Simultaneous use of cannabis and alcohol increases after states legalize recreational cannabis use
New research from Columbia University's Mailman School of Public Health examined changes in heavy drinking after the implementation of recreational cannabis laws.
Analysis of national survey data of Americans aged 12 and older showed that past-month binge drinking increased overall among people aged 31 and older between 2008 and 2019 At the same time, binge drinking has declined overall among people aged 12 to 30. The results are published online in the International Journal of Drug Policy.
The largest declines in binge drinking were seen among those aged 12 to 20 (from 17,5% in 2008 to 11% in 2019), followed by respondents aged 21 to 30 ( from 44% to 40%). While overall increases in binge drinking have been recorded in all U.S. states, regardless of cannabis laws, among people aged 31 and older, the largest increases between 2008 and 2019 were seen among older adults. 31 to 40, 28% to 33%, followed by those aged 51 and over (13% to 17%).
Studying the prevalence of binge drinking before and after the implementation of recreational cannabis laws, the authors observed a 4,8% decrease in binge drinking among people aged 12 to 20. However, they also found an increase after the implementation of recreational cannabis laws among people aged 31 and older (with an increase of 1,7% for adults aged 31 to 40, from 2,5. 41% for those aged 50 to 1,8, and 51% for those aged XNUMX and over). So far, research on the relationship between recreational cannabis laws (RCLs) and heavy drinking has been limited to data from a few states, small study samples, and groups of people. age combined.
The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as drinking 5 or more drinks for men and 4 or more drinks for women per drinking session. Excessive alcohol consumption has been associated with serious negative consequences, such as traffic accidents and deaths, exposure to the legal system, poor school performance, and visits to emergency departments.
This study, one of the first to report associations between binge drinking and recreational cannabis laws among adolescents and adults at the national level, builds on existing literature using nationally representative data. to investigate the potential effects of changing cannabis policy across all age groups, also considering a comprehensive measure of state alcohol policies.
Our previous research has shown the impact of cannabis legalization on the perception and availability of cannabis use and on changes in drinking habits.”
Silvia S. Martins, MD, PhD, professor of epidemiology in the Department of Epidemiology at Columbia's Mailman School, and lead author of the study.
“Current literature supports two possible hypotheses. The complementary hypothesis is that the consumption of cannabis and alcohol may increase after the legalization of cannabis, because individuals consume these substances together. The surrogate hypothesis is that alcohol consumption may decline after cannabis legalization because individuals may consume cannabis instead of alcohol when both are readily available. Data related to these hypotheses are inconclusive, especially regarding the impact of cannabis legalization on excessive alcohol consumption in different age groups,” said Priscila Dib Gonçalves, PhD, post-doctoral researcher in the Substance Abuse Epidemiology Program in the Department of Epidemiology at Columbia's Mailman School, and first author of the study.
The researchers therefore emphasize that further research is needed to understand the gradual change in binge drinking associated with RCL using nationally representative data across different age groups. “We believe that future studies should examine the relationship between other environmental and individual factors, such as risk perception, disapproval, availability, peer drinking, drinking expectancy , between excessive alcohol consumption and recreational cannabis laws in this age group,” remarked Dib Gonçalves.
“It should be noted that cannabis legislation is complex and involves multiple policy decisions, including regulation of supply chain and operation: government monopoly, retail, legal home cultivation, advertising, types of products distributed, prices and taxes, and each state may have different policies when regulating recreational cannabis use,” Martins said. “As the cannabis legislative landscape continues to evolve in the United States, efforts to minimize the harms associated with binge drinking are essential. »
Co-authors are Emilie Bruzelius, Natalie S. Levy, Luis E. Segura, Ofir Livne, Sarah Gutkind, Pia M. Mauro, Columbia University Mailman School of Public Health; Anne E. Boustead and Deborah S. Hasin, Department of Psychiatry, Columbia University Irving Medical Center; Diana Silver, New York University School of Global Public Health; and James Macinko, UCLA Fielding School of Public Health.
The study was supported by grants from the US National Institute on Drug Abuse, R01DA037866, T32DA031099, R01DA048860, and K01DA045224. This research was supported in part by the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 1 R49 CE002096-01. The contents of this article are the sole responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.