About

Rachel Gunn is an Associate Professor of Psychiatry and Human Behavior and also holds a position in the Department of Behavioral and Social Sciences at Brown University. She is a clinical psychologist whose research focuses on understanding the etiology of alcohol and cannabis use across different populations. Her work employs mixed-method approaches, including laboratory and ambulatory assessments, to investigate the behavioral and pharmacological factors influencing substance use and related consequences. Dr. Gunn received her Ph.D. in Clinical Psychology from Indiana University-Bloomington, where she studied impulsive personality and executive functioning in relation to young adult drinking. She completed her clinical internship at the Alpert Medical School at Brown University and a postdoctoral fellowship at the Center for Alcohol and Addiction Studies in the School of Public Health, during which she studied the behavioral pharmacology of cannabis use and laboratory administration methods. Her current projects examine the impact of simultaneous alcohol and cannabis use, cannabis use on alcohol treatment outcomes, and the effects of perinatal cannabis use on mental health. Her research is funded by several grants, and she collaborates with multiple faculty members at Brown University.

Research topics

• Psychology
• Medicine
• Psychiatry
• Clinical psychology
• Environmental health
• Chemistry
• Biology
• Medical emergency

Selected publications

• Alcohol quantity mediates the association between daily alcohol and cannabis co-use and alcohol consequences

  Drug and Alcohol Dependence · 2026-01-13

  articleOpen access1st authorCorresponding

  BACKGROUND: Alcohol and cannabis are commonly used substances for young adults, and person-level co-use (i.e., concurrent or simultaneous use of both) is associated with increased likelihood of experiencing positive and negative alcohol-related consequences. However, findings regarding within-person effects (i.e.,day-level) co-use on consequences are mixed, possibly due to inconsistency in including alcohol quantity (i.e., total number of standard drinks consumed) when examining the association between co-use and consequences. In the present study, we examined whether the number of drinks mediates the association between co-use and positive or negative alcohol consequences at the day level. METHODS: Data from morning reports in a 28-day field-based study of young adults reporting frequent past 60-day alcohol and cannabis use (N = 115) were used to test multilevel mediation models. RESULTS: We found significant mediation for both positive and negative alcohol consequences; consuming more alcoholic drinks on co-use days, relative to alcohol-only days, was associated with a higher likelihood of experiencing negative consequences and a lower likelihood of positive consequences. These results suggest that daily number of drinks is a significant driver of the relationship between co-use and alcohol-related consequences at the day-level. CONCLUSIONS: In the context of increased cannabis use among young adults, this finding provides critical information for prevention and intervention efforts aimed at reducing the alcohol-related consequences associated with co-use days. Overall, reducing total alcohol consumption remains a prominent harm-reduction strategy among this population.

  PublisherDOI

• Perinatal Cannabis Use, Depression, and the Mother-Child Dyad: Protocol for a Prospective Multimethod Study

  JMIR Research Protocols · 2025-10-28 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: Postpartum depression (PPD) rates in the United States are among the highest globally, and PPD can pose significant, long-term risks to families. Concurrently, perinatal cannabis use is increasing in prevalence and may exacerbate PPD. Although evidence links cannabis use with PPD, little is known about its impact on immediate depressive symptoms or depression trajectories across the perinatal period. Moreover, the potential impact of cannabis use on mother-child attachment, bonding, and emotional availability could intensify the effects of cannabis on PPD. OBJECTIVE: This protocol study is a longitudinal investigation aimed at detecting initial signals of the daily and long-term associations between cannabis use, PPD symptoms, and the mother-infant relationship. METHODS: Participants (N=20) were individuals carrying a singleton pregnancy who reported using cannabis at least twice weekly. Recruitment was through community outreach and online advertisements. Study participation began with a baseline laboratory assessment during pregnancy, which included surveys on mental health and substance use. Follow-ups were conducted virtually at 6 weeks post partum and in the laboratory at 6 months post partum and included additional surveys on infant development, aspects of the mother-infant relationship (eg, attachment), as well as behavioral interaction tasks. Each assessment was paired with a 2-week ecological momentary assessment burst, resulting in three bursts. To support retention, brief check-in visits were completed during the second and third trimesters (depending on gestational age at enrollment), and a postdelivery phone call was conducted within 2 weeks of delivery. A 2-level linear mixed-effect models will be used to examine both event-level and person-level associations of cannabis use with momentary negative affect, PPD symptoms, and attachment, bonding, and emotional availability. Interaction models will test whether these characteristics of the mother-child relationship intensify the association between cannabis use and PPD symptoms. RESULTS: This project received institutional review board approval on December 19, 2022, and was awarded funding on February 1, 2023. The recruitment goal of 20 participants was reached on September 4, 2024. Recruitment challenges were encountered early in the study, leading to successful adaptations in recruitment and data collection protocols. Follow-up data collection is ongoing, with completion expected by October 2025 and results anticipated by April 2026. Retention rates approach 100% at follow-up, and ecological momentary assessment compliance rates exceed those observed in nonpregnant samples (ie, >80%). CONCLUSIONS: This protocol study demonstrates our ability to collect momentary and longitudinal data to examine the daily and cumulative impact of cannabis use on PPD and the mother-infant relationship. These data are well-positioned to provide preliminary evidence on how cannabis use may shape depressive symptoms during a particularly high-risk period for maternal mental health. The findings will inform a larger-scale study and advance understanding of the potential effects of cannabis use on perinatal mental health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/71302.

  PublisherDOI

• Online conversations on perceived stigma among pregnant individuals who use cannabis

  Drug and Alcohol Dependence Reports · 2025-06-18

  articleOpen accessSenior author

  Perinatal cannabis use (PCU) is a controversial topic, as it is associated with negative neonatal and maternal outcomes. However, PCU persists, often reported in the context of perceived symptom management, and those who engage in PCU can face significant stigma. Such stigma can deter individuals from discussing their cannabis use with support persons, potentially exacerbating negative health outcomes for the parent and child. The current study explores how PCU stigma manifests and is navigated in online communities, focusing on discussions within an online space for individuals who use cannabis during pregnancy. First, a random sample of 10 threads per month from June 2020 to May 2021 were extracted from a cannabis-focused forum on a pregnancy and parenting website. Next, analyses involved a two-cycle coding process (i.e., topical followed by conceptual) to identify key themes surrounding stigma in the context of PCU. Three primary themes were identified: 1) experiencing stigma (e.g., familial and societal sources of judgment, emotional responses such as guilt and frustration); 2) contradictions in substance stigma, highlighting the contrast between societal attitudes and expectations towards cannabis versus alcohol or tobacco use during pregnancy; and 3) challenging stigma, in which participants actively provide support, share personal experiences, and offer evidence to counteract stigma. Online communities may play a critical role in combating stigma, offering a platform for connection, support, and education. Results emphasize that a nonjudgmental approach to information dissemination may be more effective. Understanding stigma is essential for developing effective interventions and reducing the harms of PCU. • Perinatal cannabis use is increasing, despite known risks to parent and child health. • Stigma around perinatal cannabis use affects access to care and support networks. • Qualitative analysis of online forum with two-cycle coding to identify stigma themes. • Users report stigma from society and peers, reporting guilt and frustration. • Contradictions emerge between societal views on cannabis vs. alcohol/tobacco use.

  PublisherDOI

• Intentions matter: How planned and unplanned alcohol and cannabis use influences outcomes.

  Psychology of Addictive Behaviors · 2025-08-11 · 2 citations

  articleOpen accessSenior author

  OBJECTIVE: An important antecedent of substance use among young adults is intentions for use (e.g., planned vs. unplanned use). In contrast to previous theories, emerging evidence suggests planned use, rather than unplanned use, is primarily related to consumption and sometimes consequences. As this has been most recently investigated with alcohol-only use, there remains a limited understanding of planned versus unplanned cannabis use, as well as how cannabis consumption influences planned versus unplanned alcohol events. METHOD: = 110) that frequently use alcohol and cannabis, we examined how planned versus unplanned alcohol and cannabis use influence consumption levels and consequences while controlling for the impact of each substance on the other. RESULTS: Alcohol models revealed that planned alcohol use was linked to greater alcohol consumption at the day level and higher likelihood of experiencing positive alcohol consequences at the person level. The use of cannabis on a drinking day was also positively associated with experiencing a positive alcohol consequence. There were no day-level associations between planned alcohol use and negative alcohol consequences. Cannabis models revealed planned use was associated with higher likelihood of experiencing a negative cannabis consequence at the day level but was not associated with cannabis consumption or positive consequences. CONCLUSIONS: This study highlighted differences in planned alcohol and cannabis use in predicting consumption and related consequences in young adults. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

  PublisherDOI

• Working memory capacity predicts cannabis-induced effects on alcohol urge

  Addictive Behaviors · 2025-11-20

  article1st authorCorresponding
  PublisherDOI

• Acute Effects of Cannabis on Alcohol Craving and Consumption: A Randomized Controlled Crossover Trial

  American Journal of Psychiatry · 2025-11-19 · 8 citations

  articleOpen access

  OBJECTIVE: Cannabis use is strongly linked with heavy drinking and worse alcohol treatment outcomes; however, it may also contribute to decreased alcohol consumption. To date, no human studies have established a causal effect of cannabis on alcohol motivation. The aim of this double-blind crossover randomized clinical trial was to examine dose-dependent acute effects of delta-9-tetrahydrocannabinol (THC) on alcohol craving and consumption. METHODS: Across three experimental days, 157 participants reporting heavy alcohol use and cannabis use two or more times weekly were randomized to smoke cannabis cigarettes containing 7.2% THC, 3.1% THC, or 0.03% THC (placebo), followed by exposures to neutral and personalized alcohol cues and an alcohol choice task for alcohol self-administration. A total of 138 participants completed two or more experimental sessions (mean age, 25.6 years [SD=5.1]; 35% women; 45% racial/ethnic minorities). Primary outcomes included craving, Alcohol Craving Questionnaire-Short Form, Revised (ACQ-SF-R), and an alcohol urge question; the secondary outcome was percent of total available milliliters of alcohol consumed. RESULTS: There were no significant effects of cannabis on ACQ-SF-R ratings after smoking and during alcohol cue exposure, but 7.2% THC reduced alcohol urge immediately after smoking. Participants consumed significantly less alcohol after smoking cannabis with 3.1% THC and 7.2% THC, reducing consumption by 19% and 27%, respectively. CONCLUSIONS: Following overnight cannabis abstinence, smoking cannabis acutely decreased alcohol consumption compared to placebo. Further controlled research on a variety of cannabinoids is needed to inform clinical alcohol treatment guidelines.

  PublisherOA PDFDOI

• Examining the relationship between cannabis use and drinking levels on co‐use days

  Alcohol Clinical and Experimental Research · 2025-07-03

  article

  BACKGROUND: Co-use of alcohol and cannabis among young adults is often associated with more alcohol consumption than alcohol-only use, yet little work has examined cannabis use specifically during heavy drinking. Much of the work examining heavy drinking has focused on heavy episodic drinking (HED, 4+/5+ drinks/occasion for females/males); however, young adults report drinking levels that far exceed this, frequently reporting high-intensity drinking (HID; 8+/10+ drinks/occasion for females/males), double the HED threshold, which confers greater risk of acute negative consequences. This study examined whether day-level co-use (vs. alcohol-only use) was associated with greater odds of heavier drinking levels: HID vs. HED vs. moderate drinking (1-3/1-4 drinks/occasion for females/males). We explored whether within-person variations in cannabis use characteristics (frequency, form, and quantity) differentiated moderate drinking, HED, and HID on co-use days. METHODS: Young adults who reported simultaneous alcohol and cannabis use (N = 318) from three US universities completed five repeated daily surveys for 54 days reporting number of drinks and number of cannabis uses (i.e., frequency/events), forms, and quantity. RESULTS: Participants reported increased likelihood of HID and HED versus moderate drinking on co-use versus alcohol-only days. HID versus HED did not differ between co-use and alcohol-only days. On co-use days, heavier drinking was more likely on days with more cannabis use. The form of cannabis used and the use of multiple versus single forms of cannabis were not associated with drinking level. Yet, HID was more likely than HED and moderate drinking when more grams of flower were used and HID was also more likely than moderate drinking when more hits of concentrates were used. CONCLUSIONS: Findings show heavy drinking (HID, HED) was more likely than moderate drinking on co-use days and cannabis use characteristics may influence drinking levels. Co-use interventions may benefit from a focus on heavy drinking and cannabis use characteristics.

  PublisherDOI

• Evaluating the age of individuals who are seeking treatment for alcohol and substance use disorder in a community-based recovery center

  Alcohol and Alcoholism · 2025-03-14 · 1 citations

  article

  To understand the need for addiction treatment across the spectrum of adult age, this study evaluated the age of individuals with alcohol/substance use disorder (N = 541) who sought treatment in a local center in Rhode Island. Data extracted from the community showed a need for clinical research to support future addiction medicine that is age-inclusive (e.g. including older adults in clinical trials).

  PublisherDOI

• Does making early evening social plans impact alcohol use outcomes over evening hours?

  Drug and Alcohol Dependence · 2025-12-12

  articleOpen access
  PublisherOA PDFDOI

• Perinatal Cannabis Use, Depression, and the Mother-Child Dyad: Protocol for a Prospective Multimethod Study (Preprint)

  2025-01-23

  preprintOpen accessSenior author

  <sec> <title>BACKGROUND</title> Postpartum depression (PPD) rates in the United States are among the highest globally, and PPD can pose significant, long-term risks to families. Concurrently, perinatal cannabis use is increasing in prevalence and may exacerbate PPD. Although evidence links cannabis use with PPD, little is known about its impact on immediate depressive symptoms or depression trajectories across the perinatal period. Moreover, the potential impact of cannabis use on mother-child attachment, bonding, and emotional availability could intensify the effects of cannabis on PPD. </sec> <sec> <title>OBJECTIVE</title> This protocol study is a longitudinal investigation aimed at detecting initial signals of the daily and long-term associations between cannabis use, PPD symptoms, and the mother-infant relationship. </sec> <sec> <title>METHODS</title> Participants (N=20) were individuals carrying a singleton pregnancy who reported using cannabis at least twice weekly. Recruitment was through community outreach and online advertisements. Study participation began with a baseline laboratory assessment during pregnancy, which included surveys on mental health and substance use. Follow-ups were conducted virtually at 6 weeks post partum and in the laboratory at 6 months post partum and included additional surveys on infant development, aspects of the mother-infant relationship (eg, attachment), as well as behavioral interaction tasks. Each assessment was paired with a 2-week ecological momentary assessment burst, resulting in three bursts. To support retention, brief check-in visits were completed during the second and third trimesters (depending on gestational age at enrollment), and a postdelivery phone call was conducted within 2 weeks of delivery. A 2-level linear mixed-effect models will be used to examine both event-level and person-level associations of cannabis use with momentary negative affect, PPD symptoms, and attachment, bonding, and emotional availability. Interaction models will test whether these characteristics of the mother-child relationship intensify the association between cannabis use and PPD symptoms. </sec> <sec> <title>RESULTS</title> This project received institutional review board approval on December 19, 2022, and was awarded funding on February 1, 2023. The recruitment goal of 20 participants was reached on September 4, 2024. Recruitment challenges were encountered early in the study, leading to successful adaptations in recruitment and data collection protocols. Follow-up data collection is ongoing, with completion expected by October 2025 and results anticipated by April 2026. Retention rates approach 100% at follow-up, and ecological momentary assessment compliance rates exceed those observed in nonpregnant samples (ie, &amp;gt;80%). </sec> <sec> <title>CONCLUSIONS</title> This protocol study demonstrates our ability to collect momentary and longitudinal data to examine the daily and cumulative impact of cannabis use on PPD and the mother-infant relationship. These data are well-positioned to provide preliminary evidence on how cannabis use may shape depressive symptoms during a particularly high-risk period for maternal mental health. The findings will inform a larger-scale study and advance understanding of the potential effects of cannabis use on perinatal mental health. </sec> <sec> <title>CLINICALTRIAL</title> <p/> </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> DERR1-10.2196/71302 </sec>

  PublisherDOI

Recent grants

• Ambulatory Assessment of Simultaneous Alcohol and Marijuana Use: Impact on Alcohol Use and Consequences

  NIH · $561k · 2019–2024

Frequent coauthors

• Kristina M. Jackson

  Pacific Institute For Research and Evaluation

  87 shared

• Jane Metrik

  Rutgers, The State University of New Jersey

  65 shared

• Angela K. Stevens

  Brown University

  50 shared

• Alexander W. Sokolovsky

  John Brown University

  46 shared

• Helene R. White

  Rutgers, The State University of New Jersey

  38 shared

• Lauren Micalizzi

  John Brown University

  29 shared

• Brian Borsari

  21 shared

• Holly Boyle

  Brown University

  20 shared

Labs

• Gunn, RachelPI

Education

• Ph.D.

  Indiana University at Bloomington

  2017