Exploring sensation-seeking and first cannabis use experiences as correlates of current cannabis use problems in young adult cannabis and tobacco co-users.

Abstract

Introduction: Current cannabis use is high in young adults (ages 18-24) and cannabis use disorder (CUD) rates have increased over the last decade. Subjective responses to one’s first use of cannabis may explain continued use, wherein more positive first use experiences influence progression to regular and problematic use. Sensation seeking is associated with cannabis use and may also influence cannabis problem severity. This study examined the relationship between subjective experiences at first cannabis use and sensation seeking on cannabis use behavior and CUD diagnosis. Method: Participants were 97 young adult current cannabis and tobacco co- users (55.7% male, 50.5% White) who completed the baseline survey of a longitudinal study examining daily patterns of tobacco and cannabis use and co-use. Participants completed the 4-item Brief Sensation Seeking Scale and indicated intensity of 15 sensations at first cannabis use (1 = not at all to 5 = intense): dizziness, lightheadedness, nausea, paranoia, confusion, happiness, anxiety, taste, smell, relaxation, energy, difficulty inhaling, coughing or choking, giddiness or laughter, and rush or “buzz.” Cannabis use outcomes included: (1) past 30-day number of days used cannabis; (2) past 30-day cannabis intoxication intensity (1 = not at all high to 10 = extremely high); and (3) likelihood of a CUD (score ≥ 12 on the Cannabis Use Disorder Identification Test- Revised). Analyses: A principal components analysis (PCA) reduced the 15 sensations into factors. Next, separate regression analyses (linear or binary logistic) were conducted to examine the associations of the PCA-derived factors and sensation seeking on the cannabis outcomes, controlling for gender, race, and age at first cannabis use. Results: Over half (61.9%) of the participants met criteria for a CUD. PCA results indicated a 4-factor solution: (1) “positive emotional experiences” (e.g., happy); (2) “negative physical experiences” (e.g., dizzy); (3) “negative emotional experiences” (e.g., paranoia); and (4) “taste and smell.” Regression results indicated greater negative physical experiences were associated with an increased likelihood of a CUD diagnosis (AOR = 1.93, p = .038) and lower average cannabis intoxication (b = -0.343, p = .049). Greater negative emotional experiences at first use were associated with less frequent cannabis use in the past 30 days (b = -2.043, p = .028). Conclusion: Negative emotional experiences associated with first use of cannabis may impede continued use. Negative physical experiences (e.g. nausea, lightheadedness) may be variable in perception, which could explain the inconsistent associations of this factor with CUD diagnosis and past 30-day use. Understanding subjective experiences of first cannabis use could be used as a treatment target by helping patients identify reinforcing sensations associated with their use, and guiding them to sober activities with similar sensations.