Alcohol and marijuana co-use among adults with chronic low back pain: Associations with substance misuse, mental health, and pain experience.

Abstract

Individuals with chronic lower back pain (CLBP) report using alcohol and marijuana to cope with pain. Little research has tested whether co-use is associated with worse psychological outcomes. Participants had CLBP and past-month alcohol/marijuana co-use (n = 192), alcohol use (n = 148), marijuana use (n = 78), or no use (n = 101). Co-use was associated with more drinking-related problems, anxiety, and pain anxiety compared to alcohol-(but not marijuana-) only, whereas marijuana-only use was associated with worse psychological outcomes than alcohol use-only; effect sizes were small to medium. Co-use and marijuana-only were associated with worse outcomes than alcohol-only. The present findings extend current understanding of co-use by finding that marijuana use among people with CLBP (a group with especially high rates of use of these substances) is associated with worse alcohol-related problems and psychological outcomes.