Assessment of Changes in Alcohol and Marijuana Abstinence, Co-Use, and Use Disorders Among US Young Adults From 2002 to 2018.

Importance: Recent information on the trends in past-year alcohol abstinence and marijuana abstinence, co-use of alcohol and marijuana, alcohol use disorder, and marijuana use disorder among US young adults is limited. Objectives: To assess national changes over time in past-year alcohol and marijuana abstinence, co-use, alcohol use disorder, and marijuana use disorder among US young adults as a function of college status (2002-2018) and identify the covariates associated with abstinence, co-use, and marijuana use disorder in more recent cohorts (2015-2018). Design, Setting, and Participants: This study examined cross-sectional survey data collected in US households annually between 2002 and 2018 as part of the National Survey on Drug Use and Health. The survey used an independent, multistage area probability sample for all states to produce nationally representative estimates. The sample included 182 722 US young adults aged 18 to 22 years. The weighted screening and weighted full interview response rates were consistently above 80% and 70%, respectively. Main Outcomes and Measures: Measures included past-year abstinence, alcohol use, marijuana use, co-use, alcohol use disorder, marijuana use disorder, prescription drug use, prescription drug misuse, prescription drug use disorder, and other drug use disorders based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Results: The weighted sample comprised 51.1% males. Between 2002 and 2018, there was an annual increase in past-year alcohol abstinence among young adults (college students: 0.54%; 95% CI, 0.44%-0.64%; non-college students: 0.33%; 95% CI, 0.24%-0.43%). There was an annual increase in marijuana use from 2002 to 2018 (college: 0.46%; 95% CI, 0.37%-0.55%; non-college: 0.49%; 95% CI, 0.40%-0.59%) without an increase in marijuana use disorder for all young adults. Past-year alcohol use disorder decreased annually (college: 0.66%; 95% CI, 0.60%-0.74%; non-college: 0.61%; 95% CI, 0.55%-0.69%), while co-use of alcohol and marijuana increased annually between 2002 and 2018 among all young adults (college: 0.60%; 95% CI, 0.51%-0.68%; non-college: 0.56%; 95% CI, 0.48%-0.63%). Young adults who reported co-use of alcohol and marijuana or met criteria for alcohol use disorder and/or marijuana use disorder accounted for 82.9% of young adults with prescription drug use disorder and 85.1% of those with illicit drug use disorder. More than three-fourths of those with both alcohol use disorder and marijuana use disorder reported past-year prescription drug use (78.2%) and illicit drug use (77.7%); 62.2% reported prescription drug misuse. Conclusions and Relevance: The findings of this study suggest that US colleges and communities should create and maintain supportive resources for young adults as the substance use landscape changes, specifically as alcohol abstinence, marijuana use, and co-use increase. Interventions for polysubstance use, alcohol use disorder, and marijuana use disorder may provide valuable opportunities for clinicians to screen for prescription drug misuse.

Trends in non-drinking among Australian adolescents.

BACKGROUND AND AIMS: Recent evidence suggests that there has been a sharp increase in non-drinking among Australian adolescents. This study aimed to explore the socio-demographic patterns of this increase to identify the potential causal factors. DESIGN: Two waves (2001 and 2010) of cross-sectional data from the National Drug Strategy Household Survey, a large-scale population survey. Logistic regression analyses were used to identify significant changes over time, with interaction terms used to test whether trends varied by respondent characteristics. SETTING: Australia. PARTICIPANTS: Respondents aged 14-17 years (n = 1477 in 2001 and 1075 in 2010). MEASUREMENTS: The key outcome measure was 12-month abstention from alcohol. Socio-demographic variables including sex, age, income, socio-economic status, state and rurality were examined. FINDINGS: Rates of abstention increased overall from 32.9% [95% confidence interval (CI) = 30.0-35.7%) to 50.2% (95% CI = 46.7-53.6%) (P < 0.01). Abstention increased significantly across all population subgroups examined. CONCLUSIONS: A broad change in drinking behaviour has occurred among Australian adolescents in the last decade, with rates of abstention among 14-17-year-olds increasing markedly. Increases in abstention have occurred consistently across a wide range of population subgroups defined by demographic, socio-economic and regional factors.

Cannabis use during a voluntary quit attempt: an analysis from ecological momentary assessment.

BACKGROUND: There is little research that has sought to identify factors related to quit success and failure among cannabis users. The current study examined affective, cognitive, and situational factors related to cannabis use among current cannabis users undergoing a voluntary, self-guided quit attempt. METHOD: The sample consisted of 30 (33% female) current cannabis users, 84% of whom evinced a current cannabis use disorder. Ecological momentary assessment was used to collect multiple daily ratings of cannabis withdrawal, negative affect, peer cannabis use, reasons for use, and successful coping strategies over two weeks. RESULTS: Findings from generalized linear models indicated that cannabis withdrawal and positive and negative affect were significantly higher during cannabis use than non-use episodes. Additionally, when negative and positive affect were entered simultaneously, negative affect, but not positive affect, remained significantly related to use. Participants were significantly more likely to use in social situations than when alone. When participants were in social situations, they were significantly more likely to use if others were using. Participants tended to use more behavioral than cognitive strategies to abstain from cannabis. The most common reason for use was to cope with negative affect. CONCLUSIONS: Overall, these novel findings indicate that cannabis withdrawal, affect (especially negative affect), and peer use play important roles in cannabis use among self-quitters.

Self-reported never-drinkers in England 1994-2003: characteristics and trends in adults aged 18-54 years.

AIMS: This paper describes prevalences, time-trends and characteristics of self-reported never-drinkers, during the period 1994-2003, focussing particularly on white adults aged 18-54. METHODS: Data on 122,809 adults (18 + ) were obtained from the Health Survey for England (HSfE). Logistic regressions were used to estimate time trends in self-reported never-drinking, and associations between never-drinking and living alone, and educational qualification. Analyses were stratified by gender, age group and period. RESULTS: The overall proportion of white, female never-drinkers was 5.5%, rising monotonically with age. Proportions among men were much lower, with the lowest proportion (1.1%) in the 30-54 age group. Odds of never-drinking increased by 3% per year in those aged 30-54, a trend not explained by any covariates. Smaller increases were seen among those aged 18-29. Never-drinking was strongly associated with living with another adult and with lower qualification. The association with qualification increased over time among young women, and the association with living with another adult increased among men aged 30-54. CONCLUSIONS: Never-drinkers are a significant minority in England, whose prevalence rose, between 1994 and 2003, among adults aged under 55 years. The prevalence varies considerably by age, sex, and social characteristics, and the social discrepancies in never-drinking appear to be widening.