Unplanned versus planned simultaneous alcohol and marijuana use in relation to substance use and consequences: Results from a longitudinal daily study.

Abstract

Objective: The current study expands the literature on simultaneous alcohol and marijuana (SAM) use by focusing on the distinction between unplanned and planned SAM use to identify potential intervention targets. This study explored whether unplanned or planned SAM use was associated with differences in alcohol and/or marijuana use and consequences. Method: A community sample of young adults (aged 18-25) with recent alcohol and SAM use was recruited [N = 409; mean (SD) = 21.61 (2.17) years; 50.9% female; 48.2% non-Hispanic/Latinx White]. Participants completed five 2-week bursts of online daily surveys (2×/day; 81.99% of morning and 82.23% of afternoon surveys completed) and reported on substance use intentions and behavior. Results: Descriptive findings showed that among days on which participants reported SAM use, 41.85% of the days were unplanned SAM use days. Based on daily-level results from multilevel models, on days with unplanned SAM use, young adults reported consuming fewer drinks, fewer hours high from marijuana, and lower subjective intoxication/high, compared to planned SAM use days, thus indicating that planned SAM use was riskier. Unplanned SAM use was not significantly associated with positive or negative consequences related to alcohol or marijuana, after accounting for the number of drinks or hours high from marijuana. Conclusions: Current findings suggest that interventions should target days on which young adults are planning to engage in SAM use. Future work is needed to identify factors that predict planned SAM use on specific occasions and also to disentangle the potential role of unplanned heavy use. Public Health Significance StatementIt is critical that we enhance our understanding of risky substance use behaviors, namely, young adults' use of alcohol and marijuana at the same time so that effects overlap. Current findings suggest that intervention efforts should target planned simultaneous alcohol and marijuana (SAM) use to reduce the risk for increased substance use. Event-level predictors and interventions for SAM use may be particularly important.

Simultaneous Alcohol and Marijuana Use Among Young Adults: A Scoping Review of Prevalence, Patterns, Psychosocial Correlates, and Consequences

“… 45 Still, not all papers found a link between same-day co-use and consequences after controlling for alcohol and/or marijuana use. 29 , 32 , 67 , 75 For example, among college men, there was no evidence of same-day co-use increasing the likelihood of interpersonal conflict above and beyond alcohol or marijuana use. 67 …”

“… 15 , 23 – 28 One paper also found that males consumed greater amounts of alcohol and were high for greater lengths of time on SAM use days than females. 29 Fewer papers examined race/ethnicity differences. Those that did generally found that White young adults, in comparison to young adults of other racial/ethnic groups, were more likely to engage in SAM use, did so more frequently, and tended to consume greater quantities of alcohol and marijuana when engaging in SAM use.…”

“…Four papers using daily assessments explored associations between SAM use and its perceived or subjective positive effects or consequences (e.g., feeling relaxed, social, or buzzed). 29 , 32 , 45 , 58 Across these papers, the measurement of positive consequences centered around alcohol, 29 , 32 , 58 marijuana, 29 , 58 or substance use more broadly. 45 Findings revealed a positive association between SAM use days and perceived positive consequences of alcohol 32 and/or substance use, 45 such that more positive consequences tended to be reported on SAM use days relative to alcohol-only 32 and marijuana-only days.…”

Unplanned versus planned simultaneous alcohol and cannabis use in the daily lives of a predominantly white college student sample: What are the motives, contexts, and outcomes?

“…Likewise, we hypothesized that engaging in simultaneous use at a party, at a friend's place, with friends, with more intoxicated people, and with more people using cannabis would be associated with planned simultaneous use, whereas using at home or alone would be related to unplanned simultaneous use. Consistent with Fairlie et al (2021), we hypothesized that planned versus unplanned simultaneous use would be linked to greater alcohol and cannabis consumption, but not to negative simultaneous use-related consequences.…”

Within‐ and between‐person effects of naltrexone on the subjective response to alcohol and craving: A daily diary investigation

“…First, although our analyses were more ecologically valid than many, data were collected at the daily rather than momentary level. Although next-day retrospective reports of subjective response are subject to recall bias, several other studies have used daily dairies to test overall past-day subjective response (e.g., Fairlie et al, 2021;Linden-Carmichael et al, 2020;Lipperman-Kreda et al, 2017). Nonetheless, it was not possible in the current study to establish temporal precedence for drinking and subjective responses/craving and medication ingestion.…”