Social cannabis use may amplify craving in people with more problems

AIMS: Cannabis craving is a central component of cannabis use disorder and is thought to increase during acute cannabis use episodes. However, our understanding of the relations between social contexts and naturalistic cannabis craving, and for whom these relations exist during daily life use episodes, remains scant. Equally limited is research characterizing the within-episode progression of cannabis use, particularly if social context and craving may be associated with continuation of use after initiation. The current study tested a theoretical model wherein social (vs. solitary) cannabis use contexts are associated with acute, in-the-moment cannabis craving and likelihood of continuation of cannabis use, particularly for individuals with more severe cannabis problems. DESIGN: Participants completed a baseline assessment and 14 days of ecological momentary assessment (EMA). As part of the EMA protocol, participants completed four random reports throughout the day and event-contingent cannabis use reports shortly after cannabis initiation, which triggered follow-up reports 1.5 hours and 3 hours later. Baseline and event-contingent reports were used in analyses. SETTING: Arizona, United States of America. PARTICIPANTS: N = 104 individuals (Mage = 36.16; 53% female) completed the study protocol. MEASUREMENTS: Participants reported their severity of cannabis problems at baseline. Participants reported their current social context, type and potency of cannabis used and cannabis craving during cannabis use reports, and reported if they used any additional cannabis 1.5 and 3 hours later during follow-up cannabis reports. RESULTS: Higher cannabis craving during cannabis initiation reports was associated with higher likelihood of continuing to use cannabis [standardized beta (b) = 0.22, 95% Bayesian credible interval (BCI) = 0.09-0.33]. There was a statistically significant interaction between social context and severity of cannabis problems in relation to craving (b = 0.36, 95% BCI = 0.12-0.56), such that social (vs. solitary) cannabis use contexts were associated with higher cannabis craving, but only within individuals reporting above average (but not below average) cannabis use problems. Thus, there was a conditional indirect association of social context on cannabis use continuation operating via augmented cannabis craving in individuals reporting more (b = 0.06, 95% BCI = 0.01-0.16) but not less (b = -0.06, 95% BCI = -0.17, 0.01) severe cannabis problems. Findings were consistent when estimating continuation of cannabis occurring 1.5 and 3 hours after the cannabis use report, when covarying for other cannabis use products, and when conducting subgroup analyses within cannabis flower vs. edible occasions. SUMMARY: Within individuals who report more severe cannabis problems, social (vs. solitary) contexts appear to be associated with amplified craving, which appears to be associated with higher likelihood of continued cannabis use.