Sex differences in the acute pharmacological and subjective effects of smoked cannabis combined with alcohol in young adults.

Wright, Madison; Wickens, Christine M.; Ciano, Patricia Di; Sproule, Beth; Fares, Andrew; Matheson, Justin; Mann, Robert E.; Rehm, Jürgen; Shuper, Paul A.; George, Tony P.; Huestis, Marilyn A.; Stoduto, Gina; Foll, Bernard Le; Brands, Bruna

doi:10.1037/adb0000749

Cited by 15 publications

(16 citation statements)

References 92 publications

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“…Wright and colleagues conducted a laboratory drug administration study to assess for the presence of sex differences in the acute pharmacological effects of alcohol and cannabis co-use. 85 Alcohol and cannabis were administered concurrently in the laboratory using fixed-dose (target, .08% blood alcohol concentration measured through breath) and ad libitum (12.5% THC cannabis) procedures. When alcohol and cannabis were co-administered, females smoked less cannabis as compared to males.…”

Section: Resultsmentioning

confidence: 99%

Patterns of Cannabis and Alcohol Co-Use: Substitution Versus Complementary Effects

Gunn

2122

ARCR

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PURPOSE The purpose of this review is to discuss the literature regarding the concurrent use (co-use) of alcohol and cannabis and competing hypotheses as to whether cannabis acts as a substitute for (i.e., replacing the effects of alcohol, resulting in decreased use) or a complement to (i.e., used to enhance the effects of alcohol, resulting in increased use) alcohol. The impact of cannabis use on alcohol-related outcomes has received increased attention in the wake of ongoing legalization of cannabis for both medical and recreational purposes. Evidence for both hypotheses exists in the literature across a broad range of data collection methods and samples and is carefully reviewed here. In addition, various mechanisms by which cannabis may act as an alcohol substitute or complement are explored in depth with the goal of better understanding equivocal findings. SEARCH METHODS This review includes articles that were identified from a search for studies on alcohol and cannabis co-use, with a specific focus on studies exploring complementary versus substitution aspects of co-use. Search terms were included in Google Scholar, PsycINFO, MEDLINE, and Web of Science. Eligible studies were those that measured alcohol and cannabis co-use in human samples in laboratory, survey, or ecological momentary assessment studies, or that directly referenced substitution or complementary patterns of use. SEARCH RESULTS Search results returned 650 articles, with 95 meeting inclusion criteria. DISCUSSION AND CONCLUSIONS Results of this review reveal compelling evidence for both substitution and complementary effects, suggesting nuanced yet significant distinctions across different populations examined in these studies. Several mechanisms for the impact of cannabis use on alcohol-related outcomes are identified, including patterns and context of co-use, timing and order of use, cannabinoid formulation, pharmacokinetic interactions, and user characteristics (including diagnostic status), all of which may influence substitution versus complementary effects. This review will inform future research studies examining this topic in both clinical and community samples and aid in the development of treatment and prevention efforts targeting those populations most vulnerable to negative consequences of co-use. Finally, this review highlights the need for additional research in more diverse samples and the use of mixed-methods designs to examine both pharmacological and contextual influences on co-use.

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Section: Resultsmentioning

confidence: 99%

Patterns of Cannabis and Alcohol Co-Use: Substitution Versus Complementary Effects

Gunn

2122

ARCR

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“…While female participants exhibited lower concentrations of delta‐9‐tetrahydrocannabinol (THC) and its primary metabolite 11‐nor‐9‐carboxy‐THC (11‐COOH‐THC) than male participants, females also tended to smoke less of the joint than males which suggests that this difference was simply due to reduced THC consumption 16 . In another recent study, 17 female participants smoked less of a joint than male participants while experiencing similar subjective effects, although this was only apparent in a combined alcohol‐cannabis condition. When cannabis was administered alone, no sex differences were observed either in amount of cannabis smoked or in pharmacological or subjective effects.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in acute cannabis effects revisited: Results from two randomized, controlled trials

et al. 2021

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Some evidence suggests that males and females may differ in their responses to acute cannabis effects, including subjective drug effects and behavioural effects, and cannabinoid pharmacokinetics. This is significant given current changes to cannabisrelated policies and, in consequence, increased cannabis accessibility. The present study combines data from two randomized controlled trials to investigate possible differences among males (n = 21) and females (n = 19) in the acute effects of vaporized cannabis containing 13.75 mg Δ9-tetrahydrocannabinol (THC), with and without cannabidiol (CBD; 13.75 mg). To control for differences in the timing of assessments, peak (or peak change from baseline) scores were calculated for a range of measures including subjective drug effects, cognitive performance, cardiovascular effects, and plasma concentrations of THC, CBD, and their respective primary metabolites. While THC elicited robust and significant changes in all but one outcome measure relative to placebo, relatively few sex differences were observed after controlling for BMI and plasma THC concentrations. Relative to females, males performed better overall on a divided attention task (DAT) and had higher peak plasma concentrations of 11-nor-9-carboxy-THC (11-COOH-THC). Males and females did not differ with respect to plasma concentrations of any other analyte, subjective drug effects, or cardiovascular measures. These data indicate an absence of systematic sex differences in acute cannabis effects given a moderate dose of vaporized cannabis. They do not preclude the possibility that sex differences may emerge with higher THC doses or with other commonly used routes of administration (e.g., orally administered oils or edibles).

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“…Nevertheless, these results suggest that craving is a possible mechanism through which alcohol use increases the probability of simultaneous cannabis use in males, but not females (Venegas et al, 2020). Another recent study examined sex differences in the acute pharmacological and subjective effects of an intoxicating dose of alcohol (target 0.08% BrAC) combined with a moderate dose of cannabis (12.5% THC) using an ad libitum smoking procedure (Wright et al, 2021). In the alcohol–cannabis combined condition, females smoked significantly less of the cannabis cigarette compared to males.…”

Section: Sex and Gender Considerationsmentioning

confidence: 99%

Effects of combining alcohol and cannabis on driving, breath alcohol level, blood THC, cognition, and subjective effects: A narrative review.

Fares¹,

Wright²,

Matheson³

et al. 2022

Experimental and Clinical Psychopharmacology

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Alcohol and cannabis are the two most commonly found intoxicating substances in fatally injured drivers. Epidemiological studies have demonstrated that the use of alcohol or cannabis can lead to an increase in the risk of a motor vehicle collision. Reducing the risks associated with driving under the influence of alcohol or cannabis is achieved partly through roadside detection of breath alcohol concentrations (BrAC) or blood delta-9-tetrahydrocannabinol (THC) levels. The purpose of the present review is to compile the laboratory studies on the combined effects of alcohol and cannabis on simulated driving as well as those evaluating combinations of these drugs on BrAC or blood THC. Given that driving can be affected by a number of cognitive processes, the literature on the cognitive effects of combinations of alcohol and cannabis is also reviewed, along with a discussion of a potential additive effect on the subjective qualities of these drugs. In sum, it is concluded that alcohol and cannabis have additive effects on driving skills, cognition and subjective effects. Public Health SignificanceAlcohol and cannabis are the two most commonly found intoxicating substances in fatally injured drivers. In the present review, we present evidence that the use of these two drugs at the same time produces additive effects on driving and other measures. Despite this, evidence that breath alcohol levels or blood delta-9-tetrahydrocannabinol (THC) are impacted by co-use of these drugs is inconclusive.

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Sex differences in the acute pharmacological and subjective effects of smoked cannabis combined with alcohol in young adults.

Cited by 15 publications

References 92 publications

Patterns of Cannabis and Alcohol Co-Use: Substitution Versus Complementary Effects

Patterns of Cannabis and Alcohol Co-Use: Substitution Versus Complementary Effects

Sex differences in acute cannabis effects revisited: Results from two randomized, controlled trials

Effects of combining alcohol and cannabis on driving, breath alcohol level, blood THC, cognition, and subjective effects: A narrative review.

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