Patterns and predictors of simultaneous and concurrent use of alcohol, tobacco, marijuana, and hallucinogens in first-year college students

doi:10.1016/0899-3289(92)90039-Z

Journal of Substance Abuse

Volume 4, Issue 3, 1992, Pages 319-326

https://doi.org/10.1016/0899-3289(92)90039-Z Get rights and content

Abstract

Polydrug use produces important health and safety risks. Little research has examined whether multiple drugs are used simultaneously (at the same time or in close temporal sequence). Instead, researchers have assessed concurrent polydrug use (the use of multiple drugs within a given time period such as years or months). The research here examined patterns and predictors of both simultaneous and concurrent polydrug use in 575 first-year college students. Both concurrent and simultaneous polydrug use were common for alcohol, tobacco, and marijuana. The percentage of concurrent polydrug users who were also simultaneous polydrug users ranged from 82% to 93% across subgroups defined by gender and the use of a single drug. Male gender, high levels of sensation seeking, and frequent alcohol use predicted single-drug versus polydrug use status as well as simultaneous polydrug use. Patterns and predictors of simultaneous and concurrent polydrug use should be addressed in prevention research and preventative interventions.

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Cited by (88)

Simultaneous use of marijuana and alcohol: Potential prevention targets among young adults who use alcohol
2022, Addictive Behaviors
Citation Excerpt :
Because beliefs and attitudes about alcohol and marijuana use are malleable and targeted by many substance use prevention programs, it is helpful to know whether they are related to SAM and differentially predict SAM from CAM. Furthermore, most research conducted on SAM in young adulthood has been among college students, (White et al., 2019; Schulenberg et al., 2018; Martin et al., 1992; Schulenberg et al., 2017) and results may not be generalizable to the larger noncollege population. Some research suggests that SAM may be more prevalent among college students, (Patrick et al., 2019) but others have found that, for example, using alcohol and marijuana on the same day was more common among nonstudents. (
Simultaneous alcohol and marijuana use (SAM) such that their effects overlap has emerged as a behavior that is riskier than using either substance separately. It has been associated with high-risk binge drinking and driving while intoxicated during young adulthood, and it has been demonstrated to cause greater physical and mental impairment than use of alcohol or marijuana separately. To identify intervention and prevention targets specific to SAM, we examined the relationships between alcohol- and marijuana-specific beliefs and attitudes (risk factors) and self-reported SAM compared to non-simultaneous co-use (CAM) and alcohol use only in the past 30 days in a sample of young adults (n = 1,023, mean age = 23.17; SD = 0.43). Of those who reported drinking alcohol in the past 30 days, 20.7% reported SAM, 12.6% reported CAM, and 66.6% reported using only alcohol. Results from multinomial logistic regression analyses indicated that some marijuana-specific risk factors (e.g., belief that it is not at all wrong for someone their age to use marijuana) differentiated SAM or CAM from alcohol use only, but alcohol-specific risk factors generally did not. However, the perceptions that parents approved of their using marijuana or frequently drinking heavily were associated with a greater likelihood of SAM compared to CAM (OR ranged from 2.25 to 3.53). Findings point to the salience of individuals’ attitudes and beliefs around marijuana use and their perception of parental approval of heavy drinking and marijuana use as potential targets for prevention programs targeting risk reduction among young adults.
Behavioral inhibition and reward processing in college binge drinkers with and without marijuana use
2020, Drug and Alcohol Dependence
Binge drinking is common during college, and studies have shown that many college students drink in quantities that far exceed the standard binge drinking threshold. Previous research has noted personality differences in individuals who engage in binge drinking, but few studies have examined neurobiological differences in both standard bingers (4/5 drinks in two hours for females/males; sBinge) and extreme binge drinkers (8+/10+ drinks in two hours for females/males; eBinge).
The current study of 221 college students used functional magnetic resonance imaging (fMRI) to study neural activation on a stop signal task (SST) to assess behavioral inhibition and a monetary incentive delay (MID) task to assess activation to rewards and losses. Non-bingeing controls, sBinge, and eBinge freshmen and sophomores were recruited. In addition, because binge/extreme binge drinking is often associated with marijuana (MJ) use, MJ + sBinge and MJ + eBinge groups were also included.
All five groups showed strong activation in expected key cortical and striatal regions on both the SST and the MID. However, there were no significant differences between groups either at the whole-brain level or in specific regions of interest. Behavioral performance on the fMRI tasks also did not differ between groups.
These results suggest that our sample of individuals who engage in binge or extreme binge drinking with or without MJ co-use do not differ in brain activity on reward and inhibitory tasks. Neural differences may be present on other cognitive tasks or may emerge later after more sustained use of alcohol, MJ, and other drugs.
Alcohol and marijuana co-use: Consequences, subjective intoxication, and the operationalization of simultaneous use
2020, Drug and Alcohol Dependence
Alcohol and marijuana are frequently co-used with overlapping effects. However, the absence of consistent operational definitions delineating simultaneous alcohol and marijuana use (SAM) from concurrent use (CAM) challenges consistent inferences about these behaviors. This study first examined whether daily alcohol and marijuana co-use predicted substance-use related consequences and subjective intoxication; and then evaluated whether competing operationalizations of SAM and CAM were associated with differences in these outcomes on co-use days.
A sample of 341 young adult college students who reported past-month use of both alcohol and marijuana “at the same time so that their effects overlapped” completed a two-wave survey with paired 28-day daily experience sampling bursts examining alcohol and marijuana co-use. Outcomes were (a) daily substance-use related consequences; and (b) daily subjective intoxication. Focal predictors were daily drinks and marijuana uses; daily co-use versus single-substance use (Aim 1) or CAM versus SAM (Aim 2); and their interaction.
Participants reported more negative consequences on co-use days versus marijuana-only days and greater subjective intoxication relative to alcohol or marijuana-only days. Competing operationalizations of SAM, defined as daily co-use occurring within 1−240 min in increments of 1 min, found no difference in consequences or subjective intoxication regardless of operationalization.
Co-use days involve greater risk than alcohol-only or marijuana-only days. Although there was no evidence of additional daily risk from simultaneous use regardless of the timeframe used to operationalize it, investigating these effects remains challenging due to the generally small timeframe between substances on co-use days in this sample.
Alcohol, tobacco, and marijuana consumption is associated with increased odds of same-day substance co- and tri-use
2019, Drug and Alcohol Dependence
Little is known about event-level patterns of marijuana co- or tri-use with alcohol and tobacco. Thus, the study goal was to examine patterns of same-day alcohol, cigarette, and marijuana co- and tri-use at the individual level in non-treatment-seeking alcohol users.
Participants (N = 551) completed an in-person interview for alcohol, cigarette, and marijuana use over the previous 30 days, and the event-level substance use patterns of n = 179 participants who reported using each of these substances at least once per month were analyzed.
The use of alcohol, marijuana, or cigarettes independently increased the probability of subsequent, simultaneous co-use of one of the two remaining substances. The co-use of alcohol with cigarettes and marijuana with cigarettes produced generally additive effects on the odds of same day tri-use of marijuana and alcohol, respectively. Conversely, the co-use of alcohol and marijuana produced sub-additive effects on likelihood of cigarette use. Sex moderated several of the observed patterns of co- and tri-use: the relationship between alcohol or cigarette use predicting marijuana co-use was stronger in men, whereas the observed additive relationships between drug co-use leading to tri-use was stronger in women.
The presented results may aid in the understanding of how simultaneous co-use of marijuana with alcohol and/or tobacco relates to the etiology, maintenance, and treatment of comorbid and trimorbid substance use disorder. Replication and extension of the results in treatment seeking populations using more fine-grained analysis approaches, e.g. ecological momentary assessment, is needed.
Concurrent use of alcohol with other drugs and DSM-5 alcohol use disorder comorbid with other drug use disorders: Sociodemographic characteristics, severity, and psychopathology
2018, Drug and Alcohol Dependence
Little is known about the sociodemographic profiles, the intensity of drinking, the severity of alcohol use disorder (AUD), and psychopathology among individuals with specific patterns of concurrent alcohol and drug use and AUD and other drug use disorders (DUDs) comorbidity.
Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III. We examined sociodemographic correlates and psychopathology among individuals with specific patterns of concurrent use of alcohol and drug and AUD-DUD comorbidity relative to alcohol use or AUD only, respectively, using multinomial logistic regression. We also examined whether concurrent alcohol and drug use and AUD-DUD comorbidity increased the intensity of drinking and severity of AUD, respectively.
The majority (62.0%) of past-year drinkers used only alcohol. The 12-month prevalence of AUD only was 53.5%. Individuals with concurrent use of alcohol and drugs and AUD-DUD comorbidity were more likely to be men, younger, never/previously married, with lower education and income (odds ratios (ORs) ≥ 1.2). Concurrent use of alcohol and drugs and AUD- DUD comorbidity groups were more likely to experience psychopathology than the alcohol use only and AUD only groups, respectively (ORs ≥ 1.3). The intensity of drinking was greater among the concurrent use groups relative to the alcohol use only group, while the severity of AUD was greater among AUD-DUD comorbidity groups relative to the AUD only group.
Research on consequences and treatment outcome of concurrent use of alcohol and drugs and AUD-DUD comorbidity is warranted to inform the development of more effective prevention/intervention programs.
Close only counts in alcohol and violence: Controlling violence near late-night alcohol establishments using a routine activities approach
2017, Journal of Criminal Justice
Assess whether 5 a.m. bars and nightclubs in Little Rock, AR were in fact serving to attract or generate violence in and around their premises and what impacts a new ordinance, requiring increased guardianship, served its intended purpose to reduce the incidence of violence.
Using violent crime data from the Little Rock Police, a series of Risk Terrain Models were utilized to examine whether the influence that proximity to a risk factor (5 a.m. alcohol establishments) has on violent crime changes after the new ordinance is established.
Support for the ordinance was found for yearlong risk assessment, in that requiring 5 am alcohol establishments in Little Rock to employ a minimum of two law enforcement officers in and around the establishment acted as effective strategies to alter the guardianship and reduced the relative risk of violent crime in close proximity to these establishments.
The establishments were serving to attract/generate violent crime in and around their vicinity; however, support was found for the effectiveness risk reduction through increasing levels of guardianship and thus, reducing relative risk for violent crime. Furthermore, depending on the temporal aggregation, results varied on the potential riskiness associated with the 5 a.m. alcohol establishments.

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^☆: Parts of this report were presented at the annual meeting of the Research Society on Alcoholism, Marco Island, FL, June 8-13, 1991.

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Brief reportPatterns and predictors of simultaneous and concurrent use of alcohol, tobacco, marijuana, and hallucinogens in first-year college students☆

Abstract

Journal of Substance Abuse

Pharmacology, Biochemistry, and Behavior

Life Sciences

Increased marijuana-induced fetotoxicity by a low dose of concomitant alcohol administration

Journal of Studies on Alcohol

Diagnostic and statistical manual of mental disorders

The relationship of MMPI and sensation seeking scales to adolescent drug use

Journal of Personality Assessment

Ethanol and diazepam as causative agents in road traffic accidents

American drinking practices

Alcoholism and smoking

Journal of Studies on Alcohol

Predictor variables of adolescent drinking

Advances in Alcohol and Substance Abuse

The role of peer and adult models for drug taking at different stages in adolescence

Journal of Youth and Adolescence

The prediction of drug use among college students from MMPI, MCMI, and sensation seeking scales

Journal of Personality Assessment

Brief report
Patterns and predictors of simultaneous and concurrent use of alcohol, tobacco, marijuana, and hallucinogens in first-year college students☆