Combined use of alcohol and cannabis: Introduction to the special issue.

Abstract

Objective: Combined use of alcohol and cannabis has increased in recent years among certain age groups, and it is well established that individuals who use both alcohol and cannabis (especially if they use both at the same time) are at increased risk for substance-related harms relative to individuals who use only one substance. Far less attention has been placed on the patterns, predictors, and psychological processes associated with alcohol and cannabis co-use, which may inform prevention and intervention programming. Accordingly, this special issue was assembled to advance our understanding of the characteristics and consequences of combined use of alcohol and cannabis. Method: In this introductory article, the Guest Editors present the background for this work and provide an overview of the 14 articles that comprise this special issue. Results: Studies contained in this special issue capitalize on a variety of methodologies, with a particular focus on investigating typologies of alcohol and cannabis co-use, clarifying motivational and social contexts of co-use, and tracking co-use in daily life via daily diary and ecological momentary assessment designs. Experimental and neuroimaging examinations of co-use are also included. Collectively, the studies generally provide evidence that combined use of alcohol and cannabis is associated with unique characteristics, predictors, consequences, and psychological processes relative to single-substance use. Conclusions:The studies in this special issue provide new insight into combined use of alcohol and cannabis. They also highlight a number of promising avenues for future inquiry as the literature on alcohol and cannabis co-use continues to grow. Public Health Significance StatementThe studies in this special issue suggest that combined use of alcohol and cannabis is associated with unique characteristics, predictors, outcomes, and psychological processes that distinguish this behavior from use of cannabis or alcohol alone. Findings from these studies provide new insight into the combined use of alcohol and cannabis that may inform interventions and suggest several avenues for future research.

Assessment of simultaneous alcohol and cannabis use and its related consequences and cognitions in college students: A narrative review

“…Data from California indicate that about half of young adults (ages 18–21 years; about 52% college students) obtained cannabis from family or friends (D'Amico, Rodriguez, Dunbar, et al., 2020); they may not have packaging with labels and therefore may not know the potency of the product. Assessment of cannabis use is complicated by varying potency across different routes of cannabis administration (Linden‐Carmichael & Wardell, 2021), and inaccuracies in self‐reported estimation of cannabis quantity. As assessment of SAM use quantity and intensity is dependent on measuring single substance use quantity and intensity, more research is needed to establish a standardized approach to assess cannabis use in a common metric across multiple routes, or modes, of administration.…”

Associations between Alcohol-Free Sources of Reinforcement and the Frequency of Alcohol and Cannabis Co-Use among College Freshmen

“…Furthermore, the prevalence of co-use has increased by 7% over the past 20 years [7] and has occurred against the backdrop of public policy changes in many US states that have legalized medicinal and/or recreational cannabis [8]. The increased prevalence of co-use and legislative changes have yielded concerns regarding the potential health consequences of alcohol and cannabis co-use [9,10]. In the literature, co-use of alcohol and cannabis has consistently been associated with greater negative consequences, including blackouts, driving under the influence, and social consequences, compared to use of either alcohol or cannabis alone [11,12].…”

Temporal trends in alcohol, cannabis, and simultaneous use among 12th‐grade U.S. adolescents from 2000 to 2020: Differences by sex, parental education, and race and ethnicity

“…Simultaneous use of alcohol and cannabis affects THC absorption and intoxication (Lukas & Orozco, 2001), and is positively associated with high‐intensity substance use (Patrick et al, 2017), injury and impaired driving (Gonçalves et al, 2021; Subbaraman & Kerr, 2015) and other harms (D'Amico et al, 2022; Patrick et al, 2017). Motivations to use alcohol and cannabis simultaneously among young people include to enhance intoxication (“cross fading”; Patrick et al, 2020), to enhance and facilitate social experiences with peers (Arterberry et al, 2021; Linden‐Carmichael & Wardell, 2021; Patrick et al, 2020), and to increase positive affect (Arterberry et al, 2021; Linden‐Carmichael & Wardell, 2021). Long‐term consequences of simultaneous use include disruptions to social connections (Subbaraman & Kerr, 2015), decreased educational attainment prospects (Patrick et al, 2018), and continued use is associated with changes in neurological morphometrics (Medina et al, 2007; Schweinsburg et al, 2011).…”