Department of Psychological Sciences, University of Missouri-St. Louis.
Department of Psychological and Brain Sciences, Washington University in St. Louis.
Psychol Addict Behav. 2024 Nov;38(7):747-758. doi: 10.1037/adb0000992. Epub 2024 Feb 15.
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 ( = 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 ( = 1.48,95% CI [1.06, 2.06], = .023) and alcohol use ( = 1.52, CI [1.03, 2.26], = .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 ( = 1.37, CI [1.11, 1.70], = .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).
酒精和大麻通常被认为具有缓解疼痛的作用。然而，很少有研究关注人们在日常生活中是否会在感到疼痛后使用或同时使用这些物质。
46 名每周至少使用一次酒精和/或大麻的成年人完成了 60 天的生态瞬时评估方案，每天至少回答四次关于他们的酒精和大麻使用情况以及疼痛的报告（在 2656 天内共回答了 10769 次报告）。我们考察了当天迄今为止的自我报告疼痛（累积平均疼痛）是否与随后的酒精和大麻使用以及同一场合的同时使用有关。模型还解决了启动与继续使用一个使用阶段时，关联是否不同的问题。假设已预先注册。
一项多项多层模型研究发现，与不使用（ = 1.48，95%CI[1.06，2.06]， =.023）和酒精使用（ = 1.52，CI[1.03，2.26]， =.037）相比，累积平均疼痛与同一场合的同时使用（ = 1.48，95%CI[1.06，2.06]， =.023）和酒精使用（ = 1.52，CI[1.03，2.26]， =.037）相比，在继续阶段更有可能发生同时使用，而在启动阶段则不然。累积平均疼痛与仅使用酒精和仅使用大麻的情况基本没有关联。在使用酒精之后，更大的疼痛与大麻的使用有关（ = 1.37，CI[1.11，1.70]， =.004），但反之则不然。二次分析发现，前一场合（非累积）的疼痛与酒精使用的启动和饮酒量，以及大麻使用的启动和持续有关，但与大麻摄入量无关。
尽管并非所有假设都得到了支持，但在这个经常使用物质且未招募到慢性疼痛患者的样本中，疼痛与随后的物质使用有关。累积疼痛可能与酒精-大麻同一场合的同时使用特别相关，这可能会随着时间的推移增加与物质使用相关问题的风险。
