scholarly journals Additive roles of tobacco and cannabis co-use in relation to delay discounting in a sample of heavy drinkers

2021 ◽  
Author(s):  
Steven J. Nieto ◽  
Alexandra Venegas ◽  
Elizabeth M. Burnette ◽  
James MacKillop ◽  
Lara A. Ray
Keyword(s):  
Delay Discounting ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Cannabis Use ◽  
Additive Effect ◽  
Laboratory Studies ◽  
The Past ◽  
Baseline Visit ◽  
Heavy Drinkers ◽  
Human Laboratory

Abstract Rationale Alcohol use disorder (AUD) is associated with steeper delay discounting rates; however, it is unknown whether substance co-use, particularly cannabis use, has an additive effect on discounting rates among heavy drinkers. Furthermore, it is unclear whether substance co-use and delay discounting are independently associated with AUD severity. Objectives The purpose of this study was to determine whether alcohol, tobacco, and cannabis co-use impacts delay discounting rates. We also sought to determine whether substance co-use and delay discounting were associated with AUD symptom counts. Methods The study sample was culled from several human laboratory studies and consisted of 483 heavy drinking individuals who completed a baseline visit (prior to experimental procedures). Participants were divided into groups based on self-reported alcohol, tobacco, and cannabis use during the past 30 days: alcohol only (n = 184), alcohol + cigarettes (n = 89), alcohol + cannabis (n = 82), and tri-use (n = 128). We examined discounting rates across the 4 groups and used multiple linear regression to test whether co-use and delay discounting were associated with AUD symptoms. Results After adjusting for covariates, individuals in the alcohol + cannabis group and the tri-use group had steeper discounting rates relative to the alcohol-only group. In addition, tri-use and delay discounting rates were independently correlated with a greater number of AUD symptoms. Conclusions Delay discounting rates were significantly greater among subgroups reporting cannabis use providing partial support for an additive effect, while also highlighting the importance of co-use substance type. Both tri-use and delay discounting were associated with greater AUD severity, which may provide relevant intervention targets.

scholarly journals Inclusion of Cannabis Users in Alcohol Research Samples: Screening In, Screening Out, and Implications

2020 ◽  
Vol 55 (4) ◽  
pp. 416-423
Author(s):  
Alexandra Venegas ◽  
Lindsay R Meredith ◽  
Ziva D Cooper ◽  
Brandon Towns ◽  
Lara A Ray
Keyword(s):  
Alcohol Use ◽  
Binge Drinking ◽  
Tobacco Use ◽  
Alcohol Use Disorder ◽  
Cannabis Use ◽  
Clinical Severity ◽  
Treatment Seeking ◽  
Higher Alcohol ◽  
The Past ◽  
Heavy Drinkers

Abstract Background Alcohol and cannabis are frequently co-used, as 20–50% of those who drink alcohol report co-using cannabis. This study is based on the argument that alcohol researchers should enroll cannabis users in human laboratory studies of alcohol use disorder (AUD) to strengthen generalizability. This study examines how heavy drinking cannabis users differ from non-cannabis using heavy drinkers. Methods In a community sample of non-treatment-seeking heavy drinkers (n = 551, 35% female), cannabis users were identified through: (a) self-reported cannabis use in the past 6 months and (b) positive urine toxicology test for tetrahydrocannabinol (THC). Cannabis users, identified as described previously, were compared with non-cannabis users on demographic and clinical characteristics. Results Those who endorsed cannabis use in the past 6 months reported more binge drinking days. Participants who tested positive for THC had higher Alcohol Use Disorder Identification Test scores and more binge drinking days. Younger age and being a tobacco smoker were associated with an increased likelihood of cannabis use in the past 6 months, whereas male gender and being a tobacco use were associated with a greater likelihood of testing positive for THC. Individuals with cannabis use disorder (CUD) endorsed more depression and anxiety and had higher AUD symptom counts than cannabis users without CUD. Conclusions The inclusion of cannabis users in AUD samples allows for increased clinical severity. Excluding cannabis users from AUD studies may limit representativeness and expend unnecessary study resources. Lastly, tobacco use may explain a large portion of the effects of cannabis use on sample characteristics. Short Summary Alcohol and cannabis are frequently co-used substances. In a sample of non-treatment-seeking heavy drinkers (n = 551, 35% female), cannabis users reported higher alcohol use and higher likelihood of tobacco use than non-cannabis users. Including cannabis users in alcohol research studies will improve representativeness and likely increase clinical severity.

scholarly journals Alcohol Tolerance in Human Laboratory Studies for Development of Medications to treat Alcohol Use Disorder

2020 ◽  
Vol 55 (2) ◽  
pp. 129-135
Author(s):  
Carolina L Haass-Koffler ◽  
Roberta Perciballi
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Motor Impairment ◽  
Alcohol Tolerance ◽  
Subjective Response ◽  
Laboratory Studies ◽  
Phenotypic Profile ◽  
Additional Information ◽  
Research Opportunity ◽  
Human Laboratory

Abstract Aims Human laboratory studies have contributed extensively in the research and development of novel medications to treat alcohol use disorder (AUD). Alcohol tolerance may represent one additional variable that can be utilized to expand the understanding of the AUD wide phenotypic profile and provide support to the medication development process. Tolerance is characterized as an individual’s subjective response to alcohol and has been recognized as a predictor of AUD progression. Tolerance can be evaluated both by self-reported response (e.g. assessments) and objective measurements (e.g. motor impairment); as such, it represents an exploitable variable in the field of alcohol research. Methods This Narrative Review focuses on the use of alcohol tolerance, specifically within alcohol laboratory studies, for medication development. It seeks to identify a research gap and a research opportunity in clinical studies to evaluate biobehavioral responses captured in order to develop medications to treat AUD. Results Alcohol tolerance may provide additional information on the safety and tolerability of medications to treat AUD, in particular, when novel medications are co-administered with alcohol within the AUD population. Conclusions As such, alcohol tolerance represents an additional outcome that may be included in randomized clinical trial (RCT) protocols designed for developing AUD pharmacotherapies.

scholarly journals Impaired control in heavy drinking and its association with alcohol craving and alcohol use disorder severity

Salud Mental ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 151-157
Author(s):  
Edén Sánchez ◽  
Carlos S. Cruz Fuentes ◽  
Corina Benjet ◽  
María Elena Medina-Mora
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Perceived Control ◽  
Alcohol Use Disorder ◽  
Latent Class ◽  
Heavy Drinking ◽  
Alcohol Craving ◽  
Heavy Drinkers ◽  
Impaired Control ◽  
The Relationship

Introduction. Impaired control over drinking has been frequently cited in diverse theoretical descriptions regarding harmful alcohol use and is considered a DSM criterion for alcohol use disorder. Differences in the frequency of endorsement of impaired control have been viewed as a reflection of the severity of the problem. Moreover, it has been posited that the ability to place a limit on alcohol consumption may be mediated through enhanced craving. Objective. In this study, we addressed the relationship between impaired control, self-reported craving, and alcohol dependence severity among heavy drinkers. Method. We conducted a latent class analysis of impaired control dimensions (perceived control, failed control, and attempted control) of 208 heavy drinkers. To determine whether the identified classes could represent different forms of severity of the disorder, the best-fit model was contrasted with scores on the Alcohol Dependence Scale. Furthermore, we assessed the relationship between impaired control criteria (using the Impaired Control Scale [ICS]) with alcohol craving. Results. We identified a three-class solution based on impaired control severity. A graded increase of the craving scores and alcohol severity among the three classes was also identified. Only the ICS items comprising perceived control and partially those related to failed control, but not those evaluating attempted control, distinguished the gradient among the latent classes. Discussion and conclusion. This study provides further support of the proposal of a unidimensional continuum of severity among heavy drinkers and strengthens the theoretical relationship between impaired control and alcohol craving.

scholarly journals Frequency of cannabis use and alcohol-associated adverse effects in a representative sample of U.S. adolescents and youth (2002–2014) a cross-sectional study

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Majed M. Ramadan ◽  
Jim E. Banta ◽  
Khaled Bahjri ◽  
Susanne B. Montgomery
Keyword(s):  
Alcohol Use ◽  
Adverse Effects ◽  
Alcohol Dependence ◽  
Heavy Drinking ◽  
Interpersonal Problems ◽  
Risky Behaviors ◽  
Cannabis Use ◽  
Cross Sectional ◽  
The Past ◽  
Frequent Use

Abstract Background While the link between frequent cannabis use and alcohol use disorders is well documented, it is not clear whether alcohol drinkers who use cannabis less frequently are also vulnerable to alcohol use disorders. We estimate the association of frequency of past 12-months cannabis use with alcohol-associated adverse effects variables in the same time frame: alcohol dependence, heavy drinking, driving under alcohol influence, alcohol-related interpersonal problems, use after interpersonal problems, alcohol-related risky behaviors, and alcohol-related legal problems. Methods We analyzed data from U.S. individuals aged 12 to 25 years who participated in annual, cross-sectional U.S. National Surveys on Drug Use and Health from 2002 to 2014. Logistic regression models were used to examine the association of cannabis use with six alcohol-associated adverse effects variables. Frequency of cannabis use served as the primary independent variable, and were divided into four categories: frequent use (21–30 days per month), less frequent use (1–20 days per month), no use over the past 12 months, and no lifetime cannabis use. Alcohol dependence and six alcohol-associated adverse effects variables served as our primary outcomes. Results The study included 465,090 respondents aged 12 to 25 years, among all past-year cannabis users, (47.5%) were less frequent (1–20 days/month) users. Less frequent cannabis use was highest among male, 15–25-year-olds, and non-Hispanic white 11.8, 84 and 10.6%, respectively. In adjusted models, past-year less frequent cannabis use (1–20 days/month) was significantly associated with past-year alcohol dependence (adjusted odds ratio aOR 5.57, 95% confidence interval (CI) 5.5–6.4); heavy drinking in the past-year (aOR 3.41, 95% CI 3.2–3.5); alcohol-related interpersonal problems in the past-year (aOR 7.33, 95% CI 7.0–7.5); use after interpersonal problems (aOR 5.17, 95% CI 4.8–5.5); alcohol-related risky behaviors (aOR 7.29, 95% CI 7.0–7.5), and, driving under influence of alcohol (aOR 7.19, 95% CI 6.9–7.4). No cannabis use past-year were more likely to report alcohol dependence (aOR 2.81, 95% CI 2.6–3) compared with no lifetime cannabis use. Conclusion These findings indicated that within the general population, not only frequent cannabis user (21–30 days per month) but even less frequent cannabis use (1–20 days/month) was significantly associated with past-year alcohol dependence and alcohol-associated adverse effects than no lifetime cannabis use. These adverse alcohol-related outcomes associated with less frequent cannabis use, should be taken under careful consideration in alcohol use disorder treatment setting and policy planning.

scholarly journals Neuroendocrine Response to Exogenous Ghrelin Administration, Combined With Alcohol, in Heavy-Drinking Individuals: Findings From a Randomized, Double-Blind, Placebo-Controlled Human Laboratory Study

2021 ◽  
Author(s):  
Mehdi Farokhnia ◽  
Kelly M Abshire ◽  
Aaron Hammer ◽  
Sara L Deschaine ◽  
Anitha Saravanakumar ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Alcohol Administration ◽  
Neuroendocrine Response ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Human Laboratory

Abstract Background Accumulating evidence has established a role for the orexigenic hormone ghrelin in alcohol-seeking behaviors. Accordingly, the ghrelin system may represent a potential pharmacotherapeutic target for alcohol use disorder. Ghrelin modulates several neuroendocrine pathways, such as appetitive, metabolic, and stress-related hormones, which are particularly relevant in the context of alcohol use. The goal of the present study was to provide a comprehensive assessment of neuroendocrine response to exogenous ghrelin administration, combined with alcohol, in heavy-drinking individuals. Methods This was a randomized, crossover, double-blind, placebo-controlled human laboratory study, which included 2 experimental alcohol administration paradigms: i.v. alcohol self-administration and i.v. alcohol clamp. Each paradigm consisted of 2 counterbalanced sessions of i.v. ghrelin or placebo administration. Repeated blood samples were collected during each session, and peripheral concentrations of the following hormones were measured: leptin, glucagon-like peptide-1, pancreatic polypeptide, gastric inhibitory peptide, insulin, insulin-like growth factor-1, cortisol, prolactin, and aldosterone. Results Despite some statistical differences, findings were consistent across the 2 alcohol administration paradigms: i.v. ghrelin, compared to placebo, increased blood concentrations of glucagon-like peptide-1, pancreatic polypeptide, cortisol, and prolactin, both acutely and during the whole session. Lower levels of leptin and higher levels of aldosterone were also found during the ghrelin vs placebo session. Conclusion These findings, gathered from a clinically relevant sample of heavy-drinking individuals with alcohol use disorder, provide a deeper insight into the complex interplay between ghrelin and appetitive, metabolic, and stress-related neuroendocrine pathways in the context of alcohol use.

scholarly journals Prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa: results of a national survey in 2017

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shandir Ramlagan ◽  
Karl Peltzer ◽  
Supa Pengpid
Keyword(s):  
South Africa ◽  
Logistic Regression ◽  
Alcohol Use ◽  
Drug Use ◽  
Alcohol Use Disorder ◽  
Labour Force ◽  
Cannabis Use ◽  
Never Married ◽  
The Past ◽  
Male Sex

Abstract Background The study aimed to assess the prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa. Method In a national cross-sectional 2017 survey, 39,207 persons 15 years and older (Median = 34 years) responded to a questionnaire on cannabis use and health variables. Multinominal logistic regression was used to assess the determinants of nondaily and daily cannabis use among the general population and logistic regression for the determinants of daily cannabis use among active cannabis users. Results Results indicate that 5.0% of the participants engaged in non-daily and 2.8% in daily cannabis use in the past 3 months. In adjusted multinomial logistic regression analysis, male sex, Grade 8–11 education, Coloureds, alcohol use disorder, never married, and other drug use were positively associated with daily cannabis use while not in not labour force was negatively associated with daily cannabis use. Moreover, male sex, never married, alcohol use disorder, and other drug use were positively, while physical multimorbidity was negatively associated with nondaily cannabis use. In adjusted logistic regression, compared to nondaily cannabis users, daily cannabis users were more likely male and were less likely not in the labour force and were less likely using other drugs. Conclusion About one in ten participants had used cannabis in the past 3 months in South Africa. Several sociodemographic and health indicators were identified that were associated with non-daily and/or daily cannabis use.

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