Examining substitution behaviors in a non-treatment sample of current drinkers: an exploratory study

In a sample of adults who reported cutting down on their alcohol use in the past 3 months, study goals were to Identify how many increased consumption of licit substances (called 'substituters'); and analyze the psychological profiles of substituters compared to non-substituters. Participants (25.6% Latinx, 46.2% female) were recruited using Amazon's Mturk and completed questionnaires on substance use substitution (i.e. any increased use of a substance while cutting down on another substance) and stress, depression, and anxiety. Among those reporting decreases in alcohol use (N = 78), 78% substituted (N = 61), defined as concomitant increases in food, cannabis, or nicotine. Substituters had higher levels of pysychological distress, reported greater polysubstance use and significantly higher levels of problems related to use than non-substituters. All of the Latinx participants (n = 20) reported substitution and reported significantly higher psychological distress than non-Latinx substituters. Latinxs who reported substitution had more serious psychological profiles and problems related to substance use. The findings provide evidence for a clinical phenomenon involving substitution in a non-treatment sample. Future studies should examine this phenomenon among people in addiction treatment and among Latinxs.