Substance Use & Misuse最新文献

Substance use and mental health are highly correlated, though few studies assess the risk for depression and anxiety associated with dual and polysubstance use among college students. The purpose of this study was to characterize the relationship between alcohol, cannabis, and e-cigarette exclusive, dual, and polysubstance use and depression and anxiety among U.S. college students by racial and ethnic subgroup and stratified by sex.

Data from 83,467 undergraduate students participating in the 2020-2021 Health Minds Survey, a multi-campus, web-based survey, were used. Sex-stratified logistic regression models examined the effects of exclusive (past 30-day cannabis use, past 30-day e-cigarette use, past 2-week heavy alcohol use), dual (two among cannabis, e-cigarette, or alcohol use), and polysubstance (all three substances) use on anxiety (≥10 GAD-7 score) and depression (≥15 PHQ-9 score).

The study included 60,746 females and 22,721 males. Among females, compared to those who exclusively used alcohol, dual users of cannabis and e-cigarette had the largest odds for depression (adjusted odds ratio (aOR) = 1.92) and anxiety (aOR = 1.69) followed by polysubstance users (aORs = 1.85 and 1.53, respectively). Among males, compared to those who exclusively used alcohol, dual users of cannabis and e-cigarette had the largest odds for depression (aOR = 2.72) and anxiety (aOR = 2.23) followed by polysubstance users (aOR = 1.71 and 1.85, respectively). African American female and male students had lower odds of anxiety and depression compared to White students.

The results suggest that single, dual, and polysubstance use are associated with anxiety and depression among U.S. college students, though not necessarily in additive ways.

Background: Black men who have sex with men (BMSM) face multiple minority stressors (e.g., homophobia, racism, and presumed HIV status) that may indirectly erode their confidence in pursuing HIV testing uptake through exacerbating alcohol use disorder (AUD). Objectives: Using cross-sectional data from 203 community-based BMSM (71.4% as homosexual with a mean age of 26 years) living in a Southern US city, we conducted a causal mediation and moderation analysis to investigate in/direct pathways linking minority stressors, AUD risk, and self-efficacy of HIV testing, including how resilience may moderate these associations. Results: Our mediation analysis revealed that AUD risk accounted for 32.1% of the total effect of internalized homonegativity (β_{total effect} = -0.424; SE=0.071; p<0.001), 28.6% of the total effect of experienced homophobia (β_{total effect} = -0.684; SE=0.122; p<0.001), and 15.3% of the total effect of perceived HIV stigma (β_{total effect} = -0.361; SE=0.164; p<0.05) on HIV testing self-efficacy. Resilience significantly moderated the associations of experienced homophobia (β = -0.049; SE=0.011; p<0.001), internalized homonegativity (β = -0.065; SE=0.027; p<0.01), and perceived HIV stigma (β = -0.034; SE=0.013; p<0.05) with AUD risk. Resilience also significantly moderated the associations of experienced homophobia (β = -0.073; SE=0.021; p<0.01), internalized homonegativity (β = -0.082; SE=0.012; p<0.001), perceived HIV stigma (β = -0.037; SE=0.039; p<0.05), and AUD risk (β = -0.021; SE=0.015; p<0.05) with HIV testing self-efficacy. Conclusions: Our study provides important implications in identifying multilevel sources for building resilience among BMSM to buffer the effects of minority stress on AUD risk and improve HIV testing outcomes.

Background and objectives: We examined associations between sources of social influence (i.e. close friends, other underage people present) within specific settings with the number of drinks underage youth consumed.

Methods: Data were collected through a cross-sectional survey with 422 underage youth in California (14 to 19 years old) who reported past-6-month alcohol use. Participants were asked to think about the last time they drank alcohol in the past 6 months at: restaurants, bars/nightclubs, own home, another's home, outdoors, and fraternities/sororities. Outcomes were the number of whole drinks participants drank the last time in each setting. Independent measures were social characteristics of these drinking events including number of people <21 years old present, number of close friends present, number of <21 years old who consumed alcohol, and number of close friends who consumed alcohol. We also assessed socio-demographics and accounted for the overall exposure to each setting in the past 6 months.

Results: Using negative binomial regression models, the number of close friends was positively associated with number of drinks consumed at restaurants, another's home, and outdoors. The number of close friends drinking was positively associated with the number of drinks at restaurants, own home, another's home, and outdoors. Number of people <21 years old was positively associated with number of drinks at own home, and number of people <21 years old who consumed alcohol was positivity associated with number of drinks consumed at restaurants, own home, another's home, and outdoors.

Conclusions: Results suggest that social influence from close friends and from other underage youth are context-specific.

Introduction: Flavorings are one of the major appealing factors of current tobacco products, especially for young adults. They constantly evolve, and new flavorings are introduced to the market every year, but little is known about user profiles of flavored tobacco products (FTPs). Methods: We analyzed young adult (ages 18-24) tobacco product users (N = 4,707) from Wave 5 of the Population Assessment of Tobacco and Health Study. We applied bivariate analyses to compare individuals who use FTP and non-FTPs by different flavor types (i.e., menthol/mint, fruit, candy/sweets, and tobacco). Parameter estimates were weighted by applying the sample and replicate weights for the complex study design to produce population-representative estimates. Results: Sixty percent of the current combustible tobacco users and 90% of electronic nicotine delivery systems (ENDS) users were FTP users. FTP users were more likely to be multiple product users than non-FTP users. Being non-Hispanic White, drinking alcohol in the past year, experiencing internalizing problems in the past month, and having tobacco dependence were associated with FTP use. Flavored ENDS users had different sociodemographic characteristics by flavor types but did not differ significantly in vaping-related behaviors (e.g., frequency). Also, preferred flavors differed among tobacco user groups (i.e., ENDS, hookah, and cigars). Conclusions: FTPs appear to be gaining popularity among young adults and tend to show co-use with multiple tobacco products and other substances. Future studies are warranted to monitor the risk factors of young adult FTP use, especially in the context of flavor ban on ENDS products.

Background: Population prevalence and patterns of cannabis use for mental health (CUMH) are underexplored. This is important to understand in the Canadian territories which has the highest prevalence of cannabis use in Canada. This study aimed to examine socio-demographic factors associated with CUMH in the territories and associations between CUMH and cannabis use outcomes.

Methods: This study is a cross-sectional analysis of survey data from the 2022 Cannabis Policy Study in the Territories, including 2431 respondents aged 16+. Multivariable logistic regression models were used to examine socio-demographic characteristics associated with CUMH. Among past 12-month cannabis consumers, multivariable logistic regression models were used to examine whether CUMH was associated with daily/near-daily use, cannabis product type, healthcare interactions, and self-reported impacts on mental health, controlling for socio-demographic characteristics.

Results: Overall, 29.6% of all participants, and 55.5% of past 12-month cannabis consumers reported ever using cannabis for mental health. Use for mental health was higher among those with lower education, lower perceived income adequacy, and younger ages. Those reporting CUMH were more likely to report daily/near-daily use (OR_adj = 3.00, 95%CI: 2.01-4.49), potent product types like solid concentrates (OR_adj = 2.76, 1.62-4.70), and perceived positive impacts on mental health (OR_adj = 3.71, 2.49-5.52).

Conclusion: Due to the high prevalence of CUMH, more research is needed to examine its long-term impacts and effectiveness. Future research is also needed to understand the social context underlying socioeconomic inequalities in CUMH, including access to mental healthcare and harm reduction measures for mitigating adverse mental health impacts.

Introduction: Blunt and hemp wraps, as a means of consuming cannabis, have emerged into the retail space where the prevalence has been increasing since 2017. There is limited epidemiological research on the prevalence of use of these products across the U.S. particularly among young adults who are at greater risk of tobacco and cannabis use.

Methods: This study draws from a U.S. national representative sample of young adults (n = 1178) captured in May 2022. Respondents participated in an online survey about their use of blunt and hemp wraps. Multinomial regression was used to examine differences in sociodemographic characteristics (gender, race/ethnicity, sexual orientation, educational attainment, and region) in relation to use of each wrap type.

Results: One quarter (22.7%) of young adults reported ever having used a blunt wrap, 3.2% in the past 30-days. One in seven (14.3%) had ever used a hemp wrap, 2.3% in the past 30-days. Non-Hispanic Black young adults were 1.55 and 2.91 times as likely to have ever used blunt or hemp wraps, respectively, compared to non-Hispanic Whites. Similarly, participants who identified as gay or lesbian or bisexual similarly had greater odds of having ever used blunt or hemp wraps. Hispanic young adults were 2.49 times as likely to have used hempwraps compared to non-Hispanic Whites.

Conclusion: Blunt and hemp wrap use is prevalent among young adults, particularly among minoritized populations. Continued research and surveillance of use of these products is needed to fully evaluate the impact their use may have on the broader population.

Background: African American/Black (hereafter referred to as Black) persons who smoke constitute a tobacco disparities group in the United States. Within the Black population, female smokers experience a disproportionate percentage of these disparities and are less likely to quit cigarettes than their male counterparts. Two factors implicated in female smokers' relatively worse quit success are (1) motives to smoke to reduce negative affect and (2) expectancies that smoking will reduce negative affect.

Objectives: The present study sought to test sex differences in these two clinically relevant cognitive constructs and evaluate the indirect effects of sex and severity of problems when trying to quit via smoking motives and expectancies for negative affect reduction among Black adults who smoke. Participants included 103 Black adults who smoke daily (72% male; M_age = 44.5 years, SD = 11.5 years).

Results: Results revealed sex differences in both negative affect reduction motives and expectancies, as well as a partial indirect effect for sex on the severity of problems when trying to quit through negative affect reduction motives (a₁b₁ = 0.18, 95% CI [0.04, 0.38]) but not negative affect reduction expectancies (a₂b₂ = -0.01, 95% CI [-0.11, 0.09]) in a simultaneous model of indirect effects.

Conclusions: These findings shed light on the complex relationship between race, sex, and severity of problems when trying to quit, particularly when complicated by smoking motives and expectancies. Current data should be considered when developing sex-specific, tailored smoking cessation interventions for Black women.

Background: The present study aimed to explore women's perception of men with different addictions in terms of their short- and long-term mate value. Objectives: 2,525 women (age range: 18-40, M = 28.35, SD = 6.39) were randomized to six conditions in a vignette-based experiment where a male of otherwise high mating value was described as suffering from either gambling, gaming, cannabis, anabolic androgenic steroid, and alcohol addiction or as not suffering from addiction (control). Results: Regarding long-term mate value of the target, the control target was rated higher than each of the targets. The gaming target was rated higher than the alcohol, cannabis, and gambling targets. Finally, the AAS target was rated as higher on long-term mate value than the alcohol and gambling addiction targets. Conclusions: Overall, women seem to perceive risk-taking in the face of uncertainty, reflected by gambling addiction, as an attractive behavioral tendency in men in terms of short-term mating. In contrast, potential long-term mates with gaming or chemical addictions are viewed more negatively, probably because it signals inadequate time and resources to be invested in a relationship.

Background: Engagement in food and alcohol disturbance (FAD; e.g., restricting caloric intake in the context of using alcohol to quicken/increase intoxication [FAD-intoxication] and/or to offset calories consumed from alcohol [FAD-calories]) confers risk to college students. Much research suggests that students overestimate the frequency of high-risk drinking among their peers, leading to greater participation in personal high-risk drinking. However, limited work has examined social norms related to FAD and their association with FAD behaviors. Objectives: The present study investigated: (a) whether normative misperceptions exist for FAD, (b) whether FAD norms are associated with FAD behaviors, and (c) whether gender moderates the association between FAD norms and FAD behaviors. Participants were 1,499 college students from six universities who consumed alcohol in the last month and identified as a woman or man. A plurality of participants identified as being White, non-Hispanic (59.5%) and female (68.1%), with a mean age of 19.66 (SD = 2.09) years. Results: Analyses revealed that students overestimated the frequency and approval of both FAD-intoxication and FAD-calories behaviors among their same-gender peers. Notably, these misperceptions were greater for FAD participators compared to FAD abstainers. Moreover, the associations between FAD norms and FAD behaviors were generally stronger for women compared to men. Conclusions: Our preliminary findings identify social norms as a potential target for interventions aiming to reduce FAD among college students. Further, our results provide preliminary evidence that college women, especially those who engage in FAD, may reap the greatest benefit from interventions targeting normative misperceptions (e.g., personalized normative feedback) related to FAD.

Background: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), categorizes betel-quid use disorder (BUD) under Other (Or Unknown) Substance Use Disorder, and the diagnostic criteria used are adapted from those of Substance Use Disorder. Because different substances have different characteristics, an improved set of diagnostic criteria is required to better detect BUD.

Objective: The objective of this study was to examine the different measures of accuracy for DSM-5 BUD by using the addiction characteristics defined by the American Society of Addiction Medicine (ASAM).

Methods: A certified psychiatrist conducted face-to-face diagnostic interviews. Questionnaires were administered to assess betel-quid use history, patterns of use, and dependence features. All betel-quid users were evaluated for BUD by using the DSM-5 criteria and addiction characteristics defined by the ASAM.

Results: One of the DSM-5 diagnostic criteria for BUD, namely large amount of time spent on obtaining and using betel quid and recovering from betel-quid use, showed the lowest sensitivity of 0.14, lowest diagnostic accuracy of 0.63, and lowest diagnostic odds ratio of 2.61. Another DSM-5 diagnostic criterion, namely continued betel-quid use despite knowledge of physical or psychological problems, had the lowest specificity of 0.49. The diagnostic threshold of five or more DSM-5 BUD criteria showed a sensitivity of 0.86 and a specificity of 0.97.

Conclusions: This study is the first to evaluate the different measures of accuracy for DSM-5 BUD. Given that each addictive substance has unique addictive characteristics, the composition and number of criteria for diagnosing DSM-5 BUD must be reconsidered.