Drug Exposure Opportunities and Use Patterns among College Students: Results of a Longitudinal Prospective Cohort Study

Abstract

Underage drinking and drug use among college students are major public health concerns, yet few studies have examined these behaviors and their associated risk factors and consequences prospectively. This paper describes the sampling and recruitment methods of a longitudinal study of 1,253 college students at a large, mid-Atlantic university. Incoming first-year students were screened during the unique window between high school and college in order to oversample drug users for longitudinal follow-up. Intensive recruitment strategies yielded a 95% cumulative response rate in annual interviews and semi-annual surveys. We report preliminary results on exposure opportunity, lifetime prevalence, initiation, continuation, and cessation of substance use for alcohol, tobacco, and ten illicit and prescription drugs during the first two years of college. Findings suggest that while some substance use represents a continuation of patterns initiated in high school, exposure opportunity and initiation of substance use frequently occur in college. Implications for prevention and early intervention are discussed. Keywords NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript IntroductionUnderage drinking and illicit substance use among college students are major public health concerns. Annually, at least 1,400 deaths are attributable to alcohol use on college campuses (1). High-risk drinking among young adults is associated with sexual assault, destruction of property, academic problems, accidental injury, and several adverse health consequences (2-5). Binge drinking and illicit drug use often co-occur (2,6-10), but in contrast to longitudinal studies of alcohol consumption (11), surprisingly few longitudinal prospective studies have examined patterns, correlates, and consequences of illicit drug use among college students. Little information is available on the patterns of initiation and cessation during college-that is, it is not known how often drug use is initiated after coming to college versus continuing a pattern that began in high school, and how often a pattern of regular drug use resolves among college students. Moreover, a majority of the conceptual models used to explain the onset and course of early drug use were developed from studying samples of adolescents, many of whom were deviant and disadvantaged (12)(13)(14)(15)(16)(17). Although the application of these models to samples of educated, academically-achieving youths might be appropriate, other risk factors and consequences might be needed to fully describe the natural history and course of drug use and other health risk behaviors during this unique developmental window. For example, an important potential outcome of drug use among college students might be diminished expectations regarding career goals or difficulty establishing autonomy.This paper describes results from the College Life Study (CLS), funded by the National Institute on Drug Abuse in October 2003 to address critical gaps in our knowledge base concerning the longi...

Caffeinated Alcohol, Sensation Seeking, and Injury Risk

“…Previous studies indicate that individuals who are highsensation seekers tend to be drawn to high-risk activities, including the use of alcohol and illicit drugs. [19][20][21][22][23]27,[24][25][26] Previous research suggests that both CaffAlc 14,43-45 and sensation seeking [46][47][48][49] predict the likelihood of experiencing adverse consequences.…”

“…18 Previous studies indicate that individuals who are high-sensation seekers tend to be drawn to high-risk activities, including the use of alcohol and illicit drugs. [19][20][21][22][23][24][25][26][27] High-sensation seekers may have an increased susceptibility to the subjective rewarding effects of alcohol. 28 Among college students, higher levels of sensation seeking have been linked to binge drinking.…”

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