Individualized assessment and treatment program (IATP) for cannabis use disorder: Randomized controlled trial with and without contingency management

The daily association between affect and alcohol use: A meta-analysis of individual participant data

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Too Much Information? Excessive Media Use, Maladaptive Coping, and Increases in Problematic Cannabis Use during the COVID-19 Pandemic

During a health crisis like the COVID-19 pandemic, the public depends on the media for accurate and up-to-date information. However, frequent use of media for COVID-19-related information may be associated with maladaptive coping, and with increased prevalence of substance use. This study examined indirect associations between the frequency of media use for information about COVID-19 and increases in cannabis use behaviors through maladaptive coping strategies. We use data from an online survey of Israeli adult cannabis users (N = 440), conducted in May of 2020, to test associations between media use frequency for COVID-19 information and three problematic cannabis use behaviors: increased cannabis use, increased use alone, and increased use before midday. Among all respondents, 41% agreed that their cannabis use had increased since the onset of the pandemic. Analyses showed that higher frequency of media use was positively associated with all three indicators of problematic cannabis use, and that associations were partly mediated by maladaptive coping strategies. Higher frequency of media use for information about COVID-19 may be an indicator of difficulty with coping and of increased risk of escalation of cannabis use. These results have implications for assessing and mitigating the risk of coping-motivated cannabis use during a crisis.

Momentary coping and marijuana use in treated adults: Exploring mechanisms of treatment

OBJECTIVE

This study was designed to test the hypothesis that an Individualized Assessment and Treatment Program (IATP) for cannabis use disorder (CUD) that utilized experience sampling (ES) data to individualize treatment would be more effective at eliciting adaptive coping responses in high-risk situations than a more conventional cognitive-behavioral treatment. It was further expected that increases in momentary adaptive coping, positive affect, and self-efficacy expectancies would mediate the effects of treatment on momentary drug use in the hours following a temptation-to-use episode.

METHOD

The participants were 198 adults seeking treatment for CUD, randomized to receive either a conventional motivational enhancement + cognitive-behavioral treatment (MET-CBT) with or without contingency management (CM) or an IATP with or without CM. Treatment took place over nine individual sessions, and follow-ups were conducted out to 14 months post-intake. ES data were recorded in all treatments at pretreatment, and at various points during and after treatment.

RESULTS

Analyses of ES data indicated that the IATP conditions yielded greater increases in use of adaptive coping skills during temptation episodes than did the MET-CBT conditions. Mediation analyses supported the hypothesis that momentary use of coping skills mediates the effects of IATP on use or non-use of marijuana in the hours following a temptation episode.

CONCLUSIONS

Use of an individualized coping treatment approach results in lower use of marijuana in high-risk situations, and actual utilization of adaptive coping appears to be a mechanism of that effect. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Decreased drinking in adults with co-occurring cannabis and alcohol use disorders in a treatment trial for marijuana dependence: Evidence of a secondary benefit?

The purpose of the present study was to investigate whether cannabis dependent users who met criteria for a secondary diagnosis of alcohol use disorder (AUD) would increase their use of alcohol in response to decreasing their use of marijuana in a behavioral treatment trial for cannabis use disorder (CUD). This phenomenon is commonly known as "substance substitution." Participants were randomly assigned to one of four 9-session treatment conditions with cannabis and alcohol use measured at baseline, posttreatment, and at 4 follow-ups through 14 months. Of those enrolled (n = 198), 27 (13.6%) also met criteria for AUD. Linear mixed models were used to analyze alcohol use over time with cannabis use and time as predictors. Findings demonstrated that there were no associations between declines in cannabis use and changes in alcohol consumption in the full sample. However, among those with CUD who also had AUD, declines in cannabis use significantly predicted concurrent declines in alcohol use (p < .05). This study did not find evidence of substance substitution among individuals receiving treatment for CUD. Contrary to expectations, the results indicated that individuals with AUD were more likely to decrease, rather than increase, their alcohol use when they reduced their marijuana use. Treatment for CUD in this study appeared to result in improvements in substance use generally, at least for those with comorbid AUD.