Decision-making impairments in binge drinking and cannabis use among young adults.

Adverse childhood experiences (ACEs) predict problematic health outcomes (eg, substance use, mental health) among young adults; whether specific ACEs are differentially associated with specific substance use and mental health symptoms is understudied. Latent class analysis (LCA) identified classes of ACEs among 2209 US young adults (Mage = 24.69, range: 18-34; 57.4% female; 30.9% sexual minority; 35.8% racial/ethnic minority) in a 2-year study (2018-2020). Multivariable logistic regressions examined ACEs (reported in 2019) in relation to 2020 reports of current (past 30-day) substance use (ie, tobacco use; cannabis use and hazardous use; alcohol use and binge drinking) and mental health (ie, ≥moderate depression and anxiety symptoms), controlling for sociodemographics (ie, age, gender, race, ethnicity, sexual orientation, education). Overall, 65.4% reported ≥1 ACE (M = 2.09, SD = 2.30); 34.8%, 39.1%, and 71.1% current tobacco, cannabis, and alcohol use; 39.1% and 15.3% hazardous cannabis use and binge drinking; and 24.2% and 34.5% ≥moderate depression and anxiety symptoms, respectively. LCA yielded 4 classes: Low ACEs (referent; 55.6%), Poor family health and divorce (16.3%), Parental abuse (16.0%), and High ACEs (12.1%). High ACEs (vs Low ACEs) was associated with each adverse substance use and mental health outcome except alcohol use. Poor family health and divorce was associated with tobacco use, cannabis use, and both mental health outcomes. Parental abuse was associated with tobacco use, cannabis use, hazardous cannabis use, and both mental health outcomes. Health promotion interventions for young adults must assess ACEs, given that certain types of ACEs may be associated with distinct substance use and mental health outcomes.

OBJECTIVES/GOALS: Cannabis laws may impact cannabis and tobacco use, given high prevalence of co-use of these products among young adults (YAs). The objective of this study was to examine trends in YA any cannabis, blunt, cigarette, and cigar use from 2002-2018 in states that passed adult and medical use (AMU) or medical use only (MUO) cannabis laws during that time (N=16). METHODS/STUDY POPULATION: Using data from the National Survey on Drug Use and Health, we conducted a segmented regression analysis to calculate absolute percent change (APC) in past 30-day cannabis and tobacco use between time points. The National Cancer Institute’s Joinpoint software was used to also estimate points of inflection (Joinpoints) when the slope of a trend significantly (p<0.05) changes. Separate models were estimated for each state, with time as the independent variable measured in years. Up to three Joinpoints per model were allowed. The model with optimal Joinpoints was determined using a model selection criterion via a permutation test. Joinpoints and APCs were compared with key legalization dates to describe patterns within and across states with varying cannabis policies. RESULTS/ANTICIPATED RESULTS: Generally, the 16 states showed a steady decline in YA cigarette smoking over time, a slight decline in cigar smoking, and increases in cannabis and blunt use. AMU states had lower average 2018 prevalence of cigarette smoking than MUO states (18.3% vs. 21.5%) and higher cannabis use (32.3% vs. 21.3%). Cannabis use consistently increased following opening of MUO retail outlets. Generally, there appears to be a slight delay in cannabis use increases following AMU laws, and in some states temporary declines. For example, Washington experienced an initial decrease (-20.3%) following AMU passage (2012) then increase (+16.3%) after retail dispensaries opened in 2014. In AMU states, blunt use has surpassed cigar smoking, while in MUO states, the prevalence of blunt and cigar use is similar. DISCUSSION/SIGNIFICANCE: Introduction of cannabis laws are correlated with increases in YA cannabis and blunt use, with higher cannabis use in AMU states. Trends may also correlate other state political, economic, or social factors. Joinpoint regression can assess changes in a policy’s target behavior with no a priori assumptions regarding timing of policy effects.

Neural reward sensitivity and longitudinal patterns of alcohol and cannabis use in college-aged youth.

Background: Although the relation between impulsivity and substance use outcomes is well-documented (Jones et al., 2014; Stautz et al., 2017), less is known about individual facets of impulsivity among individuals who use cannabis. There is some research suggesting that positive urgency, sensation seeking, and lack of premeditation are associated with greater cannabis use problems, but much of this research has been conducted in normative adolescent or young adult samples (VanderVeen et al., 2016). Given that more than 11% of legal cannabis users currently use daily/near daily (Goodman et al., 2020), this study examined relations between individual facets of impulsivity and cannabis use, alcohol use, simultaneous cannabis and alcohol use, and problem use within a sample of frequent, adult cannabis users. Methods: Individuals (n=167) with a mean age of 34.89 (SD=11.19) who reported using cannabis on average once per day completed measures of individual facets of impulsivity (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking; UPPS-P), cannabis use frequency, alcohol use frequency, simultaneous cannabis and alcohol use frequency, cannabis use problems, cannabis use disorder, and alcohol use disorder. Path models were used to predict frequency of use (cannabis, alcohol, and simultaneous cannabis/alcohol) and problem use (cannabis consequences, cannabis use disorder, and alcohol use disorder) from each facet of impulsivity. Models were first run using sex, age, and race as covariates, and subsequently run after adding depressive and anxiety symptoms as covariates. Results: After controlling for sex, age, and race, positive urgency was associated with less frequent cannabis use (b=-0.28, S.E.=0.13, p=0.03), more frequent simultaneous cannabis and alcohol use (b= 0.24, S.E.=0.11, p=.04), and greater cannabis consequences (b=0.30, S.E.=0.10, p=0.002). Negative urgency was associated with greater cannabis consequences (b=0.31, S.E.=0.09, p&lt;0.001), cannabis use disorder (b=0.27, S.E.=0.09, p=0.002), and alcohol use disorder (b=0.27, S.E.=0.10, p=0.01). After including depressive and anxiety symptoms as covariates, relations with positive urgency, but not negative urgency, remained significant. Conclusions: The findings of the current study suggest that positive urgency may be uniquely linked to riskier behavior in frequent cannabis users given that no other facet of impulsivity was significantly associated with cannabis use outcomes after all covariates were included in the model. Although not directly assessed in the current study, the findings suggest that relations between negative urgency and cannabis use frequency and cannabis and alcohol use disorder may be mediated by depressive and anxiety symptoms. This possibility should be explicitly examined in future studies. The lack of relations between other facets of impulsivity and alcohol and cannabis use outcomes in the current study suggest that effects of impulsivity among daily users may be restricted to urgency, in contrast to studies in normative adolescent and young adult samples (VanderVeen et al., 2016).

The Evidence for SBIRT in Adolescents

Subjective memory decline is an early sign of cognitive decline and dementia. Understanding risk factors associated with midlife poor memory is crucial for effective prevention. This study prospectively examines associations between young adult (YA) heavy substance use and late midlife poor memory, and the mediating role of early midlife problematic substance use. Data on number of waves of YA (age 18-30) heavy alcohol, binge drinking, cannabis and cigarette use, early midlife (age 35) substance use disorder symptoms and heavy cigarette use, and late midlife poor self-rated memory (age 50-65) were from the Monitoring the Future (MTF) Panel study (N = 14,659). Mediation analyses assessed whether early midlife problematic substance use mediated YA heavy substance use associations with late midlife poor memory. YA heavy alcohol use and binge drinking were associated with higher odds of early midlife disordered (vs. non-disordered) alcohol use (AOR=1.69 and 1.66, both p&amp;lt;.001), and with late midlife poor memory (AOR=1.34 and 1.39, both p&amp;lt;.001). Partial mediation for alcohol (AOR=1.17, p&amp;lt;.001) and full mediation for binge drinking (AOR=1.18, p&amp;lt;.001) were observed. YA heavy cannabis use was associated with early midlife disordered use (vs. non-disordered; AOR=1.42, p&amp;lt;.001), and with late midlife poor memory (AOR 1.41, p = 0.008); full mediation (AOR=1.13, p = 0.010) was observed. YA daily cigarette use was directly associated with late midlife poor memory (AOR=1.05, p = 0.047), with no evidence of mediation. These findings underscore long-term risks of sustained YA substance use for cognition, and indicate that long-term associations may partially or completely operate through early midlife disordered substance use.

Person-centered patterns of substance use during the COVID-19 pandemic and their associations with COVID-related impacts on health and personal finances in young Black and White women

Background: Adolescence is a common time for experimentation with substance use and the emergence of sex differences in substance use patterns. Although similar in early adolescence, male and female substance use patterns historically diverge by young adulthood, with males using more substances than females. We aim to add to current literature by utilizing a nationally representative sample, assessing a broad range of substances used, and focusing on a sentinel period during which sex differences emerge. We hypothesized that certain sex-specific substance use patterns emerge in adolescence. Methods: Data are from the 2019 Youth Risk Behavior Survey (n = 13,677), a nationally representative sample of high school students. Weighted logistic analyses of covariance adjusting for race/ethnicity evaluated males’ and females’ substance use (14 outcomes) by age category. Results: Among all adolescents, more males reported illicit substance use and cigarette smoking than females, whereas more females reported prescription opioid misuse, synthetic cannabis use, recent alcohol use, and binge drinking. Divergence between male and female use usually occurred at 18+ years. Odds of using most illicit substances were significantly greater among males than females at age 18+ years (aORs 1.7–4.47). Among 18+ year-olds, males and females did not differ in electronic vapor product use, alcohol use, binge drinking, cannabis use, synthetic cannabis use, cigarette smoking, or prescription opioid misuse. Conclusions: Sex differences in adolescent use of most but not all substances emerge by age 18+ years. Sex-specific patterns of adolescent substance use may inform specific prevention efforts and identify peak ages for intervention.

Tobacco, alcohol and cannabis are psychoactive substances that is often tried for the first time during adolescence and further continued in later life. Regular tobacco and cannabis use as well as alcohol abuse are associated with serious health consequences. According to the importance of health reporting, this article describes current prevalence of adolescent substance use and the associations between psychoactive substance use and specific social determinants. Representative data for Germany from the 2017/18 Health Behaviour in School-Aged Children (HBSC) study among schoolchildren aged 11, 13 and 15 years are used. The article analyses both, the lifetime and 30-day prevalence of tobacco, alcohol and cannabis use (in the latter case, data were only available for 15-year-olds) among adolescents as well as their experiences of alcohol-related misuse (binge drinking). Tobacco and alcohol are used comparatively rarely by 11- and 13-year-olds. However, the prevalence increases significantly among 15-year-olds. In addition, cannabis use is also quite common among this age group. Schoolchildren who do not attend grammar schools are at greater risk of smoking and those with high family affluence are at a greater risk of alcohol use, this applies particularly to girls. Finally, adolescents with a migration background are less at risk of regular alcohol use or binge drinking, but face an increased risk of cannabis use (girls with one-sided migration background). The results indicate that prevention measures should start early, as the prevalence of substance use is significantly higher among older schoolchildren. Depending on the substance, different risk groups can be identified that require particular consideration when drawing up preventive measures.

To quantify the trends in frequent and occasional cannabis vaping, demographic differences and concurrent nicotine and alcohol use. Observational study. Survey-weighted multinomial logistic regression models assessed trends and disparities in past 30-day cannabis use. Trends were assessed overall and by sex, race/ethnicity, parental education and urbanicity. Multinomial logistic regression models also estimated associations of cannabis use (none, use without vaping, use with vaping) with past 2-week binge drinking and past 30-day nicotine/tobacco use. United States, 2017-19. Participants in the national Monitoring the Future (n = 51 052) survey. Past 30-day frequent cannabis use (six or more times/30 days) and past 30-day occasional use (one to five times/30 days), with and without vaping. Past 30-day frequent cannabis use with vaping and occasional use with vaping rose from 2017 to 2019. Past 30-day frequent and occasional cannabis use without vaping declined. Certain groups, such as Hispanic/Latino or lower socio-economic status adolescents, experienced particularly notable increases in frequent cannabis use with vaping (e.g. prevalence among Hispanic/Latino adolescents). Adolescents who reported smoking and vaping nicotine, and 10+ occasions of binge drinking, were 42.28 [95% confidence interval (CI) = 33.14-53.93] and 10.09 (95% CI = 4.51-22.53) times more likely to report past 30-day cannabis use with vaping, respectively, compared with no use. Cannabis use without vaping appears to be declining among adolescents in the United States, while cannabis use with vaping is accelerating; frequent cannabis vaping is especially increasing, with consistent increases across almost all adolescent demographic groups. Cannabis use among US adolescents remains highly associated with other substance use.

"Stealthing" is a form of sexual violence wherein a sexual partner purposefully removes a condom during penetration without the receptive partner's knowledge. Given the role of substance use in sexual violence broadly, we examined demographic and substance use correlates of stealthing perpetration (SP) and victimization (SV) among emerging adults. Participants comprised 2,550 18- to 25-year-olds (M age = 20.8, SD = 2.3), recruited via social media (48% female; 53.9% non-Hispanic White; 46.0% had another racial/ethnic identity; 67.4% heterosexual; 85.3% had some college education). Unadjusted analyses (t tests, χ2 analysis) and adjusted logistic regression analyses examined associations between demographics (age, education, race/ethnicity, sexual orientation) and substance use (binge drinking, marijuana use, other illegal drug use, and prescription drug misuse) with male SP and male and female SV. Five percent of males and 18.9% of females reported SV; 6.1% of males reported SP. In adjusted analyses, significant correlates of SP were: non-Hispanic White race/ethnicity (odds ratio [OR] = 0.39), binge drinking (OR = 1.39), cannabis use (OR = 1.37), and other drug use (OR = 1.43). Significant correlates of male SV were: non-Hispanic White race/ethnicity (OR = 0.28), non-heterosexual orientation (OR = 0.24), binge drinking (OR = 1.49), and other illegal drug use (OR = 1.79). Significant correlates of female SV were: older age (OR = 1.13), non-Hispanic White race/ethnicity (OR = 0.57), binge drinking (OR = 1.28), cannabis use (OR = 1.29), and other drug use (OR = 1.22). Consistent with literature linking alcohol to sexual violence, binge drinking correlated with both SV and SP, with other substance use also playing a role. Data are needed to explore these relationships using longitudinal, event-level assessments to investigate the influence of acute intoxication. Interventions to reduce sexually transmitted infections, unintended pregnancy, and sexual assault should include content on stealthing and substance use.

Development of individuals’ own and perceptions of peers’ substance use from early adolescence to adulthood

Heavy drinking is common among men who have sex with men (MSM) and significantly increases HIV acquisition risk. MSM who report heavy drinking also report higher cannabis use, which has also been associated with sexual behaviors known to elevate HIV transmission risk. Despite evidence of associations at the between-subjects level, the effects of alcohol and cannabis use on sexual risk behavior among MSM who engage in heavy drinking are largely unknown. The current study used ecological momentary assessment to examine the between- and within-subject associations of heavy drinking, cannabis use, and sexual behavior. This is a secondary data analysis of a study on alcohol intoxication and sexual decision making that included 115 MSM who reported cannabis use and were not using pre-exposure prophylaxis (PrEP) at baseline. Participants reported daily alcohol and cannabis use and sexual activities over 6 weeks. Multilevel multinomial regression was used to evaluate how alcohol and cannabis use were associated with sexual behaviors. Higher alcohol use was associated with higher rates of intercourse at the between-persons level and a higher likelihood of all sexual behaviors at the event level. In contrast, cannabis use at the between-person level was associated with an increased rate of condomless anal intercourse relative to both anal intercourse with a condom as well as no sex. At the within-person level, cannabis was associated with an increased likelihood of anal sex with or without a condom relative to no sex. Cannabis and alcohol may have independent effects on sexual risk behavior among MSM. Interventions addressing sexual health among MSM who engage in heavy drinking should also consider the additive risks of cannabis use.

Binge drinking is elevated among recreational drug users, but it is not clear whether this elevation is related to intoxication with recreational drugs. We examined whether stimulant intoxication and cannabis intoxication were associated with binge drinking among young adults. An online survey of 18- to 30-year-old Australians who had drunk alcohol in the past year (n = 1994) were quota sampled for: (i) past year ecstasy use (n = 497); (ii) past year cannabis (but not ecstasy) use (n = 688); and (iii) no ecstasy or cannabis use in the past year (alcohol-only group, n = 809). Binge drinking last Saturday night (five or more drinks) was compared for participants who took stimulants (ecstasy, cocaine, amphetamine or methamphetamine) or cannabis last Saturday night. Ecstasy users who were intoxicated with stimulants (n = 91) were more likely to binge drink than ecstasy users who were not (n = 406) (89% vs. 67%), after adjusting for demographics, poly-drug use and intoxication with cannabis and energy drinks (adjusted odds ratio 3.1, P = 0.007), drinking a median of 20 drinks (cf. 10 drinks among other ecstasy users). Cannabis intoxication was not associated with binge drinking among cannabis users (57% vs. 55%) or ecstasy users (73% vs. 71%). Binge drinking was more common in all of these groups than in the alcohol-only group (34%). Stimulant intoxication, but not cannabis intoxication, is associated with binge drinking among young adults, compounding already high rates of binge drinking among people who use these drugs.

Purpose While research on the association between childhood abuse and substance use has proliferated in recent years, most studies have relied on less representative samples, hindering scholars’ ability to make larger generalizations. Moreover, very few studies have explored the moderating effects embedded in that association. With these gaps in mind, the present study examines: First, are childhood physical and sexual abuse associated with drinking, binge drinking, and cannabis use? Second, how does religion moderate those associations? Methods The present study uses a nationally representative sample of Canadians aged 15 and older (N= 32,519) – the 2014 Canadian General Social Survey (Cycle-28). A series of ordinal and logistic regression models are applied. Results We discover that childhood physical abuse is positively associated with drinking, binge drinking, and cannabis use. Similar patterns have also been observed for individuals who experienced childhood sexual abuse. Moreover, religious beliefs moderate the association between childhood physical abuse and binge drinking, suggesting that the positive association between childhood physical abuse and binge drinking is stronger among those with greater religious beliefs. Conclusions Consistent with more recent literature, the present study highlights that the buffering role of religiosity might not apply to substance use within the context of childhood abuse.