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. 2021 Sep;35(6):760-768.
doi: 10.1037/adb0000743. Epub 2021 Aug 26.

Effect of alcohol, tobacco, and cannabis co-use on gray matter volume in heavy drinkers

Erica N Grodin  1 , Elizabeth Burnette  1 , Brandon Towns  1 , Alexandra Venegas  1 , Lara A Ray  1
Affiliations

Effect of alcohol, tobacco, and cannabis co-use on gray matter volume in heavy drinkers

Erica N Grodin et al. Psychol Addict Behav. 2021 Sep.

Abstract

Objective: Alcohol, tobacco, and cannabis are the three most frequently used drugs in the United States and co-use is common. Alcohol, tobacco, and cannabis use has been separately associated with altered brain structure, and alcohol and tobacco co-use results in decreases in gray matter volume. Less is known about the effect of alcohol and cannabis co-use, and alcohol, tobacco, and cannabis tri-use. Therefore, this study examined the effect of co- and tri-use on gray matter volume, a measure of brain cell density, in heavy drinkers.

Method: Heavy drinkers (n = 237; 152m/85f; age = 32.52; white = 111; black = 28; Latino = 9; American Indian = 2; Pacific Islander = 4; Asian = 59; mixed = 15; other = 9) were classified into four groups based on their alcohol, tobacco, and cannabis use: alcohol only users (n = 70), alcohol and tobacco co-users (n = 90), alcohol and cannabis co-users (n = 35), and alcohol, tobacco, and cannabis tri-users (n = 42). All participants completed a structural MRI scan. Voxel-based morphometry was conducted to evaluate the effect of co-use on gray matter volume, with alcohol only users as the reference group. Age, sex, and scanner were included as covariates.

Results: Alcohol and tobacco co-users had significantly decreased left orbitofrontal gray matter volume relative to alcohol only users (Cohen's d = .79). There were no differences in gray matter volume between the alcohol only and alcohol and cannabis co-users, or between the alcohol only and tri-user groups.

Conclusion: The additive effect of tobacco co-use on gray matter volumes in heavy drinkers was limited and localized. The effect of tri-use of alcohol, tobacco, and cannabis may have interacted, such that overlapping cannabis and tobacco use masked volume differences present in separate co-using groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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Figures

Figure 1.
Figure 1.
Alcohol and tobacco co-users had decreased gray matter volume in the left orbitofrontal cortex (significant voxels shown in red [dark gray]) relative to alcohol only users (p=0.046, corrected).
See this image and copyright information in PMC

References

    1. Adamson SJ, Kay-Lambkin FJ, Baker AL, Lewin TJ, Thornton L, Kelly BJ, & Sellman JD (2010). An improved brief measure of cannabis misuse: the Cannabis Use Disorders Identification Test-Revised (CUDIT-R). Drug and Alcohol Dependence, 110(1–2), 137–143. - PubMed
    1. Agrawal A, Lynskey MT, Madden PA, Bucholz KK, & Heath AC (2007). A latent class analysis of illicit drug abuse/dependence: results from the National Epidemiological Survey on Alcohol and Related Conditions. Addiction, 102(1), 94–104. doi:10.1111/j.1360-0443.2006.01630.x - DOI - PubMed
    1. Andersson JL, Jenkinson M, & Smith S. (2007). Non-linear registration aka Spatial normalisation FMRIB Technial Report TR07JA2. FMRIB Analysis Group of the University of Oxford, 1–22.
    1. Anton RF, Moak DH, & Latham P. (1995). The Obsessive Compulsive Drinking Scale: a self-rated instrument for the quantification of thoughts about alcohol and drinking behavior. Alcohol Clin Exp Res, 19(1), 92–99. doi:10.1111/j.1530-0277.1995.tb01475.x - DOI - PubMed
    1. Battistella G, Fornari E, Annoni J-M, Chtioui H, Dao K, Fabritius M, … Giroud C. (2014). Long-term effects of cannabis on brain structure. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 39(9), 2041–2048. doi:10.1038/npp.2014.67 - DOI - PMC - PubMed