Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Procedures
2.2. Measures
2.2.1. Mental Health Symptoms
2.2.2. Substance Use
2.2.3. Substance-Related Harm
2.3. Analysis Plan
3. Results
3.1. Demographics of Co-Use Groups
3.2. Mental Health Outcomes
3.3. Substance Use
3.4. Substance-Related Harm
3.5. Associations with Frequency of Simultaneous Use
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Patrick, M.E.; Terry-McElrath, Y.M.; Lee, C.M.; Schulenberg, J.E. Simultaneous alcohol and marijuana use among underage young adults in the United States. Addict. Behav. 2019, 88, 77–81. [Google Scholar] [CrossRef]
- Thompson, K.; Merrin, G.J.; Ames, M.E.; Leadbeater, B. Marijuana trajectories in Canadian youth: Associations with substance use and mental health. Can. J. Behav. Sci. 2018, 50, 17–28. [Google Scholar] [CrossRef]
- White, A.; Hingson, R. The Burden of Alcohol Use: Excessive Alcohol Consumption and Related Consequences among College Students. Alcohol. Res. Curr. Rev. 2013, 35, 201–218. [Google Scholar]
- Merrin, G.J.; Thompson, K.; Leadbeater, B.J. Transitions in the use of multiple substances from adolescence to young adulthood. Drug Alcohol. Depend. 2018, 189, 147–153. [Google Scholar] [CrossRef]
- Brière, F.; Fallu, J.-S.; Descheneaux, A.; Janosz, M. Predictors and consequences of simultaneous alcohol and cannabis use in adolescents. Addict. Behav. 2011, 36, 785–788. [Google Scholar] [CrossRef] [Green Version]
- Subbaraman, M.S.; Kerr, W.C. Simultaneous Versus Concurrent Use of Alcohol and Cannabis in the National Alcohol Survey. Alcohol. Clin. Exp. Res. 2015, 39, 872–879. [Google Scholar] [CrossRef] [PubMed]
- Downey, L.A.; King, R.; Papafotiou, K.; Swann, P.; Ogden, E.; Boorman, M.; Stough, C. The effects of cannabis and alcohol on simulated driving: Influences of dose and experience. Accid. Anal. Prev. 2013, 50, 879–886. [Google Scholar] [CrossRef] [PubMed]
- Marijuana Policy Project—We Change Laws! Available online: https://www.mpp.org/ (accessed on 20 February 2021).
- Terry-McElrath, Y.M.; O’Malley, P.M.; Johnston, L.D. Simultaneous alcohol and marijuana use among US high school seniors from 1976 to 2011: Trends, reasons, and situations. Drug Alcohol. Depend. 2013, 133, 71–79. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Arterberry, B.J.; Treloar, H.; McCarthy, D.M. Empirical Profiles of Alcohol and Marijuana Use, Drugged Driving, and Risk Perceptions. J. Stud. Alcohol. Drugs 2017, 78, 889–898. [Google Scholar] [CrossRef] [PubMed]
- Chihuri, S.; Li, G.; Chen, Q. Interaction of marijuana and alcohol on fatal motor vehicle crash risk: A case-control study. Inj. Epidemiol. 2017, 4, 8. [Google Scholar] [CrossRef] [Green Version]
- Yurasek, A.M.; Aston, E.R.; Metrik, J. Co-use of Alcohol and Cannabis: A Review. Curr. Addict. Rep. 2017, 4, 184–193. [Google Scholar] [CrossRef]
- Egan, K.L.; Cox, M.J.; Suerken, C.K.; Reboussin, B.A.; Song, E.Y.; Wagoner, K.G.; Wolfson, M. More drugs, more problems? Simultaneous use of alcohol and marijuana at parties among youth and young adults. Drug Alcohol. Depend. 2019, 202, 69–75. [Google Scholar] [CrossRef] [PubMed]
- Jackson, K.M.; Sokolovsky, A.W.; Gunn, R.L.; White, H.R. Consequences of alcohol and marijuana use among college students: Prevalence rates and attributions to substance-specific versus simultaneous use. Psychol. Addict. Behav. 2020, 34, 370–381. [Google Scholar] [CrossRef]
- Linden-Carmichael, A.N.; Stamates, A.L.; Lau-Barraco, C. Simultaneous Use of Alcohol and Marijuana: Patterns and Individual Differences. Subst. Use Misuse 2019, 54, 2156–2166. [Google Scholar] [CrossRef] [PubMed]
- Lipperman-Kreda, S.; Gruenewald, P.J.; Grube, J.W.; Bersamin, M. Adolescents, alcohol, and marijuana: Context characteristics and problems associated with simultaneous use. Drug Alcohol. Depend. 2017, 179, 55–60. [Google Scholar] [CrossRef] [PubMed]
- Sokolovsky, A.W.; Gunn, R.L.; Micalizzi, L.; White, H.R.; Jackson, K.M. Alcohol and marijuana co-use: Consequences, subjective intoxication, and the operationalization of simultaneous use. Drug Alcohol. Depend. 2020, 212, 107986. [Google Scholar] [CrossRef] [PubMed]
- Lee, C.M.; Patrick, M.E.; Fleming, C.B.; Cadigan, J.M.; Abdallah, D.A.; Fairlie, A.M.; Larimer, M.E. A Daily Study Comparing Alcohol-Related Positive and Negative Consequences for Days with Only Alcohol Use Versus Days with Sim-ultaneous Alcohol and Marijuana Use in a Community Sample of Young Adults. Alcohol. Clin. Exp. Res. 2020, 44, 689–696. [Google Scholar] [CrossRef]
- Cummings, C.; Beard, C.; Habarth, J.M.; Weaver, C.; Haas, A. Is the Sum Greater than Its Parts? Variations in Substance-Related Consequences by Conjoint Alcohol-Marijuana Use Patterns. J. Psychoact. Drugs 2019, 51, 351–359. [Google Scholar] [CrossRef] [PubMed]
- Hasin, D.S. US Epidemiology of Cannabis Use and Associated Problems. Neuropsychopharmacology 2018, 43, 195–212. [Google Scholar] [CrossRef] [Green Version]
- Canadian Centre on Substance Abuse. Canadian Centre on Substance Abuse; Canadian Centre on Substance Abuse: Ottawa, ON, Canada, 2014. [Google Scholar]
- Lai, H.M.X.; Cleary, M.; Sitharthan, T.; Hunt, G.E. Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: A systematic review and meta-analysis. Drug Alcohol. Depend. 2015, 154, 1–13. [Google Scholar] [CrossRef]
- Leadbeater, B.J.; Ames, M.E.; Linden-Carmichael, A.N. Age-varying effects of cannabis use frequency and disorder on symptoms of psychosis, depression and anxiety in adolescents and adults. Addiction 2019, 114, 278–293. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Volkow, N.D.; Swanson, J.M.; Evins, A.E.; DeLisi, L.E.; Meier, M.H.; Gonzalez, R.; Bloomfield, M.A.P.; Curran, H.V.; Baler, R. Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review. JAMA Psychiatry 2016, 73, 292–297. [Google Scholar] [CrossRef] [PubMed]
- Cunningham, C.E.; Boyle, M.H.; Hong, S.; Pettingill, P.; Bohaychuk, D. The Brief Child and Family Phone Interview (BCFPI): 1. Rationale, development, and description of a computerized children’s mental health intake and outcome assessment tool. J. Child Psychol. Psychiatry 2009, 50, 416–423. [Google Scholar] [CrossRef] [PubMed]
- Leadbeater, B.; Thompson, K.; Gruppuso, V. Co-occurring Trajectories of Symptoms of Anxiety, Depression, and Oppositional Defiance from Adolescence to Young Adulthood. J. Clin. Child Adolesc. Psychol. 2012, 41, 719–730. [Google Scholar] [CrossRef] [Green Version]
- Derogatis, L. SCL-90-R Manual II: Administration, Scoring and Procedures; Clinical Psychometric Research: Towson, MD, USA, 1984. [Google Scholar]
- Sheehan, D.V.; Lecrubier, Y.; Sheehan, K.H.; Amorim, P.; Janavs, J.; Weiller, E.; Hergueta, T.; Baker, R.; Dunbar, G.C. The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J. Clin. Psychiatry 1998, 59, 22–33. [Google Scholar]
- Muthén, L.; Muthén, B. Mplus User’s Guide, 8th ed.; Version 7; Muthén & Muthén: Los Angeles, CA, USA, 2007. [Google Scholar]
- Bornstein, M.H.; Hahn, C.-S.; Suwalsky, J.T.D.; Haynes, O.M. Socioeconomic status, parenting, and child development: The Hollingshead Four-Factor Index of Social Status and The Socioeconomic Index of Occupations. In Socioeconomic Status, Parenting, and Child Development; Monographs in parenting series; Lawrence Erlbaum Associates Publishers: Mahwah, NJ, USA, 2003; pp. 29–82. ISBN 978-0-8058-4242-5. [Google Scholar]
- Hu, L.T.; Bentler, P.M. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct. Equ. Model. 1999, 6, 1–55. [Google Scholar] [CrossRef]
- Bollen, K.A.; Curran, P.J. Latent Curve Models: A Structural Equation Perspective, Latent Curve Models: A Structural Equation Perspective; John Wiley & Sons, Inc: Hoboken, NJ, USA, 2006. [Google Scholar]
- Childhood and Adolescent Pathways to Substance Use Disorders (Report)|Canadian Centre on Substance Use and Addiction. Available online: https://www.ccsa.ca/childhood-and-adolescent-pathways-substance-use-disorders-report (accessed on 23 February 2021).
- Thompson, K.D.; Leadbeater, B.J.; Ames, M.E. Reciprocal Effects of Internalizing and Oppositional Defiance Symptoms on Heavy Drinking and Alcohol-Related Harms in Young Adulthood. Subst. Abuse 2015, 9, 21–31. [Google Scholar] [CrossRef] [Green Version]
Alcohol-Only (n = 189; 42%) | Concurrent (n = 60; 13%) | Simultaneous (n = 182; 41%) | |||
---|---|---|---|---|---|
Range | Mean (SD) or n (%) | Mean (SD) or n (%) | Mean (SD) or (%) | F or χ2 | |
Gender | |||||
Boys | 74 (39%) a | 21 (35%) a | 108 (59%) b | 19.26 *** | |
Girls | 115 (61%) | 39 (65%) | 74 (41%) | ||
Substance Use History | |||||
Age of Onset Alcohol | 10–23 | 15.05 (2.48) a | 14.00 (2.02) b | 14.08 (1.87) b | 10.91 *** |
Age of Onset Marijuana | 6–26 | 16.22 (2.67) a | 15.87 (2.73) ab | 15.74 (2.56) b | 4.38 * |
T1 Freq of HED | 1–5 | 1.43 (0.83) a | 1.67 (1.10) ab | 1.83 (1.14) b | 7.34 *** |
T1 Freq of Marijuana | 0–4 | 1.47 (0.91) a | 1.70 (1.06) ab | 1.98 (1.37) b | 9.09 *** |
Mental Health T6 | |||||
Anxiety | 0–12 | 5.40 (2.93) a | 6.37 (2.93) b | 5.19 (2.38) a | 3.85 * |
Depression | 0–12 | 2.68 (2.60) | 3.44 (2.81) | 2.75 (2.34) | 1.99 |
Psychosis | 0–10 | 1.70 (2.15) a | 2.07 (2.21) ab | 2.58 (2.35) b | 6.56 ** |
ADHD | 0–11 | 3.39 (2.28) a | 4.00 (2.65) ab | 3.99 (2.29) b | 3.21 * |
ODD | 0–11 | 2.67 (2.03) a | 3.37 (2.43) b | 3.24 (2.11) b | 4.06 * |
CD | 0–7 | 0.80 (1.00) a | 1.13 (0.97) a | 1.25 (1.06) b | 8.33 *** |
Substance Use T6 | |||||
Freq of HED | 0–4 | 1.03 (1.08) a | 1.30 (1.19) b | 1.94 (1.14) b | 28.11 *** |
Cigarettes Past week | 0–4 | 0.36 (1.07) | 0.55 (1.29) | 0.97 (1.51) | 9.53 *** |
Freq of Marijuana | 0–4 | 0.20 (0.55) | 1.09 (1.23) | 2.13 (1.43) | 131.55 *** |
Freq of Illicit Drugs | 0–10 | 0.21 (0.63) a | 0.44 (0.63) b | 0.63 (0.79) b | 15.14 *** |
Substance-related Harms T6 | |||||
Social harms | 37 (21%) a | 17 (32%) ab | 66 (41%) b | 16.04 *** | |
Alcohol Use Disorder | 45 (25%) a | 23 (43%) b | 91 (57%) c | 33.93 *** | |
Marijuana Use Disorder | 2 (1%) a | 5 (10%) b | 48 (30%) c | 56.90 *** | |
Driving/riding drunk | 35 (20%) a | 17 (32%) ab | 58 (36%) b | 11.39 ** | |
Driving/riding high | 9 (5%) a | 13 (24%) b | 69 (43%) c | 67.92 *** |
Dependent Variables | Model 1 | Model 2 | |||||
---|---|---|---|---|---|---|---|
Alcohol (Ref) | Concurrent | Simultaneous | R2 | Concurrent (Ref) | Simultaneous | R2 | |
Mental Health Symptoms | Est (SE) | Est (SE) | Est (SE) | ||||
Anxiety | - | 0.10 (0.06) | −0.01 (0.05) | 0.158 | - | −0.15 (0.07) * | 0.219 |
Depression | - | 0.10 (0.06) | 0.03 (0.05) | 0.142 | - | −0.12 (0.08) + | 0.210 |
Psychosis | - | 0.05 (0.05) | 0.17 (0.05) *** | 0.120 | - | 0.08 (0.07) | 0.320 |
ODD | - | 0.10 (0.05) | 0.11 (0.05) * | 0.153 | - | −0.02 (0.07) | 0.214 |
ADHD | - | 0.08 (0.05) | 0.11 (0.05) | 0.127 | - | −0.04 (0.08) | 0.145 |
CD | - | 0.11 (0.05) * | 0.19 (0.06) *** | 0.042 | - | 0.03 (0.07) | 0.015 |
Substance Use | Est (SE) | Est (SE) | Est (SE) | ||||
HED | - | 0.07 (0.05) | 0.32 (0.05) *** | 0.184 | - | 0.20 (0.07) ** | 0.120 |
Tobacco use | - | 0.05 (0.05) | 0.16 (0.05) ** | 0.146 | - | 0.09 (0.07) | 0.104 |
Illicit drug use | - | 0.10 (0.05) * | 0.26 (0.06) *** | 0.096 | - | 0.11 (0.06) + | 0.028 |
Marijuana | - | - | - | - | 0.29 (0.06) *** | 0.137 | |
Substance-related Harm | Odds Ratio (95% CI) | Odds Ratio (95% CI) | Odds Ratio (95% CI) | ||||
Social harms | - | 1.53 (0.77–3.0) | 2.37 (1.42–3.94) *** | 0.071 | - | 1.55 (0.79–3.04) | 0.028 |
AUD symptoms | - | 2.05 (1.07–3.93) * | 2.96 (1.81–4.83) *** | 0.049 | - | 1.52 (0.78–2.93) | 0.022 |
Driving/riding drunk | - | 1.75 (0.88–3.49) | 1.97 (1.18–3.29) ** | 0.117 | - | 1.11 (0.56–2.18) | 0.134 |
Driving/riding high | - | - | - | - | 1.95 (0.94–4.00) | 0.049 |
Dependent Variables | SAM Frequency Est (SE) | R2 |
---|---|---|
Mental health symptoms | ||
Anxiety | −0.01 (0.05) | 0.190 |
Depression | 0.06 (0.05) | 0.231 |
Psychosis | 0.18 (0.05) *** | 0.292 |
ODD | 0.11 (0.05) * | 0.218 |
ADHD | 0.11 (0.05) * | 0.151 |
CD | 0.16 (0.06) ** | 0.045 |
Substance use | ||
HED | 0.32 (0.05) *** | 0.195 |
Tobacco use | 0.20 (0.06) ** | 0.140 |
Illicit drug use | 0.28 (0.06) *** | 0.152 |
Marijuana | 0.67 (0.04) *** | 0.513 |
Harms | OR (95% CI) | |
Social harms | 1.28 (1.05–1.56) * | 0.049 |
AUD symptoms | 1.41 (1.15–1.73) ** | 0.053 |
Driving/riding drunk | 1.38 (1.12–1.70) ** | 0.247 |
Driving/riding high | 2.04 (1.62–2.58) *** | 0.090 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Thompson, K.; Holley, M.; Sturgess, C.; Leadbeater, B. Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood. Int. J. Environ. Res. Public Health 2021, 18, 3652. https://doi.org/10.3390/ijerph18073652
Thompson K, Holley M, Sturgess C, Leadbeater B. Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood. International Journal of Environmental Research and Public Health. 2021; 18(7):3652. https://doi.org/10.3390/ijerph18073652
Chicago/Turabian StyleThompson, Kara, Maria Holley, Clea Sturgess, and Bonnie Leadbeater. 2021. "Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood" International Journal of Environmental Research and Public Health 18, no. 7: 3652. https://doi.org/10.3390/ijerph18073652
APA StyleThompson, K., Holley, M., Sturgess, C., & Leadbeater, B. (2021). Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood. International Journal of Environmental Research and Public Health, 18(7), 3652. https://doi.org/10.3390/ijerph18073652