Opioid Addiction in Youth

Dr. Marc Fishman, MD, discusses the treatment of opioid addiction for adolescents and young adults. Dr. Fishman is an addiction psychiatrist and a member of the faculty of the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine.

The From Research to Recovery Town Hall brings together speakers from across the country to address mental health, substance use and other facets of behavioral and emotional health.

To find out more, visit http://www.cobe.vcu.edu/cobe-town-hall

Alcohol Use and the Brain: A Look Inside

Megan Cooke discusses the relationship between the brain and substance use. Cooke is a 6th year graduate student in the Clinical and Translational Sciences PhD program at Virginia Commonwealth University with a concentration in Psychiatric, Behavioral, and Statistical Genetics.

The From Research to Recovery Town Hall brings together speakers from across the country to address mental health, substance use and other facets of behavioral and emotional health.

To find out more, visit http://www.cobe.vcu.edu/cobe-town-hall-2017

Gender & Substance Use, Misuse, Treatment and Recovery

Dr. Mishka Terplan talks about how developing addiction to opioids and other drugs vary across gender, including how the rate of death for women is higher than for men. Dr. Terplan is a Professor of Obstetrics and Gynecology and Psychiatry and the Associate Director of Addiction Medicine at Virginia Commonwealth University.

The From Research to Recovery Town Hall brings together speakers from across the country to address mental health, substance use and other facets of behavioral and emotional health.

To find out more, visit http://www.cobe.vcu.edu/cobe-town-hall

Race, Addiction and Illiteracy Among Adult Incarcerated Populations

Dr. Raymond Tademy, Ph.D., presents on the relationship between educational history, race and substance use as they pertain to recovery and re-entry into society. Dr. Tademy is the Education Department Coordinator at the Richmond City Justice Center.

The From Research to Recovery Town Hall brings together speakers from across the country to address mental health, substance use and other facets of behavioral and emotional health.

To find out more, visit https://www.cobe.vcu.edu/cobe-town-hall

From Research to Recovery Town Hall in Photos

On April 18th and 19th, COBE and the Department of Behavioral Health and Developmental Services hosted From Research to Recovery, a town hall meeting on adolescent substance use, mental health and recovery.

Speakers from around the country came to VCU to address an audience of over students, professionals and members of the Richmond community on topics ranging from the Opioid Crisis to ADHD support services in higher education.

Below are photo galleries from both days of the Town Hall. We also filmed all of the presentations, and we will be hosting those for free on our website in the coming weeks.

Day 1:

Day 2:

Spit for Science: A How-To Guide

By Danielle M. Dick, Ph.D.
Project Director, Spit for Science
Director, College Behavioral and Emotional Health Institute

In 2011, I launched a university-wide research project focused on substance use and emotional health outcomes among college students with my colleague Dr. Ken Kendler. Over four years, we invited all incoming freshmen to be a part of this university-wide opportunity, with high rates of participation (approaching 70%) at our diverse, urban, public university. We have now collected longitudinal survey information and DNA from nearly 10,000 participants.

Further, the project has led to an extensive series of collaborations among faculty from multiple divisions across the university. In 2015 we launched the College Behavioral and Emotional Institute (COBE) to formalize and grow these research collaborations, and to translate research findings into coursework, programming, and policy designed to promote well-being in our students.

I have recently been contacted by multiple investigators from other universities who are interested in starting “Spit for Science” projects at their own universities, and who want to gain a deeper understanding about how we launched the project.

In going through old files, I discovered the following “Lessons Learned” document that I put together at the time we were initiating the project. I publish them here in the event that they could be of use to investigators hoping to initiate similar projects at their own universities.



Lesson #1: Get University Buy In

Before we ever launched the project we met with multiple stakeholders across the university, including administrators at multiple levels including the President, Provost, Vice Presidents, Deans, the registrar’s office, faculty and staff, the public relations and media offices, and the IRB, to name a few.

This project would not have been possible without support from the highest levels of the administration at the university, as these individuals opened doors to relevant faculty and staff across the campus who were necessary for implementation of the project. This included everyone from staff who worked with us to find space for the data collection, to persons involved with admissions who helped us obtain the contact information for eligible participants.

We made particular efforts to raise awareness of the project with faculty and staff who interfaced with incoming students (and potentially parents). This was very helpful, as these individuals were often more connected to where the students spend time, how best to get information out to them, and other logistical aspects regarding the undergraduates.

We created a website and a Facebook page for the project, which contained extensive information about the study, including all project materials and documents (mailings to students/parents, consent forms, etc). We held multiple focus groups to solicit feedback on the project, both student-focused, and open to the university as a whole. We thought this was particularly critical since projects with genetic components have greater potential for misunderstanding.

Accordingly, raising awareness about the project, involving individuals across the campus in its development, and striving for complete transparency was key. My advice to other faculty who want to launch a similar project: start by getting buy-in from the top. You are likely to encounter resistance and/or you will certainly need the assistance of many people across the university; having strong support at the highest level of the university is critical.

Lesson #2: Expect Resistance

This one surprised me. I thought the idea of applying our research expertise to study substance use and emotional health challenges – issues known to be problems on college campuses – would be universally met with the enthusiasm that we had for the project. Not so. A variety of different concerns were raised when we first began speaking to individuals around the university about the project.

Common concerns involved the possibility of bad press or upset parents resulting from misunderstanding about the project (primarily the genetic component), concern about minority involvement in genetic research, and concern that we were “using the students as guinea pigs”.

In response to concerns about misunderstanding about the study by parents, we mailed letters to the parents of all incoming freshman informing them about the project and also used this as an opportunity to send them information about how to talk to their children about alcohol use on college campuses and to educate them about the resources available on the campus.

This material was developed in collaboration with The Wellness Resource Center at VCU, and the materials for parents was mailed at the same time that we separately sent letters to the incoming students explaining the project. We also developed a handout on Frequently Asked Questions about the DNA component, which was included in the student mailing, made available at the data collection site, and available on the website.

We worked with a minority faculty member who led focus groups with African American students, parents, and faculty/staff to solicit thoughts and feedback about the project. This feedback contributed to the creation of a section of the study website addressing concerns about minority (most specific to the African American community) participation in genetic research.

We took steps to ensure that our students understood that although the project was university-supported, it was not university-sponsored, i.e., it was not mandatory and that their class performance would not be adversely affected in any way if they chose not to participate. We took the extra precaution when setting up the confidentiality procedures that no faculty member (including the PIs) would ever have access to the names of the students who had participated.

Accordingly, the project/registry coordinator(s) are the only individuals who have access to student names and contact information. We took this step to further ensure that students would feel no pressure to participate. Finally, and perhaps most importantly, we thought critically about how to use the project to enhance the educational experience to our university’s students, as detailed further below.

Having honest and hard discussions about concerns raised by individuals across the university ultimately improved the study on multiple fronts, as we worked to address and think through potential challenges collaboratively with our university partners. By preemptively reaching out to multiple groups, including students, parents, faculty, and staff, we believe that we minimized the potential for misunderstanding about the project.

In addition to the efforts described above to heighten understanding about the project, coinciding with the mailing of the initial information about the study to incoming freshman and their parents, the university launched a media release about the project. We contacted local newspaper outlets and also did interviews for the student paper, for local radio, and the local magazine.

In the six years that we have been running the project we have had, to my knowledge, only one parent contact the university to raise concern about the project (we worked with our IRB to prepare a response to the parent that I believe satisfactorily addressed their concern). I think it’s also fair to say that the project has now been warmly and rather universally embraced as something innovative and fun that is part of the fabric of our university.

When I meet new people at VCU and introduce myself, I generally start with the standard route of telling them what department I am in and what my research is on, and inevitably I eventually say “I run Spit for Science”, to which the response is nearly universally, “Oh! You’re the Spit for Science lady!”. My parents must be so proud.




Lesson #3: It’s About More than the Science

Although the scientific aims of the project were the original impetus for launching the study, as we met with individuals around the university, it became clear that launching a project of this magnitude, which necessitated assistance from individuals across many facets of the university, required that the project be about more than the science. It also needed to be about the unique learning opportunities that the project would afford the students.

In other words, it had to be good for the university to justify the large amount of effort of so many around the campus, not just good for the researchers.

We used the project as a way to introduce students to the importance of research at universities. It also provided a means to raise awareness about substance use and emotional health issues on college campuses and to get students talking about these issues.

Further, it provided a venue to talk about the importance of genetics in health related outcomes, and to increase understanding about complex genetic outcomes – outcomes that are genetically influenced, but don’t follow simple single gene inheritance patterns. If genetic information will ultimately be useful for prevention, intervention, and practice, there needs to be greater understanding by the public about how complex genetics works.

The project was used as an impetus for initiating these discussions. The PIs spoke on these topics at sessions during the students’ Welcome Week activities, and also in guest lectures across many undergraduate classes. We planned monthly educational forums on topics related to the project. We tried to make these activities both fun and educational. For example, we hosted a movie night showing of the movie GATTACA with free popcorn, and discussed what might be feasible and what was unrealistic about the use of genetics in the movie. We presented a seminar on Genes, Substance Use, and Morality.

We did multiple seminars presenting results from the project. We found that providing free food was the best way to increase student attendance! We also gave out free Spit for Science t-shirts at all educational forums, which were open to everyone across the university. This also provided a means for upperclassman to get involved in the project even though the data collection was limited to the incoming freshman class. Finally, we created newsletters at the end of each semester with information about the project and preliminary results.

In addition to the opportunity for all incoming students to participate in the research project, a select group of students also has the opportunity to be a part of the undergraduate research team each semester. We structured this experience as a 3 credit independent research class, for which students could receive credit across multiple departments.

After training them about the project and its goals, as well as conducting human subjects training, the students become a critical part of recruitment for the project, passing out flyers and being stationed outside dorms and in central university buildings to talk about the project and answer questions. The students are also split into teams and come up with a research question of interest using the Spit for Science data, analyze the data, write up the results, and then present these results in both poster and oral form at the end of the semester.

We also have faculty from across the university who are engaged in research related to behavioral health come in and discuss an article/topic of interest from their field, so that the students are exposed to various related areas of research.

In addition, we have the student teams come up with their own educational and outreach programming for their fellow students on topics related to the study goals. Accordingly, they get exposure to many aspects of the research process.

The way the course is structured allows them to take it either for a single semester or for multiple semesters. Research teams are each supervised by a graduate student, allowing one to expand the number of students involved (we aim for ~5 students/team). The students come from multiple majors including psychology, chemistry, biology, biomedical engineering, anthropology, forensic science, international studies, sociology, bioinformatics and marketing, suggesting that interest in the project is far-ranging. Since the launch of the project we have had >150 students involved in the project; this spring we had over 100 students apply for 15 slots!

Finally, we found that university support for the project was strong because it aligned with the university’s strategic plan of creating unique learning opportunities for students, furthering the research mission, cutting across multiple disciplines (as well as the undergraduate and medical campuses) and had a focus on improving human health, all of which are central themes in the university’s strategic plan. We found that thinking about how the project would benefit the university, in addition to the science, increased support across the various levels of the administration that were ultimately necessary to successfully launch the project.

Lesson #4: Get the Word Out!

The ultimate success of a project of this sort comes down to marketing as much as anything else. Students are inundated with information, opportunities, and requests when they start college, so the project had to stand out and be widely recognized. In some ways, this task is simplified by the fact that the target population is largely concentrated in a known area: on campus.

We worked with a graphic designer to create t-shirts and logos for the project that were well-received by undergraduates. We came up with a catchy project name: Spit for Science. We also ensured that the marketing materials were representative of the diverse student body and included different minority groups and both sexes. We saturated the campus with Spit for Science banners and flyers.

We worked with the residence hall directors to have all resident assistants (upperclass students who live in the freshman dorms and assist incoming freshmen with welcome week activities when they arrive at campus) informed about the project and wearing Spit for Science t-shirts on the first day of welcome week. We had door hanging tags put on every freshman dorm room the day before the common reimbursement area opened. We put out ground signs during the day to direct students to the reimbursement area from various locations around the campus (“Spit for Science this way!”). We gave out free Spit for Science t-shirts to every participant. The students were excited about the t-shirts, and this also helped to increase visibility of the project around the campus.

In the fall semester, all participants get the “classic” Spit for Science t-shirt. In the spring semesters we hold t-shirt contests and select a student design for the t-shirt. We had random days throughout the semester when we gave out coupons, free food, and other small tokens of appreciation to anyone wearing a Spit for Science t-shirt. We also gave t-shirts to administrators and staff around the university who helped in various ways with launching the project and supporting it.

We had a Spit for Science appreciation party with free food, music, and games for everyone who had participated in the project; wearing one’s Spit for Science t-shirt was the ticket for admittance. We had the undergraduate research team position themselves at high traffic areas around the university (targeting freshman residence halls and activities planned for incoming freshman) to hand out flyers about the project and answer any questions that students had. The undergraduate research team also staffed an informational table in the student building for the duration of data collection.

We are continually looking for new ways to raise awareness about the project across the campus.

Lesson #5: Develop a Close Working Relationship with your IRB

Launching a project of this magnitude created unique circumstances that represented challenges for many of the policies and procedures that were in place with our institutional review board. Data collection is time-sensitive, occurring in the two week window when students arrive on campus. Accordingly, traditional turn around times for review of IRB protocols would jeopardize the project.

Despite extensive advanced planning, there were inevitably issues that arose when data collection was launched on a sample of thousands of individuals simultaneously invited to participate in a short window of time. For example, despite extensive pre-testing, when we launched the survey, we discovered that there was a bug with a particular internet browser that caused the survey to freeze for some students, with all data lost. We wanted to send out an e-mail notification to students to make them aware of this issue and indicate that they should use a different browser.

Contact with participants of course requires IRB approval. Even turnaround times traditionally considered quick (e.g., within a week) would mean that for a 2 week data collection period, half of the critical study period would have elapsed. Accordingly, developing a flexible plan by which the IRB and the research team worked together collaboratively to address these challenges was key to the success of the project.

Spit for Science Research Symposium

Lesson #6: Get to Know your IT Office

We worked closely with the university information technology office to develop and launch the on-line survey. The survey software was used to program the survey, e-mail all invitations (to >3000 students simultaneously) and reminders, and collect survey responses in a secure and confidential manner. It also needed the capability to allow the temporary workers who staffed the reimbursement area to access the names of completed participants without access to their data, in order to dispense reimbursement payments while maintaining confidentiality of survey responses.

Each of these steps presented a number of complex challenges. Faculty and staff at our informational technology office were exceedingly helpful in going the extra mile to ensure the success of the project.



Survey Says…

Based in large part on the tremendous work that went into launching the project, with assistance from countless individuals across the campus, the project has been a huge success. We have nearly 10,000 students, representing nearly 70% of incoming freshmen, who participated in our first four years of data collection 2011-2014.

After taking a break from new data collection to launch the College Behavioral and Emotional Health Institute (COBE), we plan to launch a new data collection with incoming freshmen this fall.

We currently have 62 faculty and 32 trainees (pre and post-doctoral) from 18 different departments working with the Spit for Science data. 31 faculty have contributed new item content to the surveys over the years, underscoring the inclusive, collaborative nature of data collection and research expertise across the project.

There have been 9 spin off studies, where data from the surveys are used to select students for more intensive study, ranging from ecological momentary assessments of smokers, to brain imaging studies, to prevention trials. There have been 19 awarded grants, include 6 training grants, related to the project, with 8 additional grants submitted for review.

Each month we spotlight results from Spit for Science in our university Stall Seat Journal, placed on the back of bathroom stalls in over 1300 bathrooms across the campus every month, in collaboration with the Wellness Resource Center at VCU. This is part of our effort to give the science back to our students and our university.

We launched the COBE Connect lunch lecture series as a way to facilitate and build collaborations between researchers with shared interests in behavioral and emotional health outcomes, and to present this research to the broader community. Since 2015, the series has featured 19 presenters across 9 departments and 3 divisions with a total attendance of more than 450 people.

Further, last spring we launched the COBE Town Hall meeting in an effort to bring together researchers with members of the community, to discuss issues related to substance use and mental health outcomes in young people. We were overwhelmed to have >300 people attend, and this year we are hosting our second annual town hall with joint sponsorship from the Virginia Department of Behavioral Health Services.

Additionally, COBE has created new coursework for students that grows out of our faculty expertise and research findings, as well as extensive research training and mentoring opportunities.

It’s been a wild ride, but also one of the most rewarding endeavors of my career thus far.

Service Utilization and Mental Health at VCU

Jessica Bourdon is a second year Ph.D. student in the Clinical and Translational Sciences program with a concentration in Psychiatric, Behavioral, and Statistical Genetics. Her research interests are bimodal and focus on studying the etiology and risk factors of anxiety to better characterize psychopathology as well as how to translate these findings to providers to improve treatment and outcomes.

Jessica strongly believes in the translational science model where researchers and clinicians work together via partnerships to close the science-practice gap. This enthusiasm has led to several collaborations across VCU and the creation of the Translational Partnership for Mental Health.

The COBE Connect lunch series brings together researchers, student affairs professionals, students, and other members of the university community to present on research and programming related to behavioral and emotional health in students.

To learn more, visit http://cobe.vcu.edu/about/cobe-connect/

Why I’m Excited About the From Research to Recovery Town Hall

The From Research to Recovery Town Hall is April 18th and 19th at Virginia Commonwealth University. To get your tickets today, visit the Town Hall website.

Event sponsors include the College Behavioral and Emotional Health Institute, the Department of Behavioral Health and Developmental Services, VCU Rehabilitation Counseling, Origins Behavioral Healthcare, St. Christopher’s Addiction Wellness, the Virginia Center for Addiction Medicine, The Family Counseling Center for Recovery, The Farley Center, Summit Behavioral Health, River City Counseling, Beacon Tree Foundation, The Chris Atwood Foundation and Life of Purpose.

We are just 3 short weeks away from our second COBE Town Hall, and I am a mix of nerves and excitement. Will people show up to the party? Will the speakers bring their A game? Will the food arrive on time? Will we run out of coffee? There is a lot to worry about when you’re hosting an event like this, but here is why I’m excited.

On April 18th and 19th, we will host a group of brilliant speakers at VCU who will present on a range of issues impacting young people’s health. While I almost prefaced “health” with behavioral and emotional health, if we pay attention to what is killing our young people, it is primarily substance misuse and mental health related, not other diseases. When it comes to health problems in 15-24 year olds and even 25-34 year olds, “behavioral and emotional health” should be our primary focus area. Yet, that is not the reality we have built.

We have built school, medical, criminal justice and family systems that have set these crucial health issues to the side, paying them lip service at best. Less than 10% of school administrators use evidence based prevention in their schools. Our medical system has divided out substance use and mental health from the rest of medicine, relying primarily on external systems for services. Our criminal justice system has largely failed to provide true rehabilitation to those who are incarcerated. In many families, we have failed to create environments where we have been able to discuss mental health and substance use challenges.

These are challenges that touch every part of our society, and too often we have taken far too narrow a lens in viewing and addressing these health issues. This conference is meant to be a zoom out on these challenges, so that we can tackle the issues as a community.

At COBE, we believe that the promotion of wellbeing requires us to both promote mental health and treat substance use disorders and mental health challenges with compassionate, evidence based care. We agree strongly with researchers who remind us that the promotion of mental health is not simply the absence of mental illness. Rather, the promotion of mental health must also encompass emotional, psychological, and social well-being.  

We have the ambitious goal of gathering a diverse audience that includes students, parents, professionals and faculty to hear a variety of perspectives that represent everything from lived experience, to professional practice, and basic research.

Additionally, our speakers represent a range of different lenses, from researching recovery, to working within the criminal justice system, to preventing violence in inner city schools, to promoting mindfulness and changing drug policy. While these are not often groups and voices that gather under the same roof, the health challenges affecting our young people, including the opiate epidemic, demand that each of us exit our silos and look for collaborative solutions for both preventing these challenges and treating them effectively when they occur.

We look forward to seeing you on the 18th,

Tom Bannard
Administrative Director, COBE

What Does Science Say about Marijuana Use?

By Tricia Smith, Professor of Biology at VCU and drugs of abuse researcher, and COBE media specialist Craig Zirpolo

Parts of this article were previously printed in the Stall Seat Journal’s Marijuana 101 issue. To see that issue and more, visit The Wellness Resource Center’s website.

While states like Colorado and Washington have experimented with legalization, it’s no secret that cannabis is an illegal drug on the federal level. But it’s also scientifically known that marijuana is in many ways less toxic than other legal substances like alcohol and tobacco.

This complex, layered situation can send mixed signals to young people about the true harms and benefits of marijuana use. So what does the research say? In short, though it is safer than other drugs, that does not necessarily mean that it is safe. To learn more, let’s delve into the science that informs the current cultural conversation on marijuana.

Is marijuana risk-free?

First, let’s talk about addiction and withdrawal. Because where there is withdrawal, there is addiction.

Marijuana withdrawal is not as explosive as withdrawal from other drugs, say morphine or alcohol, which can cause vomiting and convulsions, but it has still been recorded clearly and carefully in rodents, monkeys and humans.

Mice administered high doses of tetrahydrocannabinol (THC), a psychologically active component of marijuana, twice a day for a week experience sleep disturbances and “wet dog shakes,” thought to be a sign of restlessness and unease. Humans report a wide range of unpleasant symptoms, including anger, sleeplessness, weight loss, gastrointestinal disturbance, anxiety and drug craving.

In one study, long-term current users and infrequent marijuana users played a frustrating computer game; daily smokers made significantly more aggressive responses than infrequent users in each session.

Smart Approaches to Marijuana

On February 22nd, Smart Approaches to Marijuana (SAM), an advocacy group made up of scientists and researchers from across the country, hosted a briefing in Washington, D.C., entitled “The Link between Marijuana, Tobacco, Alcohol, and Other Drug Abuse” to discuss the potential impact of marijuana legalization and the current science behind potential medical uses.

Dr. Hoover Adger, from the Johns Hopkins School of Medicine, noted that over 114 million Americans have tried marijuana at least once and 2.4 million used it for the first time in the past year. He also pointed out that the rate of adolescent daily marijuana use has increased from 2009 to 2014; however, there is a decreased percentage reporting knowledge of the risk from regular marijuana use.

Dr. Eden Evins, from the Harvard Medical School, suggested that more research is needed on the endocannabinoid system and pain to determine dosage and long-term effects. Dr. Evins also described major bias problems in the research: weak trial completion; selective outcome reporting; inadequate description of methods; small sample size; and enrollment of only experienced cannabis users.

Dr. Kevin Sabet, President of Smart Approaches to Marijuana, suggested that the legalization debate revolves around three main themes: medicinal value; criminalization; and affirmative legalization.

Dr. Sabet closed the briefing by emphasizing that SAM opposes marijuana legalization in an effort to curb adolescent addiction.

What about synthetic “marijuana”?

Synthetic versions of marijuana have been available legally at head shops and gas stations from time-to-time in the United States.

If marijuana is becoming legalized in some states, logic might suggest that a synthetic version of the same drug sold in stores must be safe, right?

Unfortunately, they are not safe.

THC binds to the cannabinoid receptor and turns it “on,” causing effects in the user’s neurons. THC — and other compounds from marijuana — do a poor job of activating the receptor, switching it to about 30% of its potential “volume,” like turning on a radio, but very softly.

Synthetic cannabinoids created in the laboratory can turn on the cannabinoid receptor 100%, like a full-tilt death metal concert, and the effects are not good. Synthetic cannabinoids have resulted in hospitalizations for panic attacks, vomiting, convulsions, heart attacks and hallucinations, and they have been documented to cause psychosis that does NOT go away when the drug wears off.

Synthetic cannabinoids are dangerous compounds.

VCU Resources

About 9% of marijuana users become addicted. How would you know if you are one of the 9%?

The best indication would be to ask yourself:

“Would my life be different without marijuana?

“Would I have hobbies that did not include marijuana? Would I have more friends who don’t smoke?”

“Would I have a better job? Would I not plan my life around getting stoned? Would I not be anxious when my stash is low? Would I be able to keep promises to smoke less?”

If you realize that your life would be better with less cannabis in it, contact Kristen Donovan at The Well.


Tackling The Surgeon General’s Report: Part 3, 10 Things I Like and Don’t Like

This is the last of a three part series on the Surgeon General’s Report on Alcohol, Drugs and Health by COBE Administrative Director Tom Bannard. Part 1 was dedicated to the historical context of the report. Part 2 was a user’s guide, focusing on practical uses for the report to different target audiences.

1. The Public Health Approach – The report’s call for treating substance use from a public health standpoint, by a non-partisan, well respected government office is important. And its about time. The document is written in a general way and meets the needs of many different constituencies. It is readable and full of references. Considering the billions of dollars we have put into research on substance use, we deserve a document of this quality.

2. Drug Interdiction Efforts – The word “interdiction” (law enforcement-centered supply reduction) appears 0 times in the document. In one sense, this is a repudiation of the primary tactic of addressing substance use in America. On the other hand, there is no reference to studies that consider the effectiveness of interdiction efforts. Do these exist? If we are spending more than $50 billion a year in the criminal justice system (compared to $4 billion in treatment), we should know how well it is working.[1]

3. Differing Consequences for African Americans and Latinos – While each section of the report spends some time on “Special Populations”, the report never dives into the enormous disparity in consequences (especially criminal justice related) despite similar rates of use. This is a glaring omission.

4. Call for Integration of Substance Use into the Rest of Healthcare – This is a long overdue call-out of the failure to integrate substance use throughout the health care system despite the far reaching health consequences of substance use. Calls for early intervention, more education and better prescribing practices are obvious areas for growth for a health care system that has failed to meet the needs of those with substance use disorders.

5. A Whole Chapter on Recovery – This is exciting! A whole chapter on recovery recognizes that a variety of recovery support services deserve a seat at the table in the larger conversation about substance use. While it is clear that we need far more research in this area, with comparatively few scholarly references, this inclusion is a nudge to the hard work of recovery advocates over the past 30 years.

6. A Solid Free Textbook – Most research on substance use disorders is publicly funded. We deserve this information. I have one text book from my counselor studies in substance use that I still reference from time to time; I use this once a week. This is a tremendous resource, it is easily searchable, and I will certainly use it in future classes I teach. No textbook is perfect, but this is a great place to start.

7. Show Me the Treatment Outcomes – While the report calls for “the establishment of recovery outcomes and measures” and for research that “measures the value of the recovery oriented system of care”, which are both incredibly important, it fails to call out treatment providers on their inability to implement long term tracking measures and consistent outcomes. This is a multibillion dollar health care industry. Can you imagine if providers did not track cancer treatment success rates? Where is the accountability? The report also entirely fails to mention the “blueprint studies” about physicians help programs or pilot’s programs which have far and away the best treatment outcomes of any intervention and who track patients for 5 years. Perhaps there are some take-aways in those programs that we should examine.

8. Shout Out to Recovery High Schools and Collegiate Recovery – (Bias alert! I run the Collegiate Recovery Program at VCU) The report mentions these two interventions as promising practices, and the support of this respected voice has helped make inroads as we advocate for the value of these programs.

9. Stop Talking Dirty – The call for changing language around substance use is really welcome, and professionals need to be the leaders in this effort. We need to use person centered language, we need to switch from substance abuse to misuse, and we need to end our obsession with the dichotomous “alcoholic/addict” and understand that substance use challenges happen on a continuum.

10. Why Aren’t We Talking about This? – Maybe I’m a little biased because I took the 6 hours to read it, but you cannot read through this document without learning a whole heck of a lot and opening your mind to some different approaches to substance use. Is it perfect? No, but it’s a really good starting point.

[1] “The Economic Impact of Illicit Drug User on American Society.” U.S. Department of Justice. 2011. https://www.justice.gov/archive/ndic/pubs44/44731/44731p.pdf

Spit for Science Research Roundup #5


Spit for Science is a VCU-wide research project that aims to understand how genes and the environment come together to influence substance use and emotional health. Students can join the project by enrolling in the Spit for Science undergraduate research class and completing their own spinoff projects. Undergrads can also work as research assistants who help with recruitment and data collection, meet different faculty involved in the project and work in teams to develop research questions and analyze Spit for Science data. For more information about how to support and get involved in Spit for Science, visit spit4science.vcu.edu.

Below are reflections from two undergraduate students in the Spit for Science research course on the March COBE Connect lunch lecture with e-cigarette researcher Tory Spindle.

What Is Going On With Vaping?
by Rachel Fallavollita

On February 28th COBE Connect hosted Tory Spindle to explain the research he has been doing on electronic cigarettes. Spindle is a doctoral candidate at VCU Health Psychology and Center for the Study of Tobacco Products.  The research Spindle has been focusing on is what e-cigarettes do and who is using them at VCU. The report starts off with the common components that make up an e-cigarette, a power source, an electrical heating element, and a liquid storage compartment. Spindles goes on to explain there are various e-cigarette devices and models, ranging in customization and price, but they all contain those three components.

With the audience all on the same page Spindle talks about the research he has been doing at VCU. The lab methods that were used was recruiting experience users of e-cigarettes, asking them to use their vape, and while doing so the researchers measure physiological effects such as, nicotine levels in the blood, heart rate, blood pressure, and also measure puffing behaviors. While looking at the puffing behaviors focus was put on the size and volume of the puffs. The participants were also asked questions on what they liked and disliked about the products, and if they used the product long-term.

The findings were e-cigarettes usually deliver similar levels of nicotine  as tobacco cigarettes. This was shown through two types of puffs the researchers asked the participants to do. The first type the participants took 10 puffs in 5 minutes over 30 seconds, the second type the participants were recorded for 90 minutes, as they watched a movie or were entertained during the time, and the researchers recorded how many times the participant took a puff. It was also noted that e-cigarettes vary considerably, considering the different models and the amount of customization that could be done. It was concluded the variability in the product influenced puffing behaviors.

Further details on the various characteristics was discussed. One such characteristic is the liquid used in the devices. A user of e-cigarettes can purchase liquids with different concentrations of nicotine, although unfortunately vaporizers have not been well regulated and purchases of liquid online does not give a reliable amount of the nicotine.  Another variable is the base of the liquid, which is either propylene glycol (PG) or vegetable glycerin (VG). it was found that VG delivers more nicotine to the user.

For future direction on studying e-cigarettes and nicotine levels, Spindle suggests experimenting with other devices and liquid factors, such as customization in the battery. Another suggestion is researching e-cigarettes and illicit drug use, especially considering the growing legalization of marijuana.

The next part of Spindle’s presentation was who was using them at VCU. To gather such information Spindle teamed with Spit4Science. Spindle sets up this section with information that 25% of high school students use some form of tobacco ( when questioned they had at least used a tobacco product in the last 30 days). Also a trend has been seen over the last 5 year, an increase in e-cigarettes use and a decline in the tradition tobacco cigarette. Spindle liked to put it as the “changing of the guard”. There also has been a growing trend in non-smoking adults being e-cigarette users. There are multiple concerns for this, one being nicotine can have a negative impact on brain development, the long-term use of e-cigarettes is unknown, and the device could serve as a starter to other tobacco products.

With this information given to the audience Spindle presented the research questions. First, were non-smokers who used e-cigarettes more likely to try traditional cigarettes? Second, could the use of tobacco cigarettes lead to e-cigarettes use? The sample used was of 2,163 students, with information gathered from the initial Fall S4S survey and the followup Spring survey. The results showed that if a student ever used an e-cigarette they were significantly more likely to try traditional cigarettes and were a current cigarette user. Results also showed current cigarette users were significantly more likely to try e-cigarettes and be a current user. Surprisingly to the researchers depression at the first survey did not show significance in use during the second survey. What the researchers found was the only significant indicator of use was stressful life events. Factors that predicted the onset of e-cigarette use were ever using an e-cigarette, tried marijuana, and male. Males were also more likely to become a dual user, using both traditional and e-cigarettes, from the time of the first survey to the second.

To summarize the research, during the first survey students who had never smoked or not currently using e-cigarettes had an increased probability of having tried cigarettes by the second survey. Also found was the initiation of  e-cigarette  use was not largely influenced by internalizing (depression, anxiety), or externalizing factors (impulsiveness), which are typically predictive of traditional cigarette use. To conclude, e-cigarette use increased the chances of non-smokers to try tobacco products.

Spindle closed the presentation with future directions he would like to see the research go. Spindles would like research to look into the use of e-cigarettes in unorthodox ways, such as competitions, and illicit drug use. Another direction is researching why people are using the products, to quit smoking? For the yummy flavors? Influence of friends? Ad influence?

The presentation Tory Spindle gave informed the audience on the popular e-cigarettes which can be seen on VCU’s campus, and other campus across the world. Next time I see another cloud of strawberry scented smoke walking through the Compass, I will think back on the research Spindle presented.

COBE Connect: E-Cigarettes and the Risk Factors Behind Usage
by Thomas Raymond

On February 28th, I had the pleasure of attending a talk by Tory Spindle on e-cigarettes at COBE Connect. Spindle began the talk with background information on e-cigarettes, including components and types. Differences in e-cigarettes include battery voltage and disposability among other features. From here, Spindle moved on to discussing his own research. Spindles’ lab seeks to understand the differences between nicotine delivery efficiency by e-cigarettes vs. old fashioned cigarettes. This is done by monitoring nicotine levels in the blood over a set amount of time while participants smoke.

Spindle then discussed the future of smoking with e-cigarettes and why people may use them. Some see e-cigarettes as a safer nicotine delivery system due to the lack of chemicals used in cigarettes. These users usually point out that the vapors used are water vapors, which ignores the other chemicals in the solution. Additionally, due to the many different vapor flavors available, users won’t just be smoking tar flavored cigarettes. Users can chose from flavors such as mint or a variety of fruits, similar to hookah. In addition to flavors many are drawn to the idea of “vaping,” and there are actually competitions in which people attempt to blow the largest cloud of vapor.

From the introduction to e-cigarettes and his own lab research Spindle moved on to discussing his ties with Spit4Science. A year-long longitudinal study was done using data from the study seeking to understand links between e-cigarettes and tobacco cigarettes in addition to looking at risk factors for smoking e-cigarettes. The study found that those who smoked e-cigarettes were likely to go on to try cigarettes. This was deduced by looking at those who had smoked e-cigarettes in the fall, but had never smoked traditional cigarettes. By the spring, that group of people was more likely to have tried cigarettes than those who did smoked neither in the fall survey. These findings can help in designing campaigns to discourage cigarette usage aimed specifically at e-cigarette users.

COBE Researcher Wins IPAS Most Outstanding Student Award

Nate Thomas, a COBE research assistant and recent graduate of the International Programme in Addiction Studies (IPAS), received the IPAS Most Outstanding Student Award for 2015-2016.

The International Programme in Addiction Studies is a unique collaboration of three of the world’s leading research universities in the field of Addiction Science: King’s College London, the University of Adelaide, and Virginia Commonwealth University. This partnership offers three nested graduate program options available to students from around the globe via distance learning technologies.

Students are introduced to the latest information on topics ranging from the biological basis of addiction to addiction treatment, prevention and policy through lectures produced exclusively for IPAS by an international Who’s Who of experts in the field.

The mission of the IPAS is to offer students cross-cultural exposure through distance learning technologies to the critical prevention, treatment, policy and research issues facing the field of addiction studies. These programs will speed the dissemination of the latest international addictions-related knowledge, especially to remote locations around the world.

Students become familiar with international perspectives and research as well as the importance of translating this knowledge into more effective prevention and treatment practices and evidence-based policies within their own countries.

At the end of each academic year, the IPAS program assess’ students performance and awards the best student Most Outstanding.

If you are interested in enrolling in one of the programs, complete the electronic expression of interest form .

How Does Research Inform COBE Coursework and Programming?

Marcie Walsh, M.S.W., and Zoe Neale, M.S., presented about the Science of Happiness course and the THRIVE living-learning community at the March meeting of the Positive Psychology research group at VCU.

The Science of Happiness examines the state of college student mental health and wellness on a personal and systems level. This class is an opportunity to re-evaluate your beliefs, values, and assumptions, and to do so in the context of learning about the science behind health and wellness. In this course we look at how individuals can create positive change by reinterpreting their goals and identifying steps towards having a successful experience in college and beyond. Key findings from the fields of positive psychology and the study of mental illness will inform our understanding of the biopsychosocial underpinnings of well-being.

THRIVE is a partnership between COBE and VCU Residential Life and Housing that provides students with a living-learning experience focused on well-being from the time they start college. By integrating research, teaching and programming into an action-packed living experience, THRIVE helps students learn how to make the most out of their college years and lead healthy, prosperous lives.

To view a copy of their slides from the presentation, click here.

How A Breakup Helped Me Discover Self-Care

Kedron Walsh is a student in Dr. Sally Mountcastle’s Personal Health and Behavior Change course in the Health, Physical Education and Exercise Science Department at VCU. In this blog post, she recounts how a seemingly bad situation turned into an opportunity to develop her self-care practices.

Wellness truly came to me following a breakup of an almost 5-year, long-distance relationship.

When it came, it hit full force. It was as if, all of the sudden, a massive light bulb came on within me, signaling me to start treating myself better—to start treating myself right for once.

Somehow everything that I had done before, the kind of person that I had been before and every negative and pessimistic thought and idea that I had of and about myself before, just vanished.

I started to realize something that I had never even honored—the notion that I was worth it. That I was worth eating well. I was worth sleeping well. I was worth doing what makes me happy, with who makes me happy and following the things that made me proud to be alive.

Before my breakup, everything that I had put into my body, every exercise that I did and every negative thought that came across my brain, stemmed from this hyper-critical approach to myself, my life, my health, my body, and more.

It doesn’t help that society and media hyper-focuses all attention on the idea that one’s outward appearance and image is of separate and uniquely important value in comparison to health and wellness of the mind, body, and spirit as a whole.

And it was not until I was alone that I began to accept the fact that my self-worth was more than what was on the outside and further that it demanded taking my overall health and wellness seriously.

I think that once I realized this, I found compassion for myself, instead of just for and in others.

The self is not a separate entity from mind, body, spirit. And you don’t have to practice yoga, meditation or any religion to know or accept this fact. It comes from within.

Because identity, health and wellness are interlocked, everything seemingly falls into place. And when it does, it is so magical.

Uncovering the Science Behind E-Cigarettes

For the March COBE Connect lecture, Health Psychology doctoral candidate and VCU Center for the Study of Tobacco Products researcher Tory Spindle presented on his research with e-cigarettes.

Tory’s primary area of research is focuses on understanding the acute effects of e-cigarettes by using clinical laboratory methods. He has also utilized the Spit for Science dataset to conduct a year-long longitudinal examination of e-cigarette and tobacco cigarette use patterns of VCU undergraduates to determine whether the use of e-cigs would lead non-smoking individuals to later use tobacco cigarettes and to explore whether several factors which are historically predictive of initiating cigarette smoking such as anxiety and impulsivity, also result in the uptake of e-cigs.

The COBE Connect lunch series brings together researchers, student affairs professionals, students, and other members of the university community to present on research and programming related to behavioral and emotional health in students.

To learn more, visit http://cobe.vcu.edu/about/cobe-connect/

Episode 15 – The Psychology of Forgiveness with Dr. Everett Worthington

Welcome back to Why Science! For Episode 15 we welcome Dr. Everett Worthington, the Commonwealth Professor of Counseling Psychology at VCU. Dr. Worthington is a preeminent scholar on the psychology of forgiveness, and in this conversation he explores the relationship between empathy and humility, health and justice.

Why Science is a podcast about behavioral and emotional health research at Virginia Commonwealth University. During each episode we welcome a new guest from VCU to discuss their work ranging from substance use to stress, mindfulness to empathy and everything in between.

Why Science is produced in partnership with the National Institute for Alcohol Abuse and Alcoholism, the ALT Lab at VCU and WVCW Student Radio. Each episode is hosted, recorded and edited by COBE media specialist Craig Zirpolo.

Genes, Marshmallows and You: How Alcohol Effects Adolescents

On Monday, February 27th, COBE Director Dr. Danielle Dick presented to high schoolers at Collegiate School about the effects of adolescent alcohol use and how to understand who is most at risk.

Dr. Dick will present alongside researchers from across the nation at the From Research to Recovery Town Hall in April. For more information about other COBE events, visit our pages on COBE Connect, the Family Education Program and our University-Wide Events Calendar.

Tackling The Surgeon General’s Report: Part 2, A User’s Guide


This is part 2 of a 3 part series on the Surgeon General’s Report on Alcohol, Drugs and Health. Part 1 was dedicated to the historical context of the report. Part 2 is meant to be a user’s guide, focusing on practical uses for the report to different target audiences.

While working closely with family members of substance users over the past 5 years, the dearth of easily accessible, accurate information about drugs, alcohol, and their treatment has been hugely frustrating. There are good resources that address pieces of the discussion, such as “Get Your Loved One Sober” by Robert Myers and the Recovery Research Institute by John Kelly and his team at Harvard. But I have found nothing as comprehensive (and free!) as the Surgeon General’s Report.

While its 413 pages are certainly intimidating (I must admit, I have not run into anyone else on campus who has read it cover to cover), the report does a really nice job breaking the information into somewhat manageable chunks and highlighting key findings. I think the report could be an ideal text-book for an introductory class on substance use and an invaluable resource for family members hungry for education about substance use disorders.

This section of our series is meant to help you navigate the report and make use of the work presented by some of our most brilliant researchers.

A Note on Terminology

Importantly, the report formalizes a new language for substance use. It highlights the preferred terms which are outlined in new medical standards in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The new standards replace the terms substance abuse and substance dependence with three levels of substance use disorder: mild, moderate and severe.

In the report, addiction is often used to describe severe cases of the disorders. Importantly, this shifts the focus away from the dichotomous terms “addict”/ “alcoholic” which often leaves families wondering, “Is he one?” and not responding until the problem was extreme. The report is very clear that interventions can be effective at every level of problem severity and emphasizes the importance of early interventions and different levels of care.

Additionally, though people often reclaim the stigmatized language in order to empower their own recoveries, external labeling of these conditions can be stigmatizing and unhelpful. People can more readily admit there is an issue if they are not backed into a corner with, “Are you an addict?”

Scientific Standards

Our friends in the field will be pleased to know that throughout the report, the authors identify whether a finding is well-supported, supported, or promising depending on how rigorous and numerous the research studies are that examine the intervention. (Note: Intervention here means a professionally delivered program, service, or policy designed to prevent substance misuse or treat an individual’s substance use disorder. It does not mean intervention like you see on TV.) While the report is not an exhaustive exploration of all of the science available, it emphasizes findings that have the potential for the greatest public health impact and the greatest potential for action.

Broad Audiences & Applications

Like our COBE Town Hall coming up in April, the report attempts to reach a broad audience that includes people with substance use disorders, families, community members, educators, professionals, advocates, policymakers, and researchers.

This is quite a difficult task as these groups have a broad range of experience, education, and each come with their own bias. But it is incredibly important that we create cohesion and common ground because none of these groups can progress far on their own.

Here are some of the ways the report might be useful to these groups:

People with Substance Use Disorders – Without explicitly calling out incarceration as an ineffective solution, the report is clear that substance use and misuse and substance use disorders are public health challenges that must be met with compassion and evidence based services. The report dedicates an entire chapter to recovery, which has been under studied, and explicitly validates several recovery supports including 12 step, recovery housing, recovery support services, and peer recovery coaching. Additionally, the report outlines the effectiveness and value of treatment in general, and affirms several different treatment modalities including Medication Assisted Treatment, Cognitive Behavioral Therapy, Twelve Step Facilitated Treatment, Community Reinforcement Approach, The Matrix Model, and Contingency Management. Of note, the report does not dive into contemplative science based approaches, though there is promising evidence of the effectiveness of these interventions as well. Finally, the report emphasizes the importance of prevention (especially school, family and community based prevention) and the importance of early intervention by all health care providers, not just those practicing in specialty substance use facilities.

Families – While the report may feel overwhelming, families are very fortunate to have a comprehensive and free resource to start to understand substance use. For those raising children, Chapters 2 (The Neurobiology of Substance Use, Misuse, and Addiction) and Chapter 3 (Prevention Programs and Policies) would be very helpful in understanding risk and getting a primer on what effective prevention looks like. For those who have a loved one who has developed a substance use disorder, Chapters 2, Chapter 4 (Early Intervention, Treatment and Management of Substance Use Disorders), and Chapter 5 (Recovery) will be most useful.

Community Members – There are very few people who do not know someone who is affected by a substance use disorders, and the consequences of substance misuse impact everyone. The report is very clear on effective interventions, policy implementations that work, and also identifies the chasms in implementing evidence based interventions. For example, the Prevention section reports that less than 10% of principles use evidence based prevention in their schools. The report offers a great reference point for community members looking for solutions that really work. As Linda Hancock, one of our prevention gurus at The Wellness Resource Center at VCU says, “When doing Prevention, we have to ask ourselves: ‘Am I busy or am I effective’. We need to be both.

Educators – While many of the uses that community members may find are echoed here, there are numerous ways educators can use this report, from making prevention programming decisions guided by the existing evidence, to use the report as text book for substance use classes (Your students will love the price!). Additionally, the report repeatedly emphasizes the importance of better integrating primary care and other medical providers with substance use treatment (More on this in part 3!). The report points out workforce, resource and training shortages that have hampered efforts at better care.

Professionals – For professionals, it is helpful to have a 1 stop refresher on broader areas of substance use. Because we tend to work in very specialized parts of the field, it is too easy to avoid stepping back and looking at the big picture. Taking some time to get an update on the state of science in the field is quite a worthy exercise.

Advocates and Policymakers – The report offers a tremendous reference and has the weight of the Surgeon General behind it. Advocates may be writing lots of letters and emails that say, “As pointed out in the Surgeon General’s report…” The report can be a great playbook for progress in different states and nationally.

Researchers – Apart from validating and giving voice to the incredible work of many of our brightest minds, the report offers very clear recommendations on the future of research. Given the collaborations between SAMHSA, NIAAA, NIDA, and other governmental agencies on this report, researchers would do well to listen. A simple search for “Recommendations for Researchers” might be a great starting point. Additionally, researchers interested in dipping their toe in another area of the field have a great literature review starting point in the 1400 + references. Having some of our best minds looking at other aspects of substance use with fresh eyes could result in some tremendous breakthroughs.


Organization of the Report (This is taken directly from the Report itself)

This Report is divided into Chapters, highlighting the key issues and most important research findings in those topics. The final chapter concludes with recommendations for key stakeholders, including implications for practice and policy.

Chapter 1 – Introduction and Overview describes the overall rationale for the Report, defines key terms used throughout the Report, introduces the major issues covered in the topical chapters, and describes the organization, format, and the scientific standards that dictated content and emphasis within the Report.

Chapter 2 – The Neurobiology of Substance Use, Misuse, and Addiction reviews brain research on the neurobiological processes that turn casual substance use into a compulsive disorder.

Chapter 3 – Prevention Program and Policies reviews the scientific evidence on preventing substance misuse, substance use-related problems, and substance use disorders.

Chapter 4 – Early Intervention, Treatment, and Management of Substance Use Disorders describes the goals, settings, and stages of treatment, and reviews the effectiveness of the major components of early intervention and treatment approaches, including behavioral therapies, medications, and social services.

Chapter 5 – Recovery: The Many Paths to Wellness discusses perspectives on remission and recovery from substance use disorders and reviews the types and effectiveness of RSS.

Chapter 6 – Health Care Systems and Substance Use Disorders reviews ongoing changes in organization, delivery, and financing of care for substance use disorders in both specialty treatment programs and in mainstream health care settings.

Chapter 7 – Vision for the Future: A Public Health Approach presents a realistic vision for a comprehensive, effective, and humane public health approach to addressing substance misuse and substance use disorders in our country, including actionable recommendations for parents, families, communities, health care organizations, educators, researchers, and policymakers.

Spit for Science Research Roundup #4


Spit for Science is a VCU-wide research project that aims to understand how genes and the environment come together to influence substance use and emotional health. The project works with a large number of undergraduate researchers each semester. Assistants help with recruitment and data collection, meet different faculty involved in the project and work in teams to develop research questions and analyze Spit for Science data.  

Below are brief blog posts from current undergraduate researchers covering recent events and research relating to substance use and emotional health.

For more information about how to support and get involved in Spit for Science, visit spit4science.vcu.edu.

Being Physically Active and Its Benefits for Depression
by Sophia Rattana

In our course we talked about mental illnesses such as depression. Depression is often prevalent due to genetics. However, we also spoke about how the environment that a child grew up in may also play a big factor. That is where the phrase “nature and nurture” comes in.

The article I chose to highlight about this was “Physically active children are less depressed,” from the Science DailyResearchers from the Norwegian University of Science and Technology found that children around the ages of 6-8 that were involved with physical activities are less likely to develop depression. Any activity that produces some sort of sweat is beneficial.

Also, in those who had depression, doing physical activities such as running around helped decrease depressive symptoms. Speaking of environmental factors, if a child grew up in a home where both parents are physically active a child is less likely to develop depression because the parental influence they would have on their child’s lifestyle. It’s upsetting because now a days children are always inside on their iPads and video game consoles. It is now considered a norm to see a 5 year old walking around with an iPhone, but yet seeing a child riding a bike around a neighborhood is not as common. There were studies conducted before that stated that adults and children who were constantly indoors being in active were usually depressed. However, that was proven to not be correlated according to the study.

Smoking and Depression
by Courtney Mulligan

A study conducted by Cancer Research UK published in Newsmax Health looked at the relationship between depression and smoking. The study included 3775 patients in the Czech Republic who were attending a clinic in order to help them quit smoking. The findings showed that individuals who successfully quit smoking also displayed fewer symptoms of depression. Two-thirds of the participants who had previously rated themselves as having moderate to severe depression while smoking dramatically reduced their depression symptoms ratings to minimal or non-existent one year after they quit smoking.

The UK has researched mental health and smoking and reports that smoking rates among people with mental health conditions are two times higher than the general population. Furthermore, smoking lowers the life expectancy of those individuals with mental health conditions – around 10 to 20 years shorter than the general population. The researchers emphasized the importance of this research and how it is crucial in order for us to help develop support systems for those with mental health conditions who may need some extra help and guidance on their journey to quit smoking.

Episode 14 – The History of Spit for Science and COBE with Dr. Danielle Dick

Welcome back to Why Science! In this episode we speak with COBE Director Dr. Danielle Dick about her career studying substance use and mental health outcomes in adolescents, the creation of Spit for Science and how that project relates to COBE.

Why Science is a podcast about behavioral and emotional health research at Virginia Commonwealth University. During each episode we welcome a new guest from VCU to discuss their work ranging from substance use to stress, mindfulness to empathy and everything in between.

Why Science is produced in partnership with the National Institute for Alcohol Abuse and Alcoholism, the ALT Lab at VCU and WVCW Student Radio. Each episode is hosted, recorded and edited by COBE media specialist Craig Zirpolo.

Can You Really Be Drunk In Love?

“I can’t stop drinking about you
I gotta numb the pain
I can’t stop drinking about you
Without you I ain’t the same
So pour a shot in my glass, and I’ll forget forever!
So pour a shot in my glass ’cause it makes everything better!”
“I Can’t Stop Drinking About You” by Bebe Rexha

In music, movies and many other parts of popular culture, we are surrounded by media portrayals likening love to mind-altering substances – Billie Holiday’s lover goes to her head; Beyoncé is drunk in love; the Weeknd compares his lover to the anesthetic Novocain.

As shown above, pop singer Bebe Rexha’s song, “I Can’t Stop Drinking About You,” is a word-for-word description of turning to alcohol after a bad breakup.

Despite the ubiquity of these comparisons across media and the prevalence of substance use on college campuses, it is not often that students get to unpack these topics in an academic setting.

To bridge this gap, COBE researcher Dr. Jessica Salvatore created a new course called Love and Drugs: The Science Behind Media Portrayals of Romance and Substance Abuse.

In the 5-week Psychology Spotlight short course, students examine the science behind portrayals of romance and substances of abuse in popular culture using developmental, social psychological and neurobiological perspectives.

“The idea of this course is to identify the many types of media portrayals linking love and addiction, examine what kind of scientific evidence there is either in support or in opposition to those examples and discuss how research about relationships can help us better understand and support those with substance use problems,” Dr. Salvatore said.

Topics covered range from the neurobiology of love and addiction to the effects of relationships on substance use and the effects of substance use on relationships.

Each week introduces a different theme in studying love and substance use:

1. The science of relationships and substance use
2. Relationship satisfaction, conflict and substance use
3. Neurobiological and genetic influences on love and substance use
4. Relationship-based interventions and partner effects on health behaviors
5. New directions in research on relationships and substance use

As they study the science of relationships and substance use, students use their knowledge of psychological theories and studies to evaluate and interpret the accuracy of common representations of substance use and romantic relationships in films and songs of their choice.

Psychology major Michaela Blankenship chose to write her first paper for the course on Rexha’s song because to her it is the perfect example of “romanticizing coping with a breakup by drinking.”

“Drinking to cope with a breakup or other emotional situation is often overlooked because it is assumed to be normal,” Blankenship said.

“But Dr. Salvatore’s class provided me with theories and studies to analyze the song, as well as information about warning signs in my own relationships.”

Registration for the course has closed for this semester, but Dr. Salvatore hopes to expand from a spotlight to full semester-long course in the future.

For more information about the course, visit the VCU Psychology course list.

An Update and Overview of Spit for Science

The February COBE Connect Lunch series featured Dr. Danielle Dick discussing the history of Spit for Science and the creation of the College Behavioral and Emotional Health Institute.

The Spit for Science VCU Student Survey is an effort to understand how genetic and environmental factors come together to contribute to the development of problems associated with the use of alcohol, the use of other substances, and emotional health.

The study brings together researchers from across the university and asks a broad base of questions, covering topics including living situation; personality; family history and childhood upbringing; experience of stressful life events; social support; involvement in extracurricular activities; alcohol and other drug use; other mental health related problems, such as depression, anxiety and eating disorders; caffeine use; friends’ behavior; nicotine use; and religiosity – to name a few!

A big focus is on substance use and emotional health since the life stage that college students are entering is a high risk period for the onset of problems associated with these outcomes. In any given year in the U.S., one in four adults over the age of 18 suffers from one or more psychiatric or substance use disorders. Nicotine and alcohol dependence are among the most common, preventable causes of mortality and morbidity. In 2020, major depression will exceed cardiovascular illness as the leading biomedical source of world-wide morbidity.

Collectively, psychiatric and substance use disorders are the most costly U.S. public health concerns in, both, human and financial terms. The magnitude of these adverse health effects underscores the need to understand the root causes of these disorders in order to provide more effective approaches to both primary and secondary prevention in addition to treatment.

Does Experiencing Divorce Cause Drinking Problems, or Vice Versa?


Research shows that having an alcohol use disorder and getting divorced are closely related, meaning that if you experience one then you are more likely to experience the other.

But how exactly does this association hold?

In their article, “Alcohol Use Disorder and Divorce: Evidence for a Genetic Correlation in a Population-Based Swedish Sample,” VCU researchers Dr. Kenneth Kendler, M.D., and Dr. Jessica Salvatore and their Swedish counterparts Sara Larsson Lönn, Jan Sundquist, Kristina Sundquist and Paul Lichtenstein aimed to untangle the complex relationship underlying AUD and divorce.

Although previous studies have asked whether AUD’s or divorce are the chicken or egg in terms of causing one another, in this study researchers took a step back and asked, “Are there underlying genetic or environmental factors that make people more vulnerable to both AUD and divorce?”

Studies show that divorced individuals consume more alcohol and in more harmful patterns than married individuals. Those who are divorced, separated or widowed are also more likely to have a lifetime or past 12-month AUD diagnosis and to engage in alcohol-related risk behaviors such as drinking and driving compared to married people.

Individuals affected with AUD and couples where partners are discordant for heavy drinking are more likely to get divorced, and divorce predicts longitudinal increases in drinking.

Because these associations have tangible costs, and alcohol-related mortality is higher among divorcees compared to their married counterparts, it is important to understand their relationship and the underlying processes at play to help reduce negative outcomes.

In their study the researchers found that in the Swedish population, AUD and divorce are indeed related. Digging deeper into this link, they  found that genetic factors account for approximately half of the association between AUD and divorce.

Researchers were not entirely surprised by their findings about the genetic influences shared between alcohol use disorder and divorce, as previous studies have shown that divorce and difficult personality traits share some genetic influences. Still, this was some of the first direct evidence that AUD and divorce share genetic factors.

The researchers also found that unique environmental factors accounted for half of the association between AUD and divorce. Unique environmental factors are events and experiences that make people different from one another. One very potent unique environmental influence on drinking and relationship outcomes is one’s partner. Specific partners influence both the degree to which people are drinking, as well as their likelihood to divorce.

Researchers also found that what is sometimes considered to be an aspect of the environment, like a history of divorce, can also be influenced by genetic factors and thus not be indicative of a directly causal relationship as once assumed.

For example, when a clinician is counseling someone, they use information about what a person has experienced and their symptoms to inform their response. If they are divorced first and then develop an AUD, it might seem reasonable to assume that the divorce led to the AUD.

So it is important to know that even if things happen in a certain sequence, that does not mean that current symptoms are caused by an earlier event. In fact, they can be representative of an underlying genetic or environmental factor.

Researchers hope that by identifying risk factors that predispose individuals to both AUD and divorce, their work may inform avenues for prevention for these socially and personally costly behaviors.

You can learn more about this study via VCU News.

Episode 13 – Relationships and Substance Use with Dr. Jessica Salvatore

Welcome back to Why Science! In this episode we are joined by Dr. Jessica Salvatore, an assistant professor in the Department of Psychology at VCU, to discuss her research on the shared genetic and environmental influences on relationships and substance use.

Why Science is a podcast about behavioral and emotional health research at Virginia Commonwealth University. During each episode we welcome a new guest from VCU to discuss their work ranging from substance use to stress, mindfulness to empathy and everything in between.

Why Science is produced in partnership with the National Institute for Alcohol Abuse and Alcoholism, the ALT Lab at VCU and WVCW Student Radio. Each episode is hosted, recorded and edited by COBE media specialist Craig Zirpolo.

Tackling the Surgeon General’s Report: Part 1


This is part 1 of a 3 part series on the Surgeon General’s Report written by COBE Administrative Director and Rams in Recovery Director Tom Bannard.  This section focuses largely on the historical context of the report.

In 1964 the average adult American smoked 4000 cigarettes per year.  By 2014, that number was inching towards 1000 cigarettes per year, saving hundreds of thousands of lives and hundreds of billions of dollars in health care and productivity.

Among the drivers of the change was a comprehensive public health effort which was propelled in part by the 1964 Surgeon General’s Report on Smoking, and the 34 follow up reports on tobacco and nicotine that followed.

In 2016, in the midst of growing awareness of an opioid epidemic that claims more lives just due to overdose than car accidents or gun violence, the Surgeon General has released the first Report on Alcohol, Drugs and Health with the hope of encouraging a similar decline in alcohol and other drug use.

Importantly, the report takes an explicitly public health approach with substantial focus on prevention and early intervention, and contains recommendations for practitioners and administrators throughout the healthcare system, substance users, family members impacted, researchers, and policy makers.  Indeed, the Surgeon General (most known from the warnings on numerous labels) occupies a position of relatively low authority.

While the Surgeon General is nominated by the President and confirmed by the Senate, he or she is only the #2 officer in the Office of the Assistant Secretary for National Health, one of 34 Offices, Administrations, or Agencies under the Secretary for Health and Human Services, which comprises only a tiny fraction of the federal budget dedicated to health care.  Public health approaches seek to leverage limited resources to encourage individuals to pursue social, economic, and environmental strategies on health care topics that work in their own best interest.

In short public health people try to do a lot with a little, and they truly have.  Public health approaches are responsible for improvements in immunizations, motor vehicle safety, workplace safety, control of infectious diseases, declines in deaths from heart disease and stroke, safer and healthier food, healthier mothers and babies, family planning, fluoridation of drinking water, and tobacco use.

Historical Context

The Report comes at an incredibly important time for substance use in America.  While the opioid crisis has grabbed the public’s attention, substance misuse, especially alcohol and opioids, have driven an unprecedented increase in mortality among middle-aged White Americans between 1999 and 2014 causing a roughly 4 month decline in life expectancy in this population.

Meanwhile, a Recovery, Prevention, and Harm Reduction Advocacy movement has gained increasing traction as populations, family members and people in recovery, have broken through stigma and are demanding an improved response.  This movement is bolstered by an accumulation of scientific evidence that Substance Use Disorders are preventable and treatable medical conditions (see the more than 1400 scholarly references in the report).

Finally, scholars, public health officials, and policy makers are casting increasing doubts about the efficacy of Drug Prohibition and “The War on Drugs” as a primary means of addressing substance use, and numerous states are moving to decriminalize or legalize marijuana use.

Family members who have lost loved ones to substance use have been crucial players in this new advocacy movement.  These grieving family members have transformed their struggle by leading large national non-profits such as Facing Addiction, Transforming Youth Recovery, and Shatter Proof.  Locally, grieving parents lead the JHW Foundation, Beacon Tree Foundation, and The Chris Atwood FoundationImportantly, this mirrors leadership by organizations such as Mothers Against Drunk Driving (MADD) who played a crucial role in the decline of DUI related accidents and death.

Additionally, proliferation of mutual aid supports and Recovery Community Organizations that support many paths to recovery that include but are not limited to 12 step have aided in decreasing stigma and supporting recovery creating a wave of advocacy from those with lived experience.

Finally, advocacy has come from unlikely places with organizations such as The Gloucester Police Department in Massachusetts leading a charge to make law enforcement a point of entry for those seeking substance use treatment.  Locally, Mike Zohab and the Virginia Recovery Foundation are starting this effort in Richmond.

While this blog will not dive far into the “legalization/decriminalization” debate, it is important to consider some of the key talking points in this discussion.  The key arguments against legalization or decriminalization are about controlling supply, discourage public acceptance of substance use, and especially limited use by people whose brains are still developing.  These are relatively straightforward arguments.  These are addictive substances such that increasing supply also increases demand, increasing public acceptance will lead more people to try a substance, and there is robust evidence that the younger someone starts using a substance the more likely they are to have subsequent challenges.

The argument goes that increasing societal availability and acceptance will lead to increased use and increased use related problems.  This has been the argument that has driven our public policy approach to substance use for the past 40 years (and one could argue the last 100 years if considering Alcohol Prohibition in 1920 and the initiation of drug prohibition in 1914 with the Harrison Act).

This argument has lead to a significant majority of public monies devoted to substance use being put into enforcement and incarceration within in the United States, and policing and military action internationally related to reducing supply.

While there is a significant range of stances when it comes to decriminalization or legalization, the arguments are significantly more complex and have far fewer “real world” experiments to support them (International treaties driven by the US began requiring drug prohibition in the 1950s and 1960s).

These arguments range from the somewhat obvious: enormous costs of incarcerating people paired with minimal effectiveness in rehabilitating them; to the more complex and perhaps harder to prove: Drug Prohibition incentivizes violence as a primary means of market regulation at home and abroad creating cycles of violence that promote organized crime.

Other arguments include the effect prohibition has on stigmatizing and preventing help seeking in those struggling with the #1 most stigmatized health condition in the world, the impact prohibition has on increasing potency as a way to maximize profit and reduce risk, and how prohibition reduces access to evidence-based harm reduction and prevention.

Perhaps the most important argument within this conversation also lends significant insight in how we came to be a country that holds 25% of the world’s prisoners while only having 5% of the world’s populations.  Mass Incarceration and its deep links to Drug Prohibition has expanded to unprecedented scale in the past 40 years, and has had a hugely disparate impact on African Americans and Latinos especially men.

While these populations use substances at similar rates to whites, they fare worse at every stage of the criminal justice process, from being stopped more often to being less likely to get parole. Targeted policing, racial charged policies such as disparate crack-cocaine sentencing, and racial profiling also drove incarceration rates in disparate ways. Telling of the impact is the more than 2600% increase in drug related incarceration of African Americans and 2200% increase in drug related incarceration of Latinos  between 1983 and 2000 driven by the “War on Drugs”.  Whites were not spared from the Drug War as their drug related incarceration increased by 800% in that same time period.

We must carefully consider the role of race in the changing discourse around substance use as opioid misuse is disproportionately white and suburban or rural, and often the source of the drugs have been medical professionals.

The Surgeon General’s Report marks an incredibly important moment in the history of substance use in America.  It represents a significant step towards taking ownership of a challenge that is deeply human.  We have finally started to acknowledge that this is not a problem we can blame on others, either those outside of the US, those that don’t look like us, or those “druggie” people.  Substance use and misuse is deeply ingrained in the fabric of America it is time to dive into how we better address it.

Join us for next week for part 2 of the series that dives into the report.

Nearly 20% of College Students Experience Sexual Assault

Nearly one in five college students experience sexual assault, with women facing significantly higher rates compared with men according to a study by COBE researchers using data generated by Spit for Science.

The study, entitled “Prevalence and Predictors of Sexual Assault Among a College Sample” in the Journal of American College Health, also found that experiencing sexual assault before college is related to a greater risk of repeat experiences during college for both males and females.

Sexual assault, defined as unwelcome sexual behavior in which an individual exerts their will on a person in a less powerful position, is the most common form of violence on US college campuses today.

A comprehensive report from the Department of Justice found that 20%–25% of women and 4%–6% of men are victims of sexual assault while they are enrolled in college, and more than 90% of survivors do not report the assault.

Using data from the large, representative Spit for Science sample, researchers found that the prevalence of sexual assault since beginning college was similar to previous studies at 18.7% (23.0% of women & 11.6% of men).

However, an exact comparison of prevalence is challenging given that prior studies often report the prevalence of rape, whereas VCU researchers examined the prevalence of all unwanted sexual experiences, which includes rape.

This distinction is particularly salient with the college population, given that previous research has found that many survivors do not report being raped despite reporting experiences that meet the legal definition of rape.

Previous research has found that 4%–6% of men are victims of rape while enrolled in college, whereas in the Spit for Science sample 11.6% of males experienced sexual victimization, with only 2.8% reporting rape.

The authors hypothesized that men have been experiencing higher rates of sexual victimization than previously thought, but due to historical and social forces that may shape men’s views of what constitutes rape, their experiences are not being accurately captured.

Nearly one fifth of the sample reported experiences with sexual assault prior to college, while about 40% of those participants reporting revictimization during college. A new finding from this study is that there was no statistically significant difference between men and women who reported revictimization. Therefore, although women experience higher rates of sexual victimization overall, once sexual assault has occurred, both men and women experience similar risk of revictimization.

Although none of the early environmental factors examined in this study were significant, the experience of an interpersonal trauma prior to college was a significant predictor of collegiate experiences with sexual assault for both men and women.

Prior research investigating the association between personality and sexual assault has focused mainly on one facet of personality, whereas the Spit for Science study examined associations between experience and multiple personality factors (ie, neuroticism, openness, extraversion, conscientiousness) in order to identify possible risk or protective factors that may inform education and prevention efforts.

Although neuroticism in men and extraversion in women were significant in the first analysis, in the final analysis, openness in males was the solitary personality factor that was a significant predictor. Given that men are not socialized to fear and expect sexual victimization as women are, the role openness plays in the risk for victimization in men should be explored in future research.

Additionally, in terms of mental health factors, lifetime alcohol use and depression conferred a greater risk for females only. Taken together, these findings uncover a more nuanced picture of the importance ways male and female risk factors for victimization may differ.

Given the need for sexual assault intervention and prevention on college campuses, identification of factors potentially contributing to exposure within this population is essential to curbing the prevalence of sexual assault.

Consistent with previous literature related to resilience, social support served as a protective factor for both groups. This finding underscores the importance of cultivating a positive campus culture where student support can be leveraged to encourage active bystander behaviors.

Understanding the risk factors and correlates of experiencing sexual violence is a step towards improving sexual violence programming and response by bolstering protective factors and minimizing modifiable risk factors.

Does Working a Job During College Lead to Drinking and Smoking?

The rate of students holding a job during college has risen from 45% in 1959 to 61% in 2011. Substance use also becomes more prevalent during this time, with 40% of students saying they have been drunk and 14% saying they have smoked a cigarette in the past month.

Since both employment and substance use are common among college students, understanding if, and how, the two relate is important for students, parents, colleges, and employers.

Research in adolescents shows that those with jobs are more likely to drink and smoke, and that association grows based on how many hours they work per week.

So is there a link between working a job in college and how much someone smokes or drinks?

Rose Bono, a research assistant at the Department of Health Behavior and Policy, and health behavior and policy researcher Dr. Andrew Barnes, teamed up with COBE director Dr. Danielle Dick and Virginia Institute for Psychiatric and Behavioral Genetics director Dr. Kenneth Kendler to conduct a study on the relationship between substance use and employment in college students based on data from Spit for Science.

The study, published recently in Substance Use and Misuse, examined how many hours a week each student worked and how much money they earned compared to how frequently they reported drinking and smoking.

Researchers found that weekly earnings did not predict drinking frequency. Work hours did predict greater odds of drinking less than once a week (working ten hours or more increased the likelihood of drinking less than once per week over the past month by 16%), but were not associated with drinking once a week or more.

Each 10-hour increase in weekly work hours and $50 increase in weekly earnings predicted modestly greater odds of drinking 1–4 drinks per day, but did not relate to drinking 5+ drinks per day. Increases in hours and pay did not related to smoking frequency.

In other words, employment may play a role in substance use, but work hours and earnings are likely only small parts of a larger web of influences on drinking and smoking.

These findings, which are a new addition to the literature on substance use in college students, suggest that interventions to reduce freshman drinking and smoking may not be particularly effective when targeting employment characteristics.

Nonetheless, college behavioral health counselors and others working with students may still wish to include employment characteristics in discussions about substance use, since employment may become a greater demand as students continue through school and may have a larger effect on moderate drinkers compared to heavy drinkers.

It’s Never Too Early for Self-Care

Whether it came from a Ted Talk, a Buzzfeed listicle or an issue of the Stall Seat Journal, you’ve probably heard about the importance of self-care and the myriad ways people practice it.

Mindfulness and practices like yoga and meditation may seem ubiquitous online, but for many it can still seem like a distant goal while facing the day-to-day struggles of life.

So what exactly is self-care, why is it so important and how can you make time to prioritize your physical and emotional health?

Self care at its core means providing “adequate attention to one’s own physical and psychological well-being” (Beauchamp & Childress, 2001).

While there are many obstacles to implementing self-care practices,stress and anxiety are the most pervasive according to VCU students in the Spit for Science survey.

Stress is problematic for a number of reasons. There is a clear pathway between stress/anxiety and being overwhelmed by your responsibilities that can lead to burnout and feelings of hopelessness. This in turn can impact your health and ability to work, which can in turn feed back into more stress.

Stress is not just mentally tasking either. In the short term, stress can increase muscle tension, cause shallow or quickened breathing and constrict blood vessels. In the long term, stress can lead to major health problems including increased risk of cardiovascular disease, hypertension, cancer, stroke, alcohol and substance use problems, obesity, diabetes and more.

Everyone experiences stress differently. Thus, the ways we manage stress need to be geared toward the individual based on their lifestyle, emotional needs, support system and the types of stressors they currently experience.

Some basic stress management and self-care techniques include:
Deep breathing
Diet and nutrition
Healthy eating
Talk to a friend
Drinking water
Sleep and time management
Sleep hygiene
Get some sun

As for what specific strategies are most effective at promoting your mental and physical health at any given moment, the short answer is that there is no one size fits all approach.

But there are concrete ways to introduce self-care into your daily life. Be sure to make time for self-care and specifically schedule it. In moments of peak stress you may feel like you don’t have time for self-care. But those are the times that self-care is most important!

Make SMART Goals (specific, measurable, attainable, realistic and time-based) and know your warning signs for when you are stressed or anxious. And never shy away from seeking community support from friends or professionals.

When in doubt, use a checklist:
Have you drank enough water today?
Have you eaten recently?
When was the last time you exercised?
Have you gone outside?
Have you taken a shower?

And remember there are resources both on campus and online that can help, including:

University Counseling Services
The Wellness Resource Center
Student Stress and Anxiety Guide
Kaiser Permanente Healthy Living Podcasts

Ted Talks such as:

Got a Meeting? Take a Walk by Nilofer Merchant
Self-Compassion Exercises by Dr. Kristin Neff
The Space Between Self-Esteem and Self-Compassion with Dr. Kristin Neff

And apps for self-care that will help you integrate daily practices into your spare time:

Stop, Breathe, & Think

Remember, if you are experiencing stress, you are not alone.

Self-care takes many forms, and it does not have to be an extra hoop to jump through. You can increase your productivity and overall life satisfaction through daily practice of self-care in small bursts. Even in the busiest and most stressful of times, there’s always a moment to take care of your emotional and physical needs.

How Is Vaping Different than Smoking?

E-cigarettes are often portrayed as a healthy alternative or even a way to quit smoking. But how does e-cig use actually differ from tobacco cigarettes? Researchers at VCU set off to find out more using data generated by Spit for Science.

Tory Spindle and Marzena Hiler, graduate students in VCU’s health psychology doctoral program and the Center for the Study of Tobacco Products led by Dr. Thomas Eissenberg, teamed up with COBE researcher Megan Cooke, a doctoral candidate in the Virginia Institute for Psychiatric and Behavioral Genetics and member of the EDGE Lab, to conduct a study on longitudinal tobacco use patterns of VCU undergraduates over the course of one year using the Spit for Science dataset.

The study, published recently in Addictive Behaviors, examined the extent to which the use of electronic cigarettes led participants to later use tobacco cigarettes. The study also explored whether several factors such as anxiety and impulsivity, which are historically predictive of starting/using tobacco cigarettes, functioned similarly with e-cigs.

Results demonstrated that those who began the study having never smoked tobacco cigarettes had a greater chance of later trying cigarettes if they were an e-cig user, suggesting e-cig use served as a catalyst to initiating cigarette smoking.

The study also revealed that the many factors that are typically predictive of the uptake of cigarette smoking such as anxiety, depression and impulsivity were not predictive of the uptake of e-cigs, indicating that individuals may begin using e-cigs through alternative pathways such as increased exposure to advertising.

Finally, males and marijuana users were more likely to initiate e-cig use relative to females and non-marijuana users.

Prior to this study, the phenomenon of e-cigs serving as a starter product to trying tobacco cigarettes had only been seen in middle and high school students.

In light of these findings, the authors suggested that future laws may need to limit young adults’ access to e-cigs, perhaps by increasing the minimum purchasing age for tobacco products to 21 as Hawaii and California have already done.

Do Genetic and Environmental Influences Affect Adolescent Drinking?

Data from the Finnish twin studies demonstrating the changing degree of genetic and environmental influences across adolescence.


When it comes to problems with alcohol use, genes play an increasingly important role as you get older. But scientists still struggle to pinpoint exactly which genes are most to blame.

An article entitled “Genetic Influences on Adolescent Behavior,” published in November 2016 in the journal Neuroscience and Biobehavioral Reviews by COBE researchers Dr. Danielle Dick, Dr. Amy Adkins and Dr. Sally Kuo looked at prior studies on adolescent twins, pathways of risk and specific genes that impact alcohol outcomes in an effort to unite this information to be used for prevention and intervention programs at VCU and beyond.

In the article, Dr. Dick and co explain that psychology as a whole can be boiled down to a study of nature versus nurture, genes versus the environment, and using these relationships to predict and treat positive and negative outcomes.

Over time researchers have discovered that the environment and genes both play an important role in development, but that their relative importance changes throughout one’s life.

In alcohol use and misuse, genes and the environment both play a big role in determining outcomes. Specifically, researchers have found that the environment is more important when you are younger and that genes are more important when you are older.

As a young person there is less opportunity for your personal traits and character to drive your decision-making, and you are more likely to reflect elements of your environment. But as you get older and have more agency, your personal choices and predispositions become more central.

Beyond agency, aspects of the home environment, peer network and community playing a role in the extent to which genetic predispositions are engendered or diminished. In this way you can have all of the genetic predispositions to put you at risk for alcohol misuse, but if you are never exposed to opportunities to indulge those risks you can avoid that negative outcome.

In this way, the researchers stress that it is important to have a relationship with your own genetic predisposition and to consider the way you self-select into environments that increase or decrease the expression of those risky behaviors.

And although researchers have made great progress in understanding how the nature of genetic effects unfold across adolescence, there has not been equal progress in identifying specific genes that impact key adolescent outcomes.

Beyond that there is a lack of broad, translated research for practitioners and professionals to use while crafting prevention and intervention measures. In that way this study is emblematic of the kind of work COBE aims to do both in terms of science and in terms of research translation into improvements in community health and wellness.

As such the main goal of this study was to bring together the latest research and operationalize it for professionals in treatment and recovery fields to improve outcomes for college students and more broadly members of the community as a whole.