Affect variability in relation to alcohol use frequency, intensity, and concurrent cannabis use among college students during the COVID-19 pandemic

Although alcohol use is related to daily affect, findings regarding affect variability—the degree to which individuals exhibit day-to-day fluctuations in affect—and alcohol use have been mixed. The present study assessed whether individuals who use alcohol tend to have higher positive and negative affect variability than individuals who do not, as well as whether higher affect variability is related to more frequent and intense alcohol use among individuals who use alcohol. We also explored whether affect variability differed between individuals who use alcohol and those who concurrently use alcohol and cannabis. College students (N = 1909; M = 20.1, SD = 1.3; 67.7% female; 76.6% white; n = 1147 individuals who use alcohol) completed a 21-day protocol between February-December 2021 in which they reported daily affect, number of drinks consumed, and any cannabis use. As hypothesized, individuals who used alcohol had higher positive and negative affect variability than individuals who did not. Among individuals who used alcohol, individuals with higher negative affect variability drank alcohol more frequently, and both higher positive and negative affect variability were related to more intense alcohol use. No differences emerged between individuals who used alcohol and those who concurrently used alcohol and cannabis. Taken together, higher positive and negative affect variability were related to higher odds of using alcohol and more frequent and intense use among individuals who use alcohol, over and above average affect. Higher affect variability could relate to alcohol use because of difficulties with emotion regulation or heightened sensitivity to the environment.</p

Identification of prescription opioid misuse and abuse behaviors and risk factors in chronic pain patients using the Prescription Opioid Misuse and Abuse Questionnaire (POMAQ)

To identify patient risk factors associated with prescription opioid misuse and abuse as well as groupings of misuse and abuse behaviors as measured by the Prescription Opioid Misuse and Abuse Questionnaire (POMAQ). Adults with chronic pain requiring long-term treatment with opioids completed the POMAQ and other study questionnaires. Latent class analysis (LCA) was used to examine underlying subgroups exhibiting particular risk profiles. Patient demographic and clinical characteristics were examined as covariates and the concordance between the identified latent classes at-risk classifications and the POMAQ clinical scoring algorithm was assessed. Analysis of data from 809 patients revealed 4 classes: “chronic pain, low risk” (n = 473, low to no prevalence of POMAQ behaviors), “chronic pain, comorbid condition” (n = 152, high prevalence of anti-anxiety, sleeping pill, and antihistamine use), “at risk” (n = 154, taking more opioids than prescribed and drinking alcohol with opioids more frequently than other groups), and “high risk” (n = 30, highest prevalence of each behavior). The “high risk” group was associated with being younger, less educated, and unemployed compared to other groups. When examining the LCA classes by groups defined by the original POMAQ clinical scoring algorithm, the “high risk” class had the highest proportion of participants identified with abuse behaviors (46.7%), compared to just 4.7% in the “chronic pain, low risk” group. Findings suggest there are four distinct subgroups of patients defined by chronic opioid misuse and abuse behaviors and support the use of the POMAQ to identify risk factors associated with prescription opioid misuse and abuse.</p