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AbstractPain is highly prevalent among emerging adults (18–25 years old), and rates of cannabis use are increasing among this population. Research indicates pain is a unique risk factor and motivator for substance use. However, evidence for pain-cannabis use relations among emerging adults is largely cross-sectional, and the only prospective evidence focuses on the frequency, quantity, and consequences of cannabis use, not initiation. Accordingly, this is the first study to examine pain as a prospective predictor of cannabis initiation among emerging adults. Data were drawn from five annual waves of the Population Assessment of Tobacco and Health Study. Emerging adults who denied cannabis use at baseline (n = 4,185) were included in the analysis. At baseline, a tenth of emerging adults reported moderate/severe pain (≥4/10). Adjusted Cox regression analysis revealed that emerging adults with moderate/severe baseline pain were more likely to initiate cannabis use, and did so earlier over the subsequent 4 years, than those with no/low baseline pain. These findings provide initial evidence for pain as a risk factor for cannabis initiation during emerging adulthood. Future research is needed to identify mechanisms by which pain motivates cannabis initiation and to examine the utility of pain-targeted content in cannabis use prevention and intervention efforts among emerging adults. [ABSTRACT FROM AUTHOR]

Background: Alcohol and pain frequently co-occur and interact in a positive feedback loop that maintains and exacerbates both conditions. The Expectancies for Alcohol Analgesia (EAA) is a recently developed, single-factor measure that assesses the extent to which individuals expect alcohol will reduce their pain. Alcohol-related outcome expectancies motivate drinking and predict drinking trajectories among emerging adults (18–24). The EAA was initially validated among adults with chronic pain who drink alcohol and has been associated with several indices of pain and alcohol. We are unaware of prior work that examined the psychometric properties of the EAA among emerging adults, who are at high-risk for developing positive expectancies regarding the utility of alcohol for pain management. Objectives: The goal of this study was to examine the factor structure, reliability, and validity of the EAA among emerging adult college students. Methods: Emerging adult college students who endorsed lifetime alcohol use and varying pain levels (N = 555, 74.4% Female, 75.2% White) completed an online survey of pain and alcohol use. Results: Confirmatory factor analysis indicated the single-factor structure was a good fit (CFI = 0.99, TLI = 0.99, SRMR = 0.01, RMSEA = 0.04). Internal consistency was excellent (α =.95), and EAA scores were positively associated with alcohol consumption, alcohol-related consequences, drinking motives, and pain intensity and disability (ps <.01). Conclusion: These findings suggest the EAA is a valid and reliable measure for assessing expectancies for alcohol analgesia among emerging adult college students, which may also be a promising intervention target to include in expectancy challenge interventions. [ABSTRACT FROM AUTHOR]

As student athletes exhibit unique alcohol use patterns based on being in- versus out-of-season and biological sex, we aimed to explore student athlete (N = 442) alcohol use, pregaming behaviors, and associated negative outcomes. Results suggest being out-of-season and male are positively associated with negative alcohol-related consequences, and male athletes report greater numbers of pregame specific alcohol-related consequences than female athletes (p < 0.05). Female athletes indicated significantly higher estimated blood alcohol concentrations than male athletes on pregaming nights. No differences emerged between in- and out-of-season athletes on pregame consequences. Results suggest that further emphasis on the role season status and sex has on pregaming behaviors and experiencing negative outcomes may be an important next step toward enhancing prevention and intervention approaches.

Background: Pain motivates alcohol and cannabis use, with evidence that pain catastrophizing (i.e., ruminative exaggeration of pain) mediates these associations. Student-athletes represent a unique population who engage in riskier substance use, experience more substance-related consequences, and are more likely to develop chronic pain compared to non-athletes. Objectives: This study examined relationships between pain, catastrophizing, alcohol and cannabis use and consequences. Student-athletes from two Division I universities (N = 549; 51% female) completed a cross-sectional survey. Moderated mediation tested the conditional indirect effect of pain catastrophizing on associations between pain and alcohol- and cannabis- use and consequences, separately, with sex moderating the a and b paths. Results: There was a significant direct effect between pain and alcohol-related consequences (b = 0.11, p =.008). Pain and pain catastrophizing were positively associated in all four models (bs = 0.68-0.72, ps <.001), and this relationship was stronger among female than male athletes. No other direct or conditional indirect effects were observed. Conclusions: Student-athletes experiencing pain report more alcohol-related consequences, and pain catastrophizing may be particularly relevant for student-athletes with greater pain. Future research should examine other factors proposed by theoretical models, such as negative affect, while focusing on athletes with more significant pain (e.g., injured athletes). [ABSTRACT FROM AUTHOR]

Pain and cannabis use are highly prevalent among emerging adults but research regarding how pain is associated with cannabis-related expectancies is limited. Emerging adults who reported past three-month cannabis use (N = 173) were recruited through an online sampling platform. Participants completed the Graded Chronic Pain Scale, Cannabis Use Disorders Identification Test – Revised, and Marijuana Effect Expectancy Questionnaire. Multiple linear regressions indicated that pain intensity and disability were associated with hazardous cannabis use and expectancies for global negative effects (ps < .001). Sex did not moderate any of these relationships (ps > .14). Findings suggest that emerging adults who experience pain report greater hazardous cannabis use and may expect more negative effects of cannabis use. Researchers and clinicians should consider assessing pain in the context of cannabis studies and interventions. [ABSTRACT FROM AUTHOR]

Background: College student-athletes are a high-risk population for both pain and alcohol use. Although a growing literature indicates that pain motivates alcohol consumption, no studies have tested associations between pain and alcohol in college student-athletes. Methods and Results: Among National Collegiate Athletic Association Division I student-athletes at a large public university (N = 65; 48% Female), nearly all student-athletes (97%) reported alcohol use and 65% reported pain due to an athletic injury. Pain intensity was positively associated with greater motivation to reduce drinking prior to receiving a brief alcohol intervention. Among females, pain intensity was associated with lower self-reported alcohol consumption. Among male athletes, pain-related interference was associated with greater alcohol-related problems and lower perceived ability to deal with alcohol-related situations. Conclusion: Results provide initial evidence that pain may be important to consider when addressing alcohol use among student-athletes. [ABSTRACT FROM AUTHOR]

Aims To review differences in alcohol- and cannabis-related motives and consequences among National Collegiate Athletic Association (NCAA) athletes as a function of athlete characteristics (e.g. gender and competition season status). Methods Procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, PsycINFO and manual reference list review were used to identify studies that reported alcohol- or cannabis-related motives and consequences among NCAA athletes as a function of gender, race, season status, division level or sport-type through December 2019. Relevant findings and any reported psychosocial correlates were extracted by two independent reviewers. Results The majority of studies (K  = 15) focused on alcohol-related motives or consequences, with one examining cannabis-related motives, and no studies examined cannabis-related consequences. Social drinking motives were strongest among men and White NCAA athletes, and athlete-specific motives were most salient for men and in-season athletes. Cannabis use motives for positive reinforcement (e.g. enhancement) and coping were also strongest during the in-season. Negative alcohol-related consequences were greatest among men, athletes of color and out-of-season athletes, although women and in-season athletes experienced more consequences in athletic performance. Our exploratory aim revealed two studies that examined psychosocial correlates, and the results indicate that sensation-seeking, stress and negative affect were associated with more alcohol-related consequences. Conclusion NCAA athletes are a heterogenous population, and their motives and consequences of use appear to vary across multiple athlete factors (e.g. gender). This review highlights the gaps in the literature and suggests future research directions to identify the risk and protective factors for substance use among NCAA athletes. [ABSTRACT FROM AUTHOR]

Alcohol use, cannabis use, and pain are public health concerns among emerging adults (18-24 years old). Co-use of alcohol and cannabis is of particular concern since individuals who co-use alcohol and cannabis use more of each substance and experience greater substance-related harm. Pain and substance use frequently co-occur, and a growing body of literature indicates pain is unique risk factor for substance use. The goal of the current study was to examine moderate/severe pain (vs. no/low pain) as a prospective predictor of engaging in co-use of alcohol and cannabis among emerging adults, and to test sex as a moderator of this hypothesized relationship. Data were drawn from Waves 1-5 of the Population Assessment of Tobacco and Health Study (n = 3,544). Unadjusted logistic regression revealed that those with moderate/severe pain at baseline were 1.4 times more likely to engage in past-month co-use of alcohol and cannabis over the next four years (p = .046). The effects of pain on co-use were no longer significant after inclusion of covariates and a pain*sex interaction term, which was also nonsignificant (ps > .05). These findings provide initial support for pain as a risk factor for engaging in co-use of alcohol and cannabis during emerging adulthood. Future research should continue investigating how pain may motivate co-use of alcohol and cannabis, exploring how pain is associated with other measures of co-use, and determining how providers can incorporate pain-substance use psychoeducation for emerging adults in clinical settings., Competing Interests: Declaration of Competing Interest ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Inc. All rights reserved.)