Covid-19 pandemic and changes in the prevalence, patterns, and trajectories of substance use and related health risk outcomes among young adults in WA State

摘要 新冠肺炎疫情扰乱了许多人的生活，影响了他们的行为健康。不健康的变化 物质使用是一个非常令人担忧的问题。早期数据表明，在大流行期间，药物使用发生了变化， 特别是对人口中的一些亚群而言。该项目旨在检查大麻、酒精、 以及烟草使用和相关的健康危险行为(即在以下情况下驾驶-或与司机一起骑车 在COVID过程中大麻、酒精的影响以及大麻和酒精的同时作用) 19日在华盛顿州的年轻人中流行。具体来说，我们将解决以下问题： 在大流行期间，年轻人使用药物的模式是什么？这些与使用有什么关系？ 在大流行之前，无论是在个人轨迹方面，还是在青少年时期的规范模式方面 成年？在大流行期间，使用升级与停止使用的预测因素是什么？ 大流行压力在这些过程中是否起作用？社区级别的访问差异如何 资源和获取物质是否与大流行期间的物质使用模式有关？回答 为了回答这些问题，我们将使用我们从西澳青年成人健康调查(YAHS)收集的数据 过去7年，由佤邦行为健康和康复部提供资金。雅斯是一位 18-25岁年轻人的加速纵向队列序贯研究，每年增加队列和 随着时间的推移(2015-2021年)。在大流行开始后增加了两个队列，五个队列 有从大流行前到大流行期间的纵向数据。这些数据将与 社区一级的变量(例如，社区劣势、与药物使用有关的渠道的可用性和 服务)在新冠肺炎大流行之前和期间。我们将评估模式的变化(例如，使用模式， 来源、频率和数量)大麻、酒精和烟草的使用、大麻和酒精的同时使用 从大流行前到大流行期间，与SU相关的危险行为(如醉酒驾驶)。这个 社区一级因素的作用和社会人口特征的差异(例如，性别、性别和性别) 这些变化中的性别小型化地位、种族/民族、大学生身份)将被审查。此外， 我们将检查个人内部风险因素的变化，如大麻、烟草、 社会人口和社区层面的酒精使用和新冠肺炎大流行相关压力源 特点。最后，我们将评估个人在物质使用和相关危险行为方面的变化(例如， 醉酒驾驶)，特别关注启动、升级和终止及其预测因素和 潜在的解释机制。调查结果将为预防和干预工作的规划提供信息，旨在 增进健康，减少问题行为。

ABSTRACT The COVID-19 pandemic has disrupted lives and affected behavioral health of many. Unhealthy changes in substance use are a great concern. Early data indicate substance use has changed during the pandemic, particularly for some sub-groups of the population. This project aims to examine changes in cannabis, alcohol, and tobacco use and related health risk behaviors (i.e. driving while—or riding with a driver—under the influence of cannabis, alcohol, and simultaneous effects of cannabis and alcohol) during the course of COVID- 19 pandemic among young adults in Washington State. Specifically, we will address the following questions: What are the patterns of young adult substance use during the pandemic and how do these relate to use before the pandemic both in terms of individual trajectories and normative patterns over the course of young adulthood? What are the predictors of escalation of use vs. desistance from use during the pandemic and what is the role of pandemic stressors in these processes? How do community-level differences in access to resources and access to substances relate to patterns of substance use during the pandemic? To answer these questions, we will use data from the WA Young Adult Health Survey (YAHS) that we collected over the past 7 years with funding from the WA State’s Division of Behavioral Health and Recovery. YAHS is an accelerated longitudinal cohort sequential study of young adults ages 18-25, with cohorts added annually and followed over time (2015-2021). Two cohorts were added after the onset of the pandemic, and five cohorts have longitudinal data spanning the time from before to during the pandemic. These data will be linked with community-level variables (e.g., neighborhood disadvantage, availability of substance use-related outlets and services) before and during the COVID-19 pandemic. We will assess changes in patterns (e.g., mode of use, sources, frequency, and amount) of cannabis, alcohol, and tobacco use, simultaneous cannabis and alcohol use, and SU-related risk behaviors (e.g., driving while intoxicated) from before to during the pandemic. The role of community-level factors and differences by socio-demographic characteristics (e.g., sex, sexual and gender minoritized status, race/ethnicity, college student status) in these changes will be examined. Moreover, we will examine within-person changes in risk factors such as norms and perceived harm of cannabis, tobacco, and alcohol use and COVID-19 pandemic related stressors by socio-demographic and community-level characteristics. Finally, we will assess within-person changes in substance use and related risk behaviors (e.g., driving while intoxicated), focusing specifically on initiation, escalation, and desistance and their predictors and potential explanatory mechanisms. Findings will inform planning of prevention and intervention efforts aimed at improving health and reducing problem behaviors.