Public Religiosity,Religious Importance,and Substance Use Among Latino Emerging Adults

Objective: This study examined the relationship between religiosity (religious importance and public religion) and substance use (binge drinking and marijuana use) among Latino emerging adults. Method: Study utilized data (N = 2,442; 51.9% male) from wave 3 of the National Longitudinal Study of Adolescent Health (Add Health). Results: Only public religion was found to be a protective factor for both binge drinking and marijuana use. Conclusion: The study results suggest the potential for public forms of religion, such as attendance to services and activities, to act as a protective factor for substance use.     

Simultaneous Use of Alcohol and Marijuana: Patterns and Individual Differences

Background: Simultaneous alcohol and marijuana (SAM) use, or using alcohol and marijuana in such a way that their effects overlap, is associated with negative health and behavioral outcomes. Objectives: Our study sought to fill gaps in our knowledge on this emerging public health concern by comparing SAM users and alcohol-only users on individual-level factors and substance use outcomes as well as examining associations of SAM use frequency, within users. Methods: Participants were recruited through online postings. Our analytic sample consisted of 1017 young adults (18–25?years) who reported past-month alcohol use. Most were male (67.8%), Caucasian (71.5%), and had attended at least some college (74.8%). Results: Past-year SAM users reported higher levels of sensation seeking and greater perceptions of their close friends’ drinking behavior in comparison to alcohol-only users. SAM users reported heavier and more frequent alcohol use than alcohol-only users. Within past-year SAM users, 70% reported SAM use at least weekly. More frequent SAM use was associated with all alcohol use outcomes (e.g., weekly quantity, frequency, alcohol-related problems) and marijuana use outcomes (e.g., quantity, frequency, peak use) and higher drinking norms. Conclusions/Importance: It is clear that SAM users are a vulnerable sub-population of young adult drinkers. SAM users are differentiated from alcohol-only users in terms of their personality characteristics and perceptions of peer groups’ drinking. SAM users and more frequent users are also at heightened risk for substance use outcomes. Prevention and intervention efforts targeting high-risk drinking may benefit from also assessing whether they simultaneously use alcohol and marijuana.     

Personal Income and Substance Use among Emerging Adults in the United States

Background: Taxation and other policy measures have been implemented across the United States to curb the accessibility of substance use, especially among youth. While the inverse relationship between price and youth consumption is well known, available research on youth earned income and substance use is sparser, particularly among emerging adults. Objectives: We examined the association between emerging adult past-year personal income and 30-day substance use. Methods: We analyzed data from Wave 5 (n = 2,202) of the NEXT Generation Health Study, an annual survey study administered to a nationally representative sample of emerging adults in the U.S. Wave 5 (mean age = 20.28 years, SE = 0.02 years) was administered during the 2013–2014 academic year. After grouping participants into five levels of self-reported, pre-tax personal income, we used binomial logistic regression to examine the association between personal income and cigarette smoking, marijuana use, alcohol use, and heavy episodic drinking (HED). Results: In unadjusted models, those at certain levels of higher past-year income were more likely to smoke cigarettes, consume alcohol, or engage in HED at least once in the past 30 days. Several associations remained significant after controlling for covariates. Most associations were no longer significant after including perceived peer norms as additional covariates. Personal income was not associated with 30-day marijuana use in unadjusted or adjusted models. Conclusions/Importance: Higher earned income may provide emerging adults greater economic access to cigarettes and alcohol, but the association might be partly attenuated by social factors, particularly perceived peer norms.     

Adolescence to Young Adulthood: When Socioeconomic Disparities in Substance Use Emerge

We examined trends in cigarette, alcohol, and marijuana use by eventual educational attainment in 1,902 participants from Project EAT, a 10-year longitudinal study following participants from early adolescence through young adulthood. Generally, for cigarettes and marijuana, disparities were evident by early adolescence with prevalence of use highest among those who had no secondary education. With alcohol, use diverged during young adulthood when the college group reported the most weekly alcohol use while those without postsecondary education reported greatest daily use. When disparities in substance use behaviors first emerge and later escalate can guide how to craft and target interventions.     

Age of First Use as a Predictor of Current Alcohol and Marijuana Use Among College-Bound Emerging Adults

Background: Alcohol and marijuana are the most commonly used psychoactive substances; however, the sequencing and relationship between age of first use and continued current problematic use among college-bound emerging adults is not well understood.

Methods: This is a cross-sectional study of current and historical alcohol and marijuana use among college-bound recent high school graduates (N = 1,365; age ～18 years).

Results: Drinking was prevalent (78%, N = 1,055) and marijuana use was prevalent (46%, N = 622). Stepwise logistical regression revealed the lower the age of first use, the higher the prevalence of current problematic substance use. Those who initiate alcohol ≤ 12 are twice as likely to currently use marijuana frequently. A significant relationship was found between age of first use and non-social substance use (drinking, p = 0.0001; marijuana, p = 0.0025). The temporal ordering of substance use indicates that alcohol precedes marijuana use, and age of first alcohol use is relevant to rates of initiation and current marijuana use.     

Usefulness of the CRAFFT to Diagnose Alcohol or Cannabis Use Disorders in a Sample of Emerging Adults with Past-Month Alcohol or Cannabis Use

Background: Emerging adults between the ages of 18 and 25 have the highest rates of illicit drug use and heavy alcohol use. The purpose of this study was to determine the performance of the Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) screening to identify alcohol and cannabis use disorders using Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria in a sample of emerging adults who use alcohol or cannabis or both. Methods: Study participants were recruited as part of a larger intervention study of health behaviors among emerging adults between the ages of 18 and 25 reporting alcohol and/or cannabis use. As part of baseline data collection, responses to the CRAFFT (score range: 0–6) and the Structured Clinical Interview for DSM-IV (SCID) were recorded. Additional questions about craving permitted approximation with DSM-5 diagnoses of alcohol and cannabis use disorders. Results: Participants (N = 382) averaged 21 (±2.1) years of age, 47% were male, 65% were non-Latino Caucasian, and using the SCID 42% met criteria for an alcohol use disorder and 45% met criteria for cannabis use disorder. When evaluating for any alcohol use disorder alone, using a cutoff score of 4, the sensitivity was 81.4% but the specificity was only 45.3%. At a cutoff score of 4, sensitivity for identifying any cannabis use disorder alone was 83.7% and specificity was 48.6%. Conclusions: In emerging adults who report using alcohol or cannabis, the CRAFFT had low specificity for predicting alcohol or cannabis use disorder, despite using higher cut scores than previously published. The CRAFFT's utility in determining clinical substance use disorders in this population may be limited.     

Psychological Risk Factors for Alcohol,Cannabis, and Various Tobacco Use among Young Adults: A Longitudinal Analysis

Background: Alcohol, cannabis, and tobacco use are prevalent in young adults and may be differentially related to psychological symptoms characterized as externalizing or internalizing. Objectives: This study examined the use of alcohol, cannabis, and various tobacco products in relation to externalizing (ADHD) versus internalizing factors (depression, anxiety), hypothesizing alcohol and cannabis use are associated with externalizing factors whereas tobacco use is related to internalizing factors. Methods: Data from a 2-year longitudinal study of 2,397?US college students (aged 18–25) launched in 2014 were analyzed. Adult ADHD Self-Report Scale, Patient Health Questionnaire-9 item (assessing depressive symptoms), and the Zung Self-Rating Anxiety Scale scores were examined in relation to subsequent past 30-day use of alcohol, cannabis, and tobacco products (cigarettes, little cigars/cigarillos, smokeless tobacco, e-cigarettes, hookah), as well as nicotine dependence per the Hooked on Nicotine Checklist. Results: Participants were 20.49 (SD = 1.93) years old, 64.7% female, and 65.5% White. In multivariable analyses, greater ADHD symptoms predicted alcohol and cannabis use (p = .042 and p = .019, respectively). Cigarette and little cigar/cigarillo use were predicted by greater depressive (p = .001 and p = .002, respectively), and anxiety symptoms (p = .020 and p = .027, respectively). Nicotine dependence was correlated with greater anxiety symptoms (p = .026). Counter to hypotheses, smokeless tobacco use was predicted by greater ADHD symptoms (p = .050); neither e-cigarette nor hookah use were predicted by these psychological symptoms. Conclusions/Importance: Research examining risk factors for tobacco use must distinguish among the various tobacco products. Moreover, interventions may need to differentially target use of distinct substances, including among the range of tobacco products.     

Novel Psychoactive Substance and Other Drug Use by Young Adults in Western Australia

Abstract

There is a lack of information regarding the use of novel psychoactive substances (NPS) in Western Australia. The aim of this study was to pilot-test an online survey to obtain data on the prevalence of NPS and other drug use by young Western Australians aged between 18 and 35 years. The Young Adult Drug and Alcohol Survey (YADAS) was a questionnaire deployed online for a period of six months. Participants were recruited via a combined targeted sampling and snowball methodology. There were 472 valid responses. Overall lifetime use of NPS was relatively high (17.6%), while use in the last year was lower (6.6%). These proportions were comparable to that of cocaine use. The most popular NPS were the synthetic cannabinoids. The proportions of respondents drinking alcohol at risky levels, mixing alcohol with energy drinks, and using pharmaceuticals such as ADHD medications for non-medical reasons were high. The YADAS is the first survey to ascertain the prevalence of use of numerous types of NPS in a large sample of young Western Australian adults. The utilization of an online survey methodology yielded valid results as compared to more intensive surveys, and enables researchers greater flexibility in being able to capture current trends.     

Religiosity,Refusal Efficacy,and Substance Use Among African-American Adolescents and Young Adults

Abstract

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.     

High Socioeconomic Status Predicts Substance Use and Alcohol Consumption in U.S. Undergraduates

Background: In health sociology, the prevailing consensus is that socioeconomic status (SES) lowers illness risk. This model neglects the fact that unhealthful consumption patterns may covary with affluence. The current study examines consumption of drugs and alcohol among affluent U.S. college students. Objectives: The article tests the hypothesis that undergraduate students from high-SES households have higher rates and levels of drug and alcohol consumption than their peers. Methods: The study used self-report data from 18,611 18- to 24-year-old undergraduates across 23 public and private U.S. institutions from the Healthy Minds 2016 dataset. Results: I found that high-SES undergraduates were more likely than peers to use marijuana, choose varied drugs, consume alcohol frequently, and use alcohol and substances to cope with stress. The first three results were robust after controlling for gender, race, residence type, and relationship status. Marital status and race were stronger predictors than SES. Asians and married students were the least likely to use alcohol and drugs. Conclusions/Importance: Findings supported the main hypotheses, and the effects were robust to controls. Consumption of illicit drugs and alcohol may be one hitherto neglected reason for downward mobility among economically privileged college students.     

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.     

The Association of Alcohol Consumption with Tobacco Use in Black and White College Students

This study explored the association of alcohol and tobacco use among college students. A survey was administered in 2004 to 2,189 Black and White students from the southeastern United States. The prevalence of alcohol and tobacco use, tobacco use characteristics according to level of alcohol consumed, and percentage of students using tobacco according to type of alcoholic beverages consumed were evaluated. The interaction of race and gender with alcohol and tobacco use was explored. Our findings extend prior investigations that have found alcohol use associated with smoking and suggest attention be paid to the relation of alcohol to other forms of tobacco. Racial and gender differences are highlighted. This study was funded by Mayo Clinic. The study's limitations were noted.     

Alcohol Use Severity Among Hispanic Emerging Adults in Higher Education: Understanding the Effect of Cultural Congruity

Background: Identifying and understanding determinants of alcohol use behavior among Hispanic college students is an increasingly important public health issue, particularly during emerging adulthood. Studies examining ethnocultural determinants of alcohol use behavior among Hispanic college students have focused on direct associations with cultural orientation (e.g., acculturation and enculturation); yet there is a need for research that accounts for the complex interplay of other culturally relevant sociocultural factors. Objectives: This study examined associations of behavioral acculturation, behavioral enculturation, and cultural congruity (perception of cultural fit between the values of the academic environment and the student's personal values) with alcohol use severity (AUS); and tested if gender moderated those associations. Methods: A hierarchical linear regression and moderation analysis were conducted on a sample of 167 Hispanic emerging adults (ages 18–25) enrolled in college. Results: All predictor variables entered in the regression model accounted for 20.9% of the variance in AUS. After controlling for demographic variables and depressive symptoms, behavioral acculturation and enculturation did not have a statistically significant association with AUS. Further, gender did not moderate either of these associations. Conversely, greater cultural congruity was associated with lower reports of AUS. A moderation analysis suggested that cultural congruity predicted lower reports of AUS among men, but not among women. Conclusions: This was the first known study to examine the association of cultural congruity with alcohol use. Findings highlight the value of examining contextual factors of culture and moving beyond reductive measures of cultural orientation.     

Aggression Among Young Adults in the Social Context of the Bar

The purpose of the study was to explore the use of naturalistic observation and interview data to increase understanding of aggression in the social drinking context of the bar. Fifty-two incidents of aggression in bars were documented through interviews with 34 respondents aged 19–25, and 117 incidents were documented by male-female pairs of researcher-observers over 93 nights of observation, usually conducted between midnight and 2:30 a.m. on weekend nights. The data indicated that naturally-occurring incidents sometimes had no clear beginning or end and participants' roles often changed during the conflict (e.g., peacemaker to aggressor). Most incidents involved five or more participants; almost 3/4 of incidents involved only males; 2/3 of incidents involved at least moderate physical aggression; and 1/3 occurred partly or wholly outside the bar. Participants in incidents involving severe aggression or a larger number of participants tended to be more intoxicated than participants in less severe incidents with fewer participants. Four general issues were identified as triggering aggression: conflict with staff, bar activities, trouble making and offensive behavior, and interpersonal or relationship issues. The implications for research and prevention are discussed.     

Reported Maternal Styles and Substance Use: A Cross-Sectional Study Among Educated Albanian Young Adults

The study explored a predictive model of substance use including perceived maternal parenting style, age and gender. Participants were 347 Albanian young adults (144 males and 203 females) aged 18 to 28 years. They completed the Parental Authority Questionnaire and the Adolescent Alcohol and Drug Involvement Scale. Gender, perceived authoritative maternal style, and age predicted a proportion of substance use involvement. Gender and perceived authoritative maternal style also predicted the proportion of young people at risk for substance use or abuse. Implications of the findings and limitations of the study are discussed.     

Relations between Positive Temperament,Substance Use,and Internalizing Problems among Adolescents and Young Adults with and without Medical Conditions

Background: Substance use problems are prevalent during emerging adulthood and may be particularly harmful for individuals with medical conditions. Understanding the role of positive temperament in substance use for adolescents and young adults (AYAs) may facilitate the identification of intervention and prevention targets given the complex relations between positive emotions and substance use. Objective: To examine whether components of positive temperament differentially relate to substance use in a sample of AYAs with and without medical conditions. Internalizing problems were examined as a secondary outcome given their comorbidity with substance use. Method: In a cross-sectional study that took place in 2015–2016, 494 AYAs (M_age = 19.30 years, SD = 1.33, 73% female) who were enrolled in college completed online questionnaires in a laboratory regarding their levels of positive temperament (i.e., high intensity pleasure and positive affect) as well as their substance use and internalizing problems. The primary analyses were conducted using structural equation modeling. Results: For healthy AYAs, high intensity pleasure was positively associated with drug and alcohol use problems and positive affect was negatively associated with drug use problems. Among AYAs with medical conditions, high intensity pleasure was positively associated with alcohol use problems. Positive affect was negatively associated with internalizing problems for both groups. Conclusions/Importance: Findings identify paths between components of temperament and substance use and internalizing problems that may inform prevention and intervention efforts tailored to the unique and overlapping needs of AYAs with a range of healthcare demands.     

Reasons for Marijuana and Tobacco Co-use Among Young Adults: A Mixed Methods Scale Development Study

Background: Marijuana-tobacco co-use has increased recently, particularly in young adults. Objectives: We conducted a mixed-methods study to: (1) examine reasons for co-use; and (2) develop a scale assessing reasons for co-use among participants in a longitudinal cohort study of 3,418 students aged 18-25 from 7 Georgia colleges and universities. Methods: Phone-based semi-structured interviews were conducted in Summer 2015 among 46 current (past 30-day, n = 26) or lifetime (n = 20) marijuana users. Subsequently, scale items were developed and included at Wave 3. Participants reporting past 4-month tobacco and marijuana use (n = 328) completed the Reasons for Marijuana-Tobacco Co-use section. Results: Per qualitative data, reasons for marijuana-tobacco co-use included synergistic effects, one triggering or preceding the other's use, using one to reduce the other's use, co-administration, social context, and experimentation. The survey subsample included 37.1% who used cigarettes, 30.4% LCCs, 9.4% smokeless, 23.7% e-cigarettes, and 30.4% hookah. Four subscale factors emerged: (1) Instrumentality, indicating synergistic effects; (2) Displacement, indicating using one product to reduce/quit the other; (3) Social context, indicating use in different settings/social situations; and (4) Experimentation, indicating experimentation with both but no specific reasons for co-use. These subscales demonstrated distinct associations with tobacco type used; nicotine dependence; marijuana and alcohol use frequency; tobacco and marijuana use motives, respectively; perceptions of tobacco and marijuana; and parental and friend use. Including these subscales in regressions predicting nicotine dependence and days of marijuana use significantly contributed to each model. Conclusions: These findings might inform theoretical frameworks upon which marijuana-tobacco co-use occurs and direct future intervention studies.     

Synthetic Cannabinoids: Use and Predictors in a Community Sample of Young Adults

Background: Synthetic cannabinoids (SCs) are a class of drugs of abuse with deleterious consequences. Despite governmental regulations related to distribution and sale, SC variants are still available online. More research is needed to determine SC use prevalence and factors associated with SC use, especially among young adults. Methods: One thousand eighty individuals, 18–25 years old, were surveyed, between January 2012 and July 2013, during recruitment for a randomized controlled trial investigating health behaviors in young adults. Advertisements were placed online and in community locations seeking individuals “who had recently used marijuana or alcohol.” Respondents were queried about their use of alcohol and drugs, including SCs, in the last month. Results: Participants averaged 21.4 years old and were 53.4% male. Nearly 59% were non-Hispanic white, 15% were African American, 15% were Hispanic, and 11% identified as other. Approximately 9% reported SC use in the last month, a level higher than the reported use of opioids, cocaine, or hallucinogens. SC use was significantly associated with male gender, not being enrolled in school, and with use of cigarettes, binge alcohol drinking, daily and weekly marijuana use, and other drugs of abuse. There was a significant decrease in SC use after the federal ban in July 2012. Conclusions: SC use was common in the past month and often overlaps with other drug use, particularly marijuana use, and should be asked about during clinical encounters with young adults.     

Legally Tripping: A Qualitative Profile of Salvia Divinorum Use Among Young Adults

Abstract

During recent years, there has been increasing interest in “legal highs” among youth and young adults. Salvia divinorum is a legally available hallucinogenic plant, primarily utilized in smokable form, that produces a brief but intense hallucinogenic experience for the user. Data are presented from an ethnographic project to provide a qualitative profile of salvia use among young adults. Most users report primarily using in home settings such as apartments and houses, although a significant minority report use in environments such as parks, bars, and parties. The intense nature of the substance creates a differential subjective experience. Some describe the intensity of the hallucinogenic experience in positive ways. Others find the experience so intense that they would not continue to use the substance. With regard to the health effects of salvia, most young adults report no significant negative health effects from salvia use, although some report a mental cloudiness. Beyond their own experiences, users did not report any negative health events among peers. The lack of reports of negative effects may reinforce social norms favorable towards salvia use. Overall, young adults report a relatively low risk profile for salvia divinorum, which may be influenced, in part, by its legal status.