Behavioral Health, Mental Health, Substance Abuse
Drug involvement during and after college: Estimates of opportunity and use
(School of Public Health (UMD) Behavioral and Community Health Doctoral Student)
Rationale: College students perceive widespread availability of illicit substances and prescription medications on campus, but less is known about the relationship between exposure opportunity, use, and use given opportunity of these substances during and after college. Aims: This secondary analysis study describes annual trends in (1) opportunity, (2) use, and (3) use given opportunity of eight illicit substances and three prescription medications used nonmedically. Methods: Data were derived from a longitudinal cohort study of 1,253 first-year college students (49% male, 72% non-Hispanic white) at one large public university. For seven years (Year 2-8), past-year substance use opportunity and use were measured using standard questions for marijuana, hallucinogens, inhalants, cocaine, ecstasy, amphetamines, methamphetamine, heroin, and nonmedical use of prescription stimulants, analgesics, and tranquilizers. Binary variables were created to represent opportunity, use, and use given opportunity for each drug. Results: Participants had the highest opportunity to use marijuana compared to other substances during the 7-year study period, but there was a significant decline in the opportunity to use marijuana from Year 2 to Year 8. Notably, opportunity to use all substances consistently declined over the 7-year period while use given opportunity of illicit drugs other than marijuana and prescription drugs used nonmedically remained relatively stable throughout this period, indicating that changes in opportunity to use were an essential driver of changes in substance use in this sample. Significance: We found that opportunity risk was related to substance use risk, even in the post-college years. Higher opportunity and use of all drugs during the college years in comparison to the post-college years confirms the high-risk nature of the college environment. Environmental-level policies that decrease availability and limit opportunity to use illicit substances and prescription medications nonmedically are an important public health strategy to reduce drug use.