Individual Differences in Substance Use Motives, Trauma, and Stress Among College-Based Polysubstance Users.

Background: Co-use of alcohol and other drugs within a certain time frame (i.e., polysubstance use) has become increasingly prevalent, particularly among college-aged individuals, but understanding motives for co-use remains limited. Polysubstance use has been associated with a higher likelihood of negative health consequences as compared to single substance use. Objectives: The current study examined associations between motivations for using alcohol, tobacco, and cannabis among college students who use multiple substances versus students using only one substance or no substances. Additionally, we examined the effect of trauma and daily stress on polysubstance use in self-report data from individuals (N=134) participating in the MAPme Study. Results: First, the observed prevalence of polysubstance use was greater than expected by chance, with most individuals co-using alcohol and cannabis. "Alcohol and Other Drug Users" were more frequently motivated to drink for social (ß=0.27, CI=[0.07, 0.44]), enhancement (ß=0.26, CI=[0.01, 0.42]) and coping (ß=0.21, CI=[0.06, 0.47]) reasons compared to individuals who consumed alcohol alone. Conclusions: Individual differences in motivations for use were partly explained by frequency of alcohol use and alcohol problem severity, but not by history of trauma or stress. Finally, while patterns of correlations among motivations for use across substances suggested a general tendency to be motivated to use substances for similar reasons, this was not supported by confirmatory factor models. Overall, shared motives may inform potential behavioral patterns for co-use of substances during college and might advise future treatment efforts.

Emerging adults tend to use multiple substances, particularly alcohol and cannabisCorrelation patterns suggest shared motives within rather than across substancesAlcohol problem severity and alcohol frequency predict motives for use.

Characteristics of Cannabis and Opioid Users Among Older U.S. Veterans and Their Health Outcomes: A Longitudinal Perspective.

Medical cannabis use among U.S. Veterans has continued to rise. However, data on cannabis use by older Veterans is generally less available. This study aims to understand the characteristics of older Veterans who enrolled in the Medical Cannabis Patient Program in Illinois and analyze their health outcomes and co-use of cannabis and opioids using longitudinal survey data. Overall, participants reported positive outcomes for pain, sleep, and emotional problems because of cannabis use in two survey periods. Approximately, 62% and 85% respondents reported no change in memory and falls, respectively, with only 3% and 1% reporting a negative outcome for the conditions in both surveys. About 20.4% of those who indicated cannabis use only in the initial survey started to co-use opioids in the follow-up survey, while 44.1% of those who indicated the use of both substances in the initial survey reported no longer using opioids in the follow-up survey. However, these changes were not statistically significant (α=0.05). The logistic regression showed that both clinical and contextual factors affected co-use. In conclusion, older U.S. Veterans may be using cannabis to alleviate their pain and other chronic conditions. More research is needed to understand the effect of cannabis use on reducing or substituting opioids.

Associations Between Product Type and Intensity of Tobacco and Cannabis Co-use on the Same Day Among Young Adult Smokers: Smartphone-Based Daily-Diary Study.

BACKGROUND: Co-use of tobacco and cannabis is highly prevalent among young US adults. Same-day co-use of tobacco and cannabis (ie, use of both substances on the same day) may increase the extent of use and negative health consequences among young adults. However, much remains unknown about same-day co-use of tobacco and cannabis, in part due to challenges in measuring this complex behavior. Nuanced understanding of tobacco and cannabis co-use in terms of specific products and intensity (ie, quantity of tobacco and cannabis use within a day) is critical to inform prevention and intervention efforts. OBJECTIVE: We used a daily-diary data collection method via smartphone to capture occurrence of tobacco and cannabis co-use within a day. We examined (1) whether the same route of administration would facilitate co-use of 2 substances on the same day and (2) whether participants would use more tobacco on a day when they use more cannabis. METHODS: This smartphone-based study collected 2891 daily assessments from 147 cigarette smokers (aged 18-26 years, n=76, 51.7% female) during 30 consecutive days. Daily assessments measured type (ie, cigarette, cigarillo, or e-cigarette) and intensity (ie, number of cigarettes or cigarillos smoked or number of times vaping e-cigarettes per day) of tobacco use and type (ie, combustible, vaporized, or edible) and intensity (ie, number of times used per day) of cannabis use. We estimated multilevel models to examine day-level associations between types of cannabis use and each type of tobacco use, as well as day-level associations between intensities of using cannabis and tobacco. All models controlled for demographic covariates, day-level alcohol use, and time effects (ie, study day and weekend vs weekday). RESULTS: Same-day co-use was reported in 989 of the total 2891 daily assessments (34.2%). Co-use of cigarettes and combustible cannabis (885 of the 2891 daily assessments; 30.6%) was most commonly reported. Participants had higher odds of using cigarettes (adjusted odds ratio [AOR] 1.92, 95% CI 1.31-2.81) and cigarillos (AOR 244.29, 95% CI 35.51-1680.62) on days when they used combustible cannabis. Notably, participants had higher odds of using e-cigarettes on days when they used vaporized cannabis (AOR 23.21, 95% CI 8.66-62.24). Participants reported a greater intensity of using cigarettes (AOR 1.35, 95% CI 1.23-1.48), cigarillos (AOR 2.04, 95% CI 1.70-2.46), and e-cigarettes (AOR 1.48, 95% CI 1.16-1.88) on days when they used more cannabis. CONCLUSIONS: Types and intensities of tobacco and cannabis use within a day among young adult smokers were positively correlated, including co-use of vaporized products. Prevention and intervention efforts should address co-use and pay attention to all forms of use and timeframes of co-use (eg, within a day or at the same time), including co-use of e-cigarettes and vaporized cannabis, to reduce negative health outcomes.

Co-use among confidants: An examination of polysubstance use and personal relationships in southeastern Nebraska.

This study examines the relationship between personal networks and polysubstance use among people who use drugs (PWUD) in a medium sized city in the Midwest. A large body of work has demonstrated that personal relationships have an ambivalent association with substance use. On the one hand, a supportive network is associated with safer drug use practices and dramatically improves the outlook for recovery. However, individuals whose personal networks are composed of co-drug use partners are more likely to engage in risky practices. We argue that this notion of "supportive" social contacts and "risky" social contacts is ultimately incomplete: risky behaviors are introduced and further developed in a social context, often with the people who provide emotional support. We argue that personal networks with more multiplex relationships (where co-drug use and confiding fuse) are harmful because they combine norms of trust and reciprocity with drug use. We use data from the Rural Health Cohort (RHC) study to test this idea. The sample consists of 120 adult PWUD in a medium sized city located in southeastern Nebraska who were recruited using respondent-driven sampling. Participants listed up to nine confidants and nine co-drug use partners, indicating any overlap between the two networks. Our results demonstrate that multiplex ties are as strongly associated with polysubstance use as simple co-drug use relationships. As the drug crisis has increasingly shifted to underserved populations outside large urban centers, this paper represents an important advance in our understanding of the current drug crisis.

Stress and Affect as Daily Risk Factors for Substance Use Patterns: an Application of Latent Class Analysis for Daily Diary Data.

At the population level, use of multiple substances (or "co-use") is prevalent in young adulthood and linked with increased risk for experiencing substance-related harms. Less understood is the heterogeneity of substance use behaviors within individuals and across days, as well as the proximal predictors of these daily use patterns. The present study applied latent class analysis to daily diary data to identify daily substance use patterns and compare day-level class membership based on day-level stress and positive and negative affect among a higher-risk sample of young adult substance users. Participants (n = 152) completed up to 13 daily assessments of stress, affect, and substance use behavior. Among substance use days, five classes of days were identified: cannabis (some alcohol; 43% of days), alcohol-only (26%), vaping (some alcohol, cannabis; 24%), stimulant + alcohol (some cannabis, vaping; 4%), and cigarette-only (3%) days. Days with lower levels of perceived stress were significantly more likely to be alcohol-only Days relative to being days characterized by cigarette use, cannabis use, or multiple drug combinations. Days with higher levels of stress and negative affect were more likely to be cigarette-only days relative to cannabis and vaping days. Study findings document the wide range of substance use and co-use behaviors exhibited among young adults in daily life and highlight the importance of considering risk factors that correspond to days of problematic use patterns.

Conductas sexuales de riesgo en una muestra de estudiantes universitarios argentinos: relación con consumo de sustancias, inicio sexual temprano e impulsividad rasgo / Risky sexual behaviors in a sample of Argentinean college students: Relationship with substance use, early sexual onset and trait-like impulsivity

Resumen Introducción: Los adultos emergentes universitarios son particularmente vulnerables a presentar consumo abusivo de sustancias y conductas sexuales de riesgo (CSR), lo que incrementa el riesgo de contraer infecciones de transmisión sexual (ITS) o embarazo no deseado. Objetivo: Examinar, en universitarios, si el tipo de consumo de sustancias (alcohol versus uso concurrente de alcohol y marihuana) y el nivel de impulsividad rasgo se asocian con la frecuencia de CSR con parejas ocasionales. Método: Una muestra de 467 estudiantes completó una encuesta online que medía frecuencia de CSR, ocurrencia de consumo de alcohol y de marihuana en el último año y nivel de impulsividad. Resultados: Los consumidores de alcohol y marihuana, comparados con los consumidores de alcohol, reportaron mayor promedio de parejas sexuales al año y mayor arrepentimiento por no cuidarse contra ITS/embarazo. Los participantes con uso concurrente de sustancias, y niveles medios y altos en las facetas de impulsividad, falta de perseverancia y de premeditación, mostraron mayor frecuencia de encuentros sexuales que los consumidores de alcohol o con baja impulsividad. Conclusiones: Los hallazgos sugieren que el uso concurrente de sustancias y ciertas facetas de impulsividad se asocian a una mayor frecuencia de determinadas CSR. Esta información podría ser útil para intervenir preventivamente en CSR en universitarios argentinos.

Abstract Introduction: College students, a subpopulation of emerging adults, are particularly vulnerable to exhibit substance abuse and risky sexual behaviors. These behaviors put people at risk for sexually transmitted infections and/or unwanted pregnancy. Aim: To examine, in college students, whether the pattern of substance use (i.e., alcohol versus co-use of alcohol and marijuana) and the level of impulsivity are associated with the frequency of risky sexual behaviors with occasional partners. Method: A sample of 467 college students completed an online survey that assessed the frequency of risky sexual behaviors, past-year alcohol and marijuana use and trait-like impulsivity. Results: Alcohol/marijuana co-users, compared with alcohol users, reported a higher average of sexual partners per year and greater feelings of regret following careless sexual encounters. Co-users with medium or high levels in lack of perseverance and lack of premeditation (i.e., two facets of impulsivity) reported higher frequency of sexual encounters than alcohol users and/or students with low impulsivity. Conclusions: Findings suggest substance co-use, alongside different facets of impulsivity, are associated with greater frequency of specific risky sexual behaviors. These findings could better inform interventions aimed at prevent risky sexual behaviors in Argentinean college students.