The Role of Impulsivity on Cannabis and Alcohol Use Frequency and Problems Among Frequent Cannabis Users

Abstract

Background: Although the relation between impulsivity and substance use outcomes is well-documented (Jones et al., 2014; Stautz et al., 2017), less is known about individual facets of impulsivity among individuals who use cannabis. There is some research suggesting that positive urgency, sensation seeking, and lack of premeditation are associated with greater cannabis use problems, but much of this research has been conducted in normative adolescent or young adult samples (VanderVeen et al., 2016). Given that more than 11% of legal cannabis users currently use daily/near daily (Goodman et al., 2020), this study examined relations between individual facets of impulsivity and cannabis use, alcohol use, simultaneous cannabis and alcohol use, and problem use within a sample of frequent, adult cannabis users. Methods: Individuals (n=167) with a mean age of 34.89 (SD=11.19) who reported using cannabis on average once per day completed measures of individual facets of impulsivity (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking; UPPS-P), cannabis use frequency, alcohol use frequency, simultaneous cannabis and alcohol use frequency, cannabis use problems, cannabis use disorder, and alcohol use disorder. Path models were used to predict frequency of use (cannabis, alcohol, and simultaneous cannabis/alcohol) and problem use (cannabis consequences, cannabis use disorder, and alcohol use disorder) from each facet of impulsivity. Models were first run using sex, age, and race as covariates, and subsequently run after adding depressive and anxiety symptoms as covariates. Results: After controlling for sex, age, and race, positive urgency was associated with less frequent cannabis use (b=-0.28, S.E.=0.13, p=0.03), more frequent simultaneous cannabis and alcohol use (b= 0.24, S.E.=0.11, p=.04), and greater cannabis consequences (b=0.30, S.E.=0.10, p=0.002). Negative urgency was associated with greater cannabis consequences (b=0.31, S.E.=0.09, p<0.001), cannabis use disorder (b=0.27, S.E.=0.09, p=0.002), and alcohol use disorder (b=0.27, S.E.=0.10, p=0.01). After including depressive and anxiety symptoms as covariates, relations with positive urgency, but not negative urgency, remained significant. Conclusions: The findings of the current study suggest that positive urgency may be uniquely linked to riskier behavior in frequent cannabis users given that no other facet of impulsivity was significantly associated with cannabis use outcomes after all covariates were included in the model. Although not directly assessed in the current study, the findings suggest that relations between negative urgency and cannabis use frequency and cannabis and alcohol use disorder may be mediated by depressive and anxiety symptoms. This possibility should be explicitly examined in future studies. The lack of relations between other facets of impulsivity and alcohol and cannabis use outcomes in the current study suggest that effects of impulsivity among daily users may be restricted to urgency, in contrast to studies in normative adolescent and young adult samples (VanderVeen et al., 2016).