Link Between Cannabis Use and Alcohol Consequences Among College Students

Cannabis use may have an impact on negative outcomes of alcohol consumption, but longitudinal data is lacking. Using data from a cohort study of 997 US college students (evaluated 4 times/year during their first 3 years of college), researchers assessed associations between cannabis use changes and negative alcohol consequences.*

  • Changes in cannabis use were not associated with the overall number of alcohol consequences (after accounting for changes in alcohol use).
  • However, when alcohol consequences were analyzed separately by type of consequence, increases in cannabis use were associated with an increase in alcohol-related risky behaviors, physical dependence symptoms, and lack of self-care.
    • Sex was not a moderator in these associations.

* Measured with the Young Adult Alcohol Consequences Questionnaire (YAACQ), comprising 48 items grouped in 8 domains: blackout/hangover consequences, social/interpersonal consequences, impaired control, risky behaviors, academic/occupational consequences, self-perception consequences, self-care consequences, and physical dependence.

Comments: These results suggest that, among college students, increased cannabis use has a detrimental effect on some consequences of alcohol use that can be considered more severe (e.g., physical dependence symptoms). Providers should consider incorporating discussions about cannabis use into alcohol use harm-reduction strategies in this population.

Nicolas Bertholet, MD, MSc

Reference: Wardell JD, Egerton GA, Read JP. Does cannabis use predict more severe types of alcohol consequences? Longitudinal associations in a 3-year study of college students. Alcohol Clin Exp Res. 2020;44(5):1141–1150.

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