OBJECTIVE People who use cannabis for medicinal (vs. nonmedicinal) reasons report greater cannabis use and lower alcohol use, which may reflect a cannabis-alcohol substitution effect in this population. However, it is unclear whether cannabis is used as a substitute or complement to alcohol at the day level among people who use cannabis for both medicinal and nonmedicinal reasons. This study used ecological momentary assessment to examine this question. METHOD Participants (N = 66; 53.1% men; mean age 33 years) completed daily surveys assessing previous-day reasons for cannabis use (medicinal vs. nonmedicinal), cannabis consumption (both number of different types of cannabis used and grams of cannabis flower used), and number of standard drinks consumed. RESULTS Multilevel models revealed that, in general, greater cannabis consumption on a given day was associated with greater same-day alcohol use. Further, days during which cannabis was used for medicinal (vs. exclusively nonmedicinal) reasons were associated with reduced consumption of both cannabis and alcohol. The day-level association between medicinal reasons for cannabis use and lower alcohol consumption was mediated by using fewer grams of cannabis on medicinal cannabis use days. CONCLUSIONS Day-level cannabis-alcohol associations may be complementary rather than substitutive among people who use cannabis for both medicinal and nonmedicinal reasons, and lower (rather than greater) cannabis consumption on medicinal use days may explain the link between medicinal reasons for cannabis use and reduced alcohol use. Still, these individuals may use greater amounts of both cannabis and alcohol when using cannabis for exclusively nonmedicinal reasons. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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出于医学和非医学原因使用大麻的人中大麻使用和酒精使用之间的日常关联：替代还是互补？

目标 因药用（相对于非药用）原因使用大麻的人报告说大麻使用更多，酒精使用更少，这可能反映了该人群中的大麻-酒精替代效应。但是，尚不清楚在出于医疗和非医疗原因使用大麻的人群中，大麻是否被用作日间酒精的替代品或补充品。本研究使用生态瞬时评估来检验这个问题。方法 参与者（N = 66；53.1% 男性；平均年龄 33 岁）完成每日调查，评估前一天使用大麻的原因（药用与非药用）、大麻消费（使用的不同类型大麻的数量和大麻花的克数） used），以及消耗的标准饮料数量。结果 多级模型显示，一般来说，某一天的大麻消费量增加与当天饮酒量增加有关。此外，将大麻用于药用（相对于完全非药用）原因的日子与大麻和酒精消费量减少有关。大麻使用的医学原因与较低酒精消费之间的日级关联是通过在药用大麻使用日使用较少克数的大麻来调节的。结论 在出于药用和非药用原因使用大麻的人群中，白天的大麻-酒精关联可能是互补的，而不是替代的，药用日大麻消费量较低（而不是较多）可以解释大麻使用的药用原因与大麻酒精使用之间的联系减少饮酒。仍然，这些人在完全出于非医学原因使用大麻时可能会使用更多的大麻和酒精。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。