Day-level shifts in social contexts during youth cannabis use treatment.

Abstract

Objective: Social context plays a critical role in youth cannabis use. Yet few studies have examined if and when social contexts shift during cannabis use treatment. This study examined daily shifts in youths' social contexts with the goal of characterizing how specific social contexts (e.g., time with cannabis-using friends or siblings) relate to cannabis craving and use during cannabis treatment. Method: Participants were 65 cannabis users (51% male), ages 15-24 years, who participated in a double-blind randomized clinical trial that tested the effects of motivational enhancement and cognitive behavioral therapies plus either adjunctive pharmacotherapy or placebo on cannabis craving and use. Ecological momentary assessment (EMA) data, collected from a pre-randomization period through the completion of the six-week intervention, assessed youths' social contexts, cannabis use, and craving. Results: Time-varying effects models identified shifts in social contexts during treatment. Overall, time spent with cannabis-using friends and siblings decreased, where time spent with non-using friends or alone increased across the trial. Time with parents or non-using siblings was unchanged. Comparing the relative associations of social contexts with same-day craving and use, more time with cannabis-using friends and with siblings was uniquely associated with greater craving and use. Conclusions: Social context is an important factor in youth substance-use treatment. While time spent with cannabis-using friends and siblings decreased over treatment for all participants, those who continued to spend time with using individuals reported greater craving and use. This research supports increased attention to shifting youths' social contexts to enhance treatment success. Public Health Significance StatementThis study highlights that youth undergoing treatment for cannabis misuse decrease their time with cannabis-using peers and increase their time with non-using peers over the course of treatment. Attention should be given to the time youth spend with cannabis-using peers and siblings during treatment as these social contexts are associated with higher levels of craving and cannabis use.

Mechanisms of behavior change in adolescent substance use treatment: A systematic review of treatment mediators and recommendations for advancing future research.

“…Another difference between adolescents and adults is the importance of peers in SU behaviors during adolescence (Chassin et al, 2016). Adolescent SU primarily occurs in the context of peers and a central target of interventions is shifting adolescents from social networks supportive of SU to social networks supportive of recovery (Meisel et al, 2021). Although most interventions for adolescent SU address the peer context (Hogue et al, 2018), no studies examined changes in adolescents’ social contexts.…”

Time‐varying effect modeling with intensive longitudinal data: Examining dynamic links among craving, affect, self‐efficacy and substance use during addiction recovery

“…This study found that RMCs were protective with respect to several non‐substance use recovery outcomes at certain periods in recovery, informing strategies for improving the timing and intensity of check‐ups [16]. Another recent study applied TVEM to understand how the time‐varying associations between time spent in social contexts (with substance‐using versus non‐using people) and craving unfold across time in recovery [53], showing that greater time spent with using friends increased craving among youth receiving cannabis treatment. Together, these results showcase the utility of TVEM, helping to delineate aspects of recovery that otherwise may be too complex to model.…”

“…An empirical demonstration: dynamic associations and moderation effects during early recovery Substance use researchers have been at the forefront of using TVEM with ILD, with investigations primarily involving the study of tobacco use/smoking behaviors and a few studies on alcohol use [41,[45][46][47][48][49][50][51], but only a few very recent investigations have used TVEM to study addiction recovery processes [16,17,52,53]. The present empirical study builds upon prior research by studying time-varying self-reported experiences of affect and craving and their associations with recovery outcomes (i.e.…”

A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults.

“…Emery et al (2020) used prerandomization data to examine how affect and situational cues relate to planned and unplanned cannabis use. Meisel, Carpenter, et al (2021) examined changes in day-level associations between cannabis-using peers, nonusing peers, cannabis craving, and grams used per day. Meisel, Padovano, and Miranda (2021) examined how time spent with cannabis-using versus nonusing peers related to cannabis use and craving.…”