Effects of Alcohol and Tobacco Co-use on Momentary Subjective Cannabis Effects: Risks for Increasingly Hazardous Cannabis Use

项目摘要 近年来，年轻人中大麻与酒精和烟草共同使用的比例继续上升。 年相当多的研究表明，共同使用的地方，个人在更大的风险下驾驶 影响，较差的心理健康和认知，以及共病物质使用障碍相比， 单一物质使用。尽管与大麻同时使用有关的流行率和风险有所增加， 其他物质，这些关联的机制仍不清楚。已经假设 个体参与共同使用，以获得超出使用感知的更大主观反应 每一种物质单独。鉴于先前的研究发现，与以下方面相关的结果不一致且无结果 共同使用的模式，这表明变化可能是复杂的，需要更仔细的检查内- 人的过程。以前的研究也表明，对大麻的主观反应可能是 符合大麻使用障碍（CUD）的发展;然而，从现有的文献中还不清楚 大麻与其他物质（如酒精和 烟草，随着时间的推移增加了危险使用的风险。这项研究将利用先进的统计技术， 方法（例如，多层次模型，纵向分析），以检查生态瞬时评估 NIDA R01项目中年轻成人娱乐性大麻使用者的纵向数据。目标1 一项提案将研究大麻与酒精或烟草共同使用的情况（药物，订购，时间）如何影响 大麻的主观药物滥用倾向影响;目标2将研究这些主观反应是否 共同使用来预测一年后的危险大麻使用。识别与风险相关的潜在机制 联合使用大麻将有助于制定更有针对性的干预方法，以减少公共卫生风险。 青年人中的CUD负担。

PROJECT SUMMARY The rates of cannabis co-use with alcohol and tobacco among young adults has continued to rise in recent years. Considerable research has shown that co-use places individuals at greater risk for driving under the influence, poorer mental-health and cognition, and co-morbid substance use disorders when compared to single-substance use. Despite the increased prevalence and risk associated with the co-use of cannabis with other substances, the mechanisms underlying these associations remains unclear. It has been hypothesized that individuals engage in co-use to achieve greater subjective responses beyond that perceived with the use of each substance alone. Given prior research has found inconsistent and null findings for outcomes related to patterns of co-use, this suggests changes may be complex and require more careful examination of within- person processes. Previous studies have also shown that subjective responses to cannabis may underlie or coincide the development of cannabis use disorder (CUD); however, it is unclear from the existing literature whether subjective drug effects of cannabis resulting from co-use with other substances, such as alcohol and tobacco, increases the risk for hazardous use over time. The proposed study will utilize advanced statistical methodology (e.g., multilevel modeling, longitudinal analyses) to examine ecological momentary assessment and longitudinal data in young adult recreational cannabis users from a NIDA R01 project. Aim 1 of the proposal will examine how cannabis co-use occasions with alcohol or tobacco (drug, ordering, timing) affects subjective drug abuse liability effects of cannabis; and Aim 2 will examine whether these subjective responses to co-use predict hazardous cannabis use one year later. Identifying underlying mechanisms of risk associated with cannabis co-use will help to develop better tailored intervention approaches to decrease the public health burden of CUDs among young adults.