Department of Psychiatry, University of Maryland, Baltimore, MD, USA.
Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Drug Alcohol Depend. 2019 Jul 1;200:40-49. doi: 10.1016/j.drugalcdep.2019.02.035. Epub 2019 May 7.
Little is known about event-level patterns of marijuana co- or tri-use with alcohol and tobacco. Thus, the study goal was to examine patterns of same-day alcohol, cigarette, and marijuana co- and tri-use at the individual level in non-treatment-seeking alcohol users.
Participants (N = 551) completed an in-person interview for alcohol, cigarette, and marijuana use over the previous 30 days, and the event-level substance use patterns of n = 179 participants who reported using each of these substances at least once per month were analyzed.
The use of alcohol, marijuana, or cigarettes independently increased the probability of subsequent, simultaneous co-use of one of the two remaining substances. The co-use of alcohol with cigarettes and marijuana with cigarettes produced generally additive effects on the odds of same day tri-use of marijuana and alcohol, respectively. Conversely, the co-use of alcohol and marijuana produced sub-additive effects on likelihood of cigarette use. Sex moderated several of the observed patterns of co- and tri-use: the relationship between alcohol or cigarette use predicting marijuana co-use was stronger in men, whereas the observed additive relationships between drug co-use leading to tri-use was stronger in women.
The presented results may aid in the understanding of how simultaneous co-use of marijuana with alcohol and/or tobacco relates to the etiology, maintenance, and treatment of comorbid and trimorbid substance use disorder. Replication and extension of the results in treatment seeking populations using more fine-grained analysis approaches, e.g. ecological momentary assessment, is needed.
对于大麻与酒精和烟草同时或分别使用的事件水平模式，人们知之甚少。因此，本研究的目的是在非治疗寻求的酒精使用者中，在个体水平上检查同时或分别使用大麻、酒精和香烟的模式。
参与者（N=551）完成了一项关于过去 30 天内酒精、香烟和大麻使用情况的面对面访谈，对报告每月至少使用过一次这些物质的 179 名参与者的事件水平物质使用模式进行了分析。
单独使用酒精、大麻或香烟会增加随后同时使用两种剩余物质之一的可能性。酒精与香烟同时使用，以及大麻与香烟同时使用，分别对大麻和酒精的同一天三用的可能性产生了一般的相加效应。相反，酒精和大麻同时使用对香烟使用的可能性产生了亚相加效应。性别调节了几种同时使用和三用的模式：酒精或香烟使用预测大麻同时使用的关系在男性中更强，而药物同时使用导致三用的观察到的相加关系在女性中更强。
所呈现的结果可能有助于理解大麻与酒精和/或烟草同时使用与共病和三病物质使用障碍的病因、维持和治疗的关系。需要在寻求治疗的人群中使用更精细的分析方法（例如，生态瞬时评估）复制和扩展这些结果。
