Dangerous alcohol use among college students in the United States continues to prove to be a complex and demanding public health issue for enrollees and the communities surrounding them.  Alcohol use causes a myriad of negative physical and mental health outcomes, even in populations who have not participated in chronic risky drinking for long periods of time.  Cannabis continues to be the most heavily used illicit substance on college campuses (legality defined on a state-by-state basis), and has been associated with decreased academic performance, potential respiratory injury, depression, and even psychosis.  When used together, alcohol and cannabis may produce synergistic intoxicating effects, leading to elevated levels of impairment.  This study aims to identify negative consequences in college students as a result of using this combination (known as “simultaneous alcohol and marijuana use” or “SAM”).   

The study’s sample was composed of 341 students from three different universities of states with varying cannabis laws.  Eligibility criteria included being currently enrolled in one of the three universities, being 18-24 years old, reporting past-year alcohol use, reporting past-year cannabis use, and reporting SAM use.  Participants completed general baseline and 3-month follow up surveys in addition to repeated daily surveys detailing their SAM use from a day-to-day perspective.  The following measures were recorded: demographics, motives for SAM use, types of alcohol used, forms of cannabis used, other substances used, and negative consequences experienced. The data was analyzed using covariate and multilevel mediation modeling.  The data was appropriately adjusted for missing values within the daily survey database.  

Results of the study found SAM use was directly associated with nausea in the context of effect enhancement motives, total number of consequences in the context of social motives, and blackout experiences in the context of coping motives.  Indirect interactions of effect- enhancement, social, and offered (offered a product from a friend or peer) motives on negative consequences were primarily mediated via the use of an increasing number of alcohol products.   

Takeaway: the combination of alcohol and cannabis consumption is suggested to be linked with a variety of negative consequences in the context of multiple different use motives.

Stevens AK, Boyle HK, Sokolovsky AW, White HR, Jackson KM. Nuanced relations between simultaneous alcohol and cannabis use motives and negative consequences among college students: The role of multiple product use. Experimental and Clinical Psychopharmacology. Published online 20210311. doi:10.1037/pha0000454