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.
Peters
Erica N
EN
Yale University School of Medicine, The APT Foundation, One Long Wharf, New Haven, CT 06511, USA. erica.peters@yale.edu
Hughes
John R
JR
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