Using ecological momentary assessment to identify risk factors for simultaneous alcohol and cannabis use
Abstract
Using alcohol and cannabis simultaneously, such that their effects overlap, is prevalent among individuals who drink alcohol and is associated with greater negative consequences than use of either substance alone. Understanding the factors that contribute to and maintain simultaneous versus single-substance use may shed light on reinforcement processes and intervention targets for this pattern of use. We used ecological momentary assessment to examine these processes in individuals' daily lives. The study had three aims: 1) test whether baseline motives for simultaneous use moderated daily-life associations between affect and simultaneous use, 2) test whether momentary motives for using alcohol or cannabis differed depending on whether individuals were simultaneously using the other substance, and 3) test whether simultaneous use moments were associated with greater affectively reinforcing outcomes compared to single-substance use. After completing baseline measures of motives for alcohol, cannabis, and simultaneous use, participants (N = 88, mean age 25.22, 60.2 percent female) reported 6+ times daily for 14 days on alcohol and cannabis use, affect, momentary motives for use, and subjective appraisals of use. Multilevel models were used to test each aim. Results from aim 1 include that baseline motives for simultaneous use did not moderate affect-use associations in daily life. Results from aim 2 demonstrated that social, conformity, and expansion motives were endorsed more strongly during simultaneous- compared to single-substance use moments. Results from aim 3 include that simultaneously using cannabis during alcohol-use moments attenuated the positive association between momentary anxiety-coping drinking motives and subjective drinking-contingent relief but also attenuated the increase in negative affect that accompanied coping-motivated drinking. In addition, simultaneously using cannabis during alcohol-use moments attenuated the positive association between enhancement drinking motives and subjective drinking-contingent pleasure despite no attenuation of the increase in positive affect that accompanied enhancement-motivated drinking. Collectively, this study furthers our understanding of the experiences that individuals are hoping to achieve by using alcohol and cannabis simultaneously and highlights ways in which this pattern of substance use may be reinforced.
Degree
Ph. D.