Journal of studies on alcohol and drugs最新文献

Objective: More than 30% of women who experience sexual assault (SA) during college experience sexual revictimization (SRV) prior to graduating. Current SA interventions have been developed with predominantly White samples and most do not focus on reducing SRV or include effective alcohol reduction techniques. The purpose of the current study was to conduct a pilot randomized controlled trial to assess the feasibility and acceptability of a new intervention designed to reduce SRV in Black and White college women.

Method: A sample of 59 women (n = 43, White; n = 16, Black) were randomly assigned to either the intervention or time and attention control condition. Both conditions consisted of two, 90-minute in-person group sessions and two, 30-minute online self-administered learning units. During the intervention, participants watched culturally specific videos (e.g., created in partnership with the cultural group, culturally congruent with regard to race of actors, vernacular, dress, and social situations) embedded with SA risk cues. Women participated in discussions designed to improve risk recognition and assertive responding to SA threat. All groups were racially homogeneous with same race facilitators. Online intervention units included alcohol reduction strategies (e.g., personalized normative feedback) and safe dating practices.

Results: Acceptability and feasibility of the intervention were good and suggested that cultural specificity was important for Black women. However, attrition was higher than expected and barriers to participating were noted for Black women.

Conclusions: These preliminary findings highlight the potential importance as well as the challenges in developing culturally specific SA interventions for college women.

Objective: One in five college women experiences sexual assault (SA). Feminist scholars have called for the use of programming that empowers women by increasing their ability to recognize and resist SA. One such program, the Enhanced Assess, Acknowledge, Act SA Resistance Education Program (EAAA), has demonstrated lower rates of SA up to 24 months (Senn et al., 2015, 2017). EAAA could be further enhanced by directly targeting women's risky alcohol and cannabis use, two known risk factors for SA, within an integrated framework. This study evaluated the acceptability and preliminary efficacy of an integrated version of EAAA with enhanced alcohol and new cannabis content.

Methods: College women (n=14) aged 18-24 who reported engaging in past-month heavy alcohol use, cannabis use, and simultaneous alcohol and cannabis use participated in the adapted program. Women completed a baseline assessment, measures of acceptability at strategic points during the program, and a post-program assessment.

Results: Women rated the program very high in likability, quality, organization, relevance, and usefulness and were likely to recommend it to other women. Overall, acceptability and usability ratings for EAAA+ were high. Content analysis of open-ended questions indicated that some women wanted more cannabis and/or alcohol content included.

Conclusion: Results indicate that the adapted content is acceptable for the target population and has promising pre-post changes on alcohol, cannabis, and SA-related outcomes.

Objective: Substance use patterns vary considerably in the general population, yet little is known about patterns before and during pregnancy. The purpose of this study was to describe single substance and polysubstance use (PSU) before and during pregnancy among recent births in the United States (US) and compare exposure patterns.

Methods: We used data from the Pregnancy and Risk Assessment Monitoring System (PRAMS) postpartum survey for 2016-2018 to estimate the prevalence and identify patterns of substance use by participants one to three months before and during pregnancy. Data on use of cigarettes, cannabis, opioids, amphetamines, heroin, and cocaine were available for seven states. We used latent class analysis to identify patterns of substance use and tested whether participants with those patterns differed by age, income, race/ethnicity, and pre-pregnancy alcohol use. Analyses were weighted using PRAMS' state-level weights.

Results: We studied 15,429 participants representing 384,918 live, singleton births. Approximately half (51.3%) were 20-29 years old, 42.3% were above 200% of the Federal Poverty Level, and 73.3% were non-Hispanic White. We identified seven latent classes of maternal substance use: minimal users (70.7%), pre-pregnancy cigarette users (10.5%), persistent cigarette users (6.8%), pre-pregnancy cannabis users (5.5%), broad PSU (3.6%), opioid-only users (1.9%), and persistent cigarette/opioid co-users (1.0%). Participants in these groups differed significantly by age, income, race/ethnicity, and pre-pregnancy alcohol use (p<0.001).

Conclusions: This novel empirical classification of single and PSU could help to further our understanding of the impact of PSU on perinatal health and to design interventions for maternal substance use.

Objective: Prenatal alcohol and tobacco exposure continue to impact a significant portion of the US population every year. Differences in neighborhood environment may be a contributing factor. The current study examines whether prenatal alcohol and tobacco exposure differ by neighborhood environment.

Methods: We utilized neighborhood environment data linked to a US based, nationally representative cohort of adolescents (N = 8731 (47.2% female); Age: M = 118.6 months, SD = 7.4 months).

Results: Lower neighborhood deprivation, less air pollution, higher lead risk and perceived neighborhood safety were associated with prenatal alcohol exposure, while higher neighborhood deprivation and lower perceived neighborhood safety were associated with prenatal tobacco exposure.

Conclusions: Neighborhood environments differ between prenatal alcohol exposed children and unexposed children, as well as between prenatal tobacco exposed children and unexposed children. Future research should consider the cumulative and interactive effects of prenatal exposure to alcohol and tobacco and neighborhood environment.

Background: A low level of response (LR) to alcohol is a known risk factor for alcohol use disorder (AUD). Although higher total body water (TBW) is associated with lower blood alcohol concentrations and reduced responses following alcohol consumption, the relationship between morphometric measures such as body mass index (BMI) and LR is less clear. This study aimed to examine the relationship between BMI and LR to alcohol, and the contribution of TBW to this relationship.

Methods: Participants (n=1,086) enrolled in the NIAAA Natural History Protocol were assessed for LR to alcohol using the Self-Rating of the Effects of Alcohol (SRE) Questionnaire. BMI was estimated using height and weight, and TBW was estimated from height, weight, age and sex. Participants were categorized based on BMI into 3 groups: normal weight (18.5-25.0 kg/m²; n=430), overweight (25.0-30.0 kg/m²; n=403), and obese (≥30.0 kg/m²; n=253). Associations between BMI group and SRE scores for the most recent three-month period (SRE-Recent), and the effect of TBW, were analyzed using ANOVA. Linear regression analysis was conducted to estimate the proportion of variation in SRE-Recent explained by BMI and TBW.

Results: BMI category was associated with LR, with the normal weight group showing higher responses (lower SRE-Recent scores) to alcohol than the overweight or obese groups. After controlling for TBW, the relationship became non-significant. Linear regression models confirmed these findings.

Conclusions: Higher BMI is associated with lower LR to alcohol. However, TBW seems to account for this relationship, suggesting that concentrations achieved following alcohol consumption may be the primary determinant of BMI-related differences in LR. Future work should replicate these findings and examine these relationships throughout the lifespan and in individuals with AUD.

Background: A handful of studies have examined differences in the subjective effects and consequences of utilizing different modes of cannabis (e.g., smoking vs. vaping) at the daily level. However, results have been mixed and recent research suggests that there may be individual-level differences in these effects based on how often individuals use each mode. We aimed to determine within-person associations between mode of cannabis use (i.e., smoking, vaping plant material, vaping concentrates, dabbing, edibles, multiple modes) and quantity, subjective intoxication, consequences, contexts of cannabis use, and co-use with alcohol or tobacco varied based on how often individuals used each mode.

Methods: We used data from a 30-day EMA study of cannabis use with 338 sexual minority women and gender diverse young adults assigned female at birth, populations at high risk for cannabis use disorder.

Results: Several associations between mode of cannabis use and outcomes differed based on how frequently individuals used each mode. People who used edibles less frequently experienced more consequences when using edibles compared to smoking cannabis, while people who used edibles more frequently did not. People who used multiple modes more frequently took fewer hits when using multiple mode, while those who used multiple modes less frequently did not.

Conclusions: Analyses suggest that frequency, quantity, and consequences of some modes of use differed based on how frequently individuals used each mode. Further research is needed to identify protective behavioral strategies that may be utilized by individuals who use particular modes more often.

Objective: Racial and ethnic discrimination is a risk factor for substance use among United States adults. However, whether discrimination is associated with substance use disorders (SUDs) overall and by race and ethnicity is less understood.

Methods: We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n=35,355) and defined past-year discrimination as a summary scale (range: 0-4). Past-year SUDs included alcohol use disorder (AUD), tobacco use disorder (TUD), cannabis use disorder (CUD), and illicit drug use disorder (IDUD) based on DSM-5 criteria, and number of SUDs included one, two, or three or more SUDs. We estimated associations between discrimination and each SUD outcome using logistic and multinomial logistic regression and examined effect modification by race and ethnicity.

Results: Discrimination was associated with each substance-specific SUD (OR range: 1.36-1.78) and with one, two, and three or more number of SUDs (OR range: 1.34-2.19). Models stratified by race and ethnicity revealed that discrimination was associated with AUD among all groups (OR range: 1.42-1.52), with TUD only among adults who were non-Hispanic White, non-Hispanic Black and another non-Hispanic race, with CUD only among non-Hispanic White and non-Hispanic Black adults, and with only IDUD among Hispanic, non-Hispanic White, and non-Hispanic Black adults. In addition, discrimination was associated with three or more number of SUDs among all groups.

Conclusions: Discrimination was associated with all SUD outcomes, with variation in these relationships by race and ethnicity. Understanding this heterogeneity can inform efforts to prevent problematic substance use and promote health equity.

Background: There is a robust body of work demonstrating that certain drinking practices, such as pregaming or playing drinking games, are linked to heavier, riskier patterns of drinking among college students. However, less attention has been paid to other drinking practices that are relatively common among undergraduates, such as daytime drinking (i.e., drinking before 4:00 PM).

Method: Using data from an intensive longitudinal study (bursts of daily data over the course of 12 months; 6,842 total days of data) collected from a high-risk sample of college students (N=403), the present study tested daytime drinking as both a proximal (daily level drinking outcomes) and distal (AUD symptoms) risk factor for hazardous drinking.

Results: Daytime drinking was reported by over 70% of the sample and on approximately 15% of drinking days. Daily-level findings indicated that compared to non-daytime drinking days, daytime drinking days were significantly associated with more drinks consumed, more high-risk drinking practices (i.e., heavy episodic or high intensity drinking), and greater subjective intoxication. Longitudinal analyses identified frequent daytime drinking as a risk factor for increased hazardous drinking behavior, particularly among individuals who were younger or reported lower hazardous drinking at baseline.

Conclusions: Findings add to a sparse literature supporting daytime drinking as a risky drinking practice among college students. Future work should aim to further characterize contextual and psychosocial factors associated with daytime drinking practices.

Objective: Five U.S. states where recreational cannabis is legal require mandatory warning signs for cannabis use during pregnancy (MWS-cannabis) to be posted in cannabis dispensaries. Previous research has found adverse health consequences associated with MWS-cannabis and that people lack trust in information on signs. This qualitative study explores people's perspectives and preferences regarding MWS-cannabis.

Method: We conducted in-depth interviews with 34 pregnant or recently pregnant individuals from multiple states with varying policy climates in the United States who used cannabis before or during pregnancy. We asked participants about their perspectives on MWS-cannabis and reactions to specific messages. We reviewed transcripts using thematic analysis.

Results: Participants reported mostly negative views on MWS-cannabis, suggesting that they may have stigmatizing and negative impacts on pregnant people who use cannabis, discouraging them from seeking care. Many said that the scientific evidence is not strong enough to justify MWS-cannabis and that they are unlikely to deter pregnant people from using cannabis. Participants asserted that vague or fear-based messages, distrust of government, and the location and timing of the signs undermine the goals of MWS-cannabis. When reacting to specific messages, participants preferred messages that are evidence-based, clear, specific, and aligned with autonomous decision-making.

Conclusions: Pregnant and recently pregnant people who use cannabis have mostly negative perceptions of MWS-cannabis and believe they have negative consequences. More work is needed to develop health information resources that meet the needs of people who use cannabis during pregnancy without increasing stigma.