Prevalence and correlates of daily-level reasons not to drink among young adults who use alcohol.

BACKGROUND: This study examined reasons not to drink in young adults in relation to demographics, alcohol use patterns, timing (weekend vs. weekday), and typical drinking motives. METHODS: Young adults who reported past 30-day alcohol use and at least one nondrinking day (n = 614; mean age = 21.5 years ±0.53) completed a survey of alcohol-related measures (e.g., typical drinking motives) and up to 14 daily surveys that included 12 reasons not to drink assessed on nondrinking days. Multilevel logistic regressions were estimated for each reason not to drink and related covariates. RESULTS: The most common reasons not to drink on a given day were "wasn't interested in drinking" (83.4% of nondrinking days) and "didn't want to get drunk" (81.8% of nondrinking days), with over 96% of participants endorsing each of these at least once. On days (11.6%; by 29.5% of participants) when another drug was used instead of alcohol, 81.8% used cannabis. Sex, race/ethnicity, weekend (vs. weekday), and drinking motives were differentially linked to reasons not to drink. Reporting high-intensity drinking (i.e., ≥10 drinking on a day) versus binge (5-9 drinks on a day) in the past 2 weeks was linked to "had a hangover recently" (odds ratio = 2.85) as a reason not to drink. CONCLUSIONS: Findings suggest that reasons not to drink reflect personal decisions and highlight ways to acknowledge situational barriers (e.g., saving money for food and essentials) that can be emphasized in brief interventions. Furthermore, reasons not to drink and alcohol motives may work in tandem within the motivational model to impact alcohol use behaviors.

First semester college experiences: Associations with substance use and mental health.

Introduction: Substance use (SU) and mental health (MH) concerns often occur as students transition from high school to college and may be associated with first semester experiences. Methods: Incoming first-year college students at a U.S., predominantly white, midwestern university were recruited for an intervention study. Participants reported on substance use, mental health, and college experiences at the end of their first semester of college (n = 781; 62.9 % female, mean age = 18.06 [SD = 0.24]; 77.2 % non-Hispanic white; 84.6 % heterosexual). Data for these current analyses were cross-sectional. Results: Identifying as Black, Indigenous, or another Person of Color, as a sexual minority, or as female was associated with more challenging first semester experiences. Social experiences that represent more social engagement were associated with greater substance use. College experiences reflecting an easier transition were associated with fewer mental health concerns. Alcohol use moderated the relation between academic challenges and mental health with stronger associations found at greater levels of alcohol use. Conclusions: First semester experiences were related to student mental health and substance use, suggesting the importance of early, targeted support for students to adjust to campus life.

Historical Trends in Cannabis Use among U.S. Adults Aged 19-55, 2013-2021.

OBJECTIVE: The current study used U.S. national data to examine trends in cannabis use from 2013-2021, focusing on changes in cannabis prevalence during young and middle adulthood, and whether trends differed by sociodemographic characteristics. METHOD: Data from 2013-2021 from 21,133 respondents aged 19-30 and 29,898 aged 35-55 in the national Monitoring the Future panel study (followed since they were in 12th grade in 1976-2020) were used to model historical trends in cannabis prevalence (any 12-month use, any 30-day use, and near-daily use [20+ occasions in the past 30 days]). RESULTS: Prevalence of 12-month, 30-day, and near-daily cannabis use significantly increased from 2013-2021 for both young and middle adults. Trends for all three behaviors indicated either consistent linear increases or two-slope increases where the slope estimate was larger in more recent years. Historical increases in 12-month and 30-day use were similar for young and middle adulthood; the historical increase in near-daily use among middle adults had some evidence for a possible pandemic-related deviation. Historical trends did not differ by race/ethnicity or college degree. Trends for 12-month and 30-day use differed by sex, with females increasing more than males over time, especially during middle adulthood. CONCLUSIONS: Significant increases in the prevalence of cannabis use have occurred over the past decade for young and middle adults across sociodemographic groups, with some indication that near-daily use increased among middle adults at the onset of the pandemic. Although males continue to have higher prevalence than females, the gap has narrowed with greater increases in cannabis use among women.

Incremental Predictive Validity of the Dualistic Model of Passion for Cannabis Use Among College Undergraduate Students With and Without a Cannabis Use Disorder.

Introduction: We examined whether the Dualistic Model of Passion (DMP; i.e., obsessive passion [OP] and harmonious passion [HP]) for cannabis use was prospectively associated with cannabis use and use-related outcomes, and with academic performance, relationship attachment style, and social connectedness among college students. We also explored whether the DMP was associated with outcomes when included in a model using established constructs (e.g., coping motives, refusal self-efficacy, cannabis use disorder [CUD] symptoms) as predictors of cannabis use and outcomes. Methods: Using a longitudinal cohort design (baseline, 5-month, 10-month [timepoints chosen to better correspond to 9-month academic year]), 513 undergraduate students from two universities who reported using cannabis at least four times in the past month completed a baseline survey (308 meeting criteria for CUD). We used Generalized Estimating Equations to assess longitudinal associations between OP/HP and cannabis use and academic/social outcomes at 5-month and 10-month. Results: At baseline, participants were young adults (Mean age = 20.57, SD = 2.51), 78.8% non-Hispanic, 83.8% White, 55.0% female, and 72.3% heterosexual. Greater HP was not associated with greater past month cannabis use or cannabis-related problems. Greater OP was associated with greater past month cannabis use and more cannabis-related problems. There were no significant passion by time interactions. Greater HP was associated with more anxious attachment. OP was associated with less social connection. Conclusion: This research suggests that the DMP provides novel information about factors associated with cannabis use and use-related consequences, which can aid in our understanding of cannabis use, misuse, and CUD among college students.

Examining engagement effects in an adaptive preventive intervention for college student drinking.

OBJECTIVE: This study determined the characteristics of engagement and whether engagement in an adaptive preventive intervention (API) was associated with reduced binge drinking and alcohol-related consequences. METHOD: Incoming students were recruited for a sequential multiple assignment randomized trial (SMART; N = 891, 62.4% female, 76.8% non-Hispanic White) with an assessment-only control group. The API occurred during the first semester of college, with outcomes assessed at the end of the semester. The API involved two stages. Stage 1 included universal intervention components (personalized normative feedback [PNF] and self-monitoring). Stage 2 bridged heavy drinkers to access additional resources. We estimated the effect of engagement in Stage 1 only and in the whole API (Stages 1 and 2) among the intervention group, and the effect of the API versus control had all students assigned an API engaged, on alcohol-related outcomes. RESULTS: Precollege binge drinking, intention to pledge a fraternity/sorority, and higher conformity motives were most associated with lower odds of Stage 1 engagement. Action (readiness to change) and PNF engagement were associated with Stage 2 engagement. API engagement was associated with significant reductions in alcohol-related consequences among heavy drinkers. Compared to the control, we estimated the API would reduce the relative increase in alcohol-related consequences from baseline to follow-up by 25%, had all API students engaged. CONCLUSIONS: Even partial engagement in each component of the "light-touch" API rendered benefits. Analyses suggested that had all students in the intervention group engaged, the API would significantly reduce the change in alcohol-related consequences over the first semester in college. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The moderating role of mental health on the association between COVID-related stress, isolation, and economic hardship and using substances to cope.

Since young adulthood is a vulnerable period for adverse mental health experiences and high-risk substance use, it is critical to understand the impact of the COVID-19 pandemic on young adult mental health and substance use behaviors. Therefore, we determined whether the relationship between COVID-related stressors and using substances to cope with COVID-related social distancing and isolation was moderated by depression and anxiety among young adults. Data were from the Monitoring the Future (MTF) Vaping Supplement (total N = 1244). Logistic regressions assessed the relations between COVID-related stressors, depression, anxiety, demographic characteristics, and interactions between depression/anxiety and COVID-related stressors with vaping more, drinking more, and using marijuana to cope with COVID-related social distancing and isolation. Greater COVID-related stress due to social distancing was associated with vaping more to cope among those with more depression symptoms and drinking more to cope among those with more symptoms of anxiety. Similarly, COVID-related economic hardships were associated with using marijuana to cope among those with more symptoms of depression. However, feeling less COVID-related isolation and social distancing stress was linked to vaping and drinking more to cope, respectively, among those with more symptoms of depression. These findings suggest that the most vulnerable young adults are seeking substances to cope with the pandemic, while potentially experiencing co-occurring depression and anxiety along with COVID-related stressors. Therefore, intervention programs to support young adults who are struggling with their mental health in the aftermath of the pandemic as they transition into adulthood are critical.

Young Adult Physical, Social, and Temporal Contexts of Simultaneous Alcohol and Marijuana Use.

OBJECTIVE: Simultaneous alcohol and marijuana (SAM) use is reported to be associated with heavier alcohol and marijuana use and more negative consequences, but less is known about the social, physical, and temporal contexts of SAM use. METHOD: Young adults (N = 326, 51.2% male, 49.1% White non-Hispanic) who reported past-month SAM use completed up to 14 daily surveys across five bursts that assessed SAM use and negative consequences and social, physical, and temporal contexts. We used multilevel models to examine SAM use contexts' associations with alcohol/marijuana quantity and consequences. RESULTS: The social context of alone only (vs. with others only) was associated with consuming fewer drinks. Physical contexts that included using both at home and outside the home (vs. only at home) were associated with greater alcohol and marijuana quantity and negative consequences (but not after controlling for alcohol quantity); use outside the home only (vs. only at home) was associated with more alcohol use, more alcohol consequences (but not after controlling for alcohol quantity), and fewer marijuana consequences (even after controlling for marijuana quantity). The temporal context of first engaging in SAM use before 6 P.M. (vs. after 9 P.M.) was associated with greater alcohol and marijuana quantity and more marijuana consequences (but not after controlling for number of hours high), and first engaging in SAM use between 6 and 9 P.M. was associated with more hours high. CONCLUSIONS: SAM use contexts such as using with others, using outside the home, and using earlier in the evening are typically associated with greater alcohol/marijuana quantity and consequences.

Alcohol Use Disorder Symptoms Reported during Midlife: Results from the Monitoring the Future Study among US Adults at Modal Ages 50, 55, and 60.

BACKGROUND: The extent to which adolescent substance use is associated with alcohol use disorder (AUD) symptoms in midlife is not yet fully explored. METHODS: Longitudinal data from the national Monitoring the Future study was used. The sample included 11,830 12th graders (1976-1987) who were surveyed again at modal ages 50 (37.8%), 55 (46.3%), or 60 (15.8%) in 2008-2019. Approximately 48.7% were male; 81.5% identified as non-Hispanic White. Weighted logistic and multinomial logistic regressions were used to examine associations between past 30-day use of cigarettes, marijuana, and alcohol at age 18, sociodemographics, and a midlife AUD symptom outcome (coded as non-drinking, drinking without AUD [endorsed ≤1 criterion], or AUD symptoms [endorsed 2+ criteria]). RESULTS: Prevalence of midlife AUD symptoms was 27.1%. Higher relative risk of reporting AUD symptoms (vs. drinking without AUD) was associated with age 18 substance use (any cigarette use [vs. no use], any marijuana use [vs. no use], binge drinking [vs. both no use and drinking at less than binge levels]), being male (vs. female), being non-Hispanic White (vs. non-Hispanic Black), and having a 4-year college degree. Higher relative risk of reporting non-drinking (vs. drinking without AUD) was associated with no 30-day alcohol use at age 18, being non-Hispanic Black or non-Hispanic other (vs. non-Hispanic White), and not having a 4-year college degree. CONCLUSIONS: Findings suggest substance use at age 18 has meaningful associations with midlife AUD symptoms. Dissemination of prevention and intervention efforts in adolescence and early adulthood may be important for reducing hazardous midlife drinking.

Initiation of and Escalation to High-Intensity Drinking in Young Adults.

Importance: High-intensity drinking (HID) (≥10 drinks in a row) is associated with acute negative outcomes. Identifying factors associated with HID initiation in adolescence and how it is associated with young adulthood outcomes can inform screening and prevention. Objective: To identify when individuals initiate HID and speed of escalation from first drink and first binge to first HID; characteristics associated with initiation and escalation; and whether these characteristics are associated with weekly alcohol consumption, HID frequency, and symptoms of alcohol use disorder at age 20 years. Design, Setting, and Participants: This cohort study analyzed web-based survey data from respondents in the US who reported alcohol use in the past 30 days recruited from the 2018 12th grade Monitoring the Future study and surveyed again from February 14 through April 17, 2020, at modal age 20 years in the Young Adult Daily Life Study. Only respondents who reported HID by modal age 20 years were included in the analyses. Exposures: Retrospective alcohol use initiation and self-reported alcohol use measures. Main Outcomes and Measures: Key retrospective measures included year of initiation for alcohol, first binge (≥5 drinks), and HID (≥10 drinks). Measures at age 20 years included weekly alcohol consumption, HID frequency, and Alcohol Use Disorders Identification Test (AUDIT) scores. Covariates included biologic sex, race and ethnicity, parental college education, family history of alcohol problems, and college status. Descriptive statistics and multivariable regression models were used, and all analyses were weighted. Results: Of the 451 participants with data eligible for analysis, 62.0% were male (38.0% female). On average, alcohol, binge, and HID were initiated during high school. Mean time of escalation from first drink to first HID was 1.9 (95% CI, 1.8-2.1) years and between first binge and first HID, 0.7 (95% CI, 0.6-0.8) years. Initiating HID by grade 11 (vs later) was associated with higher average weekly alcohol consumption (adjusted incidence rate ratio [aIRR], 1.40; 95% CI, 1.10-1.79]), HID frequency (aIRR, 2.01; 95% CI, 1.25-3.22]), and AUDIT score (adjusted odds ratio, 1.17; 95% CI, 1.02-1.34]) at age 20 years. Escalation from first binge to first HID in the same year (vs ≥1 year) was associated with higher HID frequency at age 20 years (aIRR, 1.66; 95% CI, 1.06-2.61). Conclusions and Relevance: These findings suggest that understanding ages and patterns of HID initiation and escalation associated with particular risk may facilitate screening for adolescents and young adults.

Alcohol use contexts (social settings, drinking games/specials, and locations) as predictors of high-intensity drinking on a given day among U.S. young adults.

BACKGROUND: This study examined whether variability in young adult drinking social settings, drinking games/drink price specials, and locations differentiated daily high-intensity drinking (HID) likelihood; whether contexts varied by legal drinking age and college status (attending a 4-year college full-time); and whether legal drinking age and college status moderated drinking context/intensity associations. METHODS: Participants (n = 818 people, 46.3% female) were part of the Young Adult Daily Life Study in 2019 to 2022. They were originally selected because they were past 30-day drinkers from the 2018 U.S. national probability Monitoring the Future 12th grade sample and because they reported one or more days of alcohol use during 14-day data collection bursts across the following 4 years (n = 5080 drinking days). Weighted multilevel modeling was used to estimate drinking context/intensity associations. Drinking intensity was defined as moderate (females 1 to 3, males 1 to 4 drinks), binge (4 to 7, 5 to 9 drinks), or HID (8+, 10+ drinks). Models controlled for other within-person (weekend, historical time period) and between-person (sex and race/ethnicity) covariates. RESULTS: Contexts differentiating HID and binge drinking days included drinking with large groups, strangers, pregaming, drinking games, and more drinking locations. Legal drinking age was associated with lower odds of free drinks but greater odds of drinking at bars/restaurants. College status was associated with lower odds of drinking alone or free drinks, but greater odds of drinking with friends, large groups, pregaming, drinking games, discounted price drinks, and at bars/restaurants, parties, and more drinking locations. Legal drinking age and college status moderated some context-intensity associations. CONCLUSIONS: Social settings, pregaming, drinking games, and drinking at more locations were associated with increased risk of HID on a given day. Legal drinking age and college status were associated with specific drinking contexts and moderated some context/intensity associations. Incorporating the contexts associated with HID into interventions may help to reduce HID and related consequences in young adults.

Race, Ethnic, and Sex Differences in Prevalence of and Trends in Hallucinogen Consumption Among Lifetime Users in the United States Between 2015 and 2019.

Background: The current study is one of the first to examine race, ethnic, and sex differences in the prevalence of and trends in hallucinogen use among lifetime users in the United States. Methods: Data came from the 2015-2019 National Survey on Drug Use and Health and included respondent's reporting ever-using hallucinogens (n = 41,060; female = 40.4%). Descriptive and multinomial logistic regression analyses were conducted in Stata. Results: Highest prevalence of past year hallucinogen use was among Asian females (35.06%), which was two-or-more times larger than prevalence of past year use among White males/females and Native American males. More than half of White males/females, Multiracial males, and Hispanic males reported had ever-used psilocybin or LSD, whereas less than one-quarter of Black males/females reported lifetime psilocybin use, and less than a third of Black females reported lifetime LSD use. Native American males had the lowest prevalence of lifetime MDMA use (17.62-33.30%) but had the highest lifetime prevalence of peyote use (40.37-53.24%). Pacific Islander males had the highest prevalence of lifetime mescaline use (28.27%), and lifetime DMT use was highest among Pacific Islander males/females (15.68-38.58%). Black, Asian, and Multiracial people had greater odds of past-year (ORs = 1.20-2.02; ps < 0.05) and past-month (ORs = 1.39-2.06; ps < 0.05) hallucinogen use compared to White people. Females had lower odds of past-year (OR = 0.79; ps < 0.05), past-month (OR = 0.78; ps < 0.05) hallucinogen use compared to males, except for lifetime use of MDMA (OR = 1.29; ps < 0.05). Conclusions: These findings should inform public health initiatives regarding potential benefits and risks of hallucinogen use among racial/ethnic groups and women.

Examining Same-Day Associations Between Cannabis Use Motives and Condom Use in Urban Emerging Adults: A Brief Report.

OBJECTIVE: Cannabis use is broadly associated with risky sexual behaviors, but evidence regarding how cannabis is related to condomless sex at the individual level is mixed. A better understanding of the context in which cannabis use is occurring, that is, why individuals are using cannabis on a particular day, could help clarify these relationships. Accordingly, we examined whether same-day cannabis use motives were associated with condomless sex on cannabis use days in a sample of unmarried, urban emerging adults from a resource-poor community. METHOD: Participants (N = 86; mean age = 22.0 years; 52.4% female) were recruited from an emergency department. They provided data over 28 days on cannabis use, cannabis use motives, and sexual behaviors via text message surveys. Multilevel, multinomial regression was then used to examine the associations between cannabis use motives and condomless sex at both the within-day and between-person levels. RESULTS: Results suggested that individuals who more frequently endorse conformity motives for cannabis use are more likely to engage in condomless sex, whereas individuals who more frequently endorse social cannabis use motives are less likely to engage in condomless sex. CONCLUSIONS: These findings help illuminate some of the factors related to the co-occurrence of cannabis use and condomless sex, which is important for informing interventions to prevent sexually transmitted infections for cannabis-using individuals. The results here specifically indicate that interventions targeting co-occurring cannabis and risky sex behaviors might benefit by incorporating cannabis use motives as markers of vulnerability.

Alcohol and cannabis motives: Differences in daily motive endorsement on alcohol, cannabis, and alcohol/cannabis co-use days in a cannabis-using sample.

OBJECTIVE: Same day use of alcohol and cannabis is prevalent among emerging/young adults and increases the risk for negative consequences. Although motives for alcohol and cannabis use are well-documented, specific motives on co-use days are under-investigated. We examined differences in motives on single substance use (i.e., alcohol or cannabis) versus co-use days in a sample of primarily cannabis-using emerging/young adults. METHODS: Participants (N=97) aged 18-25 (Mage=22.2) were recruited from an urban Emergency Department (55.7% female, 46.4% African American, 57.7% public assistance) for a prospective daily diary study about risk behaviors. Participants received prompts for 28 daily text message assessments (up to 2716 surveys possible) of substance use and motives (social, enhancement, coping, conformity). We divided use days into three groups: alcohol use only (n=126), cannabis use only (n=805), and co-use (n=237). Using fixed effects regression modeling, we fit models to estimate within-person effects of alcohol and cannabis motives on day type (alcohol/cannabis co-use versus single use). RESULTS: In adjusted models, greater cannabis-related enhancement and social motives were associated with increased likelihood of co-use days compared to cannabis-only days. In contrast, greater alcohol-related social motives were associated with co-use days versus alcohol-only days in unadjusted, but not in adjusted models. CONCLUSIONS: Findings suggest that cannabis use motives associated with increasing positive affect may be most compelling for those engaging in alcohol/cannabis use on a given day. Intervention programs for alcohol/cannabis use should address alcohol and cannabis use motives in relation to increasing positive affect and engaging in social situations.

Differences in child and adult biopsychosocial characteristics associated with regular cannabis use in individuals with and without cannabis use disorder.

BACKGROUND: Regular cannabis use, even without cannabis use disorder (CUD), is associated with numerous biopsychosocial problems. Biopsychosocial risk factors that precede regular use and CUD might reflect broader pre-existing risk factors rather than the consequence of cannabis use. We aimed to (1) replicate prior work differentiating psychosocial problems associated with regular cannabis use with or without CUD relative to no-use in adulthood, and (2) test if these use groups differed in biopsychosocial functioning in early and middle childhood. METHODS: Biopsychosocial characteristics of individuals at-risk for substance use problems (n = 402) reporting no-use, regular use without CUD, and regular use with CUD by young adulthood were prospectively compared during early childhood (ages 3-5), middle childhood (ages 9-11) and young adulthood (ages 18-25). RESULTS: Regular use (vs. no-use) was associated with more health problems (mean d = |0.57|), psychopathology (mean d = |0.72|), social and family environment risk (mean d = |0.88|) in childhood and adulthood and comorbid substance use in adulthood (mean d = |1.25|). Regular use with and without CUD was linked to similar, developmentally-persistent patterns of problems across domains. CONCLUSIONS: We found that childhood risk factors present many years prior to cannabis initiation (as early as age 3) differentiated patterns of adult cannabis use and CUD status in adulthood. Therefore, biopsychosocial impairments associated with regular cannabis use in adulthood is not solely attributable to cannabis exposure but can be traced back to early and persistent biopsychosocial risk that may benefit from early behavioral intervention, irrespective of CUD diagnosis.

Latent profile analysis of interpersonal problems: Attachment, basic psychological need frustration, and psychological outcomes.

The purpose of this project was to identify distinct profiles of circumplex interpersonal problems, cross-validate the profiles, and examine construct validity through associations with adult attachment, basic psychological needs frustration, and psychological outcomes. Undergraduates at two universities provided survey data. In Study 1 (N = 469), latent profile analysis identified three distinct profiles of interpersonal problems. We labeled these: Flexible-Adaptive, Exploitable-Subservient, and Hostile-Avoidant. Construct validity analyses suggested the Flexible-Adaptive profile was distinguished from the other two by lower attachment anxiety, whereas the Hostile-Avoidant profile was distinguished from the other two by higher attachment avoidance. In Study 2 (N = 423), we conducted profile similarity analyses to cross-validate Study 1 results, following the multistep procedure proposed by Morin et al. (Organizational Research Methods, 2016, 19, p. 231). Results suggested that when the data from Study 2 were constrained to fit the profile model derived from Study 1, with respect to means, variance, and latent profile membership, the model fit was equivalent. In Study 2, further evidence of construct validity suggested that the Flexible-Adaptive profile was distinguished from the other two by lower relatedness frustration and by lower competence frustration. Additionally, the Hostile-Avoidant profile was distinguished from the Exploitable-Subservient profile by higher relatedness need frustration. Validity evidence for these profiles indicated that those with the Hostile-Avoidant profile reported the most negative psychological outcomes, followed by those with the Exploitable-Subservient profile, while those with the Flexible-Adaptive profile reported the best psychological outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A quadripartite model of passion for marijuana use: Associations with consumption, consequences, craving, and satisfaction with life.

BACKGROUND: Identifying factors that can be targeted in intervention/prevention programs aimed at reducing marijuana-(MJ) related consequences is of critical concern due to the changing legislative landscape of MJ. The dualistic model of passion for MJ has indicated that two factors, obsessive passion (OP) and harmonious passion (HP), have unique effects associated with MJ use outcomes. New research suggests that a quadripartite approach could provide a more nuanced method to interpret risk and protective factors associated with MJ use. Therefore, we used moderation to investigate the associations among OP, HP, and MJ use outcomes. METHOD: A community sample of frequent MJ users was recruited using internet-based advertisements and completed web-based surveys (n=161; M age=27.3, SD=8.9; Male=87%; White/Caucasian=86%; M past30-dayMJuse=22.3, SD=9.9). HP was tested as the moderator between OP, and MJ related outcomes and conditional effects (+/-1 SD) were examined when interaction effects were significant. RESULTS: Only main effects for OP had a relation to quantity/frequency of MJ use and MJ intoxication, while main effects for OP and HP were associated with reduction attempts. Interaction effects were significant for MJ consequences, craving, and life satisfaction. Neither OP nor HP were significantly associated with substance use outcomes. CONCLUSIONS: Findings demonstrate that Pure OP and Mixed Passion are associated with greater risk. Mixed Passion may be a precursor to Pure OP and experiencing MJ-related consequences. Furthermore, Mixed Passion and Pure OP may be important targets for intervention/prevention programs designed to reduce negative outcomes.

Sex Differences in the Association Between Gaming and Serious Violence Among Predominantly African American Youth.

Video gaming, a remarkably popular hobby in the United States, has been consistently identified as a correlate of aggressive behavior, and this association is not limited to violent video gaming. Prior studies of sex differences in the association between video gaming and aggression have not controlled for other well-known violence correlates (e.g., substance use, community violence exposure, violence attitudes) or focused primarily on high-risk youth. In this study, we used data from an emergency department in Flint, Michigan (N = 409, 59.9% female, 93.4% African American) to identify sex differences in the association between video gaming and serious peer violence. Youth aged 14 to 20 years were recruited from October 2011 to March 2015, and self-administered computerized surveys including measures of demographics, violence perpetration, gaming frequency, substance use, community violence exposure, and violence attitudes. The primary outcome was an indicator of any serious violence perpetration (e.g., choking, burning, weapon violence) in the past 2 months. Using logistic regression, we estimated the association between gaming and serious violence perpetration, and how it varied by sex, while controlling for demographics, substance use, community violence exposure, and violence attitudes. Approximately 36.6% of males and 27.3% of females reported past 2-month serious violence. On adjusted analysis, hours spent gaming was associated with violence among females (odds ratio [OR] = 1.40, 95% confidence interval [CI] = [1.16, 1.78]), but not males (OR = 1.03, 95% CI = [0.89, 1.19]); in the model including both males and females, the interaction between hours gaming and sex was significant (p < .01). Our findings suggest video gaming is a stronger marker of severe violence perpetration in females than males among at-risk youth. Violence interventions among females may be improved by including content related to video gaming and identifying other prosocial activities for youth as an alternative to video gaming. Additional research is required to clarify the causal process underlying the identified associations, and to determine what aspects of video gaming are risk-enhancing.

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.

Evaluation of the Dualistic Model of Passion for Alcohol Consumption among Emerging Adults Engaged in Risky Drinking.

Understanding factors influencing risky drinking among emerging adults could enhance interventions to reduce adverse outcomes. As a motivational construct, the dualistic model of passion (i.e., obsessive passion: drinking is compelling and conflicts with other life activities/values; harmonious passion: drinking is an important, but not overwhelming, part of life) offers a novel explanation for persistent alcohol use. Yet, the dualistic model of passion has not yet been evaluated in this at-risk population. Therefore, we examined whether the variables proposed by the dualistic model of passion were associated with sex, binge-drinking, and alcohol-related consequences among young risky drinkers. We analyzed cross-sectional baseline data collected as part of an ongoing randomized controlled trial of emerging adults (n=327; M age=22.6, SD=1.1, range 21-24; 61% female; 76% White non-Hispanic) engaged in risky drinking (AUDIT-C score ≥ 4 females, ≥ 5 males) recruited nationally via social media advertisements. A path analysis revealed significant positive direct effects between obsessive passion and binge drinking and alcohol-related consequences, and significant negative direct effects between male sex and harmonious passion and binge drinking. There was also a positive direct effect between binge drinking and alcohol-related consequences. Male sex and obsessive passion were both indirectly related to alcohol-related consequences via binge drinking. Type of passion and male sex differentiates risky drinkers who binge drink and who experienced alcohol-related consequences. Future research should examine whether targeting obsessive passion reduces binge drinking and negative outcomes.

Prevalence and Predictors of Driving after Prescription Opioid Use in an Adult ED Sample.

INTRODUCTION: Prescription opioid use and driving is a public health concern given the risks associated with drugged driving, but the issue remains under-studied. We examined the prevalence and correlates of driving after taking prescription opioids (DAPO) among adults seeking emergency department (ED) treatment. METHODS: Participants (aged 25-60) seeking ED care at a Level I trauma center completed a computerized survey. Validated instruments measured prescription opioid use, driving behaviors, and risky driving. Patients who reported past three-month prescription opioid use and drove at least twice weekly were administered an extended study survey measuring DAPO, depression, pain, and substance use. RESULTS: Among participants completing the screening survey (n = 756; mean age = 42.8 [standard deviation {SD} =10.4]), 37.8% reported past three-month prescription opioid use (30.8% of whom used daily), and 14.7% reported past three-month DAPO. Of screened participants, 22.5% (n = 170) were eligible for the extended study survey. Unadjusted analyses demonstrated that participants reporting DAPO were more likely to use opioids daily (51.1% vs 15.9%) and had higher rates of opioid misuse (mean Current Opioid Misuse Measure score 3.4 [SD = 3.8] vs 1.1 [SD = 2.1]) chronic pain (80.7% vs 42.7%), and driving after marijuana or alcohol use (mean intoxicated driving score 2.1 [SD = 1.3] vs 0.3 [SD = 0.8]) compared to patients not reporting DAPO (all p<0.001). Adjusting for age, gender, employment, and insurance in a logistic regression model, participants reporting DAPO were more likely to report a chronic pain diagnosis (odds ratio [OR] = 3.77, 95% confidence interval [CI], 1.55-9.17), daily opioid use (OR = 3.81, 95% CI, 1.64-8.85), and higher levels of intoxicated driving (OR = 1.62, 95% CI, 1.07-2.45). Alcohol and marijuana use, depression, and opioid misuse were not associated with DAPO in adjusted analyses. CONCLUSION: Nearly one in six adult patients seeking ED care reported DAPO. The ED may be an important site for interventions addressing opioid-related drugged driving.