Daily marijuana users with past alcohol problems increase alcohol consumption during marijuana abstinence.
Drug abuse treatment programs typically recommend complete abstinence because of a fear that clients who stop use of one drug will substitute another. A within-subjects study investigated whether consumption of alcohol and other substances changes during marijuana abstinence. Twenty-eight daily marijuana users who were not trying to stop or reduce their marijuana consumption completed an 8-day baseline period in which they used marijuana and other drugs as usual, a 13-day marijuana abstinence period, and a 7-day return-to-baseline period. Participants provided self-report of substance use daily and submitted urine samples twice weekly to verify marijuana abstinence. A diagnosis of past alcohol abuse or dependence significantly moderated the alcohol increase from baseline to marijuana abstinence (p<0.01), such that individuals with this diagnosis significantly increased alcohol use (52% increase) but those without this history did not (3% increase). Increases in marijuana withdrawal discomfort scores and alcohol craving scores from baseline to marijuana abstinence significantly and positively correlated with increases in alcohol use. Increases in cigarettes, caffeine, and non-marijuana illicit drugs did not occur. This study provides empirical validation of drug substitution in a subgroup of daily marijuana users, but results need to be replicated in individuals who seek treatment for marijuana problems.
Yale University School of Medicine, The APT Foundation, One Long Wharf, New Haven, CT 06511, USA. erica.peters@yale.edu
Erica N
EN
Peters
John R
JR
Hughes
D000293:Adolescent; D000328:Adult; D000374:Aggression; D000428:Alcohol Drinking; D000437:Alcoholism / Q000150:complications* / Q000523:psychology; D000786:Anger; D003863:Depression / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D013759:Dronabinol / Q000652:urine; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data; D001068:Feeding and Eating Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation / Q000652:urine; D017533:Marital Status; D018579:Patient Selection; D012893:Sleep Wake Disorders / Q000209:etiology; D013375:Substance Withdrawal Syndrome / Q000523:psychology*
D013759:Dronabinol