Discussion of alcohol consequences during a brief motivational intervention session: Comparing those who do and do not increase readiness to change.

The present study was designed to take an inductive, qualitative approach to understanding how discussion of alcohol-related consequences during brief motivational interventions (BMI) relate to readiness to change (RTC) prior to versus at the end of a session. Participants were thirty-four adults (35% female) recruited from the emergency room and enrolled in a randomized clinical trial of a BMI for risky alcohol use and risky sex. Seventeen participants both began and remained low on RTC over the course of the session. We selected 17 additional participants, matched on demographics, but who increased RTC over the session. Transcripts were qualitatively coded and analyzed separately within groups. Among participants who increased their RTC relative to participants who remained low on RTC by BMI end, evaluation of alcohol consequences as negative was more typical. In both groups, several consequences were neutrally evaluated. Many who remained low on RTC attributed consequences to something other than alcohol and/or minimized consequence severity. Study findings highlight the value for clinicians in eliciting and maximizing the importance of subjectively negative recent consequences to perhaps increase heavy drinkers' readiness to decrease heavy alcohol use.

A qualitative examination of the decision-making process of simultaneous alcohol and cannabis use: Intentions and willingness.

BACKGROUND: Alcohol and cannabis use are common among young adults and most young adults who use both substances have used them simultaneously (i.e., using both substances so their effects overlap). Because simultaneous use is associated with a greater number and severity of consequences than single substance use, research is needed to examine the decision-making process of engaging in this high-risk behavior. We conducted a qualitative examination of intentions (i.e., plans) and willingness (i.e., one's openness to engage in the behavior if an opportunity presents itself) to engage in simultaneous use from the perspective of young adults who frequently report this substance use behavior. METHODS: We recruited 36 young adults who reported simultaneous use and heavy drinking (4+/5+ drinks for women/men; 64% women, ages 18 to 25) to participate in semi-structured interviews. All interviews were double coded for thematic analysis and both novel and a priori themes were found. RESULTS: Young adults distinguished between intending to engage in simultaneous use and being willing to engage in simultaneous use. They reported that intentions and willingness varied from occasion to occasion. They also reported that context and alcohol consumption influenced their willingness to engage in simultaneous use. Peer pressure or offers increased their willingness to use cannabis while drinking and having current or next-day responsibilities decreased their willingness to engage in simultaneous use. Additionally, planned simultaneous use occasions were characterized as being special events where young adults consumed more substances, but were more likely to monitor their use than unplanned occasions. CONCLUSIONS: Intentions and willingness may be important proximal predictors of simultaneous use of alcohol and cannabis. Building off this qualitative work, quantitative research should identify which factors influence the decision-making process to engage in simultaneous use and determine when intentions and willingness are most predictive of risky simultaneous use behavior.

A qualitative examination of positive and negative consequences young adults experience from simultaneous alcohol and cannabis use.

OBJECTIVE: Alcohol and cannabis are two of the most commonly used substances among young adults, and most individuals who use both substances use them simultaneously, that is, on the same occasion such that their effects overlap. Given the high prevalence of simultaneous alcohol and cannabis use, it is important to understand the relationship between simultaneous use and consequences. This study presents a qualitative examination of positive and negative consequences of simultaneous use. METHOD: We conducted individual interviews among 36 young adults who engage in simultaneous use (23 women, 12 men, 1 trans man). Interviews included open-ended questions examining negative and positive consequences of simultaneous use and how simultaneous use differed from single substance use (alcohol only use, cannabis only use). Interviews were analyzed using applied thematic analysis. RESULTS: Young adults reported numerous negative and positive consequences of simultaneous use, many overlapping with single substance use. Yet, they also reported unique combinations of positive consequences not experienced by single substance use. Young adults discussed patterns of use that were sometimes approached intentionally (e.g., quantity of substances used, order) that influenced consequences. CONCLUSIONS: Together these findings provide further insight into young adults' simultaneous use experiences. Next steps should include quantitative exploratory research to identify and determine the frequency of specific consequences experienced during simultaneous use and examine the relationship between simultaneous use consequences and particular patterns of use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Insights into the context of simultaneous alcohol and cannabis use among young adults.

Simultaneous alcohol and cannabis use (simultaneous use) is common among young adults and is associated with a greater number of substance use-related consequences compared to single substance use. Understanding what drives simultaneous use among young adults is crucial. This study aimed to gather qualitative data on physical, social, and situational characteristics of simultaneous use among young adults. Participants were 36 heavy drinking young adults (Mage = 21.79) who engaged in simultaneous use at least twice during the past 30 days. Individual semistructured interviews were conducted via Zoom videoconferencing. Thematic analyses were used to analyze interview data. Findings indicated that young adults are selective of where and with whom they engage in simultaneous use with. Physical characteristics associated with simultaneous use included being in familiar and safe locations. Young adults were less likely to engage in simultaneous use in public spaces. Social characteristics associated with simultaneous use included being at parties, being around close peers, and if others are approving of and/or also using alcohol and cannabis so their effects overlap. Being around family or being alone decreased the likelihood of simultaneous use. Situational characteristics associated with simultaneous use included having access to alcohol and/or cannabis, being a weekend and/or evening, pregaming, and using cannabis at the end of a drinking occasion. Young adults based their decision to engage in simultaneous use on a range of physical, social, and situational contextual factors. Future research should examine multiple characteristics of the context in order to identify specific context with an increased risk of simultaneous use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gender, acculturation, and alcohol-related consequences among college students of color.

OBJECTIVE: The present study examined if identification with mainstream American culture (acculturation) and heritage culture (enculturation) are differentially associated with blackouts and other drinking consequences among male and female college students of color. PARTICIPANTS: Participants were college students (N = 150) who self-identified as a racial/ethnic minority and endorsed blackouts in the past year. METHODS: Regression models were used to examine gender-by-acculturation/enculturation interaction effects on alcohol-induced blackout and other alcohol-related consequences. RESULTS: While acculturation was not significantly associated with either drinking outcome, enculturation showed a significant relationship with blackout frequency. Gender moderated this relationship; greater enculturation was associated with increased blackout frequency among male but not female students. CONCLUSIONS: The present findings suggest the importance of considering the interplay between enculturation and gender in understanding alcohol use among college students of color. Men who endorse high levels of enculturation may be at an increased risk of experiencing negative drinking-related consequences.

How do college students subjectively evaluate "blackouts"?

Blackouts (i.e., alcohol induced memory impairment) are common among college student drinkers, and they are associated with several additional harms. However, alcohol consequences are not perceived universally as negative by the students who experience them, and little is known regarding students' specific thoughts and feelings about blackouts. We conducted a series of single-gender focus groups (8 groups; 5-8 per group; n = 50, 56% female) with college student drinkers. Questions focused on: (a) their subjective evaluations of blackouts and (b) factors influencing those evaluations (i.e., what determines whether a blackout is perceived as a negative/neutral/positive experience). Verbatim transcripts were content analyzed using applied thematic analysis with NVivo software. Evaluations of blackouts were primarily negative, with some notable positive, neutral and mixed reactions. Influences on blackout evaluations included those demonstrated as influential on broader alcohol consequences in prior work (e.g., normative perceptions, social context). However, some contextual influences on evaluations that may be specific to blackouts included pre-blackout events, the objective severity (extent/length) of memory loss, what participants later learned had happened during the blackout, and whether or not they had expected to blackout. Findings provide insight into why some students are not necessarily concerned with blackout experiences.

College student knowledge of blackouts and implications for alcohol intervention: A qualitative analysis.

Blackouts (periods of alcohol-induced anterograde amnesia) are common among young adults and place individuals at significant risk for alcohol-related harm; thus, researchers have advocated for increased efforts to educate young adults on blackouts. This qualitative study examined college student knowledge of blackouts as well as their ideas for intervening on blackout drinking behavior in order to inform prevention and intervention efforts. College students who had experienced a blackout in the past 6 months participated in eight focus groups, stratified by gender (N = 50, five to eight/group, 56% female). Discussions followed a semistructured agenda. Audio recordings were transcribed verbatim and coded using applied thematic analysis. Themes related to knowledge were reviewed in comparison to the empirical literature. Empirically derived risk factors for blackouts included biology (e.g., genetics, biological sex), drinking behavior (i.e., rate of consumption), other drug use, and "indirect" influences (e.g., pregaming, drinking location). Participants' knowledge of the risk factors for blackout was inconsistent and, in some cases, inaccurate. While participants generally understood the behavioral risk factors for blackouts, they demonstrated less understanding of the role of genetics, biological sex, drinking speed (vs. quantity), and other drug use. They also identified dehydration and sleep as perceived risk factors for blackout. They suggested avenues for intervention at the policy (e.g., amnesty policies), peer (e.g., expressing concern), and individual (e.g., education) levels. College students with a history of blackout have limited understanding of the biological risk factors for blackout. These knowledge gaps represent targets for intervention. Findings indicate promise for blackout-specific interventions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).