Predictors and consequences of simultaneous alcohol and cannabis use in adolescents

Background/AimsThe simultaneous use of alcohol and cannabis is common among adolescents, but has been little studied. In this study, we examine predictors and consequences of this behavior in a population-based sample of high school students.MethodSelf-reports were obtained from students in Quebec (Canada) followed throughout high school (N = 6589). Logistic regressions were used to test the association between individual, family, and peer-related predictors in grades 7–8 and simultaneous alcohol and cannabis use in grade 10, as well as between simultaneous alcohol and cannabis use in grade 10 and experiencing 3 or more substance-related problems of various types (legal, physical, etc.) in grade 11.ResultsMost predictors in grades 7–8 were associated with simultaneous alcohol and cannabis use in grade 10. Only variables reflecting early-onset substance use involvement — alcohol intoxication, cannabis use, and drug use by close friend(s) — remained predictive in a multivariate model. Simultaneous alcohol and cannabis use was associated with increased substance-related problems in grade 11, above and beyond baseline problems and the concurrent use of the two substances in separate episodes in grade 10.ConclusionsSimultaneous alcohol and cannabis use 1) is anticipated by multiple psychosocial risk factors which come together with individual and peer substance use in early high school and 2) is independently predictive of subsequent substance-related problems. Providing adolescents with adequate information regarding the potential harm of simultaneous use may be a useful prevention strategy.

Research highlights
► Most adolescent alcohol and cannabis users engaged in past-year simultaneous use.
► Early involvement with substances was strongly predictive of later simultaneous use.
► Simultaneous alcohol and cannabis use was independently associated with later problems.