Cross-substance primed and cue-induced craving among alcohol and cannabis co-users: An experimental psychopharmacology approach.

Abstract

Co-use of alcohol and cannabis is highly prevalent and often problematic. However, mechanisms underlying their co-use remain unclear. This randomized and crossover study tests cross-substance subjective craving for alcohol and cannabis. A community sample of nontreatment-seeking alcohol and cannabis co-users (N = 30 completers, 40% female) reporting high-risk levels of alcohol and cannabis use completed two experimental sessions in their homes and were monitored remotely using internet meeting technology (i.e., Zoom). The two counterbalanced and randomized sessions were as follows: (a) consumption of a standard alcoholic beverage followed by cannabis cue exposure and (b) consumption (i.e., smoking) of a miniature cannabis cigarette (containing 18%–22% tetrahydrocannabinol), followed by alcohol cue exposure. Participants rated their subjective craving for both alcohol and cannabis at baseline, following alcohol/cannabis administration, and following the presentation of cross-substance-related cues. Repeated measures analysis of variances revealed a statistically significant difference in cannabis craving across time, such that craving for cannabis was significantly higher following cannabis cue reactivity, compared to baseline and following alcohol administration (p‘s < .001). Similarly, there was a statistically significant difference in alcohol craving across time, such that craving for alcohol was significantly higher following alcohol cue reactivity, compared to baseline and following cannabis administration (p‘s < .001). Overall, results suggest that individuals who co-use alcohol and cannabis are most sensitive to the cue-induced, rather than the pharmacologically induced effects, of substance administration on cross-substance craving. This pattern of findings does not support a complementarity model. Conversely, these results may be interpreted as indicative of a substitution model for alcohol and cannabis co-use.

Cannabis craving in response to alcohol cues in the laboratory and in daily life among adolescents ages 15–17 years

“…Our findings of no significant cross‐cue reactivity in the laboratory among adolescents and emerging adults in either sample are consistent with recent work finding no cross‐cue reactivity for alcohol and cannabis among adults in an experimental pharmacology study of cross‐cue‐induced craving following consumption of alcohol or cannabis (Venegas & Ray, 2023). One important limitation of our work, however, is that we did not assess adolescents' history of simultaneous use of alcohol and cannabis.…”

“…In our previous sample, given that we had a wider age range that included college-aged participants and participants above the age of 21 years, we were unsure whether the contexts in which craving oc- (Venegas & Ray, 2023). One important limitation of our work, however, is that we did not assess adolescents' history of simultaneous use of alcohol and cannabis.…”

The role of sex in daily levels of high-risk alcohol and cannabis co-use

“…The sample consisted of individuals recruited with high-risk alcohol use and high-risk cannabis use and was drawn from assessment data collected during an experimental psychopharmacology study ( Venegas and Ray, 2022 ). The inclusion criteria for the study were: ≥ 21 years of age, English fluency, meeting criteria for hazardous drinking and cannabis use (i.e., score of 8 or higher on the AUDIT/CUDIT-R), smoking combustibles as preferred route of cannabis administration, and negative for alcohol and all drugs (except cannabis) at the time of the study visit.…”