Substitution of marijuana for alcohol: the role of perceived access and harm

Research has shown significant declines in gateway drug use among participants in a school/community substance abuse prevention intervention in a midwestern, suburban school district (Lohrmann, Alter, Greene, & Younoszai, 2005). Though still at or below national levels, student marijuana use was not impacted as positively. The current study investigated the possibility that efforts to prevent alcohol use resulted in an unintentional substitution effect thereby increasing marijuana use. Factors including perceived access to alcohol and marijuana, along with perceived harm associated with alcohol and marijuana use, were examined to determine their role in marijuana use. Findings revealed a relationship between perceived access to and perceptions of harm associated with marijuana and its use that depended on the level of perceived access to and harm associated with alcohol.     

Are substance use prevention programs more effective in schools making adequate yearly progress? A study of Project ALERT

This exploratory study sought to determine if a popular school-based drug prevention program might be effective in schools that are making adequate yearly progress (AYP). Thirty-four schools with grades 6 through 8 in 11 states were randomly assigned either to receive Project ALERT (n = 17) or to a control group (n = 17); of these, 10 intervention and nine control schools failed to make AYP. Students completed three self-report surveys. For lifetime cigarette use and 30-day alcohol use, Project ALERT was more effective in schools that made AYP. However, in these schools, Project ALERT negatively affected students' lifetime marijuana use. This study provided some preliminary evidence that prevention programming may not work as well in poorer performing schools; however, further exploration is needed.     

Say Yes First: follow up of a five-year rural drug prevention program

Say Yes First--To Rural Youth and Family Alcohol/Drug Prevention (SYF) was a 5-year, federally-funded U.S.D.H.H.S. Center for Substance Abuse Prevention (CSAP) project that involved 859 children in the class of the year 2000. The children in four rural school districts were followed from Grade 4 to Grade 8 from 1991 to 1996. Initial results in a previous publication showed significant lower drug usage in this cohort than comparison students. A follow-up of 120 SYF participants and 136 comparison students in high schools using the National Youth Survey (Follow Up Questionnaire) indicated lower usage of alcohol, tobacco and other drugs for the program students and lower lifetime prevalence of marijuana use for program vs. comparison students. SYF students had higher course grades, lower school absenteeism, more positive attitudes toward school, less trouble in school and less negative self-appraisal. Program students also reported greater participation in sports, more family communication and fewer disagreements or arguments with their parents.     

Parental Influence on Adolescent Cigarette,Alcohol and Marijuana Use: A Focus on Race/Ethnicity and Age

This study examined the racial/ethnic differences in the influence of perceived parental attitudes on adolescent cigarette, alcohol, and marijuana use. The 2014 National Survey on Drug Use and Health (NSDUH) was used and included African American, Hispanic, non-Hispanic White, and other race youth (N?=?13,600), aged 12–17. We tested the direct and moderating effects of perceived parental attitudes by race/ethnicity and age on adolescent substance use. Results show that perceived parental disapproval decreased cigarette and alcohol use among older adolescents. Perceived parental disapproval also varied by race/ethnicity and the type of substance used in that non-Hispanic White adolescents were more influenced by perceived parental disapproval for cigarette use, and perceived parental disapproval influenced Hispanic adolescents’ use for all three substances. African American adolescents were less influenced by perceived parental disapproval for all three substances. We also examined perceived harm in substance use and found that only 22.5% of the sample perceived the use of marijuana as harmful compared to cigarette and alcohol use (66 and 62.1%, respectively). Implications for preventive and intervention measures are discussed.     

Neighborhood Effects on Youth Substance Use in a Southwestern City

This study examines neighborhood influences on alcohol, cigarette and marijuana use among a predominantly Latino middle school sample. Drawing on theories of immigrant adaptation and segmented assimilation, we test whether neighborhood immigrant, ethnic, and socioeconomic composition, violent crime, residential instability, and family structure have differential effects on substance use among youth from different ethnic and acculturation backgrounds. Data are drawn from self-reports from 3,721 7(th) grade students attending 35 Phoenix, Arizona middle schools. Analysis was restricted to the two largest ethnic groups, Latino students of Mexican heritage and non-Hispanic Whites. After adjusting for individual-level characteristics and school- level random effects, only one neighborhood effect was found for the sample overall, an undesirable impact of neighborhood residential instability on recent cigarette use. Sub-group analyses by individual ethnicity and acculturation showed more patterned neighborhood effects. Living in neighborhoods with high proportions of recent immigrants was protective against alcohol, cigarette, and marijuana use for Latino students at different acculturation levels, while living in predominantly Mexican heritage neighborhoods (mostly non-immigrants) was a risk factor for alcohol and marijuana use for less acculturated Latinos. There were scattered effects of neighborhood poverty and crime, which predicted more cigarette and alcohol use, respectively, but only among more acculturated Latinos. Inconsistent effects confined to bilingual and more acculturated Latinos were found for the neighborhood's proportion of single mother families and its residential instability. No neighborhood effects emerged for non-Hispanic White students. Results suggested that disadvantaged neighborhoods increase substance use among some ethnic minority youth, but immigrant enclaves appear to provide countervailing protections.     

Alcohol and other substance use among deaf and hard of hearing youth

Little research has focused on alcohol and illicit drug use among deaf and hard of hearing youth. Findings are reported from survey data collected among high school students at two phases of a program of research primarily focusing on tobacco use [Phase 1: (1999/2000) n = 226, Phase 2: (2004) n = 618). Evidence of considerable ever (lifetime) drinking (59.1%, 42.6%) and other substance use (21.1%, 18.9%) was found. Gender, age, race/ethnic, grade, school type (mainstream vs. school for the deaf), age when deafened, and aspects of self-perception were examined for their possible association with substance use. Current use rates are reported, and study findings are discussed in relation to national data. Understanding these use patterns is critical to developing interventions for this culturally and linguistically unique population.     

Mexican/Mexican American Adolescents and keepin' it REAL: An Evidence-Based Substance Use Prevention Program

A randomized trial tested the efficacy of three curriculum versions teaching drug resistance strategies, one modeled on Mexican American culture; another modeled on European American and African American culture; and a multicultural version. Self-report data at baseline and 14 months post-intervention were obtained from 3, 402 Mexican heritage students in 35 Arizona middle schools, including 11 control sites. Tests for intervention effects used simultaneous regression models, multiple imputation of missing data, and adjustments for random effects. Compared with controls, students in the Latino version reported less overall substance use and marijuana use, stronger intentions to refuse substances, greater confidence they could do so, and lower estimates of substance-using peers. Students in the multicultural version reported less alcohol, marijuana, and overall substance use. Although program effects were confined to the Latino and multicultural versions, tests of their relative efficacy compared with the non-Latino version found no significant differences. Implications for evidence-based practice and prevention program designs are discussed, including the role of school social workers in culturally grounded prevention.     

Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

Sense of Belonging in School as a Protective Factor Against Drug Abuse Among Native American Urban Adolescents

This article presents the results of a study conducted with 243 Native American students who were part of a multi-ethnic sample of adolescents attending middle school in a large urban center in the Southwest region of the United States. Native adolescents who felt a stronger sense of belonging in their school were found to report a lower lifetime use of alcohol and cigarettes, lower cigarette and marijuana use in the previous month, lower frequency of current use of these substances, fewer substances ever used, and a later age of initiation into drug use than other Native students. Research implications are discussed in relationship to school environment, culturally-grounded prevention curricula, and school social work practice.     

Substance use, self-esteem, and depression among Asian American adolescents

The relationship of self-esteem and depression with alcohol, tobacco, and other drug (ATOD) use was tested in a California statewide sample of more than 4,300 Asian American high school students comprising five subgroups: Chinese, Japanese, Korean, Filipino, and Vietnamese. Estimated prevalence rates of alcohol, tobacco, and marijuana use among males and females from these Asian American subgroups are presented. Correlations revealed that cigarette, alcohol, and marijuana use were generally more related to high depression and low self-esteem in females than in males. Logistic regression analysis with only the female subjects investigated whether the relationship between the psychological variables and ATOD use was maintained even after controlling for traditionally important constructs in ATOD use (grade level in school, born in the United States, ethnicity, and ATOD use by friends). These results indicated that for females, depression was significantly related to alcohol and tobacco use, but self-esteem was not. Neither self-esteem nor depression was a significant contributor to marijuana use. Issues related to the application of these results are discussed.     

Sense of Belonging in School as a Protective Factor Against Drug Abuse Among Native American Urban Adolescents

ABSTRACT

This article presents the results of a study conducted with 243 Native American students who were part of a multi-ethnic sample of adolescents attending middle school in a large urban center in the Southwest region of the United States. Native adolescents who felt a stronger sense of belonging in their school were found to report a lower lifetime use of alcohol and cigarettes, lower cigarette and marijuana use in the previous month, lower frequency of current use of these substances, fewer substances ever used, and a later age of initiation into drug use than other Native students. Research implications are discussed in relationship to school environment, culturally-grounded prevention curricula, and school social work practice.     

A short-term, quasi-experimental evaluation of D.A.R.E.'s revised elementary school curriculum

We present the short-term results of a quasi-experimental evaluation of the revised D.A.R.E. (Drug Abuse Resistance Education) curriculum. Study outcomes examined were D.A.R.E.'s effects on three substances, namely students' lifetime and 30-day use of tobacco, alcohol, and marijuana, as well as their school attendance and academic performance. The study comprised students in 17 urban schools, each of which served as its own control; 5th graders in the 2006-2007 school year constituted the comparison group (n = 1490), and those enrolled as 5th graders in the 2007-2008 school year constituted the intervention group (n= 1450). We found no intervention effect on students' substance use for any of the substance use outcomes assessed. We did find that students were more likely to attend school on days they received D.A.R.E. lessons and that students in the intervention group were more likely to have been suspended. Study findings provide little support for the implementation and dissemination of the revised D.A.R.E. curriculum.     

A Longitudinal Analysis of Adolescent Substance Use and School Motivation Among African American Youth

Cross‐sectional research has shown a link between adolescent substance use and educational motivation. The purpose of the current study was to examine this link in a longitudinal sample of African American youth. The study examined the interrelationships between alcohol and both marijuana use and school motivation over the high school years and their effect on graduation in 681 African American adolescents (50.8% female). School motivation was shown to relate to subsequent alcohol use throughout high school and marijuana use early in high school. School motivation did not affect graduation status, but alcohol and marijuana use were related to a lower likelihood of graduating from high school. Some gender differences and differences among those who had tried alcohol or marijuana at the first wave as opposed to those who had not tried each substance were found. The findings support a systems model where school experiences can affect substance use, which, in turn, can affect the completion of high school.     

Internalizing Symptoms,Peer Substance Use,and Substance Use Initiation

This study used longitudinal survey and social network data covering sixth through ninth grades to test whether internalizing symptoms make early adolescents more prone to (1) exposure to and (2) influence by substance‐using peers. Random effects regressions revealed that increases in symptoms were significantly associated with increases in the proportion of friends who used cigarettes, alcohol, and marijuana; some associations weakened across grades. Event history models revealed that the effect of friends' smoking on smoking initiation decreased as internalizing symptoms increased; symptoms did not moderate the effects of friends' alcohol and marijuana use on alcohol and marijuana use initiation. These findings counter the influence hypothesis of the co‐occurrence of internalizing symptoms with substance use and partly support the exposure hypothesis.     

Trends from 1987 to 1991 in alcohol, tobacco, and other drug (ATOD) use among adolescents exposed to a school district-wide prevention intervention.

This study involved a school-based prevention program initiated to reduce alcohol, tobacco, and other drug (ATOD) use among adolescents in the Troy School District in the Detroit area. One purpose was to describe the current ATOD situation by investigating changes in reported ATOD use from 1987 to 1991. Another purpose was to explore and identify the most salient risk and protective factors present. In 1987, 1,490 students (comprising grades 8 and 11) and in 1991, 3,171 students (comprising grades 8 to 12) completed questionnaires. Significant decreases were found for use of most drugs with the exception of alcohol. Involvement in problem behaviors was identified as the most salient risk factor, while having a member of a non-using peer group was the most salient protective factor. Implications for the design of subsequent intervention programs are discussed.     

Patterns of Alcohol and Marijuana Use at School

The problem of adolescent substance use has been examined extensively. Beyond simple prevalence estimates, however, little research has been conducted on substance use in the school context. The present investigation was an in‐depth study of students' attitudes and behaviors regarding alcohol and marijuana use during the school day. Based on a representative sample of 1123 high school students, this study assessed the frequency of alcohol and marijuana use at school among demographic subgroups, the accessibility of drugs in school, and students' perceived consequences of being caught using drugs in school. The results showed that male and Hispanic students had higher levels of drug use at school than female and white students, respectively; that school drug use increased with age, and that alcohol and marijuana were easily obtained and used on school grounds. A large percentage of students were not aware of the specific actions taken in their schools to punish drug use. The need for additional research on school‐related drug use is emphasized.     

How Academic Achievement,Attitudes, and Behaviors Relate to the Course of Substance Use During Adolescence: A 6‐Year,Multiwave National Longitudinal Study

Self‐report data regarding alcohol, cigarette, and marijuana use were collected biennially from ages 14 to 20 in a nationally representative panel sample of adolescents (N=1,897) from the Monitoring the Future study. Growth curve analyses were performed using hierarchical linear modeling to consider psychosocial background, motivation and school attitudes, and parental and peer influences at age 14 as predictors of concurrent substance use and change in substance use. Results indicated that school misbehavior and peer encouragement of misbehavior were positively associated with substance use at age 14 and with increased use over time; school bonding, school interest, school effort, academic achievement, and parental help with school were negatively associated. The protective effects of positive school attitudes and perceptions of high status connected to academics were stronger for low‐achieving compared with high‐achieving youth. Implications for a developmental perspective on substance use etiology and prevention are discussed.     

Drug prevention with high risk families and young children

The effects of a school and home-based drug prevention program on risk factors for subsequent alcohol, tobacco, and other drug (ATOD) use among children were studied. Data on parent and child risk factors for ATOD use were collected from fifty-six low-income parents and their children, ages four to six years, using a pretest-posttest design. The parent-child intervention was conducted over a two-month period. The intervention had no effect on parent or child risk factors. However, the program was favorably received by parents and children. Almost two-thirds of the parents at the experimental school were involved in the program. Almost half of the parents had high depressive symptoms. The high rates of ATOD use and depressive symptoms among these parents are cause for concern.     

The impact of the positive action program on substance use,aggression, and psychological functioning: Is school climate a mechanism of change?

The social emotional learning (SEL) conceptual model posits that SEL programs lead to increased knowledge and skills, improved attitudes about self, others, and school, and supportive learning environments, which in turn improve student emotional, behavioral, and academic outcomes. Positive Action (PA) is an SEL program for elementary-, middle-, and high-school students. Extensive research documents the effectiveness of PA in decreasing adolescent risk factors and enhancing protective factors, however, minimal research has examined the mechanisms of change responsible for these effects. The current study examined whether PA was associated with SEL outcomes (i.e., alcohol use, aggression, depression, and anxiety) through school hassles (a proxy for school climate). The analytic sample consisted of 8333 ethnically/racially diverse, rural adolescents (51% female) in grades 6 through 12. Structural Equation Modeling was used to analyze the data. Engagement in PA was significantly associated with decreased school hassles, indicating an improvement in school climate. Subsequently, decreases in school hassles were significantly associated with decreased alcohol use, aggression, depression, and anxiety. Thus, there was an indirect effect between PA, decreased school hassles, and improved adolescent outcomes. Implications were discussed.