Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor.
Institute for Research on Women and Gender, University of Michigan, Ann Arbor.
JAMA Pediatr. 2021 Jan 1;175(1):64-72. doi: 10.1001/jamapediatrics.2020.3352.
Recent information on the trends in past-year alcohol abstinence and marijuana abstinence, co-use of alcohol and marijuana, alcohol use disorder, and marijuana use disorder among US young adults is limited.
To assess national changes over time in past-year alcohol and marijuana abstinence, co-use, alcohol use disorder, and marijuana use disorder among US young adults as a function of college status (2002-2018) and identify the covariates associated with abstinence, co-use, and marijuana use disorder in more recent cohorts (2015-2018).
DESIGN, SETTING, AND PARTICIPANTS: This study examined cross-sectional survey data collected in US households annually between 2002 and 2018 as part of the National Survey on Drug Use and Health. The survey used an independent, multistage area probability sample for all states to produce nationally representative estimates. The sample included 182 722 US young adults aged 18 to 22 years. The weighted screening and weighted full interview response rates were consistently above 80% and 70%, respectively.
Measures included past-year abstinence, alcohol use, marijuana use, co-use, alcohol use disorder, marijuana use disorder, prescription drug use, prescription drug misuse, prescription drug use disorder, and other drug use disorders based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria.
The weighted sample comprised 51.1% males. Between 2002 and 2018, there was an annual increase in past-year alcohol abstinence among young adults (college students: 0.54%; 95% CI, 0.44%-0.64%; non-college students: 0.33%; 95% CI, 0.24%-0.43%). There was an annual increase in marijuana use from 2002 to 2018 (college: 0.46%; 95% CI, 0.37%-0.55%; non-college: 0.49%; 95% CI, 0.40%-0.59%) without an increase in marijuana use disorder for all young adults. Past-year alcohol use disorder decreased annually (college: 0.66%; 95% CI, 0.60%-0.74%; non-college: 0.61%; 95% CI, 0.55%-0.69%), while co-use of alcohol and marijuana increased annually between 2002 and 2018 among all young adults (college: 0.60%; 95% CI, 0.51%-0.68%; non-college: 0.56%; 95% CI, 0.48%-0.63%). Young adults who reported co-use of alcohol and marijuana or met criteria for alcohol use disorder and/or marijuana use disorder accounted for 82.9% of young adults with prescription drug use disorder and 85.1% of those with illicit drug use disorder. More than three-fourths of those with both alcohol use disorder and marijuana use disorder reported past-year prescription drug use (78.2%) and illicit drug use (77.7%); 62.2% reported prescription drug misuse.
The findings of this study suggest that US colleges and communities should create and maintain supportive resources for young adults as the substance use landscape changes, specifically as alcohol abstinence, marijuana use, and co-use increase. Interventions for polysubstance use, alcohol use disorder, and marijuana use disorder may provide valuable opportunities for clinicians to screen for prescription drug misuse.
最近关于美国年轻成年人过去一年的酒精禁欲和大麻禁欲、酒精和大麻共同使用、酒精使用障碍和大麻使用障碍趋势的信息有限。
评估美国年轻成年人过去一年的酒精和大麻禁欲、共同使用、酒精使用障碍和大麻使用障碍的国家变化，这些变化与大学生身份（2002-2018 年）有关，并确定最近队列中与禁欲、共同使用和大麻使用障碍相关的协变量（2015-2018 年）。
设计、地点和参与者： 本研究检查了 2002 年至 2018 年期间在美国家庭中每年进行的横断面调查数据，这些数据是国家药物使用和健康调查的一部分。该调查使用独立的、多阶段地区概率抽样对所有州进行抽样，以产生具有全国代表性的估计值。该样本包括 182722 名 18 至 22 岁的美国年轻成年人。加权筛选和加权完整访谈的应答率分别保持在 80%以上和 70%以上。
测量指标包括过去一年的禁欲、酒精使用、大麻使用、共同使用、酒精使用障碍、大麻使用障碍、处方药物使用、处方药物滥用、处方药物使用障碍和其他药物使用障碍，这些障碍是基于《精神障碍诊断与统计手册》第四版（DSM-IV）标准确定的。
加权样本中男性占 51.1%。2002 年至 2018 年期间，年轻成年人的过去一年的酒精禁欲率每年都有所增加（大学生：0.54%；95%置信区间，0.44%-0.64%；非大学生：0.33%；95%置信区间，0.24%-0.43%）。从 2002 年到 2018 年，大麻的使用量每年都在增加（大学生：0.46%；95%置信区间，0.37%-0.55%；非大学生：0.49%；95%置信区间，0.40%-0.59%），但所有年轻成年人的大麻使用障碍并没有增加。过去一年的酒精使用障碍率每年都在下降（大学生：0.66%；95%置信区间，0.60%-0.74%；非大学生：0.61%；95%置信区间，0.55%-0.69%），而在 2002 年至 2018 年期间，所有年轻成年人的酒精和大麻共同使用率每年都在增加（大学生：0.60%；95%置信区间，0.51%-0.68%；非大学生：0.56%；95%置信区间，0.48%-0.63%）。报告酒精和大麻共同使用或符合酒精使用障碍和/或大麻使用障碍标准的年轻成年人占处方药物使用障碍和非法药物使用障碍年轻成年人的 82.9%和 85.1%。超过四分之三的同时患有酒精使用障碍和大麻使用障碍的人报告过去一年曾使用处方药物（78.2%）和非法药物（77.7%）；62.2%的人报告有处方药物滥用。
这项研究的结果表明，随着物质使用情况的变化，美国的学院和社区应为年轻成年人创造和维护支持性资源，特别是随着酒精禁欲、大麻使用和共同使用的增加。针对多物质使用、酒精使用障碍和大麻使用障碍的干预措施可能为临床医生提供有价值的机会，以便筛查处方药物滥用。
