TY - JOUR
T1 - Cannabis Recreational Legalization and Prevalence of Simultaneous Cannabis and Alcohol Use in the United States
AU - Gonçalves, Priscila Dib
AU - Levy, Natalie S.
AU - Segura, Luis E.
AU - Bruzelius, Emilie
AU - Boustead, Anne E.
AU - Hasin, Deborah S.
AU - Mauro, Pia M.
AU - Martins, Silvia S.
N1 - Funding Information:
This study was funded by grants from the U.S. National Institutes of Health, National Institute on Drug Abuse R01DA037866 (Martins), T32DA031099 (Hasin), R01DA048860 (Hasin), K01DA045224 (Mauro). This research was supported in part by a Grant 1 R49 CE002096-01 from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention to the Center for Injury Epidemiology and Prevention at Columbia University (New York, NY).
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Society of General Internal Medicine.
PY - 2023/5
Y1 - 2023/5
N2 - Background: Simultaneous cannabis/alcohol use, using both substances within a short time interval so that their effects overlap, has a greater risk of potential negative consequences than single-substance use and is more common in younger age. Relationships between recreational cannabis laws (RCLs) and changes in simultaneous cannabis/alcohol use prevalence remain untested. Objective: To examine trends in simultaneous cannabis/alcohol use from 2008 to 2019, and investigate associations between implementation of RCLs (i.e., presence of active legal dispensaries or legal home cultivation) and simultaneous cannabis/alcohol use in the United States (U.S.). Design: Repeated cross-sectional samples from the 2008–2019 U.S. National Survey on Drug Use and Health (NSDUH). Participants: Respondents (51% female) aged 12 and older. Interventions: Changes in simultaneous cannabis/alcohol use before and after RCL implementation (controlling for medical cannabis law implementation) were compared in different age groups (12–20, 21–30, 31–40, 41–50, 51+), using adjusted multi-level logistic regression with state random intercepts and an RCL/age group interaction. Measurements: Self-reported simultaneous cannabis/alcohol use. Results: From 2008 to 2019, the overall prevalence of simultaneous cannabis/alcohol use declined among those aged 12–20 but increased in adults aged 21+. Model-based simultaneous cannabis/alcohol use prevalence increased after RCL implementation among respondents aged 21–30 years (+1.2%; aOR= 1.15 [95%CI = 1.04–1.27]), 31–40 years (+1.0; 1.15 [1.04–1.27]), and 41–50 years (+1.75; 1.63 [1.34–1.98]), but not in individuals aged <21 or 51+ years. Conclusions: Implementation of recreational cannabis policies resulted in increased simultaneous use of cannabis and alcohol, supporting the complementarity hypothesis, but only among adults aged 21+. Efforts to minimize harms related to simultaneous cannabis/alcohol use are critical, especially in states with RCLs. Future studies should investigate cultural norms, perceived harm, and motives related to simultaneous use.
AB - Background: Simultaneous cannabis/alcohol use, using both substances within a short time interval so that their effects overlap, has a greater risk of potential negative consequences than single-substance use and is more common in younger age. Relationships between recreational cannabis laws (RCLs) and changes in simultaneous cannabis/alcohol use prevalence remain untested. Objective: To examine trends in simultaneous cannabis/alcohol use from 2008 to 2019, and investigate associations between implementation of RCLs (i.e., presence of active legal dispensaries or legal home cultivation) and simultaneous cannabis/alcohol use in the United States (U.S.). Design: Repeated cross-sectional samples from the 2008–2019 U.S. National Survey on Drug Use and Health (NSDUH). Participants: Respondents (51% female) aged 12 and older. Interventions: Changes in simultaneous cannabis/alcohol use before and after RCL implementation (controlling for medical cannabis law implementation) were compared in different age groups (12–20, 21–30, 31–40, 41–50, 51+), using adjusted multi-level logistic regression with state random intercepts and an RCL/age group interaction. Measurements: Self-reported simultaneous cannabis/alcohol use. Results: From 2008 to 2019, the overall prevalence of simultaneous cannabis/alcohol use declined among those aged 12–20 but increased in adults aged 21+. Model-based simultaneous cannabis/alcohol use prevalence increased after RCL implementation among respondents aged 21–30 years (+1.2%; aOR= 1.15 [95%CI = 1.04–1.27]), 31–40 years (+1.0; 1.15 [1.04–1.27]), and 41–50 years (+1.75; 1.63 [1.34–1.98]), but not in individuals aged <21 or 51+ years. Conclusions: Implementation of recreational cannabis policies resulted in increased simultaneous use of cannabis and alcohol, supporting the complementarity hypothesis, but only among adults aged 21+. Efforts to minimize harms related to simultaneous cannabis/alcohol use are critical, especially in states with RCLs. Future studies should investigate cultural norms, perceived harm, and motives related to simultaneous use.
KW - alcohol use
KW - cannabis use
KW - recreational cannabis laws
KW - simultaneous cannabis/alcohol use
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U2 - 10.1007/s11606-022-07948-w
DO - 10.1007/s11606-022-07948-w
M3 - Article
C2 - 36451010
AN - SCOPUS:85143159363
SN - 0884-8734
VL - 38
SP - 1493
EP - 1500
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - 6
ER -