Research News Roundup: March 24, 2022

    Patterns of Cannabis and Alcohol Co-Use: Substitution Versus Complementary Effects

    Journal: Alcohol Research, 2022, doi: 10.35946/arcr.v42.1.04

    Authors: Rachel L. Gunn, Elizabeth R. Aston & Jane Metrik


    Purpose: The purpose of this review is to discuss the literature regarding the concurrent use (co-use) of alcohol and cannabis and competing hypotheses as to whether cannabis acts as a substitute for (i.e., replacing the effects of alcohol, resulting in decreased use) or a complement to (i.e., used to enhance the effects of alcohol, resulting in increased use) alcohol. The impact of cannabis use on alcohol-related outcomes has received increased attention in the wake of ongoing legalization of cannabis for both medical and recreational purposes. Evidence for both hypotheses exists in the literature across a broad range of data collection methods and samples and is carefully reviewed here. In addition, various mechanisms by which cannabis may act as an alcohol substitute or complement are explored in depth with the goal of better understanding equivocal findings.

    Search Methods: This review includes articles that were identified from a search for studies on alcohol and cannabis co-use, with a specific focus on studies exploring complementary versus substitution aspects of co-use. Search terms were included in Google Scholar, PsycINFO, MEDLINE, and Web of Science. Eligible studies were those that measured alcohol and cannabis co-use in human samples in laboratory, survey, or ecological momentary assessment studies, or that directly referenced substitution or complementary patterns of use.

    Search Results: Search results returned 650 articles, with 95 meeting inclusion criteria.

    Discussion and Conclusion: Results of this review reveal compelling evidence for both substitution and complementary effects, suggesting nuanced yet significant distinctions across different populations examined in these studies. Several mechanisms for the impact of cannabis use on alcohol-related outcomes are identified, including patterns and context of co-use, timing and order of use, cannabinoid formulation, pharmacokinetic interactions, and user characteristics (including diagnostic status), all of which may influence substitution versus complementary effects. This review will inform future research studies examining this topic in both clinical and community samples and aid in the development of treatment and prevention efforts targeting those populations most vulnerable to negative consequences of co-use. Finally, this review highlights the need for additional research in more diverse samples and the use of mixed-methods designs to examine both pharmacological and contextual influences on co-use.

    To read the full text of the article, please visit the publisher’s website.

    Journal: International Journal of Environmental Research and Public Health, 2022, doi: 10.3390/ijerph19010577

    Authors: Yeonwoo Kim, Sehun Oh, Paul J. Fadel, Christopher P. Salas-Wright & Michael G. Vaughn


    Despite the adverse effects of substance use on health among individuals with preexisting cardiovascular disease (CVD), little is known about trends and correlates for substance use among individuals with CVD. We examined trends of use in tobacco, alcohol, and cannabis among US adults with heart disease. Using nationally representative data from the 2015–2019 National Survey on Drug Use and Health (N = 7339), we conducted survey-adjusted logistic regression analyses to test the significance of trends in substance use while controlling for sociodemographic factors and related correlates. Results showed that the prevalence of cannabis use among adults with a heart condition significantly increased. Notably, the prevalence of cannabis use increased by 91% among non-Hispanic Whites, while the increasing trends were not present among other racial/ethnic groups. Our results also showed that increase in cannabis use was associated with easier access, lower disapproval, and risk perceptions of cannabis. Special attention is needed to raise awareness of the risk associated with cannabis use among individuals with CVD and the implementation of an early screening and treatment strategy among those with CVD.

    To read the full text of the article, please visit the publisher’s website.

    Young Adult Healthcare Exposure and Future Opioid Misuse: A Prospective Cohort Study

    Journal: American Journal of Preventive Medicine, 2022, doi: 10.1016/j.amepre.2021.12.026

    Authors: Kirkpatrick B. Fergus, Marisa E. Schwab, Christi Butler, Benjamin N. Breyer, Hillary L. Copp & Jason M. Nagata


    Introduction: Outpatient opioid prescribing is associated with opioid misuse in young adults, but the longitudinal association between general healthcare exposure and opioid misuse has not been explored. The objective of this study is to examine the association between healthcare exposure in young adulthood and future opioid misuse.

    Methods: Data were drawn from the National Longitudinal Study of Adolescent to Adult Health (2001–2018) and analyzed in 2021. Healthcare exposure (i.e., inpatient hospitalization and visits to the clinic, emergency department, mental-health facility, or dentist) between individuals aged 18 and 26 years was the primary independent variable; only patients who did not report opioid misuse at baseline were included. Opioid misuse was defined as using prescription painkillers without a doctor’s permission and was measured 17 years after exposure. Multivariable logistic regression was used to examine any associations with opioid misuse (ages 33–43 years).

    Results: A total of 8,225 young adults with a mean baseline age of 21.8 (SE=0.12) years met inclusion criteria. Approximately 13.7% reported new opioid misuse at follow-up. Those reporting opioid misuse at follow-up were more likely to be White, lack a college education, or report depression. Those exposed to inpatient hospitalization, emergency departments, or mental-health facilities had an increased risk of future opioid misuse.

    Conclusions: In young adults reporting no opioid misuse at baseline, healthcare exposure was associated with an increased risk of opioid misuse later in adulthood in this large, national cohort. Physicians encounter this at-risk population daily, reinforcing the importance of responsible prescribing practices and the need for targeted screening, patient education, and intervention efforts in the healthcare setting.

    To read the full text of the article, please visit the publisher’s website.

    Comorbid Substance Use and Mental Health Disorders: Prior Treatment/Admission as a Predictor of Criminal Arrest among American Youths

    Journal: Cureus, 2022, doi: 10.7759/cureus.21551

    Authors: Stanley Nkemjika, Eniola Olatunji, Connie Olwit, Oluwole Jegede, Colvette Brown, Tolu Olupona & Ike S. Okosun


    Background: There is a dearth of literature with regards to substance use disorder (SUD) treatment outcomes and criminal arrest relationships.

    Aim: We aimed to examine the association between criminal arrest within a month prior to SUD treatment admissions among 12- to 24-year-old Americans and the role of recurrent or prior SUD treatment.

    Methods: The 2017 United States Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Episode Data Set – Admissions (TEDS-A; N = 333,322) was used for this analysis. Prevalence odds ratios from the multivariate logistic regression analyses were used to determine associations between recurrent or prior SUD treatment and criminal arrest one month before admission, adjusting for selected independent variables.

    Results: Prior history of SUD treatment remained associated with past criminal arrest (adjusted OR = 0.972; 95% CI: 0.954-0.991; P = 0.004) after adjusting for gender, marital status, employment status, and source of income. Comorbid SUD-mental disorder was associated with past criminal arrest (adjusted OR = 1.046; 95% CI: 1.010-1.083; P = 0.012) after adjusting for gender, marital status, employment status, education, and source of income.

    Conclusion: Our study shows that there is a protective association between history of previous substance treatment re-admissions and its relationship with criminal arrest one month before admission.

    To read the full text of the article, please visit the publisher’s website.

    Reward Deficiency Syndrome (RDS): A Cytoarchitectural Common Neurobiological Trait of all Addictions

    Journal: International Journal of Environmental Research and Public Health, 2022,

    Authors: Kenneth Blum, Abdalla Bowirrat, Eric R. Braverman, David Baron, Jean Lud Cadet, Shan Kazmi, Igor Elman, Panyotis K. Thanos, Rajendra D. Badgaiyan, William B. Downs, Debasis Bagchi, Luis Llanos-Gomez & Mark S. Gold

    Alcohol and other substance use disorders share comorbidity with other RDS disorders, i.e., a reduction in dopamine signaling within the reward pathway. RDS is a term that connects addictive, obsessive, compulsive, and impulsive behavioral disorders. An estimated 2 million individuals in the United States have opioid use disorder related to prescription opioids. It is estimated that the overall cost of the illegal and legally prescribed opioid crisis exceeds one trillion dollars. Opioid Replacement Therapy is the most common treatment for addictions and other RDS disorders. Even after repeated relapses, patients are repeatedly prescribed the same opioid replacement treatments. A recent JAMA report indicates that non-opioid treatments fare better than chronic opioid treatments. Research demonstrates that over 50 percent of all suicides are related to alcohol or other drug use. In addition to effective fellowship programs and spirituality acceptance, nutrigenomic therapies (e.g., KB220Z) optimize gene expression, rebalance neurotransmitters, and restore neurotransmitter functional connectivity. KB220Z was shown to increase functional connectivity across specific brain regions involved in dopaminergic function. KB220/Z significantly reduces RDS behavioral disorders and relapse in human DUI offenders. Taking a Genetic Addiction Risk Severity (GARS) test combined with a the KB220Z semi-customized nutrigenomic supplement effectively restores dopamine homeostasis (WC 199).

    To read the full text of the article, please visit the publisher’s website.


    March 2022