A recent study provides evidence that the initial subjective effects of alcohol and cannabis can vary greatly among individuals and may be indicative of future substance abuse problems. The new findings have been published in Experimental and Clinical Psychopharmacology.
The study aimed to determine whether the experiences people have with substances at the time of their first use differ across individuals, and if those experiences are associated with problematic use.
“As the lead author of this manuscript, I was interested in this topic because initial drug experiences can have a significant impact on an individual’s future drug use and addiction risk,” explained Neil B. Varshneya, a pharmacologist at the U.S. Food and Drug Administration. “By understanding the relationship between initial drug experiences and future drug abuse risks, we can develop more effective prevention and intervention strategies.”
For their study, the researchers recruited U.S. participants from Amazon Mechanical Turk to complete an internet survey on health behaviors. Participants were screened using a brief questionnaire and deemed eligible if they were 18 years or older, used alcohol or drugs more than once in their lifetime with the intention of getting drunk or high, and agreed to voluntarily answer questions related to their lifetime alcohol/drug use.
Only persons whose first use was alcohol or cannabis were included in the analyses. The study had a final sample size of 463 participants.
Participants were asked basic demographic information and presented with a series of identical questions for each drug class they reported having used more than once in their lifetime with the intention of getting drunk or high. For each substance, a list of 42 potential subjective effects was presented and participants were asked to retrospectively recall whether they had experienced any of these responses during their initial alcohol/cannabis use.
Current alcohol and cannabis use severity was assessed by a DSM-5 symptoms checklist, and behavioral economic demand was assessed using a hypothetical purchase task. In the task, the researchers asked participants to imagine they were buying alcohol or cannabis and to say how much they would buy at different prices. They were told they had to use all the substances within a week and could not sell or save it. The researchers looked at how much people were willing to buy at different prices and calculated things like the maximum price they were willing to pay and how much they would consume.
The researchers found that positive affective states such as relief or energetic, reported at the time of first use, were associated with a greater likelihood of increased severity of Alcohol Use Disorder (AUD) and Cannabis Use Disorder (CUD), respectively. In other words, those who described an initial drug effect in positive terms were more likely to exhibit behaviors consistent with problematic use of that substance.
Additionally, participants who used alcohol for relief from negative emotions were willing to pay more money for it compared to those who didn’t use it for relief.
“The average person should take away from our study that the subjective effects experienced during an individual’s first use of alcohol or cannabis can predict their future risk for developing alcohol or cannabis use disorder,” Varshneya told PsyPost. “Additionally, our findings suggest that behavioral economic demand may be a useful tool for assessing addiction risk.”
However, there are limitations to the study’s conclusions. The online, survey-based assessment used in the study could not verify substance use history or current severity, and the retrospective nature of the recall could be impacted by subsequent experiences in ways that cannot be determined. Also, few participants reported cannabis as their first substance, limiting further analysis.
“One major caveat is that our study relied on self-reported data, which may be subject to bias or inaccuracies,” Varshneya explained. “Additionally, our study only examined the relationship between initial drug experiences and future addiction risk for alcohol and cannabis – more research is needed to explore this relationship for other substances.”
Despite these limitations, the study suggests that initial subjective effects of substances may vary across individuals in a way that could predict future substance abuse risks. It is important to note that initiating this line of research with simple constructs will support future research in this area.
Overall, this study adds to the limited evidence on this topic and highlights the importance of understanding individual experiences with substances to better predict and prevent problematic use in the future.
“We hope that our study will contribute to a better understanding of addiction risk factors and help inform prevention and intervention efforts,” Varshneya said. “We believe that further research in this area is crucial for addressing the ongoing public health crisis of substance abuse and addiction.”
(The views expressed by Varshneya do not necessarily represent the views of the Food and Drug Administration.)
The study, “Can Initial Experiences With Drugs Predict Future Drug Abuse Risks?” was authored by Neil B. Varshneya, Kelly E. Dunn, Caitlyn J. Grubb, Sandra I. Okobi, Andrew S. Huhn, and Cecilia L. Bergeria.
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