Intercorrelation of Alcohol and Other Drug Use Disorders among a National Sample of Drivers

Cannabis Adaptation During and After Alcohol Ignition Interlock Device Installation: A Longitudinal Study

OBJECTIVE

A common intervention to prevent alcohol-impaired driving are alcohol ignition interlock devices (IIDs), which prevent drivers with a blood alcohol concentration greater than .025% from starting the car. These devices force drivers to adapt their drinking to accommodate the device. Prior studies indicated a transfer of risk as some drivers with an IID may increase cannabis use as they decrease alcohol use. This study examines whether this increase in cannabis use persists after IID removal when alcohol use reverts to pre-IID levels.

METHOD

The data are from the Managing Heavy Drinking (MHD) study of drivers in New York State. The MHD is a comprehensive three-wave study of drivers convicted of driving under the influence from 2015 to 2020. Participants (N = 189) completed all waves, and provided oral fluid/blood and hair samples to measure cannabis and alcohol use, respectively. Mixed between-within analysis of variance was conducted to assess cannabis use at IID installation (Time 1), removal (Time 2), and at 6-month follow-up (Time 3).

RESULTS

In aggregate, participants increased their cannabis use over the course of the study. Drivers who decreased their alcohol use while the IID was installed on their car significantly increased their cannabis use while the IID was in place and further increased cannabis use after the device's removal.

CONCLUSIONS

IIDs are efficacious in preventing alcohol-impaired driving. However, in some cases, they may have the unintended effect of increasing other substance use. The current study outlines the need for supplemental treatment interventions while on IID to prevent a transfer of risk to other substances, or polysubstance use after the device is removed.

The association between quantity, frequency and duration of cocaine use during the heaviest use period and DSM-5 cocaine use disorder

BACKGROUND

Quantity (Q), frequency (F), and duration (D) of cocaine use during a person's heaviest use period are important aspects of cocaine use patterns that associated with cocaine use disorder (CocUD).

METHODS

A total 2988 lifetime cocaine users who met CocUD after the onset of cocaine heaviest use were identified from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). QFD were each categorized into four levels. Hierarchical regressions were used to examine the association between QFD of cocaine use and CocUD. Two-way interactions between QFD were also examined.

RESULTS

As the level of cocaine use increased from low to very high, the prevalence of CocUD increased. Compared to people with low F, cocaine users with very high F were 12.09 times (95 %CI 6.33, 23.07) as likely to meet criteria for CocUD. Similarly, Q was associated with 4.84 (95 %CI 2.55, 9.18) times the risk of CocUD. D was not significantly associated with the risk of CocUD. Significant additive interaction was identified between Q*F on CocUD prevalence. Approximately one-third of the excess risk associated with having high Q & high F was due to the interactive effect.

CONCLUSION

Of these three cocaine use patterns, F had the strongest association with CocUD, followed by the Q. High Q and high F was a very dangerous pattern of cocaine use as the combination had as a synergistic effect on the risk of CocUD. It is important for intervention programs to focus on the reduction of both Q and F.

Potential for cannabis adaptation among participants in a drunk driving intervention

Background

Some alcohol interventions have been found to have the adverse outcome of increasing non-alcohol-related substance use. It is unknown, however, how changes in alcohol use over the course of alcohol ignition interlocks - a common DUI intervention - may impact other substance use.

Methods

Alcohol and cannabis use were measured using hair ethylglucuronide and Delta-9-Tetrahydrocannabinol concentrations in blood, respectively. Participants (N = 69) were measured at the interlock installation period and again 6-months later while the interlock was installed. A mixed ANOVA was conducted to examine changes in levels of ethanol and THC over time.

Results

On measures of marijuana use, there was a significant interaction effect between the group that increased alcohol use and time F(2, 66) = 7.863, p =.001; partial η ² =.192; as well as a main effect for time F(2, 66) = 21.106, p <.001; partial η ² =.242.

Conclusions

Installing interlocks may inadvertently increase cannabis use among those who decrease alcohol use. Crash risk associated with cannabis use is notably less than that of alcohol use, however, continued cannabis use may be problematic when the device is removed and alcohol use is expected to return to the higher pre-interlock levels.

Characteristics of Prescription-Opioid-Impaired and Other Substance-Impaired Drivers in Rural Appalachian Kentucky

Previous studies have highlighted the prescription opioid epidemic in rural Appalachia and its associated risk behaviors; however, no studies have examined prescription-opioid-impaired driving as a consequence of this epidemic. The purpose of the present study was to describe prescription-opioid-impaired drivers in rural Appalachian Kentucky and examine how they are similar to and different from other substance-impaired drivers from the region. A sample of convicted DUI offenders from rural Appalachian Kentucky completed a confidential research interview focused on their substance use, mental health, and criminal activity. Prescription-opioid-impaired drivers (n = 33) were compared to other drug-impaired drivers (n = 29) and to alcohol-only-impaired drivers (n = 44). Overall, prescription-opioid-impaired drivers had a similar prevalence of illicit substance use and criminal activity, including impaired driving frequency, to other drug-impaired drivers, but had a higher prevalence of illicit substance use and more frequent impaired driving when compared to alcohol-only-impaired drivers. Study implications include the importance of comprehensive substance abuse assessment and treatment for DUI offenders and the need for tailored interventions for prescription-opioid-impaired and other drug-impaired drivers.