Assessment of contextualized reinforcement pathology in a community sample of young adult substance users

Alcohol, tobacco, and cannabis are the most commonly used substances among young populations, often leading to polysubstance use, which correlates with problematic consumption and adverse health outcomes. The contextualized reinforcer pathology (CRP) model explains addictive behaviors through several constructs, including the following: drug demand, delay discounting (DD), and substance-free and substance-related reinforcement. Most previous studies have focused on a single CRP construct and the couse of only two substances. This study aimed to characterize three subgroups of young adults reporting past month use of alcohol only, alcohol + tobacco or cannabis, and alcohol + tobacco + cannabis, in terms of the three constituents of the CRP model.

Young adult students (N = 1487) completed CRP measures including the Alcohol Purchase Task, the Delay Discounting Task (for monetary rewards), and an abbreviated version of the Adolescent Reinforcement Survey Schedule-Substance Use Version (ARSS-SUV). ANOVA, chi-square, and Student's t-tests were conducted to analyze group differences in terms of the CRP model.

Higher demand intensity (p = 0.001) and reinforcement from substance-related activities (p < 0.001) significantly predicted using alcohol + cannabis + tobacco compared to alcohol only use. DD and some alcohol demand indices (i.e., O_max, P_max, breakpoint and elasticity) were not associated with any substance use pattern.

Findings suggest that polysubstance use may enhance reward from leisure and social activities. Individuals with high reinforcement from substance-related activities or high alcohol demand should be delivered interventions promoting activities that are both reinforcing and serve as alternatives to substance use.