionAlcohol and drugs are widely used among college students. Emotion dysregulation has been identified as a key mechanism in the etiology, maintenance, and treatment of alcohol and drug misuse. Yet, research in this area has been limited by its narrow focus on dysregulation stemming from negative emotions. The goal of the current study was to extend past research by examining the relation of difficulties regulating positive emotions to alcohol and drug misuse.MethodsParticipants were 311 college students (M_age = 19.24; 66.1% female; 66.0% White) who completed measures assessing difficulties regulating positive emotions and alcohol and drug misuse.ResultsStructural equational modeling was used to model the relation between difficulties regulating positive emotions and alcohol and drug misuse. In a hypothesized structural model, higher levels of difficulties regulating positive emotions were found to relate to greater alcohol and drug misuse. Moreover, an alternative model provided support for an association of greater drug (but not alcohol) misuse to higher levels of difficulties regulating positive emotions.ConclusionsIf replicated, findings may suggest the utility of targeting difficulties regulating positive emotions in treatments aimed at reducing alcohol and drug misuse among college students.     

The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University

Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (M_age = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.     

Why are caffeinated alcoholic beverages especially risky?

PurposeEvidence suggests that people drink more alcohol and experience more adverse alcohol-related consequences (ARCs) on occasions when they also consume caffeine. The current study examined whether this increase in risk is a result of caffeine attenuating the subjective effects of alcohol intoxication (i.e., the masking hypothesis).MethodsUndergraduate students (n = 148) reported their drinking patterns using a modified Timeline Followback approach. For each recalled drinking occasion, alcohol consumption, caffeine consumption, perceived blood alcohol concentration, and ARCs were assessed. Generalized linear mixed models were used to examine the influence that alcohol and caffeine consumption had on perceived intoxication and the experience of ARCs.ResultsAt the occasion level, greater caffeine consumption was associated with increased consumption of alcohol and increased ARCs. There was also a significant curvilinear relationship between the amount of alcohol consumed and perceived intoxication, such that the more alcohol was consumed on each occasion the less each additional drink increased perceived intoxication. Increased caffeine consumption weakened the association between alcohol consumption and perceived intoxication and it also weakened the association between alcohol consumption and ARCs. Specifically, the weakest relationship between ARCs and alcohol consumption existed at the highest level of caffeine consumption (240+ mg). Caffeine increased subjective intoxication.ConclusionsThese findings do not support the masking hypothesis. Caffeine was strongly associated with ARCs when consumed at high doses and this effect does not appear to be the result of drinking more alcohol or underestimating one's blood alcohol content. Efforts to reduce caffeinated alcohol beverage use are greatly needed.     

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,marijuana, and opioid use disorders: 5-Year patterns and characteristics of emergency department encounters

ABSTRACT

Background: Changes in substance use patterns stemming from opioid misuse, ongoing drinking problems, and marijuana legalization may result in new populations of patients with substance use disorders (SUDs) using emergency department (ED) resources. This study examined ED admission trends in a large sample of patients with alcohol, marijuana, and opioid use disorders in an integrated health system. Methods: In a retrospective design, electronic health record (EHR) data identified patients with ≥1 of 3 common SUDs in 2010 (n = 17,574; alcohol, marijuana, or opioid use disorder) and patients without SUD (n = 17,574). Logistic regressions determined odds of ED use between patients with SUD versus controls (2010–2014); mixed-effect models examined 5-year differences in utilization; moderator models identified subsamples for which patients with SUD may have a greater impact on ED resources. Results: Odds of ED use were higher at each time point (2010–2014) for patients with alcohol (odds ratio [OR] range: 5.31–2.13, Ps < .001), marijuana (OR range: 5.45–1.97, Ps < .001), and opioid (OR range: 7.63–4.19, Ps < .001) use disorders compared with controls; odds decreased over time (Ps < .001). Patients with opioid use disorder were at risk of high ED utilization; patients were 7.63 times more likely to have an ED visit in 2010 compared with controls and remained 5.00 (average) times more likely to use ED services. ED use increased at greater rates for patients with alcohol and opioid use disorders with medical comorbidities relative to controls (Ps < .045). Conclusions: ED use is frequent in patients with SUDs who have access to private insurance coverage and integrated medical services. ED settings provide important opportunities in health systems to identify patients with SUDs, particularly patients with opioid use disorder, to initiate treatment and facilitate ongoing care, which may be effective for reducing excess medical emergencies and ED encounters.     

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.     

College student motivational determinants for combining alcohol and energy drinks: Early identification could be the key

Aims: Strategic energy drink marketing continues to target college students despite this group already being identified as high-risk for experiencing negative consequences. To better understand and predict drinking behaviors and to develop more effective prevention programs, this study examined students alcohol-only and combined-use positive drinking motives within subjects.

Methods: A convenience sample of college students (n?=?540) from a university in the Southwest United States voluntarily completed an online version of the Drinking Motives Questionnaire-Revised (α?=?0.96) to explore motives for consuming alcohol only and alcohol combined with energy drinks.

Findings: Results indicate college students who combine alcohol and energy drinks have more positive drinking motives than those who consume alcohol-only.

Conclusions: Positive drinking motivational determinants can be used to improve existing prevention programs and to help practitioners work more effectively with students to address alternative ways to achieve the desired social and cognitive effects of drinking.     

Opioid,cocaine, and amphetamine use disorders are associated with higher30-day inpatient readmission rates in the United States

Abstract

Background: Patients with substance use disorders (SUDs) are more likely to experience serious health problems, high healthcare utilization, and premature death. However, little is known about the contribution of SUDs to medical 30-day readmission risk. We examined the association between SUDs and 30-day all cause readmission among non-pregnant adult in-patients in the US. Methods: We conducted a retrospective study using 2010–2014 data from the Nationwide Readmissions Database. Our primary focus was on opioid use compared to stimulant use (cocaine and amphetamine) identified by ICD-9-CM diagnosis codes in index hospitalizations. Multivariable logistic regression models were used to estimate adjusted odds ratios and 95% CI representing the association between substance use and 30-day readmission, overall and stratified by the principal reason for the index hospitalization. Results: Nearly 118 million index hospitalizations were included in the study, 4% were associated with opioid or stimulant use disorder. Readmission rates for users (19.5%) were higher than for nonusers (15.7%), with slight variation by the type of substance used: cocaine (21.8%), opioid (19.0%), and amphetamine (17.5%). After adjusting for key demographic, socioeconomic, clinical, and health system characteristics, SUDs and stimulant use disorders increased the odds of 30-day all-cause readmission by 20%. Conclusions: Reducing the frequency of inpatient readmission is an important goal for improving the quality of care and ensuring proper transition to residential/outpatient care among patients with SUDs. Differences between groups may suggest directions for further investigation into the distinct needs and challenges of hospitalized opioid- and other drug-exposed patients.     

A computer-based feedback only intervention with and without a moderation skills component

Research on the efficacy of computer-delivered feedback-only interventions (FOIs) for college alcohol misuse has been mixed. Limitations to these FOIs include participant engagement and variation in the use of a moderation skills component. The current investigation sought to address these limitations using a novel computer-delivered FOI, the Drinkers Assessment and Feedback Tool for College Students (DrAFT-CS). Heavy drinking college students (N = 176) were randomly assigned to DrAFT-CS, DrAFT-CS plus moderation skills (DrAFT-CS +), moderation skills only (MSO), or assessment only (AO) group, and were assessed at 1-month follow-up (N = 157). Participants in the DrAFT-CS and DrAFT-CS + groups reported significantly lower estimated blood alcohol concentrations (eBACs) on typical heaviest drinking day than participants in the AO group. The data also supported the incorporation of a moderation skills component within FOIs, such that participants in DrAFT-CS + group reported significantly fewer drinks per week and drinks per heaviest drinking occasion than participants in the AO group.