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Addiction. 2017 Apr;112(4):685-694. doi: 10.1111/add.13693. Epub 2017 Jan 10.

Cannabis use during treatment for alcohol use disorders predicts alcohol treatment outcomes.

Author information

1
Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.
2
Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA.
3
Providence Veterans Affairs Medical Center, Providence, RI, USA.

Abstract

AIMS:

To compare post-treatment alcohol use between those who use cannabis and those who abstain during treatment for alcohol use disorders (AUD); and to examine potential cannabis use thresholds by comparing post-treatment alcohol use between four frequency groups of cannabis users relative to abstainers.

DESIGN:

Secondary analyses of the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) Study, a randomized control trial of AUD treatments. The current study compares longitudinal drinking data between those who used cannabis versus those who abstained during COMBINE treatment.

SETTING:

The COMBINE Study treatments were delivered on an out-patient basis for 16 weeks. The current analyses include 206 cannabis users and 999 cannabis abstainers.

PARTICIPANTS:

All participants met diagnosis of primary alcohol dependence (n = 1383).

MEASUREMENTS:

Primary exposures were any cannabis use and quartiles of cannabis use (Q1: 1-4 use days during treatment, Q2: 5-9 days, Q3: 10-44 days, Q4: 45-112 days). Outcomes were percentage of days abstinent from alcohol (PDA), drinks per drinking day (DPDD) and percentage of heavy drinking days (PHD), all measured at treatment end and 1 year post-treatment.

FINDINGS:

Compared with no cannabis use, any cannabis use during treatment was associated with 4.35% [95% confidence interval (CI) = -8.68, -0.02], or approximately 4 fewer alcohol abstinent days at the end of treatment. This association weakened by 1 year post-treatment (95% CI = -9.78, 0.54). Compared with no cannabis use, only those in the second quartile of cannabis use (those who used once or twice per month during treatment) had 8.81% (95% CI = -17.00, -0.63), or approximately 10 fewer days alcohol abstinent at end of treatment, and 11.82% (95% CI = -21.56, -2.07), or approximately 13 fewer alcohol abstinent days 1 year post-treatment. Neither any cannabis use nor quartiles were associated with DPDD or PHD at either time-point.

CONCLUSIONS:

Among individuals in alcohol treatment, any cannabis use (compared with none) is related to a significantly lower percentage of days abstinent from alcohol post-treatment, although only among those who used cannabis once or twice per month.

KEYWORDS:

Alcohol; alcohol dependence; alcohol use disorders; cannabis; marijuana; treatment

PMID:
27865015
PMCID:
PMC5339049
DOI:
10.1111/add.13693
[Indexed for MEDLINE]
Free PMC Article

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