Marijuana use and achievement of abstinence from alcohol and other drugs among people with substance dependence: A prospective cohort study

Abstract

Background Many with alcohol and other drug dependence have concurrent marijuana use, yet it is not clear how to address it during addiction treatment. This is partially due to the lack of clarity about whether marijuana use impacts one’s ability to achieve abstinence from the target of addiction treatment. We examined the association between marijuana use and abstinence from other substances among individuals with substance dependence. Methods A secondary analysis of the Addiction Health Evaluation And Disease management study, a randomized trial testing the effectiveness of chronic disease management. Individuals met criteria for drug or alcohol dependence and reported recent drug (i.e. opioid or stimulant) or heavy alcohol use. Recruitment occurred at an inpatient detoxification unit, and all participants were referred to primary medical care. The association between marijuana use and later abstinence from drug and heavy alcohol use was assessed using longitudinal multivariable models. Results Of 563 study participants, 98% completed at least one follow-up assessment and 535 (95%) had at least one pair of consecutive assessments and were included. In adjusted analyses, marijuana use was associated with a 27% reduction in the odds of abstinence from drug and heavy alcohol use (adjusted odds ratio 0.73 [95% CI, 0.56–0.97], P=0.03). Conclusions Marijuana use among individuals with alcohol or other drug dependence is associated with a lower odds of achieving abstinence from drug and heavy alcohol use. These findings add evidence that suggests concomitant marijuana use among patients with addiction to other drugs merits attention from clinicians.

Post-treatment drinking among HIV patients: Relationship to pre-treatment marijuana and cocaine use

“…That we did not find marijuana to be a risk factor for continued heavy drinking despite intervention is worth noting, as two other studies found marijuana to be associated with worse drinking outcomes (Aharonovich et al, 2005; Mojarrad et al, 2014). Several explanations may account for our finding.…”

“…Regarding marijuana’s effects, Aharonovich et al (2005) showed that marijuana use after discharge from inpatient substance abuse treatment was associated with higher likelihood of relapse to alcohol use. Similarly, Mojarrad et al (2014) found that baseline marijuana use reduced substance abstinence after outpatient substance abuse treatment, with no difference in effect by dependence type (i.e., alcohol, drugs, both). That comorbid drug use is associated with less successful alcohol outcomes following treatment in several studies may reflect drug interference with engagement in treatment (Mitchell and Selmes, 2007), or drug-related impairments in ability to manage drinking behavior (e.g., impairment in self-regulation of impulses and cravings; Pani et al, 2010).…”

Cannabis use during treatment for alcohol use disorders predicts alcohol treatment outcomes

“…Concurrent use of marijuana and alcohol is associated with heavy episodic drinking, and the combined use of cannabis and alcohol may lead to more substance use and related problems compared to the use of alcohol alone . Cannabis use has been examined as a predictor of substance use outcomes in a few treatment studies , and was found to have a deleterious impact.…”

Characterizing the Interrelationships of Prescription Opioid and Benzodiazepine Drugs With Worker Health and Workplace Hazards

“…95,136–141 The literature supports the premise that previous substance abuse may be associated with prescription opioid use 139 and that the use of prescription opioids may in turn be associated with substance abuse. 138,140,141 The use of heroin was associated with previous use of prescription opioids among 75% of 18 to 25-year-old respondents in a retrospective cohort of subjects admitted for substance abuse treatment. 138 In a cross-sectional study among adolescents, both medical users (6%) and nonmedical users (65.9%) of opioids reported more substance abuse than those who had never used opioids ( P < 0.01).…”