Is the deliberate self-induction of alcohol tolerance associated with negative alcohol outcomes?

Research indicates 10% of college student drinkers report deliberately training to increase alcohol tolerance (a diagnostic criterion for alcohol use disorder) to avoid passing out early or to keep up with peers. Given that tolerance training may be considered a harm reduction technique designed to reduce acute aversive consequences, we examined the associations between tolerance training and the use of protective behavioral strategies (PBS) more generally. A cross-sectional survey of 1080 lifetime drinkers was conducted at a large Midwestern university. Of this sample, 5.6% (n=60) reported training to increase their tolerance. Drinkers who endorsed having trained to increase tolerance reported notably more alcohol-related problems than those who reported never training (Madj=51.80 versus Madj=39.30; p<0.0001). Further, participants who endorsed tolerance training reported utilizing significantly fewer PBS (e.g., avoid drinking games) on the Protective Behavioral Strategies Scale (PBSS, Martens et al., 2005) than participants who had never trained (Madj=16.89 versus Madj=18.90; p<0.01). An exception was that drinkers who trained to avoid passing out early used significantly more PBS (e.g., using a designated driver, knowing where your drink is at all times). Despite this, these trainers consumed more alcohol and experienced more alcohol-related harms. The present findings support previous research demonstrating that trainers consume more alcohol than non-trainers, and provide further evidence that deliberately training to increase tolerance is indicative of problematic drinking behavior. Prevention efforts might aim to inform drinkers of the problems associated with deliberately inducing alcohol tolerance, and focus on developing alternative strategies for minimizing acute harm from drinking.

How Strong is the "Fake ID Effect?" An Examination Using Propensity Score Matching in Two Samples.

BACKGROUND: Underage college students who obtain and use false identification (fake ID) are at risk for negative outcomes. However, it is currently unclear how uniquely the fake ID itself serves as a vehicle to subsequent harm (i.e., the "fake ID effect") over and above general and trait-related risk factors (e.g., deviant peers, low self-control). METHODS: To investigate whether the "fake ID effect" would hold after accounting for phenotypic risk, we utilized propensity score matching (PSM) in a cross-sectional sample of 1,454 students, and a longitudinal replication sample of 3,720 undergraduates. Individuals with a fake ID were matched with individuals without a fake ID, in terms of a number of trait-based and social risk factors. These matched groups were then compared on 5 problematic outcomes (i.e., frequent binge drinking, alcohol-related problems, arrests, marijuana use, and hard drug use). RESULTS: Findings showed that "fake ID effects" were substantially-although not fully-diminished following PSM. The "fake ID effect" remained strongest for alcohol-related arrests. This may relate to issues of enforcement and students' willingness to engage in deviant behavior with a fake ID, or it may be a function of combined processes. CONCLUSIONS: Overall, the findings suggest that interventions should not only be aimed at reducing the fake ID-related alcohol access specifically, but should also be aimed more generally toward at-risk youths' access to alcohol. Future research might examine whether fake IDs have their strongest potency as moderators of the effects of risky traits-such as impulsiveness-on drinking outcomes.

How Robustly Does Cannabis Use Associate to College Grades? Findings From Two Cohorts.

Along with recent changes in cannabis legalization and decriminalization, there has been an increasing amount of attention aimed at cannabis use and outcomes in college. Although some amount of cannabis use might be expected under theories of collegiate identity development, public health research indicates that cannabis use ultimately associates with negative vocational outcomes. To examine how cannabis use associates with college grade point average specifically, we surveyed n = 1,080 full-time college students and a replication sample of n = 590. Results showed that even after accounting for other measures of student identity formation and drug use, increased cannabis use was robustly associated with lower grade point average. Future research should examine the mechanisms underlying this association. Nevertheless, while laws and attitudes toward cannabis evolve, initiatives to decrease college use should continue.

Drinking consequences and subsequent drinking in college students over 4 years.

There is some evidence that college student drinkers may continue drinking in the face of adverse consequences. We examined 2 hypotheses: (a) that this seemingly pathological behavior is a phenomenon of university life, occurring with consistency throughout the entirety of college, and (b) that individuals accumulate these consequences over multiple semesters in college. A sample of 3,720 students from a large Midwestern university was asked to complete surveys the summer before college and every semester thereafter for 4 years. Results showed that certain drinking-related consequences (e.g., blackouts, regretted sexual experiences) consistently predicted continued frequent heavy drinking in the following semester, even after controlling for sex, race, age, and previous-semester frequent heavy drinking (range of odds ratio = 1.17 to 1.45 across semesters, p < .01). Such potent consequences may predict subsequent drinking for a number of possible reasons that may be examined and addressed as they would pertain to specific protective behavioral strategy-related and cognitive interventions. Furthermore, consequences were accumulated over multiple semesters by notable proportions of students. For example, 13.8% of students reported blacking out 5 time-points or more--describing a full half or more of their college careers. Experimental studies which aim to modify students' perceptions of norms associated with these consequences may aid in developing interventions to reduce the burden of harm to students. In the broader context, and given the prevalence of students' accumulation of consequences, future study might aim to determine how and in what ways these findings describe either pathological or normative processes.

Deliberate induction of alcohol tolerance: empirical introduction to a novel health risk.

AIMS: Alcohol tolerance is a hallmark indicator of alcohol dependence. Even so, the allure of peers' admiration for having the ability to drink heavily may lead some adolescents and young adults to practice, or 'train', to increase their tolerance (particularly at US colleges, where heavy drinking is highly prevalent and central to the social culture). This is a potential health hazard that has not been documented empirically. Thus, we initiated a study of tolerance 'training' and its association to risky and heavy drinking. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional online survey of 990 college student life-time drinkers at a large Midwestern US university. FINDINGS: Of the sample, 9.9% (n = 97) reported deliberately 'training' to increase tolerance. On average, they reported increasing from approximately seven to 10 US standard drinks in a night prior to 'training' to 12-15 drinks at the end of 'training,' over approximately 2-3 weeks' duration. Although the proportion of frequent binge drinking among 'non-trainers' (34.4%) was similar to national rates, 'trainers' were much more likely to be frequent bingers (76.3%; OR = 6.15). CONCLUSIONS: A number of students report deliberately inducing alcohol tolerance, probably directly increasing the risk for alcohol poisoning and other acute harms and/or dependence. This phenomenon might additionally be applicable to other populations, and deserves further study and attention as a potential personal and public health risk. Prevention efforts might aim to reduce the perceived importance of heavy-drinking abilities.

Two scales to evaluate cocaine craving.

The cocaine craving questionnaire-brief (CCQ-Brief English) asks cocaine users to report their level of craving now. We constructed two brief scales of cocaine craving in a sample of 107 Spanish-speaking natives in treatment for cocaine abuse or dependence: the CCQ-Brief(Spanish) and the pictographic assessment of desire (PAD), which relies less on language. Principal component analyses yielded a one-component solution for the CCQ-Brief, explaining between 62% and 68% of the sample variability. Cronbach's alpha ranged from .92 to .94. The CCQ-Brief and the PAD were strongly correlated; effect sizes ranged from .42 to .68 in separate trials. Laboratory cue-exposure results showed that in both scales craving was higher upon presentation of cocaine-related rather than neutral pictorial stimuli. The CCQ-Brief and PAD are potentially valuable scales for evaluating cocaine craving.

Methods of "fake ID" obtainment and use in underage college students.

Fake IDs are highly prevalent among underage college students, and are strongly associated with heavy drinking. However it is not currently known how exactly fake IDs are most commonly obtained and used, and how often individuals are caught. Such information could aid law enforcement and school personnel in their enforcement responsibilities, and might further elucidate the extent and means by which students "make ethical compromises" to gain illegal access to alcohol. A cross-sectional online survey of 1098 underage students at a large Midwestern university indicated that comparable to previous findings, 21.0% reported possessing a fake ID (which was strongly associated with past-month frequent heavy drinking; OR=4.84, 95% CI=3.41-6.86). Of those with fake IDs, 93.5% reported having used them, and 29.1% reported having been caught. Greek (i.e., fraternity/sorority) members were more likely than others to obtain them through a Greek organization (OR=8.02, 95% CI=1.81-35.54). Also, men were more likely than women to buy (OR=2.74, 95% CI=1.57-4.77), yet less likely to be given them (OR=0.53, 95% CI=0.31-0.90). Future studies might examine whether and how fake ID capture reduces (or exacerbates) drinking over time.

Blue-Collar Scholars?: Mediators and Moderators of University Attrition in First-Generation College Students.

Many college entrants' parents do not have college degrees. These entrants are at high risk for attrition, suggesting it is critical to understand mechanisms of attrition relative to parental education. Moderators and mediators of the effect of parental education on attrition were investigated in 3,290 students over 4 years. Low parental education was a risk for attrition; importantly, college GPAs both moderated and mediated this effect, and ACT scores, scholarships, loans, and full-time work mediated this effect. Drug use, psychological distress, and few reported academic challenges predicted attrition, independent of parental education. These findings might inform interventions to decrease attrition.

A new minimum legal drinking age (MLDA)? Some findings to inform the debate.

Despite support that the minimum legal drinking age (MLDA) of 21 is an important public health provision in the United States, a group of college presidents are petitioning for the MLDA to be lowered. To inform this debate, we examined whether heavy and risky drinking was associated with a stance to lower the MLDA in 865 college students under the age of 21. Results showed that, in comparison to other students, heavy/risky drinkers more often had a stance to lower the MLDA. Thus, for students, the MLDA debate seems to be less a philosophical issue about prohibition and harm reduction, and appears to be more a political stance that reflects students' concurrent behaviors. We discuss how drinking and MLDA laws in Europe might compare with the United States, and how future policy work might benefit from empirical and cross-cultural study.

Development of the brief Spanish Cocaine Craving Questionnaire-General.

Combining two different samples of cocaine users (N = 183), we tested the factor structure of a brief (12-item), Spanish version of the Cocaine Craving Questionnaire-General using confirmatory factor analysis. The four-factor model provided excellent fit to the measure. Moreover, the measure significantly differentiated between recent cocaine users and abstainers, as well as between participants with different levels of severity of drug-use history. Factor 1 expresses highly intense and overwhelming desires, Factor 2 expresses lack of self-control over cocaine use, Factor 3 items express lack of positive reinforcement expectancies, and Factor 4 expresses stimulating expectancies for cocaine use. The results revealed the validity of the CCQ-General brief as an instrument to assess cocaine craving in Spanish and supported the conceptualization of cocaine craving as a multifaceted construct.

Is heavy drinking really associated with attrition from college? The alcohol-attrition paradox.

Student attrition at colleges across the United States poses a significant problem for students and families, higher educational institutions, and the nation's workforce competing in the global economy. Heavy drinking is a highly plausible contributor to the problem. However, there is little evidence that it is a reliable predictor of attrition. Notably, few studies take into account indicators of collegiate engagement that are associated with both heavy drinking and persistence in college. Event-history analysis was used to estimate the effect of heavy drinking on attrition among 3,290 undergraduates at a large midwestern university during a 4-year period, and student attendance at a number of college events was included as covariates. Results showed that heavy drinking did not predict attrition bivariately or after controlling for precollege predictors of academic success. However, after controlling for event attendance (an important indicator of collegiate engagement), heavy drinking was found to predict attrition. These findings underscore the importance of the college context in showing that heavy drinking does in fact predict attrition and in considering future intervention efforts to decrease attrition and also heavy drinking.

Development of the brief Spanish Cocaine Craving Questionnaire- General / Desarrollo de la versión española breve del Cocaine Craving Questionnaire-General

Combining two different samples of cocaine users (N= 183), we tested the factor structure of a brief (12-item), Spanish version of the Cocaine Craving Questionnaire-General using confirmatory factor analysis. The four-factor model provided excellent fit to the measure. Moreover, the measure significantly differentiated between recent cocaine users and abstainers, as well as between participants with different levels of severity of drug-use history. Factor 1 expresses highly intense and overwhelming desires, Factor 2 expresses lack of self-control over cocaine use, Factor 3 items express lack of positive reinforcement expectancies, and Factor 4 expresses stimulating expectancies for cocaine use. The results revealed the validity of the CCQ-General brief as an instrument to assess cocaine craving in Spanish and supported the conceptualization of cocaine craving as a multifaceted construct (AU)

En este estudio comprobamos la estructura factorial de una versión breve (12 ítems) del «Cocaine Craving Questionnaire-General» en población española, combinando dos muestras de consumidores de cocaína (N= 183). El análisis factorial confirmatorio señaló que el modelo se ajustaba a cuatro factores. Además, el cuestionario diferenciaba entre consumidores no abstinentes y abstinentes, así como diferentes grados de severidad en la adicción. El Factor 1 hacía referencia al deseo intenso por consumir, el Factor 2 hacía referencia a la ausencia de control sobre el consumo, el Factor 3 expresaba la ausencia de expectativas positivas sobre el consumo y el Factor 4 se refería a las expectativas sobre los efectos estimulantes derivados del consumo. Los resultados mostraron la validez del CCQ-G breve como instrumento para evaluar el craving por la cocaína en población española y apoyan la conceptualización del craving por la cocaína como un constructo multifactorial (AU)

Fake ID ownership and heavy drinking in underage college students: prospective findings.

The authors examined the ownership of false identification (fake ID) for the purpose of obtaining alcohol and the relation of fake ID ownership to heavy drinking in a longitudinal sample of college students under 21 years of age. A sample of 3,720 undergraduates was assessed the summer prior to college entrance and during the 4 semesters comprising freshman and sophomore years. Regression analyses were used to estimate bidirectional relations between consumption and fake ID ownership. Sex, Greek membership, and prior drinking were controlled. Results showed that fake ID ownership increased over time (12.5% pre-college to 32.2% fourth semester) and that Greek members were more likely than others to own fake IDs. Fake ID ownership predicted concurrent and next-semester heavy drinking with increasing strength over time. Also, the acquisition (onset) of fake ID ownership at each time point was predicted by previous-semester consumption. When traditional, robust risk factors of consumption are controlled, fake ID ownership meaningfully relates to heavy drinking in college. It thus presents a significant public health problem, addressable through training for alcohol servers and retailers, punitive measures toward fake ID owners, and other possible interventions.