Objective This study examined the extent to which protective behavioral strategies (PBS) mediated the influence of drinking motives on alcohol consumption, and if these hypothesized relationships were corroborated across subsamples of gender and race. Method Online surveys were completed by 1592 heavy drinking college undergraduates from two universities (49.9% male and 50.1% female; 76.9% Caucasian and 23.1% Asian). Independent samples t-tests compared males and females as well as Caucasians and Asians on measures of drinking motives, PBS use, and alcohol consumption, and structural equation models examined the mediating role of PBS. Results Consistent with predictions, t-tests revealed that males reported greater levels of consumption than females, but females reported greater use of PBS than males. Caucasians reported greater consumption levels, endorsed higher enhancement motives, and higher PBS related to serious harm reduction, but Asians endorsed higher coping and conformity motives, and PBS focused on stopping/limiting drinking. In multiple-sample SEM analyses, PBS were shown to largely mediate the relationship between motives and consumption in all demographic subsamples. Conclusions Findings indicate that PBS use leads to reductions in drinking despite pre-established drinking motives, hence pointing to the potential value of standalone PBS skills training interventions in lowering alcohol use among diverse groups of heavy drinking college students.

Objectives Personalized normative feedback (PNF) interventions are generally effective at correcting normative misperceptions and reducing risky alcohol consumption among college students. However, research has yet to establish what level of reference group specificity is most efficacious in delivering PNF. This study compared the efficacy of a web-based PNF intervention employing eight increasingly-specific reference groups against a Web-BASICS intervention and a repeated-assessment control in reducing risky drinking and associated consequences. Method Participants were 1663 heavy drinking Caucasian and Asian undergraduates at two universities. The referent for web-based PNF was either the typical same-campus student, or a same-campus student at one (either gender, race, or Greek-affiliation), or a combination of two (e.g., gender and race), or all three levels of specificity (i.e., gender, race, and Greek-affiliation). Hypotheses were tested using quasi-Poisson generalized linear models fit by generalized estimating equations. Results The PNF intervention participants showed modest reductions in all four outcomes (average total drinks, peak drinking, drinking days, and drinking consequences) compared to control participants. No significant differences in drinking outcomes were found between the PNF group as a whole and the Web-BASICS group. Among the eight PNF conditions, participants receiving typical student PNF demonstrated greater reductions in all four outcomes compared to those receiving PNF for more specific reference groups. Perceived drinking norms and discrepancies between individual behavior and actual norms mediated the efficacy of the intervention. Conclusions Findings suggest a web-based PNF intervention using the typical student referent offers a parsimonious approach to reducing problematic alcohol use outcomes among college students.

Introduction Adverse childhood experiences are associated with the development of substance use disorders. With opioid use disorder, a growing concern in the United States, we were interested in examining the relationship between adverse experiences and three landmarks of opioid use: age of opioid initiation, injection drug use, and lifetime overdose. Methods Between May and December 2015, we interviewed consecutive persons seeking inpatient opioid detoxification. Participants were asked about age of opioid initiation, last month injection drug use, and lifetime history of overdose, and completed the ten-item Adverse Childhood Experience (ACE) questionnaire. Results Participants (n=457) averaged 32.2 (± 8.64) years of age, 71.3% were male, and 82.5% were non-Hispanic White. The mean score on the ACE scale was 3.64 (± 2.75). Mean age at time of initiating opioid use was 21.7 (± 7.1) years, 68.7% had injected drugs within the past month, and 39.0% had overdosed. After adjusting for age, gender, and ethnicity, the ACE score was inversely associated with age of initiating opioid use (b = −0.50, 95% CI −0.70; −0.29, p < .001), and positively associated with recent injection drug use (OR = 1.11, 95% CI 1.02; 1.20, p = .014) and the likelihood of experiencing an overdose (OR = 1.10, 95% CI 1.02; 1.20, p = .015) in a graded dose response manner. Conclusion Greater adverse childhood experiences are associated with three landmarks of opioid use risk. ACE screening may be useful in identifying high-risk subsets of opioid-using populations.