Protocol - Alcohol and Cannabis Simultaneous Use
- Alcohol - 30-Day Quantity and Frequency
- Medication Inventory
- Medications (Current and Past Use of Pain Relievers, Statins, and Steroids)
- On-site Urine Drug Screen
- Substances - 30-Day Frequency
- Tobacco - 30-Day Quantity and Frequency - Adult
Description
The Alcohol and Cannabis Simultaneous Use Scale (ACSUS) is a self-administered questionnaire. Respondents answer nine questions about simultaneous alcohol and cannabis use frequency, quantity, and impact.
Specific Instructions
When there is a specific interest in assessing medical cannabis use, the PhenX Substance Use and Recovery Working Group (WG) recommends replacing “marijuana” with “medical cannabis” to specifically capture use of products for medical use. When there is an interest in capturing a broader range of cannabis products, the WG recommends considering replacing “marijuana” with “cannabis”.
The image in Question 3 displaying cannabis flower quantities was obtained from the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU; Cuttler et al. [2017]).
Protocols may include terms, images, and language that could be triggering to respondents. Investigators are encouraged to have resources in place to help respondents cope with triggers as needed.
Terminology related to substances, substance use, and recovery is fluid. Updates in protocol language may be appropriate based on circumstance. Suggestions for revision have been offered to update answer responses or other components of the questionnaires to account for the constantly changing landscape. These suggestions have not been tested or validated in research studies but may be considered by investigators to enhance relevance.
Availability
This protocol is freely available; permission not required for use.
Protocol
Alcohol and Cannabis Simultaneous Use Scale (ACSUS)
Instructions: The following questions ask about your use of alcohol and marijuana at approximately the same time, so that the effects of each substance overlapped. That is, these questions ask about times you have used alcohol and marijuana together.
1. How often did you use both alcohol and marijuana on the same occasion during the past 12 months, so that the effects of alcohol and marijuana overlapped?
0[ ]Never
1[ ]Monthly or Less
2[ ]2 to 4 times a month
3[ ]2 to 3 times a week
4[ ]4 or more times a week
2. How many drinks containing alcohol did you have on a typical day when you were using both alcohol and marijuana on the same occasion during the past 12 months, so that the effects of alcohol and marijuana overlapped?
0[ ]1 or 2
1[ ]3 or 4
2[ ]5 or 6
3[ ]7 to 9
4[ ]10 or more
3. Please use the image below to refer to various quantities of marijuana. The image is not to scale; the dollar bill is included to help provide size perspective.
Note: 1/8 of a gram = 0.125 grams,
1/4 of a gram = 0.25 grams,
1/2 of a gram = 0.5 grams,
3/4 of a gram = 0.75 grams,
1/8 of an ounce = 3.5 grams,
1/4 of an ounce = 7 grams,
1/2 ounce = 14 grams,
1 ounce = 28 grams
How much marijuana did you use (in grams) on a typical day when you were using both alcohol and marijuana on the same occasion during the past 12 months, so that the effects of alcohol and marijuana overlapped?
0[ ]0.125 grams or less
1[ ]0.25 grams
2[ ]0.50 grams
3[ ]0.75 grams
4[ ]1 gram or more
4. How often did you have 4 (for women)/5 (for men) or more drinks on one occasion while also using marijuana on the same occasion during the past 12 months, so that the effects of alcohol and marijuana overlapped?
0[ ]Never
1[ ]Less than monthly
2[ ]Monthly
3[ ]Weekly
4[ ]Daily or almost daily
5. How often during the past 12 months did you find that you were not able to stop drinking once you started when using both alcohol and marijuana on the same occasion, so that the effects of alcohol and marijuana overlapped?
0[ ]Never
1[ ]Less than monthly
2[ ]Monthly
3[ ]Weekly
4[ ]Daily or almost daily
6. How often during the past 12 months did you find that you were not able to stop using marijuana once you started when using both alcohol and marijuana on the same occasion, so that the effects of alcohol and marijuana overlapped?
0[ ]Never
1[ ]Less than monthly
2[ ]Monthly
3[ ]Weekly
4[ ]Daily or almost daily
7. How often during the past 12 months did you fail to do what was normally expected from you because of using both marijuana and alcohol on the same occasion, so that the effects of alcohol and marijuana overlapped?
0[ ]Never
1[ ]Less than monthly
2[ ]Monthly
3[ ]Weekly
4[ ]Daily or almost daily
8. In the past 12 months, were you or someone else injured as a result of your using both marijuana and alcohol on the same occasion, so that the effects of alcohol and marijuana overlapped?
0[ ]No
2[ ]Yes, but not in the last 12 months
4[ ]Yes, during the last 12 months
9. In the past 12 months, was a relative, friend, doctor, or other health worker concerned about you using both marijuana and alcohol on the same occasion, so that the effects of alcohol and marijuana overlapped, or suggested you cut down?
0[ ]No
2[ ]Yes, but not in the last 12 months
4[ ]Yes, during the last 12 months
Scoring Instructions: Response options were coded from 0 to 4 for items 1 through 7. For items 8 and 9, responses were coded as 0 (Never), 2 (Yes, but not in the past 12 months), and 4 (Yes, in the past 12 months). The ACSUS scores can be calculated by either utilizing the total overall score or using total scores from either factor by summing the appropriate items together (items 1–4 for quantity/frequency; items 5–9 for associated problems). The total score can range from 0 to 36, with higher scores indicating more simultaneous alcohol and cannabis use and related problems.
Personnel and Training Required
None
Equipment Needs
None
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Self-administered questionnaire
Lifestage
Adult
Participants
18 years or older
Selection Rationale
The Working Group selected the Alcohol and Cannabis Simultaneous Use Scale (ACSUS) for being concise and validated for measuring simultaneous alcohol and cannabis use.
Language
English
Standards
| Standard | Name | ID | Source |
|---|
Derived Variables
None
Process and Review
Not Applicable
Protocol Name from Source
Alcohol and Cannabis Simultaneous Use Scale (ACSUS)
Source
Cuttler, C., & Spradlin, A. (2017). Measuring cannabis consumption: Psychometric properties of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU). PLoS ONE, 12(5), e0178194. https://doi.org/10.1371/journal.pone.0178194
Kolp, H., Horvath, S., Fite, P. J., Metrik, J., Stuart, G. L., Lisdahl, K. M., & Shorey, R. C. (2023). Development of the Alcohol and Cannabis Simultaneous Use Scale (ACSUS) in college students. Journal of Substance Use, 29(4), 509-516.
General References
Shipley, J. L., & Braitman, A. L. (2024). Assessment of simultaneous alcohol and cannabis use and its related consequences and cognitions in college students: A narrative review. Alcohol: Clinical and Experimental Research, 48(2), 230-240.
Protocol ID
511502
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping |
|---|
Measure Name
Patterns of Polysubstance Use
Release Date
January 30, 2025
Definition
Patterns of polysubstance use refers to the characteristics (types of drugs, numbers of drugs, primary and secondary drugs, routes of administration, etc.) of the consumption of at least two substances at the same time or taken sequentially within a 24-hour period.
Purpose
Polysubstance use behaviors, including patterns of combination, are important to understand as polysubstance use is a risk factor for overdose and overdose related mortality.
Keywords
polysubstance use, opioid overdose, risk behaviors, substance use, drug interactions, prescription opioids, addiction, dependence, tolerance, withdrawal, harm reduction, overdose prevention, public health, cannabis, alcohol, marijuana, co-use
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 511501 | Co-use of Opioids with Other Drugs and Overdose Risk |
| 511502 | Alcohol and Cannabis Simultaneous Use |