Heavy Substance Use Research Articles

Protective factors and college student drinking patterns in pre and post Katrina New Orleans

Rates of heavy drinking, tobacco use and illicit substance use peak among college students between 18 and 25 years of age. Attitudes, personal characteristics, and behaviors that are called protective factors could play a role in reducing college students’ use of alcohol and drugs. We studied the relationships between selected protective factors and alcohol consumption in college students from a public commuter university in New Orleans, Louisiana pre-and post-Hurricane Katrina utilizing the Core Alcohol and Drug Survey (CADS) Long Form. We applied Hirschi’s social control theory to examine the relationships between drinking and the identified protective factors. Three research questions with null and alternative hypotheses were tested to explore the impact of Hurricane Katrina on protective factors and drinking utilizing linear/ logistic and multivariate regression models to test the hypotheses. We found that post-Katrina students were on average about 1.5 years older and drank approximately 1.5 more drinks per week than pre-Katrina students. Both pre and post Katrina age, gender, and race/ethnicity were significantly related to drinking among these groups of college students such that older students, women, and non-Whites tended to have reduced odds of drinking. There were no statistically significant relationships between individual protective factors or any group of protective factors and drinking after controlling for age, gender, and race/ethnicity indicating that these 3 individual characteristics that cannot be altered were stronger predictors of drinking than any other factors we tested.

Individual and Social Network Sexual Behavior Norms of Homeless Youth at High Risk for HIV Infection.

Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner's risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual history, availability, pregnancy, and the prevention of sexually transmitted infections (STIs). Sixteen homeless youth indicate that they do not discuss safe sex practices with their partners or social network members.

Are symptoms of ADHD related to substance use among college students?

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder that often persists into adolescence and adulthood and has been associated with an increased risk for substance use. Due to improved treatment and educational policies, more students with high levels of ADHD symptoms are attending college despite continued ADHD symptoms. Little research has examined whether college students with higher levels of ADHD symptoms are at increased risk for heavy substance use compared to college students with few ADHD symptoms. The current study examined the relation of ADHD symptoms to substance use (e.g., cigarette smoking, alcohol use, marijuana use, and cocaine use). We hypothesized that greater ADHD symptomatology (inattentive, hyperactive/impulsive, and total ADHD) would be related to higher rates of cigarette smoking, alcohol use, alcohol-problems, and illicit drug use. Participants were 889 college undergraduates who completed an online survey. Results suggest that ADHD symptoms, particularly inattentive symptoms, were positively associated with cigarette smoking and problems associated with alcohol after controlling for conduct disorder (CD) symptoms. ADHD symptoms were not significantly associated with alcohol use or illicit drug use after the effects of CD symptoms were accounted for. Results have important implications for prevention and treatment of college student substance use. Limitations and future directions are discussed.

Substance Use and First-Episode Psychosis

Back to table of contents Next article Taking IssueFull AccessSubstance Use and First-Episode PsychosisMelanie Bennett, Ph.D., and Lisa B. Dixon, M.D., M.P.H.Melanie BennettSearch for more papers by this author, Ph.D., and Lisa B. DixonSearch for more papers by this author, M.D., M.P.H.Published Online:14 Jan 2015https://doi.org/10.1176/ps.62.9.pss6209_0997AboutSectionsView articleView PDFView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleSubstance use and abuse frequently complicate a first episode of psychosis. The ways in which substance use affects the treatment of psychosis may be critical to the resolution of the first episode and may influence the course of psychosis and its treatment in the future. However, few studies have focused on substance use and treatment strategies for young adults with psychosis. In this issue, Wisdom and colleagues take an important step forward by reviewing the literature on changes in substance use after treatment for psychosis among individuals who receive and who do not receive specialized substance abuse treatment.In addition to what the review tells us about the course of substance use after a first episode of psychosis, it shines a light on the limitations of our knowledge. For example, although many individuals stop drinking or using drugs after a first episode, probably due in part to the belief that their substance use is somehow related to or a cause of the psychosis, the longer-term implications of this belief are unclear. Would a person who abstains from substance use and who experiences another episode of psychosis reconsider his or her substance-using behavior? In addition, it is unclear whether assessment and diagnosis of substance use and abuse require tailoring for young adults with psychosis; research on assessment methods and measures in this population is lacking. Given the relatively recent development of effective treatment strategies for the general adult population with comorbid psychotic and substance use disorders, it is not surprising that the literature on young adults is even leaner. Critical information about how to identify young adults with psychosis who are most in need of additional treatment for substance abuse is not available.Much can be learned about these topics from the extensive literature on substance use and abuse among adolescents and young adults without psychosis. Studies have explored how substance use, assessment, and diagnosis differ between the young adult and the adult populations. Researchers have defined different types of drinking and drug use—such as binge drinking—that are more prevalent among youths. Studies have also identified predictors of heavy substance use or problem use, including individual characteristics (personality factors and expectancies), family characteristics (family history of substance use and parental vigilance), and peer characteristics (peer norms and involvement in substance use). Researchers have developed and tested strategies for motivating youths to participate in substance abuse treatment and have studied the efficacy of treatment strategies, such as behavioral and family therapy. This literature will provide directions for research and will identify promising strategies for assessment and treatment of young adults who are experiencing a first episode of psychosis.Department of Psychiatry, University of Maryland School of Medicine, Baltimore FiguresReferencesCited byDetailsCited ByNone Volume 62Issue 9 September 2011Pages 997-997 Metrics History Published online 14 January 2015 Published in print 1 September 2011

P1-440 Latent class analysis of student substance use

IntroductionData were collected from a student population to investigate how substance use is related to perceived substance use of friends and the wider University population, during the period February to...

Adolescent Binge Drinking Linked to Abnormal Spatial Working Memory Brain Activation: Differential Gender Effects

Binge drinking is prevalent during adolescence, and its effect on neurocognitive development is of concern. In adult and adolescent populations, heavy substance use has been associated with decrements in cognitive functioning, particularly on tasks of spatial working memory (SWM). Characterizing the gender-specific influences of heavy episodic drinking on SWM may help elucidate the early functional consequences of drinking on adolescent brain functioning. Forty binge drinkers (13 females, 27 males) and 55 controls (24 females, 31 males), aged 16 to 19 years, completed neuropsychological testing, substance use interviews, and an SWM task during functional magnetic resonance imaging. Significant binge drinking status × gender interactions were found (p < 0.05) in 8 brain regions spanning bilateral frontal, anterior cingulate, temporal, and cerebellar cortices. In all regions, female binge drinkers showed less SWM activation than female controls, while male bingers exhibited greater SWM response than male controls. For female binge drinkers, less activation was associated with poorer sustained attention and working memory performances (p < 0.025). For male binge drinkers, greater activation was linked to better spatial performance (p < 0.025). Binge drinking during adolescence is associated with gender-specific differences in frontal, temporal, and cerebellar brain activation during an SWM task, which in turn relate to cognitive performance. Activation correlates with neuropsychological performance, strengthening the argument that blood oxygen level-dependent activation is affected by alcohol use and is an important indicator of behavioral functioning. Females may be more vulnerable to the neurotoxic effects of heavy alcohol use during adolescence, while males may be more resilient to the deleterious effects of binge drinking. Future longitudinal research will examine the significance of SWM brain activation as an early neurocognitive marker of alcohol impact to the brain on future behaviors, such as driving safety, academic performance, and neuropsychological performance.

A Prospective Study of the Effects of Optimism on Adolescent Health Risks

The promotion of optimism has been widely advocated for children and adolescents, but epidemiologic data to support this approach are scant. This was a 3-wave longitudinal study of health and social development in younger adolescents from 3 Australian states. The 5634 student participants, initially aged 12 to 14 years, were assessed for optimistic thinking style, emotional problems, substance use, and antisocial behaviors. Cross-sectional associations between optimism and each of the study outcomes were strongly protective but tended to differ according to gender in extent. In prospective analyses of the onset of new cases of each study outcome, protective associations were weaker. Those in the highest optimism quartile had risks for depressive symptoms that were reduced by almost half (odds ratio: 0.54 [95% confidence interval: 0.42-0.70]) compared with those in the lowest category. No effect was seen in prevention of anxiety symptoms after adjustment for other aspects of psychological style. In predicting the onset of heavy substance use and antisocial behavior, high optimism had modest protective effects. Optimistic thinking style is somewhat protective against adolescent health risks; the clearest effects are seen against depressive symptoms. Promoting optimism along with other aspects of psychological and emotional style has a role in mental health promotion that is likely to be enhanced if an intervention also addresses risk and protective factors in an adolescent's social context.

Substance use changes and social role transitions: proximal developmental effects on ongoing trajectories from late adolescence through early adulthood.

Substance use changes rapidly during late adolescence and early adulthood. This time in the life course is also dense with social role changes, as role changes provide dynamic context for individual developmental change. Using nationally representative, multiwave longitudinal data from age 18 to 28, we examine proximal links between changes in social roles and changes in substance use during the transition to adulthood. We find that changes in family roles, such as marriage, divorce, and parenthood, have clear and consistent associations with changes in substance use. With some notable exceptions, changes in school and work roles have weaker effects on changes in substance use compared to family roles. Changes in socializing (i.e., nights out for fun and recreation) and in religiosity were found to mediate the relationship of social role transitions to substance use. Two time-invariant covariates, socioeconomic background and heavy adolescent substance use, predicted social role status, but did not moderate associations, as within-person links between social roles and substance use were largely equivalent across groups. This paper adds to the cascading effects literature by considering how, within individuals, more proximal variations in school, work, and family roles relate to variations in substance use, and which roles appear to be most influential in precipitating changes in substance use during the transition to adulthood.

Preventing disruptive boys from becoming heavy substance users during adolescence: A longitudinal study of familial and peer-related protective factors

Childhood disruptiveness is one of the most important antecedents of heavy substance use in adolescence, especially among boys. The first aim of the present study is to verify whether parental monitoring and friend conventionality protect disruptive boys from engaging in heavy substance-use in adolescence. The second purpose is to examine whether these protective effects are strengthened by attachment to parents or friends respectively. Finally, the third objective is to verify whether the expected protective effect of parental monitoring could be mediated through exposure to conventional friends. A sample of 1037 boys from low socioeconomic neighbourhoods was followed from childhood (age 6) to adolescence (age 15). Parent, teacher, and self-reported measures were used to measure disruptiveness, parental monitoring, family attachment, friend conventionality, and attachment to friends. Results suggest that parental monitoring and friends' conventionality mitigated the relationship between childhood disruptiveness and adolescence heavy substance use. Exposure to conventional friends further mediated the protective effect of parent monitoring. The postulated enhancement of attachment quality on the protective effect of parents or peer behaviors was not confirmed, but low attachment was related to heavier substance use in highly monitored disruptive boys. Parental monitoring, family attachment, and peer conventionality are factors amenable to intervention, and thus represent promising targets for future prevention strategies aimed at-risk boys. Our results underscore the importance of simultaneously addressing the behavioral and the affective dimensions in interventions with parents.

Running Away From Home: A Longitudinal Study of Adolescent Risk Factors and Young Adult Outcomes

Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at Grade 10 and/or Grade 11. Controlling for demographics and general delinquency, running away from home was predicted by lack of parental support, school disengagement, greater depressive affect, and heavier substance use at Grade 9. In turn, runaways had higher drug dependence scores and more depressive symptoms at age 21 than non-runaways, even after taking these antecedent risk factors into account. Runaway status did not predict alcohol dependence risk at age 21. Results highlight the importance of substance use and depression, both as factors propelling adolescents to run away and as important long-term consequences of running away.

Negotiating the Early Developing Body: Pubertal Timing, Body Weight, and Adolescent Girls’ Substance Use

Despite knowledge that early pubertal timing predicts adolescent girls' substance use, it is still unclear whether this relationship persists beyond early adolescence and whether it is conditional on girls' body weight. This study examined the moderating role of body weight in the association between early pubertal timing and adolescent girls' substance use using three waves of data from the National Longitudinal Study of Adolescent Health. The analytic sample included 5,591 adolescent girls attending middle-schools and high-schools in the United States (ages 10-15, 71% White, 14% Black). Results indicated that early pubertal timing was associated with substance use risk but effects were attenuated after controlling for prior use. Body weight moderated the association between early pubertal timing and girls' reported number of substances tried in middle adolescence. Body weight magnified the risk of having tried one substance, but buffered the risk of having tried three substances. Among those girls who did use substances, body weight did not moderate the relationship between early pubertal timing and heavy substance use. It is concluded that the substance use risk associated with early pubertal timing is most salient during the developmental period in adolescence when sensitivity to bodily changes may be heightened.

Hypothalamic–pituitary–adrenal axis and smoking and drinking onset among adolescents: the longitudinal cohort TRacking Adolescents' Individual Lives Survey (TRAILS)

We examined within a prospective longitudinal study whether cortisol levels were associated with smoking or drinking behaviours, taking parental substance use into account. The influence of parental substance use on cortisol levels of their adolescent offspring at age 10-12 years was examined. Next, cortisol levels of adolescents who initiated smoking or drinking at the first data collection (age 10-12) were compared to non-users. Finally, we examined whether cortisol levels could predict new onset and frequency of smoking and drinking 2 years later. First and second assessment data of the TRacking Adolescents' Individual Lives Survey (TRAILS) were used, including 1768 Dutch adolescents aged 10-12 years, who were followed-up across a period of 2 years. Cortisol was measured in saliva samples at awakening, 30 minutes later, and at 8 p.m. at age 10-12. Self-reported substance use at age 10-12 and 13-14, and parental self-reported substance use were used. Only maternal substance use was related to slightly lower adolescent cortisol levels at 8 p.m. Both maternal and paternal substance use were associated with adolescent smoking and drinking at age 13-14, although fathers' use only predicted the amount used and not the chance of ever use. Finally, higher cortisol levels were related moderately to current smoking and future frequency of smoking, but not to alcohol use. In a general population, parental heavy substance use does not seem to affect cortisol levels consistently in their offspring. We found some evidence for higher, instead of lower, hypothalamic-pituitary-adrenal axis activity as a predictor of smoking in early adolescence.

Does technology use moderate the relationship between parental alcoholism and adolescent alcohol and cigarette use?

The primary goals of this study were to examine the associations between technology use and alcohol and cigarette use during adolescence and to explore whether technology use moderates the relationship between parental alcoholism and substance use (alcohol and cigarette use). The sample included 328 14–16 year-old adolescent boys and girls. The adolescents completed a battery of self-report questionnaires which included measures that assessed their substance use, their use of technology, and their parents' alcohol use (including alcoholism). Results indicated that adolescents who had an alcoholic parent reported relatively higher levels of alcohol consumption. Heavier use of technology (particularly text messaging, e-mailing/IMing, and watching television) also was related to earlier and heavier substance use during adolescence. Moreover, these effects tended to be more pronounced in adolescents with an alcoholic parent. Results from this study suggest that high levels of technology use during adolescence may be related to an increased risk of alcohol and cigarette use, particularly for children of alcoholic parents (COAs).

Party package travel: alcohol use and related problems in a holiday resort: a mixed methods study

BackgroundPeople travelling abroad tend to increase their use of alcohol and other drugs. In the present study we describe organized party activities in connection with young tourists' drinking, and the differences between young people travelling with and without organized party activities.MethodsWe conducted ethnographic observations and a cross-sectional survey in Sunny Beach, Bulgaria.ResultsThe behaviour of the guides from two travel agencies strongly promoted heavy drinking, but discouraged illicit drug use. Even after controlling for several potential confounders, young people who travelled with such "party package travel agencies" were more likely to drink 12 or more units when going out. In univariate analyses, they were also more likely to get into fights, but were not more likely to seek medical assistance or medical assistance for an accident or an alcohol-related problem. After controlling for confounders, the association between type of travel agency and getting into fights was no longer significant. Short-term consequences of drinking in the holiday resort did not differ between party package travellers and ordinary package travellers.ConclusionThere may be a small impact of party package travels on young people's drinking. Strategies could be developed used to minimise the harm associated with both party package travel and other kinds of travel where heavy substance use is likely to occur.

The Relationship Between Substance Use Patterns and Economic and Health Outcomes Among Low-Income Caregivers and Children

This study estimated how patterns of substance use are related to work status, public program use, and well-being among a sample of female caregivers and children. This study assessed work, public program use, and well-being measures as a function of substance use among 1,623 female caregivers of children aged zero to four or ten to 14 who participated in the Welfare of Children and Families study and lived in low- and moderate-income neighborhoods in Boston, Chicago, and San Antonio. Data were analyzed from baseline interviews that were conducted from March through December 1999 and from follow-up interviews that were conducted 11 to 26 months after baseline (average of 16 months). Substance use patterns were placed into three categories: light or no substance use reported in both interviews, moderate or heavy substance use (that is, moderate or heavy use in both interviews or increased substance use during the study period), and reduced substance use during the study period. Among caregivers who reduced their substance use, measures of work status, receipt of income assistance, mental health symptoms, and reports of child behavior problems were not significantly different at follow-up from those of caregivers with light or no substance use. At follow-up, compared with caregivers with light or no substance use, those with moderate or heavy substance use were significantly less likely to experience improvements in mental health symptoms and to see improvements in their children's behavioral problems. Caregivers with moderate or heavy substance use were more likely to be "detached" (p=.051)--that is, neither working nor collecting income assistance--although this difference was only marginally significant. Caregivers with increased substance use fared poorly on measures of well-being and work. Policies that promote, rather than impede, reductions in substance use are more likely to promote self-sufficiency and well-being.

The Relationship Between Substance Use Patterns and Economic and Health Outcomes Among Low-Income Caregivers and Children

This study estimated how patterns of substance use are related to work status, public program use, and well-being among a sample of female caregivers and children. This study assessed work, public program use, and well-being measures as a function of substance use among 1,623 female caregivers of children aged zero to four or ten to 14 who participated in the Welfare of Children and Families study and lived in low- and moderate-income neighborhoods in Boston, Chicago, and San Antonio. Data were analyzed from baseline interviews that were conducted from March through December 1999 and from follow-up interviews that were conducted 11 to 26 months after baseline (average of 16 months). Substance use patterns were placed into three categories: light or no substance use reported in both interviews, moderate or heavy substance use (that is, moderate or heavy use in both interviews or increased substance use during the study period), and reduced substance use during the study period. Among caregivers who reduced their substance use, measures of work status, receipt of income assistance, mental health symptoms, and reports of child behavior problems were not significantly different at follow-up from those of caregivers with light or no substance use. At follow-up, compared with caregivers with light or no substance use, those with moderate or heavy substance use were significantly less likely to experience improvements in mental health symptoms and to see improvements in their children's behavioral problems. Caregivers with moderate or heavy substance use were more likely to be "detached" (p=.051)--that is, neither working nor collecting income assistance--although this difference was only marginally significant. Caregivers with increased substance use fared poorly on measures of well-being and work. Policies that promote, rather than impede, reductions in substance use are more likely to promote self-sufficiency and well-being.

Risky drinking in college changes as fraternity/sorority affiliation changes: A person-environment perspective.

This study aimed to resolve the direction of the relation between Greek affiliation and substance use by taking advantage of the quasi-experimental nature of change in college fraternity/sorority affiliation. Precollege individual differences and college substance use were examined as a function of time-varying Greek status to characterize self-selection (by which heavy substance users opt into Greek systems) and socialization (by which Greek systems foster heavy substance use). Prospective data on continuously enrolled college students (N=2,376), assessed at precollege and in the first 6 semesters of college, were used. Latent class analysis indicated 4 discrete groups of status: constant Greek members (30%), constant nonmembers (64%), late joiners (2%), and droppers (4%). Random coefficient models demonstrated disaffiliation with Greek systems is associated with decreases in risky drinking and alcohol-conducive environmental factors (peer norms and alcohol availability), whereas affiliation is associated with increases, indicating Greek socialization via sociocognitive and physical environments. Future Greeks differed from nonmembers in diverse individual characteristics and heavier substance use at precollege, suggesting multiple selection paths into Greek systems. Findings suggest a reciprocal relation between Greek environment and individuals in determining the trajectories of college drinking and heterogeneity in drinking as functions of changes in Greek affiliation.

Trafficking among youth in conflict with the law in São Paulo, Brazil

Engagement in drug trafficking may place a child or youth at risk for exposure to severe violence, drug abuse, and death. However, little is know about the nature of youth involvement in drug trafficking. The purpose of this study is to describe drug trafficking behaviour of delinquent youth and identify adverse experiences as potential predictors of trafficking. Cross-sectional sample of youth (12-17 years of age) incarcerated in detention facilities for delinquent or criminal acts in São Paulo City, Brazil. Structured face-to-face interviews completed with 325 youth (289 boys, 36 girls). Approximately half of the boys and girls in this sample have had at least some role in drug trafficking prior to incarceration. Though youth who had engaged in drug trafficking activities did not differ on basic socio-demographic variables, they were more likely to have been exposed to a number of adverse experiences. Beyond heavy substance use, no longer attending school, gang involvement, witnessing violence, and easier access to guns, drugs and alcohol remained significantly related to trafficking involvement in the final regression model. Girls experienced a very similar pattern of adverse exposures as boys. Special efforts may be required for rehabilitation of youth who engage in drug trafficking. Potential targets may include keeping or re-engaging delinquent youth in school for longer periods of time and reducing youth exposure to violence in poor urban communities.

Gene-Environment Correlation and Interaction in Peer Effects on Adolescent Alcohol and Tobacco Use

Peer relationships are commonly thought to be critical for adolescent socialization, including the development of negative health behaviors such as alcohol and tobacco use. The interplay between genetic liability and peer influences on the development of adolescent alcohol and tobacco use was examined using a nationally-representative sample of adolescent sibling pairs and their best friends. Genetic factors, some of them related to an adolescent's own substance use and some of them independent of use, were associated with increased exposure to best friends with heavy substance use--a gene-environment correlation. Moreover, adolescents who were genetically liable to substance use were more vulnerable to the adverse influences of their best friends--a gene-environment interaction.

Age of Alcohol Use Initiation, Suicidal Behavior, and Peer and Dating Violence Victimization and Perpetration Among High-Risk, Seventh-Grade Adolescents

We examined the cross-sectional associations between reports of an early age of alcohol use initiation and suicidal ideation, suicide attempts, and peer and dating violence victimization and perpetration among high-risk adolescents. Data were obtained from the Youth Violence Survey conducted in 2004 and administered to all public school students enrolled in grades 7, 9, and 11/12 (N = 4131) in a high-risk school district in the United States. Our analyses were limited to seventh-grade students who either began drinking before the age of 13 or were nondrinkers, with complete information on all covariates (n = 856). Cross-sectional logistic and multinomial logistic regression analyses were conducted to determine the associations between early alcohol use and each of the 6 outcome behaviors (dating violence victimization and perpetration, peer violence victimization and perpetration, suicidal ideation, and suicide attempts) while controlling for demographic characteristics and other potential confounders (ie, heavy episodic drinking, substance use, peer drinking, depression, impulsivity, peer delinquency, and parental monitoring). In our study, 35% of students reported alcohol use initiation before 13 years of age (preteen alcohol use initiators). Students who reported preteen alcohol use initiation reported involvement in significantly more types of violent behaviors (mean: 2.8 behaviors), compared with nondrinkers (mean: 1.8 behaviors). Preteen alcohol use initiation was associated significantly with suicide attempts, relative to nondrinkers, controlling for demographic characteristics and all other potential confounders. Early alcohol use is an important risk factor for involvement in violent behaviors and suicide attempts among youths. Increased efforts to delay and to reduce early alcohol use among youths are needed and may reduce both violence and suicide attempts.