RESUMO
Objective: Concurrent and simultaneous cannabis and alcohol co-use confers risk for daily negative alcohol consequences. However, studies often treat co-use as a dichotomy, precluding examination of higher- and lower-risk co-use days. Additionally, little is known about specific alcohol consequences associated with daily co-use. Therefore, the current study 1) differentiated days based upon alcohol consumption, co-use, and simultaneous use, and 2) tested whether certain day-level use patterns conferred risk for daily alcohol consequences. Methods: College student co-users (N=489) completed an online Timeline Followback, reporting daily alcohol consumption, negative alcohol consequences, concurrent cannabis and alcohol co-use, and simultaneous co-use (SAM) on drinking days over the past month. Day-Level Latent Profile Analysis differentiated days based upon drinking quantity, co-use, and simultaneous use, and tested whether patterns of use conferred risk for overall and specific negative alcohol consequences. Results: Four day-level profiles emerged, including moderate consumption of alcohol-only days (57.5%), moderate consumption SAM use days (29.1%), higher consumption alcohol-only days (7.4%), and higher consumption SAM use days (6%). Higher consumption SAM use days were associated with more negative alcohol consequences than all other days; however, higher consumption SAM use days differed from higher consumption alcohol-only days in acute dependence symptoms. Higher consumption alcohol-only days were associated with more negative alcohol consequences than moderate consumption SAM days, particularly those that were action-oriented (i.e., dependence symptoms, blackout drinking, impaired control, risky behavior, social/interpersonal consequences). Conclusions: Findings suggest that there are in fact lower-risk co-use days, and that links with unique negative alcohol consequences depend on levels of alcohol consumption and co-use.
RESUMO
Background: The legal cannabis landscape has greatly outpaced scientific knowledge. Many popular cannabis claims, such as cultivar (colloquially referred to as strain) classification and terpene content producing different subjective effects, are unsubstantiated. This study examined, for the first time, whether cultivar classification (sativa/indica) and terpene content (caryophyllene, limonene, myrcene, pinene, and terpinolene) were associated with subjective cannabis effects (i.e., pain levels, low-arousal ["indica-like"] effects, high-arousal ["sativa-like"] effects, and negative effects). Methods: Regular cannabis users (n=101) took part in a 2-week long ecological momentary assessment study in which they responded to questions about their cannabis use, stated their preference for sativa versus indica, and reported their in-the-moment subjective effects within 30 min of smoking cannabis. Cultivars were coded for sativa versus indica classification and primary terpene content using Leafly, a popular search engine. Linear mixed-effect models then examined subjective response by sativa/indica and primary terpene. Covariates included demographics (age, sex, race, income), cannabis use (medical use, cannabis use frequency, stated preference for sativa/indica, global expected cannabis effects), morning pain ratings, and specific smoked cannabis occasions (hour of day, minutes since use, context, number of hits, and tetrahydrocannabinol). Results: The majority of participants (78.3%) had a preference for either sativa or indica and reported reasons for their preference that aligned with industry claims. After controlling for covariates, findings revealed that cultivars classified as indica dominant were associated with greater low-arousal (e.g., sluggish, slow) effects relative to the unweighted mean of all cannabis cultivars (b = 0.44, SE=0.16, p=0.01). Cultivars with primary caryophyllene were associated with greater pain ratings (b = 0.53, SE=0.24, p=0.03) and negative effects (b = 0.22, SE=0.08, p=0.01) relative to the mean of all other terpene types. Cultivars with primary pinene were associated with less negative effects (b = -0.35, SE=0.18, p=0.04). Conclusions: Cultivars classified as indica dominant were associated with greater low-arousal effects in models that accounted for both within- and between-person variation, despite the scientific challenges distinguishing between sativa and indica. Preliminary findings also suggest terpenes may play a role in subjective effects. These results emphasize the need for further research, particularly controlled lab studies.
