Discipline: Social, Behavioral, and Economic Sciences
Subcategory: Social Sciences/Psychology/Economics
Villisha Gregoire - University of the Virgin Islands
Co-Author(s): Karl Alcover and Hui Cheng, Michigan State University, Michigan, MI
Background: In the world and in the United States, alcohol is one of the most commonly used legal drugs and cannabis is the most commonly used internationally regulated drug (NIAAA, 2016; NIDA, 2015). Recently, in the United States (US), epidemiological estimates for prevalence of use of most internationally regulated drugs have stabilized, but this has not been the case for prevalence of cannabis use, which is increasing somewhat (NIDA, 2015). Both alcohol and cannabis are psychoactive drugs. As such when they are taken prematurely primarily during early teens (12-17 year olds), there are concerns about toxic effects on the developing central nervous system and associated impairments in cognitive functions. At present, early teen cannabis use raises the possibility that cannabis use now starts first, and then triggers onset of drinking alcoholic beverages. In this study we aim to determine whether cannabis onset changes alcohol use using the epidemiologic case-crossover design in which cases serve as their own controls. Methods: Estimates are from newly incident alcohol and cannabis users (combined n= 51,122), whose month and year of first use are known from the US National Surveys on Drug Use and Health (NSDUH), 2002-2014. NSDUH annually assesses non-institutionalized US residents aged 12 years and older. For the case-crossover analysis, we used the month prior to the month of alcohol onset as the ‘hazard’ interval, while two months prior to the month of alcohol onset served as the ‘control’ interval. The association is measured by the epidemiologic ‘case-crossover’ (CCO) method, obtained using the McNemar’s test of matched data. Results: Relative risk (RR) estimates were statistically robust for individuals 12 years and older as well as for both 12-17 year olds and 18-21 year olds. RR 95% CI for each age group does not entrap the null value (RR=1.0). Conclusions: We found evidence that cannabis onset now may be a trigger for onset of drinking alcohol. Future research on the short horizon short-term horizon is to stratify by Sex (in addition to these age stratifications) while on a long-term horizon would entail prospective and longitudinal studies, with bio-samples to confirm self-report of use, as well as randomized controlled trials to estimate the degree to which prevention or delay of cannabis onsets is followed by reduced risk of underage drinking.
Funder Acknowledgement(s): This research was funded by the NIH and Michigan State University SROP program. I am grateful for their funding, Dr. Anthony my mentor, Karl and Hui who worked alongside with me in the lab and Madhur who assisted with analysis.
Faculty Advisor: Hui Cheng, hcheng@epi.msu.edu
Role: I introduced a research question to my mentor, who then helped me to rethink and plan a proper epidemiological approach to address the question. I conducted the study under the supervision of my mentor and a graduate student. First, I had to learn data management using a statistical software (Stata) to manage 13 years of cross-sectional data from the National Survey on Drug Use and Health (NSDUH. 2002-2014), which conducts nationally representative survey annually. At the same time, I was learning the research design that my mentor introduced to conduct the statistical analysis. I presented my progress on the project during our weekly meeting, where I would receive suggestions and comments from my mentor among others. I completed the research by creating and presenting a poster.