Adolescent, Parent, and Provider Perspectives of a Social-Media-Based Support Tool for Parents of Teens in Treatment for Substance Use.

ABSTRACT: Adolescent substance use disorder contributes to negative psychosocial and physical health outcomes. Parents best support their child's treatment and recovery when they are equipped with knowledge and skills; however, barriers hinder parental engagement. Social-media-based groups present an opportunity for parents who may not otherwise seek support. Qualitative data were collected via focus groups to examine the opinions of adolescents, parents, and treatment providers on the potential utility and possible concerns of a Facebook-based parent support group; input constituted the development phase for an online group (PURPOSE). Fifty-eight participants, recruited through adolescent treatment programs, took part in six focus groups: two parent ( n = 18), two adolescent ( n = 21), and two provider ( n = 19) groups. Groups were audio recorded and transcribed, and themes were extracted. Three main themes emerged: (a) traditional support groups and treatment services, (b) PURPOSE intervention content and delivery, and (c) issues related to PURPOSE implementation. Traditional treatment/support groups can be helpful, but participation in them is limited. Emotional support offered by peers is valuable, but parents also need and seek out psychoeducation, parenting skills, and self-care support. PURPOSE could offer easy access to skills and real-time peer support.

Associations of cannabis product source and subsequent cannabis use among adolescents.

BACKGROUND: Cannabis is obtained from a variety retail and illicit sources, with unknown implications for youth cannabis use. This study assessed whether source of obtaining cannabis was associated with future cannabis use among adolescents. METHODS: High-schoolers (N = 835) completed 3 semiannual surveys, reporting use of 7 cannabis sources (i.e., free, bought from someone, from an online dispensary, with a [valid/invalid] medical card, self-grown, or other; separate dichotomous exposure variables) at wave 1 (n = 621; M[SD] age=17.14[.40]) or wave 2 (n = 622; M[SD] age=17.51[.39]). Past-6-month (yes/no) and number of past-30-day (0-30) non-medical use of any cannabis product, combustible, edible, and vaporized cannabis, blunts, and concentrates (i.e., dabs) were reported at waves 2-3. Random-effect time-lagged repeated-measures regression was used to test longitudinal associations of youth's cannabis source (waves 1-2; time-varying exposure) with cannabis use outcomes 6 months later (waves 2-3). RESULTS: Most youth (72.1%) received cannabis for free; 50.9% bought cannabis from someone, 15.9% used a valid medical card at a brick-and-mortar dispensary, and 3.9% grew cannabis. Buying cannabis from someone (OR=1.46, 95% CI: 1.07-1.99, p = .02) or using a valid medical card (OR=1.99, 95% CI: 1.20-3.31, p = .008) conferred greater odds of any cannabis product use 6 months later. Buying from someone predicted subsequent past-30-day use frequency (RR=1.25, 95% CI:1.05-1.48, p = .01). Some associations between particular cannabis sources and products were observed. CONCLUSIONS: Adolescents may access cannabis from several sources. Those who purchase cannabis illicitly from someone or from a brick-and-mortar dispensary using a valid medical card may be at increased risk for more persistent and frequent patterns of non-medical cannabis use.

Bidirectional associations between e-cigarette use and alcohol use across adolescence.

INTRODUCTION: Evidence on prospective bidirectional associations between e-cigarette and alcohol use among adolescents can inform prevention and policy but is largely absent from the literature. METHODS: Data were drawn from a prospective cohort of students attending 10 Los Angeles high schools (N = 3396; baseline mean age = 14.1, SD = 0.4). Students completed surveys every 6-months from 2013 to 2017; 8 total waves. Analyses were restricted to (a) individuals who were never users of alcohol (N = 2394) or (b) individuals who were never users of e-cigarettes (N = 2704) at baseline. Repeated-measures, generalized linear mixed models were used to estimate the adjusted odds of past 6-month alcohol and e-cigarette initiation, in separate models. RESULTS: Among alcohol never-users at baseline, 15.7 % (N = 375) initiated alcohol use over the study period. Compared to never-users of e-cigarettes, those who reported use of e-cigarettes had 3.5 times the odds of subsequently initiating alcohol use in the following wave (OR = 3.54; 95 % CI: 2.81, 4.47). Stronger associations were observed for males (OR = 4.94; 95 % CI: 3.78, 6.45) than for females (OR = 3.21; 95 % CI: 2.33, 4.41; pinteraction = 0.04). Among e-cigarette never-users at baseline, 26.3 % (N = 709) initiated e-cigarette use over the study period. Compared to never-users of alcohol, those who reported use of alcohol had 3.2 times the odds of subsequently initiating e-cigarette use in the following wave (OR = 3.23; 95 % CI: 2.68, 3.89). This association did not differ by gender. CONCLUSIONS: E-cigarette and alcohol use can be markers to identify youth at risk for future alcohol and e-cigarette use, respectively. Research examining mechanisms underlying these associations is needed to infer causality.

Digital media use and subsequent cannabis and tobacco product use initiation among adolescents.

BACKGROUND: Digital media engagement, such as browsing the internet or social media posting, may be associated with cannabis and tobacco product use initiation among adolescents. Whether certain digital media exposure confers greater - or reduced - risk for specific cannabis or tobacco products is unknown. METHODS: Adolescents completed surveys on digital media and substance use every 6 months from 2015 to 2017 (4 waves). Self-reported digital media use (14 items) was classified into six subcategories (e.g., "social media posting," "reading news/articles & browsing photos"). Random-effect repeated-measures regression models examined the association of exposure to each digital media subcategory with subsequent cannabis or tobacco product use initiation in the next 6 months, among baseline cannabis and tobacco never-users (n = 1841; n = 1558, respectively). RESULTS: High frequency digital media use (multiple times/day) of "social media posting" (vs. no high frequency use; OR = 1.95; 95%CI:1.20-3.17) and "checking in" (OR = 1.71; 95%CI:1.23-2.38) was associated with greater odds of any cannabis product use initiation 6 months later. "Reading news/articles & browsing photos" was associated with decreased odds of initiation (OR = 0.52; 95%CI:0.34-0.79). "Checking in" and "reading news/articles & browsing photos" were similarly associated with any tobacco use initiation. "Chatting and shopping" was associated with greater odds (OR = 4.63; 95%CI:1.53-14.06) of e-cigarette initiation, but not of other product use initiation. CONCLUSIONS: Some subcategories of digital media use conferred increased odds, others conferred reduced odds, and others were not associated with cannabis and tobacco use initiation. Research exploring mechanisms that put users of specific digital media at greater risk for substance use initiation is warranted.