Cannabis' Impact on Alcohol Consumption: Integrating Laboratory and Ecological Momentary Assessment Methods

项目摘要/摘要 在酗酒的人中，大麻是与酒精一起使用的最常见的精神活性药物 精神障碍(澳元)。目前的提案推进了我们团队对大麻使用(CU)和 大麻--酒精联合使用对酒精相关结果的影响。临床研究结果表明，CU是 与饮酒密切相关，尽管有证据表明大麻是减少还是增加饮酒 好坏参半。我们的研究表明，Δ-9-四氢大麻酚(THc)能显著降低相对酒精含量 在受控实验室条件下，大量大麻和酒精共同使用者的价值和消费量。 来自大麻二酚(CBD)动物模型的证据表明，CBD也可以减少酒精渴望和 消费。当前临床研究中的一个重要缺口是缺乏检查 与大麻有关的酒精消费在大麻素成分(THC和CBD)方面有所不同。此外， 除了大麻和酒精之间的药效相互作用的数据外，没有人体实验室研究 研究了酒精和大麻(即大麻；同时使用-SAM)对 饮酒。最后，以前没有任何研究评估过大麻对酒精使用的影响。 在受控实验室条件下和在自然环境中的同一个体。这个项目将 使用多种方法对大麻对酒精结果的影响进行最全面的测试 设计：(1)THC和CBD的受控实验室管理，单独吸烟或同时吸烟 酒精和(2)事件级背景因素的生态瞬时评估(EMA)，可以帮助 阐明CU与日常生活中与酒精相关的结果之间的关系。实验室 阶段将采用3(受试者内大麻类药物剂量：12%THC/&lt；1%CBD，12%CBD/&lt；1%THC，安慰剂)X 2(受试者间：大麻+酒精激发剂量与大麻+酒精安慰剂)混合因素 研究200例未寻求治疗的重度间歇性酒精对随后饮酒的影响的设计 每周使用大麻的饮酒者(目标1)。该实验室阶段的数据将与智能手机集成- 基于CU模式(数量、THC/CBD比率、效力、模式)、上下文(地点、社会)、酒精 在为期4周的EMA期间，从相同的个体收集渴望、消费和后果。 综合实验室和环境管理协会的数据，能够检查实验室大麻的独特影响 国家依赖的酒精反应变量和基于现场的CU和环境因素对酒精渴望的影响， 消费和后果(目标2)。大麻(医疗和娱乐)、萨姆动机和澳元 严重程度将被探索为CU和酒精行为之间关联的潜在调节因素 自然环境(目标3)。这项研究与合作研究的目标是一致的 并对大麻调控科学和AUD治疗具有重要意义 处理特定大麻素的相对影响以及大麻-酒精联合使用的背景风险。

PROJECT SUMMARY/ABSTRACT Cannabis is the most common psychoactive drug co-used with alcohol among individuals with alcohol use disorder (AUD). The current proposal advances our team’s research on the impact of cannabis use (CU) and cannabis-alcohol co-use on alcohol-related outcomes. Findings from clinical studies indicate that CU is strongly linked with alcohol use, although evidence regarding whether cannabis reduces or increases drinking is mixed. Our research has demonstrated that Δ-9-tetrahydrocannabinol (THC) acutely reduces relative alcohol value and consumption in heavy cannabis and alcohol co-users under controlled laboratory conditions. Evidence from animal models on cannabidiol (CBD) suggests CBD may also reduce alcohol craving and consumption. An important gap in current clinical research is lack of human laboratory studies that examine alcohol consumption in relation to cannabis varying in cannabinoid composition (THC and CBD). Moreover, aside from data on pharmacodynamic interactions between cannabis and alcohol, no human laboratory studies have examined the combined effects of alcohol and cannabis (i.e., marijuana; simultaneous use-SAM) on alcohol consumption. Finally, no previous study has evaluated the impact of cannabis on alcohol use within the same individual under both controlled laboratory conditions and in the natural environment. This project will provide the most comprehensive tests of the impact of cannabis on alcohol outcomes using a multi-method design: (1) controlled laboratory administration of THC versus CBD smoked alone versus simultaneously with alcohol and (2) ecological momentary assessment (EMA) of event-level contextual factors that can help elucidate the associations between CU and alcohol-related outcomes in daily life contexts. The laboratory phase will employ a 3 (within-subjects cannabinoid dose: 12% THC/<1% CBD, 12% CBD/<1%THC, placebo) X 2 (between-subjects: cannabis + an alcohol-priming dose versus cannabis + alcohol placebo) mixed factorial design to examine these effects on subsequent drinking in 200 nontreatment-seeking heavy episodic alcohol drinkers who use cannabis weekly (Aim 1). Data from this laboratory phase will be integrated with smartphone- based data on CU patterns (amount, THC/CBD ratio, potency, mode), context (location, social), alcohol craving, consumption, and consequences collected from the same individuals over a 4-week EMA period. Integration of laboratory and EMA data enables examining the unique influences of laboratory-based cannabis state-dependent alcohol response variables and field-based CU and contextual factors on alcohol craving, consumption, and consequences (Aim 2). Cannabis (medical and recreational) and SAM motives and AUD severity will be explored as potential moderators of the associations between CU and alcohol behaviors in the natural environment (Aim 3). This research is well-aligned with the objectives of the Collaborative Research on Addiction at NIH and has important implications for cannabis regulatory science and AUD treatment by addressing the relative impact of specific cannabinoids as well as contextual risk in cannabis-alcohol co-use.