HE ACADEMIC OPPORTUNITY COSTS OF … Coalition Substance Abuse Prevention Conference . Spokane, WA ....

College Coal it ion Substance Abuse Prevention Conference Spokane, WA June 10, 2013

THE ACADEMIC OPPORTUNITY COSTS OF SUBSTANCE USE DURING COLLEGE

Amelia M. Arr ia, Ph.D. University of Maryland School of Publ ic Health

Center on Young Adult Health and Development aarr [email protected]

The Education-Health Connection National expressions of concern regarding academic outcomes

Alcohol and other drug use among college students

Is substance use related to academic outcomes?

Research studies conducted with college students

The importance of mental health

Innovative intervention strategies: Creating Blue Oceans

OVERVIEW

THE EDUCATION-HEALTH CONNECTION

• Having less education is related to being employed in jobs with less autonomy, leading to higher levels of occupational stress.

• Individuals with less education are much less likely to access and utilize preventive health care services (Katz and Hofer, 1994).

• Schooling provides basic literacy and critical reasoning skills essential in today’s complex health care environment.

• Education enables one to acquire, absorb and evaluate health-related information.

Health Education

Health Risk Behaviors Education

• Low levels of schooling places an individual at increased risk for obesity.

• Smoking and illicit drug use during pregnancy is strongly related to lower levels of education (Currie and Moretti, 2002; Arria, et al., 2008).

• Lower academic achievement has intergenerational effects

(e.g., low birthweight, childhood obesity) (Breierova, Duflo, 2004; Grossman, 2005; Feinstein, 2006).

Health Education

BUT… highly educated individuals are not necessarily immune from problems:

• Sedentary lifestyles are common among highly educated

individuals.

• Adolescent drinking and marijuana use is more common among children of higher educated parents.

• College graduates are more likely to drink and drive than their less educated counterparts.

20.9

5.7

34.8

12.4

6.2

23.1

6.2

31.3

10.1 9.4

22.7

6.4

29.7

12.5 13.8

19.6

4.7

15.4

9.6

16.1

0

5

10

15

20

25

30

35

40

Past-month bingealcohol use*

Past-month heavyalcohol use**

Past-month tobaccouse

Past-year illicit drug use Past-year drunkdriving***

<High School

High School Graduate

Some College

College Graduate

*“Binge use” defined as “Five or more drinks on the same occasion at least once in the past 30 days.”

**“Heavy use” defined as “Five or more drinks on the same occasion on each of 5 or more days in the past 30 days.”

***Among persons aged 18 and older.

Source: Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Detailed Tables, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.

Alcohol, tobacco, and illicit drug use by educational level among persons aged 26 and older

Health Education

• Dietary practices are related to academic achievement in childhood (Ross, 2010).

• Substance use significantly contributes to cognitive

problems, poor academic achievement, and risk for dropout in high school (DuPont et al., 2013).

• Substance use during college associated with skipping

class, less time studying.

• Mental health problems and substance use disorders increase risk for early termination from high school and college (Hunt, 2010; Breslau et al., 2008; Kessler, 1995).

NATIONAL EXPRESSIONS OF CONCERN REGARDING

ACADEMIC OUTCOMES

DISCONNECTED YOUTH, 2012

• Nationally, 13% of 16-19 year olds and 20% of 20-24 year olds are “disconnected”―defined as not enrolled in school and not working. • A total of 6.5 million young people are disconnected. • Employment rates among 16-24 year olds are at their lowest level since WWII.

• Cost: 1.56 trillion dollars (Belfield, 2012)

HIGH SCHOOL GRADUATION RATES, 2012

70-100%

Below 70%

Not reported

National African-American students

70-100%

Below 70%

Not reported

HOW MUCH ARE WE INVESTING IN COLLEGE STUDENTS?

Preparation

Economic Costs

Time & Energy

$21,889: Average cost of attending college, 2010

$19.1 billion: Tax breaks for students and their families in 2013.

$800 million: U.S. college preparation test market

IMPACT ON GLOBAL COMPETITIVENESS

“Low college completion rates—as with the declining rates of high school completion—are depriving the nation of college-educated and trained workers need to keep the American workforce competitive globally.”

READINESS FOR EMPLOYMENT

“There are disturbing signs that many students who do earn degrees have not actually mastered the reading, writing, and thinking skills we expect of college graduates. Over the past decade, literacy among college graduates has actually declined. Unacceptable numbers of college graduates enter the workforce without the skills employers say they need in an economy in which, as the truism holds correctly, knowledge matters more than ever.”

ALCOHOL AND OTHER DRUG USE

AMONG COLLEGE STUDENTS

Post College Year 4

24 Months: Interview

(n=1,101) 88% Screening (n=3,401)


(n=1,142) 91%


(n=1,097) 88%


(n=1,019) 81%


(n=1,001) 80%

Post College Year 3


(n=951) 76%

Post College Year 2

Post College Year 1

Senior Year

Junior Year

Sophomore Year

First Year

Summer Orientation

Baseline Interview (n=1,253)

Oversampling for illicit drug use in high

school


(n=982) 78%

Demographics Family Composition Gender Race/Ethnicity Socioeconomic Status Parental Education

Individual Characteristics Personality/Temperament Religiosity Sensation-seeking Physical Health

Mental Health Major Depression Bipolar Disorder Anxiety Disorder ADHD Suicidal Behaviors

Stress & Social Support Peer Relations Peer Drug Use

Parent Influences Parental Monitoring Relationship Quality Communication Parental Authority Style Family History

Academic Achievement Personal Goals Employment Quality of Life

Health Services

Major Domains Measured in the College Life Study Alcohol and Other Drugs DSM-IV Disorders Quantity/Frequency Consequences Nonmedical Prescription Drug Use Sharing & Selling Prescription Drugs Perceived Harmfulness

Risk & Protective Factors

AOD Problems

Impact: future screening protocols could be designed to assess not only for the presence of current problems, but on the RISK factors that might be related to developing a future problem and the possible consequences of the problem.

Academic

Employment

Health

Consequences

Alcohol and other drug use by the fourth year of college

0 10 20 30 40 50 60 70 80 90 100

Inhalants

Amphetamines/Methamphetamine

Heroin

Ecstasy

Nonmedical use of prescription tranquilizers

Cocaine

Hallucinogens

Nonmedical use of prescription analgesics

Nonmedical use of prescription stimulants

Marijuana

Alcohol

Weighted percentage of students who used drug at least once during lifetime

Source: College Life Study. Not to be shown or redistributed without written permission from Amelia M. Arria, PI

8.2 8.4

6.1

4.0 3.3

11.7 12.5

12.9

11.9

9.5

.0

5.0

10.0

15.0

20.0

25.0

Y2 Y3 Y4 Y5 Y6

% of

sam

ple

Dependence Abuse

Marijuana Abuse and Dependence (DSM-IV), over time among CLS participants


= “medium-risk” drinker = 39.5%wt

(3 to 5 drinks/drinking day)

= “low-risk” drinker = 22.3%wt

(1 to 2 drinks/drinking day)

Drinking patterns in first-year students in the CLS

= “high-risk” drinker = 25.8%wt

(6 or more drinks/drinking day)

= “non-drinker” = 12.4%wt

(did not drink in the past year)

X


2.3% 2.7% 2.3% 1.9%

5.2% 5.9%

5.2%

4.3%

15.1%

17.2%

15.2%

12.8%

22.3%

25.0%

22.4%

19.0%

0%

5%

10%

15%

20%

25%

30%

Year 1 Year 2 Year 3 Year 4

Estimated probability of developing

alcohol dependence

Non-drinkers

Low-risk drinkers

(1-2 drinks/day)

Medium Risk drinkers

(3-5 drinks/day)

High-risk drinkers

(6+ drinks/day)

Drinking level at college entry:

Year of College

Estimated probabilities of developing alcohol dependence based on drinking level at college entry


A. Based on brain development science, risk-taking in adolescence is:

• normative; important to development • evolutionarily adaptive • is due primarily to emotional and contextual, not

cognitive, factors

Q. What’s behind drinking excessively and using drugs?

Neurodevelopmental Origins of Risk-taking

The area that develops earlier: Limbic System • Processing emotions

• Processing social info

• Experience reward, punishment

• Deliberative thinking

• Logical reasoning

• Planning ahead

• Weighing costs and benefits

• Regulating impulses

The area that develops later: Prefrontal Cortex

Limbic System

Or… said in another way,

IS SUBSTANCE USE RELATED TO ACADEMIC OUTCOMES?

CONCEPTUAL MODEL

Alcohol Use

Mental Health

Drug Use

Intermediary Processes • Skipping Class

• Studying Less

•Decreased Motivation

•Poor Quality/Less Sleep

• Cognitive Problems

•Declining GPA

•Dropping Classes

• Lost Opportunities (internships, work, special studies)

Short-Term Manifestations

Long-Term Outcomes •Delayed Graduation

• Failure to Graduate

•Attenuation of Goals

• Lack of Readiness for Employment

•Underemployment

RESEARCH STUDIES CONDUCTED WITH

COLLEGE STUDENTS

0

5

10

15

20

25

Y1 Y2 Y3 Y4

Wei

ghte

d m

ean

num

ber o

f hou

rs/w

eek

spen

t stu

dyin

g

Year of College

Time Spent Studying, By High-Intensity Drinking and Year

High-intensity drinkers All others

High-intensity drinkers were individuals in the top gender-specific quartiles for both quantity and frequency of alcohol use. High-intensity drinkers were significantly different from all others regardless of year (p<.001).


5

10

15

20

25

Y1 Y2 Y3 Y4

Wei

ghte

d m

ean

num

ber o

f hou

rs/w

eek

spen

t stu

dyin

g

Year of College

Time Spent Studying, by Frequency of Illicit Drug Use and Year

Used 50 or more days Used 1-49 days Non-users

Overall drug use frequency inclusive of marijuana, hallucinogens, cocaine, amphetamines, ecstasy, heroin, and nonmedical use of prescription stimulants, analgesics, and tranquilizers. Non-users were significantly different from both drug-using groups, and the “50 or more” users were significantly different from the “1-49” users (all p<.001).


Nonmedical stimulant users spend less time studying, skip classes more often, and earn lower grades.

Source: Arria AM, O'Grady KE, Caldeira KM, Vincent KB, Wish ED. (2008). Nonmedical use of prescription stimulants and analgesics: Associations with social and academic behaviors among college students. Journal of Drug Issues. 38(4), 1045-1060.

“It doesn't seem to be causing too much trouble since most [students] use the drugs not to get high but to

function better….

When exams are over, they go back to normal and stop abusing the drugs.”

—University psychiatrist quoted in U.S. News & World Report, March 3, 2008

Misperceptions about nonmedical prescription

stimulant use

Nonmedical Use of Prescription Stimulants for Studying

Time

Marijuana Use

Skipping Class

Academic Performance

Marijuana Dependence

“Late discontinuity”:

Years 3-4 (n=233)

20%

“Early discontinuity” Years 1-2

(n=107) 9%

MARIJUANA AND ALCOHOL USE: RELATIONSHIPS TO DISCONTINUOUS ENROLLMENT

Continuously enrolled Years 1-4 (n=805)

70%

Arria, A.M., Caldeira, K.M., Vincent, K.B., Winick, E.R., Baron, R.A., O'Grady, K.E. (2013). Discontinuous college enrollment: Associations with substance use and mental health. Psychiatric Services. 64(2), 165-172.

First year alcohol use (typical number of drinks/day) and frequency of marijuana use was related to late discontinuity, even after controlling for demographics, psychiatric symptoms and diagnosis, and high school GPA.

Discontinuity during college

0

1

2

3

4

1 2 3 4

Num

ber o

f illi

cit d

rugs

use

d in

the

past

yea

r, ot

her t

han

mar

ijuan

a

Year of College

Discontinuous enrollment and past-year illicit drug use

Minimal Use 24.2% stop-out

High Use 41.0% stop-out

Low Use 34.9% stop-out

Arria, A.M., Garnier-Dykstra, L.M., Caldeira, K.M., Vincent, K.B., Winick, E.R., O'Grady, K.E. (2013). Drug use patterns and continuous enrollment in college: Results from a longitudinal study. Journal of Studies on Alcohol and Drugs. 74(1), 71-83.

0

5

10

15

20

25

1 2 3 4

Day

s us

ed m

ariju

ana

in th

e pa

st m

onth

Year of College

Chronic/Heavy Use 40.8% stop-out

Decreasing Use 30.5% stop-out

Increasing Use 36.1% stop-out

Minimal Use

Infrequent Use 36.1% stop-out

Discontinuous enrollment and past-month marijuana use

24.9% stop-out

Arria, A.M., Garnier-Dykstra, L.M., Caldeira, K.M., Vincent, K.B., Winick, E.R., O'Grady, K.E. (2013). Drug use patterns and continuous enrollment in college: Results from a longitudinal study. Journal of Studies on Alcohol and Drugs. 74(1), 71-83.

82.90% 84% 84.30%

73.70%

15.40% 9.60% 10.90%

16.20%

1.70% 6.40% 4.80%

10.10%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Non-users (n=117) Infrequent Marijuana Users(n=156)

Sporadic Dug Users (n=248) Persistent Drug Users(n=99)

% of

par

ticip

ants

Unemployed

Employed Part-time

Employed Full-time

Post-college Employment Status by College Drug Use Patterns

Arria, A.M., Garnier-Dykstra, L.M., Cook, E.T., Caldeira, K.M., Vincent, K.B., Baron, R.A., O'Grady, K.E. (2013). Drug use patterns in young adulthood and post-college employment. Drug and Alcohol Dependence. 127(1-3), 23–30.

MECHANISMS

• “Hijacking” brain reward pathways • Peer affiliation • Brain development

Excessive drinking and

drug use

Academic performance

?

In adolescents, heavy alcohol use is associated with: Structural and function changes in the brain Differences in sleep patterns Poor planning Impaired executive functioning Spatial deficits Attention deficits

NEUROBIOLOGICAL CONSEQUENCES OF ALCOHOL USE

Acutely, marijuana use is associated with: Attention and concentration difficulties Decreased working memory Decreased information processing Decreased decision response speed

Longer-term… Impaired planning, organizing, and problem solving Deficits to allocation of attentional resources and filtering

out irrelevant material Retrieval and immediate verbal memory deficits

NEUROBIOLOGICAL CONSEQUENCES OF MARIJUANA USE

Deficits are more likely when marijuana use is initiated earlier in life and when use is more frequent.

Early chronic marijuana use is associated with declines in IQ of up to 8 points.

(Corresponds to a drop from the 50th to 30th percentile)

NEUROBIOLOGICAL CONSEQUENCES OF MARIJUANA USE

THE IMPORTANCE OF MENTAL HEALTH

0 10 20 30 40 50

Any psychiatric diagnosis

Any Axis 1 disorder

Alcohol abuse/dependence

Any personality disorder

Any anxiety disorder

Any mood disorder

Obsessive-compulsive PD

Specific phobia

Major depression

Drug abuse/dependence

Paranoid PD

Antisocial PD

Histrionic PD

Schizoid PD

Bipolar

Social anxiety

% of students

12-MONTH PREVALENCE OF PSYCHIATRIC DISORDERS AMONG COLLEGE STUDENTS

HOW MANY COLLEGE STUDENTS SCREEN POSITIVE FOR CURRENT MENTAL HEALTH PROBLEMS?

0 10 20 30 40 50

Missed academic obligationsdue to mental health*

Mental health affectedacademic performance*

Suicide ideation*

Anxiety (panic or GAD)

Depression (major or other)

Any depressive or anxietydisorder

% of students

Under-graduate students

Graduate students

*During the past 4 weeks

PSYCHIATRIC DISORDERS AND FAILURE TO GRADUATE COLLEGE AMONG COLLEGE ENTRANTS

Kessler, R. C. and C. L. Foster (1995). Social consequences of psychiatric disorders, I: Educational attainment. American Journal of Psychiatry. 152(7): 1026-32.

1.4 (1.2-1.6)

2.9 (1.4-5.8)

0

1

2

3

Anxiety Mood*

Odds Ratio (95% CI) associated with anxiety and mood disorders for failure to graduate among

college entrants

*Mood disorders = major depression, dysthymia, and bipolar disorder.

1.3 (1.0-1.7)

1.8 (1.3-2.4)

2.3 (1.4-3.7)

0

1

2

3

One Two Three

Odds Ratio (95% CI) associated with the number of psychiatric disorders for failure to graduate among

college entrants

Breslau, J., M. Lane, et al. (2008). "Mental disorders and subsequent educational attainment in a US national sample." Journal of Psychiatric Research 42(9): 708-716.

Odds Ratio (95% Confidence Interval) of Failure to Graduate by Disorder

The following were not significant predictors of failure to graduate college: • Anxiety disorders with the exception of panic disorder/agoraphobia • Depression and dysthymia • Conduct disorder and Oppositional defiant disorder • Alcohol dependence • Drug dependence

1.4 (1.0-1.8) 1.4

(1.0-2.0) 1.3

(1.0-1.6)

1.5 (1.2-2.1) 1.3

(1.1-1.6) 1.3

1.0-1.6)

1.7 (1.3-2.2) 1.5

(1.2-1.8)

0

1

2

Panic disorder oragoraphobia

Bipolar disorder Intermittentexplosive disorder

ADHD Any impulsedisorder

Alcohol abuse Drug abuse Any SUD

PSYCHIATRIC DISORDERS AND FAILURE TO GRADUATE COLLEGE AMONG COLLEGE ENTRANTS

Hunt, J., D. Eisenberg, et al. (2010). Consequences of receipt of a psychiatric diagnosis for completion of college. Psychiatric Services. 61(4): 399-404.

Odds Ratio (95% Confidence Interval) of Failure to Graduate by Diagnosis

The following were not significant predictors when adjusting for demographics and other diagnoses:

1.70 (1.18-2.43)

1.31 (1.03-1.66) 1.26

(1.08-1.46)

1.50 1.10-2.05)

1.69 (1.29-2.23)

0

1

2

Bipolar Antisocial personality Marijuana use disorder Amphetamine use disorder Cocaine use disorder

• Depression • Panic disorder with agoraphobia • Social anxiety disorder • Generalized anxiety disorder • Alcohol use disorder

PSYCHIATRIC DISORDERS AND FAILURE TO GRADUATE AMONG COLLEGE ENTRANTS

Nearly half of students say that their mental health affected their academic performance in the past month.

The presence of a psychiatric disorder makes a student significant less l ikely to complete a college degree, especially when the disorder is diagnosed during college.

MENTAL HEALTH AND DISCONTINUOUS ENROLLMENT IN COLLEGE

MENTAL HEALTH PROBLEMS RELATED TO DISCONTINUOUS ENROLLMENT DURING COLLEGE

“Late discontinuity”:

Years 3-4 (n=233)

20%

“Early discontinuity” Years 1-2

Continuously enrolled Years 1-4 (n=805)

70%

Arria, A.M., Caldeira, K.M., Vincent, K.B., Winick, E.R., Baron, R.A., O'Grady, K.E. (2013). Discontinuous college enrollment: Associations with substance use and mental health. Psychiatric Services. 64(2), 165-172.

(n=107) 9%

Individuals who were diagnosed with depression during college were three times more likely to experience early discontinuity, even after controlling for demographics, drug and alcohol use, and high school GPA.

Excessive drinking, drug use, and mental health problems tend to cluster among the same students, but their effects on academic outcomes do not overlap completely.

The effects of mental health and substance use on academic outcomes are separate and additive.

Academic consequences of drinking (e.g., fall ing behind on work, missing class) can be more pronounced when the drinker also has mental health problems.

MENTAL HEALTH AND SUBSTANCE USE

MARIJUANA USE AND MENTAL HEALTH

• Some studies have demonstrated an association

between marijuana use and bipolar, major depression and mania (Henquet, 2006).

• Clear evidence has accumulated showing that marijuana is a contributory factor for the development of schizophrenia (DiForti, 2009; Bossong, 2010; Arseneault, 2004).

INNOVATIVE INTERVENTION STRATEGIES:

CREATING BLUE OCEANS

A 2010 study of 351 colleges and universities found that:

58% of college administrators had reviewed the recommendations, but 1 in 5 were not aware that recommendations had been made. 98% of colleges and universities offered alcohol education programs, but less than

half required students to complete it. Only half of schools offered intervention programs that were empirically supported.

FEW COLLEGES ARE AWARE OF NIAAA RECOMMENDATIONS AND VERY FEW ARE

IMPLEMENTING EVIDENCE-BASED STRATEGIES

Red Oceans represent all industries

in existence today.

They have defined rules, competitors, and market boundaries.

Key words:

competition, price wars, market share, commoditization, benchmarking, strategic

positioning, value add.

Blue Oceans represent all industries

NOT in existence today.

This is undefined market space, otherwise

known as OPPORTUNITY.

Key words: value innovation, focus, differentiation,

creation of demand, new marketplace

1. DEVELOP A LONG-RANGE STRATEGIC PLAN

• Establish a roadmap that describes the coordinated and standardized plan regarding actions to take at various touchpoints.

• Keep group small; monitor progress regularly

• Involve “speciality stakeholders” (e.g., family/parent affairs representative, academic leaders, community leaders surrounding campus on an as needed basis).

2. EXPAND ROLE OF ACADEMIC ASSISTANCE CENTERS

• Implement AOD/mental health screening in academic assistance centers.

• Focus on students who are struggling academically.

• Include questions about concentration problems, missed classes due to AOD use, and personal academic goals.

• “Connect the dots” for students regarding the contribution of AOD use to mental health and to academic difficulties.

EXPAND ROLE OF ACADEMIC ASSISTANCE CENTERS

• Explain how continued AOD use and untreated mental

health problems can compromise long-term opportunities.

• Empower staff who work at academic assistance centers to assess and respond to AOD and mental health problems.

• Monitor both AOD use and academic performance to chart progress to student.

USE RESEARCH DATA TO PERSONALIZE INTERVENTION SESSIONS: UNDER CONSTRUCTION

• Work is underway to develop more personalized information that could be used in interventions.

• Work is underway to develop confidential methods for “electronic student records” which facilitate self-reflection of student progress and changing goals and aspirations.

• Such a system might help track student progress toward goals and draw connections between individual behaviors and achievements (or becoming de-railed).

3. PROACTIVELY ENGAGE PARENTS ON AN ONGOING BASIS

• Employees of institutions of higher education ARE parents. Disseminate information on substance use/mental health among youth through human resource employee listservs.

• Engage in virtual conversations with parents of college-bound juniors and seniors about the link between AOD and college-readiness and academic performance during college.

• During college, establish learning opportunities for parents to detect problems and intervene appropriately.

4.INVOLVE POTENTIAL EMPLOYERS AND ALUMNI

• Leverage opportunities with alumni to discuss the possible impact of AOD/mental health on student success to rally support from them to enhance/expand capacity to implement innovative solutions.

• Proactively engage local and national businesses in the discussion – during job fairs, sponsor talks by CEOs to get the message to young people about what they are looking for in potential employees – that AOD use will not be part of the road to a successful career.

• Facilitate similar interactions with graduate school deans, alumni networks.

• PHYSICAL DEVELOPMENT good health habits good health risk management skills

• INTELLECTUAL DEVELOPMENT knowledge of essential life skills knowledge of essential vocational skills critical thinking and reasoning skills cultural competency good decision-making skills • PSYCHOLOGICAL AND EMOTIONAL DEVELOPMENT good mental health, including positive self-regard good emotional self-regulation skills good coping skills

ULTIMATE VISION FOR STUDENTS

OUR OUTSTANDING TEAM AND COLLABORATORS

Kevin E. O'Grady, Ph.D. Co-Invest igator Kimberly M. Caldeira, Associate Director, CYAHD Kathryn B. Vincent Carr, M.A. Director of Operations, CYAHD Brittany A. Bugbee, B.S/B.A., Faculty Research Assistant Rebecca Kurikeshu, M.P.H., Faculty Research Assistant Joanna Hurwitz, Research Assistant Katie Hippen, Research Assistant Joanna Smith, Research Assistant Olga Moskovich, B.S. , Graduate Research Assistant Consultants/Advisors: Ralph E. Tarter, Ph.D. University of Pittsburgh School of Pharmacy Kenneth J. Sher, Ph.D. University of Missouri -Columbia Kenneth H. Beck, Ph.D. University of Maryland School of Publ ic Health Ken C. Winters, Ph.D. University of Minnesota

For more information, please visit our website:

www.cyahd.umd.edu

or send me an email:

[email protected]

Thank you!

Amelia M. Arria, Ph.D. University of Maryland School of Public Health

Center on Young Adult Health and Development

mailto:[email protected]

A r r i a , A . M . , K u h n , V . , C a l d e i r a , K . M . , O ’ G r a d y , K . E . , V i n c e n t , K . B . , & W i s h , E . D . ( 2 0 0 8 a ) . H i g h s c h o o l d r i n k i n g m e d i a t e s t h e r e l a t i o n s h i p b e t w e e n p a r e n t a l m o n i t o r i n g a n d c o l l e g e d r i n k i n g : A l o n g i t u d i n a l a n a l y s i s . S u b s t a n c e A b u s e T r e a t m e n t , P r e v e n t i o n , a n d P o l i c y , 3 ( 6 ) , 1 - 1 1 .

A r r i a , A . M . , O ' G r a d y , K . E . , C a l d e i r a , K . M . , V i n c e n t , K . B . , & W i s h , E . D . ( 2 0 0 8 b ) . N o n m e d i c a l u s e o f p r e s c r i p t i o n s t i m u l a n t s a n d a n a l g e s i c s : A s s o c i a t i o n s w i t h s o c i a l a n d a c a d e m i c b e h a v i o r s a m o n g c o l l e g e s t u d e n t s . J o u r n a l o f D r u g I s s u e s , 3 8 ( 4 ) , 1 0 4 5 - 1 0 6 0 . A r r i a , A . M . , C a l d e i r a , K . M . , V i n c e n t , K . B . , W i n i c k , E . R . , B a r o n , R . A . , & O ’ G r a d y , K . E . ( 2 0 1 3 a ) . D i s c o n t i n u o u s c o l l e g e e n r o l l m e n t : A s s o c i a t i o n s w i t h s u b s t a n c e u s e a n d m e n t a l h e a l t h . P s y c h i a t r i c S e r v i c e s , 6 4 ( 2 ) , 1 6 5 - 1 7 2 .

A r r i a , A . M . , G a r n i e r - D y k s t r a , L . M . , C a l d e i r a , K . M . , V i n c e n t , K . B . , W i n i c k , E . R . , & O ’ G r a d y , K . E . ( 2 0 1 3 b ) . D r u g u s e p a t t e r n s a n d c o n t i n u o u s e n r o l l m e n t i n c o l l e g e : R e s u l t s f r o m a l o n g i t u d i n a l s t u d y . J o u r n a l o f S t u d i e s o n A l c o h o l a n d D r u g s , 7 4 ( 1 ) , 7 1 - 8 3 .

A r r i a , A . M . , G a r n i e r - D y k s t r a , L . M . , C o o k , E . T . , C a l d e i r a , K . M . , V i n c e n t , K . B . , B a r o n , R . A . , & O ’ G r a d y , K . E . ( 2 0 1 3 c ) . D r u g u s e p a t t e r n s i n y o u n g a d u l t h o o d a n d p o s t - c o l l e g e e m p l o y m e n t . D r u g a n d A l c o h o l D e p e n d e n c e , 1 2 7 ( 1 - 3 ) , 2 3 – 3 0 .

A r r i a , A . M . , W i l c o x , H . C . , C a l d e i r a , K . M . , V i n c e n t , K . B . , G a r n i e r - D y k s t r a , L . M . , & O ’ G r a d y , K . E . ( 2 0 1 3 d ) . D i s p e l l i n g t h e m y t h o f “ s m a r t d r u g s ” : C a n n a b i s a n d a l c o h o l u s e p r o b l e m s p r e d i c t n o n m e d i c a l u s e o f p r e s c r i p t i o n s t i m u l a n t s f o r s t u d y i n g . A d d i c t i v e B e h a v i o r s , 3 8 ( 3 ) , 1 6 4 3 - 1 6 5 0 .

B l a n c o , O k u d a , W r i g h t , H a s i n , G r a n t , L i u , & O l f s o n ( 2 0 0 8 ) . M e n t a l h e a l t h o f c o l l e g e s t u d e n t s a n d t h e i r n o n - c o l l e g e a t t e n d i n g p e e r s : R e s u l t s f r o m t h e N a t i o n a l E p i d e m i o l o g i c S t u d y o n A l c o h o l a n d R e l a t e d C o n d i t i o n s . A r c h G e n P s y c h i a t r y . 6 5 ( 1 2 ) : 1 4 2 9 - 1 4 3 7 .

B o l l a , K . I . , B r o w n , K . , E l d r e t h , D . , T a t e , K . , & C a d e t , J . L . ( 2 0 0 2 ) . D o s e - r e l a t e d n e u r o c o g n i t i v e e f f e c t s o f m a r i j u a n a u s e . N e u r o l o g y , 5 9 ( 9 ) , 1 3 3 7 - 1 3 4 3 .

B o r s a r i , B . , & C a r e y , K . B . ( 2 0 0 0 ) . E f f e c t s o f a b r i e f m o t i v a t i o n a l i n t e r v e n t i o n w i t h c o l l e g e s t u d e n t d r i n k e r s . J o u r n a l o f C o n s u l t i n g a n d C l i n i c a l P s y c h o l o g y , 6 8 ( 4 ) , 7 2 8 - 7 3 3 .

B r e s l a u , J . , L a n e , M . , S a m p s o n , N . , & K e s s l e r , R . C . ( 2 0 0 8 ) . M e n t a l d i s o r d e r s a n d s u b s e q u e n t e d u c a t i o n a l a t t a i n m e n t i n a U S n a t i o n a l s a m p l e . J o u r n a l o f P s y c h i a t r i c R e s e a r c h , 4 2 ( 9 ) , 7 0 8 - 7 1 6 .

B r o w n , S . A . , T a p e r t , S . F . , G r a n h o l m , E . , & D e l i s , D . C . ( 2 0 0 0 ) . N e u r o c o g n i t i v e f u n c t i o n i n g o f a d o l e s c e n t s : E f f e c t s o f p r o t r a c t e d a l c o h o l u s e . A l c o h o l i s m : C l i n i c a l a n d E x p e r i m e n t a l R e s e a r c h , 2 4 ( 2 ) , 1 6 4 - 1 7 1 .

C a r e y , K . B . , C a r e y , M . P . , M a i s t o , S . A . , & H e n s o n , J . M . ( 2 0 0 6 ) . B r i e f m o t i v a t i o n a l i n t e r v e n t i o n s f o r h e a v y c o l l e g e d r i n k e r s : A r a n d o m i z e d c o n t r o l l e d t r i a l . J o u r n a l o f C o n s u l t i n g a n d C l i n i c a l P s y c h o l o g y , 7 4 ( 5 ) , 9 4 3 - 9 5 4 .

d e l a J a r a , R . ( 2 0 0 6 ) . I Q p e r c e n t i l e a n d r a r i t y c h a r t . R e t r i e v e d M a y 1 , 2 0 1 3 , f r o m h t t p : / / w w w . i q c o m p a r i s o n s i t e . c o m / i q t a b l e . a s p x D e p a r t m e n t o f E d u c a t i o n . ( 2 0 1 2 ) . F i s c a l y e a r 2 0 1 3 b u d g e t s u m m a r y a n d b a c k g r o u n d i n f o r m a t i o n . W a s h i n g t o n , D C : D e p a r t m e n t o f

E d u c a t i o n . D i l l , A . L . , G i l b e r t , J . A . , H i l l , J . P . , M i n c h e w , S . S . , & S e m p i e r , T . A . ( 2 0 1 0 ) . A s u c c e s s f u l r e t e n t i o n p r o g r a m f o r s u s p e n d e d s t u d e n t s .

J o u r n a l o f C o l l e g e S t u d e n t R e t e n t i o n : R e s e a r c h , T h e o r y a n d P r a c t i c e , 1 2 ( 3 ) , 2 7 7 - 2 9 1 . D u P o n t , R . L . , C a l d e i r a , K . M . , D u P o n t , H . S . , V i n c e n t , K . B . , S h e a , C . L . , & A r r i a , A . M . ( 2 0 1 3 ) . A m e r i c a ’ s d r o p o u t c r i s i s : T h e

u n r e c o g n i z e d c o n n e c t i o n t o a d o l e s c e n t s u b s t a n c e u s e . R o c k v i l l e , M D : I n s t i t u t e f o r B e h a v i o r a n d H e a l t h . E h r e n r e i c h , H . , R i n n , T . , K u n e r t , H . J . , M o e l l e r , M . R . , P o s e r , W . , S c h i l l i n g , L . , G i g e r e n z e r , G . , & H o e h e , M . R . ( 1 9 9 9 ) . S p e c i f i c

a t t e n t i o n a l d y s f u n c t i o n i n a d u l t s f o l l o w i n g e a r l y s t a r t o f c a n n a b i s u s e . P s y c h o p h a r m a c o l o g y , 1 4 2 ( 3 ) , 2 9 5 - 3 0 1 .

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http://www.iqcomparisonsite.com/iqtable.aspx

E i s e n b e r g , D . , G o l l u s t , S . E . , G o l b e r s t e i n , E . , & H e f n e r , J . L . ( 2 0 0 7 ) . P r e v a l e n c e a n d c o r r e l a t e s o f d e p r e s s i o n , a n x i e t y , a n d s u i c i d a l i t y

a m o n g u n i v e r s i t y s t u d e n t s . A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y , 7 7 ( 4 ) , 5 3 4 - 5 4 2 . d o i : 1 0 . 1 0 3 7 / 0 0 0 2 - 9 4 3 2 . 7 7 . 4 . 5 3 4 E i s e n b e r g , D . , G o l b e r s t e i n , E . , & H u n t , J . B . ( 2 0 0 9 ) . M e n t a l h e a l t h a n d a c a d e m i c s u c c e s s i n c o l l e g e . T h e B . E . J o u r n a l o f E c o n o m i c

A n a l y s i s a n d P o l i c y , 9 ( 1 ) , 1 - 3 5 . d o i : 1 0 . 2 2 0 2 / 1 9 3 5 - 1 6 8 2 . 2 1 9 1 F o n t e s , M . A . , B o l l a , K . I . , C u n h a , P . J . , A l m e i d a , P . P . , J u n g e r m a n , F . , L a r a n j e i r a , R . R . , B r e s s a n , R . A . , & L a c e r d a , A . L . T . ( 2 0 1 1 ) .

C a n n a b i s u s e b e f o r e a g e 1 5 a n d s u b s e q u e n t e x e c u t i v e f u n c t i o n i n g . T h e B r i t i s h J o u r n a l o f P s y c h i a t r y , 1 9 8 ( 6 ) , 4 4 2 - 4 4 7 . G u i d e t o C o m m u n i t y P r e v e n t a t i v e S e r v i c e s . ( 2 0 0 6 , 1 2 / 1 6 / 2 0 1 1 ) . P r e v e n t i n g e x c e s s i v e a l c o h o l c o n s u m p t i o n : E n f o r c e m e n t o f l a w s

p r o h i b i t i n g s a l e s t o m i n o r s . R e t r i e v e d A p r i l 3 , 2 0 1 3 , f r o m h t t p : / / w w w . t h e c o m m u n i t y g u i d e . o r g / a l c o h o l / l a w s p r o h i b i t i n g s a l e s . h t m l H u n t , J . , E i s e n b e r g , D . , & K i l b o u r n e , A . M . ( 2 0 1 0 ) . C o n s e q u e n c e s o f r e c e i p t o f a p s y c h i a t r i c d i a g n o s i s f o r c o m p l e t i o n o f c o l l e g e .

P s y c h i a t r i c S e r v i c e s , 6 1 ( 4 ) , 3 9 9 - 4 0 4 . H u s t a d , J . T . P . , B a r n e t t , N . P . , B o r s a r i , B . , & J a c k s o n , K . M . ( 2 0 1 0 ) . W e b - b a s e d a l c o h o l p r e v e n t i o n f o r i n c o m i n g c o l l e g e s t u d e n t s : A

r a n d o m i z e d c o n t r o l l e d t r i a l . A d d i c t i v e B e h a v i o r s , 3 5 ( 3 ) , 1 8 3 - 1 8 9 . I p s o s P u b l i c A f f a i r s . ( 2 0 1 2 ) . H o w A m e r i c a p a y s f o r c o l l e g e 2 0 1 2 . W a s h i n g t o n , D C : S a l l i e M a e . K e s s l e r , R . C . , & F o s t e r , C . L . ( 1 9 9 5 ) . S o c i a l c o n s e q u e n c e s o f p s y c h i a t r i c d i s o r d e r s , I : E d u c a t i o n a l a t t a i n m e n t . A m e r i c a n J o u r n a l o f

P s y c h i a t r y , 1 5 2 ( 7 ) , 1 0 2 6 - 1 0 3 2 . K u l e s z a , M . , M c V a y , M . A . , L a r i m e r , M . E . , & C o p e l a n d , A . L . ( 2 0 1 3 ) . A r a n d o m i z e d c l i n i c a l t r i a l c o m p a r i n g t h e e f f i c a c y o f t w o a c t i v e

c o n d i t i o n s o f a b r i e f i n t e r v e n t i o n f o r h e a v y c o l l e g e d r i n k e r s . A d d i c t i v e B e h a v i o r s , 3 8 ( 4 ) , 2 0 9 4 - 2 1 0 1 . M a r t i n e z , J . A . , S h e r , K . J . , & W o o d , P . K . ( 2 0 0 8 ) . I s h e a v y d r i n k i n g r e a l l y a s s o c i a t e d w i t h a t t r i t i o n f r o m c o l l e g e ? T h e a l c o h o l -

a t t r i t i o n p a r a d o x . P s y c h o l o g y o f A d d i c t i v e B e h a v i o r s , 2 2 ( 3 ) , 4 5 0 - 4 5 6 . M e i e r , M . H . , C a s p i , A . , A m b l e r , A . , H a r r i n g t o n , H . , H o u t s , R . , K e e f e , R . S . E . , M c D o n a l d , K . , W a r d , A . , P o u l t o n , R . , & M o f f i t t , T . E .

( 2 0 1 2 ) . P e r s i s t e n t c a n n a b i s u s e r s s h o w n e u r o p s y c h o l o g i c a l d e c l i n e f r o m c h i l d h o o d t o m i d l i f e . P r o c e e d i n g s o f t h e N a t i o n a l A c a d e m y o f S c i e n c e s , 1 0 9 ( 4 0 ) , E 2 6 5 7 - 2 6 6 4 .

M e z q u i t a , L . , S t e w a r t , S . H . , & R u i p é r e z , Á . ( 2 0 1 0 ) . B i g - f i v e p e r s o n a l i t y d o m a i n s p r e d i c t i n t e r n a l d r i n k i n g m o t i v e s i n y o u n g a d u l t s . P e r s o n a l i t y a n d I n d i v i d u a l D i f f e r e n c e s , 4 9 ( 3 ) , 2 4 0 - 2 4 5 .

N a t i o n a l C e n t e r f o r E d u c a t i o n S t a t i s t i c s . ( 2 0 1 2 ) . I n t e g r a t e d p o s t s e c o n d a r y e d u c a t i o n d a t a s y s t e m . R e t r i e v e d J a n u a r y 1 7 , 2 0 1 2 , f r o m h t t p : / / n c e s . e d . g o v / i p e d s /

N a t i o n a l C e n t e r f o r P u b l i c P o l i c y a n d H i g h e r E d u c a t i o n . ( 2 0 0 8 ) . M e a s u r i n g u p 2 0 0 8 : T h e n a t i o n a l r e p o r t c a r d o n h i g h e r e d u c a t i o n . S a n J o s e , C A : N a t i o n a l C e n t e r f o r P u b l i c P o l i c y a n d H i g h e r E d u c a t i o n .

N a t i o n a l I n s t i t u t e o n A l c o h o l A b u s e a n d A l c o h o l i s m . ( 2 0 1 2 ) . F a c t s h e e t : C o l l e g e d r i n k i n g . B e t h e s d a , M D : N a t i o n a l I n s t i t u t e o n A l c o h o l A b u s e a n d A l c o h o l i s m .

N e l s o n , T . F . , T o o m e y , T . L . , L e n k , K . M . , E r i c k s o n , D . J . , & W i n t e r s , K . C . ( 2 0 1 0 ) . I m p l e m e n t a t i o n o f N I A A A C o l l e g e D r i n k i n g T a s k F o r c e r e c o m m e n d a t i o n s : H o w a r e c o l l e g e s d o i n g 6 y e a r s l a t e r ? A l c o h o l i s m : C l i n i c a l a n d E x p e r i m e n t a l R e s e a r c h , 3 4 ( 1 0 ) , 1 6 8 7 - 1 6 9 3 .

P a s c a r e l l a , E . T . , T a g l i a p i e t r a - N i c o l i , G . , G o o d m a n , K . M . , P a r k , S . , S e i f e r t , T . A . , & W h i t t , E . J . ( 2 0 0 7 ) . C o l l e g e s t u d e n t b i n g e d r i n k i n g a n d a c a d e m i c a c h i e v e m e n t : A l o n g i t u d i n a l r e p l i c a t i o n a n d e x t e n s i o n . J o u r n a l o f C o l l e g e S t u d e n t D e v e l o p m e n t , 4 8 ( 6 ) , 7 1 5 - 7 2 7 .

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http://www.thecommunityguide.org/alcohol/lawsprohibitingsales.html

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P i n c h e v s k y , G . M . , A r r i a , A . M . , C a l d e i r a , K . M . , G a r n i e r - D y k s t r a , L . M . , V i n c e n t , K . B . , & O ' G r a d y , K . E . ( 2 0 1 2 ) . M a r i j u a n a e x p o s u r e o p p o r t u n i t y a n d i n i t i a t i o n d u r i n g c o l l e g e : P a r e n t a n d p e e r i n f l u e n c e s . P r e v e n t i o n S c i e n c e , 1 3 ( 1 ) , 4 3 - 5 4 .

P o p e , H . G . , J r . , G r u b e r , A . J . , H u d s o n , J . I . , C o h a n e , G . , H u e s t i s , M . A . , & Y u r g e l u n - T o d d , D . ( 2 0 0 3 ) . E a r l y - o n s e t c a n n a b i s u s e a n d c o g n i t i v e d e f i c i t s : W h a t i s t h e n a t u r e o f t h e a s s o c i a t i o n ? D r u g a n d A l c o h o l D e p e n d e n c e , 6 9 ( 3 ) , 3 0 3 - 3 1 0 .

R o s a n d e r , P . , B a c k s t r o m , M . , & S t e n b e r g , G . ( 2 0 1 1 ) . P e r s o n a l i t y t r a i t s a n d g e n e r a l i n t e l l i g e n c e a s p r e d i c t o r s o f a c a d e m i c p e r f o r m a n c e : A s t r u c t u r a l e q u a t i o n m o d e l l i n g a p p r o a c h . L e a r n i n g a n d I n d i v i d u a l D i f f e r e n c e s , 2 1 ( 5 ) , 5 9 0 - 5 9 6 .

S c h u l e n b e r g , J . , O ' M a l l e y , P . M . , B a c h m a n , J . G . , W a d s w o r t h , K . N . , & J o h n s t o n , L . D . ( 1 9 9 6 ) . G e t t i n g d r u n k a n d g r o w i n g u p : T r a j e c t o r i e s o f f r e q u e n t b i n g e d r i n k i n g d u r i n g t h e t r a n s i t i o n t o y o u n g a d u l t h o o d . J o u r n a l o f S t u d i e s o n A l c o h o l , 5 7 ( 3 ) , 2 8 9 - 3 0 4 .

S c r i b n e r , R . , M a s o n , K . , T h e a l l , K . , S i m o n s e n , N . , S c h n e i d e r , S . K . , T o w v i m , L . G . , & d e J o n g , W . ( 2 0 0 8 ) . T h e c o n t e x t u a l r o l e o f a l c o h o l o u t l e t d e n s i t y i n c o l l e g e d r i n k i n g . J o u r n a l o f S t u d i e s o n A l c o h o l & D r u g s , 6 9 ( 1 ) , 1 1 2 - 1 2 0 .

S c r i b n e r , R . A . , T h e a l l , K . P . , M a s o n , K . , S i m o n s e n , N . , S c h n e i d e r , S . K . , T o w v i m , L . G . , & D e j o n g , W . ( 2 0 1 1 ) . A l c o h o l p r e v e n t i o n o n c o l l e g e c a m p u s e s : T h e m o d e r a t i n g e f f e c t o f t h e a l c o h o l e n v i r o n m e n t o n t h e e f f e c t i v e n e s s o f s o c i a l n o r m s m a r k e t i n g c a m p a i g n s . J o u r n a l o f S t u d i e s o n A l c o h o l & D r u g s , 7 2 ( 2 ) , 2 3 2 - 2 3 9 .

S i n g l e t o n , R . A . , & W o l f s o n , A . R . ( 2 0 0 9 ) . A l c o h o l c o n s u m p t i o n , s l e e p , a n d a c a d e m i c p e r f o r m a n c e a m o n g c o l l e g e s t u d e n t s . J o u r n a l o f S t u d i e s o n A l c o h o l & D r u g s , 7 0 ( 3 ) , 3 5 5 - 3 6 3 .

S o l o w i j , N . , J o n e s , K . , R o z m a n , M . , D a v i s , S . , C i a r r o c h i , J . , H e a v e n , P . L . , L u b m a n , D . , & Y ü c e l , M . ( 2 0 1 1 ) . V e r b a l l e a r n i n g a n d m e m o r y i n a d o l e s c e n t c a n n a b i s u s e r s , a l c o h o l u s e r s a n d n o n - u s e r s . P s y c h o p h a r m a c o l o g y , 2 1 6 ( 1 ) , 1 3 1 - 1 4 4 .

S o l o w i j , N . , S t e p h e n s , R . S . , R o f f m a n , R . A . , B a b o r , T . , K a d d e n , R . , M i l l e r , M . , C h r i s t i a n s e n , K . , M c R e e , B . , & V e n d e t t i , J . ( 2 0 0 2 ) . C o g n i t i v e f u n c t i o n i n g o f l o n g - t e r m h e a v y c a n n a b i s u s e r s s e e k i n g t r e a t m e n t . J o u r n a l o f t h e A m e r i c a n M e d i c a l A s s o c i a t i o n , 2 8 7 ( 9 ) , 1 1 2 3 - 1 1 3 1 .

T a k a g i , M . , Y u c e l , M . , C o t t o n , S . M . , B a l i z , Y . , T u c k e r , A . , E l k i n s , K . , & L u b m a n , D . I . ( 2 0 1 1 ) . V e r b a l m e m o r y , l e a r n i n g , a n d e x e c u t i v e f u n c t i o n i n g a m o n g a d o l e s c e n t i n h a l a n t a n d c a n n a b i s u s e r s . J o u r n a l o f S t u d i e s o n A l c o h o l a n d D r u g s , 7 2 ( 1 ) , 9 6 - 1 0 5 .

T h e T a s k F o r c e o n C o m m u n i t y P r e v e n t a t i v e S e r v i c e s . ( 2 0 0 9 ) . R e c o m m e n d a t i o n s f o r r e d u c i n g e x c e s s i v e a l c o h o l c o n s u m p t i o n a n d a l c o h o l - r e l a t e d h a r m s b y l i m i t i n g a l c o h o l o u t l e t d e n s i t y . A m e r i c a n J o u r n a l o f P r e v e n t i v e M e d i c i n e , 3 7 ( 6 ) , 5 7 0 - 5 7 1 .

T h o m p s o n , K . M . ( 2 0 0 7 ) . A l c o h o l - r e l a t e d l e g a l i n f r a c t i o n s a n d s t u d e n t r e t e n t i o n . J o u r n a l o f S t u d i e s o n A l c o h o l a n d D r u g s , 6 8 ( 5 ) , 6 8 9 - 6 9 6 .

W e i t z m a n , E . R . ( 2 0 0 4 ) . P o o r m e n t a l h e a l t h , d e p r e s s i o n , a n d a s s o c i a t i o n s w i t h a l c o h o l c o n s u m p t i o n , h a r m , a n d a b u s e i n a n a t i o n a l s a m p l e o f y o u n g a d u l t s i n c o l l e g e . J o u r n a l o f N e r v o u s a n d M e n t a l D i s e a s e , 1 9 2 ( 4 ) , 2 6 9 - 2 7 7 .

W i l l i a m s , J . , P o w e l l , L . M . , & W e c h s l e r , H . ( 2 0 0 3 ) . D o e s a l c o h o l c o n s u m p t i o n r e d u c e h u m a n c a p i t a l a c c u m u l a t i o n ? E v i d e n c e f r o m t h e C o l l e g e A l c o h o l S t u d y . A p p l i e d E c o n o m i c s , 3 5 ( 1 0 ) , 1 2 2 7 - 1 2 3 9 .

W o l a v e r , A . M . ( 2 0 0 2 ) . E f f e c t s o f h e a v y d r i n k i n g i n c o l l e g e o n s t u d y e f f o r t , g r a d e p o i n t a v e r a g e , a n d m a j o r c h o i c e . C o n t e m p o r a r y E c o n o m i c P o l i c y , 2 0 ( 4 ) , 4 1 5 - 4 2 8 .

Z e i g l e r , D . W . , W a n g , C . C . , Y o a s t , R . A . , D i c k i n s o n , B . D . , M c C a f f r e e , M . A . , R o b i n o w i t z , C . B . , & S t e r l i n g , M . L . ( 2 0 0 5 ) . T h e n e u r o c o g n i t i v e e f f e c t s o f a l c o h o l o n a d o l e s c e n t s a n d c o l l e g e s t u d e n t s . P r e v e n t i v e M e d i c i n e , 4 0 ( 1 ) , 2 3 - 3 2 .

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HE ACADEMIC OPPORTUNITY COSTS OF … Coalition Substance Abuse Prevention Conference . Spokane, WA ....

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