Does cannabis substitute or complement alcohol after recreational cannabis legalization in the Washington State? A three-level mixed-effects modeling

IF 3.7 2区医学 Q1 PSYCHOLOGY, CLINICAL Addictive behaviors Pub Date : 2024-12-06 DOI:10.1016/j.addbeh.2024.108218

Yachen Zhu, Pamela J. Trangenstein, William C. Kerr

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Abstract

Background

Whether cannabis substitute or complement alcohol remains inconclusive. Little is known about the daily-level associations between cannabis and alcohol use by cannabis user type (medical vs. recreational use) in people who use alcohol and cannabis within a legalized environment.

Methods

Adult participants were from four waves of Washington Panel Survey during 2014–2016, who consumed both cannabis and alcohol in the past six months. Daily measurements of alcohol and cannabis use in the past week were collected at each wave. Our outcome variable was continuous alcoholic drinks, the exposure was any cannabis use. We applied three-level negative binomial models to account for within-person wave-to-wave and between-person variations, deriving pure within-person within-wave associations between cannabis and alcohol use at the daily level. A cross-level interaction between day-level cannabis use and wave-level medical cannabis recommendation investigated the potential differential substitution/complementarity patterns by medical recommendation status.

Results

259 respondents with 440 person-waves and 3,051 daily observations were included. We found a statistically significant pure Level 1 (within-person daily-level) effect of cannabis use among recreational cannabis users (IRR = 1.37, 95 % CI: 1.05–1.79, p = 0.02), showing a complementary use pattern. We also found a statistically significant cross-level interaction between medical cannabis recommendation and cannabis use at Level 1 (IRR = 0.57, 95 % CI: 0.34–0.96, p = 0.03), indicating that, differently from recreational users, medical cannabis users may have a substitution use pattern.

Conclusions

Cannabis user type may inform co-use patterns. This study suggested recreational cannabis users tended to use alcohol and cannabis in a complementary manner in Washington State following the legalization of recreational use.

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在华盛顿州娱乐性大麻合法化后，大麻是酒精的替代品还是补充？三级混合效果建模。

背景：大麻是否替代或补充酒精仍然没有定论。对于在合法环境中使用酒精和大麻的人群中，按大麻使用者类型（医疗与娱乐用途）划分的大麻和酒精使用之间的日常水平关联，了解甚少。方法：成年参与者来自2014-2016年华盛顿小组调查的四波，他们在过去六个月内既使用大麻又使用酒精。过去一周的酒精和大麻使用的每日测量数据在每一波收集。我们的结果变量是连续饮酒，暴露是任何大麻的使用。我们应用三水平负二项模型来解释人体内波对波和人与人之间的变化，得出大麻和酒精使用在日常水平上的纯粹人体内波内关联。日级大麻使用和波级医用大麻推荐之间的跨级别相互作用调查了医疗推荐状态不同的潜在差异替代/互补模式。结果：259名受访者，440人波和3051个日常观察。我们发现，在娱乐性大麻使用者中，大麻使用具有统计学意义的纯1级（人内每日水平）效应（IRR = 1.37, 95% CI: 1.05-1.79, p = 0.02），显示出互补的使用模式。我们还发现，医用大麻推荐量与大麻使用之间在1级水平上存在显著的跨水平交互作用（IRR = 0.57, 95% CI: 0.34-0.96, p = 0.03），这表明，与娱乐性大麻使用者不同，医用大麻使用者可能存在替代使用模式。结论：大麻使用者类型可能会影响共同使用模式。这项研究表明，在华盛顿州娱乐性大麻使用合法化后，娱乐性大麻使用者倾向于以一种互补的方式使用酒精和大麻。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addictive behaviors 医学-药物滥用

CiteScore

8.40

自引率

4.50%

发文量

283

审稿时长

46 days

期刊介绍： Addictive Behaviors is an international peer-reviewed journal publishing high quality human research on addictive behaviors and disorders since 1975. The journal accepts submissions of full-length papers and short communications on substance-related addictions such as the abuse of alcohol, drugs and nicotine, and behavioral addictions involving gambling and technology. We primarily publish behavioral and psychosocial research but our articles span the fields of psychology, sociology, psychiatry, epidemiology, social policy, medicine, pharmacology and neuroscience. While theoretical orientations are diverse, the emphasis of the journal is primarily empirical. That is, sound experimental design combined with valid, reliable assessment and evaluation procedures are a requisite for acceptance. However, innovative and empirically oriented case studies that might encourage new lines of inquiry are accepted as well. Studies that clearly contribute to current knowledge of etiology, prevention, social policy or treatment are given priority. Scholarly commentaries on topical issues, systematic reviews, and mini reviews are encouraged. We especially welcome multimedia papers that incorporate video or audio components to better display methodology or findings. Studies can also be submitted to Addictive Behaviors? companion title, the open access journal Addictive Behaviors Reports, which has a particular interest in ''non-traditional'', innovative and empirically-oriented research such as negative/null data papers, replication studies, case reports on novel treatments, and cross-cultural research.