Effect of Cannabis Use on Alcohol Craving and Consumption among those in Alcohol Treatment

大麻使用对酒精治疗患者的酒精渴望和消费的影响

• 批准号: 10716604
• 负责人: Rachel Lyn Gunn
• 金额: $ 66.17万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10716604
• 关键词: Acute; Address; Aftercare; Alcohol abuse; Alcohol consumption; Alcohols; Biosensor; Cannabis; Characteristics; Complement; Consumption; Data; Development; Disease remission; Ecological momentary assessment; Environment; Event; Frequencies; Future; Goals; Grain; Heavy Drinking; Impulsivity; Individual; Individual Differences; Knowledge; Laboratories; Light; Literature; Measures; Mediating; Methods; Outcome; Participant; Patient Self-Report; Patients; Pattern; Persons; Phase; Policies; Predisposition; Provider; Psychotropic Drugs; Recording of previous events; Relapse; Research; Risk; Risk Factors; Sampling; Technology; Tetrahydrocannabinol; Time; Treatment outcome; United States National Institutes of Health; Work; addiction; alcohol abstinence; alcohol abuse therapy; alcohol craving; alcohol demand; alcohol effect; alcohol measurement; alcohol use disorder; burden of illness; cannabis use behavior; clinical decision-making; clinical development; craving; design; drinking; longitudinal dataset; longitudinal design; marijuana legalization; marijuana use; marijuana user; persistent symptom; prospective; theories; therapy development; trait impulsivity; young adult

PROJECT SUMMARY/ABSTRACT Among those with AUD, cannabis is the most commonly used psychoactive substance. Although initial evidence suggests an overall detrimental impact of cannabis use (CU) on longitudinal AUD treatment outcomes, there is significant divergence about how CU impacts alcohol consumption and craving. Competing theories about the association between CU and alcohol focus on whether CU acts as a substitute (i.e., replacing the effects of alcohol, resulting in decreased craving, use, and harms) or complement (i.e., enhancing the effects of alcohol, resulting in increased craving, use, and harms). Preliminary work in non- treatment engaged samples suggests important mechanisms (e.g., craving) and moderators (e.g., frequency of CU, history of simultaneous use, trait impulsivity) may elucidate these competing theories. An important gap in the literature is in the examination of prospective and momentary effects of naturalistic CU on alcohol craving and consumption among individuals in alcohol treatment. The proposed study aims to address this gap using an intensive longitudinal design to comprehensively examine within- and between-person patterns of CU on alcohol outcomes over the critical first year after treatment initiation. Key outcomes among those early in treatment are alcohol craving and risky alcohol consumption patterns (rate of consumption and volume consumed). Use of alcohol biosensors allow for the objective measurement of these alcohol consumption patterns as they naturally occur. The proposed project will be the most comprehensive examination to date of the impact of CU on alcohol treatment outcomes and the first to examine these associations in the natural environment using the BACtrack Skyn to passively mesure transdermal alcohol concentration (TAC). Alcohol craving will be measured as an important outcome of CU in the moment, as well as a mechanism by which CU leads to alcohol consumption. A longitudinal ecological momentary assessment (EMA) burst design (four 10- day bursts at baseline, 1, 2, and 3 months) will be used to isolate the momentary impact of CU on alcohol craving and consumption (measured via TAC) in a stratified sample of recent cannabis users. Following this EMA phase, participants will engage in 6, 9, and 12 month follow-ups to fully capture CU and alcohol patterns/AUD remission over the first year after treatment initiation. This research will directly inform: a) clinical decision-making about the risks of CU during alcohol treatment, b) future intervention development for AUD, and c) policy in the wake of expanding cannabis legalization; and is well-aligned with the objectives of the Collaborative Research on Addiction at NIH.

项目概要/摘要 在澳元患者中，大麻是最常用的精神活性物质。虽然最初 有证据表明大麻使用 (CU) 对纵向 AUD 治疗产生总体有害影响 不同的结果，关于 CU 如何影响酒精消费和渴望存在显着分歧。竞争 关于 CU 和酒精之间关联的理论主要集中在 CU 是否充当替代品（即 替代酒精的作用，从而减少渴望、使用和伤害）或补充（即， 增强酒精的作用，导致对酒精的渴望、使用和伤害增加）。前期工作非 参与治疗的样本表明了重要的机制（例如渴望）和调节因素（例如治疗的频率） CU、同时使用的历史、特质冲动）可以阐明这些相互竞争的理论。一个重要的差距 该文献研究了自然主义 CU 对酒精渴望的前瞻性和暂时影响 以及酒精治疗中个体的消费情况。拟议的研究旨在通过使用来解决这一差距 深入的纵向设计，全面检查人内和人与人之间的 CU 模式 治疗开始后关键的第一年的酒精结果。早期的主要成果 治疗方法是对酒精的渴望和危险的酒精消费模式（消费率和数量） 消耗）。使用酒精生物传感器可以客观测量这些酒精消耗量 自然出现的模式。拟议的项目将是迄今为止最全面的审查 CU 对酒精治疗结果的影响，并首次在自然环境中检查这些关联 使用 BACtrack Skyn 被动测量经皮酒精浓度 (TAC)。酒精 渴求将作为当前 CU 的一个重要结果来衡量，同时也是 CU 的一种机制。 导致饮酒。纵向生态瞬时评估 (EMA) 突发设计（四个 10- 基线、1、2 和 3 个月的日爆发）将用于隔离 CU 对酒精的瞬时影响 最近大麻使用者的分层样本中的渴望和消费（通过 TAC 测量）。继此 EMA 阶段，参与者将进行 6、9 和 12 个月的随访，以充分捕获 CU 和酒精 治疗开始后第一年的模式/AUD 缓解。这项研究将直接告知：a) 临床 关于酒精治疗期间 CU 风险的决策，b) AUD 未来干预措施的发展， c) 扩大大麻合法化后的政策；并且与该组织的目标非常一致 NIH 成瘾合作研究。