Simultaneous alcohol and cannabis use (SAC) is associated with substantially greater adverse outcomes compared to isolated use of either substance and has become increasingly prevalent among young adults. Research indicates that impulsivity, particularly sensation-seeking, predicts SAC engagement, while substance-related expectancies—beliefs about the consequences of use—serve as key drivers of consumption behaviors. Although impulsivity, emotion regulation, and substance-related expectancies have traditionally been studied independently, emerging evidence suggests these factors represent interconnected pathways to substance use. The present study therefore aims to examine whether individuals reporting recent SAC use (within the past six months) can be differentiated from non-substance users and alcohol-only users based on measures of impulsivity, behavioral emotion regulation, and SAC-related expectancies.
This study examined 1,369 undergraduate students (ages 18-25) from two public universities in Argentina. Participants completed assessments measuring SAC use frequency, alcohol consumption per occasion, negative consequences associated with alcohol and SAC use, impulsivity, emotion regulation, and SAC-related expectancies. Based on substance use patterns in the past six months, participants were classified into three groups: SAC users (at least one simultaneous use episode), alcohol-only users (ALC), and non-users (NONUSE). Multinomial regression analyses identified factors distinguishing group membership, while two-way ANOVAs with Tukey post-hoc comparisons examined differences in alcohol-related problems, binge drinking frequency, and alcohol use frequency across groups and sex.
The majority of participants (96.4%) reported lifetime alcohol use, with 33.3% reporting SAC use in the past six months. No significant sex differences emerged in alcohol use patterns or SAC frequency. Five key factors distinguishing SAC users from non-users are: lower withdrawal and perseverance, higher sensation-seeking, higher positive SAC expectancies, and lower negative SAC expectancies. When comparing SAC users to alcohol-only users (ALC), the SAC group exhibited lower scores in distraction, withdrawal, and perseverance, higher sensation-seeking, more positive SAC expectancies, and fewer negative SAC expectancies. Alcohol-only users, compared to non-users, showed higher scores in seeking social support and distinct SAC expectancy patterns. SAC users reported significantly more alcohol-related problems, higher binge drinking frequency, and greater overall alcohol use frequency compared to alcohol-only users. Females experienced more alcohol-related negative consequences than males across groups, though sex did not moderate the relationship between group membership and drinking patterns.
Takeaway: SAC users exhibited higher sensation-seeking, lower emotion regulation capacity, and more positive SAC expectancies compared to both non-users and alcohol-only users, suggesting these interconnected psychological factors may serve as important targets for interventions aimed at reducing SAC use and related harms.