Alcohol and drug use among sexual minority college students and their heterosexual counterparts: the effects of experiencing and witnessing incivility and hostility on campus

Michael R Woodford1, Amy R Krentzman2, Maurice N Gattis31School of Social Work, University of Michigan, Ann Arbor, MI, USA; 2Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; 3School of Social Work, University of Wisconsin-Madison, Madison, WI, USAPurpose: Research suggests that discrimination contributes to increased substance use among sexual minorities. Subtle discrimination and witnessing mistreatment, however, have received little attention. Using minority stress theory as a conceptual framework the authors examined the intersection of sexual orientation, experiencing and witnessing incivility and hostility, and students' alcohol and drug use. The authors hypothesized that experiencing/witnessing incivility/hostility would mediate the relationship between sexual minority status and drinking and drug use, as well as problematic use of these substances.Methods: Data were taken from a campus climate survey (n = 2497; age mean [M] = 23.19 years; 61% female; 17% sexual minorities). Controlling for demographics, logistic regressions depicted specifications for each path of the mediation analysis and bootstrapping was used to assess the significance of each sexual minority-mistreatment-drinking/drug use path.Results: Experiencing incivility mediated the relationship between sexual minority status and problematic drinking. Sexual minority college students were more likely to personally experience incivility (adjusted odds ratio [AOR] = 1.87; 95% confidence interval [CI] = 1.51–2.33), which was associated with greater odds of problematic drinking (AOR = 1.64; 95% CI = 1.35–2.00). The mediation path was significant at P < 0.001. Further, witnessing hostility mediated the relationship between sexual minority status and problematic drinking. Sexual minority college students were more likely to witness hostility (AOR = 1.87, 95% CI = 1.48–2.36), which was associated with greater odds of problematic drinking (AOR = 1.53; 95% CI = 1.24–1.90). The mediation path was significant at P < 0.01.Conclusion: The results provide further evidence for minority stress theory and suggest that clinical alcohol use interventions with sexual minorities need to assess personal incivilities and witnessing interpersonal mistreatment, especially hostility. Campus climate interventions that address subtle discrimination as well as harassment and violence may help reduce problematic drinking.Keywords: sexual orientation, discrimination, minority stress, campus climate, drinking, substance us

Using the Five Pathways to Nature to Make a Spiritual Connection in Early Recovery from SUD: a Pilot Study

Spirituality is a broad concept and open to different perspectives. It is associated with a sense of connection to something larger than oneself and a search for life’s meaning. Many people find this meaning through a connection with nature, but less is known about how to create a connection for those who are actively seeking one. Individuals in early recovery from addiction are encouraged to engage in 12 Step programmes (TSPs). However, the spiritual nature of the programme with references to the word “god” can serve as a deterrent. Nature connectedness through the five pathways provides a potential opportunity to introduce the concept of a higher power (HP) through a connection with nature. In this pilot mixed-methods study, a group of participants (n=12) in outpatient treatment for SUD were exposed to the five pathways and compared to a control group. Semi-structured interviews were conducted following the initial intervention. Drawing upon nature as a higher power through the pathways led to significant increases in nature connectedness, well-being, quality of life, and spirituality compared to a control group. The pilot study indicates that nature through the five pathways to nature connectedness provides a potential alternative for a higher power to draw upon within Twelve-Step.N/