Old habits

Kevin Lewis

January 01, 2018

Medical marijuana laws and adolescent use of marijuana and other substances: Alcohol, cigarettes, prescription drugs, and other illicit drugs
Magdalena Cerdá et al.
Drug and Alcohol Dependence, February 2018, Pages 62–68

Methods: Pre-post MML difference-in-difference analyses were performed on a nationally representative sample of adolescents in 48 contiguous U.S. states. Participants were 1,179,372 U.S. 8th, 10th, and 12th graders in the national Monitoring the Future annual surveys conducted in 1991–2015. Measurements were any self-reported past-30-day use of marijuana, cigarettes, non-medical use of opioids, amphetamines and tranquilizers, other illicit substances, and any past-two-week binge drinking (5+ drinks per occasion).

Results: Among 8th graders, the prevalence of marijuana, binge drinking, cigarette use, non-medical use of opioids, amphetamines and tranquilizers, and any non-marijuana illicit drug use decreased after MML enactment (0.2–2.4% decrease; p-values: <0.0001–0.0293). Among 10th graders, the prevalence of substance use did not change after MML enactment (p-values: 0.177–0.938). Among 12th graders, non-medical prescription opioid and cigarette use increased after MML enactment (0.9–2.7% increase; p-values: <0.0001–0.0026).

Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine
Noa Krawczyk et al.
Health Affairs, December 2017, Pages 2046-2053

People in the US criminal justice system experience high rates of opioid use disorder, overdose, and other adverse outcomes. Expanding treatment is a key strategy for addressing the opioid epidemic, but little is known about whether the criminal justice system refers people to the highest standard of treatment: the use of the opioid agonist therapies methadone or buprenorphine. We used 2014 data from the national Treatment Episode Data Set to examine the use of agonist treatment among justice-involved people referred to specialty treatment for opioid use disorder. Only 4.6 percent of justice-referred clients received agonist treatment, compared to 40.9 percent of those referred by other sources. Of all criminal justice sources, courts and diversionary programs were least likely to refer people to agonist treatment. Our findings suggest that an opportunity is being missed to promote effective, evidence-based care for justice-involved people who seek treatment for opioid use disorder.

Differentials and trends in emergency department visits due to alcohol intoxication and co-occurring conditions among students in a U.S. public university
Duc Anh Ngo et al.
Drug and Alcohol Dependence, February 2018, Pages 89–95

Methods: The ED electronic medical records from academic years 2010 to 2015 were queried for student visits and their records were linked to the university’s student admission datasets. Student alcohol-related visits were identified based on ICD-9 codes. Student characteristics and trends in the rate of alcohol intoxication per 100 ED student visits were analyzed. A random sample of 600 student clinical records were reviewed to validate diagnostic codes.

Results: There were 9,616 student ED visits (48% males) to the ED of which 1,001 (10.4%) visits involved alcohol intoxication. Two thirds of ED visits with alcohol intoxication had a co-occurring diagnosis, with injuries (24%) being the most common condition. The rate of alcohol intoxication varied greatly by student demographics and campus-related factors. There was a linear increase in the rate of alcohol intoxication from 7.9% in 2009–10 to 12.3% in 2014–15 (p < 0.01). The increase was greater among female students, students below 20 years of age, Asian students, and student athletes. In the sample reviewed, only two thirds of ED visits with alcohol intoxication were recorded by diagnostic codes.

Can Technology Really Help to Reduce Underage Drinking? New Evidence on the Effects of False ID Laws with Scanner Provisions
Emily Yiying Zheng
Journal of Health Economics, January 2018, Pages 102-112

In Volume 36 of this journal, Yoruk (2014) uses data from the National Longitudinal Survey of Youth 1997 and finds that false ID laws with scanner provisions have large impacts on binge drinking participation, frequency of alcohol consumption and binge drinking frequency among minors. This paper reexamines how false ID laws with scanner provisions affect underage drinking. I first demonstrate that analyses based on NLSY97 data fail falsification exercises testing for significant pre-intervention effects, and that the estimated effects based on these data are highly sensitive to the inclusion of a lead term and to sample selection, which weakens confidence in the large estimated effects reported in Yoruk (2014). I then use data from the Youth Risk Behavior Surveillance System to show that false ID laws with scanner provisions have no effect on underage drinking behavior.

Moderation of Genetic Influences on Alcohol Involvement by Rural Residency among Adolescents: Results from the 1962 National Merit Twin Study
Christal Davis, Shanaliz Natta & Wendy Slutske
Behavior Genetics, November 2017, Pages 587–595

Adolescents in rural and urban areas may experience different levels of environmental restrictions on alcohol use, with those in rural areas experiencing greater monitoring and less access to alcohol. Such restrictions may limit expression of genetic vulnerability for alcohol use, resulting in a gene–environment interaction (G × E). This phenomenon has previously been reported in Finnish and Minnesota adolescents. The current study used data from 839 same-sex twin pairs from the 1962 National Merit Scholarship Qualifying Test to determine whether the G × E interaction would be evident in this earlier time period. We also assessed whether the G × E interaction would be moderated by sex, and whether family socioeconomic status (SES; income and parental education) may mediate the G × E interaction. Findings showed the expected interaction among females, with a weaker contribution of genes (2 vs. 44%) and greater contribution of shared environment (62 vs. 29%) to variation in alcohol involvement among rural as compared to urban residents. The G × E interaction was not observed among males, and operated independently from differences in family SES among rural and urban adolescents. This study represents a partial replication in a novel setting of the moderation of the genetic contribution to alcohol use by rural/urban residency, and suggests that SES differences may not explain this effect.

The Influence of Peer Genotypes and Behavior on Smoking Outcomes: Evidence from Add Health
Ramina Sotoudeh, Dalton Conley & Kathleen Mullan Harris
NBER Working Paper, December 2017

We introduce a novel use of genetic data for studying social influences on behavior: Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we deploy the distribution of genotypes in a given grade within a school to instrument the influence of peer smoking on an individual’s own smoking behavior. We argue that this design alleviates many problems inherent to estimating peer effects. Using this approach, we find the relationship between peer smoking and individual smoking to be larger than that estimated by prior studies. Further, we explore the reduced form relationship between peer genotypes and ego smoking and find that the impact of peers’ genetic risk for smoking on ego’s smoking behavior is at least half as large as the effect of individual’s own genotype and sex, and 30% the effect of age. Moreover, peer influence on smoking appears heterogeneous by race: although whites and non-whites are equally susceptible to peer influence with respect to smoking, white egos are more likely to be influenced by white alters. This analysis suggests a promising way that genetic information can be leveraged to identify peer effects that avoids the reflection problem, contextual effects and selection into peer groups.

University-Affiliated Alcohol Marketing Enhances the Incentive Salience of Alcohol Cues
Bruce Bartholow et al.
Psychological Science, forthcoming

We tested whether affiliating beer brands with universities enhances the incentive salience of those brands for underage drinkers. In Study 1, 128 undergraduates viewed beer cues while event-related potentials (ERPs) were recorded. Results showed that beer cues paired with in-group backgrounds (logos for students’ universities) evoked an enhanced P3 ERP component, a neural index of incentive salience. This effect varied according to students’ levels of identification with their university, and the amplitude of the P3 response prospectively predicted alcohol use over 1 month. In Study 2 (N = 104), we used a naturalistic advertisement exposure to experimentally create in-group brand associations and found that this manipulation caused an increase in the incentive salience of the beer brand. These data provide the first evidence that marketing beer via affiliating it with students’ universities enhances the incentive salience of the brand for underage students and that this effect has implications for their alcohol involvement.

Drivers with alcohol use disorders and their risks of crash involvement
Jie Yao, Robert Voas & John Lacey
Drug and Alcohol Dependence, February 2018, Pages 210–216

Background: The relationship between driver blood alcohol concentration (BAC) and crash involvement is well understood. However, the role of alcohol use disorders (AUDs) (i.e., dependence or abuse) in crash occurrence, as distinguished from non-clinical heavy alcohol consumption, has not been adequately explored.

Methods: Data from the 2010–2011 Crash Risk Study conducted in Virginia Beach, VA, were used in this study. Drivers involved in crashes were compared with control drivers, and four drinker groups were examined: alcohol dependent, alcohol abusers, heavy drinkers, and all other current (i.e., normative) drinkers. Logistic regression analyses were conducted on two outcomes: having a moderate BAC (≥.05 g/dl), and crash involvement.

Results: Overall, 2,411 crash-involved and 5,514 control drivers provided useable data, 52.4% of which were men and 70.8% Whites. The prevalence of drivers with AUDs was lower for the crash-involved drivers (8.7%) than for the control drivers (12.7%). Only heavy drinkers, but not abusive or dependent drinkers, were over four times more likely to drive with moderate BACs at nighttime. More important, at nighttime, the odds of crash involvement for dependent drinkers were only one third of those for normative drinkers. Daytime crashes, however, were more likely to involve normative drinkers than any of the other three drinker types.

Conclusions: Drivers with AUDs are not more likely than normative drinkers to drive with moderate BACs at night. After accounting for the influence of BAC, dependent drinkers have a lower risk of being involved in a crash, at any time of the day.

One Markup to Rule Them All: Taxation by Liquor Pricing Regulation
Eugenio Miravete, Katja Seim & Jeff Thurk
NBER Working Paper, December 2017

Government often chooses simple rules to regulate industry even when firms and consumers are heterogeneous. We evaluate the implications of this practice in the context of alcohol pricing where the regulator uses a single markup rule that does not vary across products. We estimate an equilibrium model of wholesale pricing and retail demand for horizontally differentiated spirits that allows for heterogeneity in consumer preferences based on observable demographics. We show that the single markup increases market power among upstream firms, particularly small firms whose portfolios are better positioned to take advantage of the policy. For consumers, the single markup acts as a progressive tax by overpricing products favored by the rich. It also decreases aggregate consumer welfare though 16.7% of consumers are better off under the policy. These consumers tend to be older, less wealthy or educated, and minorities. Simple policies therefore generate significant cross-subsidies and may be an effective tool for government to garner favor of key constituencies.

Public Opinion and Public Policy: Heroin and Other Opioids
Amy Kyle Cook & Henry Brownstein
Criminal Justice Policy Review, forthcoming

Virginia, much like other states, has experienced unprecedented rates of heroin and prescription opioid abuse, overdoses, and deaths. Given the wide range of competing voices concerning drug policy and the complicated situation of the contemporary opioid epidemic, this study examines whether public opinion is reflected in public policy toward illicit involvement with opioids. The 2016 Commonwealth Public Policy Survey, a statewide representative sample of 1,000 Virginia residents, found that Virginians are supportive of treatment over arrest for heroin and prescription pill abusers and factors such as race, education, and political affiliation are predictive of support for treatment over arrest. More importantly, the results of this poll converge with legislative policies of the 2017 General Assembly, supporting the notion that public support can have an influence on the policymaking process. Policy implications are discussed.

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