Affect, Motives for Cannabis Use, Duration of Intoxication, and Cannabis Consequences: Cannabis Use Problem Severity as a Potential Moderator

OBJECTIVE: The multistage model of substance use proposes that reinforcement mechanisms and motives for use change as individuals develop substance use disorders, with positive reinforcement driving substance use when substance use disorder symptoms are absent/mild and negative reinforcement becoming dominant when substance use disorder symptoms are more severe. We aimed to determine whether event-level associations between affect, cannabis use, motives for use, and heaviness of use were moderated by cannabis use problem severity, consistent with the multistage model of substance use. METHOD: We used ecological momentary assessment data (two observations per day for 14 days) from 571 young adult females who regularly used cannabis. The sample included a majority of sexual minority women and gender diverse individuals (77.6%). RESULTS: Elevated anxious affect was concurrently associated with coping motives for cannabis use and longer duration of intoxication at the event level, but only among those with more severe cannabis use problems. Further, positive affect was concurrently associated with a higher likelihood of endorsing enhancement motives for the full sample, but this association was stronger for those with fewer cannabis use problems. However, many other associations between affect and cannabis use outcomes were not moderated by the severity of cannabis use problems. CONCLUSIONS: Some findings were consistent with expectations based on the multistage model. However, results also suggest that positive reinforcement may continue to drive cannabis use among those with more severe cannabis use problems, which is not consistent with what would be expected based on the multistage model.