Modeling weekly and daily processes of a high-risk feedback cycle of alcohol, cannabis, and nonmedical use of prescription stimulants in college students: Impacts on use, academics, and sleep

University Of Washington, Seattle WA

Investigators

Abstract

PROJECT SUMMARY/ABSTRACT Nonmedical use of prescription stimulants (NMPS) is most common among college students (American College Health Association, 2023). NMPS has been associated with unwanted physical effects, sleep issues, and lower GPA and is a marker for cannabis and alcohol use; up to 90% of adolescents and young adults who engaged in past-year NMPS report using other drugs, particularly cannabis (Faraone et al., 2020; Kilmer et al., 2021; McCabe et al., 2006b; NIDA, 2014). We test specific mechanisms of a high-risk feedback cycle of the maintenance and escalation of NMPS, based on a novel framework grounded in the previous literature, with a focus on alcohol use, cannabis use, and sleep difficulties (all of which are key public health concerns), and academic stress. NMPS may be a compensatory behavior among those experiencing academic issues, which may have resulted from cannabis/alcohol use and concomitant inconsistent class attendance (Arria et al., 2013b). This feedback cycle operates continuously (not just during finals); therefore, it is critical to test the mechanisms of the proposed feedback cycle across the entire academic quarter. Intensive longitudinal research (e.g., weekly and daily surveys) is needed to best inform this important public health issue and provide a critical, in-depth examination of how weekly fluctuations in academic and sleep issues may contribute to NMPS and how daily fluctuations in alcohol use, cannabis use, and caffeine use may increase an individual’s vulnerability. This R01 application will provide a critical, in-depth examination of the feedback cycle focusing on NMPS, substance use, academics, and sleep. This project will recruit 300 college students (ages 18-25) who report (a) NMPS 5+ times in the past 12 months and (b) 4+ days of alcohol and/or cannabis use in the past 30 days. Across two academic quarters, participants will complete 22 weekly online surveys as well as two 21-day bursts of online morning surveys (corresponding with Fitbit sleep data). The aims are as follows. Aim 1: Using weekly data, examine how the strength of the associations between the key components of the feedback cycle vary as a function of time across the quarter. Aim 2: Using weekly data, test specific mechanisms of the feedback cycle at the week level to identify which factors of the feedback cycle, when elevated, confer heightened risk in a given week. Aim 3: Using daily data, test specific mechanisms of the feedback cycle at the day level to identify which factors of the feedback cycle, when elevated, confer heightened acute risk on a given day. Exploratory analyses will examine baseline moderators: class standing, sex assigned at birth, gender, fraternity/sorority membership, symptoms of alcohol use disorder, symptoms of cannabis use disorder, impulsivity, and sensation seeking. This application can inform our knowledge of the behavioral mechanisms that contribute to substance use and will lead to refined interventions for students who use multiple substances, enhancing our ability to target specific aspects of the feedback cycle.