Motives for Alcohol and Marijuana Use as Predictors of Use and Problem Use Among Young Adult College Students

• DOI: 10.1177/0022042620917101
• Published date: 01 October 2020
• Date: 01 October 2020
• Subject Matter: Articles

https://doi.org/10.1177/0022042620917101

Journal of Drug Issues

2020, Vol. 50(4) 359 –377

© The Author(s) 2020

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DOI: 10.1177/0022042620917101

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Article

Motives for Alcohol and Marijuana

Use as Predictors of Use and

Problem Use Among Young

Adult College Students

Akilah Patterson1, Milkie Vu1, Regine Haardörfer1,

Michael Windle1, and Carla J. Berg2

Abstract

This study examined (a) differences between alcohol-only users and alcohol–marijuana co-

users and (b) motives for use in relation to alcohol and marijuana use and problem use. Spring

2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven

Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use

measured 4 months later. Correlates of co-use (n = 345; vs. alcohol-only use, n = 1,525)

included greater alcohol and marijuana use frequency, problem drinking and marijuana use, and

alcohol use motives (p’s < .05). Controlling for covariates, alcohol use frequency correlated

with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives,

but lower Conformity alcohol use motives (p’s < .001); greater Coping and Self-enhancement

alcohol use motives (p’s < .01) predicted problem alcohol use. Marijuana use frequency

correlated with greater Coping and Expansion marijuana use motives (p’s < .05); greater

Expansion marijuana use motives (p = .005) predicted problem marijuana use. College-based

substance use interventions should target Coping and Self-enhancement alcohol use motives

and Expansion marijuana use motives.

Keywords

alcohol use, marijuana use, problem use, college students, young adults

Introduction

Alcohol and marijuana use represent significant problems among college students in the United

States, as indicated by high use prevalence. The 2018 National College Health Assessment indi-

cated that 60% of college students reported drinking alcohol in the past month and 37% reported

binge drinking (i.e., ≥4 drinks on a single occasion among females or ≥5 among males) the last

time they “partied or socialized” (American College Health Association [ACHA], 2018). The

2018 Monitoring the Future survey documented similar alcohol use prevalence in college

1Emory University, Atlanta, GA, USA

2The George Washington University, DC, USA

Corresponding Author:

Carla J. Berg, Department of Preventive and Community Health, Milken School of Public Health, The George

Washington University, Washington, DC 20052, USA.

Email: carlaberg@gwu.edu

917101JODXXX10.1177/0022042620917101Journal of Drug IssuesPatterson et al.

research-article2020

360 Journal of Drug Issues 50(4)

students (i.e., 62% past 30-day use, 33% binge drinking in the past 2 weeks; Schulenberg et al.,

2018). In addition, these 2018 surveys indicated that 21% to 22% of college students reportedly

used marijuana in the past month (ACHA, 2018; Schulenberg et al., 2018).

Alcohol and marijuana use can negatively affect U.S. college students by contributing to unin-

tentional injuries and bodily harm, negative effects on physical and mental health outcomes,

addiction, and negative academic outcomes (Arria et al., 2015, 2016; Hingson et al., 2009; White

& Hingson, 2014). Moreover, alcohol and marijuana use are risk factors that may affect future

individual health outcomes. Indicators of problem alcohol use include using alcohol before work

and/or school, passing out from drinking, trouble with the law while drinking, and various other

markers (U.S. Department of Health and Human Services [USDHHS], 2017). Problem mari-

juana use is marked by health problems due to injuries, memory loss, and failure to meet work,

school, or home responsibilities, among other indicators (Adamson & Sellman, 2003; Substance

Abuse and Mental Health Services Administration [SAMHSA], 2017).

People often engage in simultaneous use of different substances, which is indeed the case for

alcohol and marijuana (Brière et al., 2011; Suerken et al., 2014). For example, cross-sectional

studies have indicated that alcohol and marijuana co-use (i.e., the use of both substances during

a specific time period but not necessarily simultaneously) are associated with various negative

outcomes, such as increased risk of substance use disorders, motor vehicle crashes, physical

injury, and blackouts (Harrington et al., 2012; Keith et al., 2015). Furthermore, alcohol and mari-

juana co-use are associated with greater quantity and/or frequency of consumption of either

substance (Patrick et al., 2017, Patrick, Kloska et al., 2018; Subbaraman & Kerr, 2015). One

longitudinal study (Haas et al., 2015) documented that moderate drinking and marijuana use

increased the likelihood of problem drinking (e.g., drinking more than intended, drinking to get

drunk, higher rates of blackouts, physical injury, and driving under the influence) and that co-use

(vs. single product use) predicted more problem use.

Alcohol and marijuana use have been studied using a five-factor theoretical model indicating

five motives: Social (e.g., to obtain social rewards or be sociable), Coping (e.g., to manage nega-

tive emotions), Self-enhancement (e.g., to enhance positive emotions), Conformity (e.g., to avoid

rejection), and Expansion motives (e.g., to expand ideas/awareness) (Cooper, 1994; Cooper

et al., 1992; Cox & Klinger, 1988; Simons et al., 1998, 2000; Zvolensky et al., 2007). These

motives have been examined among college students in the United States (Lee et al., 2017;

Simons et al., 2000) and found to correlate with or predict increased use and use problems (Bray

et al., 2019; Buckner, 2013; Foster & Neighbors, 2013; Lee et al., 2009; Moitra et al., 2015;

Patrick et al., 2011, Patrick, Rhew et al., 2018; Van Damme et al., 2013).

Various other correlates of alcohol and marijuana use, such as sociodemographic, contextual,

and psychosocial factors, have also been documented. Sociodemographic factors, such as age,

sex, sexual orientation, race, ethnicity, as well as community-level factors, such as school type

and rural or urban school location, are associated with college students’ alcohol and marijuana

use behaviors (Keith et al., 2015; Luo et al., 2014; Siebert et al., 2003). With regard to psycho-

social factors, alcohol and marijuana use have been associated with adverse childhood experi-

ences (ACEs), both in cross-sectional (Alati et al., 2014; Chatterjee et al., 2018; Crouch et al.,

2018; Molina & Pelham, 2014) and longitudinal research (LeTendre & Reed, 2017). Other

research has also documented that alcohol and marijuana use is correlated with attention-deficit

hyperactivity disorder (ADHD; Mochrie et al., 2020), depression (Buckner et al., 2010; Mochrie

et al., 2020), and parental substance use (Agrawal & Lynskey, 2008; Alati et al., 2014; Van Der

Vorst et al., 2009; Vermeulen-Smit et al., 2012). These sociodemographic and psychosocial fac-

tors have been shown to increase the likelihood of alcohol and drug misuse and abuse, lead to

earlier initiation of use, and increase other related risk behaviors (e.g., binge drinking; Alati

et al., 2014; Chatterjee et al., 2018; Crouch et al., 2018; LeTendre & Reed, 2017; Mochrie et al.,

2020; Molina & Pelham, 2014).