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会影响大麻的使用，还会影响到大麻的使用 包括酒精在内的其他物质。酒精和大麻是人们经常使用的精神活性物质 在美国的年轻人，而且独立地与许多严重和长期的后果有关。 到目前为止，娱乐性大麻的使用已经在四个州被合法化，年龄超过21岁(华盛顿州， 科罗拉多州、俄勒冈州和阿拉斯加州)和哥伦比亚特区，许多州目前正在辩论类似的 立法。这些政策变化将注意力转移到了重要的个人和公共卫生上 同时使用酒精和大麻(SAM)的影响，以及潜在的添加或协同负面影响 影响和后果(例如，酒后驾车的风险增加，致命的车祸)。在年轻人中 在成年人中，清晰的模式正在出现；对使用大麻的危害性的看法正在减少， 大麻使用的普及率正在上升。此外，很明显，使用SAM在青年和 年轻人。考虑到与饮酒相关的公共健康成本，迫切需要了解 使用SAM的方式可能具有互补效应(酒精和大麻的使用增加)或 替代效应(与大麻一起使用时酒精使用量减少)，以及 哪种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， 关于SAM的使用与在特定场合单独使用这两种物质有何不同，人们知之甚少。这个 当前的应用程序建议通过手机收集和分析每天两次收集的密集数据，以便 两年16周(使用交互式语音响应)和每年在线收集的纵向数据 来自该州18-25岁年轻成年SAM使用者的高风险社区样本的三年时间 华盛顿。本申请的具体目的是：1)检查SAM的使用是否会造成额外的酒精- 在日常层面上，与不吸大麻的饮酒相比，相关的风险；2)了解动机， 意图，以及使年轻人更有可能和更有影响地使用SAM的情况；3) 模拟3年内SAM使用的纵向模式及其与健康后果的关联；和4) 检查这些关系的潜在调解人。拟议的研究将检查SAM在一个州的使用情况 在大麻合法的地方，观察到的影响将增加关于大麻对酒精影响的知识 在美国的年轻人中使用和相关的健康后果。

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.