Research & Resources

Changes in Alcohol Use by Cannabis Use Among Adolescents and Young Adults in the United States

Researchers in this study sought to determine if the increased use of cannabis in the U.S. contributes to either increased co-use of alcohol and cannabis (e.g., complementarity) or replacement of alcohol with cannabis (e.g., substitution). Prevalence data were drawn from the 2002–2018 National Survey on Drug Use and Health public use data files to determine the alcohol use by cannabis use status among U.S. adolescents and young adults (AYA) ages 12–25 in 2018 and trends in alcohol use by cannabis use status from 2002 to 2018. In 2018, any alcohol use and daily alcohol use were significantly more common among AYA who used cannabis than those who did not use cannabis. Overall, any alcohol use, daily alcohol use, and average drinks per day declined from 2002 to 2018 among AYA irrespective of recent cannabis use. However, the decline in any alcohol use, daily alcohol use, and average alcoholic drinks per day was more rapid among AYA who used cannabis (daily and non-daily) than among those who did not use cannabis. The rate of decline in average alcoholic drinks per day was also higher among AYA with daily cannabis use than AYA with non-daily cannabis use. Drinking was much more common among AYA who reported cannabis use, which is consistent with complementarity. Yet, because the decline in alcohol use has been more rapid among AYA who use cannabis, there is also evidence of substitution.

This paper, “Changes in alcohol use by cannabis use status among adolescents and young adults in the United States: Emerging evidence for both substitution and complementarity,” was funded by the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and published in the journal Alcoholism: Clinical and Experimental Research.

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