Exploring the underlying emotions that lead to alcohol and cannabis use

Theoretical models of alcohol and cannabis use disorders often focus on the idea that people consume alcohol and cannabis use to regulate their negative emotions – in other words, to make themselves feel better. New research does not support this idea, finding instead that people mostly consume alcohol and cannabis in their daily life when they are experiencing positive emotions. These findings will be shared on 24 June 2024 at the 47^th annual scientific meeting of the Research Society on Alcohol (RSA) in Minneapolis, Minnesota.

“Negative and positive affect can be understood as the general experience of feeling bad and good, respectively,” explained Jonas Dora, postdoctoral scientist at the University of Washington. “Someone who might experience sadness, guilt, or shame or all of these is currently experiencing negative affect – emotions that are unpleasant. Conversely, positive affect refers to joy, interest, or alertness – emotions that are pleasant. Even though theoretical models consistently emphasize negative affect, our data are more in line with the idea that positive – rather than negative – affect is a driver of substance use.”

The researchers tested the affect regulation hypothesis in a diverse sample of 496 young adults, 18 to 22 years of age, from the broader Seattle area who regularly consumed alcohol and cannabis two to three times a week on average. When they drank alcohol, they had about four to five drinks on average; 40 percent of the sample qualified for an Alcohol Use Disorder Identification Test score placing them at the threshold for problematic alcohol use. Roughly 20 percent of the sample qualified for a Cannabis Use Disorder Identification Test score that placed them at the threshold for problematic cannabis use. Researchers examined the participants’ alcohol and cannabis use, as well as their emotional states, using a variety of statistical modelling.

“We found across all models that negative affect was associated with a decreased likelihood to use alcohol later that day, and positive affect was associated with an increased likelihood to use alcohol later that day,” said Dora. When Dora and his collaborators published similar results in a large dataset from over 12,000 participants last year, many of their colleagues were skeptical. Some claimed that Dora and colleagues did not measure affect in the right way or at the right time, others claimed they did not include the right people in their study or did not use the correct statistical technique. In this new study, the researchers show that their findings are robust across hundreds of models, and thus do not depend on how and when affect is measured or whether people with an unproblematic or problematic pattern of substance use are sampled.

Dora calls these findings intriguing. “If you ask a regular alcohol drinker or cannabis user what their main motivations are for consuming the substance, chances are high they will mention that they often consume the substance in response to the experience of negative emotions. Yet our research consistently shows that people do not consume more alcohol and cannabis on days/in moments they experience heightened negative emotions. People mainly consume alcohol when they are in a good mood. That is paradoxical.”