We study the causes and consequences of substance use, especially among young people. To address this, we conduct research to understand why some people use substances and develop problems related to substance use. We consider multiple aspects of substance use, including alcohol, tobacco, marijuana, opioid, and stimulant use, problematic use, and disorder. Our research seeks to understand how using substances, both for recreational purposes and in the context of medication treatments, affects development, behavior, and broader health outcomes. We’re especially interested in adolescents and young adults, but our research explores substance use across the lifespan.
Our projects use a variety of research designs, including analyzing longitudinal studies of individuals and families and examining administratively collected healthcare data. We prioritize: (1) large-scale data, (2) rigorous analytic methods, (3) longitudinal analyses, and (4) multiple levels of analysis (including information on the social and physical environment, families, genetics, and behavior), and (5) consideration of racial and ethnic diversity.
Substance Use Disparities at the Intersection of Race/Ethnicity, Sex, Class, and Socio-economic Contexts
Individuals who belong to multiple minority groups may experience minority stress attributed to more than one of their group memberships. This stress has been linked to increased risk for alcohol use, smoking, marijuana use, and illicit drug use among individuals that belong to one or more minoritized groups. To develop more equitable policies and programs aimed at reducing substance use-related harm among this vulnerable gap, we employ national and representative data to study the complex interplay of factors that contribute to differential patterns of substance use among various demographic groups. For example, we examine:
- The interaction of social, cultural, environmental (including the familial, neighborhood, the built and natural environments), and biological factors that affect substance use disparities
- Whether there are nativity differences in etiology and risk of different product/poly-product use among individuals from the same racial group
- How multilevel and intersecting identities and social positioning (e.g., socioeconomic status, immigration status, social mobility) increase substance/polysubstance use risk among different population groups
Social Influences on Substance Use
One area of our research examines how social influences in the environment contribute to substance use, such as alcohol, marijuana, and tobacco use. For example, parenting and the home environment are important factors in development from early childhood to adolescence. In adolescence, peers become more important and can lead to delinquent behavior including alcohol, marijuana, and tobacco use. More broadly, intervention programs, neighborhood, and sociocultural influences can impact on substance use as well. Using longitudinal data, we are interested in some of the following topics:
- How does negative and positive parenting over time contribute to mental health issues and alcohol, marijuana, and tobacco use in adolescence?
- How do peers increase or decrease risk for substance use in adolescence and emerging adulthood?
- Can family-based interventions change family and peer behaviors to decrease risk for adolescent risk for substance use over time?
Genetic Influences on Substance Use
Another focus of our research is on molecular genetic influences on substance use. We use large datasets in which individuals have been genotyped to examine genetic predisposition for different behaviors. We can then examine associations between genetic predisposition and behavior. Examples of research in this area are:
- Does genetic predisposition for substance use contribute to alcohol use, marijuana use, and/or tobacco use?
- How do genetic influences on behavior change over time?
- Does genetic predisposition for aggression evoke harsh parenting or contribute to spending time with delinquent peers, leading to substance use later in life?
Opioid, Stimulant, and other Medication Prescribing in Real-World Healthcare
One area of our research explores patterns and consequences of opioid, stimulant and other medication prescribing. Here, we study the real-world use of medications with the potential for abuse and harm. We take advantage of large-scale data collected from healthcare, such as insurance claims and other administrative records. Some of the questions we are interested include:
- How do opioid prescribing practices in pain management affect risk of overdose, SUD, and other behavioral or mental health outcomes?
- What are the benefits and harms of medication treatment for ADHD, especially in terms of risk of substance use problems?
- How does medication treatment of pain during pregnancy affect offspring outcomes?
Chronic Pain, Mental Health, and Substance Use Problems
Another area of our research examines the interplay among chronic painful conditions, psychopathology, and opioid and other substance use problems. In this work, we are capitalizing on genetically informative, twin-based research designs. Our work is currently supported by a grant from the American Foundation for Suicide Prevention. Some of the questions we are interested include:
- What are the patterns of comorbidity among chronic pain and mental health conditions?
- To what extent does chronic pain increase risk of suicidal behavior?
- Can genetically informative research help reveal the etiology of chronic pain
