The present study examined the acute behavioral effects and abuse potential of three drugs commonly used to treat sleep disorders, trazodone, zolpidem and triazolam, and placebo in ten male volunteers with histories of alcohol and drug abuse. Trazodone (100, 200 and 300 mg), a triazolopyridine antidepressant, was included because antidepressants are being used more frequently to treat sleep disorders, but it is unclear whether they have a distinct behavioral pharmacologic profile relative to benzodiazepine hypnotics. Zolpidem (15, 30 and 45 mg), an imidazopyridine hypnotic, was tested because it is the most commonly prescribed hypnotic and purportedly has a unique benzodiazepine-receptor binding profile. Triazolam (0.25, 0.5 and 0.75 mg), a triazolobenzodiazepine hypnotic, was included as the standard component because previous laboratory studies have demonstrated that it has at least some abuse potential. Trazodone, zolpidem and triazolam generally produced comparable dose-related increases in scores on the PCAG scale of the ARCI, which suggests the doses tested were equivalent on some behavioral dimension. The effects of trazodone on subject-rated items thought to measure abuse potential (e.g., subject ratings of Willing to Take Again) were less than those observed with triazolam. Zolpidem and triazolam produced comparable effects on these measures. The highest dose of zolpidem, but not triazolam, increased ratings of Like Drug, Happy, Good Effects, Friendly, Elated, Carefree and Bad Effects. Triazolam and zolpidem produced dose-dependent impairment on all of the performance tasks. Trazodone impaired performance on some, but not all, of these tasks. Consistent with the pharmacokinetics of these compounds, the time-action functions of trazodone, zolpidem and triazolam were similar on these measures. These data suggest that trazodone has less abuse potential than triazolam, and may be a viable alternative to benzodiazepine hypnotics in individuals with histories of alcohol or drug abuse. By contrast, despite its unique neuropharmacological profile, the acute behavioral effects and abuse potential of zolpidem are comparable to those of triazolam.

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Structured interviews were conducted to identify factors that contribute to changes in frequency of personal cannabis use (increases, decreases or abstinences). Sixty cannabis users were recruited from locations throughout England (mean duration of use: 14.1 years). Among those who gave reasons for escalating their cannabis use, a large majority (79%) cited the importance of increased use by others. Approximately one-third cited the importance of a change in circumstances that provided more opportunities to use the drug, and a similar proportion claimed a role for the perceived beneficial effects of the drug. The reasons given for reducing or abstaining were more diverse, but changed circumstances were again highlighted (by 55% and 73% respectively). Reductions primarily followed changes to living arrangements, peer relations or employment; in contrast, changes precipitating abstention were more transient. Negative health effects were considered relevant by 31% of reducers and by the same proportion of those who had ever abstained. The results suggest that perceived external constraints play important roles in both upward and downward changes in cannabis use; that perceived functional effects influence escalation; and that concerns about addiction and health are salient to reduced use.