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Simultaneous Marijuana, Alcohol Use Linked to Worse Outcomes


Young adults who simultaneously use alcohol and marijuana (SAM) consume more drinks, are high for more hours in the day, and report more negative alcohol-related consequences.


  • The 2-year study included 409 people aged 18-25 years with a history of simultaneous alcohol and marijuana use (50.9% were women; 48.2% were non-Hispanic White; 48.9% were college students).

  • Participants completed daily online surveys about substance use and negative substance-related consequences for 14 continuous days every 4 months.


  • Alcohol use was reported on 36.1% of survey days, marijuana use on 28.0%, and alcohol and marijuana use on 15.0%.

  • Negative substance-related consequences were reported on 28.0% of drinking days and 56.4% of marijuana days.

  • SAM use was reported in 81.7% of alcohol users and 86.6% of marijuana users.

  • On SAM use days, participants consumed an average of 37% more drinks, with 43% more negative alcohol consequences, were high for 10% more hours, and were more likely to feel clumsy or dizzy, compared with non-SAM use days.


“This finding should be integrated into psychoeducational programs highlighting the risk of combining alcohol and marijuana,” the authors write. “A more nuanced harm-reduction tact could also encourage young adults to closely monitor and limit the amount of each substance being used if they choose to combine substances.”


The study was conducted by Anne M. Fairlie, PhD, University of Washington, and colleagues, and funded by the National Institute on Alcohol Abuse and Alcoholism. The study was published online September 18 in Alcohol Clinical and Experimental Research.


Study participants were recruited based on their substance use and lived in a region where recreational marijuana is legal, so the findings may not be generalizable to other populations. Substance use and consequences were self-reported and subject to bias.


The authors have reported no relevant financial relationships. 

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