Abstract
BackgroundWhile the link between frequent cannabis use and alcohol use disorders is well documented, it is not clear whether alcohol drinkers who use cannabis less frequently are also vulnerable to alcohol use disorders. We estimate the association of frequency of past 12-months cannabis use with alcohol-associated adverse effects variables in the same time frame: alcohol dependence, heavy drinking, driving under alcohol influence, alcohol-related interpersonal problems, use after interpersonal problems, alcohol-related risky behaviors, and alcohol-related legal problems.MethodsWe analyzed data from U.S. individuals aged 12 to 25 years who participated in annual, cross-sectional U.S. National Surveys on Drug Use and Health from 2002 to 2014. Logistic regression models were used to examine the association of cannabis use with six alcohol-associated adverse effects variables. Frequency of cannabis use served as the primary independent variable, and were divided into four categories: frequent use (21–30 days per month), less frequent use (1–20 days per month), no use over the past 12 months, and no lifetime cannabis use. Alcohol dependence and six alcohol-associated adverse effects variables served as our primary outcomes.ResultsThe study included 465,090 respondents aged 12 to 25 years, among all past-year cannabis users, (47.5%) were less frequent (1–20 days/month) users. Less frequent cannabis use was highest among male, 15–25-year-olds, and non-Hispanic white 11.8, 84 and 10.6%, respectively. In adjusted models, past-year less frequent cannabis use (1–20 days/month) was significantly associated with past-year alcohol dependence (adjusted odds ratio aOR 5.57, 95% confidence interval (CI) 5.5–6.4); heavy drinking in the past-year (aOR 3.41, 95% CI 3.2–3.5); alcohol-related interpersonal problems in the past-year (aOR 7.33, 95% CI 7.0–7.5); use after interpersonal problems (aOR 5.17, 95% CI 4.8–5.5); alcohol-related risky behaviors (aOR 7.29, 95% CI 7.0–7.5), and, driving under influence of alcohol (aOR 7.19, 95% CI 6.9–7.4). No cannabis use past-year were more likely to report alcohol dependence (aOR 2.81, 95% CI 2.6–3) compared with no lifetime cannabis use.ConclusionThese findings indicated that within the general population, not only frequent cannabis user (21–30 days per month) but even less frequent cannabis use (1–20 days/month) was significantly associated with past-year alcohol dependence and alcohol-associated adverse effects than no lifetime cannabis use. These adverse alcohol-related outcomes associated with less frequent cannabis use, should be taken under careful consideration in alcohol use disorder treatment setting and policy planning.
Highlights
While the link between frequent cannabis use and alcohol use disorders is well documented, it is not clear whether alcohol drinkers who use cannabis less frequently are vulnerable to alcohol use disorders
(2020) 2:38 (Continued from previous page). These findings indicated that within the general population, frequent cannabis user (21–30 days per month) but even less frequent cannabis use (1–20 days/month) was significantly associated with past-year alcohol dependence and alcohol-associated adverse effects than no lifetime cannabis use. These adverse alcoholrelated outcomes associated with less frequent cannabis use, should be taken under careful consideration in alcohol use disorder treatment setting and policy planning
Individuals reported alcohol dependence, alcohol related interpersonal problems, alcohol interpersonal problems, and alcohol-related legal problems were higher among less frequent cannabis users compared to cannabis frequent users, 32.9, 30.8, 33.2, and 36.4%, respectively
Summary
While the link between frequent cannabis use and alcohol use disorders is well documented, it is not clear whether alcohol drinkers who use cannabis less frequently are vulnerable to alcohol use disorders. Cannabis use is prospectively associated with both heavy drinking and with the development and maintenance of alcohol use disorders (AUDs) (Blanco et al 2016; Metrik et al 2012; Subbaraman and Kerr 2015). Daily use, is associated with a variety of adverse correlates and consequences (Blanco et al 2016; Volkow et al 2014) These include substance use disorder, driving impairments, and motor vehicle crash injuries (Blanco et al 2016; Hartman et al 2015b; Metrik et al 2012). While the link between daily cannabis use and AUDs is well documented, it is not clear whether this relationship is consistent with less frequent cannabis use, or whether drinkers who use cannabis less frequently are more likely to have AUD than those who do not
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