Adolescents, alcohol, and marijuana: Context characteristics and problems associated with simultaneous use

Background: Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.Methods: Data are from 15-to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).Results: We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.Conclusions: Results from this study indicate there are unique precursors and consequences of highintensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

Section: Discussionsupporting

confidence: 66%

Social and Situational Party Characteristics Associated With High‐Intensity Alcohol Use Among Youth and Young Adults

Cox

Egan

Suerken

et al. 2019

“…However, prior work (Mallett et al, ) has found that students who combined alcohol with marijuana and/or other substances had increased negative consequences compared to students who only used alcohol. With an adolescent sample, Lipperman‐Kreda and colleagues () found occasions with SAM use were associated with a 110% increase in number of negative behavioral consequences (e.g., driving after drinking, getting into a verbal argument or physical fight) compared to occasions with no substance use, and this was largely associated with increased alcohol consumed on those occasions.…”

Section: Sam Use and Consequences Among Young Adultsmentioning

confidence: 99%

“…We hypothesized that days with SAM use would be associated with greater alcohol use compared to alcoholonly days and that SAM use would be associated with greater reports of perceived positive and negative alcohol-related effects or consequences. Based on findings from prior studies (e.g., Lipperman-Kreda et al, 2017;Mallett et al, 2019), we further hypothesized that greater alcohol use on SAM occasions may account for the effects of SAM use on alcohol-related consequences.…”

Section: Present Studymentioning

confidence: 99%

A Daily Study Comparing Alcohol‐Related Positive and Negative Consequences for Days With Only Alcohol Use Versus Days With Simultaneous Alcohol and Marijuana Use in a Community Sample of Young Adults

Lee

Patrick

Fleming

et al. 2020

Background Alcohol and marijuana are psychoactive substances commonly used by young adults and are independently associated with numerous acute and long‐term consequences. Many young adults engage in simultaneous alcohol and marijuana (SAM) use to cross‐fade (i.e., to enhance the effects of intoxication), although the extent to which alcohol use and alcohol‐related consequences increase on SAM occasions compared to alcohol‐only occasions is unclear. This study examines daily data among a sample of SAM users comparing SAM days to other days when young adults only used alcohol. Methods A sample of 409 young adults (age 18 to 25; Mage = 21.6, SD = 2.2; 50.9% women) who reported SAM use in the past month completed 2 bursts of 14 days of daily surveys (28 days in total) assessing alcohol use, alcohol‐related consequences, and SAM use. Results Multilevel models based on alcohol‐only and SAM days (n = 3,016 days; 391 individuals) indicated young adults drank more alcohol on SAM days compared to alcohol‐only days (with no marijuana use). Similarly, days with SAM use were associated with more alcohol‐related positive and negative consequences. The daily association between SAM use and positive consequences was statistically significant, after accounting for the amount of alcohol consumed; in contrast, the association between SAM use and negative consequences was diminished and nonsignificant. Conclusions Among young adult SAM users, days with SAM use were associated with more alcohol use and positive consequences compared to days they only drank alcohol. Further examination of the motivational context for engaging in SAM use, as well as potential physiological interactions between alcohol and marijuana use on alcohol’s effects, is warranted. Alcohol interventions might benefit from addressing increased alcohol use and alcohol‐related consequences as risks associated with SAM use.

“…Simultaneous alcohol and marijuana (SAM) use can have more serious negative consequences than using either substance alone (for a review, see Yurasek et al., ). These include driving under the influence and having alcohol‐related accidents (Arterberry et al., ; Chihuri et al., ; Lipperman‐Kreda et al., ; Terry‐McElrath et al., ), cognitive impairment (Mallett et al., ), and substance use disorder symptomatology (Agrawal et al., ; Mallett et al., ; Midanik et al., ; Subbaraman and Kerr, ). The majority of individuals who use alcohol and marijuana engage in SAM use on at least some occasions (Agrawal et al., ; Brière et al., ; Collins et al., ; Midanik et al., ; Pape et al., ; Subbaraman and Kerr, ).…”

Section: Normative Influences On Substance Usementioning

confidence: 99%

Simultaneous Alcohol and Marijuana Use Among College Students: Patterns, Correlates, Norms, and Consequences

White

Kilmer

Fossos-Wong

et al. 2019

Background: Alcohol and marijuana users often engage in simultaneous alcohol and marijuana (SAM) use (i.e., using the 2 substances together so that their effects overlap), which can result in more negative consequences than using either substance alone. Nevertheless, little is known about SAM use among contemporary college students to aid in the development of preventive interventions. This study examined SAM use patterns, demographic correlates of SAM use, and normative influences on SAM use and related negative consequences among college students.Methods: Students who had used alcohol and marijuana in the past year were recruited from 3 state universities in states with different laws regarding recreational marijuana use (N = 1,389). They completed an online survey, which assessed their own alcohol, marijuana, and SAM use and related consequences, their perceptions of the proportion of same-gender peers and close friends who engaged in SAM use, marijuana access, and demographic characteristics.Results: About three-fourths of participants reported at least 1 occasion of SAM use in the past year with an average frequency of twice per month among SAM users. There were significant differences in SAM use prevalence and frequency by sociodemographic characteristics controlling for pastyear alcohol and marijuana frequency. Students in a state with decriminalized recreational marijuana use reported higher frequency of past-year SAM use than students in states with legalized or criminalized use. There were significant demographic differences in perceived norms regarding SAM use among close friends and same-gender peers. SAM users endorsed significantly higher perceived peer and friend norms than nonusers. Also, higher perceived norms predicted more frequent SAM use and more negative consequences of use.Conclusions: Results indicate a need for prevention programs on college campuses that address SAM use. Interventions that use personalized normative feedback may be effective.