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College Students Mandated to Substance Use Courses: Age-of-Onset as a Predictor of Contemporary Polysubstance Use

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Title: College Students Mandated to Substance Use Courses: Age-of-Onset as a Predictor of Contemporary Polysubstance Use
Language: English
Authors: Benjamin N. Montemayor (ORCID 0000-0002-3330-1323), Melody Noland (ORCID 0000-0002-0031-2501), Adam E. Barry (ORCID 0000-0001-6527-6866)
Source: Journal of American College Health. 2024 72(8):2710-2717.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 8
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: College Students, Substance Abuse, School Policy, Drug Use, Drinking, Discipline Policy, Predictor Variables, Drug Rehabilitation, Gender Differences, Sororities, Fraternities, Intervention, Referral, Age Differences, Ethnicity, Prevention, Student Characteristics, Correlation, Alcohol Abuse, Brain, Developmental Stages, Behavior Standards, Social Behavior
DOI: 10.1080/07448481.2022.2128682
ISSN: 0744-8481
1940-3208
Abstract: Objective: College campuses report alcohol and other drug policy violations as the most frequent reason students receive disciplinary referrals and, thus, are mandated to programming. This study sought to determine predictors of mandated students' alcohol use frequency, and the likelihood of early-onset alcohol using college students enrolled in mandated programming engaging in current polysubstance use. Methods and participants: Employing a purposive sampling method, n = 822 participants were recruited from a pool of students who violated their university's alcohol policy between October 2019 and July 2021. Results: Data analysis revealed early-onset alcohol use (p < 0.001), gender ID (p < 0.01), Greek Affiliation (p < 0.001), ethnicity (p < 0.05), and perceived norms (p < 0.001) significantly predicted alcohol frequency. Analysis also revealed engaging in early-onset alcohol use significantly predicted current participation in polysubstance use (p < 0.01), outside of controls. Conclusions: University programs should consider exploring polysubstance use targeted interventions to mitigate these harmful behaviors and associated negative consequences.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1448379
Database: ERIC
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  Value: &lt;anid&gt;AN0180828350;acl01nov.24;2024Nov14.03:52;v2.2.500&lt;/anid&gt; &lt;title id=&quot;AN0180828350-1&quot;&gt;College students mandated to substance use courses: Age-of-onset as a predictor of contemporary polysubstance use&#160;&lt;/title&gt; &lt;p&gt;Objective: College campuses report alcohol and other drug policy violations as the most frequent reason students receive disciplinary referrals and, thus, are mandated to programming. This study sought to determine predictors of mandated students&#39; alcohol use frequency, and the likelihood of early-onset alcohol using college students enrolled in mandated programming engaging in current polysubstance use. Methods and participants: Employing a purposive sampling method, n = 822 participants were recruited from a pool of students who violated their university&#39;s alcohol policy between October 2019 and July 2021. Results: Data analysis revealed early-onset alcohol use (p &amp;lt;.001), gender ID (p &amp;lt;.01), Greek Affiliation (p &amp;lt;.001), ethnicity (p &amp;lt;.05), and perceived norms (p &amp;lt;.001) significantly predicted alcohol frequency. Analysis also revealed engaging in early-onset alcohol use significantly predicted current participation in polysubstance use (p &amp;lt; 0.01), outside of controls. Conclusions: University programs should consider exploring polysubstance use targeted interventions to mitigate these harmful behaviors and associated negative consequences.&lt;/p&gt; &lt;p&gt;Keywords: Polysubstance use; age-of-onset; university; mandated students; alcohol; other drugs&lt;/p&gt; &lt;hd id=&quot;AN0180828350-2&quot;&gt;Introduction&lt;/hd&gt; &lt;p&gt;American college student alcohol consumption continues to be a pertinent public health issue.[&lt;reflink idref=&quot;bib1&quot; id=&quot;ref1&quot;&gt;1&lt;/reflink&gt;] For the past two decades, rates of past month binge (≥four drinks for women; ≥five drinks for men on the same occasion) and heavy use drinking (binge drinking ≥5 days in the past 30 days) among American college students have remained between 30% and 40%.[&lt;reflink idref=&quot;bib2&quot; id=&quot;ref2&quot;&gt;2&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib3&quot; id=&quot;ref3&quot;&gt;3&lt;/reflink&gt;] Over half (55.7%) of American college students are current drinkers. Among current drinkers, approximately half (49.5%) report being drunk within the last 30 days. One out of every 10 American college students report consuming more than 10 drinks in a row at some point over the last 2 weeks.[&lt;reflink idref=&quot;bib2&quot; id=&quot;ref4&quot;&gt;2&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;There is a copious amount of research documenting the negative effects of alcohol use among college students. Annually, excessive alcohol use among college students in the United States is linked to more than 1,800 deaths, nearly 600,000 injuries, 646,000 assaults, and 97,000 sexual assaults.[&lt;reflink idref=&quot;bib4&quot; id=&quot;ref5&quot;&gt;4&lt;/reflink&gt;] Excessive alcohol use among college students use may also result in being diagnosed with an alcohol use disorder (AUD).[&lt;reflink idref=&quot;bib5&quot; id=&quot;ref6&quot;&gt;5&lt;/reflink&gt;] Moreover, excessive alcohol consumption is a top five preventable leading cause of premature death in the United States.[&lt;reflink idref=&quot;bib6&quot; id=&quot;ref7&quot;&gt;6&lt;/reflink&gt;] Some of the highest rates of alcohol use on American college campuses occur among college students who violate alcohol and other drug (AOD) use policies, and as a result, receive disciplinary referrals to an intervention program.[&lt;reflink idref=&quot;bib7&quot; id=&quot;ref8&quot;&gt;7&lt;/reflink&gt;] These students are commonly referred to as mandated students in the published literature, and represent an important subgroup of the college student subpopulation.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-3&quot;&gt;Students mandated to intervention programming&lt;/hd&gt; &lt;p&gt;Most universities require students adhere to specific alcohol policies while on campus (e.g., zero tolerance policy; alcohol can only be consumed in designated areas during designated times). Every year, campuses report AOD policy violations as the most frequent reason students receive disciplinary referrals.[&lt;reflink idref=&quot;bib8&quot; id=&quot;ref9&quot;&gt;8&lt;/reflink&gt;] Studies comparing mandated students to their nonmandated peers contend mandated students use AODs at a higher rate (frequency and quantity), are more likely to engage in other risky behaviors (e.g., drive drunk), and experience more negative consequences as a result of their use.[&lt;reflink idref=&quot;bib7&quot; id=&quot;ref10&quot;&gt;7&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib9&quot; id=&quot;ref11&quot;&gt;9&lt;/reflink&gt;] Academically, mandated students fall behind in schoolwork more often, perform poorly on exams, and attend class less often.[&lt;reflink idref=&quot;bib7&quot; id=&quot;ref12&quot;&gt;7&lt;/reflink&gt;] Yet, providing support and changing the behaviors of mandated students is complicated as they are often more reticent to seek further help or sustain long-term behavior changes.[&lt;reflink idref=&quot;bib8&quot; id=&quot;ref13&quot;&gt;8&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib10&quot; id=&quot;ref14&quot;&gt;10&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;These multifaceted impacts have encouraged some universities to create programs leveraging key AOD prevention and mediation factors.[&lt;reflink idref=&quot;bib11&quot; id=&quot;ref15&quot;&gt;11&lt;/reflink&gt;] Although organizations and researchers have provided blueprints of effective prevention and intervention strategies,[&lt;reflink idref=&quot;bib10&quot; id=&quot;ref16&quot;&gt;10&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib12&quot; id=&quot;ref17&quot;&gt;12&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib13&quot; id=&quot;ref18&quot;&gt;13&lt;/reflink&gt;] a ubiquitous method for programming and curriculum development for mandated students does not exist, and excessive alcohol use on college campuses remains an issue.[&lt;reflink idref=&quot;bib1&quot; id=&quot;ref19&quot;&gt;1&lt;/reflink&gt;] Researchers contend translational efforts that use baseline user characteristics and innovative approaches to prevention and intervention programming could be effective approaches in reducing risky AOD use among active users.[&lt;reflink idref=&quot;bib14&quot; id=&quot;ref20&quot;&gt;14&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib15&quot; id=&quot;ref21&quot;&gt;15&lt;/reflink&gt;] Recent innovative approaches, such as the use of programming tailored to individual risk profiles and factors, implementation of etiology-based factors, and developing school- and community-focused AOD programs, have been robustly associated with reductions in alcohol use and psycho-social factors (e.g., hopelessness, substance use disorders [SUDs]).[&lt;reflink idref=&quot;bib14&quot; id=&quot;ref22&quot;&gt;14&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib16&quot; id=&quot;ref23&quot;&gt;16&lt;/reflink&gt;] Thus, identifying characteristics and risky behaviors of mandated students on American college campuses could benefit a subgroup of students at high-risk for negative consequences.[&lt;reflink idref=&quot;bib7&quot; id=&quot;ref24&quot;&gt;7&lt;/reflink&gt;]&lt;/p&gt; &lt;hd id=&quot;AN0180828350-4&quot;&gt;Susceptibility and age-of-onset&lt;/hd&gt; &lt;p&gt;Research on brain development highlights adolescence and young adulthood as critical periods when the brain is highly susceptible to the consequences of excessive alcohol use.[&lt;reflink idref=&quot;bib17&quot; id=&quot;ref25&quot;&gt;17&lt;/reflink&gt;] In fact, final stages of brain maturation and refinement are happening around the age individuals are typically enrolled in college (18–24).[&lt;reflink idref=&quot;bib18&quot; id=&quot;ref26&quot;&gt;18&lt;/reflink&gt;] This period of life, for most, is characterized by a development of greater functional independence, substantial changes in social and personal lives, and increased competence.[&lt;reflink idref=&quot;bib19&quot; id=&quot;ref27&quot;&gt;19&lt;/reflink&gt;] For the millions who attend universities, this transition includes exposure to substantial changes in social activities, leisure time, socialization groups, and living arrangements. The transition into college also acts as a risk factor for alcohol use due to the increased exposure to other risky behaviors, such as peer alcohol use, and experimentation with other illicit drugs.[&lt;reflink idref=&quot;bib20&quot; id=&quot;ref28&quot;&gt;20&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;An important factor in predicting future alcohol use, and reducing the associated consequences, is assessing age-of-onset.[&lt;reflink idref=&quot;bib21&quot; id=&quot;ref29&quot;&gt;21&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib22&quot; id=&quot;ref30&quot;&gt;22&lt;/reflink&gt;] Early-onset alcohol users are at a greater risk of being diagnosed with a SUD during adulthood, and are more likely to have experienced an obstruction of key stages of brain development.[&lt;reflink idref=&quot;bib23&quot; id=&quot;ref31&quot;&gt;23&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib24&quot; id=&quot;ref32&quot;&gt;24&lt;/reflink&gt;] Among those students who began alcohol use during adolescence, being away at college can act as a catalyst for further increasing their alcohol usage, thus increasing susceptibility to the negative consequ-ences.[&lt;reflink idref=&quot;bib22&quot; id=&quot;ref33&quot;&gt;22&lt;/reflink&gt;]&lt;/p&gt; &lt;hd id=&quot;AN0180828350-5&quot;&gt;Age-of-onset&lt;/hd&gt; &lt;p&gt;Studies consistently find that adolescents who used alcohol prior to, or beginning at, age 14 are considered early-onset users. This designation is primarily due to alcohol-induced developmental delays in core executive functioning skills (e.g., self-regulation), and increased long-term psychobiological problems and alcohol-related harms.[&lt;reflink idref=&quot;bib25&quot; id=&quot;ref34&quot;&gt;25&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib26&quot; id=&quot;ref35&quot;&gt;26&lt;/reflink&gt;] Furthermore, early-onset users are more likely to engage in other risky behaviors more frequently, including progressing to using multiple other substances (cannabis, other illicit drugs, etc.), both independently and concurrently.[&lt;reflink idref=&quot;bib21&quot; id=&quot;ref36&quot;&gt;21&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib27&quot; id=&quot;ref37&quot;&gt;27&lt;/reflink&gt;] The probability of participating in polysubstance use is increasing among college-attending young adults and active AOD users.[&lt;reflink idref=&quot;bib28&quot; id=&quot;ref38&quot;&gt;28&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref39&quot;&gt;29&lt;/reflink&gt;]&lt;/p&gt; &lt;hd id=&quot;AN0180828350-6&quot;&gt;Polysubstance use&lt;/hd&gt; &lt;p&gt;Concurrent (ingestion of &amp;gt;1 drug in the same time period) and simultaneous (co-ingestion of &amp;gt;1 drug instantaneously) polysubstance use among college students represents an important and pressing concern given the additive and synergetic effects of multiple substances on core executive functioning skills.[&lt;reflink idref=&quot;bib30&quot; id=&quot;ref40&quot;&gt;30&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib31&quot; id=&quot;ref41&quot;&gt;31&lt;/reflink&gt;] While polysubstance use could be incidental (e.g., cannabis lacing, drink spiking), some high-risk college students (i.e., heavy single substance users, nonprescription stimulant users) demonstrate tendencies to purposefully engage in polysubstance use to heighten cross-fading effects (i.e., feeling high and drunk) or limit undesirable effects (e.g., disguise drunkenness).[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref42&quot;&gt;29&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib32&quot; id=&quot;ref43&quot;&gt;32&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib33&quot; id=&quot;ref44&quot;&gt;33&lt;/reflink&gt;] Moreover, displays of exacerbated alcohol use is regularly exhibited among young adults who engage in polysubstance use compared to alcohol only drinkers.[&lt;reflink idref=&quot;bib31&quot; id=&quot;ref45&quot;&gt;31&lt;/reflink&gt;] Both patterns of polysubstance use have been shown to increase young adults&#39; vulnerability to negative consequences (e.g., vomiting, blackouts, driving under the influence), and confer unique risks for future SUDs.[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref46&quot;&gt;29&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib34&quot; id=&quot;ref47&quot;&gt;34&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;Most notably, college students commonly report polysubstance use of cannabis and alcohol.[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref48&quot;&gt;29&lt;/reflink&gt;] Among college student drinkers, the annual prevalence of alcohol and cannabis polysubstance use ranges from 25% to 30%.[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref49&quot;&gt;29&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib35&quot; id=&quot;ref50&quot;&gt;35&lt;/reflink&gt;] While alcohol and cannabis remain the most widespread form of polysubstance use among college students, concurrent and simultaneous use of alcohol, cannabis, and other psychoactive or stimulant drugs is increasing (e.g., hallucinogens, prescription drugs).[&lt;reflink idref=&quot;bib2&quot; id=&quot;ref51&quot;&gt;2&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib32&quot; id=&quot;ref52&quot;&gt;32&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib36&quot; id=&quot;ref53&quot;&gt;36&lt;/reflink&gt;] National estimates contend nearly 1 out of every 10 American college students engage in nonmedical use of prescription drugs (NMUPD) annually.[&lt;reflink idref=&quot;bib2&quot; id=&quot;ref54&quot;&gt;2&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib37&quot; id=&quot;ref55&quot;&gt;37&lt;/reflink&gt;] Higher levels of polysubstance use and hazardous AOD use is common among students who frequently engage in NMUPD.[&lt;reflink idref=&quot;bib32&quot; id=&quot;ref56&quot;&gt;32&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;Despite the pervasiveness of AOD and polysubstance use among American college students, there are few established, well researched preventative and treatment approaches.[&lt;reflink idref=&quot;bib20&quot; id=&quot;ref57&quot;&gt;20&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib38&quot; id=&quot;ref58&quot;&gt;38&lt;/reflink&gt;] Thus, changes in patterns of polysubstance use seem to have outpaced research on its consequences and treatment strategies.[&lt;reflink idref=&quot;bib39&quot; id=&quot;ref59&quot;&gt;39&lt;/reflink&gt;] American college students report high incidences of AOD-related consequences (e.g., financial struggles, health issues, legal problems, interpersonal problems) consistent with DSM criteria for a SUD, yet their rates of help-seeking behavior remain low.[&lt;reflink idref=&quot;bib23&quot; id=&quot;ref60&quot;&gt;23&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib37&quot; id=&quot;ref61&quot;&gt;37&lt;/reflink&gt;] In 2020, over 16% of American college students in a nationally representative sample qualified as having an AUD, nearly double the prevalence from the year before.[&lt;reflink idref=&quot;bib40&quot; id=&quot;ref62&quot;&gt;40&lt;/reflink&gt;] Furthermore, a multiple university-collaborative longitudinal study discovered that nearly half (46.8%) of their college student sample (&lt;emph&gt;n&lt;/emph&gt; = 946) met the criteria for a SUD at some point in their first 3 years of college, but only 8% of them sought professional help afterwards.[&lt;reflink idref=&quot;bib41&quot; id=&quot;ref63&quot;&gt;41&lt;/reflink&gt;] Universities are in a unique position to assist students in their health and well-being, especially for mandated students who participate in heavier AOD use, and who research has shown to be a high-risk population for academic, physical, and personal consequencs.[&lt;reflink idref=&quot;bib7&quot; id=&quot;ref64&quot;&gt;7&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib42&quot; id=&quot;ref65&quot;&gt;42&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;To date, we are unaware of any peer-reviewed examinations specifically investigating early-onset alcohol use as a predictor of polysubstance use for American college students mandated to intervention programming. Given that early-onset AOD users are among the heaviest users as young adults, and because students mandated to AOD programming are among the heaviest users in the college population, further investigating the initiation of alcohol use and current polysubstance use habits of students mandated to programming would be beneficial.[&lt;reflink idref=&quot;bib7&quot; id=&quot;ref66&quot;&gt;7&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib24&quot; id=&quot;ref67&quot;&gt;24&lt;/reflink&gt;] Understanding the behaviors and characteristics among students mandated to AOD programming could help universities provide improved, school-based alcohol prevention/intervention tailored programming that focuses on addressing characteristics and etiological factors associated with SUDs.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-7&quot;&gt;Purpose&lt;/hd&gt; &lt;p&gt;This investigation assessed: (&lt;reflink idref=&quot;bib1&quot; id=&quot;ref68&quot;&gt;1&lt;/reflink&gt;) which variables are significant predictors of mandated students&#39; alcohol use frequency; and (&lt;reflink idref=&quot;bib2&quot; id=&quot;ref69&quot;&gt;2&lt;/reflink&gt;) the likelihood of early-onset alcohol users also currently engaging in concurrent polysubstance use of alcohol and at least one other drug, outside of controls.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-8&quot;&gt;Methodology&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0180828350-9&quot;&gt;Participants&lt;/hd&gt; &lt;p&gt;This study was conducted at a large (&lt;reflink idref=&quot;bib30&quot; id=&quot;ref70&quot;&gt;30&lt;/reflink&gt;,000+ students) public university in the Southeast United States, which requires all students to adhere to specific alcohol policies while on campus premises. Specifically, policies prohibit alcohol use for all those under the age of 21 (e.g., selling, serving, using), and forbid alcohol use on University property for University business, or at University sponsored activities, unless University regulation explicitly allows it. The University&#39;s Department of Campus Recreation and Wellness is responsible for administering mandated programming to students who violate campus alcohol policies. After receiving a referral from an authoritative figure (e.g., campus police, residence hall directors, Dean of Students office), students were required to report to the Department of Campus Recreation and Wellness and enroll in a mandated course.&lt;/p&gt; &lt;p&gt;Employing a purposive sampling method, students who violated the university&#39;s policies – specifically for alcohol use and mandated to attend alcohol education programming – were recruited. Data were collected October 2019 through July 2021. A total of 1,029 students were mandated to programming during this time and of those, 822 students volunteered to participate in this study, a response rate of 80%.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-10&quot;&gt;Procedures&lt;/hd&gt; &lt;p&gt;Per course requirements, prior to students&#39; starting their alcohol intervention course, each participant was obligated to complete a baseline assessment establishing age of alcohol onset as well as current rates of AOD use (eg, frequency, quantity). Prior to each assessment, students were given a cover letter describing information about this investigation, along with an opportunity to opt out of sharing their anonymous data. Specifically, any student who wished to not have their information shared with the researcher was able to opt out by clicking &quot;I do not wish to have my data shared in this project.&quot; Per Institutional Review Board (IRB) approval, documentation of informed consent was waived. The opt-out design procedures in the study required students to manually choose not to be a part of the study. Therefore, the information sheet that preceded each survey alerted the respondent of important details of the study and served as their notice of the nature of the study and how to prevent their data from being used.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-11&quot;&gt;Measures&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0180828350-12&quot;&gt;Demographics&lt;/hd&gt; &lt;p&gt;The online survey asked participants to voluntarily respond to the following demographic variables: gender identification (ID), ethnicity or race, age, year/classification in school, whether the student was affiliated with a Greek organization on campus, and finally their age-of-onset of alcohol use.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-13&quot;&gt;Age-of-onset&lt;/hd&gt; &lt;p&gt;Students were asked to report the age they had their first full drink of alcohol, beyond just a sip. Possible responses included nine continuous options, ranging from &amp;lt; 14 to ≥ 21 years. Based on previous literature, early- (began drinking ≤ 14) and late-onset users (began drinking ≥ 15) were established.[&lt;reflink idref=&quot;bib25&quot; id=&quot;ref71&quot;&gt;25&lt;/reflink&gt;]&lt;/p&gt; &lt;hd id=&quot;AN0180828350-14&quot;&gt;Frequency of alcohol use&lt;/hd&gt; &lt;p&gt;Frequency of students past 30-day alcohol use was assessed via the following item: &quot;&lt;emph&gt;Approximately how many days of the past month did you drink alcohol?&lt;/emph&gt;&quot; with responses ranging from ranging from 0 to 31 days.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-15&quot;&gt;Polysubstance use&lt;/hd&gt; &lt;p&gt;In order to better understand the concurrent (ingestion of alcohol and ≥ 1 other drug over the last 30 days) polysubstance use behaviors of the study sample, cannabis and other drug use (conveyed as any drugs other than cannabis) were included as variables in this study. No validated or standardized scales exist for measuring concurrent polysubstance use. Instead, students reported on their frequency of cannabis or any other drug use over the same time period (i.e., concurrent) (e.g., &quot;&lt;emph&gt;Within the last 30 days, how often did you use: (&lt;reflink idref=&quot;bib1&quot; id=&quot;ref72&quot;&gt;1&lt;/reflink&gt;) cannabis (marijuana); (&lt;reflink idref=&quot;bib2&quot; id=&quot;ref73&quot;&gt;2&lt;/reflink&gt;) any drugs other than cannabis (stimulants, depressants, etc.) in ways not directed by a healthcare provider:&lt;/emph&gt;&quot;) using a standardized 5-point Likert scale ranging from 0 = &lt;emph&gt;never&lt;/emph&gt; to 4 = &lt;emph&gt;always&lt;/emph&gt;, adapted from the American College Health Association National College Health Assessment.[&lt;reflink idref=&quot;bib43&quot; id=&quot;ref74&quot;&gt;43&lt;/reflink&gt;] The variables were then dichotomized into &quot;never&quot; or &quot;ever&quot; polysubstance users for analysis purposes. Students who drank alcohol but reported 0 = &lt;emph&gt;never&lt;/emph&gt; using either cannabis or other drugs in the last 30 days were coded as &quot;never users,&quot; and those who reported alcohol and at least some concurrent use of cannabis or other drugs (1 = rarely − 4 = always) were reported as &quot;ever users.&quot;&lt;/p&gt; &lt;hd id=&quot;AN0180828350-16&quot;&gt;Other predictor variables&lt;/hd&gt; &lt;p&gt;Supplementary predictor variables were utilized to act as controls and to determine their likelihood of predicting alcohol use frequency and polysubstance use. The following supplementary predictor variables were included: &lt;emph&gt;gender ID, Greek organization affiliation, race, classification in school&lt;/emph&gt;, &lt;emph&gt;age,&lt;/emph&gt; and &lt;emph&gt;perceived norms&lt;/emph&gt;. In order to test for the characteristic of interest within each categorical demographic variable (i.e., gender ID, Greek affiliation, race, year in school), some indicator variables were utilized and dichotomized into values of 0 or 1, where 0 indicated an absence of the characteristic of interest. Values of 1 were assigned to a category within each variable who research suggested represented risky alcohol users or had a higher prevalence of alcohol use. Thus, a value of 1 was applied to each of the following demographic variables: &lt;emph&gt;gender ID (male = 1),&lt;/emph&gt;[&lt;reflink idref=&quot;bib44&quot; id=&quot;ref75&quot;&gt;44&lt;/reflink&gt;]&lt;emph&gt;Greek organization affiliation (1 = affiliated),&lt;/emph&gt;[&lt;reflink idref=&quot;bib45&quot; id=&quot;ref76&quot;&gt;45&lt;/reflink&gt;]&lt;emph&gt;race (1 = White),&lt;/emph&gt;[&lt;reflink idref=&quot;bib44&quot; id=&quot;ref77&quot;&gt;44&lt;/reflink&gt;]&lt;emph&gt;classification in school (1 = freshman)&lt;/emph&gt;.[&lt;reflink idref=&quot;bib46&quot; id=&quot;ref78&quot;&gt;46&lt;/reflink&gt;] Finally, research has long associated increased rates of alcohol use among college students with inflated rates of alcohol norms,[&lt;reflink idref=&quot;bib47&quot; id=&quot;ref79&quot;&gt;47&lt;/reflink&gt;] thus, students were asked to report on the percentage of fellow university students who they believed used alcohol over the last 30 days (i.e., &lt;emph&gt;perceived norms)&lt;/emph&gt; utilizing a sliding scale ranging from 0% to 100%. During analysis, age and perceived norms operated as continuous variables.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-17&quot;&gt;Data analyses&lt;/hd&gt; &lt;p&gt;Data analyses were conducted via SPSS (Version 27.0). First, all outcomes were assessed for normality. Descriptive statistics (mean and standard deviation) and distributions of outcome variables (frequency and quantity) were assessed for nonnormality issues. Outliers that fell above or below three standard deviations from the mean were re-coded into the highest nonoutlying value plus one to account for any nonnormality concerns.[&lt;reflink idref=&quot;bib48&quot; id=&quot;ref80&quot;&gt;48&lt;/reflink&gt;] A stepwise multivariate OLS regression was used to determine which variables were significant predictors of mandated students past 30-day alcohol frequency. Finally, a logistic regression assessed whether being an early-onset alcohol user significantly predicted participation in concurrent polysubstance use of alcohol and at least one other drug over the last 30 days, outside of controls.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-18&quot;&gt;Results&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0180828350-19&quot;&gt;Sample&lt;/hd&gt; &lt;p&gt;Table 1 displays descriptive demographic statistics for students enrolled in mandated alcohol programing (&lt;emph&gt;n&lt;/emph&gt; = 822). The average age of the students was nearly 19 years (18.8), with a majority (91%) enrolled in their first 2 years of college. Respondents were nearly equally split, with 51% identifying as male. The sample consisted of predominantly White Non-Hispanic (87.4%) students. Approximately half of the students were affiliated with Greek student organizations. Finally, 10% (&lt;emph&gt;n&lt;/emph&gt; = 80) of the sample were considered early-onset users.&lt;/p&gt; &lt;p&gt;Table 1. Participants enrolled in mandated alcohol courses: Descriptive statistics.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Variable&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Total (&amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; = 822)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Percentage (%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody valign=&quot;top&quot;&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Gender ID&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Male&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;419&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;51&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Female&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;397&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;48.29&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Gender Fluid&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;6&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;0.73&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Ethnicity&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; White Non-Hispanic&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;719&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;87.47&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Black Non-Hispanic&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;25&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;3.04&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Hispanic or Latinx&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;33&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;4.01&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Asian or Pacific Islander&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;18&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.19&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; American or Alaskan Native&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;&amp;amp;#60;1%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Other&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;25&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;3.04&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age&amp;lt;sup&amp;gt;a&amp;lt;/sup&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;18.86 (1.07)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Year in school&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Freshman&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;580&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;70.56&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Sophomore&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;167&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;20.32&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Junior&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;55&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;6.69&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Senior&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;20&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.43&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Greek Affiliated&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Yes&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;414&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;50.36&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; No&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;408&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;49.64&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Onset of alcohol use&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Early-onset&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;80&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;9.7%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt; Late-onset&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;742&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;90.3%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;1 &lt;emph&gt;Note:&lt;/emph&gt; All data are reported as sample size (&lt;emph&gt;n&lt;/emph&gt;).&lt;/p&gt; &lt;p&gt;2 Data measured in years and reported as mean and standard deviation (&lt;emph&gt;SD&lt;/emph&gt;).&lt;/p&gt; &lt;hd id=&quot;AN0180828350-20&quot;&gt;Predicting past 30-day alcohol use frequency&lt;/hd&gt; &lt;p&gt;Table 2 displays the results of the multivariate OLS regression. Overall, the results of the &lt;emph&gt;F&lt;/emph&gt;-test for the OLS regression indicate that, taken together, all the independent variables were significant predictors of past 30-day alcohol frequency (&lt;emph&gt;R&lt;/emph&gt;&lt;sups&gt;2&lt;/sups&gt; =.13, &lt;emph&gt;F&lt;/emph&gt; (&lt;reflink idref=&quot;bib7&quot; id=&quot;ref81&quot;&gt;7&lt;/reflink&gt;,&lt;reflink idref=&quot;bib814&quot; id=&quot;ref82&quot;&gt;814&lt;/reflink&gt;) = 17.64, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.001), and explained 13% of the variance in alcohol frequency. Within the model, data revealed that variables early-onset alcohol use (&lt;emph&gt;β&lt;/emph&gt; =.17, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.001), gender ID (male) (&lt;emph&gt;β&lt;/emph&gt; =.10, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.01), Greek Affiliation (&lt;emph&gt;β&lt;/emph&gt; =.22, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.001), race (white) (&lt;emph&gt;β&lt;/emph&gt; =.09, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.05), and perceived norms (&lt;emph&gt;β&lt;/emph&gt; =.20, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.001) were all significant predictors and had positive associations with mandated college students&#39; alcohol use frequency.&lt;/p&gt; &lt;p&gt;Table 2. Linear regression model predicting past 30-day alcohol use frequency.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;95% CI for odds ratios&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Variable&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;B&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;SE B&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#946;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;t&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Sig.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody valign=&quot;top&quot;&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Constant&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;2.48&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.89&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.86&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.39&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Early onset&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.42&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.47&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.17&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;5.18***&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.000&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Male&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.79&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.29&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.10&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.78**&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.006&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Greek&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.82&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.28&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.22&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;6.51***&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.000&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;White&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.1&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.42&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.09&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.55*&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.01&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Freshmen&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.31&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.27&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.04&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;1.13&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.26&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.13&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.15&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.03&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.86&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.39&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Norms&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.79&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.13&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.20&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;5.97***&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.000&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;R&amp;lt;sup&amp;gt;2&amp;lt;/sup&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.13&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;F&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;17.64***&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;3 &lt;emph&gt;Note.&lt;/emph&gt; *** &lt;emph&gt;p&lt;/emph&gt; &amp;lt;. 001, **&lt;emph&gt;p&lt;/emph&gt; &amp;lt;.01, *&lt;emph&gt;p&lt;/emph&gt; &amp;lt;.05.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-21&quot;&gt;Does early-onset use predict polysubstance use?&lt;/hd&gt; &lt;p&gt;A total of &lt;emph&gt;n&lt;/emph&gt; = 169 (21%) respondents participated in polysubstance use with alcohol and at least one other substance over the past 30 days. Overall, significant findings within −2 Log likelihood and associated chi-square test statistics (&lt;emph&gt;X&lt;/emph&gt;&lt;sups&gt;2&lt;/sups&gt; = 36.44, df = 8, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.001) indicated the model was a good fit for the data. The Hosmer and Lemeshow goodness-of-fit test also revealed a nonsignificant finding with a &lt;emph&gt;p&lt;/emph&gt;-value well above the.05 threshold (&lt;emph&gt;X&lt;/emph&gt;&lt;sups&gt;2&lt;/sups&gt; = 5.94, df = 8, &lt;emph&gt;p&lt;/emph&gt; =.65), thus indicating further support of the model.[&lt;reflink idref=&quot;bib49&quot; id=&quot;ref83&quot;&gt;49&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;Overall, some variables in the model significantly predicted contemporary participation in polysubstance use, namely: freshman classification, perceived norms, Greek affiliation, and early-onset alcohol use, Table 3. Analyses revealed a negative Beta value of &lt;emph&gt;B&lt;/emph&gt; = −.49 among freshmen students, indicating that although significant (&lt;emph&gt;p&lt;/emph&gt; &amp;lt;.05), there was an inverse relationship between freshmen students and polysubstance use (&lt;emph&gt;OR&lt;/emph&gt; =.61, &lt;emph&gt;Wald&lt;/emph&gt; = 4.24). Greek affiliation (&lt;emph&gt;B&lt;/emph&gt; =.41), perceived norms (&lt;emph&gt;B&lt;/emph&gt; =.23), and early-onset alcohol use (&lt;emph&gt;B&lt;/emph&gt; =.71) revealed positive Beta values, an indication that association with either one increases the likelihood of participation in polysubstance use. Students affiliated with a Greek organization were 1.5 times more likely to participate in polysubstance use than students who were not Greek affiliated (&lt;emph&gt;OR&lt;/emph&gt; = 1.51, &lt;emph&gt;Wald&lt;/emph&gt; = 5.15, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.05). Additionally, students with inflated perceived norms of alcohol use were 1.25 times more likely to participate in polysubstance use (&lt;emph&gt;OR&lt;/emph&gt; = 1.25, &lt;emph&gt;Wald&lt;/emph&gt; = 7.1, &lt;emph&gt;p&lt;/emph&gt; &amp;lt;.01). Finally, respondents who indicated they were early-onset alcohol users were more than twice as likely to be polysubstance users than those who were not early-onset alcohol users (&lt;emph&gt;OR&lt;/emph&gt; = 2.02, &lt;emph&gt;Wald&lt;/emph&gt; = 7.20&lt;emph&gt;, p&lt;/emph&gt; &amp;lt;.01).&lt;/p&gt; &lt;p&gt;Table 3. Logistic regression model predicting past 30-day polysubstance use.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;95% CI for odds ratios&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;Odds ratio&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Lower&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Upper&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Wald&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Sig.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody valign=&quot;top&quot;&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Early Onset&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.02&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.21&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;3.39&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;7.20**&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.007&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Male&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.27&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.88&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.82&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.60&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.21&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Greek&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.51&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.06&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.17&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;5.15*&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.02&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;White&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.80&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.48&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.33&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.74&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.39&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Freshmen&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.61&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.38&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.98&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;4.24*&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.04&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.06&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.87&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.28&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.33&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.57&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Norms&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.25&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.06&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;1.48&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;7.1**&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.008&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Constant&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;3&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;2.32&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;.13&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;4 &lt;emph&gt;Note.&lt;/emph&gt; **&lt;emph&gt;p&lt;/emph&gt; &amp;lt;.01, *&lt;emph&gt;p&lt;/emph&gt; &amp;lt;.05.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-22&quot;&gt;Discussion&lt;/hd&gt; &lt;p&gt;Alcohol use among American college students represents a continued public health issue.[&lt;reflink idref=&quot;bib1&quot; id=&quot;ref84&quot;&gt;1&lt;/reflink&gt;] More recently, an uptick in polysubstance use among American college students has emerged, specifically among those who actively engage in heavy single substance use (i.e., alcohol only).[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref85&quot;&gt;29&lt;/reflink&gt;] Those particularly susceptible to the robust consequences aligned with excessive alcohol and polysubstance use are college students mandated to intervention programing.[&lt;reflink idref=&quot;bib7&quot; id=&quot;ref86&quot;&gt;7&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib9&quot; id=&quot;ref87&quot;&gt;9&lt;/reflink&gt;] Researchers have ascertained that mandated students use AODs at an inequitable rate compared to their nonmandated counterparts, and thus experience more negative consequences (academic, personal, physical) as a result.[&lt;reflink idref=&quot;bib9&quot; id=&quot;ref88&quot;&gt;9&lt;/reflink&gt;] Furthermore, excessive rates of alcohol and polysubstance use confer unique risk for future SUDs if not addressed during a prime period of behavioral and psychological development.[&lt;reflink idref=&quot;bib26&quot; id=&quot;ref89&quot;&gt;26&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref90&quot;&gt;29&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;Among this sample, alcohol use frequency was predicted among mandated college students who (a) were early-onset alcohol users, (b) were Male, (c) were affiliated with a Greek organization on campus, (d) were White, and (e) had inflated rates of alcohol perceived norms. Output from the regression models showed that these factors collectively explained 13% of the variance in the model. While previous research has identified most of these as risk-factors for alcohol use,[&lt;reflink idref=&quot;bib44&quot; id=&quot;ref91&quot;&gt;44&lt;/reflink&gt;]&lt;sups&gt;–&lt;/sups&gt;[&lt;reflink idref=&quot;bib46&quot; id=&quot;ref92&quot;&gt;46&lt;/reflink&gt;] to our knowledge, this is this first time that this model, including age-of-onset, has been applied as predictors for alcohol use among mandated students. The exploration of age-of-onset is timely due to the ubiquity of alcohol use among college students today, a notion acknowledged by other researchers.[&lt;reflink idref=&quot;bib20&quot; id=&quot;ref93&quot;&gt;20&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib38&quot; id=&quot;ref94&quot;&gt;38&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib39&quot; id=&quot;ref95&quot;&gt;39&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib50&quot; id=&quot;ref96&quot;&gt;50&lt;/reflink&gt;]&lt;/p&gt; &lt;p&gt;Among this sample, mandated college students who engaged in polysubstance use were more likely to (a) be early-onset alcohol users, (b) be affiliated with a Greek campus organization, (c) have inflated perceptions of alcohol norms, and (d) less likely to be freshmen. Even when accounting for important covariates, early-onset alcohol use significantly predicted concurrent polysubstance use. Concurrent polysubstance use was also reported among one-fifth of the current mandated sample, consistent with previous studies (25 − 30%).[&lt;reflink idref=&quot;bib29&quot; id=&quot;ref97&quot;&gt;29&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib35&quot; id=&quot;ref98&quot;&gt;35&lt;/reflink&gt;] While we are unaware of studies similar to our own, exploring implications of early-onset alcohol use among mandated college students, we can draw inference from other published research. Evidence suggests that early-onset alcohol users are among the individuals with the greatest probability of engaging in excessive AOD use in the future.[&lt;reflink idref=&quot;bib21&quot; id=&quot;ref99&quot;&gt;21&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib51&quot; id=&quot;ref100&quot;&gt;51&lt;/reflink&gt;] Furthermore, the transition to college has been shown to initiate alcohol use among college students, as well as exacerbate rates of use among active drinkers.[&lt;reflink idref=&quot;bib52&quot; id=&quot;ref101&quot;&gt;52&lt;/reflink&gt;] For early-onset alcohol using students entering a college environment, this period and environment may act as a catalyst for hazardous alcohol use and concurrent polysubstance use.[&lt;reflink idref=&quot;bib36&quot; id=&quot;ref102&quot;&gt;36&lt;/reflink&gt;]&lt;/p&gt; &lt;hd id=&quot;AN0180828350-23&quot;&gt;Areas for future research&lt;/hd&gt; &lt;p&gt;Due to the obligations of the university to protect the health and welfare of its students, methods to combat alcohol use and rising trends in polysubstance use should encourage universities and college health practitioners to address and expand prevention (e.g., education) and intervention (e.g., counseling) efforts among mandated college students.[&lt;reflink idref=&quot;bib4&quot; id=&quot;ref103&quot;&gt;4&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib42&quot; id=&quot;ref104&quot;&gt;42&lt;/reflink&gt;] One way to achieve this is through improved, up-to-date, tailored educational programming that focuses on predictive factors and consequences of alcohol and polysubstance use. In our sample, Greek organization affiliation predicted alcohol frequency, and those students were 1.5 times more likely to participate in concurrent polysubstance use. In addition to the implementation of effective intervention strategies highlighted in previous research,[&lt;reflink idref=&quot;bib12&quot; id=&quot;ref105&quot;&gt;12&lt;/reflink&gt;] researchers and practitioners should focus on creating, implementing, and evaluating prevention and mandated intervention programs among Greek students tailored to key risk factors. Relatedly, inflated rates of perceived alcohol norms predicted alcohol frequency and increased the probability of polysubstance use by 1.25 times. Theoretically, through experiences with fellow peers in the Greek system, perceived norms about college alcohol consumption are formed, and thus predict alcohol use.[&lt;reflink idref=&quot;bib47&quot; id=&quot;ref106&quot;&gt;47&lt;/reflink&gt;] Strategies should be incorporated in general prevention and intervention programs that aim to increase knowledge of, and behavior with alcohol through education and awareness programs.&lt;/p&gt; &lt;p&gt;The use of delayed or follow-up booster programming may also prove to be effective. Typically, universities implement AOD prevention programs during, or prior to, a student&#39;s freshmen year of college, attempting to curb or prevent AOD use.[&lt;reflink idref=&quot;bib53&quot; id=&quot;ref107&quot;&gt;53&lt;/reflink&gt;] However, in our sample, freshman classification did not predict alcohol frequency among mandated college students. Additionally, freshmen students were almost 40% less likely to participate in concurrent polysubstance use. Thus, comprehensive alcohol and polysubstance prevention and intervention programs could still be implemented during a student&#39;s freshman year, but then supplemented with delayed or follow-up booster sessions.[&lt;reflink idref=&quot;bib54&quot; id=&quot;ref108&quot;&gt;54&lt;/reflink&gt;] These supplementary meetings or boosters can be scheduled periodically post-freshman year to encourage prevention of alcohol and polysubstance use, or to help sustain long-term reductions in overall AOD use.&lt;/p&gt; &lt;p&gt;Finally, intervention programs for mandated students should consider implementing screening items and screening tools related to AOD use, such as the Alcohol Use Disorders Identification Test (AUDIT – C), the Drug Abuse Screening Test-10 (DAST-10), or the Cannabis Abuse Screening Test (CAST).[&lt;reflink idref=&quot;bib55&quot; id=&quot;ref109&quot;&gt;55&lt;/reflink&gt;]&lt;sups&gt;–&lt;/sups&gt;[&lt;reflink idref=&quot;bib57&quot; id=&quot;ref110&quot;&gt;57&lt;/reflink&gt;] The utility of alcohol and drug screeners in proficiently identifying college students who suffer from a SUD has been demonstrated repeatedly.[&lt;reflink idref=&quot;bib5&quot; id=&quot;ref111&quot;&gt;5&lt;/reflink&gt;],[&lt;reflink idref=&quot;bib58&quot; id=&quot;ref112&quot;&gt;58&lt;/reflink&gt;] Early-onset alcohol users and polysubstance users are at a greater risk of being diagnosed with a SUD and engaging in future risky AOD use than their counter parts.[&lt;reflink idref=&quot;bib24&quot; id=&quot;ref113&quot;&gt;24&lt;/reflink&gt;] Screening items and tools, in addition to severity and number of policy violations, could help identify and support students enrolled in mandated programing who would benefit from more intensive programming (e.g., online vs group-based vs one-on-one).[&lt;reflink idref=&quot;bib59&quot; id=&quot;ref114&quot;&gt;59&lt;/reflink&gt;] Screening for disorders could also help reinforce collaboration efforts with other campus resources, such as counseling or health services, which are not typically mandated for students. Moving forward, longitudinal studies can be undertaken to assess the effectiveness of these multifaceted approaches in identifying those at-risk for SUDs, and in preventing or reducing alcohol and polysubstance use. The implications listed here could also have practical utility with nonmandated students and AOD programming. This could include prevention/intervention studies assessing similar risk factors among other students who research has shown participate in heavy AOD use (i.e., pre-gamers, tailgaters), or screening and programmatic collaborations for students who voluntarily seek assistance for their substance use via resources on campus (i.e., student health services, campus recreation and wellness departments).&lt;/p&gt; &lt;hd id=&quot;AN0180828350-24&quot;&gt;Limitations&lt;/hd&gt; &lt;p&gt;Researchers should interpret the results of this study within the context of the following limitations. First, the sample was predominantly White Non-Hispanic. While reflective of overall demographics of the university, it is likely not generalizable to American college students as a whole, especially considering nonethnic college students have higher incidences of alcohol use compared to their counterparts.[&lt;reflink idref=&quot;bib60&quot; id=&quot;ref115&quot;&gt;60&lt;/reflink&gt;] Second, data were self-reported, so some reported answers could be over- or underreported. It is important to note, however, self-report data can accurately reflect a respondent&#39;s true cognitions and behaviors when settings and conditions are designed to maximize response accuracy (e.g., anonymity), such as those used in this study.[&lt;reflink idref=&quot;bib61&quot; id=&quot;ref116&quot;&gt;61&lt;/reflink&gt;] Third, concurrent polysubstance use was computed using separate responses to past 30-day alcohol, cannabis, and any other drug use frequency. Though no validated scales exist for measuring polysubstance use, future studies should consider using more detailed language regarding the specific substances (e.g., stimulants, opiates) and explicit usage (i.e., concurrent, simultaneous) they wish to assess. Fourth, the study did not incorporate a comparison group, thus restricting the power of the study and allowing room for bias. Finally, the data analyzed were cross-sectional with a purposive sampling methodology, limiting any casual inferences being made.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-25&quot;&gt;Conclusion&lt;/hd&gt; &lt;p&gt;College students rank as some of the most prevalent users of AODs in the United States. Among college students, those mandated to alcohol programs have proven to be among some of the heaviest users of alcohol. Although organizations and researchers have provided blueprints of effective prevention and intervention programs, innovative approaches, such as the use of tailored programming have proven to be influential for high-risk users. The current study identified several predictors of alcohol use frequency, including early-onset alcohol use. Furthermore, early-onset alcohol use significantly increased the likelihood of reporting concurrent polysubstance use, outside of controls. Thus, mandated college students who began using alcohol at an early age appear to be an especially high-risk drinking group worthy of additional investigation and targeted strategies to reduce consumption, polysubstance use, and prevent negative alcohol-related consequences.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-26&quot;&gt;Authors&#39; contributions/roles&lt;/hd&gt; &lt;p&gt;Benjamin N. Montemayor: Conceptualization, methodology, formal analysis, investigation, writing of original draft. Melody Noland: Conceptualization, review and editing of writing. Adam E. Barry: Conceptualization, review and editing of writing.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-27&quot;&gt;Conflict of interest disclosure&lt;/hd&gt; &lt;p&gt;The authors have no potential conflicts of interest to disclose. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Institutional Review Board of the University of Kentucky.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-28&quot;&gt;Funding&lt;/hd&gt; &lt;p&gt;The author(s) received no financial support for the research, authorship, and/or publication of this article.&lt;/p&gt; &lt;hd id=&quot;AN0180828350-29&quot;&gt;Research ethics and patient consent&lt;/hd&gt; &lt;p&gt;All procedures were vetted and approved by the IRB of the University of Kentucky (IRB number: 49173 Non-medical). 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  Data: College Students Mandated to Substance Use Courses: Age-of-Onset as a Predictor of Contemporary Polysubstance Use
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  Data: &lt;searchLink fieldCode=&quot;SO&quot; term=&quot;%22Journal+of+American+College+Health%22&quot;&gt;&lt;i&gt;Journal of American College Health&lt;/i&gt;&lt;/searchLink&gt;. 2024 72(8):2710-2717.
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  Data: Taylor &amp; Francis. Available from: Taylor &amp; Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 8
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles&lt;br /&gt;Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: &lt;searchLink fieldCode=&quot;EL&quot; term=&quot;%22Higher+Education%22&quot;&gt;Higher Education&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;EL&quot; term=&quot;%22Postsecondary+Education%22&quot;&gt;Postsecondary Education&lt;/searchLink&gt;
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22College+Students%22&quot;&gt;College Students&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Substance+Abuse%22&quot;&gt;Substance Abuse&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22School+Policy%22&quot;&gt;School Policy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Drug+Use%22&quot;&gt;Drug Use&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Drinking%22&quot;&gt;Drinking&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Discipline+Policy%22&quot;&gt;Discipline Policy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Predictor+Variables%22&quot;&gt;Predictor Variables&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Drug+Rehabilitation%22&quot;&gt;Drug Rehabilitation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Gender+Differences%22&quot;&gt;Gender Differences&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Sororities%22&quot;&gt;Sororities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Fraternities%22&quot;&gt;Fraternities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Intervention%22&quot;&gt;Intervention&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Referral%22&quot;&gt;Referral&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Age+Differences%22&quot;&gt;Age Differences&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Ethnicity%22&quot;&gt;Ethnicity&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Prevention%22&quot;&gt;Prevention&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Student+Characteristics%22&quot;&gt;Student Characteristics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Correlation%22&quot;&gt;Correlation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Alcohol+Abuse%22&quot;&gt;Alcohol Abuse&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Brain%22&quot;&gt;Brain&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Developmental+Stages%22&quot;&gt;Developmental Stages&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Behavior+Standards%22&quot;&gt;Behavior Standards&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Social+Behavior%22&quot;&gt;Social Behavior&lt;/searchLink&gt;
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2022.2128682
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481&lt;br /&gt;1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: College campuses report alcohol and other drug policy violations as the most frequent reason students receive disciplinary referrals and, thus, are mandated to programming. This study sought to determine predictors of mandated students&#39; alcohol use frequency, and the likelihood of early-onset alcohol using college students enrolled in mandated programming engaging in current polysubstance use. Methods and participants: Employing a purposive sampling method, n = 822 participants were recruited from a pool of students who violated their university&#39;s alcohol policy between October 2019 and July 2021. Results: Data analysis revealed early-onset alcohol use (p &lt; 0.001), gender ID (p &lt; 0.01), Greek Affiliation (p &lt; 0.001), ethnicity (p &lt; 0.05), and perceived norms (p &lt; 0.001) significantly predicted alcohol frequency. Analysis also revealed engaging in early-onset alcohol use significantly predicted current participation in polysubstance use (p &lt; 0.01), outside of controls. Conclusions: University programs should consider exploring polysubstance use targeted interventions to mitigate these harmful behaviors and associated negative consequences.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1448379
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1448379
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/07448481.2022.2128682
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 2710
    Subjects:
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Substance Abuse
        Type: general
      – SubjectFull: School Policy
        Type: general
      – SubjectFull: Drug Use
        Type: general
      – SubjectFull: Drinking
        Type: general
      – SubjectFull: Discipline Policy
        Type: general
      – SubjectFull: Predictor Variables
        Type: general
      – SubjectFull: Drug Rehabilitation
        Type: general
      – SubjectFull: Gender Differences
        Type: general
      – SubjectFull: Sororities
        Type: general
      – SubjectFull: Fraternities
        Type: general
      – SubjectFull: Intervention
        Type: general
      – SubjectFull: Referral
        Type: general
      – SubjectFull: Age Differences
        Type: general
      – SubjectFull: Ethnicity
        Type: general
      – SubjectFull: Prevention
        Type: general
      – SubjectFull: Student Characteristics
        Type: general
      – SubjectFull: Correlation
        Type: general
      – SubjectFull: Alcohol Abuse
        Type: general
      – SubjectFull: Brain
        Type: general
      – SubjectFull: Developmental Stages
        Type: general
      – SubjectFull: Behavior Standards
        Type: general
      – SubjectFull: Social Behavior
        Type: general
    Titles:
      – TitleFull: College Students Mandated to Substance Use Courses: Age-of-Onset as a Predictor of Contemporary Polysubstance Use
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Benjamin N. Montemayor
      – PersonEntity:
          Name:
            NameFull: Melody Noland
      – PersonEntity:
          Name:
            NameFull: Adam E. Barry
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 0744-8481
            – Type: issn-electronic
              Value: 1940-3208
          Numbering:
            – Type: volume
              Value: 72
            – Type: issue
              Value: 8
          Titles:
            – TitleFull: Journal of American College Health
              Type: main
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