Search

Sales of energy drinks have increased rapidly since their introduction to the marketplace in the 1990s. Despite the health concerns raised about these beverages, which are often highly caffeinated, surprisingly little data are available to estimate the prevalence of their use. This review presents the results of secondary data analyses of a nationally representative data set of schoolchildren in the United States and reviews the available research on the association between energy drink use and risk-taking behaviors. Approximately one-third of the students surveyed were recent users of energy drinks, with substantial variation by age, sex, and race/ethnicity. Among the health and safety concerns related to energy drinks and their consumption is the possible potentiation of risk-taking behaviors. The review of available research reveals that, although there does appear to be a strong and consistent positive association between the use of energy drinks and risk-taking behavior, all but one of the available studies used cross-sectional designs, thereby limiting the ability to make inferences about the temporal nature of the association. Thus, more research is needed to understand the nature of this association and how energy drinks, particularly those containing caffeine, might impact adolescent health and safety, especially given the high prevalence of their use among youth. [ABSTRACT FROM AUTHOR]

Background It is well known that using false identification ( ID) is a common method by which underage youth in the United States obtain alcohol. While false ID use is associated with high-risk drinking patterns, its association with alcohol use disorder ( AUD), independent of other risk factors, has not been firmly established. Methods Participants were 1,015 college students recruited from 1 university and assessed annually during their first 4 years of college. Latent variable growth curve modeling was used to identify significant predictors of false ID use and test the hypothesis that false ID use increased the risk for AUD, by increasing the frequency and/or quantity of alcohol use. Several other hypothesized risk factors for AUD were accounted for, including demographics (sex, race, living situation, religiosity, socioeconomic status), individual characteristics (childhood conduct problems, sensation-seeking, age at first drink), high school behaviors (high school drinking frequency, drug use), family factors (parental monitoring, parental alcohol problems), perception of peer drinking norms, and other factors related to false ID use. Results False IDs were used by almost two-thirds (66.1%) of the sample. False ID use frequency was positively associated with baseline quantity and frequency of alcohol use, independent of all other factors tested. False ID use was not directly related to AUD risk, but indirectly predicted increases in AUD risk over time through its association with greater increases in alcohol use frequency over time. Several predictors of false ID use frequency were also identified. Conclusions False ID use may contribute to AUD risk by facilitating more frequent drinking. If replicated, these findings highlight the potential public health significance of policies that enforce sanctions against false ID use. Students who use false IDs represent an important target population for alcohol prevention activities. [ABSTRACT FROM AUTHOR]

Prevalence and correlates of HIV testing were examined in a sample of 957 unmarried recent college students in the United States. Participants were asked about HIV testing, past-six-months sexual activities, lifetime treatment for sexually transmitted infections (STI), past-year health service utilization, and DSM-IV criteria for alcohol and other drug (AOD) dependence during the 2008-2009 academic year. Two in five (41.9%wt) were ever tested for HIV. Holding constant demographics, HIV testing was positively related to AOD dependence, frequency of unprotected sex, number of sex partners, having a physical exam by a medical professional, number of visits to a health provider for physical health problems, and lifetime STI treatment. Women were more likely than men to be tested for HIV despite similar levels of risky sex. Results demonstrate the feasibility of achieving high HIV testing rates in a college population. [ABSTRACT FROM AUTHOR]

To understand the extent to which medication adherence was related to diversion of prescription analgesics. Cross-sectional analyses of data from the College Life Study, a prospective study of young adults. Participants were originally sampled as incoming first-time first-year college students from one large public university in the Mid-Atlantic United States. One hundred ninety-two young adults aged 21-26 who were prescribed an analgesic to treat acute pain in the past year. Diversion of prescription analgesics. The study tested two competing hypotheses: 1) individuals who skip doses (under-users) are at greatest risk for diversion because they have leftover medication; and 2) individuals who over-use their prescriptions (over-users) are at greatest risk for diversion, perhaps because of a general propensity to engage in deviant behavior. Fifty-eight percent followed physician's instructions regarding their prescription analgesic medication; 27% under-used their prescribed medication and 16% over-used their prescribed medication. Twenty-seven percent of the total sample diverted their medication, with over-users being the most likely to divert (63%). Holding constant demographic characteristics and perceived harmfulness of nonmedical use, over-users were almost five times as likely as adherent users to divert analgesic medications ( P < 0.05). Further research is needed to better understand the relationship between adherence and diversion. If these findings are replicated, physicians who are involved in pain management for acute conditions among young adults should take steps to monitor adherence and reduce diversion of prescription analgesics. [ABSTRACT FROM AUTHOR]

Aims: To: (1) estimate the proportion of students exposed to specific types of information regarding the positive and negative effects of ecstasy, (2) test models that quantified the relationship between exposure to these messages and subsequent ecstasy use, controlling for peer drug use and sensation-seeking. Methods: As part of the College Life Study, 447 students, aged 17–20 years, from a university in the mid-Atlantic region of the US completed an in person interview plus three follow-up assessments. Findings: Individuals who had heard a greater number of negative messages were significantly more likely to use ecstasy, even controlling for positive messages, prior ecstasy use, peer ecstasy use, perceived harm, sensation-seeking, sex and race. Some messages were significant at the bivariate level. Conclusions: Ecstasy use may have been influenced more by the content of the messages than by the quantity or diversity of messages. Interventions should be designed to address both positive and negative perceptions about a particular drug, rather than focusing exclusively on the negative information. Future evaluations should focus on the effectiveness of multi-pronged sustainable prevention programs in reducing adolescent drug use risk. [ABSTRACT FROM AUTHOR]

Study Objective. To define, among a sample of college students, the nature and extent of nonmedical use of prescription stimulants (NPS), including both overuse and use of someone else's drug, for attention-deficit-hyperactivity disorder (ADHD); to characterize NPS among individuals not medically using a prescription stimulant for ADHD; and to determine whether NPS and overuse of a medically prescribed stimulant for ADHD were independently associated with an increased risk of other illicit drug use and dependence on alcohol and marijuana. Design. Cross-sectional analysis of personal interview data. Setting. Large public university in the mid-Atlantic region. Participants. A cohort of 1253 first-year college students aged 17-20 years. Measurements and Main Results. All students completed a 2-hour personal interview to ascertain medical use and overuse of prescription stimulants, NPS, nonmedical use of other prescription drugs and illicit drug use, and dependence on alcohol and marijuana. Comparisons were made among nonusers, nonmedical users, and medical users of prescription stimulants for ADHD (ADHD+), some of whom overused their drug. Of 1208 students who were not using prescription stimulants medically for ADHD (ADHD-), 218 (18.0%) engaged in NPS. Of 45 ADHD+ students, 12 (26.7%) overused their ADHD drug at least once in their lifetime, and seven (15.6%) nonmedically used someone else's prescription stimulants at least once in their lifetime. Among 225 nonmedical users, NPS was infrequent and mainly associated with studying, although 35 (15.6%) used prescription stimulants to party or to get high. Lifetime NPS was associated with past-year other drug use. Both NPS and overuse of prescribed stimulants for ADHD were independently associated with past-year use of five drugs, holding constant sociodemographic characteristics; NPS was also associated with alcohol and marijuana dependence. Conclusions. Physicians should be vigilant for possible overuse and/or diversion of prescription stimulants for ADHD among college students who are medical users of these drugs, as well as the occurrence of illicit drug use with NPS. Initiation of comprehensive drug prevention activities that involve parents as well as college personnel is encouraged to raise awareness of NPS and its association with illicit drug use. [ABSTRACT FROM AUTHOR]

Background: College drinking is a significant public health problem. Although parental monitoring and supervision reduces the risk for alcohol consumption among younger adolescents, few studies have investigated the impact of earlier parental monitoring on later college drinking. This study examined whether parental monitoring indirectly exerts a protective effect on college drinking by reducing high school alcohol consumption. Methods: A longitudinal cohort of 1,253 male and female students, ages 17 to 19, attending a large, public, mid-Atlantic university was studied at two time points. First, data on high school parental monitoring and alcohol consumption were gathered via questionnaire during the summer prior to college entry. Second, during the first year of college, past-year alcohol consumption was measured via a personal interview. Multiple regression models tested the relationship between parental monitoring and past year alcohol use (i.e., number of drinks per drinking day). Results: Holding constant demographics, SAT score, and religiosity, parental monitoring had a significant protective effect on both high school and college drinking level. However, the association between parental monitoring and college drinking level became non-significant once high school drinking level was held constant. Conclusion: While parental monitoring did not directly influence college alcohol consumption, evidence for mediation was observed, whereby parental monitoring had an indirect influence on college drinking through reductions in high school drinking. Initiatives that promote effective parenting might be an important strategy to curb high-risk drinking among older adolescents. More research is needed to understand the nature and degree of parent-child communication that is necessary to extend the protective influence of parents into the college years. [ABSTRACT FROM AUTHOR]

Background: Highly caffeinated energy drinks (EDs) are popular with adolescents and young adults, but longitudinal consumption patterns are poorly understood especially in relation to other substance use.Methods: ED and other substance use were assessed annually (modal ages 21-25) among a sample (n=1099) who were originally recruited as first-year college students (modal age 18). Trajectory groups were derived based on probability of past-year use during ages 21-24, and compared for possible differences in substance use outcomes at age 25, holding constant demographics, sensation-seeking, other caffeine consumption, and age 21 substance use.Results: From age 21-25, ED consumption declined in both annual prevalence [62.5%wt to 49.1%wt (wt=weighted)] and frequency of use among consumers (35.2-26.3 days/year). Yet individuals exhibiting a Persistent trajectory (51.4%) of consumption outnumbered those with Non-Use (20.6%), Intermediate (17.4%), or Desisting (10.6%) trajectories. Age 25 cocaine use, nonmedical use of prescription stimulants (NPS), and alcohol use disorder (AUD) risk were significantly associated with trajectory group membership, with Persistent and Intermediate groups exhibiting the highest risk for such outcomes, even accounting for prior substance use and other risk factors. Neither marijuana nor tobacco use were associated with group membership.Conclusions: The typical pattern of ED consumption among this sample was sustained use throughout young adulthood. Such individuals appear to be at high risk for adverse substance use outcomes, and results suggest possible specificity regarding cocaine use and NPS, and AUD risk. More research is needed to understand the mechanisms underlying the connection between ED and substance use. [ABSTRACT FROM AUTHOR]

Extensive research has examined alcohol use context and motives among undergraduates, but less is known about where, when, and why graduate students drink. The current study aimed to describe the motives and situational context of graduate student alcohol use, identify demographic and program characteristics associated with alcohol use motives and context, and assess how alcohol use motives and context are associated with alcohol use behavior. A sample of master's and doctoral-level students who drank during the past month (n = 2091; 63% female) completed an online survey. An exploratory factor analysis yielded two situational context factors: drinking in social situations (e.g., with friends, at a bar) and non-social situations (e.g., alone, at home). Graduate students most frequently endorsed social and enhancement drinking motives. Results of multivariate linear regression models showed that age, sex, race/ethnicity, and international student, marital, parental, and employment status were all associated with motives and context. Drinking for enhancement and drinking to cope were the motives most strongly associated with increased alcohol quantity and frequency, respectively. Drinking in social contexts was positively associated with alcohol quantity and frequency, and drinking in non-social contexts was positively associated with alcohol use frequency but inversely related to alcohol quantity. Graduate students who drink for enhancement reasons and in social situations might be at increased risk for higher quantity alcohol use, or graduate students who drink for coping reasons and in non-social situations might be at increased risk for more frequent alcohol use. Future longitudinal research is needed to explore whether drinking in certain contexts and with certain motivations is predictive of alcohol problems during and after graduate school. [ABSTRACT FROM AUTHOR]

Background: Many underage drinkers obtain alcohol from legal-age family, friends, and acquaintances. This study aimed to understand the attitudes and behaviors of young adults related to providing alcohol to underage drinkers., Methods: Participants were 755 current or recent college students of legal drinking age (ages 22 to 26) who were approached by a minor to provide alcohol at least once since turning 21. Interviewers assessed frequency of providing alcohol, relationship to the recipients, and general attitudes about providing alcohol to minors. Separate questions asked about younger (under 18) and older (18 to 20) minors. Correlates and predictors of provision and frequency of provision were examined via logistic regression and Poisson regression, focusing on demographics, sensation-seeking, behavioral dysregulation, age at first drink, parental history of alcohol problems, fraternity/sorority involvement, attitudes about provision, violations, peer drinking norms, and alcohol use disorder (AUD) risk during and post-college., Results: Most participants (84.6%) provided alcohol to minors at least once. Provision to older minors was more prevalent (82.8%) than to younger minors (20.7%); it was also more frequent. Few (2.4%) were ever caught providing alcohol. Recipients were more commonly friends or family members rather than acquaintances or strangers. Legal concerns about providing alcohol (82.5 and 53.7% for younger and older minors, respectively) were more prevalent than health concerns (55.7 and 9.5%). Legal concerns consistently predicted lower likelihood of provision, independent of demographics. Health concerns and lower post-college AUD risk scores also independently predicted lower likelihood of provision, but only to older minors. Fraternity/sorority involvement and higher peer drinking norms were associated with higher provision frequency, whereas legal concerns and college violations were associated with lower provision frequency., Conclusions: Young adults who have recently turned 21 could represent an important target for prevention strategies to reduce underage drinking on college campuses. More research is needed to understand the motivations of young adults who provide alcohol to underage drinkers., (Copyright © 2014 by the Research Society on Alcoholism.)

Objective: This study examined the prospective relationship of substance use and mental health problems with risk of discontinuous enrollment in college., Methods: Participants were 1,145 students at a large public university who were interviewed annually for four years beginning at college entry in 2004 (year 1). Discontinuous enrollment was defined as a gap in enrollment of one or more semesters during the first two years (early discontinuity) or the second two years (late discontinuity) versus continuous enrollment throughout all four years. Explanatory variables measured in year 1 were scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory, childhood conduct problems, cannabis use, number of illicit drugs used, and alcohol consumption. In years 3 and 4, participants reported lifetime history of clinically diagnosed attention-deficit hyperactivity disorder, depression, and anxiety, including age at diagnosis. Multinomial logistic regression models were developed to evaluate the association between the independent variables and discontinuous enrollment while holding constant background characteristics., Results: Higher BDI scores predicted early discontinuity but not late discontinuity, whereas cannabis and alcohol use predicted only late discontinuity. Receiving a depression diagnosis during college was associated with both early and late discontinuity. Self-reported precollege diagnoses were not related to discontinuous enrollment once background characteristics were taken into account., Conclusions: Students who experience depressive symptoms or seek treatment for depression during college might be at risk of interruptions in their college enrollment. Cannabis use and heavy drinking appear to add to this risk. Students entering college with preexisting psychiatric diagnoses are not necessarily at risk of enrollment interruptions.

Background: Previous research has suggested important contextual factors that can differentiate problem and nonproblem drinkers., Objectives: To evaluate the strength of the prospective association between social contexts of drinking and subsequent alcohol use disorder and drunk driving 2-3 years later., Methods: The sample consisted of 652 individuals who were originally recruited at college entry, had complete data on at least one social context subscale, met the minimum criteria for Year 1 drinking, and had nonmissing data on at least one of the outcome variables in Years 3 and/or 4. Social contexts of drinking were assessed in Year 1 by using previously validated scales measuring six different situational and motivational contexts in which alcohol is consumed. DSM-IV criteria for alcohol abuse and dependence and drunk driving were assessed annually., Results: Holding constant gender, race/ethnicity, and baseline drinking frequency, the frequency of drinking in a context of social facilitation, sex-seeking, or in a motor vehicle during Year 1 was significantly related to a greater likelihood of alcohol abuse, alcohol dependence, and drunk driving in Years 3 and/or 4. Drinking in a context of emotional pain was related to alcohol dependence and drunk driving but not to alcohol abuse., Conclusions: The Social Context of Drinking Scales have utility for identifying students who are at risk for developing alcohol-related problems., Scientific Significance: Identifying college students who might develop alcohol dependence requires an assessment of both situational and motivational factors that influence drinking, especially drinking in a motor vehicle.

Objective: Few longitudinal studies have examined the relationship between illicit drug use and academic outcomes among college students. This study characterized drug use patterns of a cohort of young adults who were originally enrolled as first-time, first-year college students in a longitudinal study. It evaluated the association between these drug use patterns and continuous enrollment during college, holding constant demographic characteristics, high school grade point average, fraternity/sorority involvement, personality/temperament characteristics, nicotine dependence, and alcohol use disorder., Method: Participants (n = 1,133; 47% male) were purposively selected from one university and interviewed annually for 4 years, beginning with their first year of college, regardless of continued college attendance. Enrollment data were culled from administrative records. Group-based trajectory analyses characterized 4-year longitudinal drug use patterns. Two grouping variables were derived based on (a) marijuana use frequency and (b) number of illicit drugs used other than marijuana. Seventy-one percent of the sample was continuously enrolled in the home institution during the first 4 years of study., Results: Multivariable logistic regression models demonstrated that infrequent, increasing, and chronic/heavy marijuana use patterns were significantly associated with discontinuous enrollment (adjusted odds ratio = 1.66, 1.74, and 1.99, respectively), compared with minimal use, holding constant covariates. In separate models, drug use other than marijuana also was significantly associated with discontinuous enrollment., Conclusions: Marijuana use and other illicit drug use are both associated with a decreased likelihood of continuous enrollment in college, independent of several other possible risk factors. These findings highlight the need for early intervention with illicit drug users to mitigate possible negative academic consequences.

Marijuana is the most prevalent illicit drug used by adolescents and young adults, yet marijuana initiation is rarely studied past adolescence. The present study sought to advance our understanding of parent and peer influences on marijuana exposure opportunity and incident use during college. A sample of 1,253 students was assessed annually for 4 years starting with the summer prior to college entry. More than one-third (38%(wt)) of students had already used marijuana at least once prior to college entry; another 25%(wt) initiated use after starting college. Of the 360 students who did not use marijuana prior to college, 74% were offered marijuana during college; of these individuals, 54% initiated marijuana use. Both low levels of parental monitoring during the last year of high school and a high percentage of marijuana-using peers independently predicted marijuana exposure opportunity during college, holding constant demographics and other factors (AOR = 0.92, 95% CI = 0.88-0.96, p < .001 and AOR = 1.11, 95% CI = 1.08-1.14, p < .001, respectively). Among individuals with exposure opportunity, peer marijuana use (AOR = 1.04, 95% CI = 1.03-1.05, p < .001), but not parental monitoring, was associated with marijuana initiation. Results underscore that peer influences operate well into late adolescence and young adulthood and thus suggest the need for innovative peer-focused prevention strategies. Parental monitoring during high school appears to influence exposure opportunity in college; thus, parents should be encouraged to sustain rule-setting and communication about adolescent activities and friend selection throughout high school.

Objective: Examine trends in nonmedical use of prescription stimulants (NPS), including motives, routes of administration, sources, cost, and risk factors., Participants: 1,253 college students., Methods: Data were collected annually during academic years 2004-2005 through 2008-2009. Generalized estimating equations analyses evaluated longitudinal trends. Logistic regression models evaluated stability of associations between risk factors and NPS over time., Results: Almost two-thirds (61.8%(wt)) were offered prescription stimulants for nonmedical use by Year 4, and 31.0%(wt) used. Studying was the predominant motive (73.8% to 91.5% annually), intranasal administration was modest (< 17% annually), and the most common source was a friend with a prescription (≥ 73.9% annually). Significant changes over time included decreasing curiosity motives, increasing overuse of one's own prescription, and increasing proportion paying $5+ per pill. Lower grade point average and alcohol/cannabis use disorders were consistently associated with NPS, holding constant other factors., Conclusions: Prevention opportunities exist for parents, physicians, and college administrators to reduce NPS.

Objective: To investigate the possible association between untreated ADHD symptoms (as measured by the Adult ADHD Self-Report Scale) and persistent nonmedical use of prescription stimulants., Method: Multinomial regression modeling was used to compare ADHD symptoms among three groups of college students enrolled in a longitudinal study over 4 years: (1) persistent nonmedical users of prescription stimulants, (2) persistent users of marijuana who did not use prescription stimulants nonmedically, and (3) consistent nonusers of drugs., Results: ADHD symptoms were associated with being a persistent nonmedical user of prescription stimulants after adjustment for race/ethnicity, sex, socioeconomic status, and other illicit drug use. No associations were observed between ADHD symptoms and being a persistent marijuana user or nonuser., Conclusion: ADHD symptoms, and in particular inattention symptoms, appeared to be associated with nonmedical use of prescription stimulants., (© 2011 SAGE Publications)

Background: Suicide is the second-leading cause of death among college students in the U.S. and is preventable. Approximately 1100 college students die by suicide each year. This study examined the prevalence and predictors of one-time and persistent suicide ideation, plans, and attempts reported during college., Methods: Data were gathered prospectively over four years. Face-to-face interviews were conducted with 1253 first-year college students at one large mid-Atlantic university. Risk factors were measured in Year 1., Results: An estimated 12%(wt) of individuals experienced suicide ideation at some point during college, and of those individuals, 25% had more than one episode of ideation (persistent ideation; 2.6%(wt) of the overall sample). Ten individuals had a plan or attempt during college (0.9%(wt) of the sample). Risk factors for persistent suicide ideation included low social support, childhood or adolescent exposure to domestic violence, maternal depression, and high self-reported depressive symptoms. Persistent ideators differed from one-time ideators only by higher levels of depression (p=.027). Persistent ideators were no more likely than one-time ideators to have made a suicide plan or attempt during college (8% vs. 9%, respectively)., Limitations: Although the sample size is large, only a small percentage of participants had persistent ideation, suicide plans or attempts during college., Conclusion: These results have implications for programs aimed at identifying college students at risk for suicide. The accurate identification of college students at risk for suicide is an important step toward suicide prevention., (Copyright © 2010 Elsevier B.V. All rights reserved.)

The prevalence of substance use disorders (SUD) and aspects of the help-seeking process among a high-risk sample of 946 students at one large public university were assessed in personal interviews during the first 3 years of college. After statistically adjusting for purposive sampling, an estimated 46.8%(wt) of all third-year students met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for SUD involving alcohol and/or marijuana at least once. Of 548 SUD cases, 3.6% perceived a need for help with substance use problems; 16.4% were encouraged by someone else to seek help. Help-seeking was rare among SUD cases (8.8%) but significantly elevated among individuals who perceived a need (90.0%) or experienced social pressures from parents (32.5%), friends (34.2%), or another person (58.3%). Resources accessed for help included educational programs (37.8%), health professionals (27.0%), and 12-step programs (18.9%). College students have high rates of substance use problems but rarely recognize a need for treatment or seek help. Results highlight the opportunity for early intervention with college students with SUD.