Neurobehavioral Effects of Frequent Co-use of Alcohol and Cannabis

项目摘要 同时使用酒精和大麻/大麻（SAM）会导致对大麻的渴望、使用和 与单一使用酒精或大麻相比，然而，人们缺乏知识， 关于SAM使用者的神经，神经内分泌和行为差异增加了这些风险 消极的结果。目前的建议旨在通过审查如何解决这一重大知识差距， 与单一物质使用者相比，SAM使用者与压力相关的神经和神经内分泌过程可能不同 或对照组。440名男性和女性报告SAM的性别平衡样本 使用、仅使用酒精、仅使用大麻或既不使用狂欢/重度酒精也不使用大麻 完成一次神经成像会议和三次为期14天的生态瞬时评估（EMA）， 一年的课程。在神经成像环节，参与者将完成一项压力线索反应任务 同时进行功能性磁共振成像，并抽血评估应激诱导的皮质醇反应。参与者 将完成一个基线EMA爆发，重点是压力，渴望和药物使用的日常经验，并将 在基线后6个月和12个月完成随访爆发。该建议旨在更好地了解如何 压力过程与SAM用户的风险增加有关。具体而言，本提案将研究1） 对压力的神经和神经内分泌反应如何由组调节（即，萨姆，只喝酒精饮料 仅大麻，对照），性别，以及组x性别的相互作用; 2）组，性别，以及组x性别 相互作用和神经/神经内分泌反应缓和了压力和 日常生活中的渴望/使用;以及3）群体，性别和X组性别相互作用，以及神经/神经内分泌 在一年的随访期内，反应缓和了渴望/使用的轨迹。总的来说，我们预计， 单一物质使用者会有一些失调，SAM使用者会表现出最大的压力 相对于对照，女性（与男性相比）将表现出更大的失调， 神经/神经内分泌对压力的反应，压力和渴望/使用之间更大的瞬间关系， 和更陡峭的渴望/使用轨迹。成功实现这些目标将大大推动我们的 了解SAM使用增加物质使用障碍和其他风险的机制 这将是指导今后干预和预防工作的关键。

Project Summary Simultaneous use of alcohol and marijuana/cannabis (SAM) leads to increased craving, use, and consequences compared to single use of either alcohol or cannabis. However, there is a dearth of knowledge regarding the neural, neuroendocrine, and behavioral differences in SAM users that increases risk for these negative outcomes. The current proposal aims to address this significant gap in knowledge by examining how stress related neural and neuroendocrine processes may differ in SAM users relative to single substance users or a control group. A sex-balanced sample of four hundred forty male and female individuals reporting SAM use, alcohol use only, cannabis use only, or neither binge/heavy alcohol use nor cannabis use will be recruited to complete a neuroimaging session and three 14-day bursts of ecological momentary assessment (EMA) over the course of one year. During the neuroimaging session, participants will complete a stress cue reactivity task while undergoing fMRI and will also have blood drawn to assess stress-induced cortisol response. Participants will complete a baseline EMA burst that focuses on daily experiences of stress, craving and drug use, and will complete follow-up bursts at 6- and 12-months post-baseline. This proposal aims to better understand how stress processes are related to increased risk among SAM users. Specifically this proposal will investigate 1) how neural and neuroendocrine responses to stress are moderated by group (i.e., SAM, alcohol-only, cannabis-only, control), sex, and the interaction of group x sex; 2) how group, sex, and group x sex interactions, and neural/ neuroendocrine responses moderate the momentary relationships between stress and craving/use in daily life; and 3) how group, sex, and group x sex interactions, and neural/neuroendocrine responses moderate the trajectory of craving/use over a one-year follow-up period. Broadly, we expect that while single substance users will have some dysregulation, SAM users will exhibit the greatest stress dysregulation relative to controls, and females (vs. males) will demonstrate greater dysregulation of neural/neuroendocrine responses to stress, greater momentary relationships between stress and craving/use, and steeper trajectories of craving/use. Successful completion of these aims will significantly advance our understanding of the mechanisms by which SAM use increase risk for substance use disorders and other negative outcomes, which will be key in guiding future intervention and prevention efforts.