Predictors and consequences of young adult marijuana use and concurrent and simultaneous alcohol use: Month to month variation across 24 consecutive months

摘要 COVID-19大流行的破坏性影响可能包括对年轻人的负面影响 成年人的心理健康和物质使用。重要的是要知道酒精，大麻（MJ）， 同时使用两种物质（即，同时酒精和大麻[SAM]），以及动机， 使用可能会因COVID-19而发生变化。多重金融、住房、 大流行期间的就业、社会混乱或损失可能会出现前所未有的 对酒精和MJ使用以及YAs中的心理健康产生负面影响。特别是， 研究从COVID-19发病前几年开始的酒精和MJ使用轨迹的变化， 在急性大流行期及以后， 酒精和MJ在危机时期的使用行为，包括轨迹是否可能因政策影响而出现分歧 (e.g.,呆在家里的命令）可能会影响可用性，动机和心理健康。记录风险和 与YAs在治疗期间或治疗后增加或出现问题的风险相关的保护因素 大流行将使确定最需要干预的人和/或确定目标成为可能 在其他大规模危机期间进行干预。拟议项目将通过扩展R 01 AA 027496来补充 一项现有的对600名参与项目转型的不同年轻人（22-29岁）的纵向研究 （2015/2016年入组），连续随访24个月，完成30个月随访。 参与者最近一次接受调查是在2020年1月（大流行前）和2020年4月（疫情高峰期）。 COVID-19急性期）。使用随机交错设计，1月/4月调查的受访者 将被邀请在2020年7月至2021年6月期间完成六次双月调查。随机化 交错设计使我们能够利用我们先前的纵向密集月度设计， 随着这场动态的公共卫生危机继续演变，数据来自3- COVID前5年，提供有关过渡经历、物质使用和心理健康的详细信息 将与2019冠状病毒病急性大流行期间和之后的新评估相结合。具体目标将是 审查：（1））流行病和相关政策的影响（例如，留守令）对青少年社会角色的影响 急性大流行期间和随后年份的过渡以及社会角色 过渡和酒精，MJ和SAM使用;（2）物理距离和经济如何在过程中变化 大流行与短期和长期的酒精和MJ使用和问题（包括 AUD/CUD）和使用动机;（3）大流行对YA酒精纵向轨迹的影响， MJ和SAM使用（包括大流行是否导致替代[即，一种物质的增加]或 互补效应[即，酒精和MJ的增加），以及动机的变化 使用（即，社会和应对动机）和心理健康（即，焦虑，抑郁）;（4）谁最危险。

ABSTRACT The devastating impacts of the COVID-19 pandemic will likely include negative consequences for young adults' (YAs) mental health and substance use. It is important to know how alcohol, marijuana (MJ), and simultaneous use of both substances (i.e., simultaneous alcohol and marijuana [SAM]), as well as motives for use may be changing in response to COVID-19. The cumulative impact of multiple financial, housing, employment, and social disruptions or losses during the pandemic has the potential to have unprecedented negative effects on alcohol and MJ use as well as mental health among YAs. In particular, the ability to examine variation in trajectories of alcohol and MJ use starting from years prior to onset of COVID-19 and extending through the acute pandemic period and beyond is important to guide better prediction models for alcohol and MJ use behavior in times of crisis, including whether trajectories may diverge as policy implications (e.g., stay at home orders) may influence availability, motivations, and mental health. Documenting risk and protective factors associated with YAs' risk for increased or problematic use during or in response to the pandemic will make it possible to identify those in greatest need of interventions and/or identify targets for intervention during other large-scale crises. The proposed project will supplement R01AA027496 by extending an existing longitudinal study of 600 diverse young adults (ages 22-29) who participated in Project Transitions (enrolled 2015/2016) and were followed for 24 consecutive months and completed 30-month follow-up. Participants were most recently surveyed in January 2020 (pre-pandemic) and April 2020 (at the height of the acute phase of COVID-19). Using a randomized staggered design, respondents of the January/April surveys will be invited to complete six bi-monthly surveys between July 2020 and June 2021. The randomized staggered design allows us to capitalize on our prior longitudinal intensive monthly design and track relevant variables cost-effectively across one year as this dynamic public health crisis continues to evolve. Data from 3- 5 years pre-COVID with detailed information about transition experiences, substance use, and mental health will be combined with new assessments during and after the acute COVID-19 pandemic. Specific aims will be to examine: (1) ) impact of the pandemic and related policies (e.g., stay-at-home order) on YAs' social role transitions during the acute pandemic and subsequent year and concurrent associations between social role transitions and alcohol, MJ and SAM use; (2) how physical distancing and economic changes over the course of the pandemic are associated with shorter- and longer-term alcohol and MJ use and problems (including AUD/CUD) and motivations for use; (3) impact of the pandemic on longitudinal trajectories of YA alcohol and MJ and SAM use (including whether the pandemic led to substitution [i.e., increases in one substance] or complementary effects [i.e., increases in both substances] of alcohol and MJ), and changes to motivations for use (i.e., social and coping motives) and mental health (i.e., anxiety, depression); and (4) who is most at risk.