Cannabis Use among Treatment-Seeking Smokers: Motives and the Moderating Effects of Anxiety Sensitivity

Cannabis Use, Use Motives and Cannabis Use Disorder Among Berlin College Students

This study described cannabis use behavior among college students in Berlin, in particular, differences in use motives between subjects with frequent use and those with signs of cannabis use disorder (CUD). Cross-sectional data were collected via an online survey among Berlin college students ( N=9350; 50.7% women; Mage=24.4). Motivation scales were computed based on an exploratory factor analysis. Effects of these motive scales were compared using multivariate regression models, where the dependent variable was use intensity (ordinal), frequent use (twice or more per week, binary) or a positive substance use disorder screening test (binary). Cannabis use is known to be particularly prevalent among Berlin college students, which was confirmed by our data. The most frequent use motive was enhancement, which, however, was not associated with frequent use or CUD. The motives predicting frequent use (sociability) are different from motives predicting CUD (coping), even when controlling for a wide array of covariates.

Anxiety sensitivity and substance use: Differential levels across individuals primarily using opioids, cannabis, or stimulants

BACKGROUND

The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized that individuals primarily using opioids or cannabis would evidence higher levels of AS compared to individuals primarily using stimulants.

METHODS

The sample consisted of 110 veterans (including 29 individuals primarily using opioids, 42 primarily using cannabis, and 39 primarily using stimulants) presenting for psychological services to a Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) specialty clinic at a large southeastern Veteran Affairs (VA) hospital.

RESULTS

AS levels varied by group with individuals primarily using stimulants evidencing the highest levels followed by those primarily using opioids and then those primarily using cannabis. Individuals primarily using stimulants had statistically significantly higher levels of AS physical concerns compared to individuals primarily using cannabis but not those primarily using opioids. Further, individuals who primarily use opioids did not differ from those primarily using cannabis.

CONCLUSIONS

Taken together, these findings call into question the notion that AS may be negatively related to the use of substances that have anxiogenic properties.

Do marijuana use motives matter? Meta-analytic associations with marijuana use frequency and problems

As laws expanding the accessibility of marijuana proliferate, it is increasingly important to understand how various motivations for use are differentially associated with marijuana use (e.g., frequency, quantity) and problems associated with marijuana use (e.g., reduced productivity, relationship conflict, legal issues). We conducted a meta-analytic review (k = 48, N = 11,274) of the zero-order and partial association between five marijuana use motives (i.e., coping, enhancement, social, conformity, and expansion) and a range of marijuana use outcomes (e.g., use frequency, problematic use). For marijuana use frequency zero-order correlations, we found significant positive correlations for coping, enhancement, social, and expansion, but not conformity. For marijuana use problems zero-order correlations, we found significant positive correlations for all five motives. When adjusting for the other motives, only coping, enhancement, and expansion were significantly positively associated with marijuana use frequency, and conformity was significantly negatively related to marijuana use frequency. For marijuana use problems, only coping and conformity had significant positive correlations. These results show that marijuana use motives are an important part of understanding the frequency of marijuana use and the development of marijuana use problems. These results may have implications for intervention development and public policy.

The Interactive Influence of Cannabis-Related Negative Expectancies and Coping Motives on Cannabis Use Behavior and Problems

OBJECTIVES

The present study tested whether coping motives for cannabis use moderate the effect of negative expectancies on cannabis use.

METHODS

Participants were 149 (36.2% female, 61.59% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of cannabis-related expectancies and motives for use. Hierarchical multiple regressions were employed to investigate the predictive value of the interaction between negative expectancies and coping motives on cannabis use outcomes.

RESULTS

Results revealed interactions between negative expectancies and coping motives with respect to past 90 day cannabis use frequency and cannabis problems. Global negative effects expectancies were associated with less frequent cannabis use, particularly among those with fewer coping motives. However, negative expectancies were related to more cannabis problems, particularly among those with higher coping motives.

CONCLUSIONS

These results suggest it may be advisable to take coping motives into account when addressing expectancies among cannabis users.

Distress tolerance predicts coping motives for marijuana use among treatment seeking young adults

Given increasing marijuana use and abuse among young adults in the United States and the associated physical and mental health consequences, it is important to improve our understanding of factors that may contribute to problematic marijuana use. A convergence of theory and research underscores the relevance of particular marijuana use motives generally, and coping-related motives specifically, in enhancing risk for marijuana use problems. Distress tolerance is a transdiagnostic emotion vulnerability factor that may relate to coping-related motives for marijuana use. The current study was designed to further explore this relationship within a treatment-seeking sample of young adults (Mage=24.40; SD=2.06 years). Results were consistent with hypotheses, suggesting distress tolerance is related to coping motives for marijuana use within this treatment-seeking sample, even after accounting for a number of theoretically relevant covariates. Theoretical and applied implications of distress tolerance as it relates to coping motives for marijuana use as treatment targets are discussed.

Multisubstance Use Among Treatment-Seeking Smokers: Synergistic Effects of Coping Motives for Cannabis and Alcohol Use and Social Anxiety/Depressive Symptoms

OBJECTIVE

This study examined the impact of coping motives for cannabis and alcohol use on the relation between social anxiety/depressive symptoms and severity of substance use for alcohol, tobacco, and cannabis among treatment-seeking smokers who also use cannabis and alcohol.

METHODS

The sample included 197 daily cigarette smokers (MAge 34.81 years, SD = 13.43) who reported using cannabis and alcohol.

RESULTS

Hierarchical multiple regression analyses were conducted wherein separate models were constructed for each dependent variable. Among individuals with higher social anxiety, alcohol coping motives were associated with heavier drinking, and this was more pronounced among those low in depressive symptoms. Similarly, those at greater risk for nicotine dependence were anxious individuals with lower depressive symptoms who endorse coping-oriented motives for using cannabis. Further, among those with higher social anxiety, cannabis coping motives were associated with marginally greater drinking, particularly for those high in depressive symptoms.

CONCLUSIONS

The present findings support the perspective that among multisubstance users, the interplay between social anxiety, depressive symptoms, and coping-oriented motives for using one substance (e.g., cannabis or alcohol) may pose difficulties in refraining from other substances (e.g., tobacco). This observation highlights the importance of tailoring multisubstance treatments to specific needs of multiusers for whom single-substance interventions may be less effective. Findings also support previous work exploring the benefits of concurrently treating co-occurring substance use and lend credence to the perspective that motivation to use substances for coping reasons is of central theoretical and clinical relevance.

Cannabis Motives and Quitting Tobacco: Smoking Expectancies and Severity among Treatment-seeking Cigarette Smokers

OBJECTIVE

The present research examined the impact of cannabis motives on tobacco outcomes.

METHODS

The sample included 403 daily smokers (214 males, mean age 35.24 years). A bifactor model of cannabis motives was examined to determine whether this approach might best elucidate relations between cannabis motives and smoking.

RESULTS

Coping motives were associated with reduced barriers for smoking, fewer negative smoking expectancies, and decreased positive reinforcement with respect to smoking. Conformity motives were associated with fewer internal smoking barriers. Expansion motives were associated with more positive reinforcement related to smoking. Enhancement motives were associated with reductions in smoking for appetite/weight control consequences. The general motives variable, comprised of each of the five motives subscales, was associated with more barriers related to tobacco addiction, more external barriers, greater positive reinforcement consequences, and more negative expectancies. Coping motives were negatively associated with quit status, and were positively associated with quit status.

CONCLUSIONS

Cannabis motives subscales were not uniformly predictive of quit success. Individuals who used cannabis for conformity reasons were more likely to successfully quit smoking, however, individuals who used cannabis for coping reasons were less likely to quit smoking. Thus, those who use cannabis for conformity reasons are less likely to turn to cannabis during times of stress or to relieve tension or anxiety, a view supported by existing literature. This suggests that individuals who use cannabis for coping reasons may represent a population vulnerable to cannabis misuse and problems. Additional work is needed to better understand underlying mechanisms.

The influence of cannabis motives on alcohol, cannabis, and tobacco use among treatment-seeking cigarette smokers

OBJECTIVES

The present study evaluated the effects of cannabis motives on multi-substance use in an effort to examine the incremental validity of cannabis motives with respect to substance use outcomes.

METHODS

Participants were 167 treatment-seeking smokers (41.92% female; Mage=28.74; SD=11.88) who reported smoking an average of 10 or more cigarettes daily for at least one year.

RESULTS

Structural equation modeling was used to examine the association between cannabis motives and two dependent variables each for alcohol (drinking frequency and alcohol problems), cannabis (cannabis use frequency and cannabis problems), and tobacco (average cigarettes per day and nicotine dependence). Findings indicated that conformity motives were linked with increases in alcohol problems and cannabis problems. Enhancement motives were associated with increased cannabis use and cannabis problems. Coping motives were linked with increased cannabis use and cannabis problems. Contrary to expectations, expansion motives were associated with reductions in the number of cigarettes smoked per day. Also, results supported expectations that the observed effects due to cannabis motives were unique from shared variance with theoretically relevant covariates.

CONCLUSIONS

The present findings supported predictions that cannabis motives would evince effects on the use of multiple substances over and above theoretically relevant variables. However, results indicate that the relationship between cannabis motives and multi-substance use is complex, and therefore, additional research is warranted to better understand substance use intervention.