Intensive Daily Measurement of Simultaneous Alcohol and Marijuana Use in a High-Risk Community Sample of Young Adults: Impacts on Acute and Longer-term Use and Consequences

摘要 大麻立法的重大变化可能不仅影响大麻的使用， 其他物质，包括酒精。酒精和大麻是精神活性物质， 美国的年轻人，并与许多急性和长期后果独立相关。 到目前为止，在四个州（华盛顿， 科罗拉多、俄勒冈州和阿拉斯加）和哥伦比亚特区，许多州目前正在讨论类似的问题。 立法这些政策变化已将注意力转移到重要的个人和公共卫生上， 同时使用酒精和大麻（SAM）的影响，以及潜在的叠加或协同负面影响 影响和后果（例如，增加醉酒驾驶的风险，致命的车祸）。在青年中 和成年人，明确的模式正在出现;对大麻使用危害性的认识正在减少， 吸食大麻的流行率正在上升。此外，很明显，SAM的使用在年轻人中很常见， 年轻人考虑到与酒精使用相关的公共卫生成本，迫切需要了解 SAM使用可能具有互补效应的方式（酒精和大麻使用增加），或 替代效应（与大麻一起使用时，酒精使用量减少），以及 SAM的使用与酒精使用的急性和长期后果的增加有关。到目前为止， 在特定情况下，SAM的使用与单独使用任何一种物质有何不同，目前知之甚少。的 当前的申请提出收集和分析每天两次经由移动的电话收集的密集数据 两年16周（使用交互式语音应答），每年在线收集纵向数据 从一个高风险社区样本的年轻成年SAM用户，年龄在18-25岁，在国家的三年， 华盛顿。本申请的具体目的是：1）检查SAM使用是否会造成额外的酒精- 相关的风险，相比使用酒精没有大麻，在日常水平; 2）了解动机， 意图和情况，使SAM使用更有可能和更重要的年轻人; 3） 模拟SAM使用的纵向模式以及与3年内健康后果的关联;以及4） 研究这些关系的潜在调节者。拟议的研究将审查SAM在一个国家的使用 大麻是法律的，观察到的效果将增加有关大麻对酒精影响的知识 使用和相关的健康后果在美国的年轻人。

ABSTRACT Major changes in marijuana legislation are likely to affect not only the use of marijuana, but also the use of other substances including alcohol. Alcohol and marijuana are psychoactive substances commonly used by young adults in the US and are independently associated with numerous acute and long-term consequences. To date, recreational marijuana use has been legalized for adults age 21+ in four states (Washington, Colorado, Oregon, and Alaska) and the District of Columbia, with numerous states currently debating similar legislation. These policy changes have shifted attention to the important individual and public health implications of simultaneous alcohol and marijuana (SAM) use, and potential additive or synergistic negative effects and consequences (e.g., increased risk of driving while intoxicated, fatal car accidents). Among youth and adults, clear patterns are emerging; perceptions of the harmfulness of marijuana use are decreasing and the prevalence of marijuana use is increasing. Further, it is clear that SAM use is common among youth and young adults. Given the public health costs associated with alcohol use, there is a pressing need to understand the ways in which SAM use may have complementary effects (both alcohol and marijuana use increase) or substitution effects (amount of alcohol use decreases when used with marijuana), as well as the extent to which SAM use is associated with increases in acute and longer-term consequences of alcohol use. To date, very little is known regarding how SAM use differs from use of either substance alone on a given occasion. The current application proposes to collect and analyze intensive data collected twice daily via mobile phones for 16 weeks (using interactive voice response) across two years and longitudinal data collected annually online across three years from a high-risk community sample of young adult SAM users, aged 18-25, in the state of Washington. Specific aims of this application are to: 1) examine whether SAM use poses additional alcohol- related risks, compared to using alcohol without marijuana, at the daily level; 2) understand the motivations, intentions, and situations that make SAM use more likely and more consequential among young adults; 3) model the longitudinal patterns of SAM use and associations with health consequences across 3 years; and 4) examine potential moderators of these relationships. The proposed study will examine SAM use in a state where marijuana is legal and the observed effects will add knowledge about the effects of marijuana on alcohol use and related health consequences among young adults in the US.