Waddell Jack T, Corbin William R, Grimm Kevin J, Metrik Jane, Lee Christine M, Trull Timothy J
Department of Psychology, Arizona State University, Tempe, Arizona, USA.
Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA.
Alcohol Clin Exp Res (Hoboken). 2024 Nov;48(11):2175-2187. doi: 10.1111/acer.15451. Epub 2024 Oct 4.
Simultaneous alcohol and cannabis use is associated with riskier daily drinking. However, little research has tested momentary mechanisms through which simultaneous use predicts continued drinking during acute drinking episodes. The current study tested whether simultaneous use moments predicted within-episode increases in subjective responses, craving, and continued drinking, and whether these relations were potentiated in social versus solitary settings.
Emerging adults who co-use alcohol and cannabis (N = 85) completed 21 days of ecological momentary assessment with event-contingent reports during drinking episodes. Three-level multilevel models tested whether simultaneous (vs. alcohol-only) use moments indirectly predicted subsequent, continued drinking through subjective responses (i.e., high-arousal positive/stimulant, high-arousal negative/aggression, low-arousal positive/relaxation, low-arousal negative/impairment) and alcohol craving, and whether relations differed by social versus solitary contexts.
Within drinking episodes, simultaneous (vs. alcohol-only) use moments were associated with increased stimulation, which was indirectly associated with continued drinking through increased alcohol craving. Additionally, the relation between simultaneous (vs. alcohol-only) use and stimulating effects was potentiated during solitary drinking moments, whereas the relation between stimulating effects and craving was potentiated during social drinking moments. However, stimulating effects were higher in social contexts across all moments. Finally, simultaneous (vs. alcohol-only) use moments were associated with increased relaxation, which was indirectly associated with a lower likelihood of continued drinking through lesser craving.
Simultaneous use predicted both continued within-episode drinking and cessation of drinking, with acute subjective effects and craving as mechanisms, dependent upon context. Just-in-time interventions should consider targeting affect, craving, and context in event-specific interventions.
同时使用酒精和大麻与更危险的日常饮酒行为相关。然而，很少有研究检验同时使用酒精和大麻在急性饮酒发作期间预测持续饮酒的即时机制。本研究检验了同时使用酒精和大麻的时刻是否能预测饮酒发作期间主观反应、渴望和持续饮酒的增加，以及这些关系在社交环境与独处环境中是否会增强。
同时使用酒精和大麻的新兴成年人（N = 85）在饮酒发作期间完成了21天的生态瞬时评估，并进行了事件相关报告。三级多水平模型检验了同时（与仅饮酒相比）使用酒精和大麻的时刻是否通过主观反应（即高唤醒积极/刺激、高唤醒消极/攻击、低唤醒积极/放松、低唤醒消极/损害）和酒精渴望间接预测随后的持续饮酒，以及这些关系在社交环境与独处环境中是否存在差异。
在饮酒发作期间，同时（与仅饮酒相比）使用酒精和大麻的时刻与刺激增加有关，刺激增加通过酒精渴望增加间接与持续饮酒有关。此外，在独处饮酒时刻，同时（与仅饮酒相比）使用酒精和大麻与刺激作用之间的关系增强，而在社交饮酒时刻，刺激作用与渴望之间的关系增强。然而，在所有时刻，社交环境中的刺激作用更高。最后，同时（与仅饮酒相比）使用酒精和大麻的时刻与放松增加有关，放松增加通过较少的渴望间接与持续饮酒可能性降低有关。
同时使用酒精和大麻既预测了饮酒发作期间的持续饮酒，也预测了饮酒停止，急性主观效应和渴望是其机制，具体取决于环境。即时干预应考虑在特定事件干预中针对情感、渴望和环境。
