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Addict Behav. 2020 Mar;102:106212. doi: 10.1016/j.addbeh.2019.106212. Epub 2019 Nov 11.

Trends in college students' alcohol, nicotine, prescription opioid and other drug use after recreational marijuana legalization: 2008-2018.

Author information

1
213 Reed Lodge Department of Psychology, School of Psychological Science, College of Liberal Arts, Oregon State University, Corvallis, OR 97331, United States. Electronic address: alleyz@oregonstate.edu.
2
213 Reed Lodge Department of Psychology, School of Psychological Science, College of Liberal Arts, Oregon State University, Corvallis, OR 97331, United States.
3
161 Milam Hall, Biostatistics Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, United States.

Abstract

BACKGROUND:

Young adult college students may be particularly sensitive to recreational marijuana legalization (RML). Although evidence indicates the prevalence of marijuana use among college students increased after states instituted RML, there have been few national studies investigating changes in college students' other substance use post-RML.

METHOD:

The cross-sectional National College Health Assessment-II survey was administered twice yearly from 2008 to 2018 at four-year colleges and universities. Participants were 18-26 year old undergraduates attending college in states that did (n = 243,160) or did not (n = 624,342) implement RML by 2018. Outcome variables were self-reported nicotine use, binge drinking, illicit drug use, and misuse of prescription stimulants, sedatives, and opioids. Other variables included individual and contextual covariates, and institution-reported institutional and community covariates. Publicly available information was used to code state RML status at each survey administration.

RESULTS:

Accounting for state differences and time trends, RML was associated with decreased binge drinking prevalence among college students age 21 and older [OR (95% CI) = 0.91 (0.87 - 0.95), p < .0001] and increased sedative misuse among minors [OR (95% CI) = 1.20 (1.09 - 1.32), p = .0003]. RML did not disrupt secular trends in other substance use.

CONCLUSIONS:

In the context of related research showing national increases in college students' marijuana use prevalence and relative increases following state RML, we observed decreases in binge drinking and increases in sedative use that both depended on age. Findings support some specificity in RML-related changes in substance use trends and the importance of individual factors.

KEYWORDS:

College students; Early adulthood; Prescription opioid use; Recreational marijuana legalization; Substance use

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