Cannabis and cocaine use, drinking outcomes, and quality of life in general hospital inpatients with alcohol use disorder

Abstract

Background: While associations between cannabis and cocaine use, and heavy drinking and quality of life (QOL), are well-established in the general population, it is unclear whether they are present in hospital inpatients with alcohol use disorder (AUD). The aim of the study was to assess associations between cannabis and cocaine use and two outcomes [heavy drinking days (HDDs) and QOL] among hospital inpatients with AUD. Methods: Hospitalized patients with AUD and at least one past-month HDD participated in this cross-sectional study. Cannabis and cocaine use were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test. HDDs were assessed using the Timeline Followback. QOL was assessed by the WHOQOL–BREF instrument. Multivariable regression models assessed associations. Results: Of 248 participants, 225 (91%) had severe AUD. There were no statistically significant associations between: recent cannabis use and HDDs [Incidence Rate Ratio (IRR) = 0.95; 95% Confidence Interval (95% CI): 0.80, 1.14], cocaine use and HDDs [IRR = 0.88; 95% CI: 0.66, 1.18], or both cannabis and cocaine use and HDDs [IRR = 0.87; 95%CI: 0.70, 1.09], as compared to use of neither cannabis nor cocaine. Use of cannabis, cocaine, and both, were not associated with QOL [(odds ratio (OR) = 0.98; 95% CI:0.55, 1.74), (OR = 0.76; 95% CI:0.30, 1.93), (OR = 1.00; 95%CI: 0.49, 2.03), respectively]. Conclusions: Among hospital inpatients with AUD, there were no significant associations between cannabis and cocaine use, heavy drinking, or QOL. Our findings raise questions regarding how drug use affects AUD and whether similar results would be found among those with milder AUD and in prospective studies.

Keywords:

• Alcohol-related disorder
• inpatients
• substance use
• quality of life

Disclosure statement

Dr. Saitz reports grants from National Institutes of Health (NCATS) and grants from National Institute on Drug Abuse; non-financial support from Alkermes (medication provided for the ADOPT study), grants from National Institute on Alcohol Abuse and Alcoholism, grants and non-financial support from National Institute on Drug Abuse, grants from Philadelphia College of Osteopathic Medicine, grants from Burroughs Wellcome Fund, personal fees from American Society of Addiction Medicine, personal fees from American Medical Association, personal fees from National Council on Behavioral Healthcare, personal fees from Kasier Permanente, personal fees from UpToDate/Wolters Kluwer, personal fees from Yale University, personal fees from National Committee on Quality Assurance, personal fees from University of Oregon, personal fees from Oregon Health Sciences University, personal fees from RAND Corporation, personal fees from Leed Management Consulting/Harvard Medical School, personal fees from Partners, personal fees from Beth Israel/Deaconess Hospital, personal fees from American Academy of Addiction Psychiatry, personal fees from Group Health Cooperative, other from International Network on Brief Interventions for Alcohol and Other Drugs (INEBRIA) supported via funds from Systembolaget, other from Karolinska Institutet, personal fees and other from Institute for Research and Training in the Addictions, personal fees from Medical Malpractice Expert Witness, other from Charles University, Prague, personal fees from Brandeis University, and personal fees from Massachusetts Medical Society outside the submitted work; and President, International Society of Addiction Journal Editors; research consulting to ABT Corporation (not remunerated), Physician at Boston Medical Center, Boston, MA. Editor of a book published by Springer, Editorial Board of J Addictive Diseases and Addiction Science and Clinical Practice and Substance Abuse. He is a Professor and Chair of the Department of Community Health Sciences at Boston University.

Additional information

Funding

This work was supported by National Institute on Alcohol Abuse and Alcoholism (NIAAA) (R01AA021335) and National Institute on Drug Abuse (NIDA) INVEST/Clinical Trials Network (CTN) Research Fellowship. The funding organizations (NIAAA and NIDA) had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.