Adult Substance Use Research Articles

Substance Use and Misuse in Older Adults: A Need for Research and Intervention

Substance Use and Misuse in Older Adults: A Need for Research and Intervention

Alcohol use in adolescents and adult psychopathology and social outcomes: Findings from a 35-year cohort study.

To examine the consequences of alcohol consumption and symptoms of alcohol use disorder during adolescence and later adulthood psychopathology and social outcomes. A longitudinal, prospective birth cohort study, the Christchurch Health and Development Study, was examined across a 35-year period. We estimated the associations between two measures of adolescent alcohol use (volume of alcohol consumed and symptoms of alcohol use disorder) and two later internalising disorders, externalising psychopathology measured by substance use disorders and psychosocial outcomes in adulthood, adjusting for individual and family factors from childhood. The pattern of results indicates alcohol symptoms predict internalising disorder in adulthood. Volume of alcohol used in adolescence predicted adult substance use disorders, lower educational attainment and higher risk of welfare benefit receipt in adulthood in fully adjusted models. Early consumption of larger volumes of alcohol led to continuation of this pattern in adult life with resulting poorer educational achievement, increased welfare benefit receipt and substance use disorders. Early symptoms of alcohol use disorder, however, led to increased adult levels of mental health disorders. This relationship persisted within a 20-year study period and after adjustment for statistically significant covariate factors. The study shows that early patterns of alcohol use have a direct and specific impact upon adult outcomes.

Substance Use: Links with Sensory Sensitivity, Attachment Insecurity, and Distress in Young Adults

Background: Adolescence and young adulthood are periods of increased substance use, with insecurely attached individuals at greater risk of abusing substances. With recent evidence linking insecure attachment with sensory sensitivity, and evidence that both are linked with higher levels of distress, there is a need to consider these variables in relation to substance use in a sample of young adults. Methods: A convenience sample of 223 young adults (18–24 years) completed self-report measures of attachment, sensory sensitivity, use of various substances (e.g. alcohol, legal and illegal drugs, cigarettes, energy drinks), and distress. Correlation, t-test, and regression/mediation analyses were conducted. Results: Sensory sensitivity was positively correlated with insecure attachment. Anxious attachment was related to problematic substance use, frequent cigarette use, and misuse of prescribed medications. Avoidant attachment was associated with frequent use of cigarettes and energy drinks. Sensory sensitivity, attachment anxiety, and attachment avoidance each had significant indirect effects on problematic substance use, mediated by increased levels of distress. Conclusions: Sensory sensitivity and attachment insecurity both appear to impact problematic substance use in young adults through elevated levels of distress. Findings support consideration of sensory- and attachment-informed interventions with this population.

Peer Pressure and Substance Use in Emerging Adulthood: A Latent Profile Analysis

Introduction: Peers play an important role in influencing emerging adults’ substance use behaviors, however, research on peer pressure has typically not been extended beyond adolescence to include emerging adulthood. Little research has examined the relationships between various peer pressure domains and emerging adult substance use. Methods: This study used quantitative data from 359 emerging adults (aged 18-29 years, M = 25.46 years; 60.8% female; 74.2% White) to explore the associations between different types of peer pressure (e.g. peer pressure to socialize and peer pressure to use substances) and substance use among a diverse sample of emerging adults. Latent profile analysis and path analysis were used for analysis. Results: Three unique profiles of perceived peer pressure emerged (negative peer pressure, positive peer pressure, and no perceived peer pressure). The negative peer pressure group was more likely to engage in binge drinking, lifetime alcohol use and lifetime marijuana use than the no peer pressure group. The positive peer pressure group was less likely to engage in lifetime alcohol or marijuana use compared to the no peer pressure group. Discussion: Findings suggest that peer pressure is associated with emerging adult substance use, in both negative and positive ways. Results of the current study provide the critical groundwork for more sophisticated studies seeking to understand the pathways by which positive and negative peer pressure impact emerging adult behavior.

Association between Leukocyte Counts and Physical Fitness in Male Military Members: The CHIEF Study

Low-grade inflammation, which is related to obesity and toxic substance use in young adults, may be associated with poor physical fitness. We investigated the association between total leukocyte count and physical fitness in a military cohort of 3,453 healthy young Taiwanese males aged 20–50 years in a cross-sectional study in 2014. Low-grade inflammation was defined according to equally sized quartiles of total leukocyte counts within the suggested normal limits (4.00–9.99 × 103/mm3). Aerobic fitness was assessed by the time for a 3-kilometer run test, and anaerobic fitness was evaluated by the numbers of sit-ups and push-ups performed in 2 minutes. Automatic monitoring systems were used to verify the scores for all procedures. Multiple linear regression was utilized to identify the associations among variables. When compared with the lowest counts (4.00–5.49 × 103/mm3), the second highest (6.50–7.49 × 103/mm3) and highest normal leukocyte counts (7.50–9.99 × 103/mm3) were correlated with longer times for a 3-kilometer run (β and 95% confidence intervals =4.93 (1.61, 8.25) and 4.65 (2.20, 7.10), respectively) and fewer numbers of push-ups performed in 2 minutes (β = −0.59 (−1.15, −0.03) and −0.56 (−0.96, −0.17), respectively), after adjustments for age, service specialty, waist circumference, body mass index, alcohol consumption, tobacco smoking, and physical activity. However, the association with 2-minute sit-ups was null. Our study suggested an inverse association between total leukocyte count and not only aerobic fitness but also parts of anaerobic fitness in young males. The temporal association needs confirmation in longitudinal studies.

Early substance use in the pathway from childhood attention-deficit/hyperactivity disorder (ADHD) to young adult substance use: Evidence of statistical mediation and substance specificity.

This study tested whether early and developmentally atypical substance use mediates risk for adult substance use among children with attention-deficit/hyperactivity disorder (ADHD), and whether that risk is substance-specific. Participants were children with ADHD previously enrolled in a randomized controlled trial (RCT), and a demographically similar non-ADHD group, assessed at 2 through 16 years after the original RCT baseline. Self-reports of heavy drinking, marijuana use, daily smoking, and other illicit drug use were collected at follow-ups to establish atypically early and frequent use. Models estimated statistically mediated effects of childhood ADHD on adult substance use via early substance involvement, with planned comparisons to evaluate substance specificity. Results supported the mediation hypothesis, showing that childhood ADHD was associated with more frequent adult substance use via early substance involvement for marijuana, cigarettes, illicit drugs, and to a lesser extent, alcohol. Mediation was not escalated by comorbid childhood conduct disorder or oppositional defiant disorder except for early use of nonmarijuana illicit drugs. Substance-specificity in the mediational pathway was largely absent except for cigarette use, where ADHD-related early smoking most strongly predicted adult daily smoking. Findings from this study provide new evidence that atypically early substance use associated with childhood ADHD signals important cross-drug vulnerability by early adulthood, but cigarette use at a young age is especially associated with increased risk for habitual (daily) smoking specifically. Efforts to prevent, delay, or reduce substance experimentation should occur early and focus on factors relevant to multiple drugs of abuse in this at-risk population. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Early Life Stress and Substance Use Disorders: Underlying Neurobiology and Pathways to Adverse Outcomes

Early life stress (ELS) has been established as a major risk factor for a multitude of psychiatric and medical disorders. ELS is highly prevalent in the general population and constitutes a major public health concern. The current review will focus on the clinical literature that suggests a link between adverse early life experiences and vulnerability for adolescent and adult substance use disorders. It will investigate the characteristics of ELS that appear to increase risk for disorder onset and a more severe disease course, characterized by earlier onset, greater risk of relapse, and treatment resistance. The authors explore how ELS may increase risk for adverse substance use outcomes through long-lasting changes in the HPA axis and development of stress, reward, and executive control brain systems. The review will also discuss potential pathways to substance use disorder following ELS, with a focus on the role of comorbid mood and anxiety disorders and other modifiable traits. Finally, the authors will discuss how the current body of work presents the potential for prevention and intervention strategies to reduce the psychosocial consequences following early life stress and minimize adverse substance use outcomes.

Child maltreatment and substance-use-related negative consequences: Longitudinal trajectories from early to mid adolescence

BackgroundChild maltreatment is associated with adult substance use disorders (i.e. alcohol and/or illicit drug use). Little is known about the behavioral pathways characterizing adolescent substance users who were subjected to childhood maltreatment. Here, we investigate the longitudinal trajectories of substance-use–related negative consequences (SURNCs) in adolescence in relation to childhood maltreatment. MethodWe drew the data (N = 1515) from the longitudinal multidisciplinary research program LoRDIA (Longitudinal Research on Development In Adolescence), of which 406 reported substance use and were included in the presented analyses. The data were collected via self-report questionnaires in classroom settings at three time points (mean age: 13.5, 14.4 and 15.0). We obtained information for childhood maltreatment using the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and data of frequencies of SURNC with a questionnaire scale. ResultsEstimates from zero-inflated Poisson growth curve model revealed no baseline differences in SURNCs across children reporting none, single, or multiple maltreatment before the age of twelve. However, children experiencing multiple maltreatment displayed a greater increase in the frequency of SURNCs during the transition from early to mid adolescence than did those reporting no maltreatment. These estimates were only partly influenced by the inclusion of frequency of alcohol and substance drug use to the model. ConclusionsThese findings imply that children suffering maltreatment are at a higher risk of experiencing SURNCs, a factor known to elevate the risk of substance use disorders later in life, as they transition from early to mid adolescence.

Gun access, ownership, gun-related experiences, and substance use in young adults: a latent class analysis

ABSTRACT Background Substance use is found to associate with gun violence. However, mixed findings have been reported for gun access/ownership. To date, studies have examined gun access/ownership and gun-related experiences (e.g., carrying) separately despite the fact that gun-related experiences often occur among gun owners. Objectives This study identifies groups of young adults based on their gun access/ownership and gun-related experiences (i.e., gun carrying, threatened someone with a gun, been threatened with a gun) and assesses whether these groups differ on their use of alcohol, cigarettes, e-cigarettes, marijuana, hard drugs, and nonmedical use of prescription medication. Methods This study uses cross-sectional data from Wave 8 of the study Dating it Safe. Participants were 663 young adults (Mean age = 22 years; 62% female). Latent class analysis (LCA) was performed. Results LCA identified three classes: (1) Minimal Gun Access/Experience (65.0%), (2) Gun Access without Experience (33.4%), (3) Gun Access with Experience (1.6%). Individuals in the Gun Access with Experience class reported more frequent few past month alcohol (17 days vs. 7 and 8 days, p < .001), episodic heavy drinking (13 days vs. 2 and 3 days, p < .001) and cigarette use (21 days vs. 10 and 10 days, p < .001) compared to these in the Minimal Gun Access/Experience and Gun Access without Experience classes, respectively. Conclusions Individuals who have access to/own guns with and without gun-related experiences face different risks of substance use. Findings highlight the need to examine gun access/ownership based on actual gun experiences and further emphasize the importance of addressing substance abuse for gun violence prevention.

Incarceration and adversity histories: Modeling life course pathways affecting behavioral health.

A consequence of a growing incarceration rate is that an increasing number of children face having an incarcerated household member, a known contributor to diverse lifelong behavioral health risks such as substance use and mental health impairment. Few studies have explored how household incarceration uniquely contributes to these subsequent behavioral health concerns, nor mediational contributors to these associations, within a theoretical framework. Using state Behavioral Risk Factor Surveillance System survey data (n = 14,001), this study tests pathways of household incarceration and Adverse Childhood Experiences (ACEs) to mental health impairment and substance use in adulthood. Within a life course stress process perspective, this study uses structural equation modeling to examine mediational pathways through adulthood incarceration and indicators of adulthood adversity, low income, and supportive resources. In line with stress process theorizing, results indicate significant direct and indirect paths of ACEs through nearly all theorized mediators, and indirect pathways of household incarceration, through incarceration and low income, to adulthood mental health impairment and substance use. Implications of these findings address preventive and interventive leverage points to mitigate long-term consequences of household incarceration and other childhood adversities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Computerised emotional well-being and substance use questionnaires in young Indigenous and non-Indigenous Australian adults.

Background:Mental health disorders rank among the most substantial causes of morbidity and mortality worldwide. Almost half of Australian adults experience mental illness at some point in their lifetime, with Indigenous Australians disproportionally affected. Thus, it is imperative that effective, acceptable screening tools are used, which are tailored to the target population.Objectives:This research investigates the methodology of computerised questionnaires in assessing the emotional well-being and substance use in Indigenous and non-Indigenous young adults.Methods:Cross-sectional data from young adults (21–28 years) in the Life Course Program, Northern Territory, Australia, are presented. Through an extensive consultation process, validated questionnaires were adapted to a computerised format suitable for both remote and urban residing Indigenous and non-Indigenous adults.Results:Of the 576 participants (459 Indigenous, 117 non-Indigenous) available for assessment, high consent rates were seen, with completion rates >86%. One in three young adults in this cohort were highlighted as ‘at risk’ of psychological distress, and one in five as ‘at risk’ of suicidal ideation or self-harm.Conclusion:The target population of this study were at a critical age with high levels of psychological distress and suicidal ideation reported, particularly in Indigenous young adults. This simple, user-friendly, pictorial programme allowed assessment of a sensitive topic anonymously, while simultaneously collating data and identifying those at high risk, irrespective of literacy level or cultural background.

Supplemental Material for Early Substance Use in the Pathway From Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) to Young Adult Substance Use: Evidence of Statistical Mediation and Substance Specificity

Supplemental Material for Early Substance Use in the Pathway From Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) to Young Adult Substance Use: Evidence of Statistical Mediation and Substance Specificity

The Role of Adverse Childhood Experiences and Corporal Punishment in Early Adulthood Depression and Substance Use among Ukrainian College Students

Violence against children is a worldwide problem, and a large body of research demonstrates both short-term and long-term negative outcomes. The present study employs structural equation modeling to examine the pathways from parents’ use of corporal punishment and childhood adverse experiences to depression and substance use in adulthood. Cross-sectional data were collected from a sample of 944 students (Mage = 19.16, 69% females) attending ten public universities in 27 Ukrainian regions. The model provided a good fit for the data: χ2 (59, N = 944) = 189.49, p < 0.001, CFI = 0.96, TLI = 0.95, RMSEA = 0.048. Higher scores on adverse childhood experiences (ACE) maltreatment items (psychological, physical and sexual abuse during childhood; b = .26, p < .001) were associated with higher depression during adulthood. Higher depression scores were linked with higher multiple substance use (b = .17, p < .001). Childhood adverse experiences had significant standardized indirect effect, mediated by depression, on adulthood involvement in substance use (b = 0.043, p < 0.01). Findings from this research suggest that young adults in Ukraine who remember being maltreated as children have a higher risk to develop depression and engage in substance use as adults.

Longitudinal Associations Between the Adolescent Family Environment and Young Adult Substance Use in Australia and the United States.

Introduction: Harmful alcohol and cannabis use are social concerns associated with a range of negative outcomes. Prior research has identified links between disrupted parent-child attachment and child-adolescent substance use. Materials and Methods: This study used cross-national data from the International Youth Development Study (IYDS; Victoria, Australia and Washington State, USA) to investigate the relationship between early adolescent family environment characteristics, mid-adolescent attachment to parents, and young adult harmful alcohol and cannabis use. The moderating role of state on these relationships was also tested. State-representative samples of students in Grade 7 (age 13, 2002) were recruited and followed longitudinally at ages 14, 15, and 25 (n = 1,945, 53% female, 50% in Victoria). Results: Cross-state differences were evident in levels of family management, parent attitudes favorable to drug use, sibling alcohol and cannabis use, attachment to parents, and past year alcohol and cannabis use. Significantly higher rates of problematic alcohol use were reported by young adults in Victoria (25% vs. 14% in Washington State). Young adults in Washington State reported significantly higher rates of problematic cannabis use (14% vs. 10% in Victoria). Path modeling showed that characteristics of positive family environments (e.g., low conflict) in early adolescence were associated with higher attachment to parents and lower alcohol and cannabis use in mid-adolescence. Sibling substance use and more favorable parent attitudes to drug use were associated with past year alcohol and cannabis use in mid-adolescence. Results showed higher attachment to parents in mid-adolescence did not uniquely predict lower problematic alcohol or cannabis use in young adulthood. No significant cross-state differences in this pattern of associations were found. Discussion: The implications of the current findings suggest that prevention and intervention strategies targeted at reducing problematic substance use into young adulthood may benefit from considering the influence of behavioral norms and attitudes in family relationships.

The impact of substance use during middle school and young adulthood on parent-young adult relationships.

Sharp increases in substance use and other risk behaviors during adolescence and young adulthood threaten the quality of the parent-child relationship, a critical context for positive adjustment and well-being. There is a dearth of research, however, on the influence of adolescent and young adult substance use on the parent-young adult relationship. Study aims were to examine longitudinally the associations between classes of adolescent and young adult alcohol and marijuana use, and the impact of alcohol and marijuana use on parent-young adult relationship dynamics and quality. We analyzed longitudinal data collected with a socioeconomically and racially diverse urban community sample of 593 parents and their children over 6 years to identify latent classes of growth in adolescent alcohol and marijuana use, and test for differences in young adult alcohol and marijuana use and parent-young adult relationship quality by latent classes. Structural equation modeling results showed that (a) alcohol and marijuana use during the middle school years predicted adult alcohol and marijuana use during young adulthood; (b) high-risk alcohol and marijuana use, specifically, was associated with poorer parent-young adult relationship quality; (c) initiation of marijuana use during young adulthood was also associated with poorer parent-young adult relationship quality; and (d) for minority youth in all alcohol risk classes, parent-young adult relationship quality was lower. Results show that growth in alcohol and marijuana use during adolescence, and initiation of marijuana use later in young adulthood, exert unique, detrimental effects on parent-young adult relationship quality. Implications for future research and prevention and intervention development for young adults are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Personality, romantic relationships, and alcohol use disorder symptoms in adolescence and young adulthood: An evaluation of personality × social context interplay.

Prior research has shown that person-level characteristics (e.g., temperament, personality) correlate and interact with social-contextual factors (e.g., parent-child relationship quality, antisocial peer affiliation) to predict adolescent substance use, but less research has examined similar processes for adult substance use problems. We addressed this gap by testing for personality × romantic partner context interplay in relation to symptoms of alcohol use disorder (AUD) at ages 24 and 29. Participants were twins in the longitudinal Minnesota Twin Family Study (N = 2,769; 52% female). Results support the corresponsive principle of personality in that we found that key personality traits in late adolescence (low constraint, negative emotionality) predicted subsequent "selection" into key social contexts in early adulthood (poorer quality romantic relationships and greater romantic partner alcohol use), which subsequently reinforced those traits and associated outcomes (including correlated AUD symptoms) through late young adulthood. There were few meaningful gender differences in these associations. There was also no support for the personality × romantic partner context interaction as a significant predictor of AUD symptoms at ages 24 or 29. Taken together with prior studies, these results suggest that such interactions may be less relevant to the development of young adult AUD compared to adolescent substance use problems.

Effects of Childhood and Adult Persistent Attention-Deficit/Hyperactivity Disorder on Risk of Motor Vehicle Crashes: Results From the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder

To determine motor vehicle crash (MVC) risk in adults with a history of childhood attention-deficit/hyperactivity disorder (ADHD) and persistent ADHD symptoms. Participants with (n= 441) and without (n= 239; local normative comparison group) childhood ADHD from the Multimodal Treatment of Attention-Deficit/Hyperactivity Disorder (MTA) Study were included. Participants provided self-reports on total number of MVCs they had been involved in and the time of licensure. Driving experience was estimated as the number of months since licensure. Total number of MVCs by adulthood was regressed on baseline ADHD status adjusting for sex, age at follow-up, driving experience, baseline oppositional defiant disorder/conduct disorder comorbidity, baseline household income level, adult oppositional defiant disorder/conduct disorder symptoms, adolescent and adult substance use, and adult antisocial personality disorder symptoms. We repeated the analysis using adult ADHD status (persistent versus desistant versus local normative comparison group) and symptom level as the predictor variables. Results are presented as incidence rate ratio (IRR) and CI. Childhood ADHD was associated with a higher number of MVCs (IRR= 1.45, CI= 1.15-1.82), and adult ADHD symptom persistence was associated with more MVCs than desistance (IRR= 1.46, CI= 1.14-1.86). ADHD desistance was not associated with a significantly increased risk for MVCs compared with the local normative comparison group (IRR= 1.24, CI= 0.96-1.61). Concurrent symptoms of inattention and hyperactivity/impulsivity predicted MVC risk. Persistence of ADHD into adulthood is a stronger predictor of MVC risk than childhood-limited ADHD. Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study; https://clinicaltrials.gov; NCT00000388.

Adult substance use as a function of growth in peer use across adolescence and young adulthood in the context of ADHD: Findings from the MTA

Peer substance use strongly predicts adolescent and young adult substance use, but its role in ADHD-related risk for substance use, especially in adulthood, is unclear. In a sample with (n = 516) and without (n = 249) childhood ADHD from the Multimodal Treatment Study of ADHD, we compared associations between change over time in peer substance use and personal substance use (alcohol, cigarettes, marijuana, illicit drugs) from age 14–26 by ADHD status. Developmentally typical peer substance use trajectories across adolescence and young adulthood coincided with similar changes in personal use – but less so for those with ADHD histories. Concurrent associations between peer and personal use in adolescence and young adulthood were weaker for those with ADHD histories than without for commonly used substances (alcohol, marijuana). Prospectively, escalating peer use during adolescence forecasted adulthood declines for commonly used substances, yet persistently high substance use at age 25, regardless of ADHD history. In the reverse direction, growth in adolescent substance use predicted developmentally normative young adult declines in peer use – but for the ADHD group, adolescent heavy drinking predicted increases in young adult peer use. Findings suggest that individuals with ADHD may have difficulty emulating their peers' developmentally normative declines in substance use, highlighting the importance of social factors when treating young adults affected by ADHD and substance abuse.

Validity and reliability of Chinese version of 28-item Substance Use Risk Profile Scale in Chinese adolescents and young adults

The present study aimed to explore the validity and reliability of the Chinese version of the 28-item Substance Use Risk Profile Scale (SURPS) and provide an effective assessment tool for personalities related to substance use by which to predict and intervene in substance use cases. A total of 2114 Chinese adolescents and young adults (age 19.44 ± 1.63 years old) were enrolled. The results showed that the modified SURPS-SL_r model fit well (χ2/df = 5.15, p < 0.01, CFI = 0.851, TLI = 0.835, RMSEA = 0.037, SRMR = 0.063), indicating that the structure of the SURPS was suitable for Chinese adolescents and young adults. The SURPS significantly correlated with the Satisfaction with Life Scale, Subjective Health Complaints Index, Beck Depression Inventory, Zuckerman-Kuhlman Personality Questionnaire, and Neuroticism Extraversion Openness Five-Factor Inventory (r = 0.22 ~ 0.60, all ps < 0.01), indicating that the criterion validity of the SURPS was good. The Cronbach’s α of SURPS and its dimensions were 0.74~0.83, which suggested the SURPS has good reliability. Therefore, the Chinese version of the 28-item SURPS is an effective and reliable measure of personalities linked to substance use in Chinese adolescents and young adults.

Psychological distress and substance use among young adults with comorbid asthma and obesity

Objective This study examined psychosocial distress and substance use in young adults with asthma (A), obesity (O), comorbid asthma and obesity (AO), or neither (controls). Participants: Eight hundred eighty-one young adults were included in the A, O, AO, or control group. Methods: ANCOVA and logistic regression analyses were performed to compare responses to screeners for psychological distress and substance use among the four groups. Results: Levels of depressive symptoms, worry, nonsuicidal self-injury, emotion dysregulation, and chronic pain symptoms differed across groups, with the A and AO groups showing greater psychological distress than the O and control groups. The AO group exhibited the highest levels of cigarette and smokeless tobacco use, while the O group exhibited the least frequent binge drinking behaviors. Conclusions: Individuals with asthma or comorbid asthma and obesity appear to experience the poorest psychosocial functioning and highest use of tobacco products. Potential mechanisms and implications of these relationships are discussed.