Substance use on college campuses, including alcohol, cannabis, and e-cigarettes, has continually risen as a public health concern—particularly when co-occurring with mental health challenges such as anxiety and depression. A comprehensive exploration of these behaviours has revealed complex relationships between single, dual, and polysubstance use and mental health outcomes. Utilising data from the high-participation Healthy Minds Survey (2020–2021), recent research provides invaluable insights into substance use trends, mental health correlations, and subgroup variations by race, ethnicity, and sex.

Substance Use Among Undergraduate Populations

Participation and Methodology

The study encompassed data from 83,467 undergraduate participants, comprising 60,746 females and 22,721 males across numerous U.S. campuses. Substance use patterns were categorised into three groups:

• Exclusive Use (alcohol, cannabis, or e-cigarettes individually)
• Dual Use (a combination of two substances among cannabis, e-cigarettes, or alcohol)
• Polysubstance Use (all three substances consumed together).

Both depression and anxiety outcomes were measured using validated tools (PHQ-9 and GAD-7), and logistic regression models were employed to estimate adjusted odds ratios stratified by sex while controlling for other variables such as socioeconomic backgrounds, college clustering effects, and response weights.

Key Findings on Substance Use and Mental Health Correlation

Dual and Polysubstance Use Risks

Among females, dual users of cannabis and e-cigarettes displayed the highest adjusted odds for depression (aOR = 1.92) and anxiety (aOR = 1.69), followed by polysubstance users who exhibited odds of 1.85 and 1.53, respectively. For males, the trends were even more pronounced; dual cannabis and e-cigarette users showed adjusted odds ratios of 2.72 for depression and 2.23 for anxiety. Polysubstance use reflected similarly heightened risks, with depression and anxiety odds at 1.71 and 1.85, respectively.

Exclusive Use Trends and Highlights

Single-substance use of alcohol was associated with lower risks compared to dual or polysubstance use. Nevertheless, even students engaging exclusively with one substance often faced elevated odds of mental health issues compared to those who abstained entirely. Students with no reported substance use overwhelmingly exhibited the lowest levels of anxiety and depression.

Racial and Gender Differences in Risks

Gender-Specific Vulnerabilities

The study emphasised gender-disparity in the risks associated with substance use:

• Females were notably more susceptible to both depression and anxiety when engaging in polysubstance behaviour or dual use of cannabis and e-cigarettes.
• Males, conversely, demonstrated their highest vulnerability within dual substance use patterns rather than polysubstance behaviour, particularly for depression.

Race and Ethnicity-Based Variations

Patterns across racial and ethnic subgroups revealed substantial differences:

• African American students exhibited significantly lower odds of anxiety and depression when compared to White students across both genders.
• However, Middle Eastern/Arab American female students faced notably higher risks, particularly for anxiety outcomes.

The findings reinforced that solely examining substance use patterns without accounting for racial or gender variations might obscure important risks related to mental health outcomes.

Supporting Research Insights from HECAOD

Additional data from HECAOD further underpinned similar themes presented in the Healthy Minds Survey. Their research also concluded that dual and polysubstance users experienced heightened instances of anxiety and depression. The emphasis on female students facing greater susceptibility to co-use effects while African American students reported some protective factors in mental health outcomes paralleled the broader survey insights.

Broader Implications on Campus Health

The confluence of substance use behaviours and depression/anxiety risks signifies a pressing nexus that higher education institutions must address. Findings underscore the significance of stratified interventions that target dual and polysubstance use related mental health challenges, especially within diverse student demographics.

Source: Taylor & Francis
Complementary information can be accessed via HECAOD.