Co-use Of Alcohol Research Articles

Dyadic cannabis use, alcohol use and relationship satisfaction: A daily diary study

ObjectiveIntimate relationships are important contexts for understanding individuals’ substance use patterns and trajectories. Using a dyadic daily diary design reporting over 14 consecutive days, the present study examined the association between cannabis use, alcohol use, and momentary relationship satisfaction among adult couples MethodEligible individuals on Prolific were invited to participate. We identified 33 couples where both partners participated. Participants completed a baseline survey and a 14-day daily diary study assessing their daily cannabis use, alcohol use, and relationship satisfaction. Multilevel modeling was used, within an Actor-Partner Interdependence Model (APIM), to evaluate the individual and interactive effects of one’s own use and their partner’s use on relationship satisfaction ResultsSignificant actor and partner effects of alcohol and cannabis use were found using both baseline and daily report data. For individuals who use cannabis more heavily among sampled couples, cannabis and alcohol co-use was associated with reduction in their own next-day relationship satisfaction while alcohol-only use was significantly associated with increased next-day satisfaction. There were no significant effects of one’s own or their partner’s effects for individuals who use cannabis more lightly. ConclusionsFindings replicate and extend prior research by demonstrating the dynamic nature of dyadic substance use and highlighting the unique impact of alcohol and cannabis co-use on daily relationship functioning.

An Early Exploration into Individuals in Treatment Who Co-Use Alcohol and Hallucinogens

There is renewed interest in the therapeutic properties of hallucinogens in the treatment of psychiatric disorders including alcohol use disorder (AUD). Interestingly, however, there is little data regarding the comorbid use of hallucinogens and alcohol among persons with AUD. The paucity of such data constrains both scientific interpretation and treatment development. This analysis, which utilizes data collected from individuals seeking treatment in facilities across North Central Florida, aims to address this gap by examining the use of hallucinogens among individuals seeking treatment for problems with alcohol. Further, by focusing on use patterns among those who report recent and regular use of both alcohol and hallucinogens, this analysis describes correlates with potential clinical utility. Analyses revealed that recent and regular users of hallucinogens and alcohol were significantly younger than those in treatment who did not use hallucinogens (p <0.001). Additionally, treatment seekers who reported regular use experienced more negative life consequences than those who were not regular users (p <0.01). Results suggest that trends in age and drug consequences may contain valuable information to inform treatment modalities, risk prevention strategies, and general scientific knowledge with the help of future investigations.

Alcohol and cannabis co-use: Probing subjective response in eliciting cross-substance craving

The co-use of alcohol and cannabis is rising in prevalence, yet the mechanisms driving individuals to co-use are not well understood. Subjective response to alcohol or cannabis may predict the desire to use either substance. However, which specific facets of subjective response predict cross-substance craving remains unclear. The present study investigated whether acute administration of alcohol or cannabis facilitates cue-induced craving for the other substance, with an emphasis on the underlying subjective response mechanisms contributing to co-use. This is a secondary analysis of a behavioral pharmacology study that combined alcohol/cannabis administration with a cross-substance cue-reactivity paradigm in individuals who were heavy alcohol and heavy cannabis co-users. Over two sessions, twenty-nine individuals (17M/12F) self-administered alcohol or cannabis (in a crossover design), and then completed a cue-reactivity exercise with the other substance. Analyses tested how changes in subjective response variables following substance administration predicted cross-substance cue-induced craving. Following alcohol administration, greater subjective ratings of positive mood predicted significantly greater cue-induced cannabis craving (β = 1.14, SE = 0.41, t = 2.80, p = 0.010). Following cannabis administration, lower subjective effects ratings of positive mood/arousal predicted significantly greater cue-induced alcohol craving (β = −1.08, SE = 0.38, t = −2.85, p = 0.009; β = −2.38, SE = 1.13, t = −2.10, p = 0.047). This study identified subject response mechanisms contributing to cross-substance cue induced craving. These mechanisms include increases in positive mood following alcohol use and decreases in positive mood and arousal, akin to increases in relaxation, following cannabis use.

Bidirectional associations between sleep and cannabis and alcohol (co-)use in daily life.

Poor sleep is common in the context of cannabis use, but experimental and daily-life studies provide mixed evidence for whether cannabis use helps or disturbs same-night sleep. Despite a high prevalence of co-use of alcohol and cannabis, most studies of cannabis use and sleep do not consider alcohol use. We sought to add to this literature by examining associations between cannabis and sleep in the context of alcohol co-use and to examine these associations bidirectionally using ecological momentary assessment. Participants were 88 adults reporting cannabis use at least 3×/week and simultaneous alcohol and cannabis use at least 2×/week. For 14 days, participants completed morning surveys assessing hours slept and perceived sleep quality from the night before. In morning surveys, random surveys, and substance-specific surveys, participants also reported on alcohol and cannabis craving, use, and amounts. Primary results from multilevel models demonstrated that cannabis use was not independently associated with sleep (duration or quality). However, cannabis use attenuated alcohol's negative effects on sleep quality. Results question the utility of cannabis use to improve sleep but highlight the attenuated negative effects of alcohol as a potential reinforcer of alcohol-cannabis co-use. Future work should continue to consider polysubstance use and integrate additional self-report and objective measures of sleep health to further clarify how cannabis use affects sleep.

The effects of moderate alcohol and THC co-use during male and female rat adolescence on AKT-GSK3ß signaling in adulthood

Alcohol and cannabis are often taken in combination, and extensive co-use has been linked to enduring changes in cognitive and metabolic functioning. The underlying mechanisms for these effects are unclear, but we recently demonstrated that co-administration of ethanol and delta-9-tetrahydrocannbinol (THC) to adolescent rats caused lasting adaptations in GABA and glycogen synthase kinase 3ß (GSK3ß) signaling in the medial prefrontal cortex (mPFC). As a ubiquitous protein kinase, GSK3ß is downstream to the protein kinase B (also known as AKT) pathway that is activated by insulin receptor signaling in a main control center for metabolism and energy homeostasis, the mediobasal hypothalamus (MBH). Our goal here was to investigate if volitional co-use of low to moderate levels of ethanol and THC would impact the total and phosphorylated levels (p) of AKT and GSK3ß in the mPFC and MBH. Peri-adolescent Long Evans rats [postnatal day (P) 30–47] consumed 10 % ethanol, cookies laced with THC (3–10 mg/kg/day), both drugs, or vehicle controls. On P114, we modeled re-exposure to a behaviorally relevant dose of THC by challenging rats (i.p.) with 5 mg/kg THC (or vehicle) and sacrificed them 30 min later. Western blot analysis revealed that THC challenge increased pAKT and pGSK3ß compared to control similarly across all treatment groups, sexes, and brain regions; no effects on total levels of AKT or GSK3ß were found. Previously reported behavioral results from these rats showed no differences in working memory assessed in adulthood. Although future studies will be necessary to determine the role of exposure dose on drug-induced adaptations in AKT and GSK3ß signaling, the current findings suggest that moderate volitional co-use of alcohol and THC may not produce long-term deficits that persist into adulthood.

The psychedelic drug DOI reduces heroin motivation by targeting 5-HT2A receptors in a heroin and alcohol co-use model

There has been a recent renewed interest in the potential use of psychedelic drugs as therapeutics for certain neuropsychiatric disorders, including substance use disorders. The psychedelic drug 2,5-dimethoxy-4-iodoamphetamine (DOI) has demonstrated therapeutic efficacy in preclinical models of opioid use disorder (OUD). Alcohol is commonly co-used in individuals with OUD, but preclinical models that recapitulate this comorbidity are lacking. We developed a polydrug model wherein male and female rats were allowed to self-administer intravenous heroin and oral alcohol (or saccharin control solution) over weeks of behavioral training, and then we conducted a series of progressive ratio tests to assess the animals' motivational state for heroin and alcohol. In this model, motivation for heroin is higher than alcohol, and DOI (0.4 mg/kg) administered prior to testing significantly reduced heroin motivation measured as the animals’ break point, or maximum effort the animal is willing to expend to obtain a single infusion of heroin. The 5-HT2A receptor antagonist MDL 100,907 (0.3 mg/kg), but not the 5-HT2C receptor antagonist SB-242084 (0.5 mg/kg), blocked the therapeutic effect of DOI on heroin motivation. No significant effects on alcohol break points were observed, nor did MDL 100,907 or SB-242084 have any effect on break points on their own. These data support the view that psychedelic drugs like DOI may have therapeutic effects on opioid use in individuals with OUD and comorbid alcohol use, by acting as a 5-HT2A receptor agonist.

Alcohol and cannabis use in daily lives of college-attending young adults: Does co-use correspond to greater reported pleasure?

Co-use of alcohol and cannabis is prevalent and linked with heightened risk for substance-related harms. The current study investigated the role of substance-related pleasure as a reinforcing factor for co-use relative to alcohol or cannabis use. Specifically, we used data from a 21-day diary study of college students to examine day-level associations between co-use and self-reported substance-related pleasure (any, level of pleasure). Participants were 237 college students (65 % female sex at birth, ages 18–24) who reported 1+ alcohol and cannabis co-use occasion. Participants completed daily surveys across 21 consecutive days about yesterday’s substance use and experiences of pleasure, yielding 2,086 daily surveys involving alcohol and/or cannabis use. Multilevel models indicated that odds of substance-related pleasure were higher on days with co-use relative to days with single-substance use, and level of pleasure was higher on co-use days relative to cannabis but not alcohol use days. Pleasure may serve as a reinforcing property of co-use that may be related to continued use despite experience of negative consequences. Intensity of pleasure related to co-use appears to be largely driven by use of alcohol. However, given mixed findings concerning level of pleasure, individuals may report co-use increases feelings of pleasure but do not actually experience more pleasure. Pleasure may serve as a viable target in future prevention and intervention programming targeting co-use.

A novel alcohol+nicotine co-use self-administration procedure reveals sex differences and differential alteration of mesocorticolimbic TLR- and cholinergic-related neuroimmune gene expression in rats

Although alcohol and nicotine are two of the most commonly co-used drugs with upwards of 90% of adults with an alcohol use disorder (AUD) in the US also smoking, we don't tend to study alcohol and nicotine use this way. The current studies sought to develop and assess a novel alcohol + nicotine co-access self-administration (SA) model in adult male and female Long-Evans rats. Further, both drugs are implicated in neuroimmune function, albeit in largely opposing ways. Chronic alcohol use increases neuroinflammation via toll-like receptors (TLRs) which in turn increases alcohol intake. By contrast, nicotine produces anti-inflammatory effects, in part, through the monomeric alpha7 receptor (ChRNa7). Following long-term co-access (6 months), rats reliably administered both drugs during daily sessions, however males generally responded for more alcohol and females for nicotine. This was reflected in plasma analysis with translationally relevant intake levels of both alcohol and nicotine, making it invaluable in studying the effects of co-use on behavior and CNS function. Moreover, male rats show sensitivity to alterations in alcohol concentration whereas females show sensitivity to alterations in nicotine concentration. Rats trained on this procedure also developed an anxiogenic phenotype. Finally, we assessed alterations in neuroimmune-related gene expression in the medial prefrontal cortex – prelimbic, (mPFC-PL), nucleus accumbens core (AcbC), and ventral tegmental area (VTA). In the AcbC, where α7 expression was increased and β2 was decreased, markers of pro-inflammatory activity were decreased, despite increases in TLR gene expression suggesting that co-use with nicotine modulates inflammatory state downstream from the receptor level. By contrast, in mPFC-PL where α7 was not increased, both TLRs and downstream proinflammatory markers were increased. Taken together, these findings support that there are brain regional and sex differences with co-use of alcohol + nicotine SA and suggest that targeting nicotinic α7 may represent a novel strategy for treating alcohol + nicotine co-dependence.

Messages About Tobacco and Alcohol Co-users.

People who use both alcohol and combustible tobacco have an increased risk of developing cancer. Few interventions have been developed to inform people about the risks of co-use. This study developed and tested messages about the risks of alcohol and combustible tobacco co-use among adults. In June-July 2021, we surveyed 1,300 U.S. adults who used both alcohol and combustible tobacco products within the past 30 days. After reporting their awareness of diseases caused by tobacco and alcohol co-use, participants were randomly assigned to four between-subjects experiments that manipulated specific cancer health effects vs. the word "cancer"; cancer health effects vs. noncancer health effects; different descriptions of co-use (e.g., Using alcohol and tobacco…, Drinking alcohol and smoking tobacco…); and co-use vs. single-use messages. Participants saw one message for each experiment and rated each message using a validated perceived message effectiveness (PME) scale. Awareness of health effects caused by alcohol and tobacco co-use ranged from moderately high for throat cancer (65.4%) to moderately low for colorectal cancer (23.1%). Messages about cancer health effects increased PME more than messages about non-cancer health effects (B=0.18, p=0.01). Messages about some specific cancers-including oral cancer (B=-0.20, p=0.04) and colorectal cancer (B=-0.22, p=0.02) decreased PME more than messages with only the word "cancer." No significant differences were identified for descriptions of co-use or co-use vs. single-use messages. Messages about some cancer health effects of co-using alcohol and tobacco may be effective when communicating the harms of both drinking alcohol and using tobacco.

Tobacco and alcohol co-use among people with HIV (PWH) in Nairobi, Kenya

Introduction. Although the majority of PWH in the world reside in sub-Saharan Africa, little is known about the syndemic of tobacco and alcohol use in that region. The purpose of this study was to describe tobacco and alcohol co-use behaviors among PWH in Nairobi, Kenya. Methods. Between June–November 2021, 50 PWH with concurrent tobacco and alcohol use in Nairobi, Kenya were cross-sectionally assessed with a structured interview. Women were intentionally oversampled in order to constitute 50% of the participant group. Participants completed structured interviews by trained research assistants using standardized, culturally appropriate, tobacco use and alcohol use questionnaires. Results. Fifty PWH completed the study. All participants identified as African with a mean age of 40.3 years. Half of the sample were men, half were women, and all participants were engaged in HIV care and were receiving antiretroviral therapy (ART). Mean cigarettes smoked per day was 8.2, and 57% percent reported moderate/high cigarette dependence. The mean alcohol use disorder identification test (AUDIT) score was 18.6, and 84% reported drinking amounts in the hazardous range. Preferred alcoholic beverages were clear spirits (48%), beer (32%), and changaa (12%), a traditional home-brewed liquor made from millet, corn, or sorghum. Younger age, higher depression score, and higher anxiety score were significantly associated with higher AUDIT scores. Conclusions. Tobacco and alcohol co-use in PWH in Nairobi, Kenya is common. This syndemic may require culturally appropriate and tailored treatment approaches, especially those targeting younger health strata and those with comorbid mental illness, to improve health outcomes.

Youthful Choices: A Secondary Analysis of the NFHS-5 Data to Examine Tobacco Use in Indian Adolescent Girls and Young Women

Background and aim: Tobacco use among adolescents and young women is a global health concern. This study investigates the prevalence and determinants of tobacco use among adolescents and young women in India. Methods: Based on data from the National Family Health Survey-5, this study explored tobacco use among 241,180 young women aged 15–24 in India. The research investigated determinants of current tobacco use, encompassing any tobacco use in any form, smoked and smokeless tobacco (SLT). Independent variables include demographics, religion, caste, region, education, occupation, body mass index, wealth index, alcohol consumption, and media exposure. We used multivariable logistic regression models to estimate the adjusted odds ratio (OR) and 95% confidence intervals (95%CI). Results: Findings revealed that 1.3% of the population are current tobacco users, with 1.2% using SLT and 0.14% smoking. Significant determinants included age, urban residence, religion, scheduled tribe status, wealth index, education, alcohol co-use, region, and pregnancy/lactation status. Young women (young women, 3.5% > adolescents, 1.5%; OR 1.78, 95%CI 1.65, 1.92), urban dwellers (OR 1.38, 95%CI 1.32, 1.43), and alcohol users (OR 5.6, 95%CI 4.88, 6.33) exhibited higher odds of tobacco use. In contrast, education (higher education OR 0.15, 95%CI 0.13, 0.18) and higher socioeconomic status (richest OR 0.3, 95%CI 0.22, 0.31) were protective factors. Conclusion: Our research offered valuable insights into tobacco use among young Indian women. To effectively curb tobacco use in this population, it is imperative to address the identified determinants and vulnerabilities through tailored public health strategies and policies.

Individual Differences in Substance Use Motives, Trauma, and Stress Among College-Based Polysubstance Users

Background : Co-use of alcohol and other drugs within a certain time frame (i.e., polysubstance use) has become increasingly prevalent, particularly among college-aged individuals, but understanding motives for co-use remains limited. Polysubstance use has been associated with a higher likelihood of negative health consequences as compared to single substance use. Objectives : The current study examined associations between motivations for using alcohol, tobacco, and cannabis among college students who use multiple substances versus students using only one substance or no substances. Additionally, we examined the effect of trauma and daily stress on polysubstance use in self-report data from individuals (N=134) participating in the MAPme Study. Results : First, the observed prevalence of polysubstance use was greater than expected by chance, with most individuals co-using alcohol and cannabis. “Alcohol and Other Drug Users” were more frequently motivated to drink for social (β=0.27, CI=[0.07, 0.44]), enhancement (β=0.26, CI=[0.01, 0.42]) and coping (β=0.21, CI=[0.06, 0.47]) reasons compared to individuals who consumed alcohol alone. Conclusions : Individual differences in motivations for use were partly explained by frequency of alcohol use and alcohol problem severity, but not by history of trauma or stress. Finally, while patterns of correlations among motivations for use across substances suggested a general tendency to be motivated to use substances for similar reasons, this was not supported by confirmatory factor models. Overall, shared motives may inform potential behavioral patterns for co-use of substances during college and might advise future treatment efforts.

Gender Differences in the Co-Use of Tranquilizers, Sedatives, Sleeping Pills and Alcohol among Spanish Adolescents: A Nationwide Population-Based Study.

Adolescence is a critical developmental stage for the initiation of substance use worldwide, which is one of the main risk-taking behaviors that may impact adolescents' physical and mental well-being. The aims of this study were to (1) assess the prevalence of the co-use of tranquilizers, sedatives, and sleeping pills with alcohol (TSSp&AC) by gender in the Spanish adolescent population in 2018 and (2) identify the variables associated with TSSp&AC. An observational cross-sectional study following STROBE guidelines was conducted. We analyzed data from 38,010 adolescents aged 14 to 18 years old (18,579 males and 19,431 females) who participated in ESTUDES (Survey on Drug Use in Secondary Education in Spain) 2018. Female adolescents reported a higher prevalence of TSSp&AC than males (p < 0.001). The factors associated with female co-use were being 16-18 years of age (OR 1.65); the consumption of tobacco (OR 1.73), cocaine (OR 1.84), other illicit psychoactive drugs (OR 1.89); and novel illicit psychoactive drugs (OR 1.74); no perceived health risk from the consumption of TSSps (OR 2.45); and the perceived availability of TSSps (OR 2.23) and alcohol (OR 2.09). There are several factors associated with TSSp&AC in Spanish female adolescents with potential implications for healthcare providers.

Quantity of cigarettes smoked when co-used with alcohol and cannabis: Consideration of different definitions of co-use based on daily diary data

IntroductionCigarettes are frequently co-used with alcohol and cannabis. However, definitions of co-use vary and the extent to which cigarette use changes on days with different patterns of co-use is unclear. We compared the number of cigarettes smoked on different days based on co-use patterns of cigarettes and alcohol or cannabis. MethodsThis study analyzed 2408 smoking days collected in a 30-day smartphone-based daily diary study among 146 young adults (aged 18–26) with an oversample from sexual minority groups. Two separate multilevel models were estimated: one for cigarette and alcohol co-use and the other for cigarette and cannabis co-use. Both models examined day-level associations between the number of cigarettes smoked and 3 different types of days (smoking-only days, same-occasion co-use days, different-occasion co-use days), controlling for demographic characteristics. ResultsMore cigarettes were smoked on same-occasion co-use days compared to cigarette-smoking-only days for both alcohol (b=1.474, SE=0.136, t=10.8, p<.001) and cannabis (b=0.822, SE=0.209, t=3.9, p<.001). There were no significant differences in cigarettes smoked on days with co-use on the same day, but on different occasions, compared to days with smoking only. ConclusionsCompared to days with cigarette smoking only, more cigarettes are smoked on days when cigarettes are co-used with alcohol or cannabis on the same occasion, while the same is not true for days with co-use on different occasions. Conflating different definitions of co-use may impact findings on associations between co-use and smoking behavior.

Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine-A Systematic Review.

Background: The simultaneous use of cocaine and alcohol is highly prevalent and is associated with high numbers of emergency department admissions, primarily due to cardiovascular complications. Aims: To answer the question of whether the co-use of cocaine and alcohol increases the cardiovascular risk compared to the use of cocaine alone. Method: A systematic review of human studies comparing the cardiovascular risk of co-used cocaine and alcohol with the use of cocaine alone. Results: Despite a higher myocardial workload induced by the co-use of cocaine and alcohol and the potentiation of cocaine's cardiovascular effects by alcohol, the findings on the risk and severity of cardiovascular symptoms due to combined use are inconsistent. However, the co-use of cocaine and alcohol clearly leads to higher mortality. Interestingly, the presence of cocaethylene, a unique metabolite generated only via a pharmacokinetic interaction between alcohol and cocaine, carries an 18- to 25-fold increase over the absence of cocaethylene (cocaine-alone users) in the risk of sudden death and is associated with myocardial injury and cardiac arrest, probably due to the inhibition of cardiac ion channels by cocaethylene. Conclusion: Despite the inconsistency in some of the results, it is concluded that the co-use of cocaine and alcohol poses an additional risk of cardiovascular fatalities compared to the use of cocaine alone.

Daily Stress, Drinking Motives and Alcohol Co-Use with Other Drugs

Background: Recent evidence indicates that alcohol and other substance co-use, compared to alcohol-only use, might be more closely associated with negative reinforcement processes, and thus more likely during periods of increased stress. The present study examined this possibility by using data from an intensive longitudinal (daily) study of college student drinkers (N = 1461, 54% women). We also examined individual differences in coping and enhancement drinking motives as predictors of alcohol and other substance co-use. Results: We used multilevel multinomial logistic regression to predict, relative to alcohol-only days, the likelihood of alcohol co-use with either cigarettes or marijuana, along with alcohol use with multiple substances and other substance-only use from daily interpersonal and academic stress, day-of-the-week, sex, and individual differences in coping and enhancement drinking motives. We found that, relative to alcohol-only, alcohol and marijuana co-use was more likely, and non-alcohol related substance use was less likely, on weekends. Alcohol and marijuana co-use was less likely, and other substance-only use was more likely, on days characterized by greater academic stress, whereas alcohol and cigarette co-use was more likely on days characterized by greater interpersonal stress. Individuals with higher levels of drinking to cope motivation were more likely to engage in alcohol and cigarette co-use, other substance-only use, and alcohol plus multiple substances, relative to alcohol-only. Individuals with higher levels of enhancement motives were more likely to engage in all types of alcohol and other substance co-use and other substance-only use relative to alcohol-only. Conclusions: Findings are discussed in terms of the complex nature of different patterns of co-use patterns when evaluating indicators of positive- and negative-reinforcement processes.

Use and co-use of alcohol and cannabis following physical pain in the daily life of community adults engaged in regular substance use.

Alcohol and cannabis are often perceived as pain-relieving. However, minimal work has examined whether people use and co-use these substances following pain in daily life. Forty-six adults reporting weekly use of alcohol and/or cannabis completed a 60-day ecological momentary assessment protocol, answering at least four daily reports on their alcohol and cannabis use and pain (nassessments = 10,769 over 2,656 days). We examined whether self-reported pain so far that day (cumulative-average pain) was associated with subsequent alcohol and cannabis use and same-occasion co-use. Models also addressed whether associations differed for initiating versus continuing a use episode. Hypotheses were preregistered. A multinomial multilevel model found that cumulative-average pain was associated with a greater likelihood of same-occasion co-use in the continuation phase but not the initiation phase, compared to no use (OR = 1.48,95% CI [1.06, 2.06], p = .023) and alcohol use (OR = 1.52, CI [1.03, 2.26], p = .037). Cumulative-average pain was largely not associated with alcohol-only and cannabis-only use. After alcohol use, greater pain was associated with cannabis use (OR = 1.37, CI [1.11, 1.70], p = .004), but not the reverse. Secondary analyses found greater previous-occasion (not cumulative) pain was associated with initiation of alcohol use and number of drinks, and initiation and continuation of cannabis use, but not number of cannabis hits. Although not all hypotheses were supported, pain was associated with subsequent substance use in this sample engaged in regular substance use and not recruited for chronic pain. Cumulative pain may be particularly related to alcohol-cannabis same-occasion co-use, which may increase the risk of substance use-related problems over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Use and Co-Use of Alcohol and Cannabis Following Physical Pain in the Daily Life of Community Adults Engaged in Regular Substance Use

Supplemental Material for Use and Co-Use of Alcohol and Cannabis Following Physical Pain in the Daily Life of Community Adults Engaged in Regular Substance Use

How Much THC Is in That Joint? A Daily Diary Study of Young Adults' Knowledge of the Cannabinoid Content of Cannabis Products.

Many young adults report frequent cannabis use and are at risk for cannabis harms. Knowledge of the tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations of cannabis products may promote harm reduction, but few studies have characterized cannabinoid concentration knowledge in this population. This study used day-level data to examine predictors of cannabinoid concentration knowledge and associations of cannabinoid concentration knowledge with substance-related consequences among young adults. Participants (n = 131; mean age = 22.11 years; 64.12% female) from a larger study of cannabis and alcohol co-use completed daily surveys over 21 days assessing knowledge of the cannabinoid concentrations of cannabis used, forms of cannabis used, motives for cannabis use (medicinal, nonmedicinal, both), and substance-related consequences. On average, participants reported at least some knowledge of the THC and CBD concentrations of their cannabis on 48% and 32% of their cannabis use days, respectively. Generalized linear mixed models revealed that participants with a greater propensity to use nonflower (relative to flower) cannabis products and to report medicinal (relative to exclusively nonmedicinal) motives for cannabis use reported greater cannabinoid concentration knowledge overall across days, controlling for sociodemographic factors and level of cannabis involvement. Participants with greater overall cannabinoid concentration knowledge reported positive substance-related consequences more often. In addition, participants were more likely to report negative substance-related consequences on days during which cannabinoid concentrations were known versus unknown. Findings suggest that cannabinoid concentration knowledge may be higher among young adults who report primarily nonflower and medicinally motivated cannabis use, although cannabinoid concentration knowledge, alone, may not protect against negative substance-related consequences at the day level.

Risk of motor vehicle collision associated with cannabis and alcohol use among patients presenting for emergency care

BackgroundThe objective of this study was to examine the relationship between cannabis and alcohol use and occurrence of motor vehicle collision (MVC) among patients in the emergency department (ED). MethodsThis was a cross-sectional study of visits to EDs in Denver, CO, Portland, OR, and Sacramento, CA by drivers who were involved in MVCs and presented with injuries (cases) and non-injured drivers (controls) who presented for medical care. We obtained blood samples and measured delta-9-THC and its metabolites. Alcohol levels were determined by breathalyzer or samples taken in the course of clinical care. Participants completed a research-assistant-administered interview consisting of questions about drug and alcohol use prior to their visit, context of use, and past-year drug and alcohol use. Multiple logistic regression was used to estimate the association between MVC and cannabis/alcohol use, adjusted for demographic characteristics. We then stratified participants based on levels of cannabis use and calculated the odds of MVC across these levels, first using self-report and then using blood levels for delta-9-THC in separate models. We conducted a case-crossover analysis, using 7-day look-back data to allow each participant to serve as their own control. Sensitivity analyses examined the influence of usual use patterns and driving in a closed (car, truck, van) versus open (motorcycle, motorbike, all-terrain vehicle) vehicle. ResultsCannabis alone was not associated with higher odds of MVC, while acute alcohol use alone, and combined use of alcohol and cannabis were both independently associated with higher odds of MVC. Stratifying by level of self-reported or measured cannabis use, higher levels were not associated with higher odds for MVC, with or without co-use of alcohol; in fact, high self-reported acute cannabis use was associated with lower odds of MVC (odds ratio [OR] 0.18, 95% confidence interval [CI] 0.05–0.65). In the case-crossover analysis, alcohol use alone or in combination with cannabis was associated with higher odds of MVC, while cannabis use alone was again associated with decreased odds of MVC. ConclusionsAlcohol use alone or in conjunction with cannabis was consistently associated with higer odds for MVC. However, the relationship between measured levels of cannabis and MVC was not as clear. Emphasis on actual driving behaviors and clinical signs of intoxication to determine driving under the influence has the strongest rationale.