Patrick R. Clifford

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

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.

Harm reduction: an emerging new paradigm for drug education

Harm reduction is a new paradigm now emerging in the field of drug education. This strategy recognizes that people always have and always will use drugs and, therefore, attempts to minimize the potential hazards associated with drug use rather than the use itself. The rationale for a harm reduction strategy is presented, followed by an example of the kind of needs assessment which may be needed for planning a harm reduction strategy.

Personality, social environment, and past behavior as predictors of late adolescent alcohol use

Personality, as measured by subscales of the Sensation Seeking Scale (Zuckerman, 1979), social environmental exposure to alcohol use measured by parental and peer alcohol use, and past alcohol use were examined as predictors of late adolescent alcohol use in a sample of 575 1st-year college students. Efficacious predictors, in order of importance, include peer alcohol use, disinhibition, and age of first intoxication. The results support the relative importance of peer networks over parental models in determining late adolescent alcohol use. Our combinatorial model of personality, social environment, and past behavior is one such model in a growing trend toward the use of interactional models for predicting behavior.

Social Norms Theory-Based Interventions: Testing the Feasibility of a Purported Mechanism of Action

Social norms-based interventions targeting college student drinking behaviors have become increasingly popular. Such interventions purportedly modify student misperceptions of fellow student drinking behaviors, which leads to changes in individual drinking behavior. Despite claims of successful interventions, research demonstrating that social norms-based interventions modify student perceptions is lacking. Objective: The authors conducted a laboratory experiment examining the feasibility of this mechanism of action and aimed to determine the validity of the campus-specific drinking norms hypothesis. Participants and Methods: The authors randomly assigned 60 students to 1 of 3 research conditions: Alcohol 101 (national drinking norms), a didactic presentation of campus specific drinking norms, or a control condition. Results: Both intervention groups modified student misperceptions regarding peer alcohol use, and these changes were sustained 1 week later. Conclusions: Social norms-based interventions can contribute to more accurate drinking perceptions among college students.

Alcohol treatment research assessment exposure: a critical review of the literature.

Alcohol treatment researchers have speculated about the benefits of research participation (e.g., research follow-up interviews functioning as aftercare) for more than 4 decades (Gallen, 1974). Alternatively, research participation can decrease study design sensitivity and hamper the interpretability of research findings. To the extent that the typical alcohol treatment trial is characterized by frequent and comprehensive data collection, accounting for potential research assessment-related effects is essential for proper interpretation of study findings. Given this background, the purpose of this article is to review the alcohol treatment research literature on assessment exposure resulting in subject reactivity. In addition, interventions that use data collection activities to inform clinical practice are receiving increased attention, and such interventions share common characteristics with research assessment-related clinical improvements. Therefore, a second purpose of this article is to compare and contrast these 2 influences of behavior change. Study findings indicate that during and posttreatment data collection activities (i.e., both research and clinical data) positively influence clinical outcomes, although there appears to be important differences in regard to the mechanisms by which these 2 data collection activities exert their influence. Understanding of mechanisms of behavior change, effect boundaries, and the conditions under which clinical improvement is most likely to occur is only at a rudimentary level.

Collateral Informant Assessment in Alcohol Use Research Involving College Students

Abstract Objective: This study examined the associations between college students’ self-reported alcohol use and corresponding collateral reports and identified factors that influence agreement between both sets of reports. Participants/Methods: Subject–collateral pairs (N = 300) were recruited from undergraduate psychology courses. Results: Data yielded moderate correlations between subject-collateral pairs for all alcohol use measures, whereas discrepancy analyses revealed a tendency for subjects to report greater alcohol use relative to collateral reports. Greater subject–collateral agreement regarding frequency of subject alcohol use was predicted by a greater frequency of shared drinking occasions between the dyads, lower subject self-reported drug use, and lower levels of collateral guessing, whereas greater correspondence for quantity of alcohol consumed was predicted by fewer subject self-reported alcohol-related negative consequences, lower levels of subject self-reported drug use, and lower levels of alcohol ingestion among collaterals. Conclusions: College students appear to provide reasonably accurate self-reports of their alcohol use.

Discerning the Epidemiology of Drug Use among a Sample of College Students.

Although estimates concerning the prevalence of various forms of substance abuse vary considerably, it is critical to note that even the more conservative estimates indicate a major public health problem. Furthermore, increased drug experimentation has been frequently associated with the college experience. Utilizing a slightly modified version of the National Institute on Drug Abuse (NIDA) Monitoring the Future Survey, the present study examined the epidemiology of self-reported drug taking behaviors (e.g., alcohol, marijuana, tranquilizers, stimulants, psychedelics, etc.) among a sample (n = 683) of students attending a major public university. Data analyses focused on the specific settings and social groupings in which drug use occurred as well as on the frequency and type(s) of drug taking behaviors. Based on the results yielded from a disjoint cluster analysis, four distinct groups of drug users were identified. These four groups then served as categories of the dependent variable in a discriminant function analysis. A general linear models procedure was employed to identify the more efficacious discriminating (i.e., independent) variables.

Matching alcoholics to treatment. Failure to replicate finding of an earlier study.

The purpose of the present study was to investigate whether sociopathic alcoholics respond differentially to different types of treatment. An earlier study found that alcoholics with antisocial personality disorder had somewhat better outcomes if treated in individually focused versus relationship-focused cognitive-behavioral treatment. The present study was designed to attempt to replicate these findings. One hundred and forty-nine alcoholics (42 of whom scored high on a measure of sociopathy) were randomly assigned to receive either individually focused cognitive-behavioral treatment or a relationship-focused community reinforcement approach. Follow-up evaluations were conducted every 4 months for 2 years. Results failed to support the study hypothesis. Drinking outcomes were similar for sociopathic alcoholics in both treatment conditions. Directions for future research are identified.

Alcohol Use Post AUD Treatment Initiation as a Predictor of Later Functioning

Objective: To replicate and extend the earlier work of Maisto and colleagues showing an association between early post-treatment alcohol use and later functioning (123). Methods: The present study classified adults presenting for alcohol use disorders (AUD) treatment (n = 114) into one of three drinker groups (i.e., abstainer, moderate drinker, or heavy drinker) based upon alcohol use during the first 6-months following outpatient AUD treatment initiation, and examined the associations between drinker group classification and later alcohol use and psychosocial functioning. Results: Study results showed that individuals classified within the heavy drinker group tended to have the poorest outcomes (i.e., greater alcohol use and poorer psychosocial functioning) relative to individuals classified within the abstainer or moderate drinker groups. Conclusions: Study findings are consistent with the prior work of Maisto and colleagues. In addition, it appears that alcohol use, particularly heavy alcohol consumption, during the early post-treatment initiation period may serve as a marker for later alcohol related problems and poorer overall psychosocial functioning.

Drug use, drug prohibition and minority communities.

Drug problems, including alcohol and tobacco abuse, present major public health concerns for the American people. Drug abuse and its related difficulties have been associated with both increased morbidity and premature mortality. In the United States, ethnic minorities have experienced the overall negative impact of drug abuse much more severely than the general population. The impact of drug prohibition in the United States has not been to eliminate or minimize the use of illicit drugs. Indeed, in recent times, the use of some illegal substances (e.g., cocaine) has increased among certain segments of our population; while the use of licit substances (e.g., alcohol) has decreased among specific groups. Unfortunately, drug prohibition and related policies have contributed to the differential impact of the negative consequences of drug abuse on ethnic and racial minorities. The passage and enforcement of repressive drug laws, to curb what is essentially a public health problem, has not been demonstrated to be a productive mechanism for the amelioration of drug related problems within our minority communities.